A previously healthy 46-year-old woman comes to her physician because of an itchy rash on her legs. She denies any recent trauma, insect bites, or travel. Her vital signs are within normal limits. Examination of the oral cavity shows white lace-like lines on the buccal mucosa. A photograph of the rash is shown. A biopsy specimen of the skin lesion is most likely to show which of the following?
AInflammation of subcutaneous adipose tissue
BProliferation of vascular endothelium
CLymphocytes at the dermoepidermal junction
DDecreased thickness of the stratum granulosum
EDeposition of antibodies around epidermal cells
A 55-year-old man is brought to the emergency room by his roommate due to an abdominal pain that started 2 hours ago. His pain is dull, aching, and radiates to the back. He admits to binge drinking alcohol for the past 2 days. Past medical history is significant for multiple admissions to the hospital for similar abdominal pain events, hypertension, and hyperlipidemia. He takes chlorthalidone and atorvastatin. He admits to heavy alcohol consumption over the past 10 years. He has smoked a pack of cigarettes a day for the last 20 years. In the emergency department, his temperature is 38.9℃ (102.0℉), pulse rate is 100/min, and respiratory rate is 28/min. On physical examination, he looks generally unwell and diaphoretic. Auscultation of his heart and lungs reveals an elevated heart rate with a regular rhythm. His lungs are clear to auscultation bilaterally. His abdomen is tympanitic with generalized tenderness. Evaluation of lab values reveals a leukocyte count of 28,000/mm3 with 89% of neutrophils. His amylase level is 255 U/L. A CT scan of the abdomen shows the diffuse enlargement of the pancreas. Which pathological process is most likely occurring in this patient’s peripancreatic tissue?
AFat necrosis
BCaseous necrosis
CFibrinoid necrosis
DCoagulative necrosis
ELiquefactive necrosis
A 50-year-old Caucasian man is admitted to the ER with an 8-hour history of intense abdominal pain that radiates to the back, nausea, and multiple episodes of vomiting. Past medical history is insignificant. His blood pressure is 90/60 mm Hg, pulse is 120/min, respirations are 20/min, and body temperature is 37.8°C (100°F). Upon examination, he has significant epigastric tenderness, and hypoactive bowel sounds. Serum lipase and amylase are elevated and the patient rapidly deteriorates, requiring transfer to the intensive care unit for a month. After being stabilized, he is transferred to the general medicine floor with an abdominal computed tomography (CT) reporting a well-circumscribed collection of fluid of homogeneous density. Which of the following best describes the condition this patient has developed?
AAcute necrotic collection
BFistula formation
CWalled-off necrosis
DPancreatic pseudocyst
EPancreatic cancer
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