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15850 Medicine

A 21-year-old man has a nonproductive cough, shortness of breath, and chest pain, which changes with breathing. He also has pain in the left arm. On examination, there is tenderness over the left shoulder, heart sounds are normal, and the lungs are clear. CXR reveals a lytic lesion in the left humerus and reticulonodular opacities in the upper and middles lobes (Figure given below). The eosinophil count is normal. Which of the following is the most appropriate initial diagnostic test?

Alung biopsy
Bhumerus bone biopsy
CCT scan of chest
DBronchoscopy
Medicine
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15853 Medicine

A 63-year-old man develops edema, and dyspnea on exertion. He has no prior cardiac or renal conditions, and his examination is significant for macroglossia, elevated jugular venous pressure (JVP), hepatomegaly, and 3+ pedal edema. His investigations reveal 3.5 g/d of protein in the urine, anemia, normal fasting glucose, and serum immunoelectrophoresis is positive for a monoclonal immunoglobulin. Which of the following is the most characteristic neurologic finding associated with this condition?

Aperipheral motor and sensory neuropathy
Bspinal cord compression in the lumbar region
Cspinal cord compression in the thoracic region
Da peripheral neuropathy associated with cerebral manifestations
Medicine
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