The most common Rh-negative genotype, regardless of race, is:

A 23-year-old tall, thin man presents with sudden onset of sharp left-sided chest pain and dyspnea that began while he was sitting at his desk. He has no past medical history. Vital signs: HR 102, RR 22, BP 118/72, SpO2 95% on room air. Lung exam reveals decreased breath sounds and hyperresonance on the left.   What is the most likely diagnosis?

A 62-year-old woman presents with progressive dyspnea on exertion, fatigue, and occasional lightheadedness over the past year. She denies cough or wheezing. Past medical history includes systemic sclerosis. Vital signs: BP 110/68, HR 96, SpO2 95% on room air. Cardiac exam reveals a loud P2 and a right ventricular heave. Lung exam is clear.   Which diagnosis should be most strongly suspected?

A 71-year-old man with severe COPD presents with increased dyspnea, purulent sputum, and wheezing over the past 2 days. He uses home oxygen at 2 L/min. Vital signs: RR 30, HR 108, SpO2 88% on his usual oxygen. He is using accessory muscles and speaks in short phrases.   What is the most appropriate next step?

A 34-year-old patient is stung by a yellow jacket while gardening and presents to your clinic 10 minutes later. They report throat tightness and dizziness. Vitals: BP 86/54, HR 128, RR 26, SpO2 92% on room air. Exam shows diffuse urticaria, mild lip swelling, and audible wheezing.   What is the best next step?

A 61-year-old presents with progressive fatigue and spontaneous gum bleeding. CBC shows anemia and thrombocytopenia. Peripheral smear shows blast cells containing rod-shaped cytoplasmic inclusions. Which diagnosis is most strongly supported by this finding?

A 58-year-old man presents to urgent care with sudden-onset shortness of breath that began one hour ago. He reports pleuritic chest pain and lightheadedness. Past history includes recent knee replacement surgery 2 weeks ago. Vital signs: HR 118, RR 30, BP 104/66, SpO2 89% on room air. Lung exam is clear bilaterally.   What is the most likely cause of his dyspnea?

A 28-year-old presents with new anemia and dark urine after a recent medication exposure. CBC confirms anemia and shows significant reticulocytosis with an absolute reticulocyte count (ARC) of 140,000/mcL. What is the most appropriate next step to evaluate the likely etiology?

A 63-year-old is being evaluated for suspected lymphoma after persistent generalized lymphadenopathy. Which initial laboratory workup is most appropriate to obtain as part of the baseline evaluation?

88.  On  the diagram, which one represents a hypertonic solution