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- A 50 year old man has a six month history of dysphasia, heartburn, and occasional regurgitation. Endoscopic, biopsy specimen of the distal esophagus shows squamous epithelium containing eosinophils, neutrophils, and lymphocytes; lamina propria papillae extend into the upper third of the epithelium. Which off the following is the likely diagnosis? A) achalasia B) Barrett esophagus C) Mallory Weiss syndrome D) pharyngoesophageal (zenker)  diverticulum E) reflux esophagitisA female who is 36-year-old, experienced a recent weight loss. Her tongue was red and fissured. She also complained of chronic fatigue and shortness of breath upon exertion. Physical examination suggested signs of jaundice and increased numbness and a tingling sensation of fingers and toes. She was hospitalized with the general diagnosis of moderate anemia, jaundice, and neurological symptoms. Her admitting CBC demonstrated the following laboratory results: RBC: 2.5 X 1012/L WBC: 4.5 X 109/L Hb: 10.0 g/dL Hct: 31% MCV: 124.0 fL MCH: 40.5 pg/dL MCHC: 32.7 gm/dL RDW: 21.2 PLT: 155 X109/L WBC Differential Lymphs: % 36.0 Monos: % 3.8 Neutrophils: % 59.4 Eosinophils: % 1.0 Basophils: % 0.0 NRBCs/100WBCs: 5 The blood film shows anisocytosis and Poikilocytosis in which moderate hyper-segmented neutrophils and abnormal erythrocyte morphology was reported: Macrocytes, Ovalocytes with presence of basophilic stippling and occasional Howell-Jolly bodies. Also, 50 pg/mL (Low) Folate 10.3…A 74-year old woman with history of rheumatic fever (in her twenties) presented to her physician with complaints of increasing shortness of breath (dyspnea) upon exertion. The typical swelling she’s had in her ankles for years has started to get worse over the past two months. In the past week, she’s had a decreased appetite, some nausea and vomiting and tenderness in the right upper quadrant of the abdomen. On physical examination, the patient’s jugular veins were noticeably distended. Auscultation of the heart revealed a low-pitched, rumbling systolic murmur, heard best over the left upper sternal border. In addition, she had an extra “S3” heart sound. (i) What is causing this murmur? (ii) Is the history of rheumatic fever relevant to the patient’s current symptoms? Explain. (iii) Examination of the patient’s abdomen reveals an enlarged liver (hepatomegaly) and a moderate degree of ascites (‘water’ in the pericardial cavity). Explain these findings. (iv) Examination of the patient’s…
- A 74-year old woman with history of rheumatic fever (in her twenties) presented to her physician with complaints of increasing shortness of breath (dyspnea) upon exertion. The typical swelling she’s had in her ankles for years has started to get worse over the past two months. In the past week, she’s had a decreased appetite, some nausea and vomiting and tenderness in the right upper quadrant of the abdomen. On physical examination, the patient’s jugular veins were noticeably distended. Auscultation of the heart revealed a low-pitched, rumbling systolic murmur, heard best over the left upper sternal border. In addition, she had an extra “S3” heart sound. (i) Examination of the patient’s ankles reveals significant “pitting oedema”. Explain this finding. (ii) What is the general term describing this condition?A 62-year-old man who has had a worsening cough for several months now complains of dyspnea. He also has fatigue and has experienced a 15-lb weight loss. A chest radiograph shows hilar lymphadenopathy and a right lung mass. What other studies might be helpful in arriving at a definitive diagnosis? What are the risk factors for tumors of the lung?A 23-year-old man consulted a doctor with complaints of swelling of the face, eyelids. extremities, a decrease in the amount of urine, severe weakness, fatigue, headache in the occipital and temporal regions and inspiratory dyspnea. He is known to suffer from chronic tonsillitis. His health deteriorated in the last two weeks after the worsening of tonsillitis, when the symptoms described above appeared. On examination: the patient's condition is moderate, the skin is pale, dry. Swelling of the face, arms, legs, and abdomen. NPV 24 / min, pulse 102/ min, BP 165/95 mm Hg, t- 37.1. C. On auscultation of the lungs: weakened vesicular breathing is heard in the lower left sections, below the angle of the scapula and in the axillary region, In the same parts of the lungs, dullness is determined percussion. Pasternatsky's symptom is weakly positive on both sides, 1. What syndromes can be diagnosed in this patient? 2. What laboratory and instrumental studies should be assigned? 3. Explain the…
