All Only One STD

A 50-year-old man comes to the physician because of a skin rash, joint pains, malaise and fatigue. He has a history of intravenous drug abuse. His temperature is 37.1°C (98.9°F), blood pressure is 140/90 mm Hg, pulse is 80/min, and respirations are 14/min. Examination shows palpable purpura and hepatosplenomegaly. Urinalysis shows hematuria, red blood cell casts and proteinuria. The results of the laboratory studies are as follows: BUN 30 mg/dl, Creatinine 2.0 mg/dl, Serum complement Low, Anti-HCV Positive. Which of the following is the most likely diagnosis?

A 50-year-old man comes to the physician for a routine check-up. He has no present complaints. He has diabetes mellitus, type 2, stable angina, and gout. He takes glyburide and atenolol. He smokes two packs a day and, occasionally, consumes alcohol. His father had an early myocardial infarction; his brother has diabetes mellitus. His blood pressure is 140/90 mm Hg and heart rate is 65/min. Physical examination shows no abnormalities. There is concern about end organ damage in this patient due to diabetes mellitus. Which of the following is the earliest renal abnormality that could be seen in this patient?

A 50-year-old man presents with excessive day- time sleepiness and a history of snoring. One week ago, he fell asleep while driving his car and got into a minor accident. On examination, he is obese (body mass index [BMI] >30) and his blood pressure is 160/90 mm Hg. His lungs are clear and heart sounds are distant. Which of the following is the most likely explanation for the symptoms associated with this condition?

A 50-year-old white woman presents with aching and stiffness in the trunk, hip, and shoulders. There is widespread muscle pain after mild exertion. Symptoms are worse in the morning and improve during the day. They are also worsened by stress. The patient is always tired and exhausted. She has trouble sleeping at night. On examination, joints are normal. ESR is normal, and Lyme antibody and file:///D:/DES_Entry_2016MCQs/3C_USMLE/C-2Diagnosis/C-2Diagnos... 170 of 316 12/19/2016 2:59 PMHIV test are negative. A diagnosis is best made by which of the following?