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20451 Medicine

A 43-year-old woman complains of fatigue and night sweats associated with itching for 2 months. On physical examination, there is diffuse nontender lymphadenopathy, including small supraclavicular, epitrochlear, and scalene nodes. CBC and chemistry studies (including liver enzymes) are normal. Chest x-ray shows hilar lymphadenopathy. Which of the following is the best next step in evaluation?

AExcisional lymph node biopsy
BMonospot test
CToxoplasmosis IgG serology
DSerum angiotensin-converting enzyme level
Medicine
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