169. A 60-year-old man comes to the physician because of a 6-month history of light-headedness, numbness and paresthesias of his hands and feet, and fatigue. Physical examination shows pallor and decreased positional and vibration senses. Laboratory studies show: Hemoglobin Hematocrit Mean corpuscular volume Serum 9 g/dL 27% 102 μm³ Gastrin Intraluminal stomach acid markedly increased markedly decreased The most likely cause of this patient's symptoms is destruction of which of the following labeled areas in the photomicrograph of normal stomach mucosa?
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- Hypervitaminosis is largely attributed to which of the following? Restrictive diets Gastric bypass surgery Alcoholism Supplementation83. A 25-year-old woman comes to the physician because of a 2-week history of left flank pain. She has had progressive weakness and decreased appetite during this period. Her temperature is 38°C (100.4°F). Physical examination shows left flank tenderness. Laboratory studies show a leukocyte count of 18,500/mm³. Urinalysis shows numerous RBCs and WBCs. A CT scan of the abdomen confirms an abscess of the lower pole of the left kidney. Which of the following is most likely preventing the spread of the infection to the surrounding organs? A) Fatty layer (Camper fascia) of the abdominal tela subcutanea B) Greater omentum C) Membranous layer (Scarpa fascia) of the abdominal tela subcutanea D) Pararenal fascia E) Perirenal (Gerota) fasciaAnswer the following question: 1. What is Hepatitis B infection? Name the different antigens and antibodies found during a HepB infection. Briefly explain the disease and prognosis. 2. What is glycosylated hemoglobin? What is it used for? Why is this a better marker for the disease?
- A 14-year-old high school student with fever, chills, and severe headache is seen in an urgent care clinic. He felt nauseated and vomited before reporting to the clinic. At the clinic, his temperature is 104°F; he has neck rigidity and complains of back pain. Some small petechial spots are noted on his chest and back and in the mouth. Blood is drawn for a complete blood count (CBC) and blood glucose, and lumbar puncture is performed. Cerebrospinal fluid (CSF) is collected sequentially in three sterile tubes and examined. Blood Results White cell count: 25 × 109/L Differential: 80% neutrophils, 10% lymphocytes, 10% monocytes Glucose: 95 mg/dL CSF Results CSF pressure: Increased Gross appearance: All tubes equally cloudy, not bloody Glucose: 15 mg/dL CSF white cell count: 12.0 × 109/L; 90% neutrophils Gram stain: Many Gram-negative cocci in pairs, some intracellular Questions 1. Based on the Gram stain, what is the likely diagnosis for this patient? Explain the reason behind the answer.…mark 3. A 65-year-old man is brought to the emergency department by his wife because of a 4-hour history of severe epigastric abdominal pain that radiates toward the back and a being th about to faint. One hour ago, he vomited coffee ground-like material and passed a black, foul-smelling stool. He has a 6-month history of similar episodes of abdominal pain expically dr eating. He is pale. His pulse is 125/min, and blood pressure is 100/65 mm Hg. Abdominal examination shows exquisite tendemess of the epigastrium. Endoscopy shows active bending from a gastric ulcer in the posterior body of the stomach. The patient undergoes an exploratory operation. A perforated gastric ulcer that eroded into which of the blowing vers is the most ly cause of this bleeding? A) Hepatic B) Inferior phrenic C) Right renal D) Splenic OE) Superior mesentericMatch the terms in column A with the descriptions in column B. Column B1. activates protein-digesting enzyme trypsin2. causes emulsification of fats3. carries on phagocytosis in liver4. carbohydrate-digesting enzyme5. fat-digesting enzyme6. protein-digesting enzyme7. stimulates gallbladder to release bile8. stimulates pancreas to secrete fluids high in bicarbonate ions9. nucleic acid-digesting enzymeColumn Aa. amylaseb. bile saltsc. cholecystokinind. enterokinasee. Kupffer cellsf. lipaseg. nucleaseh. secretini. trypsin
- A 6-year-old boy is brought to the physician by his mother because of intermittent upper abdominal pain during the past 5 weeks and a rash for 1 week. Vital signs are normal. Physical examination shows yellow nodules over the extensor surfaces of the upper extremities. There's hepatomegaly and tenderness on palpation of the epigastric region. Serum studies show an increased amylase activity, increased chylomicron concentration, and a markedly increased triglyceride concentration. 3 months after beginning a fat-restricted diet, his serum chylomicron and triglyceride concentration decreased significantly, and the skin lesions resolve. A deficiency of which of the following enzymes is the most likely cause of these findings? a. Acetyl-CoA carboxylase b. HMG-CoA lyase c. HMG-CoA reductase d. Hormone-sensitive lipase e. Lipoprotein lipaseA 62 year old man was "found down" in his home by a family member earlier this AM. Per the paramedics bring him into the ER, family members state that he's a diabetic and a chronic alcoholic. Additionally, he'd been having bouts of fairly severe diarrhea for about 3 days prior to admission. On presentation to the ER, the gentlemen is nonresponsive and slightly blue. The paramedics tried to intubate but were unsuccessful, so they have been "bagging" him as best as they could en route. Labs taken upon entrance to the ER: ABG: 7.1/49/120/14 135 | 100 | 54 / 265 6 | 14 | 2.4 \ What do you think, by history and by labs and presentation, do you think is happening, at least in reference to his ACID/BASE STATUS; additionally, you may want to think about what underlying processes may be contributing to his overall condition.What is a potential severe complication of GERD if left untreated? Esophageal cancer Damage to vocal cords Risk of infection due to decreased immune system as a result of lack of sleep Esophageal stricture