MSN 621 Final Exam with Questions and
Correct Answers 2025
A ,16-year-old ,male ,presents ,with ,lethargy, ,fatigue, ,and ,occasional ,mucosal ,bleeding.
,The ,patient ,also ,reports ,weight ,loss ,in ,the ,past ,5 ,months. ,Laboratory ,analysis
,reveals ,a ,white ,blood ,cell ,count ,of ,32,000 ,cells/microL. ,On ,examination,
,hepatosplenomegaly ,is ,noted. ,Further ,evaluation ,shows ,findings ,suggestive ,of ,acute
,lymphocytic ,leukemia. ,What ,is ,the ,most ,likely ,cause ,of ,the ,patient's ,mucosal
,bleeding? ,- ,CORRECT ,ANSWER-Decreased ,platelet ,count
A ,16-year-old ,female ,presents ,with ,complaints ,of ,fever, ,lethargy, ,and ,night ,sweats.
,The ,patient ,also ,reports ,a ,6-kilogram ,(13.2 ,pound) ,weight ,loss ,in ,the ,past ,3 ,months.
,On ,examination, ,painless, ,enlarged ,cervical ,and ,supraclavicular ,lymph ,nodes ,are
,palpated. ,A ,fine-needle ,aspiration ,biopsy ,of ,one ,of ,the ,lymph ,nodes ,is ,shown ,in ,the
,image. ,The ,patient's ,findings ,are ,most ,suggestive ,of ,which ,of ,the ,following? ,(see
,photo) ,- ,CORRECT ,ANSWER-Hodgkin ,lymphoma
A ,16-year-old ,male ,presents ,with ,fatigue, ,easy ,bruisability, ,and ,weight ,loss. ,On
,examination, ,hepatosplenomegaly ,is ,noted. ,After ,a ,detailed ,evaluation, ,the ,patient ,is
,diagnosed ,with ,acute ,lymphocytic ,leukemia. ,Which ,of ,the ,following ,is ,used ,in ,the
,management ,of ,this ,patient's ,condition ,- ,CORRECT ,ANSWER-L-asparaginase
A ,57-year-old ,patient ,with ,lymphoma ,complains ,of ,nausea ,after ,starting ,morphine.
,Which ,of ,the ,following ,is ,most ,accurate ,regarding ,nausea ,and ,vomiting ,due ,to
,opioids? ,- ,CORRECT ,ANSWER-After ,starting ,opioids, ,nausea, ,often ,improves ,within
,a ,few ,days
A ,43-year-old ,man ,presents ,to ,the ,clinic ,for ,evaluation ,after ,abnormalities ,noted ,on ,a
,routine ,set ,of ,labs. ,CBC ,with ,differential ,demonstrated ,hemoglobin ,14 ,g/dL, ,WBC
,count ,26,000/microL, ,lymphocytes ,21,000/microL, ,neutrophils ,4500/microL, ,and
,platelets ,260,000/microL. ,The ,basic ,metabolic ,panel ,demonstrates ,normal
,electrolytes ,and ,renal ,function. ,LFTs ,show ,total ,bilirubin ,1.2 ,mg/dL ,and ,normal ,liver
,enzymes. ,On ,examination ,in ,office, ,his ,examination ,is ,normal, ,with ,no ,palpable
,lymph ,nodes ,or ,hepatosplenomegaly. ,He ,denies ,any ,B ,symptoms. ,Peripheral ,smear
,shows ,lymphocytosis ,with ,many ,small ,lymphocytes ,and ,smudge ,cells. ,Which ,of ,the
,following ,is ,the ,next ,best ,step ,in ,the ,management ,of ,this ,patient? ,- ,CORRECT
,ANSWER-Observation ,and ,close ,follow ,up
