A 66-year old man with a 45-pack-year smoking history presents with abdominal pain and constipation. He reports that he has had a worsening cough for several months and has lost 20 pounds over this time period. You order a complete metabolic profile, which demonstrates hypercalcemia. A chest radiograph shows a centrally located mass suspicious for malignancy. Which of the following is the most likely explanation?
AMetastatic abdominal cancer
BCarcinoid tumor causing carcinoid syndrome
CSquamous cell carcinoma producing a peptide with hormonal activity
DSmall cell carcinoma producing a peptide with hormonal activity
ESquamous cell carcinoma producing parathyroid hormone
A 24-year-old man presents with a complaint of breathlessness while jogging. He says that he recently started marathon training. He does not have any family history of asthma nor has any allergies. He currently takes no medication. The blood pressure is 120/80 mm Hg, and the heart rate is 67/min. With each heartbeat, he experiences pounding in his chest, and his head bobs. On physical examination, he has long fingers, funnel chest, and disproportionate body proportions with a decreased upper-to-lower segment ratio. On auscultation over the 2nd right intercostal space, an early diastolic murmur is heard, and 3rd and 4th heart sounds are heard. Echocardiography shows aortic root dilatation. The patient is scheduled for surgery. Which of the following is associated with this patient's condition?
AKlinefelter syndrome
BIntravenous drug abuse
CMarfan's Syndrome
DKawasaki syndrome
EGonorrhea
A 2720-g (6-lb) female newborn is delivered at term to a 39-year-old woman, gravida 3, para 2. Examination in the delivery room shows micrognathia, prominent occiput with flattened nasal bridge, and pointy low-set ears. The eyes are upward slanting with small palpebral fissures. The fists are clenched with fingers tightly flexed. The index finger overlaps the third finger and the fifth finger overlaps the fourth. A 3/6 holosystolic murmur is heard at the lower left sternal border. The nipples are widely spaced and the feet have prominent heels and convex, rounded soles. Which of the following is the most likely cause of these findings?
ADeletion of Chromosome 5p
BTrisomy 13
CFetal alcohol syndrome
DTrisomy 18
ETrisomy 21
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