A 60-Year-Old Man Comes to the Office After He Was

question 125

Multiple Choice

A 60-year-old man comes to the office after he was found to have a "low blood count" when attempting to donate blood.  The patient is in his usual state of health and feels well.  He has no chronic medical problems but has been treated for pneumonia twice during the past year.  The patient takes no medications and does not use tobacco or alcohol.  Temperature is 37 C (98.6 F) , blood pressure is 120/80 mm Hg, and pulse is 76/min.  Physical examination reveals mucosal pallor.  There are no enlarged lymph nodes.  The abdomen is soft and nontender.  The spleen tip is palpable 5 cm below the left costal margin; the liver is normal in size.  Stool guaiac is negative.  Complete blood count results are as follows: Peripheral blood smear shows predominant lymphocytes with features as seen in the image below. Which of the following is the most likely diagnosis?

• A)Acute lymphoblastic leukemia
• B)Chronic lymphocytic leukemia
• C)Gaucher disease
• D)Hairy cell leukemia
• E)Hodgkin lymphoma
• F)Infectious mononucleosis
• G)Myelodysplastic syndrome

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Definitions:

Write-Ins

A method allowing voters to write in the name of a candidate not listed on the ballot during an election.

Employee Referrals

A recruiting strategy where current employees recommend prospective candidates for positions within the organization.

Social Media

Digital platforms and technologies that enable users to create, share, or exchange information, ideas, pictures, and videos in virtual communities and networks.

Walk-Ins

Individuals who arrive at a place of business, such as a retail store or job hiring event, without a prior appointment, often for inquiries or immediate services.