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3315 Pathology

A 58-year-old male presents with the sudden onset of excruciating pain. He describes the pain as beginning in the anterior chest, radiating to the back, and then moving downward into the abdomen. His blood pressure is found to be 160/110. Your differential diagnosis includes myocardial infarction; however, no changes are seen on ECG, and you consider this to be less of a possibility. You obtain an x-ray of this patient’s abdomen and discover a “double-barrel” aoa. This abnormality most likely results from

AAtherosclerosis of the abdominal aoa
BA microbial infection
CA congenital defect in the wall of the aoa
DLoss of elastic tissue in the media
Pathology
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3319 Pathology

A 50-year-old man Shahid K. John has had increasing dyspnea for the past 3 years with associated occasional cough but little sputum production. Auscultation reveals that his lungs are hyper-resonant and is associated with expiratory wheeze. Pulmonary function tests reveal increased total lung capacity (TLC) and slightly increased FVC. There is decreased FEV1 and FEV1/FVC ratio also. ABG analysis reveals pH of 7.35, pO2 of 60 mm Hg and pCO2 of 48 mm Hg. What is the most likely diagnosis?

ACentriacinar emphysema
BSarcoidosis
CDiffuse alveolar damage
DChronic pulmonary embolism
Pathology
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3321 Pathology

A 24-year-old woman notes a lump in her right breast for the past month. She is concerned because her sister was diagnosed with poorly differentiated “triple-negative” breast cancer at age 31. Ultrasonography of the breast shows a solid mass. Fine needle aspiration is attempted but no diagnostic cells are obtained. Mammography is performed and there is a single 1-cm density with small clustered calcifications in the right breast but no lesions of the opposite breast. Which of the following is the best course of action for this patient?

ABiopsy to obtain tissue from the lesion
BContinued monthly breast self-examination
CGenetic testing for BRCA1 mutations
DHormonal therapy with tamoxifen
Pathology
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