A 21-year-old student presents with complaints of fatigue, headache, anorexia,
and a runny nose, all of which began about 2 weeks ago. She started taking
vitamins and over-the-counter cold preparations but feels worse. The smell of
food makes her nauseated. Her boyfriend had mononucleosis about 1 month ago,
and she wonder if she might have it also. Examination reveals cervical
adenopathy and an enlarged liver and spleen. Which of the following labs would
be most helpful in the differential diagnosis at this point?
a. Stool culture
b. Liver enzymes
c. Anti-hepatitis D virus
d. Thyroid-stimulating hormone test - ANS - c. Anti-hepatitis D virus
\A 29-year-old is seen in the office with complaints of pain in his chest and belly.
He quit smoking 6 months ago. He has been suffering the pain for 2 weeks and
gets temporary relief from Alka-Seltzer and Pepto-Bismol. The burning pain
wakes him at night and radiates up to his chest. Which factor favors a diagnosis
of gastric ulcer?
a. His use of Pepto-Bismol
b. His age
c. His use of Alka-Seltzer
d. His smoking cessation - ANS - c. His use of Alka-Seltzer
\A 35-year-old female patient is seen in the clinic complaining of abdominal pain.
Which of the following should be included in the examination?
a. Lumbar puncture
b. Family history of cardiac problems
c. Contrast venography
d. Pelvic exam - ANS - d. Pelvic exam
\A 45-year-old patient presents with chief complaint of generalized abdominal
pain. Her physical examination is remarkable for the left lower quadrant
tenderness. At this time, which of the following should be considered in the
differential diagnosis?
a. Endometriosis
b. Yersinia enterocolitica infection