WBR0709
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| Author | [[PageAuthor::Mohamed Moubarak, M.D. [1]]] |
|---|---|
| Exam Type | USMLE Step 3 |
| Main Category | Primary Care Office |
| Sub Category | Infectious Disease, Infectious Disease |
| Prompt | A 28 years old male comes to your office complaining loss of concentration in his work which affected his performance in last 3 weeks. He mentions a recurrent on and off fever for which some medications were prescribed, when he did his routine labs and turned to be normal. He is having a persistent dry cough, recurrent itchy rash over the face and axilla, and loss of 15 pound over the past 3 weeks. He is taking some vitamins to help him maintaining his performance at work. He admits having multiple sexual relations, and when he asked about using condoms he answered” I don’t feel comfortable using condoms”. Which of the following is the best next step in the diagnosis? |
| Answer A | Order Complete blood count |
| Answer A Explanation | Incorrect
Anemia should be excluded, but HIV infection suspicion should be high in any young patient with non specific symptoms |
| Answer B | Order chest x-ray |
| Answer B Explanation | Incorrect
Chest x-ray should be done after exclusion o HIV |
| Answer C | Order urine culture |
| Answer C Explanation | No need to order urine culture as there is no urinary symptoms |
| Answer D | Order HIV test |
| Answer D Explanation | Correct
HIV infection suspicion should be high in any young patient with non specific symptoms, and the patient should be screened for HIV infection |
| Answer E | Alternate the vitamins with another |
| Answer E Explanation | Incorrect
Vitamin deficiency is not the cause of his symptoms. |
| Right Answer | D |
| Explanation | HIV infection suspicion should be high in any young patient with non specific symptoms, and unintentional l loss of weight. New onset seborrheic dermatitis is commonly seen in HIV infected patients. The patient should be screened for HIV infection, and possible risk factors, which include detailed sexually history and any IV drugs use. Educational Objective: |
| Approved | No |
| Keyword | [[WBRKeyword::HIV]] |
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