A 53-Year-Old Man Who Has Not Seen a Physician in Years

question 70

Multiple Choice

A 53-year-old man who has not seen a physician in years presents to your office complaining of abdominal distention.  He states "Last month my stomach started to swell up and it hasn't gotten any better".  He has no other medical problems.  The patient admits to drinking 10-12 beers a day for the last 20 years.  His temperature is 36.7 C (98 F) , blood pressure is 116/72 mm Hg, pulse is 78/min and respirations are 20/min.  On examination his abdomen is distended with engorged paraumbilical veins.  There is also palmar erythema and multiple spider angiomas are present.  You decided to place him on a low-salt diet and start therapy with furosemide and spironolactone, with subsequent improvement of his abdominal distention.  Before beginning this patient's treatment, which of the following structures labeled on the image below is expected to have an increased pressure?

• A)A
• B)B
• C)C

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Definitions:

Negotiates

Engages in discussions aimed at reaching an agreement in situations involving varying interests.

Incomplete Note

A financial or promissory note missing essential details, making it unenforceable or incomplete until the information is furnished.

Unauthorized Manner

Refers to actions or operations carried out without official permission or approval.

HDC

Holder in Due Course, a term in commercial law referring to a person who has acquired a negotiable instrument in good faith and for consideration, and thus has certain rights above the original parties.