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12190 Medicine

A 34-year-old man presents with symptoms of fatigue, weakness, nose bleeds, and palpitations with exertion. On examination he is pale, blood pressure 110/70 mm Hg, pulse 100/min, heart sounds are normal, lungs are clear, and he has multiple petechiae and bruises on his legs. His blood count is abnormal: hemoglobin 8.5 g/dL white blood cells (WBCs) 4000/mL, platelets 50,000/mL, and there are blast cells in the peripheral blood. He is diagnosed with acute promyelocytic leukemia (AML-M3). Which of the following is a characteristic of this acute myelogenous leukemia? (See Fig. below.)

Apeak incidence in childhood
Bhigh leukocyte alkaline phosphatase
CPhiladelphia chromosome
DAuer bodies in blast cells
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12194 Medicine

A 25-year-old male student presents with the chief complaint of rash. He denies headache, fever, or myalgia. A slightly pruritic maculopapular rash is noted over the abdomen, trunk, palms of the hands, and soles of the feet. Inguinal, occipital, and cervical lymphadenopathy is also noted. Hypertrophic, flat, wart-like lesions are noted around the anal area. Laboratory studies show the following:Hct: 40%Hgb: 14 g/dLWBC: 13,000/mLDiff: 50% segmented neutrophils, 50% lymphocytesWhich of the following is the most useful laboratory test in this patient?

AHuman papillomavirus (HPV) serology
BRapid Plasma Reagin (RPR) test
CNucleic acid amplification test for Chlamydia
DBlood cultures
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