A 34-year-old woman presents to a surgeon to discuss the possibility of an elective splenectomy. Several weeks ago she was diagnosed with idiopathic thrombocytopenic purpura. At that time her platelet count was 24,000/mm³. Her primary care doctor started

A 69-year-old man with congestive heart failure and chronic obstructive pulmonary disease has palpable adenopathy in the neck and inguinal region. He feels perfectly well and has normal blood counts. Lymph node biopsy shows follicular small cleaved lympho

The body of a 68-year-old homeless man arrives at the medical examiner"s office for autopsy. No clinical history is known. Examination of the spinal cord is performed. Which of the following findings and diagnoses are correctly paired?

A 69-year-old woman has been in the intensive care unit for 7 days following complicated hip replacement surgery. Her post-surgical course has been uneventful and the patient is currently receiving heparin subcutaneously and wears intermittent pneumatic c

A 25-year-old woman expresses concern regarding an extensive history of colon cancer in her family. Her mother, uncle, and sister had colon cancer. Her sister also had endometrial cancer and a tumor of the small intestine. The patient is particularly conc

An infant boy experiences multiple bacterial, viral, and fungal infections during his first year of life. He has also been suffering diarrhea since birth. Tests are performed to determine the likely cause of his symptoms. Serum calcium levels are normal,

A 32-year-old man presents with a 3-month history of arthralgias, weight loss, diarrhea with fatty stools, and abdominal pain. After careful observation and testing, his physician obtains a biopsy of the lamina propria of the small intestine, which shows

A 32-year-old man with Crohn"s disease presents to the emergency department with acute-onset diffuse abdominal pain and emesis. The patient states these symptoms are different than his usual Crohn"s disease flare-ups. The pain is severe (10/10) and is cra

A 28-year-old man is working at an appliance warehouse when a 300-lb washing machine falls off a hydraulic lift and lands on his left leg. It takes several minutes for his co-workers to free him. He is taken to the emergency department, where radiographs

A 53-year-old woman with a history of polycystic kidney disease undergoes a renal transplant from a cadaveric donor. She experiences several bouts of acute rejection that are controlled by appropriate increases in immunosuppression during the first year p

An 18-year-old woman presents to her primary care doctor for a follow-up appointment subsequent to a diagnosis of infectious mononucleosis. One month ago her WBC count was 12,000/mm³, hemoglobin was 13.7 g/dL, and platelet count was 183,000/mm³. At the

A 53-year-old woman presents with diffuse back and rib pain that is worsened with movement. She states her periods have recently stopped, but denies experiencing hot flashes or other menopausal symptoms. She also notes a 6.8-kg (15-lb) weight gain over th

A 28-year-old woman with a history of refractory promyelocytic leukemia is admitted to the hospital to undergo a bone marrow transplant from a matched unrelated donor. In the week prior to the transplant she receives myeloablative chemotherapy. She remain

A 68-year-old man with chronic obstructive pulmonary disease, coronary artery disease, and atherosclerosis is brought to the emergency department with sudden onset of severe, crampy abdominal pain. The pain began after a massive bowel movement and was acc

A 29-year-old woman presents to the obstetrician-gynecologist with complaints of amenorrhea for the past 2 months. She notes that she is sexually active with her boyfriend of 6 months, and they do not use any form of contraception. She is worried about pr

A woman presents to her obstetrician-gynecologist after missing her period for 2 months. She and her husband have been trying to get pregnant since they got married last year and she discontinued her oral contraceptive medications. For the past few weeks,

A 68-year-old man presents to his primary care physician with complaints of nocturia, difficulty urinating, and occasional urine dribbling. Past medical history is significant for a 20-year history of diabetes mellitus and hypertension. Laboratory results

A 17-year-old boy is brought to the emergency department following a motor vehicle crash. The patient was not wearing a seatbelt at the time of the collision. The steering wheel was broken and the windshield was smashed during the accident. The patient is

A 53-year-old woman presents with diffuse back and rib pain that is worsened with movement. She states her periods have recently stopped, but denies experiencing hot flashes or other menopausal symptoms. She also notes a 6.8-kg (15-lb) weight gain over th

A 34-year-old G1P0 woman at 29 weeks" gestation presents to the emergency department complaining of 2 hours of vaginal bleeding. The bleeding recently stopped, but she was diagnosed earlier with placenta previa by ultrasound. She denies any abdominal pain

A 16-year-old G1P0 girl presents to the emergency department at 32 weeks" gestation with 2 hours of painless bleeding. She denies any abdominal pain, cramping, or contractions. Her past medical history is significant for two prior episodes of pelvic infla

A 24-year-old G3P1 woman pregnant with twins at 34 weeks" gestation presents to her obstetrician complaining of irregularly timed abdominal cramping and contractions. The discomfort is localized to her pelvis and has not gotten worse with time. The cervix

A 30-year-old woman presents to a primary care physician for a new patient visit. She reports recurrent episodes of pneumonia, bronchitis, and otitis over the past 4 years. Although her vaccinations were up to date, she developed tetanus following a foot

A 68-year-old woman presents to her primary care provider with complaints of fatigue, weight loss, bilateral leg pain, and a feeling of abdominal fullness increasing over the past month. Physical examination reveals a grade II/VI systolic ejection murmur

