A 21-year-old man presents with eye redness, itching, and watering; nasal congestion, and rhinorrhea. He reports that these symptoms have been occurring every year in the late spring since he was 18 years old. The patient’s medical history is significant for endoscopic resection of a right maxillary sinus polyp at the age of 16. His father and younger sister have bronchial asthma. He takes oxymetazoline as needed to decrease nasal congestion. The patient’s blood pressure is 120/80 mm Hg, heart rate is 71/min, respiratory rate is 18/min, and temperature is 36.7°C (98.0°F). On physical examination, there is conjunctival injection and clear nasal discharge bilaterally. His lymph nodes are not enlarged and his sinuses do not cause pain upon palpation. Heart and lung sounds are normal. Which of the following is most likely to be a part of his condition’s pathogenesis?
ASecretion of granzymes and perforin by cytotoxic T lymphocytes
BExcessive release of histamine by the mast cells
CProduction of specific IgM antibodies by B lymphocytes
DRelease of reactive oxygen species by neutrophils
EIL-2 secretion by Th1 lymphocytes
A 60-year-old woman presents to the emergency department due to progressive shortness of breath and a dry cough for the past week. She notes that her symptoms are exacerbated by physical activity and relieved by rest. The woman was diagnosed with chronic kidney disease 2 years ago and was recently started on regular dialysis treatment. Her pulse rate is 105/min, blood pressure is 110/70 mm Hg, respiratory rate is 30/min, and temperature is 37.8°C (100.0°F). On examination of the respiratory system, there is dullness on percussion, decreased vocal tactile fremitus, and decreased breath sounds over the right lung base. The rest of the physical exam is within normal limits. Which of the following is the most likely cause of this patient’s symptoms?
APrimary spontaneous pneumothorax (PSP)
BPleural effusion
CAcute bronchitis
DPneumonia
EPulmonary tuberculosis (TB)
A 28-year-old man makes an appointment with his general practitioner for a regular check-up. He has recently been diagnosed with asthma and was given a short-acting β2-agonist to use during acute exacerbations. He said he usually uses the medication 1–2 times per week. Which of the following is the most appropriate treatment in this case?
AHe should start using a short-acting β2-agonist every day, not just when he has symptoms.
BLong-acting β2-agonists should be added to his treatment regimen.
CInhaled corticosteroids should be added as controller therapy.
DSystemic corticosteroids should be added to his treatment regimen.
EHe should continue with current treatment.
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