A 15-year-old male presents to the emergency department with fever, malaise, and shortness of breath for 1 week. Further history reveals that the patient experiences swelling in his face in the morning that disappears as the day progresses. Physical exam reveals hepatosplenomegaly. A complete blood count shows WBC 84,000 cells/mL. Most of this patient's leukocytes are likely to express which of the following cell surface markers?
ACD20
BCD19
CCD10
DCD16
ECD2
A 5-year-old boy presents to his pediatrician with weakness. His father observed that his son seemed less energetic at daycare and kindergarten classes. He was becoming easily fatigued from mild play. His temperature is 98°F (37°C), blood pressure is 90/60 mmHg, pulse is 100/min, and respirations are 20/min. Physical exam reveals pale conjunctiva, poor skin turgor and capillary refill, and cervical and axillary lymphadenopathy with assorted bruises throughout his body. A complete blood count reveals the following: Leukocyte count: 3,000/mm^3 Segmented neutrophils: 30% Bands: 5% Eosinophils: 5% Basophils: 10% Lymphocytes: 40% Monocytes: 10% Hemoglobin: 7.1 g/dL Hematocrit: 22% Platelet count: 50,000/mm^3 The most specific diagnostic assessment would most likely show which of the following?
ABone marrow biopsy with ≥ 20% lymphoblasts
BFluorescence in situ hybridization analysis with 9:22 translocation
CPeripheral blood smear with > 50% lymphoblasts
DFlow cytometry with positive terminal deoxynucleotidyl transferase staining
EFluorescence in situ hybridization analysis with 12:21 translocation
A 47-year-old woman comes to the physician because of easy bruising and fatigue. She appears pale. Her temperature is 38°C (100.4°F). Examination shows a palm-sized hematoma on her left leg. Abdominal examination shows an enlarged liver and spleen. Her hemoglobin concentration is 9.5 g/dL, leukocyte count is 12,300/mm3, platelet count is 55,000/mm3, and fibrinogen concentration is 120 mg/dL (N = 150–400). Cytogenetic analysis of leukocytes shows a reciprocal translocation of chromosomes 15 and 17. Which of the following is the most appropriate treatment for this patient at this time?
ACyclophosphamide
BAll-trans retinoic acid
CImatinib
DRituximab
EPlatelet transfusion
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