,A ,65-year-old ,woman ,presents ,with ,an ,8-month ,history ,of ,recurrent ,low-grade ,fevers,
,a ,3-month ,history ,of ,abdominal ,fullness, ,and ,more ,recently, ,fatigue ,and ,moderately
,reduced ,exercise ,tolerance. ,Before ,this, ,she ,was ,in ,good ,health ,with ,no ,major
,medical ,conditions. ,Upon ,examination, ,she ,appeared ,to ,be ,stable ,and ,in ,no ,acute
,distress. ,She ,has ,a ,heart ,rate ,of ,95 ,bpm ,and ,blood ,pressure ,of ,128/60 ,mmHg. ,She
,had ,several ,palpable ,cervical ,and ,axillary ,lymph ,nodes ,(1-2 ,cm) ,that ,were ,non-tender
,and ,freely ,mobile. ,She ,also ,had ,palpable ,splenomegaly. ,No ,other ,abdominal
,masses/hepatomegaly ,appreciated ,on ,examination. ,Her ,complete ,blood ,count
,showed ,a ,leukocyte ,count ,of ,32,000/mm3, ,hemoglobin ,of ,9.8 ,g/dL, ,platelet ,count ,of
,145,000/mm3, ,neutrophil ,count ,1,900/mm3, ,lymphocyte ,count ,30,000/mm3, ,elevated
,LDH, ,and ,elevated ,reticulocyte ,count. ,Peripheral ,blood ,smear ,showed ,an ,increasing
,number ,of ,mature ,lymphocytes, ,spherocytes, ,and ,pol ,- ,CORRECT ,ANSWER-
Autoimmune ,hemolytic ,anemia
A ,67-year-old ,female ,with ,a ,performance ,status ,of ,0, ,is ,brought ,to ,the ,clinic ,with
,symptomatic ,anemia ,and ,has ,required ,several ,transfusions ,over ,the ,past ,2 ,to ,3
,months. ,Currently, ,her ,hemoglobin ,is ,7.5 ,g/dL, ,absolute ,neutrophil ,count ,1500/microL
,and ,platelet ,count ,is ,119,000/microL. ,She ,had ,a ,bone ,marrow ,biopsy ,performed ,that
,reveals ,myelodysplastic ,syndrome ,(MDS) ,with ,6% ,blasts ,and ,cytogenetics ,positive
,for ,5q ,deletion. ,She ,did ,not ,have ,any ,mutations ,or ,other ,cytogenetic ,abnormalities.
,Which ,of ,the ,following ,is ,the ,best ,initial ,course ,of ,treatment? ,- ,CORRECT ,ANSWER-
A ,thalidomide ,derivative
A ,36-year-old ,woman ,with ,a ,past ,medical ,history ,significant ,for ,menorrhagia ,from
,uterine ,fibroids ,presents ,with ,exertional ,dyspnea ,and ,fatigue. ,Examination ,shows
,conjunctival ,pallor. ,Laboratory ,tests ,reveal ,a ,hemoglobin ,of ,6.2 ,grams/dL, ,mean
,corpuscular ,volume ,(MCV) ,60 ,fl ,(normal: ,80-100 ,fl), ,and ,normal ,liver ,function ,tests.
,What ,is ,the ,most ,likely ,diagnosis? ,- ,CORRECT ,ANSWER-Iron ,deficiency ,anemia
A ,59-year-old ,male ,patient ,with ,a ,history ,of ,non-Hodgkins ,lymphoma ,treated ,with
,cyclophosphamide, ,adriamycin, ,vincristine, ,and ,prednisone ,eight ,years ,ago ,presents
,with ,a ,new ,diagnosis ,of ,myelodysplastic ,syndrome. ,Bone ,marrow ,biopsy ,reveals ,12%
,blasts ,and ,greater ,than ,10% ,dysplasia ,in ,the ,erythroid ,and ,granulocytic ,lineages.
