A 21-year-old woman presents to the emergency department, complaining of abdominal pain. She states that she has been experiencing increased urination, increased thirst, and a 10-lb weight loss. On examination, she has a blood pressure of 80/60 mm Hg, rapid deep breaths, and dry mucous membranes. Which lab abnormality fits with the patient’s clinical presentation?
A 50-year-old woman complains of a 2-month history of her hands becoming painful and turning white or blue in the cold. She also experiences progressive skin tightness and thickening of fingers, hands, and forearms. Additionally, she has shortness of breath on exertion and a sensation of lower chest burning and food sticking on swallowing. Antibody testing shows the presence of ANA and elevated titers of antibody to anti topoisomerase I. Which of the following pathogenetic explanations best fits this patient’s illness?
A 78-year-old man enters the hospital because of abnormalities of urination. Today, he is passing large amounts of urine; however, some days he passes no urine at all. He now has a blood pressure of 180/90 mm Hg, and otherwise, his physical examination is normal. Laboratory studies show a BUN of 120 mg/dL and a serum creatinine of 4.2 mg/dL. Urinalysis reveals a specific gravity of 1.010; urine that is negative for protein, glucose, ketone bodies, and blood; and an occasional WBC per high-power field on microscopic examination. What is the most likely cause of the renal insufficiency?
A 56-year-old man enters the emergency department complaining of dyspnea that began about 3 weeks ago and has progressed, so that he now has difficulty walking across a room. He has begun sleeping on three pillows. On physical examination, his temperature is 99°F, pulse is 102 bpm, blood pressure is 130/90 mm Hg, and respiratory rate is 24. There is jugular venous distention, and estimated central venous pressure is 10 cm H2O. Other findings include bibasilar rales and an S3 gallop. Which of the following statements is true about the treatment of the patient’s condition?
A 30-year-old man presents with hypertension, hematuria, palpable renal masses, and flank pain. He states that a kidney disease runs in his family, and his mother and maternal grandfather have it. Laboratory abnormalities confirm renal failure. Which of the following is associated with the disorder described here?
A 34-year-old woman presents in the emergency department with tachypnea and shortness of breath of acute onset. The history reveals that she has been taking oral contraceptives for 9 years. A lung scan demonstrates a perfusion defect in the left lower lobe. What happens if the blood flow to alveolar units is totally obstructed by a pulmonary thromboembolism?
A sexually active 24-year-old woman, known to be HIV-1 infected, has had a fever for 2 days and a productive cough. Chest radiographs show an infiltrate in the right lung. Two weeks earlier, her helper T cell count was 510/mm3. Testing for nontreponemal antigen (rapid plasma reagin) is positive at two dilutions, and treponemal antigen testing is also positive. What is the most likely cause of the pneumonia?
Which blood type is associated with gastric adenocarcinoma?
Which anti-Koch’s medication can cause an acne-like rash?
A 62-year-old man has had an elevated hematocrit for at least 3 years. His past medical history and review of systems are negative, except for mild, well-controlled hypertension. His latest complete blood count reveals the following: hemoglobin 18 mg/dL; hematocrit 56%; and WBC count 17,500/mm3 with platelets 800,000/mm3. On further investigation, which of the following findings is the most typical and expected?