A 45-Year-Old Man with a History of Alcohol Use Disorder

question 378

Multiple Choice

A 45-year-old man with a history of alcohol use disorder, chronic hepatitis C, and HIV is brought to the emergency department due to altered mental status and abdominal distension.  He is disoriented and unable to provide an adequate history.  He is accompanied by a friend who reports that the patient has recently been drinking heavily.  The patient's breath has a sweet, sulfurous odor.  Physical examination shows gynecomastia, palmar erythema, and multiple spider angiomata.  The abdomen is severely distended, and dilated periumbilical veins are noted.  There is 3+ bilateral lower extremity edema.  Genital examination shows testicular atrophy.  Neurologic examination shows disorientation and asterixis.  Abdominal imaging reveals splenomegaly.  Development of this patient's gynecomastia most closely resembles the pathogenesis of which of the following additional findings in this patient?

• A)Altered mental status
• B)Dilated periumbilical veins
• C)Lower extremity edema
• D)Spider angiomata
• E)Splenomegaly
• F)Sweet, sulfurous breath odor

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Definitions:

Extraneous Variables

Variables that are not the focus of a study but can affect the outcome of research if not properly controlled.

Participants' Reactivity

The alteration of participants' behavior or responses due to the awareness of being observed or studied.

Operational Definition

A clear, precise description of a variable, term, or object in terms of the operations or processes used to observe and measure it.

Attractiveness

A quality that makes a person, place, thing, or idea appealing to the senses, mind, or emotions, often leading to positive regard or interest.