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4105 Pathology

A 30-year-old man consults a physician because he has been having increasing difficulty in swallowing both solids and liquids. Physical examination of the patient is noncontributory. Barium swallow studies show a mostly dilated esophagus with slow passage of barium into the stomach. The very distal pa of the esophagus appears narrowed into a “bird’s beak.” Esophageal manometry shows incomplete relaxation of the lower esophageal sphincter in response to swallowing, high resting lower esophageal pressure, and absent esophageal peristalsis. This patient’s condition is MOST likely due to which of the following?

AAcid reflux
BCancerous destruction
CCandida infection
DLack of ganglion cells
Pathology
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4107 Pathology

A 12-year-old girl develops fever, abdominal pain, and bloody diarrhea 1 to 2 days after eating a hamburger at a fast food restaurant. Physical examination reveals an extensive purpuric skin rash. The patient develops oliguria, and laboratory studies show elevated serum levels of BUN and creatinine. Which of the following is the most likely etiologic agent responsible for this patient’s condition?

ACampylobacter jejuni
BEscherichia coli 0157-H7
CSalmonella typhi
DShigella dysenteriae
Pathology
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