A 37-year-old woman who was diagnosed with AIDS 3 years earlier is unable to work, is physically debilitated, and requests her physician to provide her with medications with which to take her own life. The most common emotional disorder that results in such requests by patients is
A 57-year-old man presents with a steady, severe pain in the right hypochondrium, nausea, vomiting, and a temperature of 102 F. He states that his signs and symptoms began shortly after eating his favorite pizza with extra cheese, pepperoni, and sausage. Laboratory examination reveals a white blood cell count of 13,400/mL and a serum bilirubin value of 2.8 mg/dL. If hepatobiliary imaging reveals an obstructed cystic duct, which of the following agents would be the drug of choice for the treatment of this patient's pain?
A pregnant woman presents at 22 weeks gestation for a routine prenatal visit. Physical examination demonstrates ankle edema and new onset hypertension. Urinalysis reveals marked proteinuria. Development of which of the following would justify a diagnosis of eclampsia?
A 4-year-old girl is discovered pulling the tail of the family dog. Her mother, who had warned her previously that this behavior was unacceptable, now assigns the girl to a 5 minute time out period . A timer is set up so that the girl can keep track of the time period. After two minutes of the period, the girl begins to scream and cry. At this point, the mother's best response would be to
A Guatemalan child with a history of meconium ileus is brought to a clinic because of a chronic cough. The mother notes a history of respiratory tract infections and bulky, foul-smelling stools. After assessment of the respiratory tract illness, the physician should also look for signs of
A 1-week-old, bottle-fed, low-birth-weight neonate develops severe abdominal pain with bloody diarrhea. Several hours later, the neonate undergoes emergency surgery. A portion of small intestine is resected , and pathologic examination demonstrates a perforation. Which of the following would most likely be seen on microscopic examination of the involved bowel?
A 68-year-old man presents to his physician with complaints of fatigue and a dragging sensation in his abdomen. Physical examination is remarkable for massive splenomegaly without lymphadenopathy. The patient's hematocrit is 30%, his platelet count is 80,000/mm3, and his leukocyte count is 2500/mm3. Bone marrow biopsy shows 'fried egg' cells expressing the pan B-cell markers CD19 and CD20, and the monocyte marker CD11c. Positive staining for which of the following substances would most likely verify the likely diagnosis?
A 22-year-old male military recruit complains of a headache and stiff neck. He is examined, blood is drawn, and a lumbar puncture performed. The glucose in the CSF is 100 mg/dL and the serum glucose is 120 mg/dL. The CSF shows 3 lymphocytes and 0 neutrophils/microliter. Which of the following conclusions concerning the interpretation of these findings is most accurate?
A newborn baby has a prominent defect at the base of his spine through which his meninges and spinal cord protrude. A failure of which of the following processes is the most common cause of this type of defect?
Which of the following is thought to be a major contributor to the cachexia often experienced by patients with advanced cancer?