,Fluorescence ,in ,situ ,hybridization ,(FISH) ,revealed ,monosomy ,7. ,He ,asks ,you ,about
,the ,risk ,of ,transformation ,into ,acute ,myeloid ,leukemia ,(AML). ,What ,is ,the ,risk ,of
,treatment-related ,myelodysplastic ,syndrome ,transforming ,into ,AML ,- ,CORRECT
,ANSWER-50% ,of ,patients ,will ,transform ,into ,AML
A ,45-year-old ,asymptomatic ,man ,is ,found ,to ,have ,leukocytosis ,on ,a ,preoperative
,complete ,blood ,count. ,His ,physical ,examination ,is ,significant ,for ,the ,spleen ,tip ,being
,palpable ,2 ,cm ,below ,the ,left ,costal ,margin. ,Enlarged, ,rubbery, ,nontender ,lymph
,nodes ,up ,to ,1.5 ,cm ,in ,size ,are ,present ,in ,the ,axillae ,and ,inguinal ,regions. ,Laboratory
,workup ,reveals ,a ,hemoglobin ,of ,13.3 ,g/dL, ,leukocytes ,40,000/microliter, ,and ,platelets
,238,000/microliter. ,His ,peripheral ,blood ,smear ,shows ,mature ,lymphocytes ,with
,smudge ,cells. ,If ,he ,fails ,first-line ,therapy, ,which ,of ,the ,following ,cytogenetic ,changes
, ,would ,be ,an ,indication ,for ,stem ,cell ,transplant ,in ,this ,patient? ,- ,CORRECT
,ANSWER-17p ,deletion
A ,60-year-old ,asymptomatic ,man ,is ,found ,to ,have ,leukocytosis ,on ,a ,preoperative
,CBC. ,Physical ,examination ,shows ,the ,spleen ,tip ,to ,be ,palpable ,2 ,cm ,below ,the ,left
,costal ,margin. ,Rubbery, ,nontender ,lymph ,nodes ,up ,to ,1.5 ,cm ,in ,size ,are ,present ,in
,the ,axillae ,and ,inguinal ,regions. ,Laboratory ,data ,include ,the ,following: ,Hgb: ,13.3 ,g/dL
,(normal ,14 ,to ,18) ,Leukocytes: ,40,000/microL ,(normal ,4300 ,to ,10,800) ,Platelet ,count:
,238,000 ,(normal ,150,000 ,to ,400,000) ,His ,peripheral ,blood ,smear ,is ,shown ,in ,the
,accompanying ,photo. ,Which ,of ,the ,following ,is ,the ,most ,likely ,diagnosis? ,(see ,photo)
,- ,CORRECT ,ANSWER-Chronic ,lymphocytic ,leukemia
A ,65-year-old ,female ,with ,renal ,cancer ,presents ,with ,dyspnea, ,fatigue, ,and ,dizziness.
,She ,is ,on ,warfarin ,to ,treat ,a ,left ,leg ,deep ,vein ,thrombosis. ,Her ,hematocrit ,is ,22%,
,hemoglobin ,is ,7.1 ,g/dL, ,platelets ,109,000/mL, ,PT ,1.3, ,PTT ,36, ,INR ,1.45, ,and ,WBC
,12,000 ,mm3. ,What ,is ,the ,next ,step ,in ,the ,management ,of ,the ,patient? ,- ,CORRECT
,ANSWER-Transfuse ,packed ,red ,blood ,cells
A ,67-year-old ,female ,presents ,with ,a ,history ,of ,high ,fevers ,and ,productive ,cough ,with
,green ,sputum ,for ,the ,last ,three ,days. ,The ,patient ,received ,the ,influenza ,vaccine ,this
,year. ,Her ,past ,medical ,history ,is ,unremarkable. ,She ,has ,a ,smoking ,history ,of ,25
,pack ,years. ,She ,does ,not ,drink ,alcohol ,or ,use ,illicit ,drugs. ,Temperature ,is ,102F,
,blood ,pressure ,is ,115/70mmHg, ,the ,pulse ,is ,101/min, ,and ,respirations ,are ,23/min.
