#march2020mccqe1
A 68-year-old woman complains of 2 days of cough and purulent sputum and right-sided chest pain exacerbated by breathing. She has had middle back pain unassociated with trauma for the past 2 months. One month ago, she was hospitalized briefly for pneumonia. On physical examination, her temperature is 39.0 C (102.2 F), blood pressure is 110/80 mm Hg, pulse is 98/min, and respirations are 28/min. There are crackles and egophony over the right lower lung field. There is no occult blood in the stool. Blood tests show a white blood cell count of 16,000/mm , a hematocrit of 18%, and a platelet count of 189,000/mm . The mean corpuscular volume is 82 μm . A chest x-ray film shows consolidation of the right middle and lower lobes, diffuse osteopenia, and multiple lytic lesions of the ribs and thoracic spine. Which of the following is the most likely laboratory finding?
(A) Decreased serum ferritin
(B) Elevated serum protein
(C) Hyperphosphatemia
(D) Hypertriglyceridemia
(E) Hypocalcemia
A 68-year-old woman complains of 2 days of cough and purulent sputum and right-sided chest pain exacerbated by breathing. She has had middle back pain unassociated with trauma for the past 2 months. One month ago, she was hospitalized briefly for pneumonia. On physical examination, her temperature is 39.0 C (102.2 F), blood pressure is 110/80 mm Hg, pulse is 98/min, and respirations are 28/min. There are crackles and egophony over the right lower lung field. There is no occult blood in the stool. Blood tests show a white blood cell count of 16,000/mm , a hematocrit of 18%, and a platelet count of 189,000/mm . The mean corpuscular volume is 82 μm . A chest x-ray film shows consolidation of the right middle and lower lobes, diffuse osteopenia, and multiple lytic lesions of the ribs and thoracic spine. Which of the following is the most likely laboratory finding?
(A) Decreased serum ferritin
(B) Elevated serum protein
(C) Hyperphosphatemia
(D) Hypertriglyceridemia
(E) Hypocalcemia
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