- A 62-year-old man who has had a worsening cough for several months now complains of dyspnea. He also has fatigue and has experienced a 15-lb weight loss. A chest radiograph shows hilar lymphadenopathy and a right lung mass. Questions What other studies might be helpful in arriving at a definitive diagnosis? What are the risk factors for tumors of the lung?A 54-year-old man presents with a 12-hour history of headache, confusion and declining consciousness. His wife says that he has recently completed oral chemotherapy for an ‘indolent form of leukemia’. Examination reveals him to be responding to painful stimuli but not to verbal commands. He has bilateral axillary and inguinal lymphadenopathy. He is clinically jaundiced and anemic. His spleen is palpably enlarged. He has neck stiffness, generalized hyper-reflexia and bilateral up going plantar reflexes. Fundal examination is normal, and there are no focal neurological signs. Full blood count shows: Hemoglobin (Hb) 7.5 g/dL White blood cells (WBC) 37 × 109/L (lymphocytes 86%) Platelets 26 × 109/L What blood component is best to harvest to find out the patient’s disease? Why lymphocytes are prevalently seen in the peripheral blood film? What is the clinical significance of the platelet count?A 54-year-old man presents with a 12-hour history of headache, confusion and declining consciousness. His wife says that he has recently completed oral chemotherapy for an ‘indolent form of leukemia’. Examination reveals him to be responding to painful stimuli but not to verbal commands. He has bilateral axillary and inguinal lymphadenopathy. He is clinically jaundiced and anemic. His spleen is palpably enlarged. He has neck stiffness, generalized hyper-reflexia and bilateral up going plantar reflexes. Fundal examination is normal, and there are no focal neurological signs. Full blood count shows: Hemoglobin (Hb) 7.5 g/dL White blood cells (WBC) 37 × 109/L (lymphocytes 86%) Platelets 26 × 109/L What blood component is best to harvest to find out the patient’s disease? Why lymphocytes are prevalently seen in the peripheral blood film? What is the clinical significance of the platelet count? NOTE: If you could answer all the questions please. Thank you!
- A 54-year-old man presents with a 12-hour history of headache, confusion and declining consciousness. His wife says that he has recently completed oral chemotherapy for an ‘indolent form of leukemia’. Examination reveals him to be responding to painful stimuli but not to verbal commands. He has bilateral axillary and inguinal lymphadenopathy. He is clinically jaundiced and anemic. His spleen is palpably enlarged. He has neck stiffness, generalized hyper-reflexia and bilateral up going plantar reflexes. Fundal examination is normal, and there are no focal neurological signs. Full blood count shows: Hemoglobin (Hb) 7.5 g/dL White blood cells (WBC) 37 × 109/L (lymphocytes 86%) Platelets 26 × 109/L What blood component is best to harvest to find out the patient’s disease? Why lymphocytes are prevalently seen in the peripheral blood film?Clinical History:This 29-year-old male's illness began 10 weeks prior to death, with an episode of "flu". Two weeks later his urine became "smoky". He was found to have hematuria, albuminuria and elevated BUN (180 mg/dl). He died from a pulmonary embolus. Photos include throat photo, blood agar, and grain stain. What specimens should be taken, aside from blood? What tests should be run? Include both a rapid test option and a lower cost test option. What signs and symptoms should have alerted the patient to come in for testing during or after his viral flu episode? What was the most likely cause to the embolus? No references, just homework please include referencesA patient of 40 years complains of constantly increasing body weight, increased appetite. He works as a cook, he constantly tries cooked food. On examination: height - 179 cm, weight 130 kg. There is excessive fat deposition on the abdomen and thighs. Questions: 7. What other diseases can be developed in this patient with high probability?