09-16-2015, 04:45 PM
NBME 3
A 68 y/o woman with metastatic small cell carcinoma of the lung is brought to the emergency department after collapsing. On arrival, she is pale, sweating, and lethargic. Her temperature is 37.2°C (99°F), pulse is 130/min and weak, respirations are 25/min, and blood pressure is 90/60 mm Hg. Breath sounds are decreased bilaterally. An x-ray of the chest shows a tumor mass in the hilar area and an additional radiodensity in the left lower lobe of the lung. She dies within a few hours despite supportive care and antimicrobial therapy. Cultures of blood collected at the time of admission grow Klebsiella pneumoniae. Which of the following is the most likely mediator released from macrophages that initiated the process that led to her death?
A. Alpha-1-Antitrypsin
B. Complement C3b
C. C-reactive protein
D. Factor XII (Hageman factor)
E. Interferon-gamma
F. Interleukin-8 (IL-8)
G. Platelet-activating factor
H. Tumor necrosis factor
I. Interferon-alpha
A 68 y/o woman with metastatic small cell carcinoma of the lung is brought to the emergency department after collapsing. On arrival, she is pale, sweating, and lethargic. Her temperature is 37.2°C (99°F), pulse is 130/min and weak, respirations are 25/min, and blood pressure is 90/60 mm Hg. Breath sounds are decreased bilaterally. An x-ray of the chest shows a tumor mass in the hilar area and an additional radiodensity in the left lower lobe of the lung. She dies within a few hours despite supportive care and antimicrobial therapy. Cultures of blood collected at the time of admission grow Klebsiella pneumoniae. Which of the following is the most likely mediator released from macrophages that initiated the process that led to her death?
A. Alpha-1-Antitrypsin
B. Complement C3b
C. C-reactive protein
D. Factor XII (Hageman factor)
E. Interferon-gamma
F. Interleukin-8 (IL-8)
G. Platelet-activating factor
H. Tumor necrosis factor
I. Interferon-alpha
