Solved

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

question 260

Multiple Choice

A 43-year-old man comes to the office due to yellowing of the skin over the past several days. He has had no fever or abdominal pain and has not traveled recently or received blood transfusions. The patient has also experienced increased shortness of breath with exercise over the past few months. He has no other medical conditions and takes no medications. The patient drinks 1 or 2 glasses of wine on social occasions and does not use tobacco or illicit drugs. His father died of liver cirrhosis attributed to alcohol use. On physical examination, expiration is prolonged and there are scattered bilateral wheezes. Laboratory results show total bilirubin of 4.1 mg/dL and alanine aminotransferase of 90 U/L. Viral hepatitis serology is negative. Chest x-ray shows hyperlucency of lung fields and flattening of the diaphragm. Abdominal ultrasound reveals increased liver span and echogenicity of the liver parenchyma but no masses. Which of the following is the most likely underlying cause of this patient's symptoms?

Definitions:

Canada

A country located in the northern part of North America, known for its vast landscapes, multicultural communities, and bilingual status (English and French).

World Trade Organization

An international organization that regulates international trade, aiming to ensure trade flows as smoothly, predictably, and freely as possible.

Trade Negotiations

Talks and discussions between countries aimed at reaching agreements to expand trade, reduce trade barriers, and address related international trade issues.

Trade Wars

Economic conflicts between countries characterized by increasing tariffs or other trade barriers on each other's goods.