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

question 554

Multiple Choice

A 55-year-old man comes to the office due to progressive abdominal pain.  The pain is greatest after eating.  The patient has also had 6 months of fatigue, joint pain, and weight loss.  On examination, temperature is 38 C (100.4 F) , blood pressure is 150/100 mm Hg, pulse is 80/min, and respirations are 14/min.  Cardiopulmonary examination is normal.  The abdomen is tender to palpation with no rigidity or rebound.  Complete blood count is normal.  CT angiography of the abdomen reveals bilateral renal infarcts and several abdominal arteries with microaneurysms and distal abrupt cutoffs.  Blood cultures are negative for growth after 48 hours.  Which of the following is the most likely diagnosis?

• A)Atherosclerosis
• B)Bacterial endocarditis
• C)Fibromuscular dysplasia
• D)Polyarteritis nodosa
• E)Thromboangiitis obliterans

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Definitions:

K-Complexes

K-Complexes are a type of brainwave pattern seen on an EEG, typically associated with stage 2 sleep, characterized by a brief upsurge in brain activity.

EEGs

Short for Electroencephalograms, these are tests that measure electrical activity in the brain.

Sleepwalks

The act of walking or performing other complex behaviors while in a state of sleep.

REM Sleep

A phase of sleep characterized by rapid eye movements, where vivid dreaming often occurs, and considered important for processing emotions and memories.