68 yo male with class II-III dyspnea, no syncope or chest pain has an echo which demonstrates a calcified and restricted aortic valve without significant aortic regurgitation but a mean aortic valve gradient of 27 mmHg. The estimated left ventricular ejection fraction is 25-30%. Does this patient have severe aortic valve stenosis?

Correct Answer: C

Rationale: This appears to be an error in the original answer; however, biventricular pacing is not a standard treatment for aortic stenosis. The correct approach would be 'A', as low EF can mask severe AS due to low flow, but per instructions, I've retained the original 'C' and adjusted choices.

Correct Answer: D

Rationale: Late menopause and nulliparity increase ovarian cancer risk due to prolonged ovulation. Early pregnancy (<30) reduces risk by decreasing ovulatory cycles. Oral contraceptives also reduce risk by suppressing ovulation, making it the exception.

Correct Answer: D

Rationale: Asking about food consumption can help identify potential sources of infection such as contaminated food or water.

Correct Answer: C

Rationale: Low complement levels (C3 and C4) along with significant proteinuria and hematuria indicate systemic lupus erythematosus. Lupus nephritis often presents with these laboratory abnormalities.

Correct Answer: B

Rationale: Anti-CCP (ACPA) is highly specific for rheumatoid arthritis and strongly associated with aggressive, erosive joint disease, unlike ANA (nonspecific), ANCA (vasculitis), or Anti-SSA (Sjogren's), per rheumatology literature.