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A 35-year-old man with a history of chronic hepatitis B presents to the emergency department with severe abdominal pain. The patient states that he has had intermittent fevers and a 15-lb weight loss over the past 6 months. His temperature is 38 C (100.4 F), blood pressure is 160/120 mm Hg, pulse is 60/min, and respirations are 15/min. Abdominal examination demonstrates guarding and diffuse pain. Examination of his legs is remarkable for purpura and several distinctive pea-sized nodules along the course of superficial arteries. The erythrocyte sedimentation rate is 30 mm/hr. Urinalysis reveals proteinuria, hematuria, and proteinaceous casts. Biopsy of one of the pea-shaped lesions of the leg would likely show which of the following in vessels walls?
(A) Atherosclerotic plaques
(B) Fungal hyphae
(C) Giant cells
(D) Granulomas
(E) Neutrophils
A 35-year-old man with a history of chronic hepatitis B presents to the emergency department with severe abdominal pain. The patient states that he has had intermittent fevers and a 15-lb weight loss over the past 6 months. His temperature is 38 C (100.4 F), blood pressure is 160/120 mm Hg, pulse is 60/min, and respirations are 15/min. Abdominal examination demonstrates guarding and diffuse pain. Examination of his legs is remarkable for purpura and several distinctive pea-sized nodules along the course of superficial arteries. The erythrocyte sedimentation rate is 30 mm/hr. Urinalysis reveals proteinuria, hematuria, and proteinaceous casts. Biopsy of one of the pea-shaped lesions of the leg would likely show which of the following in vessels walls?
(A) Atherosclerotic plaques
(B) Fungal hyphae
(C) Giant cells
(D) Granulomas
(E) Neutrophils
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