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night sweats

Practice targeted AMC-style multiple-choice questions on night sweats.

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A 45-year-old man presents to the clinic with a 2-month history of fatigue, weight loss, and night sweats. He has a history of smoking and works as a miner. On examination, he has cervical lymphadenopathy and hepatosplenomegaly. A chest X-ray shows bilateral hilar lymphadenopathy. What is the most likely diagnosis?

A. Lung cancer
B. Chronic obstructive pulmonary disease (COPD)
C. Lymphoma
D. Sarcoidosis
E. Tuberculosis
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A 45-year-old man presents to the general practice clinic with a 3-month history of fatigue, weight loss, and night sweats. He has a history of smoking and works as a construction worker. On examination, he has cervical lymphadenopathy and hepatosplenomegaly. Blood tests reveal anemia and elevated lactate dehydrogenase (LDH). A chest X-ray shows a mediastinal mass. What is the most appropriate next step in the management of this patient?

A. Initiate corticosteroid therapy
B. Start empirical antibiotic therapy
C. Order a CT scan of the chest and abdomen
D. Perform a lymph node biopsy
E. Refer for surgical excision of the mass
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Figure 3 of paper: Alveolar echinococcosis in a patient with immunosuppression.

(a) Abdominal gray-scale US shows an abscess-like hepatic image.
(b) Axial unenhanced CT shows a typical aspect of pyogenic liver abscess.
Image by Wenya Liu, Éric Delabrousse, Oleg Blagosklonov, Jing Wang, Hongchun Zeng, Yi Jiang, Jian Wang, Yongde Qin, Dominique Angèle Vuitton, Hao Wen CC BY 4.0 · Source

A 62-year-old male with a history of poorly controlled diabetes presents with fever, RUQ pain, and night sweats for 3 weeks. Initial blood cultures are negative. Imaging is performed, as shown. What is the MOST appropriate next step in management?

A. Albendazole therapy
B. Percutaneous drainage and culture of the lesion
C. Surgical resection of the affected liver segment
D. Empiric broad-spectrum antibiotics
E. Observation with serial imaging
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A 45-year-old man presents with chronic cough, weight loss, and night sweats. Chest X-ray shows apical infiltrates. Sputum smear for AFB is negative. What is the most appropriate next step in management?

A. Perform a bronchoscopy with lavage.
B. Order a CT scan of the chest.
C. Start empirical anti-tuberculosis treatment.
D. Discharge with symptomatic treatment and review.
E. Repeat sputum smear and culture, including nucleic acid amplification test (NAAT).
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A 45-year-old male with poorly controlled diabetes mellitus and ischaemic heart disease, living in a rural Indigenous community, presents with fevers, cough, lethargy, night sweats, and occasional hemoptysis. What is the most appropriate initial investigation for suspected tuberculosis in this patient if he is unable to produce sputum spontaneously?

A. Interferon-Gamma Release Assay (IGRA)
B. Sputum GeneXpert
C. Try hypertonic saline to get sputum.
D. CT chest
E. Empirical anti-TB treatment
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A 30-year-old woman presents to her GP with a 2-week history of a persistent cough, night sweats, and unintentional weight loss. She has recently returned from a trip to Southeast Asia. On examination, she appears thin and has crackles in the upper zones of her lungs. A chest X-ray shows cavitary lesions in the right upper lobe. What is the most likely diagnosis?

A. Chronic obstructive pulmonary disease (COPD)
B. Pulmonary tuberculosis
C. Pneumonia
D. Sarcoidosis
E. Lung cancer
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PET-CT of a tuberculoma
Image by Annemie Snoeckx, Pieter Reyntiens, Damien Desbuquoit, Maarten J. Spinhoven, Paul E. Van Schil, Jan P. van Meerbeeck, Paul M. Parizel CC BY 4.0 · Source

A 30-year-old immigrant presents with chronic cough and night sweats. Sputum is negative for AFB. What is the MOST appropriate next step in management?

A. Prescribe antitussives
B. Repeat sputum AFB
C. Start empiric antibiotics
D. Bronchoscopy with biopsy
E. Initiate isoniazid prophylaxis
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Figure 3 of paper: Alveolar echinococcosis in a patient with immunosuppression.

