MSN 621 final (solved 100%)

Which of the following is associated with the CD10 antigen? correct answersALL 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 answersALL 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 answersFlow cytometry of blood 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 answersTransfuse RBC 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? correct answersCLL 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 answers17p deletrion 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 answers50% will transform to AML