A 37-Year-Old Man Comes to the Emergency Department Due to Blood-Tinged

question 399

Multiple Choice

A 37-year-old man comes to the emergency department due to blood-tinged vomiting and abdominal discomfort.  Six months ago, he lost his job as an investment banker and began drinking large amounts of whiskey on a daily basis.  He has since been hospitalized several times with alcohol intoxication.  His temperature is 36.7 C (98 F) , blood pressure is 110/70 mm Hg, pulse is 84/min, and respirations are 18/min.  Physical examination shows a firm, enlarged liver.  Peripheral blood smear results show neutrophils with 6-8 nuclear lobes.  Which of the following is the most likely explanation for this patient's abnormal hematologic findings?

• A)Blood lipid abnormality
• B)Chronic blood loss
• C)Cobalamin deficiency
• D)Folate deficiency
• E)Hypothyroidism
• F)Myelodysplasia

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Definitions:

Congestion Zones

Areas in a city or region where access is regulated or priced to reduce traffic congestion, typically involving fees for entry or use during peak times.

Traffic Congestion

The condition on transport networks that occurs as use increases and is characterized by slower speeds and longer trip times.

Privatize National Defense

The concept of transferring national defense responsibilities from the government to private entities.

Public Good

A commodity or service that is provided without profit to all members of a society, either by the government or a private individual or organization.