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15967 Medicine

A 21-year-old man is seen in the clinic for assessment of a nonproductive cough, shortness of breath, and chest pain which changes with breathing. He also complains of pain in the left arm. On physical examination, there is tenderness over the left shoulder, heart sounds are normal, and the lungs are clear. A CXR reveals a lytic lesion in the left humerus and reticulonodular opacities in the upper and middle lobes (Figure 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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15971 Medicine

A 68-year old man who has had a recent syncopal episode is hospitalized with congestive heart failure. His blood pressure is 160/80 mmHg. His pulse rate is 80 beats per minute, and there is a grade III/IV harsh systolic murmur. An echocardiogram shows a disproportionately thickened ventricular septum and systolic anterior motion of the mitral valve. Which of the following findings would most likely be present in this man –

ARadiation of the murmur to the neck.
BDecrease of the murmur with hand grip
CDelayed carotid upstroke
DReduced left ventricular ejection fraction
Medicine
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