A 23-year-old male presents to the urgent care clinic complaining of sore throat, fever, and body ac

Discussion in 'Step 3' started by Santosh Jadhav, Nov 25, 2013.

  1. Santosh Jadhav

    Santosh Jadhav Active Member

    A 23-year-old male presents to the urgent care clinic complaining of sore throat, fever, and body aches. He
    reports that the illness began about 1 week ago and has persisted despite therapy with NSAIDs, acetaminophen, and sore throat lozenges. He has not sought medical advice for this condition previously.
    He denies cough, abdominal pain, nausea, or vomiting, but reports a persistent headache. His past medical
    and surgical history is unremarkable. The patient
    smokes about 1 pack of cigarettes a week, drinks occasional
    alcohol, and denies other drugs, including
    intravenous use. He is heterosexual, and has had 3 sexual
    contacts in the past year.
    On exam his vital signs are: T 38.9° C; P 112;
    BP 115/68; R 20. General: well-nourished male who
    appears uncomfortable. Head, ears, eyes, and nose are
    unremarkable. The patient has pharyngitis and enlarged
    tonsils with exudates. There is diffuse cervical
    lymphadenopathy, but the neck is supple. There are
    enlarged nodes in his axilla and inguinal areas as well.
    The spleen is palpable and nontender. The rest of the
    exam is unremarkable.
    In addition to a throat culture, blood count, and
    Mono Spot, an appropriate laboratory test to
    rule out the acute retroviral syndrome would be:
    A) HIV-1 antibody by ELISA and Western blot.
    B) HIV-1 antibody by rapid detection method.
    C) HIV-1 p24 antigen or HIV viral load by PCR.
    D) CD4 T lymphocyte count.
    E) Sperm centrifuge for viral culture.

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