A 62-Year-Old Man Comes to the Office Due to Poorly

question 117

Multiple Choice

A 62-year-old man comes to the office due to poorly localized, intermittent abdominal pain that is triggered by eating and slowly subsides over the ensuing several hours.  The patient has also lost 4.5 kg (10 lb) over the past 2 months.  He has a history of hypertension and hyperlipidemia and has smoked a pack of cigarettes daily for 40 years.  Blood pressure is 175/105 mm Hg and pulse is 70/min and regular.  The abdomen is soft and nontender.  CT scan of the abdomen reveals the renal findings shown in the image below. This patient most likely suffers from which of the following conditions?

• A)Acute glomerulonephritis
• B)Acute pyelonephritis
• C)Amyloidosis
• D)Fanconi syndrome
• E)Hemolytic uremic syndrome
• F)Hypersensitivity interstitial nephritis
• G)Ischemic tubular necrosis
• H)Myeloma kidney
• I)NSAID-associated nephropathy
• J)Papillary necrosis
• K)Renal artery stenosis
• L)Urate nephropathy

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Definitions:

Perverse Incentives

Incentives that have unintended and undesirable effects that are contrary to the intentions behind their creation.

Before-Tax Income

The total personal income earned by an individual or household before any taxes have been deducted.

High-Income Families

Households with an income significantly above the average, often associated with greater purchasing power and wealth accumulation.

College Degree

A certification awarded by colleges or universities upon successful completion of a course of study.