A 48-Year-Old Man Comes to the Emergency Department Due to 3

question 158

Multiple Choice

A 48-year-old man comes to the emergency department due to 3 days of progressively worsening retrosternal burning chest pain, dysphagia, and odynophagia.  His medical problems include hypertension and end-stage renal disease.  He underwent cadaveric renal allograft transplantation 8 months ago.  The patient's temperature is 38.3 C (101 F) , blood pressure is 130/80 mm Hg, and pulse is 94/min.  His BMI is 31 kg/m².  The oral mucosa is pink and moist without ulcerations.  Cardiopulmonary examination is normal.  The abdomen is soft with mild epigastric tenderness.  The patient's leukocyte count is 4,200/mm³.  An esophagogastroduodenoscopy demonstrates linear, shallow ulcerations in the lower esophagus.  Which of the following is most likely to be seen on esophageal biopsy?

• A)Enlarged cells with intranuclear inclusions
• B)Metaplastic columnar epithelium
• C)Mucosal tear without acute inflammation
• D)Urease-producing organisms
• E)Yeast with polysaccharide capsule

---

Definitions:

Uncertain Prices

Refers to the unpredictability in the cost of goods, services, or assets, often due to factors like market volatility, supply and demand imbalances, or economic uncertainties.

Near Future

A term referring to the time period that is just ahead, typically implying events or developments expected to occur within a short timeframe from the present.

Hedge Risk

A strategy or financial instrument used to offset potential losses or gains that may be incurred by a companion investment.

Option Positions

Refers to the holding of options contracts, including call and put options, as part of an investment strategy or portfolio.