Around three weeks after razing an old chicken house, a 71 year-old retired farmer has developed a fever, nausea and vomiting. After ruling out more common health problems, his care provider eventually made a diagnosis of histoplasmosis. Which physiological process is most likely taking place?

Antibody production against the offending fungi is delayed by the patient's age and the virulence of the organism

Macrophages are able to remove the offending fungi from the bloodstream but can't destroy them

Spore inhalation initiates an autoimmune response that produces the associated symptoms

Toxin production by Histoplasma capsulatum is triggering an immune response

Answer and Explanation

The Correct Answer is A

A. Antibody production against the offending fungi is delayed by the patient's age and the virulence of the organism: In older adults, the immune response may be slower or less effective due to age-related changes in the immune system. The virulence of Histoplasma capsulatum can also contribute to the severity of the infection, making it more difficult for the immune system to mount an effective response quickly, which explains the symptoms of fever, nausea, and vomiting.

B. Macrophages are able to remove the offending fungi from the bloodstream but can't destroy them: While macrophages play a crucial role in the immune response to fungi, in the case of histoplasmosis, they often engulf the fungi but may struggle to completely eradicate them, especially in immunocompromised individuals or the elderly. However, this option does not fully explain the delayed symptoms associated with the patient's age and the organism's virulence.

C. Spore inhalation initiates an autoimmune response that produces the associated symptoms: Histoplasmosis is caused by inhaling spores of Histoplasma capsulatum, but the symptoms are not the result of an autoimmune response. Instead, the immune system's attempt to combat the infection leads to the clinical manifestations, not an autoimmune process.

D. Toxin production by Histoplasma capsulatum is triggering an immune response: Histoplasma capsulatum does not produce toxins that directly trigger an immune response. Instead, the immune response is primarily due to the presence of the fungi themselves and the inflammatory response they provoke, which leads to the associated symptoms of the infection.

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Correct Answer is C

Explanation

A. Triglycerides: Elevated triglyceride levels are associated with an increased risk of atherosclerosis and cardiovascular disease. High triglycerides can contribute to the buildup of plaque in the arteries, leading to a higher risk of heart disease and complications such as heart attacks or strokes.

B. Very low density lipoproteins (VLDLs): Elevated VLDL levels are considered harmful and are linked to a higher risk of atherosclerosis. VLDLs contribute to the accumulation of triglycerides and promote the development of plaque in the arteries, which can significantly increase cardiovascular risk over time.

C. High density lipoproteins (HDLs): Elevated HDL levels are considered protective against the development of atherosclerosis. HDLs help transport cholesterol away from the arteries and back to the liver for excretion, which not only reduces the risk of plaque buildup but also lowers the likelihood of heart disease and enhances overall cardiovascular health.

D. Low density lipoproteins (LDLs): Elevated LDL levels are known to be a major risk factor for atherosclerosis. LDL cholesterol can contribute to the formation of plaques in the arteries, increasing the risk of heart disease and stroke, and it is important to manage LDL levels for better cardiovascular health.

A. Pulse oximetry 98% B. Diminished breath sounds over painful chest area C. Respiratory rate 34 D. ABG pH level of 7.38 E. Asymmetrical chest movements, especially on inspiration

Correct Answer is ["B","C","E"]

Explanation

A. Pulse oximetry 98%: A pulse oximetry reading of 98% indicates adequate oxygen saturation, which does not strongly suggest a pneumothorax. Patients with a pneumothorax may have lower oxygen saturation levels, but this reading alone is not indicative of the condition.

B. Diminished breath sounds over painful chest area: Diminished breath sounds are a significant clinical manifestation of pneumothorax, as air in the pleural space prevents normal lung expansion and decreases airflow to the affected side.

C. Respiratory rate 34: An elevated respiratory rate (tachypnea) is often observed in patients with pneumothorax as they may struggle to breathe effectively. This clinical manifestation indicates respiratory distress and is consistent with the condition.

D. ABG pH level of 7.38: A pH level of 7.38 indicates acidosis, which may occur in cases of pneumothorax due to impaired gas exchange and respiratory distress. This abnormal finding on arterial blood gases supports the suspicion of pneumothorax.

E. Asymmetrical chest movements, especially on inspiration: Asymmetrical chest movements are a classic sign of pneumothorax, where the affected lung does not expand as fully as the unaffected lung during inspiration, leading to visible differences in chest wall movement.

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Around three weeks after razing an old chicken house, a 71 year-old retired farmer has developed a fever, nausea and vomiting. After ruling out more common health problems, his care provider eventually made a diagnosis of histoplasmosis. Which physiological process is most likely taking place?

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Which elevated value may be protective of the development of atherosclerosis?

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Correct Answer is ["B","C","E"]

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