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128783 Medicine

A 9-year-old boy presents with fever, feeling unwell, and easy bruising on his legs. On examination he is pale, blood pressure 100/60 mm Hg, pulse 100/min, and temperature 37.8degC. His lungs are clear, abdomen is soft with a palpable spleen, and there are petechiae and bruises on his legs. His CBC reveals a hemoglobin of 8.5 g/dL, WBC of 17,000/mL, and platelets of 30,000/mL. A blood film reveals neutropenia and leukemic lymphoblasts. Which of the following is the most appropriate initial diagnostic test to confirm the diagnosis?

Amonospot test
Bbone marrow aspirate and biopsy
CCT scan abdomen
Dchest x-ray
Medicine
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