A 60-year-old rock musician presents to the office because he has been feeling increasingly tired for the past 6 months. He has a history of intravenous drug use and alcohol abuse. He states that he feels quite tired, but he otherwise has no complaints. Physical examination is noncontributory. His laboratory values are normal other than moderately elevated liver enzymes. Which of the following additional tests should you order first?
AHepatitis C virus antibodies
BHepatitis B surface antigen
CHepatitis E virus-specific IgM antibodies
DHepatitis D virus-specific IgG antibody
EHepatitis A virus-specific IgM antibodies
A 22-year-old man is brought to the emergency department by ambulance 1 hour after a motor vehicle accident. He did not require any circulatory resuscitation at the scene, but he was intubated because he was unresponsive. He has no history of serious illnesses. He is on mechanical ventilation with no sedation. His blood pressure is 121/62 mm Hg, the pulse is 68/min, and the temperature is 36.5°C (97.7°F). His Glasgow coma scale (GCS) is 3. Early laboratory studies show no abnormalities. A search of the state donor registry shows that he has registered as an organ donor. Which of the following is the most appropriate next step in evaluation?
AEvaluation of brainstem reflexes
BBrain MRI
CElectroencephalography
DCerebral angiography
EApnea test
A patient with HCC and a long history of alcohol dependence and chronic hepatitis C has been using the mTOR inhibitor sirolimus 100 mg for cancer treatment. Her cancer has shown a partial response. She also has a history of hypertension and poorly controlled type 2 diabetes mellitus complicated by diabetic retinopathy. Current medications include enalapril and insulin. She asks her oncologist and hepatologist if she could try everolimus for its purported survival benefit in treating HCC. Based on clinical considerations, which of the following statements is most accurate?
AThe patient should start everolimus 50 mg because of the survival benefit relative to sirolimus 100 mg
BThe patient is not a good candidate for everolimus due to her history of hypertension
CThe patient should start everolimus 100 mg because of the survival benefit relative to sirolimus 100 mg
DThe patient should start everolimus 50 mg because of her history of alcohol use disorder and hepatitis C
EThe patient is not a good candidate for everolimus due to her history of diabetes
+ 7 more in the PDF
Browse all chapters