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HIV infection — USMLE Step 2 CK MCQ

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HardInternal MedicineHIV infectionUSMLE Step 2 CK

A 54-year-old White woman comes to the urgent care clinic because of progressive symptoms. History and focused examination are notable for fever, weight loss, oral candidiasis, and high-risk sexual exposure. Temperature is 102.2°F (39.0°C), blood pressure is 108/66 mmHg, pulse is 112/min, respirations are 22/min, and oxygen saturation is 94% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and initial testing support the clinical pattern described in the stem. Which of the following is the most appropriate initial diagnostic study?

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Correct answer: E — Fourth-generation HIV antigen-antibody testing

The vignette describes HIV infection, supported by fever, weight loss, oral candidiasis, and high-risk sexual exposure. Fourth-generation HIV antigen-antibody testing is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: https://www.cdc.gov/#stage-9-order-25