A 65-Year-Old Man Comes to the Office with Dysphagia

question 345

Multiple Choice

A 65-year-old man comes to the office with dysphagia.  For the last 3 months, he has relied on protein shakes and juices for nourishment as he has had difficulty swallowing solid foods.  He has also had a diminished appetite and an estimated weight loss of 9.1 kg (20 lb) .  Medical history includes hyperlipidemia, emphysema, and previous episodes of pancreatitis.  Family history includes lung cancer in his mother.  The patient smoked a pack of cigarettes daily for 50 years but quit 2 years ago.  He has been drinking a fifth (750 mL) of vodka weekly for the last decade.  Vital signs are normal.  BMI is 19.2 kg/m².  Temporal wasting is present but physical examination is otherwise unremarkable.  Upper endoscopy reveals a 4-cm mass in the middle third of the esophagus, and several biopsies are taken.  Thoracic imaging reveals mediastinal lymphadenopathy.  Histologic evaluation of the biopsy specimens will most likely show which of the following in this patient?

• A)Intestinal cells without dysplasia
• B)Irregular glandular cells with tissue invasion
• C)Keratin pearls and intercellular bridges
• D)Myocytes with prominent atypia
• E)Spindle cells expressing CD117

Analyze the responses of government and institutions to protests and social movements.

Understand the theoretical frameworks of social movements, including resource mobilization, frame alignment, and relative deprivation theories.

Analyze the relationship between economic conditions and the frequency of strikes.

Recognize the historical peak periods of unionization in the United States and factors affecting union density.

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Definitions:

Published Wage Surveys

Research studies distributed publicly that report on the common wages and salaries across various industries or positions.

Compatibility

The degree to which two systems, devices, or substances are able to work or exist together without conflict or problems.

Broadbands

A compensation structure that consolidates many narrow pay grades into fewer, wider bands, allowing more flexibility in job roles and pay adjustments.

Salary Grades

A method of organizing employees into levels or bands based on their salary ranges, qualifications, or responsibilities.