Can someone explain to me the logic behind this question?

[watermen]

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A 41-year-old woman comes to the physician for a follow-up examination. She has taken aspirin for chronic headaches and phenytoin for a seizure disorder for 2 years. Examination shows mild epigastric tenderness and bilateral, 3-cm, nontender axillary lymph nodes. A lymph node biopsy shows hyperplasia.

A. Chronic lymphocytic leukemia
B. Drug reaction
C. Hodgkin disease
D. Infectious mononucleosis
E. Metastatic carcinoma
F. Sarcoidosis
G. Systemic lupus erythematosus
H. Toxoplasmosis
I. Tuberculosis
J. Tularemia

Answer is B.

I really do not understand why the answer is B.

This question is taken from the USMLE website.
http://www.usmle.org/step2/s2tqf.htm

 

[arthrodisiac]

here:

http://www.theannals.com/cgi/content/abstract/17/6/460

i dont understand the REASON for the question. nbme thinks its important to train doctors that know minutia.

 

[BlackNDecker]

I think the "point" of the question is to know what the patient doesn't have...the patient doesn't have a serious illness and doesn't need a million dollar work-up.

Get used to this type of question b/c many questions on the step hinge on your ability to rule out answer choices:

She's 41 yo, thus she doesn't have CLL or infectious mononucleosis, no mention of immunodeficiency so cross out C, H, I. Also no mention of F/C/NS or wt loss (cross out E). No mention of inflammatory dz or lung problems (cross out F, G, J).

The only choice left is the answer. This is 50% of the step...1 & 2. Have not taken 3, but pretty sure NBME will stick to the theme.