,Her ,oxygen ,saturation ,is ,91% ,on ,room ,air. ,On ,examination, ,her ,anterior ,cervical
,lymph ,nodes ,are ,enlarged ,and ,nontender. ,Chest ,auscultation ,reveals ,crackles ,in ,the
,left ,lower ,lobe. ,Hepatosplenomegaly ,is ,present. ,A ,chest ,x-ray ,shows ,a ,developing
,left ,lower ,lobe ,consolidation. ,Labs ,show ,a ,WBC ,count ,of ,45000, ,with ,lymphocytes
,being ,85%. ,Empirical ,pharmacotherapy ,is ,initiated, ,and ,blood ,cultures ,are ,sent ,to ,the
,lab. ,Which ,of ,the ,following ,is ,the ,most ,appropriate ,step ,next? ,- ,CORRECT
,ANSWER-Flow ,cytometry ,of ,blood
A ,49-year-old ,male ,with ,fatigue ,and ,easy ,bruising ,is ,found ,to ,have ,terminal
,deoxynucleotidyl ,transferase ,(TdT) ,positive ,cells ,in ,the ,blood. ,He ,may ,have ,which ,of
,the ,following ,conditions ,- ,CORRECT ,ANSWER-Acute ,lymphoblastic ,leukemia
Which ,of ,the ,following ,is ,associated ,with ,the ,CD10 ,antigen? ,- ,CORRECT ,ANSWER-
Acute ,lymphocytic ,leukemia
A ,16-year-old ,patient ,presents ,because ,she ,believes ,she ,was ,bitten ,by ,a ,tick ,while
,hiking ,in ,the ,woods ,a ,few ,days ,ago. ,She ,mentions ,swelling ,in ,her ,right ,ear ,and
,general ,malaise. ,On ,exam, ,she ,has ,a ,1 ,x ,2 ,cm ,bluish-red ,nodule ,on ,the ,right ,ear
,lobe. ,What ,is ,the ,next ,best ,step ,in ,management ,for ,this ,patient? ,- ,CORRECT
,ANSWER-lyme ,serology
A ,26-year-old ,male ,comes ,to ,the ,emergency ,department ,complaining ,of ,fatigue,
,dyspnea, ,chest ,pain, ,and ,syncope, ,especially ,when ,playing ,soccer. ,This ,has ,been
Correct Answers 2025
A ,16-year-old ,male ,presents ,with ,lethargy, ,fatigue, ,and ,occasional ,mucosal ,bleeding.
,The ,patient ,also ,reports ,weight ,loss ,in ,the ,past ,5 ,months. ,Laboratory ,analysis
,reveals ,a ,white ,blood ,cell ,count ,of ,32,000 ,cells/microL. ,On ,examination,
,hepatosplenomegaly ,is ,noted. ,Further ,evaluation ,shows ,findings ,suggestive ,of ,acute
,lymphocytic ,leukemia. ,What ,is ,the ,most ,likely ,cause ,of ,the ,patient's ,mucosal
,bleeding? ,- ,CORRECT ,ANSWER-Decreased ,platelet ,count
A ,16-year-old ,female ,presents ,with ,complaints ,of ,fever, ,lethargy, ,and ,night ,sweats.
,The ,patient ,also ,reports ,a ,6-kilogram ,(13.2 ,pound) ,weight ,loss ,in ,the ,past ,3 ,months.
,On ,examination, ,painless, ,enlarged ,cervical ,and ,supraclavicular ,lymph ,nodes ,are
,palpated. ,A ,fine-needle ,aspiration ,biopsy ,of ,one ,of ,the ,lymph ,nodes ,is ,shown ,in ,the
,image. ,The ,patient's ,findings ,are ,most ,suggestive ,of ,which ,of ,the ,following? ,(see
,photo) ,- ,CORRECT ,ANSWER-Hodgkin ,lymphoma
A ,16-year-old ,male ,presents ,with ,fatigue, ,easy ,bruisability, ,and ,weight ,loss. ,On
,examination, ,hepatosplenomegaly ,is ,noted. ,After ,a ,detailed ,evaluation, ,the ,patient ,is
,diagnosed ,with ,acute ,lymphocytic ,leukemia. ,Which ,of ,the ,following ,is ,used ,in ,the
,management ,of ,this ,patient's ,condition ,- ,CORRECT ,ANSWER-L-asparaginase
A ,57-year-old ,patient ,with ,lymphoma ,complains ,of ,nausea ,after ,starting ,morphine.
