A surgeon performing an appendectomy
makes an incision through the ventrolateral wall. Which of the following
corresponds to the order of penetration of the layers of the abdominal
wall?
1. Internal oblique
2.
External oblique
3. Peritoneum
4. Transversus abdominis
A 48-year-old white female secretary presents with progressive difficulty typing over the past month. She also notes that her hands begin to feel numb and weak after typing for long periods of time. Upon testing, which of the following deficits would be predicted?
An archaeologist who has been excavating a very old Middle Eastern site develops a pustule on his hand. The pustule then ruptures to form a black eschar surrounded by expanding brawny edema. Which of the following organisms is the most likely cause of this condition?
A boy with Duchenne muscular dystrophy (DMD) was born to parents with no family history of the disease. The most likely explanation for this occurrence is
A 2-year-old child with leukemia develops nephrotic syndrome. Light microscopic studies are normal. Electron microscopic studies demonstrate fusion of epithelial foot processes. The current hypothesis for the pathogenesis of this change is that it is secondary to which of the following?
An obese patient is brought into the emergency room in shock and in need of intravenous fluids. No superficial veins can be seen or palpated. The emergency room physician decides to make an incision to locate the great saphenous vein for the insertion of a cannula ('saphenous cutdown'). In which of the following locations should the incision be made?
A 4-year-old boy is seen by his pediatrician for epistaxis. The patient has a history of multiple bacterial and viral respiratory tract infections and eczema. An uncle had similar problems. Physical examination is remarkable for multiple petechial lesions on the skin and mucous membranes. Serum IgE is increased, and platelets are decreased. Which of the following is the most likely diagnosis?
A healthy, 37-year-old, recently divorced woman loses her job at the auto factory. She picks up her three young children from the factory day care center and gets into an automobile accident on the way home. Her 5-year-old son, who was not wearing a seat belt, sustains a severe head injury. The woman was not hurt in the accident, but is hyperventilating as she sits in the waiting room at the hospital. She complains of feeling faint and has blurred vision. Which of the following is decreased in this woman?
A 32-year old women complains of amenorrhea since delivery of a baby 15 months previously, despite the fact that she did not breast feed her baby. The delivery was complicated by excessive hemorrhage that required transfusion of 2.5 liters of blood. She has also been fatigued and has gained an additional 10 pounds since the baby was born. Laboratory data show the following: Serum LH < 1 IU/L (normal, 4-24 IU/L) Serum estradiol 5 pg/mL (normal, 20 - 100 pg/mL) Serum TSH 0.1 mU/L (normal, 0.5 - 5 mU/L) Serum GH 3 ng/mL (normal, < 5 ng/mL) Serum ACTH 28 pg/mL (normal, 10 - 50 pg/mL) Serum prolactin 2 ng/mL (normal, <20 ng/mL) Injection of 500 mg of TRH failed to produce the expected rise in both serum TSH and prolactin. Which of the following diagnoses most likely explains the findings in this patient?
A 40-year-old, moderately obese man presents with a persistent productive cough. The cough has been present for several weeks, but recently the man noted that his sputum has assumed a greenish color. Further questioning elicits a history of productive cough, usually in the winter months, over the past several years. He has smoked two packs of cigarettes per day since he was 16 years old. On examination, the man is febrile (100° F), and coarse rhonchi and wheezes can be appreciated bilaterally. Which of the following is the most likely diagnosis?