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8130 Medicine

A four year old boy was admitted with a history of abdominal pain and fever for two months maculopapular rash for ten days, and dry cough, dyspnea and wheezing for three days. On examination liver and spleen were enlarged 4 cm and 3 cm respectivley below the costal margin. His hemoglobin was 10.0 g/dl, platelet count 3.7 x 109/L and total leukocyte count 70 x 109/L, which included 80% eosinophils Bone marrow examination revealed a cellular marrow comprising of 45% blasts and 34% Eosinophils and eosinophil precursors. The blasts stained negative for my eloperoxidase and nonspecific esterase and were positive for C D19, CD10, CD22 and CD20. Which one of the following statements is not true about disease?

AEosinophils are not part of the Neoplastic clone.
Bt(5:14) rearrangement may be detected in blasts.
CPeripheral blood eosinophilia may normalize with chemotherapy
DInv (16) is often detected in the blasts and the eosinophils
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8131 Medicine

40 year old female, who has multiple sexual paners presented with fever, rash and aicular symptoms. Migratory ahritis and tenosynovitis of knees, hands, wrists, feet and ankles noticed during clinical examination. Synol fluid leukocyte count was 12,000/ml and culture was sterile. The patient has been successfully treated with injection ceftriaxone 1 g Q24 hours for 7 days. What was the diagnosis in this setting?

AAhritis due to Pseudomona aeruginosa
BDisseminated gonococcal infection
CGonococcal septic ahritis
DSyphilitic ahritis
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8134 Medicine

What is the most appropriate management of diabetic ketoacidosis?

A500ml of 0.9% Saline over 15 minutes and a fixed rate insulin infusion
B500ml of 0.9% Saline over 15 minutes with potassium chloride and a fixed rate insulin infusion
C500ml of 0.9% Saline over 30 minutes with potassium chloride and a rapid acting subcutaneous insulin injection
D500ml of 0.9% Saline over 30 minutes and a rapid acting subcutaneous insulin injection
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