A 44-Year-Old Man with a Long-Standing History of Heartburn Comes

question 65

Multiple Choice

A 44-year-old man with a long-standing history of heartburn comes to the office due to worsening substernal burning, particularly at night.  The discomfort has been less responsive than usual to over-the-counter antacids.  The patient also now has significant substernal pain after swallowing food.  However, swallowing does not result in coughing, choking, or a sensation of food getting stuck.  He has no other chronic medical conditions.  Recent HIV testing was negative.  The patient takes no other medications.  He drinks 2 or 3 beers each evening and smokes a pack of cigarettes daily.  BMI is 34 kg/m².  Vital signs are within normal limits.  Physical examination reveals no abnormalities.  The recent worsening of this patient's symptoms is most likely related to which of the following?

• A)Columnar metaplasia
• B)Herpes simplex infection
• C)Malignancy
• D)Stricture
• E)Ulceration

Evaluate the role of government in addressing agricultural surpluses and shortages through policy measures.

Discuss the impact of agricultural policies on farm income and efficiency.

Identify the factors contributing to the instability of agricultural prices and incomes.

Understand the political process and its influence on agricultural policy-making.

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Definitions:

Affirmative Action

Policies and procedures designed to combat discrimination and promote equal opportunities in education and employment for historically marginalized groups.

Color-Blind Hiring

Employment practices that emphasize fairness by not considering race or ethnicity as a factor in hiring decisions.

American Influence

Describes the impact of the United States on global politics, culture, economy, and technological advancements.

Democratic Party Convention

A national event where members of the U.S. Democratic Party select their presidential and vice presidential candidates and establish party platforms.