Audio Qbank – HY USMLE Q #451 – Surgery / Internal medicine

A 9-year-old boy is brought to emergency after a tonic-clonic seizure. He has a 3-week history of behavioral disturbance and a 2-week history of fever, fatigue, and a painful right knee. Cardiopulmonary examination shows no abnormalities. His laboratory studies are shown.

Hemoglobin                                                       9.5 g/dL
Leukocytes                                                         3,500/μL
Platelets                                                               50,000/μL
Coombs test                                                      Positive
Urine protein                                                    +1
Urine blood                                                        +1

Which of the following is the most likely diagnosis?

Henoch-Schönlein purpura
Mononucleosis
Rheumatic fever
Roseola
Scarlet fever
Systemic lupus erythematosus