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4484 Pathology

A 48-year-old man with a longstanding history of chronic constipation complains of anal itching and discomfort toward the end of the day. He describes a perianal pain when sitting and finds himself sitting sideways to avoid discomfort. Physical examination reveals painful varicose dilations in the anal region, associated with edema. Which of the following is the most likely diagnosis?

AAnal cancer
BAnal fissure
CHemorrhoids
DIschiorectal abscess
Pathology
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4488 Pathology

A 19 year old sexually active female presents to urgent care with abdominal pain and nausea. Her last menstrual period began seven days ago. Physical examination is remarkable for fever and lower abdominal pain. Pelvic examination reveals a mucopurulent discharge, adnexal tenderness, and tenderness with cervical motion. A pregnancy test is negative; the patient’s white count is elevated. Which of the following complications is associated with this disorder?

AAscites
BCervical carcinoma
CExsanguination
DInfeility
Pathology
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4489 Pathology

A 23-year-old woman has had altered consciousness and slurred speech for the past 24 hours. A head CT scan shows a right temporal hemorrhagic infarction. Cerebral angiography shows a distal right middle cerebral arterial occlusion. Within the past 3 years, she has had an episode of pulmonary embolism. A pregnancy 18 months ago ended in miscarriage. Laboratory studies show a false-positive serologic test for syphilis, normal prothrombin time (PT), elevated partial thromboplastin time (PTT), and normal platelet count. Which of the following is the most likely cause of these findings?

AAntiphospholipid antibody
BDisseminated intravascular coagulation
CFactor V mutation
DHypercholesterolemia
Pathology
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