48. A 58-year-old woman comes to the office because of a 1-month history of fatigue, fever, shortness of breath, and joint pain; she also has had a 3.2-kg (7-lb) weight loss during this period. Her temperature is 37.6°C (99.7°F), and respirations are 34/min. Physical examination shows tenderness to palpation over the maxillary sinus, nasal ulcerations, and a bulging, red left tympanic membrane. Laboratory studies show: Erythrocyte sedimentation rate Serum C-reactive protein 65 mm/h 8.2 mg/L (N=0.08-3.1) 2+ 2+ Urine Blood Protein Histologic examination of a biopsy specimen of affected lung tissue shows granulomata and vasculitis. An autoantibody is most likely directly binding which of the following cell types in this patient? OA) Basophils B) Endothelial cells C) Fibroblasts D) Neutrophils E) Plasma cells

48. A 58-year-old woman comes to the office because of a 1-month history of fatigue, fever, shortness of breath, and joint pain; she also has had a 3.2-kg (7-lb) weight loss during this period. Her temperature is 37.6°C (99.7°F), and respirations are 34/min. Physical examination shows tenderness to palpation over the maxillary sinus, nasal ulcerations, and a bulging, red left tympanic membrane. Laboratory studies show: Erythrocyte sedimentation rate Serum C-reactive protein 65 mm/h 8.2 mg/L (N=0.08-3.1) 2+ 2+ Urine Blood Protein Histologic examination of a biopsy specimen of affected lung tissue shows granulomata and vasculitis. An autoantibody is most likely directly binding which of the following cell types in this patient? OA) Basophils B) Endothelial cells C) Fibroblasts D) Neutrophils E) Plasma cells

Biochemistry

9th Edition

ISBN:9781319114671

Author:Lubert Stryer, Jeremy M. Berg, John L. Tymoczko, Gregory J. Gatto Jr.

Publisher:Lubert Stryer, Jeremy M. Berg, John L. Tymoczko, Gregory J. Gatto Jr.

Chapter1: Biochemistry: An Evolving Science

Section: Chapter Questions

Problem 1P

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45. 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
107 A 23-year-old woman comes to the physician because of a 3-hour history of sharp left chest wall pain when she breathes deeply or coughs. She also has an 8-day history of fever, headache, nasal congestion, and productive cough. Her temperature is 38°C (100 4°F), and respirations are 18/min Physical examination shows decreased breath sounds over the left posterior hemithorax. A chest x-ray shows left lower lobe pneumonia and a pleural effusion on the left. Sensory fibers in which of the following nerves most likely transmit the pain sensation from the chest wall when this patient coughs? A) Cardiac plexus B) Intercostal nerves C) Long thoracic nerve D) Thoracic splanchnic nerves E) Vagus nerve
LF, a 34 year old white male, presented to the emergency room complaining of acute and severe shortnessof breath and intense chest tightness. LF’s speech was choppy and breathing was very rapid and erratic,punctuated by noticeable wheezing. LF’s medical records included the results of pulmonary functiontesting he had undergone six months beforeHis medical records also indicated prior admission for respiratory symptoms and a history of poorly-controlled asthma.LF received high-dose bronchodilator medication through use of a valved holding chamber. This wasfollowed by intravenous glucocorticoids and nebulized bronchodilators every two hours for a twelve-hourperiod, followed by nebulized bronchodilators every four hours for a forty-eight hour period.After discharge from the hospital, LF was provided a take-home flow meter to monitor his lung function.Table 4 shows LF’s PEFR results during a 30-day period.Table 4. Peak flow monitoring from day 1-30 post-discharge. All PEFR values are given…
Liza Perez, 25-years-old, presents to the health clinic complaining of a "sinus headache." She states that there is a "feeling of heaviness" behind her nose and eyes. Minimal clear nasal discharge is also noted. The following questions will assist the nursing student in the assessment of this client suspected for sinusitis. 1. How do you check for nasal patency? 2. Describe the methods Of transilluminating the frontal and maxillary sinuses 3. What are common or usual findings in transillumination tests of the frontal and maxillary sinuses?
A 65-year-old male patient, Mr. Thompson, has been admitted to the medical-surgical floor with a diagnosis of congestive heart failure (CHF). He has a history of hypertension and type 2 diabetes mellitus. Upon admission, Mr. Thompson reports shortness of breath, fatigue, and swelling in his legs and feet. His vital signs are as follows: blood pressure 160/90 mmHg, pulse 102 bpm, respiratory rate 22 breaths/min, and oxygen saturation 92% on room air.As his nurse, you are responsible for performing a comprehensive assessment and initiating appropriate interventions based on your findings.Describe the initial nursing assessment you would perform for Mr. Thompson, detailing the specific aspects you would focus on given his diagnosis and symptoms.
47. A 56-year-old man is admitted to the hospital because of a 1-week history of progressive nausea, anorexia, dyspnea, and lethargy. He has a 15-year history of type 2 diabetes mellitus and hypertension. His respirations are 28/min, and blood pressure is 178/98 mm Hg. Physical examination shows jugular venous distention and pedal edema. Bilateral crackles are heard on auscultation of the chest. His serum creatinine concentration is 7.2 mg/dL. Which of the following is most likely to be decreased in serum in this patient? A) Alkaline phosphatase B) 1,25-Dihydroxycholecalciferol C) Parathyroid hormone D) Phosphorus E) Potassium F) Uric acid