,Which ,of ,the ,following ,is ,most ,accurate ,regarding ,nausea ,and ,vomiting ,due ,to
,opioids? ,- ,CORRECT ,ANSWER-After ,starting ,opioids, ,nausea, ,often ,improves ,within
,a ,few ,days
A ,43-year-old ,man ,presents ,to ,the ,clinic ,for ,evaluation ,after ,abnormalities ,noted ,on ,a
,routine ,set ,of ,labs. ,CBC ,with ,differential ,demonstrated ,hemoglobin ,14 ,g/dL, ,WBC
,count ,26,000/microL, ,lymphocytes ,21,000/microL, ,neutrophils ,4500/microL, ,and
,platelets ,260,000/microL. ,The ,basic ,metabolic ,panel ,demonstrates ,normal
,electrolytes ,and ,renal ,function. ,LFTs ,show ,total ,bilirubin ,1.2 ,mg/dL ,and ,normal ,liver
,enzymes. ,On ,examination ,in ,office, ,his ,examination ,is ,normal, ,with ,no ,palpable
,lymph ,nodes ,or ,hepatosplenomegaly. ,He ,denies ,any ,B ,symptoms. ,Peripheral ,smear
,shows ,lymphocytosis ,with ,many ,small ,lymphocytes ,and ,smudge ,cells. ,Which ,of ,the
,following ,is ,the ,next ,best ,step ,in ,the ,management ,of ,this ,patient? ,- ,CORRECT
,ANSWER-Observation ,and ,close ,follow ,up
,A ,65-year-old ,woman ,presents ,with ,an ,8-month ,history ,of ,recurrent ,low-grade ,fevers,
,a ,3-month ,history ,of ,abdominal ,fullness, ,and ,more ,recently, ,fatigue ,and ,moderately
,reduced ,exercise ,tolerance. ,Before ,this, ,she ,was ,in ,good ,health ,with ,no ,major
,medical ,conditions. ,Upon ,examination, ,she ,appeared ,to ,be ,stable ,and ,in ,no ,acute
,distress. ,She ,has ,a ,heart ,rate ,of ,95 ,bpm ,and ,blood ,pressure ,of ,128/60 ,mmHg. ,She
,had ,several ,palpable ,cervical ,and ,axillary ,lymph ,nodes ,(1-2 ,cm) ,that ,were ,non-tender
,and ,freely ,mobile. ,She ,also ,had ,palpable ,splenomegaly. ,No ,other ,abdominal
,masses/hepatomegaly ,appreciated ,on ,examination. ,Her ,complete ,blood ,count
,showed ,a ,leukocyte ,count ,of ,32,000/mm3, ,hemoglobin ,of ,9.8 ,g/dL, ,platelet ,count ,of
,145,000/mm3, ,neutrophil ,count ,1,900/mm3, ,lymphocyte ,count ,30,000/mm3, ,elevated
,LDH, ,and ,elevated ,reticulocyte ,count. ,Peripheral ,blood ,smear ,showed ,an ,increasing
,number ,of ,mature ,lymphocytes, ,spherocytes, ,and ,pol ,- ,CORRECT ,ANSWER-
Autoimmune ,hemolytic ,anemia
A ,67-year-old ,female ,with ,a ,performance ,status ,of ,0, ,is ,brought ,to ,the ,clinic ,with
,symptomatic ,anemia ,and ,has ,required ,several ,transfusions ,over ,the ,past ,2 ,to ,3
,months. ,Currently, ,her ,hemoglobin ,is ,7.5 ,g/dL, ,absolute ,neutrophil ,count ,1500/microL
,and ,platelet ,count ,is ,119,000/microL. ,She ,had ,a ,bone ,marrow ,biopsy ,performed ,that
,reveals ,myelodysplastic ,syndrome ,(MDS) ,with ,6% ,blasts ,and ,cytogenetics ,positive
,for ,5q ,deletion. ,She ,did ,not ,have ,any ,mutations ,or ,other ,cytogenetic ,abnormalities.
