7-1. A 55-year-old man who is extremely obese reports weakness, sweating, tachycardia, confusion, and headache whenever he fasts for more than a few hours. He has prompt relief of symptoms when he eats. These symptoms are most suggestive of which of the following disorders?

a. Diabetes mellitus b. Insulinoma c. Zollinger-Ellison syndrome d. Carcinoid syndrome e. Multiple endocrine neoplasia, type 2

7-2. An 18-year-old woman develops urticaria and wheezing after an injection of penicillin. Her blood pressure is 120/60 mm Hg, her heart rate is 155 beats/min, and her respiratory rate is 30 breaths/min. Immediate therapy should include a. Intubation b. Epinephrine c. Beta blockers d. Iodine e. Fluid challenge

7-3. A 64-year-old woman is found to have a left-sided pleural effusion on chest x-ray. Analysis of the pleural fluid reveals a ratio of concentration of total protein in pleural fluid to serum of 0.38, a lactate dehydrogenase (LDH) level of 125 IU, and a ratio of LDH concentration in pleural fluid to serum of 0.46. Which of the following disorders is most likely in this patient?

a. Uremia b. Congestive heart failure c. Pulmonary embolism d. Sarcoidosis e. Systemic lupus erythematosus

7-4. A 60-year-old man complains of pain in both knees gradually worsening over the past 2 years. The pain is relieved by rest and worsened by movement. There is bony enlargement of the knees with mild inflammation. Crepitation is noted on motion of the knee joint. The only other finding is bony enlargement at the distal interpha-langeal joint. The patient is 5 ft, 9 in. tall and weighs 190 lbs. The best way to prevent disease progression is a. Weight reduction b. Calcium supplementation c. Total knee replacement d. Aspirin e. Prednisone orally

7-5. A 13-year-old girl grunts and clears her throat several times an hour, and her conversation is often interrupted by random shouting. She also performs idiosyncratic, complex motor activities such as turning her head to the right while she shuts her eyes and opens her mouth. She can prevent these movements for brief periods of time, with effort. The most appropriate treatment for this disorder is a. Individual psychodynamic-oriented psychotherapy b. Lorazepam c. Methylphenidate d. Haloperidol e. Imipramine

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