A 56-Year-Old Woman Comes to the Office Due to Worsening

question 263

Multiple Choice

A 56-year-old woman comes to the office due to worsening fatigue and edema of the bilateral lower extremities for the past several months.  She also reports that her legs feel tight.  The patient has no prior medical conditions and takes no medications.  Family history is significant for hypothyroidism in her sister.  The patient does not use tobacco, alcohol, or illicit drugs.  Temperature is 37 C (98.6 F) , blood pressure is 112/64 mm Hg, and pulse is 86/min and regular.  Physical examination reveals normal heart and lung sounds, mild hepatomegaly, and pitting edema of the bilateral lower extremities.  Other examination findings are shown in the exhibit.  Laboratory studies are as follows: Which of the following is the most likely cause of this patient's current condition?

• A)Amyloidosis
• B)Dermatomyositis
• C)Hashimoto thyroiditis
• D)Sarcoidosis
• E)Systemic sclerosis

Explain the medical uses of cocaine in contemporary practice.

Understand the methods of cocaine administration and their implications.

Identify the impact of cocaine on the cardiovascular system.

Discuss the socio-historical context of cocaine misuse epidemics in the United States.

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Definitions:

General Ledger

A comprehensive record of all financial transactions over the life of an organization, serving as the primary source for preparing financial statements.

Factory Overhead

Indirect costs incurred during the manufacturing process, not directly tied to the production of goods, such as utilities or salaries for management.

Actual Factory Overhead

The total of all indirect manufacturing costs that have been incurred during a specific period.

General Ledger Account

The main accounting record of a company that uses double-entry bookkeeping, containing all the financial transactions.