83. A 25-year-old woman comes to the physician because of a 2-week history of left flank pain. She has had progressive weakness and decreased appetite during this period. Her temperature is 38°C (100.4°F). Physical examination shows left flank tenderness. Laboratory studies show a leukocyte count of 18,500/mm³. Urinalysis shows numerous RBCs and WBCs. A CT scan of the abdomen confirms an abscess of the lower pole of the left kidney. Which of the following is most likely preventing the spread of the infection to the surrounding organs? A) Fatty layer (Camper fascia) of the abdominal tela subcutanea B) Greater omentum C) Membranous layer (Scarpa fascia) of the abdominal tela subcutanea D) Pararenal fascia E) Perirenal (Gerota) fascia

Mr. Jonas is admitted to the hospital for fever of unknown origin. He is a 55-year-old patient who has been receiving outpatient dialysis for the last 6 months. He is no longer able to work at the construction job he had for the past 30 years. His wife has recently gone to work part time as a teacher’s aide. Mr. Jonas receives dialysis three times a week and must have someone provide transportation to and from the dialysis center. This is a constant worry for him because his wife has gone back to work. His neighbor takes him to and from the dialysis center and seems happy to have something to do. Mr. Jonas has difficulty hearing but does not consistently wear his hearing aid. When he forgets to wear the hearing aid he tends to talk loudly to everyone, which is annoying to his wife. This morning Mr. and Mrs. Jonas are sitting in his room after finishing breakfast. Lucy, a first-year student nurse who is assigned to Mr. Jonas, enters his room and introduces herself.   Question: Lucy…

169. A 65-year-old woman comes to the physician because of a 10-week history of low-grade fever, fatigue, and pain in her right arm. She recalls no trauma to the arm. She has a history of cancer treated with radiation therapy. Her temperature is 37.7°C (99.8°F). Physical examination shows tenderness of the right distal humerus. Laboratory studies show anemia. An x-ray of the right upper extremity is shown. This patient most likely has an abnormality of which of the following cell types? A) Hematopoietic stem cells B) Monomyelocytic stem cells C) Natural killer cells D) Osteoclasts E) Plasma cells

Following assessment by the surgical team, it has been determined that Mr Johns has developed sepsis from a perforated bowel during his previous surgery   Explain 4 possible signs and symptoms you would see with a patient who has developed sepsis. Minimum 2 sentences for each point.