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A 36-year-old man with profound intellectual disability is brought to the physician by staff at his facility

because of increasing abdominal girth during the past 2 weeks. He is unable to speak, and no medical

history is currently available. Physical examination shows a protuberant abdomen with a fluid wave and

shifting dullness. There are no signs of trauma to the area. Laboratory studies show no abnormalities. A CT

scan of the abdomen is shown. Fluid is present in which of the following areas as indicated by the arrow?

Which of the following is the mRNA start codon in most cases? 

A 65-year-old man develops oliguria and peripheral edema over a period of weeks. Urinalysis reveals hematuria and proteinuria; examination of the urinary sediment reveals red cell casts. Radiologic and ultrasound studies fail to demonstrate an obstructive lesion. Renal biopsy shows many glomerular crescents. This presentation is most suggestive of which of the following conditions?

A 9-month-old male is evaluated for lactic acidosis and increased levels of serum alanine. He is diagnosed with pyruvate dehydrogenase complex deficiency and placed on a special diet by the physician. This special diet most likely consists of

A 54-year-old man comes to the physician because of episodes of fainting for 3 months. He also has had difficulty performing daily tasks because he is easily fatigued. He had a myocardial infarction 12 years ago. His pulse is 40/min, respirations are 18/min, and blood pressure is 138/85 mmHg. Physical examination shows evidence of cannon a waves. An ECG shows a P-wave rate of 90/min, and an R-wave rate of 40/ min, with no apparent relation between the two. Which of the following is the most likely diagnosis?