A 74-year-old male with PMH significant for coronary artery bypass surgery (6 years ago), history of alcohol abuse and remote history of cigarette use. Patient reports that he quit smoking approximately 50 years ago. Patient presents to your office, complaining of abdominal and ankle swelling, decreased energy, and poor appetite for the past 2 months. He says that he was previously in excellent health and walked 3 miles per day. Now he is too weak and tired to even care for his own yard. The patient is a fragile-appearing elderly man with temporal wasting. There is no jugular venous distention (JVD). The lungs are clear to auscultation. The heart sounds are regular, with no murmurs or gallops. The abdomen is protuberant with bulging flanks. Shifting dullness is present. There is 2+ ankle edema bilaterally and scattered telangiectasias on skin exam. He has no asterixis. Paracentesis is performed and ascites fluid analysis reveals serum-ascites albumin gradient (SAAG) = 1.4. Which of the following statements about this patient’s SAAG result is correct?
A 43-year-old female presents with a 6-month history of vagu…
A 43-year-old female presents with a 6-month history of vague right upper quadrant discomfort. The patient denies any relation of pain to meals and describes it as a dull constant discomfort. The patient was diagnosed with type 2 diabetes mellitus 1 year ago, which is controlled with diet. She does not smoke but admits to drinking a glass of wine less than 3 times per month. She denies any medications except for over-the-counter acetaminophen, which she takes occasionally for joint pains. She does not have any family history of chronic liver disease. There is no history of blood transfusions in the past. On physical examination, the patient is obese with a BMI of 31; BP 140/90 mm Hg. The liver is palpable 3 cm below the right costal margin and is slightly tender. No other signs of chronic liver disease are evident. Pertinent laboratory test results include: serum AST 64 U/L ↑, serum ALT 70 U/L ↑, serum AST/ALT < 1, serum Alk phos 112 U/L, serum total bilirubin 1.0 mg/dL, serum albumin 3.6 g/dL, serum ferritin 48 ng/ml, serum iron 100 ug/dL, and negative Hepatitis A, B, and C serology. Based on this information, which of the following conditions is the most likely cause of this patient’s liver disease?
The accompanying image is showing the otic ganglion at the t…
The accompanying image is showing the otic ganglion at the tip of the arrow. Which cranial nerve provides preganglionic parasympathetic fibers that will synapse in this ganglion?
Which of the following statements is TRUE of the pelvic spla…
Which of the following statements is TRUE of the pelvic splanchnic nerves?
The accompanying image is showing the pterygopalatine gangli…
The accompanying image is showing the pterygopalatine ganglion at the tip of the probe. Which cranial nerve provides preganglionic parasympathetic fibers that will synapse in this ganglion?
Which of the following statements is TRUE of sympathetic eff…
Which of the following statements is TRUE of sympathetic efferent pathways?
The accompanying image is showing the submandibular ganglion…
The accompanying image is showing the submandibular ganglion at the tip of the arrow. Which cranial nerve provides preganglionic parasympathetic fibers that will synapse in this ganglion?
Which of the following statements regarding the paravertebra…
Which of the following statements regarding the paravertebral ganglia is TRUE?
The enteric nervous system in the gastrointestinal tract is…
The enteric nervous system in the gastrointestinal tract is responsible for all of the following, EXCEPT:
Which of the following statements regarding ventilation and…
Which of the following statements regarding ventilation and metabolic demands is CORRECT during 2 minutes of exercise