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10732 Medicine

A 45-year-old male presents to the emergency depament with 2 days of haemoptysis. He repos that he has been coughing up 1-3 tablespoons of blood each day. He does repo mild chest pain, low-grade fevers, and weight loss. He has had about 1 year of severe upper respiratory symptoms including frequent epistaxis and purulent discharge treated with several courses of antibiotics. His only medications are daily aspirin and lovastatin. On examination, he has normal vital signs, and upper airway is notable for saddle nose deformity and clear lungs. A CT scan of the chest shows multiple cavitating nodules, and urinalysis shows RBCs . Which of the following tests offers the highest diagnostic yield to make the appropriate diagnosis?

ADeep skin biopsy
BPercutaneous kidney biopsy
CPulmonary angiogram
DSurgical lung biopsy
Medicine
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10736 Medicine

A 33-year-old woman complains of generalized, throbbing headache that is worse in the morning and with coughing. She occasionally feels dizzy and nauseated. Examination is significant only for obesity and bilateral papilledema. CT scan of the head is nominal. At lumbar puncture the opening pressure is 220 mm H2O; CSF is clear, with protein of 12 mg/100 mL (normal is 15 to 45), glucose of 68 mg/100 mL (normal is 45 to 80), an d no cells are seen. The most likely diagnosis is:

AMigraine headache
BMultiple Sclerosis
CMalignant carcinomatosis
DPseudotumor cerebri
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