A 48-Year-Old Man Comes to the Emergency Department Due to 3

question 158

Multiple Choice

A 48-year-old man comes to the emergency department due to 3 days of progressively worsening retrosternal burning chest pain, dysphagia, and odynophagia.  His medical problems include hypertension and end-stage renal disease.  He underwent cadaveric renal allograft transplantation 8 months ago.  The patient's temperature is 38.3 C (101 F) , blood pressure is 130/80 mm Hg, and pulse is 94/min.  His BMI is 31 kg/m².  The oral mucosa is pink and moist without ulcerations.  Cardiopulmonary examination is normal.  The abdomen is soft with mild epigastric tenderness.  The patient's leukocyte count is 4,200/mm³.  An esophagogastroduodenoscopy demonstrates linear, shallow ulcerations in the lower esophagus.  Which of the following is most likely to be seen on esophageal biopsy?

• A)Enlarged cells with intranuclear inclusions
• B)Metaplastic columnar epithelium
• C)Mucosal tear without acute inflammation
• D)Urease-producing organisms
• E)Yeast with polysaccharide capsule

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Definitions:

Sales Tax

A tax imposed by governments on the sale of goods and services, calculated as a percentage of the sales price.

Proportional Rate Structure

A tax system where the tax rate remains constant regardless of the amount of income, as opposed to progressive or regressive tax structures.

Progressive Rate Structure

This is a tax system in which the tax rate increases as the taxable base amount increases, typically applied to incomes to ensure higher earners pay a greater percentage of their income.

Regressive Rate Structure

A tax system where the tax rate decreases as the taxable amount increases, placing a higher burden on lower earners relative to higher earners.