A 16-year-old G1P0 girl presents to the emergency department at 32 weeks" gestation with 2 hours of painless bleeding. She denies any abdominal pain, cramping, or contractions. Her past medical history is significant for two prior episodes of pelvic infla

A 29-year-old G3P2 woman at 31 weeks" gestation presents to the emergency department with a small amount of vaginal bleeding. She had been diagnosed with velamentous cord insertion by ultrasound earlier in the pregnancy. She denies abdominal pain, crampin

An elderly patient with a history of atrial fibrillation is started on a medication that affects the extrinisic clotting pathway. Six weeks later, he presents to the emergency department with dizziness, weakness, numerous bruises, and an International Nor

A 28-year-old G4P3 woman at 38 weeks’ gestation presents to a labor and delivery suite after several hours of increasingly frequent and forceful contractions. The fetal head is palpated by the obstetrician in the upper abdomen with Leopold maneuvers, an

A 32-year-old man recently underwent a liver transplant and was prescribed cyclosporine to reduce the chance of immune rejection. After a few weeks of taking the drug, he started experiencing acute pain, tenderness, warmth, and swelling of his right great

A 40-year-old woman comes to the physician because of hoarseness following surgery for removal of a thyroid nodule. Which branchial (pharyngeal) arch is the origin of the nerve most likely injured during her surgery?

A 32-year-old G2P1 woman at 35 weeks" gestation presents to her obstetrician for a routine prenatal check-up. The mother has been previously diagnosed with mild preeclampsia, which the obstetrician has chosen to manage expectantly. During the visit, a bio

A 15-year-old boy with cystic fibrosis was recently diagnosed with pneumonia. He has had multiple episodes of pneumonia in the past. Additionally, he had an episode of gallstones when he was 4 years old that required the removal of his gallbladder. He has

A 25-year-old woman presents to her primary care physician with complaints of intermittent episodes of chest pain, palpitations, diaphoresis, flushing, and headaches. She has no history of substance abuse and has never had any health problems in the past,

A 40-year-old man with no significant past medical history presents to the emergency department because of a 2-day history of fever, vomiting, and diarrhea. His blood pressure is 90/65 mm Hg and pulse is110/min. An intravenous line is started and he is gi

A 21-year-old man with no significant medical history presents to the emergency department after an injury to his shoulder sustained while playing football. His shoulder is swollen and erythematous. Active range of motion is limited, as he is unable to ab

An 85-year old man presents to the emergency department complaining of severe left lower quadrant pain over the past 2 days. He describes the pain as crampy and says that he has been experiencing vomiting, diarrhea, and flatulence over the past 48 hours.

A 24-year-old sexually active woman presents to her gynecologist with symptoms of genital itching, burning, and foul-smelling discharge. Samples are taken and clue cells are observed on microscopic wet mount. What is the mechanism of the drug most appropr

A 23-year-old G1P0 woman at 28 weeks" gestation presents to her obstetrician for a prenatal examination. She has received poor prenatal care up to this point, but is confident about dating the pregnancy. She denies use of alcohol and illicit drugs but has

A 23-year-old G3P2 woman at 29 weeks" gestation presents to the emergency department complaining of 2 hours of vaginal bleeding. She denies any abdominal pain, cramping, or contractions associated with the bleeding. She has a history of placenta previa bu

A 72-year-old man with a history of hypertension and hypercholesterolemia presents to the emergency department with weakness of his left leg and arm that began 5 hours ago. An ischemic stroke is demonstrated on a non-contrast CT scan of the head. His temp

A 35-year-old woman who is HIV positive presents to the physician because of jaundice and right upper quadrant abdominal pain. She reports having had multiple episodes of jaundice over the past 10 years. Physical examination is remarkable for scleral icte

A 24-year-old G1P0 woman at 31 weeks’ gestation presents to the emergency department with a 4-hour history of abdominal cramping and contractions. The contractions have been regularly spaced at 10 minutes, but seem to be increasing in intensity. She has

An otherwise healthy infant boy born via vaginal delivery has an abnormal appearance of his right limb. His arm hangs by his side, adducted, extended, and medially rotated. His forearm is pronated, and his hand is flexed at the wrist. Which of the followi

A 31-year-old G3P2 woman at 37 weeks’ gestation presents to the labor and delivery floor after 2 hours of contractions of increasing frequency and intensity. An epidural anesthetic is requested on admission and placed. The patient continues to have cont

A 72-year-old man with a history of hypertension and hypercholesterolemia presents to the emergency department with weakness of his left leg and arm that began 5 hours ago. An ischemic stroke is demonstrated on a non-contrast CT scan of the head. His temp

A 24-year-old G1P0 woman at 42 weeks’ gestation presents to her obstetrics clinic for evaluation with no specific complaints. The patient had good prenatal care including a first-trimester (10th week) ultrasound to estimate the baby’s due date, and no

A 7-year-old boy presents to the pediatrician with diarrhea following a 2-week course of ampicillin for a persistent upper respiratory infection. Results of a stool toxin test are positive. Which of the following cells helps the body control this type of

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