A 43-year-old man is seen for fever up to 38.3 °C (101 °F) that is occurring periodically over the past 3 months. He has no associated symptoms. He reports no recent travel, animal exposures, or tick bites. He does not eat raw meats or seafood, or unpasteurized dairy products. He takes no medications. Comprehensive laboratory investigations are negative. A chest radiograph is normal. Which of the following is the most appropriate diagnostic test to perform next?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. CT of the abdomen and pelvis
This is PUO with no diagnostic clues: the initial workup (CBC, cultures, LFTs, urine, CXR) is negative. The next step is CT imaging of the chest/abdomen (and pelvis) to look for occult abscess, lymphoma or other hidden pathology. Invasive tests such as liver or bone marrow biopsy are reserved for specific suspicion (e.g. TB, malignancy), and lumbar puncture only if there are CNS signs.
ليش كل خيار صح أو غلط
-
A
ليش غلط
Bone marrow biopsy and culture is the gold-standard confirmatory test for brucellosis, which is caught from infected animals or raw/unpasteurized dairy. This man denies both exposures, so nothing directs this invasive test.
✓ Inefctious Diseases 🦠.pdf · p. 7 -
B
ليش صح
When the basic PUO workup (CBC, ESR/CRP, cultures, urine, chest X-ray) is negative and there are no diagnostic clues, the next step is abdominal and chest CT.
✓ Inefctious Diseases 🦠.pdf · p. 16 -
C
ليش غلط
Liver biopsy is reserved for a specific suspicion (TB), not done as a blind next test in a PUO with no clues.
✓ Pyrexia of unknown origin (PUO).pdf · p. 4 -
D
ليش غلط
Lumbar puncture is chosen when there are CNS symptoms or signs. This man has no associated symptoms.
✓ Pyrexia of unknown origin (PUO).pdf · p. 4
- المصدر
- Inefctious Diseases 🦠.pdf · p. 16
Pyrexia of unknown origin (PUO).pdf · p. 4 - المحاضرة
- Pyrexia of Unknown Origin · Infectious Diseases · Module B
- ظهر في
- ID bank · MED41 ♂ EOM B · MED41 ♀ EOM B