A 35-Year-Old Immigrant from Eastern Europe Comes to the Office

question 205

Multiple Choice

A 35-year-old immigrant from Eastern Europe comes to the office due to dry cough, malaise, and fatigue.  He has had joint aches and involuntary weight loss over the past 3 months.  His other medical problems include severe allergies that manifest as nasal stuffiness, headache, and ear pain.  He takes over-the-counter decongestants.  He is a construction worker, smokes a pack of cigarettes a day, and drinks 6 cans of beer once a week.  His mother suffers from severe rheumatoid arthritis.
His temperature is 37.2 C (99 F) , blood pressure is 122/70 mm Hg, and pulse is 89/min.  He has tenderness on palpation of bilateral maxillary sinuses.  Tympanic membranes are full and bulging bilaterally.  Pulmonary auscultation reveals occasional rhonchi.  There are no heart murmurs.  The tip of the spleen is not palpable.  There are no skin rashes or joint swelling.
Laboratory results are as follows:

Liver panel is unremarkable.  Urinalysis is positive for blood and protein, and urine sediment analysis reveals multiple red blood cells casts.  Chest x-ray is shown below.

Which of the following is most likely to establish this patient's diagnosis?

• A)Anti-double-stranded DNA antibodies
• B)Anti-myeloperoxidase antibodies
• C)Anti-proteinase 3 antibodies
• D)Bone marrow biopsy
• E)Tuberculin skin testing

Understand the concept of subcultures based on age and their characteristics.

Identify different generational cohorts and their unique attributes.

Recognize the role of life events and shared experiences in forming consumer behavior.

Understand the impact of nostalgia and historical quality perceptions on consumer attitudes.

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Definitions:

Leo Kanner

An Austrian-American psychiatrist known for his work in child psychiatry, notably for being the first to describe autism as a distinct neurodevelopmental disorder in 1943.

Anna Freud

A pioneering child psychoanalyst and the daughter of Sigmund Freud, known for her theoretical and clinical contributions to the field of psychoanalysis.

Internalizing Problem

Psychological issues that are manifested inwardly, such as anxiety, depression, and withdrawal, as opposed to externalizing problems that involve outward behaviors towards others.

Externalizing Problem

Behaviors directed outwardly, typically involving conflicts with other individuals or society, such as aggression or defiance.