A 64-Year-Old Man Who Recently Moved to the Area Comes

question 87

Multiple Choice

A 64-year-old man who recently moved to the area comes to the office for a new patient evaluation.  He has chronic low back pain, resulting from an injury 8 years ago, for which he uses several over-the-counter analgesics.  Most recently, the patient has been taking naproxen daily.  He has no other joint pain, fever, rash, urinary symptoms, or other medical conditions.  Blood pressure is 135/70 mm Hg and pulse is 78/min.  Examination shows trace lower extremity edema.  Neurologic and musculoskeletal examinations reveal no abnormalities.  Laboratory results show blood counts within normal limits, blood urea nitrogen of 12 mg/dL, and serum creatinine of 2.0 mg/dL.  Urinalysis reveals 1+ protein and 3-4 white blood cells/hpf.  Renal ultrasound demonstrates bilateral shrunken and irregular kidneys with a few papillary calcifications.  Which of the following is the most likely cause of this patient's renal dysfunction?

• A)Chronic interstitial nephritis
• B)Chronic pyelonephritis
• C)Crystal nephropathy
• D)Focal segmental glomerular sclerosis
• E)Ischemic tubular necrosis
• F)Renal artery stenosis

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Definitions:

Imperfectly Competitive

A market structure where individual sellers have some control over the price due to lack of perfect competition, leading to a variety of prices for similar products.

Marginal Revenue Curve

A graphical representation showing how marginal revenue varies as the quantity of goods sold changes.

Demand Curve

A graph that shows the relationship between the price of a good and the quantity of it that consumers are willing to purchase at each price point.

Minimum Efficient Scale

The smallest amount of production a company can achieve while still taking full advantage of economies of scale regarding cost per unit.