Gastroenterology and Hepatology Q 25

A 43-year-old man is evaluated for 4 days of fever and arthralgia, as well as a raised purple rash over his lower extremities of 1 week's duration. He is a current intravenous drug user. He has no other medical problems and takes no medications.

On physical examination, temperature is 37.8 °C (100 °F) and blood pressure is 132/85 mm Hg; other vital signs are normal. The large and small joints are tender to palpation without evidence of synovitis. The abdomen is not tender to palpation. The liver edge is palpable below the right costal margin. The skin findings are shown.

Which of the following is the most appropriate treatment?

A Entecavir

B Plasma exchange

C Prednisone and cyclophosphamide

D Sofosbuvir and ledipasvir

E Tenofovir, emtricitabine, and raltegravir

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