A newborn male infant was delivered at 40 weeks gestation weighing 7.4 lbs. The mother was noted to have polyhydramnios. The infant was noted to have excessive drooling, and he immediately regurgitated milk upon breastfeeding. Further evaluation of this infant is most likely to show what findings?

A 68-year-old man with chronic obstructive pulmonary disease (COPD) is enrolled in a study evaluating physiologic changes in people with chronic lung disease. He was diagnosed with COPD approximately 11 years earlier and has been managed with inhaled corticosteroids, inhaled cholinergics, and home oxygen therapy. He has been relatively nonadherent to his oxygen therapy because he feels that the nasal cannula is uncomfortable. During a laboratory evaluation, he is found to have markedly elevated levels of 2,3-diphosphoglycerate (2,3-DPG). This substance affects the affinity of hemoglobin for oxygen by which of the following mechanisms?

A newborn boy is found to have an increased hemoglobin concentration on the first day of life. His white blood cell and platelet counts are normal. No splenomegaly is detected on physical examination. The mother has a history of polycythemia and says several family members have been told that they have "thick blood.” Genetic testing of the newborn shows a mutation in the hemoglobin gene.

Referring to the graph provided in the image, which of the following best explains the newborn's oxygen-hemoglobin dissociation curve (B) compared with the standard oxygen-hemoglobin curve (A)?

A 55 y/o Asian male presented to the ED with gradually worsening shortness of breath, chest pain, and a cough productive of bloody sputum. Chest X-ray showed no evidence of pleural effusion, but was remarkable for a large, poorly-defined mass in right superior lobe. Further workup revealed nodal involvement and metastasis to the liver. When added to platinum-based chemotherapy, which of the following would provide added benefit in the treatment of this patient? (select all that apply)

A 72 y/o Caucasian woman presents to the ED with difficulty breathing and severe itching on her arms and torso bilaterally. She is unable to speak due to dyspnea and tongue swelling. The daughter states her mother was recently diagnosed with lung cancer and started on chemo. Which agent is most likely to have caused this patient’s reaction?

A 64-year-old woman with a medical history of heart failure with reduced ejection fraction presents with new-onset shortness of breath. On exam, she appears to be in no distress and is able to speak in full sentences. She has bilateral 2+ pitting edema and venous stasis changes. An x-ray is ordered to evaluate her shortness of breath further. Interpretation of the film is suggestive of pleural effusion. By which mechanism did this patient’s pleural effusion most likely develop?

Twenty-five minutes after the placement of a central line in the right internal jugular vein, a patient in the intensive care unit begins to experience shortness of breath. The central line was being placed for dialysis access, and the patient has no pulmonary history. On exam, there are bilateral breath sounds, and there is no hyperresonance on percussion. Concerned, the resident orders a chest radiograph. The image shows a small, apical pneumothorax. The pulse and blood pressure were the same before and after the procedure. What is the most appropriate next step in the management of this patient?

A 50 yo male, was returning to the clinic for a follow up. Based on a histological report, a medical student misdiagnosed the patient with Idiopathic pulmonary fibrosis, because he saw thickened-appearing alveolar septum. The physician was extremely angry and exclaimed: “You would have had a better chance of getting the right diagnosis if I told you it is a lung neoplasia, and told you to guess which one he most likely has!”. Which of the following were also likely true? (select all that apply)

Which of the following are positive for neuroendocrine biomarkers (select all that apply)?

An oncology sees a patient diagnosed with glottic laryngeal carcinoma. Which of the following are true (select all that apply)

A 26-year-old medical student presents to the ED in moderate respiratory distress after spending all night in the anatomy lab; he is breathing 30 times/min while on 2L O₂ through a nasal canula.

ABGs:

PaCO₂ is 28 mmHg

PaO₂ is 52 mmHg

pH is 7.46

CO₂ (bicarb) is 9 mM

What is her acid-base disorder?

Jerry is evaluated for dyspnea on Machu Picchu in Peru after excitedly arriving to pet the alpacas. He arrived one day prior, and this is his first trip to a high-altitude location. Arterial blood gas shows a PaO2 of 60 mmHg and a PaCO2 of 30 mmHg. Which of the following is true of Jerry?

Central chemoreceptors become less responsive with chronically elevated Pco2 (eg, COPD). A COPD patient is therefore more dependent upon peripheral chemoreceptors detecting _____ to drive respiration.

You would expect a chronic COPD patient to compensate for a respiratory acidosis by renal reabsorption of bicarbonate. The mechanism that helps compensate for high-altitude sickness is: