A 72-year-old man with a history of angina pectoris presents with substernal chest pain. Laboratory studies reveal elevated serum levels cardiac troponin-l. ECG confirms a myocardial infarction of the left ventricular wall, Which of the following plasma- derived proteins is chiefly responsible for regulating coronary thrombosis in this patient?

A neonate is rushed to the hospital in acute respiratory distress and expires. The lungs are examined at autopsy (shown). This pulmonary condition is termed:

A 39-year-old man with AIDS is admitted to the hospital with a 3-week history of chest pain and shortness of breath. An x-ray film of the chest shows bilateral nodularities of the lungs. A CT-guided lung biopsy reveals granulomatous inflammation with scattered multinucleated giant cells. Giant cells in these pulmonary lesions are derived from which of the following inflammatory cells?

A 5-year-old girl had a sudden attack of suffocating cough accompanied by wheezing. There was no fever but the child appeared anxious and in distress. What is the most likely diagnosis?

A 36-year-old man with AIDS presents with fever, dry cough, and dyspnea. A chest x-ray shows bilateral and diffuse infiltrates. Laboratory studies reveal a low CD4+ cell count. A lung biopsy discloses a chronic interstitial pneumonitis and an intra-alveolar foamy exudate. A silver stain of a bronchoalveolar lavage is shown. Which of the following organisms is the most likely responsible for these pulmonary findings?

A 32-year-old woman who weighs 125 kg (275 lb) is in the hospital for open reduction and internal fixation of a fractured ankle. She states that the only medication she is taking is an oral contraceptive. Four days after the surgery, she suddenly complains of chest pain and is noted to have difficulty breathing. Pulse oximetry reveals an arterial pO2 of 75%. She becomes unresponsive. During resuscitation, she is noted to have pulseless electrical activity. Despite aggressive efforts, she dies. An autopsy is most likely to reveal which of the following conditions?

A 92-year-old woman is brought unconscious to the emergency room from a nursing home. Her blood pressure is 70/30 mm Hg. She is febrile (102°F) and breathing rapidly (tachypneic). Laboratory studies demonstrate an elevated white blood cell count with 92% segmented neutrophils. Urinalysis reveals gram-negative organisms. Which of the following types of shock most likely accounts for this patient's signs and symptoms?

A 72-year-old woman complains of shortness of breath on exertion. She states that she also becomes short of breath at night unless she uses three pillows to prop herself up (orthopnea). Physical examination reveals mild obesity, bilateral pitting leg edema, an enlarged liver, and fine crackling sounds on inspiration (rales). A chest x-ray shows cardiomegaly. What is the most likely cause of orthopnea in this patient?

An adult who has never smoked or been around cigarette smoke is unlikely to have which of the following diseases?

A 48-year-old man with a history of heavy smoking presents with a 3-year history of persistent cough and frequent upper respiratory infections, associated with sputum production. Analysis of arterial blood gases reveals hypoxia and CO2 retention. Which of the following is the appropriate diagnosis?

A 62-year-old woman suffers internal Injuries in an automobile accident and appears to be in a state of shock. Two days later, the patient develops rapidly progressive respiratory distress and a pattern of “’interstitial pneumonia” on chest x-ray (shock lung). Which of the following pathologic findings could be expected in the lungs of this patient with diffuse alveolar carriage?