A 24-year-old woman complains of intermittent fever and joint pain. She says that these symptoms have been present for the past month. Before that, she had no signs or symptoms and was completely healthy. She has also lost her appetite and some weight. A complete blood count (CBC) showed severe pancytopenia. What is the next best step in evaluating this patient?
ARepeated CBCs for several weeks and reassess
BTreatment with corticosteroids
CTreatment with antibiotics
DTreatment for acute leukemia
EBone marrow examination
A 3-year-old girl is brought to her pediatrician with 2 days of fever and abdominal pain. She has also been crying and complaining of pain while urinating. She was born at term without incident and was previously healthy at regular checkups. On presentation, her temperature is 102.2°F (39°C), blood pressure is 137/85 mmHg, pulse is 122/min, and respirations are 24/min. Physical exam reveals a palpable, painless, abdominal mass that does not cross the midline. Which of the following additional findings would be associated with this patient's disorder?
AAsh leaf spots
BOpsoclonus myoclonus
CEpstein-Barr virus
D11;22 chromosome translocation
EAniridia
An 18-month-old boy is brought to the doctor’s office for evaluation of abdominal pain. The boy looks emaciated and he is now significantly below his growth chart predicted weight. The family history is non-contributory. The vital signs are unremarkable. On physical examination, a non-tender mass is felt in the upper part of the abdomen. A magnetic resonance image (MRI) scan of his abdomen demonstrates a mass in his right adrenal gland. Biopsy of the mass demonstrates an abundance of small round blue cells. With this biopsy result, which 1 of the following findings would confirm the diagnosis?
AElevation of vanillylmandelic acid in the urine
BMRI showing the intrarenal origin of the mass
CIncreased lactic dehydrogenase
DIncreased alpha-fetoprotein
ERadiograph of the bone showing the presence of lytic bone lesion with periosteal reaction
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