You are answering a USMLE-style medical question. Question: An 18-year-old woman is brought to the emergency department because of lightheadedness and a feeling of dizziness. She has had nausea, occasional episodes of vomiting, myalgia, and a generalized rash for the past week. She also reports feeling lethargic. She has no shortness of breath. There is no family history of serious illness. She appears ill. Her temperature is 39.1°C (102.3°F), pulse is 118/min, and blood pressure is 94/60 mm Hg. Cardiac examination shows no abnormalities. There is a widespread erythematous rash on the trunk and extremities with skin peeling on the palms and soles. Laboratory studies show: Hemoglobin 13.6 g/dL Leukocyte count 19,300/mm3 Platelet count 98,000/mm3 Serum Urea nitrogen 47 mg/dL Glucose 88 mg/dL Creatinine 1.8 mg/dL Total bilirubin 2.1 mg/dL AST 190 U/L ALT 175 U/L Urinalysis shows no abnormalities. Further evaluation of this patient's history is most likely to reveal which of the following?" Options: A) Recent hiking trip B) Intravenous heroin abuse C) Exposure to a patient with mengingococcemia D) Currently menstruating Reply with ONLY the letter of the correct answer (A, B, C, or D). No explanation.

D
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