Pathology
3863.8 A 52-year-old presents to her primary care physician with a 2-month history of recurrent nonbloody diarrhea, unintentional weight loss, wheezing, and flushing. She has no history of prior gastrointestinal problems or asthma. Physical examination did confirm respiratory wheezes, and her abdomen showed minimal tenderness to palpation. Cardiac auscultation revealed a right-side murmur. A CT scan is ordered (shown here) and demonstrates a 6-cm mass in her small bowel, near the ileocecal junction. Which of the following findings would also be expected on the patient's CT scan?
female
2904.17 An 82-year-old woman with coronary artery disease comes to the emergency department because of sudden periumbilical abdominal pain. The patient has difficulty speaking because of the severity of the pain. The patient's grandson states that she has recently been complaining of stomach pain, which begins about half an hour after meals and lasts for several hours. Her medical history is significant for hypertension, type 2 diabetes mellitus, hyperlipidemia, and carotid endarterectomy for carotid artery stenosis. Abdominal examination reveals only mild guarding and rebound tenderness. While awaiting further workup, the patient experiences marked tachycardia, tachypneia, and hypotension. Exquisite abdominal tenderness and a palpable mass also develop. Despite resuscitative measures, progressive septic shock develops, and the patient dies in the emergency department. An autopsy specimen of the small intestine shows full-thickness necrosis of the small bowel. Which of the following is the most likely cause of this patient's presentation?
Hispanic
3327.12 A 67-year-old man last year comes to the clinic reporting symptoms of fatigue, weight loss, and vague abdominal pain for several months. His medical history is unknown to the clinic, and his limited fluency makes it difficult for him to communicate much information besides his recent symptoms. Physical examination reveals a palpable mass in the right upper quadrant (RUQ). An abdominal computed tomography (CT) scan (shown) confirms the most likely diagnosis. The doctor recommends surgical resection, and the man smiles and nods in response when asked whether he understands what this decision entails, as well as when he is to return for a preoperative evaluation. However, the man is lost to follow-up. He presents to urgent care several months later, short of breath and intermittently coughing up small specks of blood. Chest x-ray demonstrates a 10-cm lesion in the right lower lobe of the lung. Which of the following best explains how the new lesion developed?
who immigrated from China in English
2849.16 A 21-year-old primigravid woman at 30 weeks' gestation is evaluated for hypertension that started after week 25 of pregnancy. She denies nausea, vomiting, or abdominal pain. She follows her recommended diet closely and takes prenatal vitamins. Review of medical records show a blood pressure reading of 130/80 mm Hg at 20 weeks gestation. Her current serial blood pressure checks include four sitting manual pressures 15 minutes apart, all yielding pressures >150/110 mm Hg. A dipstick urine test shows 4+ proteinuria. Her serum glutamic oxaloacetic transaminase level is also elevated to 2300 mIU/mL (normal <35 mIU/mL). She denies a history of hypertension before the pregnancy and states that her face has become "puffier" than normal since her blood pressure has increased. Which of the following laboratory changes is most closely associated with a complication of her condition?
African-American
4740.16 A 56-year-old man presents to his primary care physician with complaints of fatigue, muscle pain, and a 20-lb (9-kg) unintentional weight loss over the past 3 months. Upon questioning, the patient admits that his stools have been unusually dark-brown for the past few weeks. Physical examination reveals palpable purpura along his extremities. He also states that he has coughed up reddish-looking sputum a few times over the past few weeks. A biopsy of his lesions reveals the presence of necrotizing vasculitis. In addition, all of the lesions which were assessed by biopsy have the same characteristic appearance. Vital signs include: blood pressure 140/70 mm Hg, temperature 100.6°F (38.1°C), respiratory rate 17/min, and pulse 70/min. The physician would expect to find which antibody in this patient?
white
