Welcome to episode 523 of the Divine Intervention Podcasts.

In today's podcast, we'll be continuing the series for the Step 2C4 Free 120, the

24 Free 120.

This is going to be part six.

We've done the first 40 questions, so we're literally going to roll into Block 2.

So it's going to be question 41.

Let's get right to it. A 40-year-old

man comes to the office during the summer because of a three-day history of fever, diffused muscle aches,

fatigue and sore throat. He has had no sick contacts. Medical history is unremarkable and he takes

no medications. He received the influenza

virus vaccine this year. Ten days ago, he returned from a trip to Malaysia, where he says he

enjoyed the local food and nightlife. Temperature is 38.8 degrees Celsius, that's 101.8 degrees

Fahrenheit. Pulse is 90 per minute. Respiration is 38.8 degrees Celsius, that's 101.8 degrees Fahrenheit.

Pulse is 90 per minute. Respirations at 16 per minute.

And blood pressure is 126 over 70 millimeters of mercury.

The remainder of the examination shows no abnormalities.

Results of laboratory studies are shown.

So his hemoglobin is 10 grams per deciliter. Okay, I'm not going to run through all these labs, but his hemoglobin is low. He has an anemia. His white count is also low. So he has a lukopenia. His platelet count is normal. His red cell distribution width appears to be normal as well. Although I don't know the normal value for that.

I'm not going to waste time looking at that.

Monosport test result is negative.

Which of the following is the most appropriate next step in diagnosis?

So option A says cytomegalovirus, serologic testing.

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