A 28-Year-Old Woman Comes to the Emergency Department Due to Bilateral

question 1270

Multiple Choice

A 28-year-old woman comes to the emergency department due to bilateral upper extremity weakness and abdominal pain.  The patient has had progressive weakness of the upper extremities for 2 days and severe, diffuse, poorly localized abdominal pain for 1 day.  Temperature is 37.3 C (99.1 F) , blood pressure is 148/86 mm Hg, and pulse is 112/min.  On physical examination, the patient appears restless and is diaphoretic.  There is no scleral icterus.  The abdomen is soft and nontender, with no organomegaly, guarding, or rebound tenderness.  Bowel sounds are decreased.  Neurological examination shows normal cranial nerves, weakness of the proximal upper extremity muscles, and loss of the biceps and triceps reflexes on both sides.  Laboratory results are as follows: Which of the following is most likely to yield the diagnosis in this patient?

• A)Blood lead concentration
• B)Cerebrospinal fluid analysis
• C)Genetic testing for JAK2 mutation
• D)Mesenteric angiography
• E)Serum ceruloplasmin level
• F)Urinary porphyrin level

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Definitions:

Asset Revaluation Reserve

An equity account that records increases in the carrying amount of a company's assets, reflecting changes in value over time.

General Reserve

A reserve fund set aside out of profits for the purpose of strengthening the company's financial position and fulfilling future needs or contingencies.

Acquisition Excess

The amount by which the purchase price of an acquired asset or business exceeds its fair value, often recognized as goodwill.

Equity Method

An accounting technique used by firms to assess the profits earned by their investments in other companies, where the investment is recorded at cost and adjusted for the investor's share of the investee's profit or loss.