A 45-Year-Old Man Comes to the Emergency Department Due to Epigastric

question 90

Multiple Choice

A 45-year-old man comes to the emergency department due to epigastric abdominal pain and fatigue.  He has had similar episodes of pain in the past.  Temperature is 37.1 C (98.8 F) , blood pressure is 128/69 mm Hg, pulse is 92/min, and respirations are 16/min.  Physical examination shows mild epigastric tenderness and hepatomegaly.  There is no jaundice or lymphadenopathy.  Laboratory results are as follows: CT scan of the abdomen shows pancreatic calcifications.  Right upper quadrant ultrasound reveals no evidence of gallstones.  Which of the following processes is most likely responsible for this patient's anemia?

• A)Diminished thymidine synthesis
• B)Impaired globin chain synthesis
• C)Impaired pyruvate decarboxylation
• D)Low rate of intracellular transamination reactions
• E)Reduced iron availability for hemoglobin synthesis

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Definitions:

BRCA1

A gene located on chromosome 17, playing a critical role in the repair of DNA breaks; mutations can significantly increase the risk of breast and ovarian cancer.

BRCA2

A gene located on chromosome 13 that produces a protein involved in DNA repair and plays a key role in maintaining the genetic stability of cells.

Mitotic Spindle

A structure composed of microtubules that segregates chromosomes into daughter cells during mitosis.

Microtubules

Cylindrical structures that are part of the cytoskeleton in all eukaryotic cells, involved in cellular movement, shape, and division.