Viral Infections USMLE Step 1 Practice Question
A 16-year-old girl presents to the emergency department with a 5-day history of fever, severe sore throat, and dysphagia. Vital signs are temperature 39.2°C, heart rate 102/min, respiratory rate 18/min, blood pressure 118/76 mmHg, and oxygen saturation 98% on room air. On examination, she has bilateral tonsillar enlargement with whitish-gray exudate, mild palatal edema, and cervical lymphadenopathy. Her oropharynx appears erythematous but maintains adequate airway patency. Laboratory studies show white blood cell count of 12,500/μL with 15% atypical lymphocytes. Rapid antigen test for group A Streptococcus is negative. Monospot test is positive. Which of the following complications is this patient at highest risk for developing?
Answer choices
- AScarlet fever rash and glomerulonephritis
- BToxic shock syndrome from superinfection
- CPost-streptococcal sequelae including acute rheumatic fever
- DSplenic rupture with minor abdominal trauma
- EAcute airway obstruction from progressive pharyngeal edemaCorrect answer
- FMyopericarditis with potential cardiogenic shock
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