Question

guy is a 65 y/o male who comes to the clinic with the following chief complaint: \i have been feeling feverish, have chills, and am tired all the time. my heart also makes a funny sound. in the physical exam the np auscultates a heart murmur, and notices that he patient has subungual hemorrhages, petechiae on the palate, violet colored nodes on the fingers and feet, and nontender red nodes on the palms and soles of his feet. the most likely diagnosis for guy is:
○ chf
○ infective endocarditis (ie)
○ acute mi (ami)
○ dissecting abdominal aortic aneurysm (aaa)

Explanation:

The patient presents with fever, chills, fatigue, heart murmur, and characteristic skin - related symptoms like subungual hemorrhages, petechiae, Osler's nodes (violet - colored nodes on fingers and feet), and Janeway lesions (nontender red nodes on palms and soles). These are typical manifestations of infective endocarditis. CHF usually presents with symptoms mainly related to heart failure like shortness of breath, edema. Acute MI has symptoms mainly centered around chest pain and cardiac - specific enzyme changes. Dissecting abdominal aortic aneurysm has symptoms related to the abdomen and vascular issues, not these skin and systemic symptoms.

Answer:

B. Infective Endocarditis (IE)