(a) Abdominal gray-scale US shows an abscess-like hepatic image.
(b) Axial unenhanced CT shows a typical aspect of pyogenic liver abscess.
Image by Wenya Liu, Éric Delabrousse, Oleg Blagosklonov, Jing Wang, Hongchun Zeng, Yi Jiang, Jian Wang, Yongde Qin, Dominique Angèle Vuitton, Hao Wen CC BY 4.0 · Source

A 62-year-old male with a history of poorly controlled diabetes presents with right upper quadrant pain, fever, and night sweats for 3 weeks. He is on immunosuppressants following a renal transplant 5 years ago. Blood cultures are pending. Imaging is performed, as shown. What is the MOST appropriate next step in management?

A. Empiric antifungal therapy
B. Observation and serial imaging
C. Metronidazole and supportive care
D. Albendazole and surgical resection
E. Percutaneous drainage and antibiotics
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A 35-year-old man with PTSD is experiencing severe nightmares despite being on an SSRI. What medication can be added to target this symptom?

A. Prazosin
B. Gabapentin
C. Quetiapine
D. Clonidine
E. Trazodone
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Figure 3 of paper: Alveolar echinococcosis in a patient with immunosuppression.

(a) Abdominal gray-scale US shows an abscess-like hepatic image.
(b) Axial unenhanced CT shows a typical aspect of pyogenic liver abscess.
Image by Wenya Liu, Éric Delabrousse, Oleg Blagosklonov, Jing Wang, Hongchun Zeng, Yi Jiang, Jian Wang, Yongde Qin, Dominique Angèle Vuitton, Hao Wen CC BY 4.0 · Source

A 62-year-old male with a history of poorly controlled diabetes presents with right upper quadrant pain, fever, and night sweats for 3 weeks. He is on immunosuppressants following a renal transplant 5 years ago. Blood cultures are pending. Imaging is performed, as shown. What is the MOST appropriate next step in management?

A. Percutaneous drainage and antibiotics
B. Observation and serial imaging
C. Metronidazole and supportive care
D. Empiric amphotericin B
E. Albendazole and surgical resection
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PET-CT of a tuberculoma
Image by Annemie Snoeckx, Pieter Reyntiens, Damien Desbuquoit, Maarten J. Spinhoven, Paul E. Van Schil, Jan P. van Meerbeeck, Paul M. Parizel CC BY 4.0 · Source

A 32-year-old male, recent immigrant from a high-TB prevalence country, presents with a persistent cough and night sweats for the past two months. He denies fever or weight loss. Physical examination is unremarkable except for mild, diffuse rhonchi on auscultation. Sputum cultures are pending. A PET-CT scan of the chest was performed, the axial view is shown. Given the clinical context and imaging findings, what is the MOST appropriate next step in management?

A. Prescribe a course of broad-spectrum antibiotics for presumed bacterial pneumonia
B. Initiate a four-drug anti-tuberculosis regimen
C. Repeat the PET-CT scan in three months to assess for interval growth
D. Start a course of oral corticosteroids to reduce inflammation
E. Order a bronchoscopy with transbronchial biopsy
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A farmer successfully treated for acute Q fever presents 6 months later with unexplained weight loss and night sweats. Physical exam reveals a new murmur. What is the most likely diagnosis?

A. Post-Q fever fatigue syndrome
B. Chronic Q fever endocarditis
C. Reactive arthritis
D. Chronic hepatitis
E. Pulmonary fibrosis
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A 30-year-old woman presents with fever, hemoptysis, and night sweats. A chest X-ray shows a round lesion with an air-fluid level. What is the most likely diagnosis?

A. Tuberculosis
B. Pulmonary embolism
C. Bronchiectasis
D. Lung cancer
E. Lung abscess
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A 28-year-old woman presents to the clinic with a 2-week history of fever, night sweats, and a non-productive cough. She has recently returned from a trip to rural Queensland. On examination, she has crackles in the right upper lung field. A chest X-ray shows a cavitary lesion in the right upper lobe. What is the most likely diagnosis?

