A 35-Year-Old Man Is Evaluated for Progressive Fatigue and Shortness

question 98

Multiple Choice

A 35-year-old man is evaluated for progressive fatigue and shortness of breath.  Recently, he has noticed bilateral leg swelling and abdominal distension despite overall weight loss.  He does not use tobacco, alcohol, or illicit drugs.  Despite treatment, the patient dies several weeks later.  Autopsy reveals significant endocardial thickening with dense fibrous deposits around the tricuspid and pulmonary valves as well as moderate pulmonary valve stenosis.  The left-sided cardiac chambers and valves are normal.  Measuring the levels of which of the following substances would have helped in diagnosing this patient?

• A)Plasma cortisol
• B)Plasma homocysteine
• C)Plasma phenylalanine
• D)Urinary 5-hydroxyindoleacetic acid
• E)Urinary porphobilinogen
• F)Urinary vanillylmandelic acid

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Definitions:

Legislative Seats

Positions held by elected members within a legislative body, such as a parliament or congress, who are responsible for making and voting on laws.

Split-Ticket Voter

A voter who selects candidates from different political parties on the same ballot during an election.

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An undecided or independent voter who can be swayed to either side of the political spectrum, often playing a crucial role in elections.

Third Party

A political party that competes alongside the two major parties in a two-party system.