A 61-year-old male is given acetazolamide to treat open-angle glaucoma. Upon diuresis, his urine is found to be highly alkaline. Which of the following accounts for the alkaline nature of this patient’s urine?
AInhibition of bicarbonate reabsorption in the proximal tubule
BInhibition of bicarbonate reabsorption in beta-intercalated cells
CInhibition of acid secretion in alpha-intercalated cells
DInhibition of chloride reabsorption in the distal convoluted tubule
EInhibition of chloride reabsorption in the thick ascending loop of Henle
A 22-year-old woman comes to the emergency department because of frontal throbbing headaches for 3 weeks. Yesterday, the patient had blurry vision in both eyes and a brief episode of double vision. She has been taking ibuprofen with only mild improvement of her symptoms. She has polycystic ovarian syndrome, type 2 diabetes mellitus, and facial acne. She has not had any trauma, weakness, or changes in sensation. Her current medications include metformin and vitamin A. She is 158 cm (5 ft 2 in) tall and weighs 89 kg (196 lbs); BMI is 36 kg/m2. Vital signs are within normal limits. Examination shows decreased peripheral vision. Fundoscopic examination of both eyes is shown. MRI of the brain shows an empty sella. Which of the following is the most appropriate next step in management?
AEmergent craniotomy
BCerebral shunt
CAlteplase therapy
DLumbar puncture
EAcetazolamide therapy
A 65-year-old patient presents with rapidly progressive dementia, myoclonus, and ataxia over 3 months. Laboratory studies, including serum vitamin B12 (cyanocobalamin), thyroxine (T4), and thyroid-stimulating hormone concentrations, are within normal limits. A lumbar puncture is performed. Cerebrospinal fluid (CSF) analysis is most likely to show which of the following?
AIncreased 14-3-3 protein concentration
BAntiganglioside GM1 antibodies
CAnti-glutamic acid decarboxylase antibodies
DIncreased α-synuclein protein concentration
EOligoclonal bands
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