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15976 Medicine

A 75-year-old woman with rheumatoid arthritis (RA) takes aspirin for symptom control. She usually adjusts the dose of her own medications depending on how she is feeling.For the above patient with a toxic ingestion or exposure, select the most likely clinical effect.

Acombines with cytochromes and catalase to block hydrogen and electron transport, thus producing tissue asphyxia
Bmethemoglobinemia
Cvertigo, hyperventilation, tinnitus, and deafness
Dbone marrow depression
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15981 Medicine

A 33-year-old woman was evaluated for symptoms of severe intense generalized pruritus. Her physical examination reveals multiple sites of excoriation. Laboratory investigations confirm the clinical diagnosis of primary biliary cirrhosis (PBC). She is now inquiring about available treatments for this condition, including if there is a cure for the disease. Which of the following treatments is most likely to “cure” her PBC?

Aursodiol
Bmethotrexate
Cazathioprine
Dliver transplantation
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15983 Medicine

A 65 year old retired accountant with a 60 pack year smoking history presents for his annual physical examination. He was last seen 3 years ago, when he presented with an episode of acute bronchitis. He repos that he has been coughing over the past several months with productive green sputum. He denies any dyspnea or limitation in his daily activities. On physical examination, his blood pressure is 126/62 mm Hg, pulse is 80/min, and respirations are 24/min. He has diffuse bilateral expiratory rhonchi with a markedly prolonged expiratory phase. His cardiac examination reveals a second hea sound that increases in intensity with inspiration. The liver edge is 14 cm into the midclavicular line and mildly tender to palpation. There is bilateral lower extremity edema to the knees. A chest x-ray film reveals hyperinflation of both lung fields, and pulmonary function tests reveal a diminished forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) ratio. Routine laboratories are sent. Which of the following would most likely be expected?

AA hemoglobin of 9 g/dL
BA hemoglobin of 17 g/dL
CA platelet count of 84,000
DA platelet count of 102,000
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