American Board of Internal Medicine (ABIM) Certification Practice Exam

What clinical symptoms are typically present with ulceroglandular syndrome caused by Francisella tularensis?

1. Fever and headaches

2. Constitutional symptoms are often absent

3. Only localized symptoms

4. Rashes and blisters

The correct answer is: Fever and headaches

Ulceroglandular syndrome, caused by Francisella tularensis, is characterized by specific clinical symptoms that include fever and headaches. This condition often arises following exposure to the bacterium, typically through contact with infected animals or bites from contaminated insects. The fever is usually abrupt in onset and can be accompanied by chills, malaise, and fatigue, which are common systemic symptoms. Headaches frequently accompany these feverish states as well, making the presence of both symptoms significant in diagnosing ulceroglandular syndrome. In contrast, the other answer choices present characteristics that do not align with the typical clinical presentation of this syndrome. For instance, constitutional symptoms are often not absent; rather, patients typically exhibit systemic involvement alongside localized ulceration. Additionally, localized symptoms such as lymphadenopathy and ulcerations are prominent aspects of the syndrome, but they do not exclude the presence of systemic symptoms. Rashes and blisters are not characteristic features of ulceroglandular syndrome, distinguishing the correct answer as focusing on the systemic manifestations of fever and headaches.