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A 68-year-old male presents with fatigue, pallor, and easy bruising. Laboratory tests reveal macrocytic anemia, neutropenia, and thrombocytopenia. Bone marrow biopsy shows dysplastic changes in myeloid cells with

A 68-year-old male presents to his primary care physician with complaints of fatigue and pain in his lower back for the past 2 months. Physical examination reveals pallor and focal bony tenderness to palpation over the lumbar vertebrae. Laboratory evaluation reveals hemoglobin 9.8 g/dL, serum calcium of 9.4 mg/dL, serum creatinine of 1.4 mg/dL, albumin of 3.7 g/dL, and rouleaux formation on peripheral blood smear. Serum protein electrophoresis reveals an elevated monoclonal IgG protein spike (M-protein concentration = 5 g/dL). Which of the following clinical findings would most likely be associated with this patient’s condition?

A 45-year-old male is brought to the emergency room by his wife because he has been acting confused for the past day. He is febrile, with an oral temperature of 103.6 deg F; vital signs are otherwise stable. His physical exam is significant for the finding shown (see image below); he has never noticed lesions like these before. He also has subtle right-sided weakness affecting upper and lower extremities. Labs reveal: hemoglobin 7.0 g/dL, hematocrit 21%, white blood count of 10,200, and platelet count of 20,000. PT/INR and PTT are normal. A peripheral blood smear is shown (see image below). What is the most likely diagnosis?

A 7-year-old boy is brought to his pediatrician’s office by his mother with a new onset rash. His mother says that the rash appeared suddenly yesterday. He is otherwise well. His medical history is unremarkable except for a recent upper respiratory infection that resolved without intervention two weeks ago. His temperature is 98.2°F (36.8°C), blood pressure is 110/74 mmHg, pulse is 84/min, and respirations are 18/min. Physical exam shows a well appearing child with a diffuse petechial rash. Complete blood count shows the following:  Hemoglobin: 12.6 Hematocrit: 37% Leukocyte count: 5,100 Platelet count: 65,000 Which of the following is the best choice in treatment for this child?

A 52-year-old female comes into your office with concerns of falling. She states that over the last few months, she has a feeling of numbness and “tingling” in her feet. She denies any problems with her balance and denies vertigo, but does not feel “sure-footed.” She denies any neurological history. Past medical history is significant for hysterectomy 10 years ago for menorrhagia and a bowel resection for Crohn’s disease. On exam, the patient has decreased reflexes and sensation bilaterally in her lower extremities. CBC shows a Hgb of 9.1 with an MCV of 114. The peripheral blood smear (see image below). The patient’s methylmalonic acid (MMA) level is elevated. What is the most likely cause?

A 54-year-old male presents to his primary care physician. He has been feeling very tired lately and thinks that he looks more pale. The physician orders a complete blood count, which shows: Hgb 8.5; WBC 1,200; platelets 70,000. The patient is referred for bone marrow biopsy, which shows the findings (see image below). Which of the following is the most likely diagnosis?

Bee Corp. has only a few layers of management between the CEO and entry-level employees, allowing for quicker decision-making and more employee autonomy. This describes a:

In order to reduce production costs, Autoworks, an automobile manufacturer, decided to buy out a glass plant and begin manufacturing the glass for the windows of cars on its own. The corporate strategy adopted by the company is known as

A 20 y/o female college student comes to student health with complaints of fatigue, fever, sore throat, and nausea.  She states that a couple of her friends have had the same thing and were told it was a virus and they needed to stay on bed rest.  Her temp today is 102F and her throat is erythematous with tender posterior cervical lymphadenopathy.  Her liver is also slightly tender and extend 2cms below the costal margin.  Which of the following tests would help you the most with your diagnosis?

The nurse reviews the chart of a patient diagnosed with a spinal cord injury. Documentation states, “Absent sacral (anal) sparing. ASIA assessment level is ‘A’.” How does the nurse interpret these findings?