WBR0005: Difference between revisions

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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor=Anonymous (Edited by Will Gibson)
|QuestionAuthor=Anonymous (Edited by Will Gibson) NOT COMPLETED.
|ExamType=USMLE Step 2 CK
|ExamType=USMLE Step 2 CK
|MainCategory=Internal medicine
|SubCategory=Oncology
|SubCategory=Oncology, Oncology
|SubCategory=Oncology
|MainCategory=Internal medicine
|SubCategory=Oncology
|SubCategory=Oncology, Oncology
|SubCategory=Oncology
|MainCategory=Internal medicine
|SubCategory=Oncology
|SubCategory=Oncology, Oncology
|SubCategory=Oncology
|MainCategory=Internal medicine
|SubCategory=Oncology
|MainCategory=Internal medicine
|SubCategory=Oncology
|SubCategory=Oncology, Oncology
|Prompt=A 52-year-old man presents to his primary care physician's office for recent fatigue, low-grade fever, anorexia, and pruritus. He states that he can feel small bumps under the skin in his neck and that they seem to become painful when he drinks alcohol. Lab studies the following:
|MainCategory=Internal medicine
{|
|SubCategory=Oncology, Oncology
| Hematocrit
|MainCategory=Internal medicine
| Normal
|SubCategory=Oncology, Oncology
|-
|MainCategory=Internal medicine
| C
|SubCategory=Oncology, Oncology
| D
|MainCategory=Internal medicine
|}
|MainCategory=Internal medicine
WBC       Normal
|SubCategory=Oncology, Oncology
Hematocrit          Normal
|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 the skin in his neck and that they seem to become 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, the results of which are pictured below:
Hemoglobin        Normal
Electrolytes          Normal
Creatinine            Normal
Glucose              Normal
 
You refer him to a surgeon to obtain a lymph node biopsy, the results of which are pictured below:
   
   
[[File:Reed-Sternberg (Hodgkin's Lymphoma).jpg]]
[[File:Reed-Sternberg (Hodgkin's Lymphoma).jpg]]

Revision as of 20:07, 14 October 2013
Author PageAuthor::Anonymous (Edited by Will Gibson) NOT COMPLETED.
Exam Type ExamType::USMLE Step 2 CK
Main Category
Sub Category SubCategory::Oncology
Prompt [[Prompt::A 52-year-old man presents to his primary care physician's office for recent fatigue, low-grade fever, anorexia, and pruritus. He states that he can feel small bumps under the skin in his neck and that they seem to become painful when he drinks alcohol. Lab studies the following:

{]]

Answer A AnswerA::Tuberculosis
Answer A Explanation AnswerAExp::
Answer B AnswerB::Hepatitis
Answer B Explanation AnswerBExp::
Answer C AnswerC::Metastatic cancer
Answer C Explanation AnswerCExp::
Answer D AnswerD::Non Hodgkin's lymphoma
Answer D Explanation AnswerDExp::
Answer E AnswerE::Hodgkin's lymphoma
Answer E Explanation AnswerEExp::
Right Answer RightAnswer::E
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.

Around one to five percent of patients with Hodgkin's disease experience alcohol-related pain; it is a rare but highly specific presentation for Hodgkin's lymphoma.

References: First Aid ___ page __ Bobrove AM (June 1983). "Alcohol-related pain and Hodgkin's disease". The Western Journal of Medicine 138 (6): 874–5.
Educational Objective:
References: ]]

Approved Approved::No
Keyword WBRKeyword::Cancer, WBRKeyword::Hodgkins, WBRKeyword::Lymphoma, WBRKeyword::Leukemia, WBRKeyword::Histology
Linked Question Linked::
Order in Linked Questions LinkedOrder::
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