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7095 Medicine

A 35-year-old man is evaluated for symptoms of shortness of breath. He reports no other lung or heart disease. He smokes half pack a day for the past 10 years. On examination, his JVP is 2 cm, heart sounds normal, and lungs are clear. A CXR shows hyperinflation and increased lucency of the lung fields. A chest CT reveals bullae and emphysematous changes, while pulmonary function tests show an FEV1/FVC ratio of <70%. Evaluation of his family reveals other affected individuals. Which of the following is the most likely diagnosis?

Aalpha1-antitrypsin deficiency
Bbeta-glycosidase deficiency
Cglucose-6-phosphatase deficiency
Dglucocerebrosides deficiency
Medicine
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7101 Medicine

A 63-year-old woman has Type 2 diabetes mellitus, which is well controlled. Her physical examination is positive for peripheral neuropathy in the feet and non-proliferative retinopathy. A urinalysis is positive for proteinuria. Which of the following treatments is most likely to attenuate the course of renal disease?

Acalcium channel blockers
BACE inhibitors
Chepatic hydroxymethylglutaryl coenzyme A (HMG-CoA) inhibitors
Ddietary carbohydrate restriction
Medicine
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