Internal-Medicine

284 14: Comprehensive Review
69. A 60-year-old woman being investigated for
menorrhagia is found on history to have
lethargy, constipation, cold intolerance, and
muscle stiffness. Which of the following is the
most likely diagnosis?
(A)
(B)
(C)
(D)
(E)
uterine carcinoma
systemic lupus
hypothyroidism
severe iron deficiency
hypercalcemia
70. A 20-year-old patient with asymptomatic lymphadenopathy
in the right supraclavicular area
is found to have nodular sclerosing Hodgkin’s
disease on biopsy. There is no other evidence of
disease on his imaging tests. Which of the following
is the most appropriate next step in
management?
Which of the following infections is the most
likely cause of these illnesses?
(A)
(B)
(C)
(D)
(E)
cryptosporidium
herpes zoster
Toxoplasma
pneumocystis carinii pneumonia
CMV
73. A 45-year-old man is evaluated for new onset
of jaundice. Investigations reveal an extrahepatic
biliary obstruction. Which of the following
is most likely correct concerning his jaundice?
(A)
(B)
(C)
(D)
(E)
negative urine bilirubin
marked increase in conjugated bilirubin
normal unconjugated bilirubin
painless jaundice
decrease in glucuronyl transferase
(A)
(B)
(C)
(D)
(E)
combination chemotherapy with MOPP
(mechlorethamine, vincristine
[Oncovin], procarbazine, prednisone)
wide surgical excision following radiotherapy
combination chemotherapy with ABVD
(adriamycin [doxorubicin], bleomycin,
vinblastine, dacarbazine)
radiotherapy alone
observation until symptoms occur
74. A 19-year-old man has a pigmented skin lesion.
Which of the following characteristics suggests
a dysplastic nevus (atypical mole) rather than
a benign acquired nevus?
(A)
(B)
(C)
(D)
(E)
uniform tan color
located on buttock
4 mm in diameter
20 similar lesions on body
located on back
71. A 45-year-old man presents with weakness,
fever, weight loss, and abdominal pain. On
examination, he is hypertensive, the heart
sounds are normal, and lungs are clear. While
being investigated, he has a focal seizure.
Laboratory studies show a high erythrocyte sedimentation
rate (ESR), anemia, ARF, and a positive
test for hepatitis B surface antigen. Which
of the following is the most likely diagnosis?
(A)
(B)
(C)
(D)
(E)
polyarteritis nodosa (PAN)
acute hepatitis B
SBE
multiple staphylococcal abscesses
chronic active hepatitis
72. Patients with AIDS can develop chorioretinitis
with blindness, enteritis with intractable diarrhea,
interstitial pneumonitis, and adrenalitis.
75. A 73-year-old man is brought to the emergency
department because of decreased urine output
for the past 2 days. Which of the following
urine values distinguishes prerenal azotemia
from ARF?
(A) urine osmolality