A 44-Year-Old Man Comes to the Emergency Department Due to Worsening

question 500

Multiple Choice

A 44-year-old man comes to the emergency department due to worsening abdominal pain and vomiting.  The patient has had 3 months of fatigue, mild abdominal pain, low-grade fever, and joint pains.  On examination, the abdomen is diffusely tender to palpation with rigidity and rebound.  Urgent laparotomy reveals bilateral renal infarcts and multiple segments of necrosis and perforation in the small bowel.  Microscopic examination of the vessel walls shows diffuse inflammation of the adventitia and marked thickening of the inner layers due to proliferation of loose connective tissue; the arterial lumen is significantly narrowed.  Which of the following is the most likely diagnosis?

• A)Bacterial endocarditis
• B)Granulomatosis with polyangiitis
• C)Inherited thrombophilia
• D)Polyarteritis nodosa
• E)Thromboangiitis obliterans

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Definitions:

Hemisphere Speech

Refers to the understanding that speech and language functions are primarily processed in the left hemisphere of the brain in most people.

Glial Cells

Non-neuronal cells in the central and peripheral nervous system that provide support, nutrition, and insulation between neurons, playing key roles in maintaining homeostasis.

Neurons

Basic working units of the brain, specialized cells designed to transmit information to other nerve cells, muscle, or gland cells.

Parietal Cortex

The region of the brain located in the parietal lobe, involved in processing sensory information from various parts of the body.