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41293 Unknown

An 11-day-old neonate presented with difficulty in breathing, poor feeding and sweating during feeding. O/E Weak femoral pulse Radial pulse -bounding Radio-femoral delay Loud S2 Systolic ejection clicks or thrill in the suprasternal notch Sho systolic murmur was heard along the left sternal border at the 3rd and 4th intercostal spaces transmitting to the left infrascapular area and to the neck. ABG of lower limbs revealed severe acidosis as compared to the upper limbs. SpO2 (upper limb)> SpO2 (lower limb) Chest X-ray Which of the following needs to be given urgently to the neonate to save the life of the neonate: –

APGE1
BPGE2
CPGF2-ALPHA
DPGD2
Unknown
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41299 Medicine

CD 19 positive, CD 22 positive, CD103 positive monoclonal B-cells with bright kappa positivity were found to comprise 60% of the peripheral blood lymphoid cells on flow cytometric analysis in a 55 year old man with massive splenomegaly and a total leucocyte count of 3.3 × 109/L. Which one of the following is the most likely diagnosis?

ASplenic lymphoma with villous lymphocytes
BMantle cell lymphoma
CB-cell prolymphocytic leukemia
DHairy cell leukemia
Medicine
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