A 19-year-old man presents to the emergency department after a motor vehicle accident. The patient reports left shoulder pain that worsens with deep inspiration. Medical history is significant for a recent diagnosis of infectious mononucleosis. His temperature is 99°F (37.2°C), blood pressure is 80/55 mmHg, pulse is 115/min, and respiratory rate is 22/min. On physical exam, there is abdominal guarding, abdominal tenderness in the left upper quadrant, and rebound tenderness. The patient’s mucous membranes are dry and skin turgor is reduced. Which of the following most likely represents the acute changes in renal plasma flow (RPF) and glomerular filtration rate (GFR) in this patient?
ANo change in RPF and decreased GFR
BDecreased RPF and decreased GFR
CNo change in RPF and increased GFR
DDecreased RPF and no change in GFR
ENo change in RPF and GFR
A 20-year-old man is brought to the emergency room for evaluation of a back injury sustained while at work. A CT scan of the lumbar spine shows an incidental 2-cm mass adjacent to the inferior vena cava. Histologic examination of a biopsy specimen of the mass shows clusters of chromaffin cells. This mass is most likely to secrete which of the following substances?
AAldosterone
BDehydroepiandrosterone
CNorepinephrine
DCortisol
EEstrogen
A 45-year-old female is undergoing renal transplantation for management of chronic renal failure secondary to glomerulonephritis. The transplant surgeon placed the donor kidney in the recipient and anastomosed the donor renal artery to the recipient's external iliac artery as well as the donor ureter to the recipient's bladder. After removing the clamps on the external iliac artery, the recipient's blood is allowed to perfuse the transplanted kidney. Within 3 minutes, the surgeon notes that the kidney does not appear to be sufficiently perfused. Upon further investigation, an inflammatory reaction is noted that led to clotting off of the donor renal artery, preventing blood flow to the transplanted organ. Which of the following best describes the pathophysiology of this complication?
AType III hypersensitivity reaction
BType IV hypersensitivity reaction
CGraft-versus-host disease
DType I hypersensitivity reaction
EHyperacute rejection
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