4-year-old with ALL, ordered meds. Most important to double-check?

Correct Answer: C

Rationale: The correct answer is C, Methotrexate 10 mg PO. In pediatric ALL treatment, Methotrexate is a critical chemotherapy drug with a narrow therapeutic index. Double-checking the dose is crucial to prevent under or overdosing. Prednisone and Amoxicillin are common medications in ALL treatment, but they have a wider therapeutic range. Filgrastim is a supportive medication used for neutropenia, not as critical as Methotrexate in ALL treatment.

Correct Answer: C

Rationale: The correct answer is C: Crimean Congo virus. This virus is known to cause viral hemorrhagic fever and can be transmitted through tick bites. The other options, Hantavirus and Rift Valley virus, are not typically associated with tick bites. Marburg virus is also a viral hemorrhagic fever but is not commonly transmitted through tick bites. Therefore, based on the patient's presentation and potential exposure history, Crimean Congo virus is the most likely causative agent.

Correct Answer: A

Rationale: The correct answer is A: Nodular sclerosis subtype of Hodgkin's lymphoma is common in young women with a good prognosis due to its characteristic presentation of fibrotic bands dividing the lymph node into nodules. This subtype is associated with less aggressive behavior and better response to treatment compared to other subtypes. Incorrect choices: B: Mixed cellularity subtype is more common in older adults and associated with a worse prognosis. C: Lymphocyte predominance subtype is more common in males and has a unique histological appearance with lymphocytic and histiocytic cells. D: Lymphocyte depletion subtype is rare, aggressive, and associated with a poor prognosis.

Correct Answer: D

Rationale: The correct answer is D, G6PD deficiency. Sulfonamides can induce oxidative stress, leading to hemolysis in individuals with G6PD deficiency due to impaired red blood cell protection against oxidative damage. Sickle cell disease (A), thalassemia minor (B), and hereditary spherocytosis (C) do not predispose individuals to sulfonamide-induced hemolysis as they do not involve oxidative stress as a primary pathophysiological mechanism.

Correct Answer: C

Rationale: The increased presence of neutrophils, bands, basophils, eosinophils, and platelets suggests Chronic Myelocytic Leukemia (CML). In CML, there is a high proliferation of myeloid cells leading to an increase in these cell types. Neutrophils, basophils, and eosinophils are myeloid cells, and their elevated levels are characteristic of CML. Bands are immature neutrophils also seen in CML. Platelets can be increased due to the bone marrow's overproduction of cells. Acute myeloid leukemia (Choice A) typically presents with blasts, not mature cells like in this scenario. Acute lymphoid leukemia (Choice B) involves the overproduction of lymphoid cells, not myeloid cells as seen here. LAP score is typically low in CML, not high as in Choice D.