Consider the steps the renin-angiotensin-aldosterone system [RAAS] goes through when there is a decrease in circulation or a drop in blood pressure, ordered from the earliest to the latest. What is the step directly after angiotensin I is produced?

A. A callus that forms on an ossicle:

No callus forms on the ossicles with cerumen impaction. Ossicle problems (like otosclerosis) involve bone remodeling, not wax.

B. Inflammation of the innermost part of the ear:

This describes labyrinthitis or inner ear infections, not cerumen impaction.

C. Blockage of the ear canal due to built-up ear wax:

Cerumen impaction is the accumulation of earwax blocking the external ear canal, leading to symptoms like hearing loss or fullness.

D. Accumulation of skin cells behind the tympanic membrane or within the mastoid bone:

This describes a cholesteatoma, not cerumen impaction.

A. Endometriosis:

Endometriosis causes chronic pelvic pain but doesn't typically present with purulent discharge, fever, or foul-smelling discharge.

B. Pelvic inflammatory disease (PID):

PID is an infection of the reproductive organs, often caused by untreated sexually transmitted infections. Symptoms like acute pelvic pain, fever, purulent vaginal discharge, and rebound pain are characteristic of PID.

C. Uterine leiomyomas:

Leiomyomas (fibroids) can cause pelvic pain but are not associated with infection, fever, or purulent discharge.

D. Polycystic ovary syndrome (PCOS):

PCOS does not cause acute infection-like symptoms (fever, purulent discharge) as seen in PID.