,Which ,of ,the ,following ,is ,the ,best ,initial ,course ,of ,treatment? ,- ,CORRECT ,ANSWER-
A ,thalidomide ,derivative
A ,36-year-old ,woman ,with ,a ,past ,medical ,history ,significant ,for ,menorrhagia ,from
,uterine ,fibroids ,presents ,with ,exertional ,dyspnea ,and ,fatigue. ,Examination ,shows
,conjunctival ,pallor. ,Laboratory ,tests ,reveal ,a ,hemoglobin ,of ,6.2 ,grams/dL, ,mean
,corpuscular ,volume ,(MCV) ,60 ,fl ,(normal: ,80-100 ,fl), ,and ,normal ,liver ,function ,tests.
,What ,is ,the ,most ,likely ,diagnosis? ,- ,CORRECT ,ANSWER-Iron ,deficiency ,anemia
A ,59-year-old ,male ,patient ,with ,a ,history ,of ,non-Hodgkins ,lymphoma ,treated ,with
,cyclophosphamide, ,adriamycin, ,vincristine, ,and ,prednisone ,eight ,years ,ago ,presents
,with ,a ,new ,diagnosis ,of ,myelodysplastic ,syndrome. ,Bone ,marrow ,biopsy ,reveals ,12%
,blasts ,and ,greater ,than ,10% ,dysplasia ,in ,the ,erythroid ,and ,granulocytic ,lineages.
,Fluorescence ,in ,situ ,hybridization ,(FISH) ,revealed ,monosomy ,7. ,He ,asks ,you ,about
,the ,risk ,of ,transformation ,into ,acute ,myeloid ,leukemia ,(AML). ,What ,is ,the ,risk ,of
,treatment-related ,myelodysplastic ,syndrome ,transforming ,into ,AML ,- ,CORRECT
,ANSWER-50% ,of ,patients ,will ,transform ,into ,AML
A ,45-year-old ,asymptomatic ,man ,is ,found ,to ,have ,leukocytosis ,on ,a ,preoperative
,complete ,blood ,count. ,His ,physical ,examination ,is ,significant ,for ,the ,spleen ,tip ,being
,palpable ,2 ,cm ,below ,the ,left ,costal ,margin. ,Enlarged, ,rubbery, ,nontender ,lymph
,nodes ,up ,to ,1.5 ,cm ,in ,size ,are ,present ,in ,the ,axillae ,and ,inguinal ,regions. ,Laboratory
,workup ,reveals ,a ,hemoglobin ,of ,13.3 ,g/dL, ,leukocytes ,40,000/microliter, ,and ,platelets
,238,000/microliter. ,His ,peripheral ,blood ,smear ,shows ,mature ,lymphocytes ,with
,smudge ,cells. ,If ,he ,fails ,first-line ,therapy, ,which ,of ,the ,following ,cytogenetic ,changes
, ,would ,be ,an ,indication ,for ,stem ,cell ,transplant ,in ,this ,patient? ,- ,CORRECT
,ANSWER-17p ,deletion
A ,60-year-old ,asymptomatic ,man ,is ,found ,to ,have ,leukocytosis ,on ,a ,preoperative
,CBC. ,Physical ,examination ,shows ,the ,spleen ,tip ,to ,be ,palpable ,2 ,cm ,below ,the ,left
,costal ,margin. ,Rubbery, ,nontender ,lymph ,nodes ,up ,to ,1.5 ,cm ,in ,size ,are ,present ,in
,the ,axillae ,and ,inguinal ,regions. ,Laboratory ,data ,include ,the ,following: ,Hgb: ,13.3 ,g/dL
,(normal ,14 ,to ,18) ,Leukocytes: ,40,000/microL ,(normal ,4300 ,to ,10,800) ,Platelet ,count:
,238,000 ,(normal ,150,000 ,to ,400,000) ,His ,peripheral ,blood ,smear ,is ,shown ,in ,the
,accompanying ,photo. ,Which ,of ,the ,following ,is ,the ,most ,likely ,diagnosis? ,(see ,photo)
,- ,CORRECT ,ANSWER-Chronic ,lymphocytic ,leukemia
A ,65-year-old ,female ,with ,renal ,cancer ,presents ,with ,dyspnea, ,fatigue, ,and ,dizziness.
