03-06-2010, 07:19 PM
A 2-vear-old girl is brought to the physician by her mother for health supervision chec kup. The mother states that the child is fine and has on ly the ' usual colds and flu that go around" The girl
lives with her grandmother most of the time because her mother is in and out of drug rehabilitation ยข prog rams. and the father has been alienated since her last visit . The child's medical records show that
she was below the 5th percen tile for weight at her last visit. almost a year earlier. She has not had , , any immunization since then . On physical examination, the patient is below the 5th percen tile for , , weight and height She stand s independently but cannot walk without assista nce . She has a body
temperature of 37.8 C (100.1 F) and a pulse of 110/min. The oral mucosa has a beefy red
appearance with multiple white. adherent plaques that ooze blood when scraped with a tongue
depressor. Her left tympanic membrane is erythematous, dull and bulging The submandibular,
cervical, axillary. and inguinal lymph nodes are en larged and firm. Which of the following ls the
most likely diagnosis?
A. Acq uired immune deficencv syndrome
B. Disseminated herpe s simplex virus infection
C. Infectious mononucieosis
D. Streptococcal pharyng itis
E. System candidiasis
lives with her grandmother most of the time because her mother is in and out of drug rehabilitation ยข prog rams. and the father has been alienated since her last visit . The child's medical records show that
she was below the 5th percen tile for weight at her last visit. almost a year earlier. She has not had , , any immunization since then . On physical examination, the patient is below the 5th percen tile for , , weight and height She stand s independently but cannot walk without assista nce . She has a body
temperature of 37.8 C (100.1 F) and a pulse of 110/min. The oral mucosa has a beefy red
appearance with multiple white. adherent plaques that ooze blood when scraped with a tongue
depressor. Her left tympanic membrane is erythematous, dull and bulging The submandibular,
cervical, axillary. and inguinal lymph nodes are en larged and firm. Which of the following ls the
most likely diagnosis?
A. Acq uired immune deficencv syndrome
B. Disseminated herpe s simplex virus infection
C. Infectious mononucieosis
D. Streptococcal pharyng itis
E. System candidiasis