A 43-Year-Old Man Comes to the Office Due to Fatigue

question 87

Multiple Choice

A 43-year-old man comes to the office due to fatigue and worsening pedal edema over the past several weeks.  The patient was diagnosed with advanced HIV infection and started on antiretroviral therapy 3 months ago.  He also has a history of hypertension.  Physical examination shows bilateral lower extremity pitting edema.  Serum creatinine is elevated and serum phosphorus is decreased compared to test results 3 months ago.  Urinalysis reveals moderate proteinuria and glucosuria.  Renal biopsy shows cytoplasmic vacuolization in the proximal tubules accompanied by loss of brush border and basement membrane denudation.  Intracytoplasmic eosinophilic inclusions are also seen in the proximal tubules.  There are no significant interstitial inflammatory infiltrates, and the glomeruli appear normal.  Which of the following is the most likely diagnosis in this patient?

• A)HIV-associated nephropathy
• B)Hypertensive nephrosclerosis
• C)Postinfectious glomerulonephritis
• D)Tenofovir-induced nephrotoxicity
• E)Trimethoprim-sulfamethoxazole-induced nephrotoxicity

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Definitions:

Fixed Manufacturing

Costs that do not vary with the volume of production, including rent, salaries of permanent staff, and equipment depreciation.

Average Costs

Calculated by dividing total costs by the total number of units produced, indicating the cost on a per-unit basis.

Produced Units

The number of units of a product that have been completed by a manufacturing process during a specific period.

Relevant Range

The level of activity or volume over which the specific cost assumptions (fixed and variable costs) are valid.