\[\frac{x^{2}}{(4 - x)x} + \frac{16}{(x - 4)x} =\]
\[= - \frac{x^{2}}{x(x - 4)} + \frac{16}{x(x - 4)} =\]
\[= \frac{16 - x^{2}}{x(x - 4)} = - \frac{(x - 4)(x + 4)}{x(x - 4)} =\]
\[= - \frac{x + 4}{x}.\]