44. A 10-year-old girl of Hispanic descent is brought to the physician by her grandmother because of an intermittent nonproductive cough during the past 4 months. She eats mostly fast food and does not exercise. She lives in an inner city apartment near a highway. Family history includes debilitating multiple sclerosis in her mother and rheumatoid arthritis in her maternal grandmother. She is at the 10th percentile for height and 70th percentile for weight. Bilateral wheezes are heard on auscultation. Which of the following historic factors has most likely increased this patient's risk for this condition? A) Ethnicity B) Family history of autoimmune disease C) Gender D) Height and weight percentiles E) Location of home F) Poor diet and exercise
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- What kind of disorder is this ?169. A 65-year-old woman comes to the physician because of a 10-week history of low-grade fever, fatigue, and pain in her right arm. She recalls no trauma to the arm. She has a history of cancer treated with radiation therapy. Her temperature is 37.7°C (99.8°F). Physical examination shows tenderness of the right distal humerus. Laboratory studies show anemia. An x-ray of the right upper extremity is shown. This patient most likely has an abnormality of which of the following cell types? A) Hematopoietic stem cells B) Monomyelocytic stem cells C) Natural killer cells D) Osteoclasts E) Plasma cellsA 50 year old male is experiencing fatigue, dizziness, and headaches with a rapid decline in his visual acuity. He treats his hypertension and type 2 diabetes with medications. His brow and jaw are enlarged (proganthism), his hands and feet and fingers are wide. His wedding ring no longer fits on his finger. He is obese and has a deep voice. -His lab tests show high blood glucose, high GH, high IGF1, normal prolactin, and low testosterone.There was a pituitary mass seen on his CT scan. A CT scan in both the 50 year old man and a 14 year old girl show a pituitary mass. Why are their symptoms not similar? a.) One is producing GH, the other isnt b.) They are the same c.) They are of different ages d.) They are of different genders
- After reading the case study, define the list of terms.A 7-year-old male Siberian husky presented to the clinic with a cough that has become more severe in the past few weeks. Todaythe dog collapsed while playing fetch and was rushed to the veterinary clinic. Once the dog was stabilized, thoracic radiographs weretaken and a tumor was seen in the cranial thoracic area. There also was hypertrophy of the right side of the heart. The veterinarian wasconcerned that the dog may have a malignant tumor and requested more tests.Define the terms using the word parts.1. thoracic _______________________________________2. tumor _______________________________________3. cranial _______________________________________4. hypertrophy _______________________________________5. malignant _______________________________________A 56-year-old Asian man with hypertension, hypercholesterolemia, and type 2 diabetes mellitus comes to a physician for a check-up. It has been several years since he has been to the doctor. His past medical history is significant for an acute illness at the age of nine, which involved a high fever, pleuritic chest pain, migrating joint pain, and a pink, nonpruritic rash on his torso. His blood pressure is 155/100 mm Hg and heart rate is 70/min. Auscultation of the heart reveals a low-pitched diastolic rumble heard best at the apex. What is the most likely pressure change that would be seen in this patient’s heart? (A) Decreased left atrial pressure (B) Decreased left ventricular pressure (C) Increased left atrial pressure (D) Increased left ventricular pressure (E) Increased right atrial pressureA 52-year-old client is in the terminal stage of leukemia. The client has been married for 25 years. He and his wife have three children, ages 15, 18, and 22. One child is graduating from high school, and the 22-year-old is graduating from college. The client and his brother are co-owners of a family hardware business that has been in the family for 60 years. The client was diagnosed with leukemia 10 years ago and has been receiving treatments during reoccurrences since then. He has always been optimistic, but, for the past 2 years, the treatments have not been as successful as in the past. His symptoms have exacerbated and return shortly after the treatments. The physician has told him that, unfortunately, further treatments are to no avail. The client is distressed and in denial of the fact that life is short. He has become depressed because he is concerned about what will happen to his family and his business. The client does not want to visit family members or friends. He has…
