Rosh Internal Medicine Boost Practice Exam

A patient with fever and a painless maculopapular rash after a camping trip is most likely suffering from?

1. Celulitis

2. Lyme disease

3. Rocky Mountain spotted fever

4. Syphilis

The correct answer is: Rocky Mountain spotted fever

The presentation of fever and a painless maculopapular rash after a camping trip is highly suggestive of Rocky Mountain spotted fever, which is caused by infection with Rickettsia rickettsii. This disease is transmitted through tick bites, which are common after outdoor activities such as camping. The classic symptoms of Rocky Mountain spotted fever include fever, headache, and a distinctive rash that typically starts as small, flat, pink spots that may become more pronounced and can progress to a petechial (small red or purple spots caused by bleeding) appearance. The rash usually appears a few days after the onset of fever and is often accompanied by a history of exposure to tick-infested areas. Other options, while may present with some overlapping symptoms, do not fit as closely with the details given. For instance: - Cellulitis generally presents with heat, swelling, and pain at the site of a skin infection. - Lyme disease characteristically presents with erythema migrans, a circular rash that typically has a central clearing, and it usually follows a different symptomatology pattern related to the bite of an infected tick. - Syphilis typically presents with a chancre in the primary stage and a rash in later stages but would