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17237 Medicine

A 71-year-old woman comes to the office with a history of headaches, fatigue, and weight loss for 3 months. The headaches are new for her, and usually not very severe. Her jaw also hurts when she is chewing food. Two days prior, she had briefly lost partial vision in her left eye. There were no other neurologic symptoms at the time. On examination, her neck is supple to flexion, fundi and neurologic examinations are normal. She is started on prednisone 60 mg/day and a biopsy is performed to confirm the diagnosis. Which of the following is the most likely change seen on the biopsy to confirm the diagnosis?

Aimmune complex deposition
Barteritis with giant cells
Clymphocytic infiltration
Dtype II muscle fiber atrophy
Medicine
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17241 Medicine

A 35-year-old man is taken to the emergency depament because he is coughing up large volumes of blood. He does not have any history suggestive of exposure to tuberculosis, and a chest x-ray film does not show a mass lesion. Chest x-ray films performed on the day of admission and daily for the next several days show asymmetric densities in both lungs that vary in shape and position from film to film. Urinary screening shows hematuria and proteinuria, and the urinary sediment contains cellular and granular casts. Renal biopsy shows rapidly progressive glomerulonephritis with prominent epithelial cell crescents. The mechanism causing this patient’s disease is closest to the mechanism underlying which of the following diseases?

ABullous pemphigoid
BGraves disease
CHereditary angioedema
DRheumatoid ahritis
Medicine
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