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CT imaging of the pelvis performed on a 29-year-old African-American woman with dysmenorrhea reveals uterine masses similar to those seen in the image. Biopsy shows a
whorled pattern of smooth muscle. These masses are most commonly associated with which of the following conditions?

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A homeless man who is an alcoholic is brought to the emergency department after being found unconscious by the side of the road.Films taken on arrival show some old trauma to the jaw. X-ray of the chest and CT of the chest reveal a mass lesion in the right lower lobe with spiculation, which appears to extend into the pleural space and involve an adjacent rib. A biopsy specimen of the mass-like lesion is shown in the image. Histologic specimens of bronchial lavage fl uid after biopsy contain numerous hyphae but no malignant cells. What should be included in the treatment regimen for this man’s condition?

Explanation:-
This man likely has
actinomycosis from infection with Actinomycesisraelii,a gram-positive anaerobic
bacterium with a branching filamentous appearance.The
image shows what is known as a “sulfur granule” formed by a colony of Actinomyces fila-ments solidifi ed with tissue exudates.The bacteria are generally normal inhabitants of the oral cavity and are found in dental caries. Poor
oral hygiene coupled with trauma increases
the risk of aspiration of the organism leading to
infection. Infections with Actinomyces tend to
be chronic and extend through multiple tissue planes. Actinomyces species appear to be susceptible to a wide range of β-lactam agents,
which are regarded as agents of fi rst choice in
treatment.

A 42-year-old woman comes to the physician with severe itching for the past 4 days. Her physical examination is signifi cant for hepatomegaly and three xanthomas on her right lower extremity. Laboratory studies reveal a normal total bilirubin level and elevated serum cholesterol and alkaline phosphatase levels. A liver biopsy shows granulomatous destruction of medium-sized intrahepatic bile ducts.Which of the followingautoantibodies is most likely to be significantly elevated in thispatient?

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A 4-year-old girl is brought to the emergency department with abdominal pain after eating 10-15 sugar-coated iron tablets. Soon after arriving
she begins to vomit,and the emesis has blood in it.
Physical examination shows hypotension and tachycardia.

Which of the following is the
best treatment for this patient’s elevated blood iron
levels?

This image depicts the
administration of drug X, which produces an increase in
systolic,diastolic, and mean arterial pressure. Drug Y is
then added, resulting in little or no change to the blood pressure. Drug X is then readministered, causing a net decrease in blood pressure.
Which of the following drug combinations are drug X and drug Y, respectively?