A. Tuberculosis
B. Lung abscess
C. Pulmonary embolism
D. Sarcoidosis
E. Pneumonia
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A 67-year-old woman presents to her GP with fatigue, weight loss, and night sweats over the past two months. She has a history of smoking and hypertension. On examination, she has palpable lymphadenopathy in the cervical and axillary regions. Blood tests reveal a hemoglobin level of 10 g/dL, elevated lactate dehydrogenase (LDH), and a peripheral blood smear showing atypical lymphocytes. What is the most likely diagnosis?

A. Non-Hodgkin's lymphoma
B. Multiple myeloma
C. Hodgkin's lymphoma
D. Chronic lymphocytic leukemia (CLL)
E. Acute myeloid leukemia (AML)
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PET-CT of a tuberculoma
Image by Annemie Snoeckx, Pieter Reyntiens, Damien Desbuquoit, Maarten J. Spinhoven, Paul E. Van Schil, Jan P. van Meerbeeck, Paul M. Parizel CC BY 4.0 · Source

A 30-year-old recent immigrant from a high-TB prevalence country presents with a persistent cough and night sweats for 2 months. Sputum cultures are negative for acid-fast bacilli. A PET-CT scan was performed, and an image is shown. What is the MOST appropriate next step in management?

A. Repeat sputum cultures in one week
B. Initiate anti-tuberculosis therapy
C. Prescribe a course of broad-spectrum antibiotics
D. Order a bronchoscopy with biopsy
E. Start the patient on corticosteroids
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PET-CT of a tuberculoma
Image by Annemie Snoeckx, Pieter Reyntiens, Damien Desbuquoit, Maarten J. Spinhoven, Paul E. Van Schil, Jan P. van Meerbeeck, Paul M. Parizel CC BY 4.0 · Source

A 32-year-old male, recent immigrant from a high-TB prevalence country, presents with a persistent cough and night sweats for the past two months. He denies fever or weight loss. Physical examination is unremarkable except for mild scattered rhonchi on auscultation. Sputum cultures are negative for acid-fast bacilli. A PET-CT scan of the chest is performed, the axial view is shown. Given the clinical context and imaging findings, what is the MOST appropriate next step in management?

A. Schedule a follow-up chest X-ray in 6 weeks to monitor for changes
B. Repeat sputum cultures for acid-fast bacilli with liquid media
C. Order a bronchoscopy with transbronchial biopsy of the lesion
D. Initiate a multi-drug anti-tuberculosis therapy regimen
E. Prescribe a course of broad-spectrum antibiotics for presumed bacterial pneumonia
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A 45-year-old man presents to the clinic with a 3-month history of persistent cough, night sweats, and weight loss. He has a history of smoking and works as a miner. On examination, he has decreased breath sounds and dullness to percussion over the right upper lobe. A chest X-ray shows a cavitary lesion in the right upper lobe. What is the most likely diagnosis?

A. Pulmonary tuberculosis
B. Chronic obstructive pulmonary disease (COPD)
C. Pneumonia
D. Lung cancer
E. Sarcoidosis
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A 35-year-old man presents to the clinic with a 3-month history of fatigue, weight loss, and night sweats. He has no significant past medical history and does not take any medications. On examination, he has palpable cervical and axillary lymphadenopathy. A lymph node biopsy reveals Reed-Sternberg cells. What is the most likely diagnosis?

A. Chronic lymphocytic leukemia
B. Sarcoidosis
C. Hodgkin's lymphoma
D. Non-Hodgkin's lymphoma
E. Tuberculosis
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A 55-year-old man presents to the clinic with a 3-month history of fatigue, weight loss, and night sweats. He has no significant past medical history. On examination, he has palpable lymphadenopathy in the cervical and axillary regions. Blood tests reveal a hemoglobin level of 10 g/dL, white blood cell count of 15,000/mm³ with a predominance of lymphocytes, and a platelet count of 150,000/mm³. A lymph node biopsy is performed, showing small lymphocytic lymphoma. What is the most appropriate initial management for this patient?

