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13423 Medicine

A 42-year-old woman presents to the clinic complaining of dry skin, fatigue, and weight gain over the past 3 months. She is not on any medications and there is no significant medical history.On physical examination, her blood pressure is 110/70 mm Hg, pulse 52/min, and heart and lungs are normal. Her skin feels rough and dry, but the rest of the examination is normal. Her biochemistry is normal but the thyroid-stimulating hormone (TSH) level is 39 mU/L (0.5-5 mU/L). Which of the following is the most likely cause for her elevated TSH?

Atrauma
Bradioactive iodine ingestion
Cautoimmune hypothyroidism
Dparathyroid surgery
Medicine
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13426 Medicine

A 27-year-old woman presents with a red rash over her cheeks, and pain and swelling in both knees as well as several small joints in her hands. She notes that the rash is worse with sun exposure. Medical evaluation reveals oral ulceration, positive ANA, and 3+ proteinuria. Which of the following is the most likely mechanism for the renal damage in this condition?

Avasculitis
Bmicro-emboli
Canti-basement membrane antibodies
Ddeposition of circulating immune complexes
Medicine
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