WBR0005: Difference between revisions

Revision as of 19:16, 15 October 2012

Author	PageAuthor::
Exam Type	ExamType::
Main Category
Sub Category	SubCategory::Pathology
Prompt	[[Prompt::A 52-year-old man comes to your office with recent issues of fatigue, low-grade fever, anorexia, and pruritus. He states that he can feel small bumps under his skin in his neck and that they seem to get painful when he drinks alcohol. Lab studies show a normal WBC, Hct, Hb, electrolytes, renal function, and glucose. You refer him to a surgeon to obtain a lymph node biopsy and the next day the pathologist calls you and describes "owl-eyed" appearance of abundant lymphocytes. What is the most likely diagnosis?]]
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Answer A Explanation	AnswerAExp::
Answer B	AnswerB::
Answer B Explanation	AnswerBExp::
Answer C	AnswerC::
Answer C Explanation	AnswerCExp::
Answer D	AnswerD::
Answer D Explanation	AnswerDExp::
Answer E	AnswerE::
Answer E Explanation	AnswerEExp::
Right Answer	RightAnswer::
Explanation	[[Explanation::This patient has many classic signs of lymphoma. Labs are indicative of early disease, and biopsy results indicate conclusively that Hodgkin's lymphoma is present. Educational Objective: References: ]]
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 {{WBRQuestion
-|Category=Neurology
+|Category=Hematology
-|SubCategory=Microbiology
+|SubCategory=Pathology
-|Prompt= A 13-year-old boy is brought to the emergency room for a laceration to his forearm while playing "tag" in a park. He states that he cut himself on a broken bottle when he fell and is otherwise in too much pain to answer history questions. His father quickly arrives at the hospital and tells you that they have just moved to the area from out of state and his medical records are unavailable. Although he states he doesn't know his son's immunization history, he does deny any known allergies. His physical exam shows a 6-cm open, linear laceration through the dermis and into the subcutaneous fat layer of the left dorsal forearm. His bleeding has slowed to some extent with direct pressure to the wound, and the distal neurovascular status remains unimpaired. You use 1% lidocaine without epinephrine to provide local anesthesia and then explore the wound during debridement. No tendon injury seems apparent and you decide to complete primary closure of the wound. What is the next step in management of this patient?
+|Prompt=A 52-year-old man comes to your office with recent issues of fatigue, low-grade fever, anorexia, and pruritus. He states that he can feel small bumps under his skin in his neck and that they seem to get painful when he drinks alcohol. Lab studies show a normal WBC, Hct, Hb, electrolytes, renal function, and glucose. You refer him to a surgeon to obtain a lymph node biopsy and the next day the pathologist calls you and describes "owl-eyed" appearance of abundant lymphocytes. What is the most likely diagnosis?
-|Answer=Complete a rabies antibody screen in case the boy is not being truthful about the injury mechanism.,Start tetanus toxoid primary series.,Give one dose of tetanus toxoid series.,Give tetanus immunoglobulin.
+|Answer=Acute myelogenous leukemia.,Non-Hodgkin's lymphoma.,,Chronic myelogenous leukemia.,Multiple myeloma.
-|Right Answer=Start tetanus toxoid primary series and give tetanus immunoglobulin.
+|Right Answer=Hodgkin's lymphoma
-|Explanation=This patient has a wound classifiable as "dirty" and also has no certain history of completion of tetanus primary immunization series. Thus, he must be assumed to have not had prior adequate tetanus immunization and should be given both tetanus immunoglobulin and the primary series.
+|Explanation=This patient has many classic signs of lymphoma. Labs are indicative of early disease, and biopsy results indicate conclusively that Hodgkin's lymphoma is present.
 }}

WBR0005: Difference between revisions

Revision as of 19:16, 15 October 2012

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