- 1. A previously healthy 25-year-old-woman comes to the emergency department because of a 3-day history of fever, chest pain, and rapidly progressive shortness of breath. Use of an over-the-counter cold medication has not relieved her symptoms. She has no history of serious illness and takes no other medications. Her temperature is 40oC (104o F), pulse is 128/min and regular, respirations are 28/min and blood pressure is 80/54 mm Hg. Physical examination shows jugular venous distention and weak pulses in all extremities. Auscultation of the chest shows diffuse crackles bilaterally, muffled heart sounds, and a soft S2 gallop. After 30 minutes she goes into ventricular fibrillation and cannot be resuscitated. At autopsy, the heart is diffusely pale and floppy with focal petechiae, all chambers are markedly dilated.Histologic examination of cardiac tissue shows a lymphocytic infiltrate and myocardial necrosis. Which of the following infectious agents is the most likely cause these…A 50 year old male is experiencing fatigue, dizziness, and headaches with a rapid decline in his visual acuity. He treats his hypertension and type 2 diabetes with medications. His brow and jaw are enlarged (proganthism), his hands and feet and fingers are wide. His wedding ring no longer fits on his finger. He is obese and has a deep voice. -His lab tests show high blood glucose, high GH, high IGF1, normal prolactin, and low testosterone.There was a pituitary mass seen on his CT scan. What is the diagnosis that best matches this patients conditions? a.) gigantism b.) crushing's c.) acromegaly d.) hypopituitarism45. A 5-year-old girl with a history of recurrent infections since the age of 4 months is brought to the physician for a follow-up examination. She has had multiple episodes of pneumonia, sinusitis, otitis media, and diarrhea. She is at the 20th percentile for height and weight. Her temperature is 37.4°C (99.3°F). Mild crackles are heard bilaterally over the lower lung lobes. Laboratory studies show: Leukocyte count Segmented neutrophils Eosinophils 10,500/mm³ (N=5500-15,500) 57% 2% Lymphocytes 34% CD3+ T lymphocytes 67% CD19+ B lymphocytes 28% CD56+ natural killer cells 5% Monocytes 7% Serum IgA IgG IgM undetectable (N=14-159 mg/dL) 25 mg/dL (N=345-1236) 410 mg/dL (N=43-207) This patient most likely has an abnormality of which of the following immune system components? A) Activation-induced deaminase B) CD40 ligand OC) Class II MHC protein D) Common y chain of the interleukin-2 (IL-2) receptor E) Recombination-activating gene 1 F) Terminal complement
- A 50 year old male is experiencing fatigue, dizziness, and headaches with a rapid decline in his visual acuity. He treats his hypertension and type 2 diabetes with medications. His brow and jaw are enlarged (proganthism), his hands and feet and fingers are wide. His wedding ring no longer fits on his finger. He is obese and has a deep voice. -His lab tests show high blood glucose, high GH, high IGF1, normal prolactin, and low testosterone.There was a pituitary mass seen on his CT scan. What accounts for the patients proganthism? a.) High growth hormone levels after epiphyseal plate closure cause thickening of bone structure b.) low testosterone leads to increased bone growth and density c.) normal bone growth with aging d.) Low IGF=-1 stimulates bone growthA 6 month-old male infant is admitted to the hospital with diagnosis of recurrent pneumonia. His vital signs on admission: respiratory rate = 50 /min; heart rate = 170 beats/min; temperature – 102˚ F. Substernal retractions are prominent. Lung auscultation: bilateral wheezes and rhonchi. Medical history: this is a third admission since birth for pneumonia. His mother also states that he hasn’t gain body weight like her older child had at 6 months of age. How is this case consistent with cystic fibrosis diagnosis? What tests could be ordered to confirm the diagnosis? What interventions could help to alleviate respiratory distress?What is the genotype of a "normal" male with no Hemophilia A? a b с d e X^NY X^n Y X^N X^N X^N X^n X^n X^n