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You are asked to evaluate a 62-year-old patient who presents complaining of fatigue and a “skin infection” and states that he has also noticed increased bruising recently.  On examination, you note that the patient has significant periorbital cellulitis.  There are also multiple areas of ecchymoses in various stages of resolution, as well as petechiae noted over the trunk and extremities.  There is no lymphadenopathy, hepatomegaly, or splenomegaly noted.  A stat CBC with differential is ordered and the results are as followsWBC: 80,000 (↑)Hgb:   9.0 (↓)HCT:  27% (↓)MCV: 90Plt: 60,000 (↓)Differential: 20% segs, 2% bands, 36% lymphs, 4% monos, 3% eosinophils, 1% basophils,34% blastsPeripheral blood smear: Blast cells with Auer rods noted Based on this information, which of the following conditions is the most likely diagnosis for this patient?      

A 22-year-old Caucasian female presents to the Emergency Department complaining of double vision. The patient was well until the morning of admission when she awoke with double vision “but only when I look to my right side.” On questioning further, she related having an episode of left leg numbness while at summer camp 6 years ago but it resolved over 3 days and she never told anyone. Also, three years ago she saw her primary care physician after a seven-day episode of right eye pain and visual blurring, which he attributed to ocular migraine. There is no history of head trauma, or recent infections, fever, or immunizations.   Exam revealed a young female who was awake, alert, and in no acute distress. Positive findings included mild pallor and atrophy of the right optic disc. Bedside visual fields and acuity were normal. Testing external ocular motion in both eyes together revealed that there was no left eye movement beyond midline when attempting to look to her right, accompanied by right eye lateral nystagmus. When the left eye was tested with the right eye closed, eye movements were full. No other motor signs were evident. There were no abnormal skin, sensory, or auditory findings. An MRI scan of the brain with gadolinium enhancement revealed a 2 x 3 cm lucency in the region of the right parietal white matter without swelling or enhancement. A diagnosis of multiple sclerosis (MS) is suspected.Which of the following groups of three ancillary tests would be the most helpful in establishing a diagnosis of MS? 

A 26-year-old male presents to the urology clinic for evaluation of a painless mass in his left testicle. He said he noticed it the other day when he was performing testicular self-examination. You palpate his scrotum and note a ‘bag of worms’ consistency in his left hemiscrotum. Which of the following conditions is the most likely diagnosis for this patient?

A 42-year-old female presents for a routine appointment. She is a relatively new patient, seen for the first time for her annual gynecologic examination 6 months ago.  Today, the patient presents for evaluation and admits that she has difficulty concentrating and has long been described as “irritable” by her co-workers and her husband.  Despite the success of her restaurant, the patient reports “feeling sad and hopeless most days for the past several years.”  She initially thought that she was menopausal, although her menses are reported to be regular.  She denies any current or past symptoms of mania and denies suicidal ideation. Physical examination is unremarkable. Lab results include normal FSH, LH, and estradiol levels. Chemistry panel and CBC values all   within normal limits. Based on this information, which of the following conditions is the most likely diagnosis for this patient?

A mother seeks medical attention for her 7-year-old son because for the last 12 months he “has not acted like his 3 older brothers.”  The mother indicates that her son has said on repeated occasions he wants to “get rid of” his male genitalia and he “wants to be a girl.”  She has found him wearing his sister’s clothing on numerous occasions, and he has asked his parents to call him only by his preferred name of “Angela.”  His male classmates are now teasing and embarrassing him in class, and it has begun to affect his schoolwork. Based on this information, which of the following conditions is the most likely diagnosis for this patient?

Complete the quote below (from the Wealth of Nations):: This __________, from which so many advantages are derived, is not originally the effect of any human wisdom, which foresees and intends that general opulence to which it gives occasion. It is the necessary, though very slow and gradual consequence of a certain propensity in human nature which has in view no such extensive utility; the propensity to _____________.

A ______________ is the depiction of the earth’s curved surface on a flat map. 

The vast majority of people live in the ________hemisphere. 

Use the pie chart to answer the question. The pie chart shows the percentage of votes received by each candidate in the student council presidential election. How many people voted for Gina?

A pharmacist is asked to weigh 50 mg of oxymorphone on a prescription balance having a sensitivity requirement of 6 mg. How would you weigh this amount with an acceptable error in weighing of 5% using lactose as the diluent?