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131348 Pathology

A 40-year-old woman has experienced chest pain on exertion for the past 2 months. A month ago, she had pneumonia with Streptococcus pneumoniae cultured from her sputum. On physical examination, she has a body mass index of 35. A random blood glucose value is 132 mg/dL. The next day, fasting blood glucose is 120 mg/dL, followed by a value of 122 mg/ dL on the following day. She is given an oral glucose tolerance test, and her blood glucose is 240 mg/dL 2 hours after receiving the standard 75-g glucose dose. On the basis of these findings, she is prescribed an oral thiazolidinedione (TZD) drug. After 2 months of therapy, her fasting blood glucose is 90 mg/ dL. The beneficial effect of TZD in this patient is most likely related to which of the following processes?

AActivation of PPARg nuclear receptor in adipocytes
BDecreased production of insulin autoantibodies
CGreater density of insulin receptors in adipocytes
DIncreased half-life of circulating plasma insulin
Pathology
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131352 Pathology

A 48-year-old woman has a 3-week history of fatigue as well as yellow skin and sclerae. Physical examination is unremarkable except for mild jaundice. The serum bilirubin level is 3.7 mg/dL, mostly in the unconjugated form. Liver function tests including serum AST, ALT, and alkaline phosphatase are normal. The hemoglobin level is 6.0 g/dL. After coicosteroids are administered, the jaundice resolves. Which of the following diseases is the most likely cause of hyperbilirubinemia in this patient?

AAcute hepatitis B infection
BAutoimmune hemolytic anemia
CGallstone in the common bile duct
DPrimary biliary cirrhosis
Pathology
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