A 42-Year-Old Man Comes to the Emergency Department Due to 4

question 87

Multiple Choice

A 42-year-old man comes to the emergency department due to 4 days of nausea, skin rash, progressive weakness, and decreased urine output.  For the past few months he has also had fatigue, tingling in his hands and feet, and occasional joint pains.  The patient has had no fever, chest pain, dysuria, hematuria, or diarrhea.  He has no chronic medical problems and takes no medication.  The patient does not use tobacco or alcohol but used injection drugs during his early 20s.  Temperature is 37.6 C (99.8 F) , blood pressure is 150/90 mm Hg, pulse is 92/min, and respirations are 16/min.  BMI is 24.8 kg/m².  Mucous membranes are dry with no lesions.  Cardiopulmonary auscultation is normal.  The liver edge is palpable 2 cm below the right costal margin.  Bilateral ankle reflexes are absent.  He has mild, bilateral, lower-extremity pitting edema and a palpable, nonblanchable, purpuric rash on both legs.  There is no joint swelling or erythema.  Laboratory results are as follows:

Which of the following is most helpful in establishing the cause of this patient's renal dysfunction?

• A)Antineutrophil cytoplasmic antibodies test
• B)Anti-dsDNA antibody levels
• C)Antiglomerular basement membrane antibody levels
• D)Serum cryoglobulin levels
• E)Streptozyme test

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Definitions:

Circular Flow Diagram

An illustration showing the flow of resources from households to firms and of products from firms to households. These flows are accompanied by reverse flows of money from firms to households and from households to firms.

Resource Market

A market where resources (like labor, capital, and land) are bought and sold, allowing businesses to acquire what they need to produce goods and services.

Resource Market

A market where resources (or inputs) for production, such as labor, land, and capital, are bought and sold.

Financial Capital

Financial capital comprises the funds necessary for businesses to buy what they need to produce their products or to provide their services, including money, credit, and other financial instruments.