A 27-year-old woman comes to the physician because of multiple nontender, pruritic lesions over her face, arms, chest, and abdomen. She first noticed the lesions over her lower abdomen 5 weeks ago and says that they have since become more diffuse. She also has had fatigue and has had weight loss of 6.8 kg (15 lb) during the past 3 months. The patient has not seen a physician during the past 9 years. She has no history of serious illness and takes no medications. Her father was diagnosed with colorectal cancer at the age of 65 years. The patient drinks one to two glasses of wine with dinner nightly and smokes marijuana two to three times weekly. She has had six male sexual partners during the past 3 years and does not use condoms regularly. Her vital signs are within normal limits. Dermatologic examination shows greater than 100 flesh-colored, dome-shaped papules over the face, upper extremities, thorax, lower abdomen, and genital regions. The lesions are nontender and have areas of central umbilication. A photograph is shown.The remainder of the physical examination shows no abnormalities. Testing for which of the following conditions is the most appropriate next diagnostic step for this patient?A. Diabetes mellitusB. Epstein barr virus infectionC. Gastric cancerD. Human herpes virus 8 infectionE. HIV infection

Mr. Santos, a 35-year-old Male, Presents to the Community Health Clinic with Complaints of Rectal Pain, Discharge and Blood in His Stool. He Reports Engaging in Unprotected Anal Intercourse with Multiple Partners. Upon Assessment, the Nurse Notes Redness and Inflammation of the Rectal MucosaWhat is the most likely diagnosis for Mr. Santos11 of 100ARectal CancerBAnal fissureCProctitisDHemorrhoids

A 45-year-old Caucasian man is referred for further workup of chronic abdominal pain and diarrhea. These symptoms have been present for 2 months, and he has lost 10 kg of weight over this time. He also reports that he has developed pain in multiple joints that comes and goes and seems to spread from one joint to the next. He denies fevers, chills, chest pain, shortness of breath, vomiting, episodes of constipation, or hematochezia. He is married and works as a farmer, with no recent sick contacts or travel. His vitals are within normal limits, and his examination is unremarkable. A complete laboratory workup is unremarkable. He undergoes a colonoscopy, which is normal, and then undergoes an upper endoscopy. Biopsy of the small intestine shows many macrophages within the lamina propria that stain positive with periodic acid-Schiff (PAS). Which of the following is likely to cure this patient of his chronic diarrhea?Ask StudybuddyGroup of answer choicesCorticosteroidsAntibioticsRadioiodineDietary changesAntiretrovirals

A 62-year-old man presents with a 3-month history of weakness, fatigue, and weight loss. He also reports a burning epigastric pain. The patient has an insignificant past medical history and smokes 2 packs of cigarettes per day. He drinks 4 to 5 beers per day as well. Work-up is initiated and the patient is found to have a positive fecal occult blood test. Esophagogastroduodenoscopy is performed and demonstrates a fundal ulcer. Biopsy is performed and is positive for adenocarcinoma. Which of the following is the best next step in management of this patient?

A 22-year-old man presents with bloody and tarry stools for the last month. The patient denies any associated symptoms and reports that he does not know his family history since he is adopted. Fecal occult blood test is positive and the patient has a hemoglobin level of 8.9 g/dL. Colonoscopy is performed and hundreds of colonic polyps are appreciated. Biopsy confirms that they are adenomatous polyps. What is the best next step in management for this patient's condition?Ask StudybuddyGroup of answer choicesRepeat colonoscopy and biopsy in 1 yearElective proctocolectomyMonthly FOBT and CEA levelsReassurance as the polyps are benign

A 68-year-old male with a history of lung cancer undergoes follow-up labs after recent cycle of chemotherapy. He has mild difficulty with concentration over the past week but is otherwise able to complete all of his daily tasks. He reports no nausea, vomiting, or positional lightheadedness. He has no other significant past medical history. He takes no medications. Vital signs are as follows: Temperature 99.8°F, RR 18, BP 135/88 mm Hg, pulse 76. On examination, he is alert and oriented. Cardiac examination reveals regular rate and rhythm, no murmurs, JVP not elevated. Lung and abdominal examinations are normal. There is no lower extremity edema. Skin turgor is normal. Neurologic examination reveals 5/5 strength in all extremities, no focal deficits, and normal gait. Laboratory tests reveal the following: serum Na+ 121 mEq/L, K+ 4.3 mEq/L, BUN 7.0 mg/dL, Cr 0.4 mg/dL, glucose 106 mg/dL. TSH 2.0 mU/L. Serum osmolality 250 mOsm/kg, urine Na 45 mEq/L, urine osmolality 450 mOsm/kg. What is the most appropriate management of this patient?