4.4 of 5 Ratings
A 42-year-old man presents to his physician with dark urine and intermittent flank pain. He has no significant past medical history and generally is healthy. His temperature is 97.5°F (36.4°C), blood pressure is 182/112 mmHg, pulse is 85/min, respirations are 15/min, and oxygen saturation is 98% on room air. Physical examination is significant for bilateral palpable flank masses and discomfort to percussion of the costovertebral angle. Urinalysis is positive for red blood cells without any bacteria or nitrites. Which of the following diagnostic modalities should be used to screen members of this patient's family to assess if they are affected by the same condition?
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A 39-year-old male is rushed to the emergency department after he developed a sudden-onset severe headache with ensuing nausea, vomiting, vision changes, and loss of consciousness. Past medical history is unattainable. He reports that the headache is worse than any he has experienced before. Noncontrast CT of the head is significant for an intracranial hemorrhage. Follow-up cerebral angiography is performed and shows a ruptured anterior communicating artery aneurysm. Which of the following has the strongest association with this patient's current presentation?
History of multiple hemangioblastomas of the retina and spine as well as pheochromocytoma
Brain MRI showing a butterfly glioma with a central necrotic core
Abdominal CT suggestive of renal cell carcinoma
Kidney ultrasound showing numerous bilateral renal cysts
History of renal transplantation at 8 years of age
A 32-year-old woman presents to her primary care doctor with a chief complaint of dark urine. She has noticed that her urine has appeared darker over the past several weeks. She otherwise states she is healthy, does yoga regularly, and is a vegetarian. Her temperature is 98.1°F (36.7°C), blood pressure is 172/103 mmHg, pulse is 83/min, respirations are 15/min, and oxygen saturation is 98% on room air. Physical exam is notable for bilateral nontender flank masses. Laboratory studies are ordered as seen below.Serum:Na+: 139 mEq/LCl-: 100 mEq/LK+: 5.5 mEq/LHCO3-: 25 mEq/LBUN: 47 mg/dLGlucose: 91 mg/dLCreatinine: 3.1 mg/dLUrinalysis:Color: DarkRed blood cells: PositiveBacteria: AbsentLeukocytes: AbsentNitrites: NegativeA computed tomography (CT) scan is performed as seen in Figure A. Which of the following could be found in this patient?
Ventricular septal defect
Fixed splitting of S2
Hepatic vein thrombosis
Preceding dermatologic infection