A 30-year-old woman has had diarrhea and weight loss for the past several months.  She also has diffuse bone pain and generalized weakness.  The patient has a history of primary hypothyroidism for which she takes levothyroxine.  She is 162.5 cm (5 ft 4 in) tall and weighs 45 kg (99.2 lb).  BMI is 17 kg/m2.  On physical examination, the abdomen is soft and nontender.  Initial laboratory evaluation reveals microcytic anemia, hypoalbuminemia, normal magnesium level, and normal serum TSH concentration.  The patient is found to have positive anti-tissue transglutaminase IgA antibodies.  Which of the following sets of additional laboratory findings are most likely present in this patient?

Physical examination of a 23-year-old man diagnosed with chronic hepatitis shows corneal changes that are visible to the naked eye, as shown in the image below.

This patient is most likely to have which of the following conditions?

A 65-year-old woman has had several months of progressive fatigue, diminished appetite, and unintentional weight loss.  The patient has no chronic medical conditions.  She has not received medical care in many years and has not had recommended cancer screening.  The patient suddenly dies while undergoing evaluation.  Autopsy reveals abnormal liver findings, as shown in the exhibit below.

Microscopic evaluation of the lesions reveals neoplastic cells.  Which of the following is the most likely cause of this patient’s liver lesions?

A 45-year-old woman recently diagnosed with Sjögren’s syndrome complains of severe pruritus that slowly progressed over the last year.  She says that pruritus is especially prominent over palms and soles and is unbearable during the night.  Laboratory testing shows:

This patient most likely has which of the following conditions?

A mass resected from the liver of a 32-year-old woman has the morphology demonstrated on the slide below.

Which of the following is the most accurate statement concerning this patient’s condition?

A 75-year-old hospitalized man is evaluated for abdominal pain and fever.  The patient was admitted 2 weeks ago due to necrotizing fasciitis of the gluteal region and severe sepsis.  He has been treated with surgical debridements, intravenous antibiotics, and fluids.  For the past 2 days, the patient has had right upper quadrant abdominal pain, nausea, and recurrent fever.  He has a history of hypertension, type 2 diabetes mellitus, and chronic obstructive pulmonary disease.  His temperature is 38.8 C (102 F).  Physical examination shows marked tenderness over the right subcostal area.  Leukocyte count is 18,000/mm3 compared to 9,600/mm3 2 days ago.  Laparoscopic surgery is planned.  Which of the following will most likely be found during this patient’s surgery?

A 62-year-old man comes to the office due to worsening dysphagia.  Three months ago, the patient started having difficulty swallowing large bites of solid food, and now he can swallow only liquids and mashed food.  He has lost 9.1 kg (20 lb) since the onset of his symptoms.  Medical history is significant for type 2 diabetes mellitus, hypercholesterolemia, and hypertension.  The patient recently reduced the doses of his diabetic medications due to weight loss and lower blood glucose levels.  He has no recent travel outside of the United States.  Vital signs are normal.  BMI is 29 kg/m2.  Physical examination is normal.  A barium swallow study reveals an esophageal mass that significantly narrows the lumen.  Endoscopic biopsy reveals moderately differentiated tumor cells with keratin nests and pearls.  This patient’s condition is most likely related to which of the following risk factors?

A 48-year-old male is admitted to the hospital with severe epigastric abdominal pain and vomiting after an episode of binge-drinking.  Four weeks later, he is found to have a palpable upper abdominal mass and a cystic lesion is visualized on computed tomography scanning (see image below, asterisk marks the lesion).

The inner walls of the lesion are most likely lined with:

A 21-year-old man comes to the emergency department due to abdominal pain, nausea, and vomiting.  The patient started having vague periumbilical pain in the morning.  Over the next several hours, the pain became more severe, sharper, and localized to the right lower abdominal quadrant.  Temperature is 38.3 C (100.9 F), blood pressure is 132/84 mm Hg, pulse is 102/min, and respirations are 12/min.  Physical examination shows maximal tenderness in the right lower abdomen two-thirds of the distance from the umbilicus to the anterior superior iliac spine.  Bowel sounds are decreased.  Laboratory studies reveal a leukocyte count of 16,000/mm3.  The change in this patient’s pain characteristics is most likely explained by which of the following?