A 55-Year-Old Man Comes to the Office Due to Progressive

question 56

Multiple Choice

A 55-year-old man comes to the office due to progressive abdominal distension for the past 2 months.  He reports that his abdomen has become so large that his clothes no longer fit.  Temperature is 37.5 C (99.5 F) , blood pressure is 152/87 mm Hg, pulse is 80/min, and respirations are 18/min.  The abdomen is grossly enlarged and nontender.  Shifting dullness is present.  Trace pitting edema is identified in the bilateral lower extremities.  Paracentesis reveals bloody ascitic fluid.  Repeat paracentesis from another site yields similar bloody fluid.  Which of the following is most likely responsible for this patient's presentation?

• A)Hepatocellular carcinoma
• B)Nephrotic syndrome
• C)Portal vein thrombosis
• D)Spontaneous bacterial peritonitis
• E)Tuberculosis

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Definitions:

Accommodation Party

An individual who signs a negotiable instrument on behalf of another party, typically to lend them their credit without receiving personal benefit.

Pay Note

A written promise to pay a specified sum of money to a designated party, also known as a promissory note.

Negotiable Instrument

A written promise or order to pay a specific amount of money that can be transferred by endorsement or delivery, such as checks and promissory notes.

Claim Negligence

The legal accusation that a party failed to exercise a reasonable standard of care, resulting in harm or damage to another.