,She ,is ,on ,warfarin ,to ,treat ,a ,left ,leg ,deep ,vein ,thrombosis. ,Her ,hematocrit ,is ,22%,
,hemoglobin ,is ,7.1 ,g/dL, ,platelets ,109,000/mL, ,PT ,1.3, ,PTT ,36, ,INR ,1.45, ,and ,WBC
,12,000 ,mm3. ,What ,is ,the ,next ,step ,in ,the ,management ,of ,the ,patient? ,- ,CORRECT
,ANSWER-Transfuse ,packed ,red ,blood ,cells
A ,67-year-old ,female ,presents ,with ,a ,history ,of ,high ,fevers ,and ,productive ,cough ,with
,green ,sputum ,for ,the ,last ,three ,days. ,The ,patient ,received ,the ,influenza ,vaccine ,this
,year. ,Her ,past ,medical ,history ,is ,unremarkable. ,She ,has ,a ,smoking ,history ,of ,25
,pack ,years. ,She ,does ,not ,drink ,alcohol ,or ,use ,illicit ,drugs. ,Temperature ,is ,102F,
,blood ,pressure ,is ,115/70mmHg, ,the ,pulse ,is ,101/min, ,and ,respirations ,are ,23/min.
,Her ,oxygen ,saturation ,is ,91% ,on ,room ,air. ,On ,examination, ,her ,anterior ,cervical
,lymph ,nodes ,are ,enlarged ,and ,nontender. ,Chest ,auscultation ,reveals ,crackles ,in ,the
,left ,lower ,lobe. ,Hepatosplenomegaly ,is ,present. ,A ,chest ,x-ray ,shows ,a ,developing
,left ,lower ,lobe ,consolidation. ,Labs ,show ,a ,WBC ,count ,of ,45000, ,with ,lymphocytes
,being ,85%. ,Empirical ,pharmacotherapy ,is ,initiated, ,and ,blood ,cultures ,are ,sent ,to ,the
,lab. ,Which ,of ,the ,following ,is ,the ,most ,appropriate ,step ,next? ,- ,CORRECT
,ANSWER-Flow ,cytometry ,of ,blood
A ,49-year-old ,male ,with ,fatigue ,and ,easy ,bruising ,is ,found ,to ,have ,terminal
,deoxynucleotidyl ,transferase ,(TdT) ,positive ,cells ,in ,the ,blood. ,He ,may ,have ,which ,of
,the ,following ,conditions ,- ,CORRECT ,ANSWER-Acute ,lymphoblastic ,leukemia
Which ,of ,the ,following ,is ,associated ,with ,the ,CD10 ,antigen? ,- ,CORRECT ,ANSWER-
Acute ,lymphocytic ,leukemia
A ,16-year-old ,patient ,presents ,because ,she ,believes ,she ,was ,bitten ,by ,a ,tick ,while
,hiking ,in ,the ,woods ,a ,few ,days ,ago. ,She ,mentions ,swelling ,in ,her ,right ,ear ,and
,general ,malaise. ,On ,exam, ,she ,has ,a ,1 ,x ,2 ,cm ,bluish-red ,nodule ,on ,the ,right ,ear
,lobe. ,What ,is ,the ,next ,best ,step ,in ,management ,for ,this ,patient? ,- ,CORRECT
,ANSWER-lyme ,serology
A ,26-year-old ,male ,comes ,to ,the ,emergency ,department ,complaining ,of ,fatigue,
,dyspnea, ,chest ,pain, ,and ,syncope, ,especially ,when ,playing ,soccer. ,This ,has ,been
