A 29-year-old woman, 7 weeks pregnant, complains of fatigue, nausea, and muscle aches, attributing them to her pregnancy. She's in an open marriage, with recent unprotected sex with multiple partners. History includes penicillin allergy and past chlamydia and gonorrhea treatment. No intravenous drug use reported. Five months ago, screening tests for various sexually transmitted infections, including chlamydia, gonorrhea, HIV, syphilis, hepatitis B, and hepatitis C, came back negative. On examination, the patient appears alert and oriented with no acute distress. Her temperature is 37.28°C, pulse: 95/min, blood pressure is 102/60 mm Hg, respiratory rate is 16 breaths/min. No scleral icterus, jaundice, or lymphadenopathy observed. Heart and lungs are clear. Abdomen is soft, nontender, with no hepatosplenomegaly. Trace pedal edema is present. Overall, examination is unremarkable.

Routine laboratory studies and a prenatal panel reveal these values:

Blood type                                                                        A+

Antibody screen                                                        Negative

White blood cell counts                                         6.8 × 109/L (3.5–10.5)

Hemoglobin                                                             121 g/L (115–155)

Platelet count                                                           230 × 109/L (130–380)

Creatinine                                                                 41 µmol/L (22–75)

Glucose level [random]                                        10 mmol/L (4.0–11.0)

Alanine aminotransferase                                        221 IU/L (17–63)

Aspartate aminotransferase                                     60 IU/L (15–37)

Rubella immunoglobulin G                                     84.7 IU/mL (> 10)

Her hepatitis C RNA polymerase chain reaction (PCR) test and Hepatitis C antibody test were reactive. Which of the following diagnoses is most likely,

Based on the patient's history and physical examination findings?

Real-Life cases to ensure you are ready for your MCCQE1 Exam!

Ace Qbank Clinical Edge


Ace Qbank Clinical Edge

Making the proper diagnosis is one of the most important aspects of any medical student’s or junior doctor’s clinical training and hence we created Clinical Edge Cases.

Ace Qbank Clinical Edge helps our students put their knowledge of symptoms and physical findings to test by applying clinical reasoning and assessment concepts to a series of common clinical vignettes. Problem-based learning is being used to focus on the cause behind the presentation of a simulated clinical case.

Each simulated Clinical Edge case contains a list of common causes of the presented condition, offers abundant references to the presented case, making additional information easy to find

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