A. Surgical excision of lymph nodes
B. Observation and regular follow-up
C. Immediate chemotherapy
D. Radiation therapy to affected lymph nodes
E. Initiation of corticosteroids
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PET-CT of a tuberculoma
Image by Annemie Snoeckx, Pieter Reyntiens, Damien Desbuquoit, Maarten J. Spinhoven, Paul E. Van Schil, Jan P. van Meerbeeck, Paul M. Parizel CC BY 4.0 · Source

A 32-year-old male, originally from a high-TB prevalence country, presents to the emergency department with a persistent cough for the past 3 weeks, night sweats, and a 5 kg weight loss. He denies any fever or shortness of breath. Physical examination reveals normal breath sounds bilaterally, with no wheezes or crackles. His vital signs are stable: temperature 37.2°C, heart rate 88 bpm, blood pressure 120/80 mmHg, and oxygen saturation 98% on room air. A chest X-ray was initially interpreted as showing a possible lung mass, prompting further investigation with a PET-CT scan, the axial view of which is shown. Sputum samples have been sent for microscopy and culture, but results are pending. Given the clinical presentation and the imaging findings, what is the MOST appropriate next step in management?

A. Order a bronchoscopy with bronchoalveolar lavage and transbronchial biopsy
B. Schedule a follow-up PET-CT scan in 3 months to monitor for changes in size and metabolic activity
C. Prescribe a course of broad-spectrum antibiotics to cover community-acquired pneumonia
D. Perform a CT-guided needle biopsy of the lesion for definitive diagnosis
E. Initiate a multi-drug anti-tuberculosis therapy regimen
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A 60-year-old man presents to his GP with a 3-month history of fatigue, weight loss, and night sweats. He has a history of smoking and hypertension. On examination, he has palpable lymphadenopathy in the cervical and axillary regions. Blood tests reveal anemia and elevated lactate dehydrogenase (LDH). What is the most appropriate next step in the investigation of this patient?

A. PET scan
B. Excisional lymph node biopsy
C. CT scan of the chest and abdomen
D. Fine needle aspiration of the lymph node
E. Bone marrow biopsy
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PET-CT of a tuberculoma
Image by Annemie Snoeckx, Pieter Reyntiens, Damien Desbuquoit, Maarten J. Spinhoven, Paul E. Van Schil, Jan P. van Meerbeeck, Paul M. Parizel CC BY 4.0 · Source

A 45-year-old male, who recently immigrated from India, presents to his primary care physician with a two-month history of progressive fatigue, unintentional weight loss of 7 kg, and intermittent night sweats. He denies any cough, chest pain, or shortness of breath. He has no significant past medical history and is not currently taking any medications. Physical examination reveals normal vital signs, including a temperature of 37.1°C, and clear breath sounds bilaterally. However, mild cervical lymphadenopathy is noted. Initial laboratory investigations, including a complete blood count and comprehensive metabolic panel, are unremarkable. A chest X-ray reveals a solitary pulmonary nodule in the right upper lobe, which prompts a PET-CT scan for further evaluation. An axial slice from the PET-CT is shown. Given the patient's clinical presentation, immigration history, and the PET-CT findings, which of the following is the MOST appropriate next step in establishing a definitive diagnosis?

A. Bronchoscopy with transbronchial needle aspiration of the lesion
B. Administer a purified protein derivative (PPD) skin test
C. Order a CT-guided percutaneous needle biopsy of the lung nodule
D. Repeat PET-CT scan in three months to assess for interval growth
E. Initiate empiric antibiotic therapy with a broad-spectrum antibiotic
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A 55-year-old man presents to the clinic with a 3-month history of worsening cough, weight loss, and night sweats. He has a 30-pack-year smoking history and worked in construction for 20 years. On examination, he has clubbing of the fingers and decreased breath sounds in the right lower lung field. A chest X-ray shows a right lower lobe mass. What is the most appropriate next step in the management of this patient?

A. Order sputum cytology
B. Perform a PET scan
C. Refer for bronchoscopy
D. Obtain a CT scan of the chest
E. Start empirical antibiotics
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