The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A 65-year-old woman presents to a physician with painful ankles for 2 days. Her symptoms began 1 week ago with a severe fever (40℃ (104℉)) for 3 days. When the fever subsided, she developed a maculopapular rash over the trunk and extremities with painful wrists and fingers. She also reports abdominal pain, nausea, vomiting, and headaches. Last week she returned from a trip to Africa where she spent several weeks, mostly in rural areas. Her temperature is 37.5℃ (99.5℉); pulse is 75/min; respiratory rate is 13/min, and blood pressure is 115/70 mm Hg. A maculopapular rash is observed over the trunk and limbs. Both ankles are swollen and painful to active and passive motion. The abdomen is soft without organomegaly. Laboratory studies show the following: Laboratory test Hemoglobin 11.4 g/d Mean corpuscular volume 90 µm3 Leukocyte count 4,500/mm3 Segmented neutrophils 70% Lymphocytes 15% Platelet count 250,000/mm3 Ring-form trophozoites are absent on the peripheral blood smear. Which of the following organisms is the most likely cause of this patient’s illness?   (A) Babesia babesia   (B) Chikungunya virus   (C) Dengue virus   (D) Leishmania major
['(B) Chikungunya virus <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Babesia babesia \n (B) Chikungunya virus \n (C) Dengue virus \n (D) Leishmania major <> possible answers', '  A 65-year-old woman presents to a physician with painful ankles for 2 days. Her symptoms began 1 week ago with a severe fever (40℃ (104℉)) for 3 days. When the fever subsided, she developed a maculopapular rash over the trunk and extremities with painful wrists and fingers. She also reports abdominal pain, nausea, vomiting, and headaches. Last week she returned from a trip to Africa where she spent several weeks, mostly in rural areas. Her temperature is 37.5℃ (99.5℉); pulse is 75/min; respiratory rate is 13/min, and blood pressure is 115/70 mm Hg. A maculopapular rash is observed over the trunk and limbs. Both ankles are swollen and painful to active and passive motion. The abdomen is soft without organomegaly. Laboratory studies show the following:\nLaboratory test\nHemoglobin 11.4 g/d\nMean corpuscular volume 90 µm3\nLeukocyte count 4,500/mm3\nSegmented neutrophils 70%\nLymphocytes 15%\nPlatelet count 250,000/mm3\nRing-form trophozoites are absent on the peripheral blood smear. Which of the following organisms is the most likely cause of this patient’s illness? <> context@']