A patient being seen in an outpatient clinic has had a complete blood count done. The results indicate increased eosinophil count. This finding is highly suggestive of a/an:

Correct Answer: A

Rationale: The correct answer is A: Parasitic infestation. Eosinophils are white blood cells that are typically elevated in response to parasitic infections. Parasites trigger an immune response that involves an increase in eosinophils to help combat the infection. Bacterial infections (choice B) usually lead to an increase in neutrophils, while viral infections (choice C) typically result in an increase in lymphocytes. Fungal reactions (choice D) can cause an increase in eosinophils, but parasitic infestations are more commonly associated with this finding. In this case, the increased eosinophil count is highly suggestive of a parasitic infestation based on the patient's clinical presentation and laboratory results.

Correct Answer: C

Rationale: The correct answer is C because using insect repellents is actually recommended to prevent tick bites, not attract them. Ticks are repelled by certain chemicals in insect repellents, so using repellents can help reduce the risk of getting Lyme disease. Therefore, the Scout's statement about not using insect repellents shows a misunderstanding and indicates a need for further instruction. In contrast, choices A, B, and D are all correct preventive measures for Lyme disease. Wearing a hat, long-sleeved tops, long pants, closed shoes, and socks that can be pulled up over pants all help to minimize skin exposure to ticks and reduce the chances of getting bitten.

Correct Answer: D

Rationale: The correct answer is D: Serum creatinine level. Foscarnet, an antiviral medication, can cause nephrotoxicity. Monitoring serum creatinine levels is crucial to assess renal function and detect any potential kidney damage. CD4+ T cell count (A) is important in HIV management but not specific to foscarnet monitoring. Lymphocyte count (B) and serum albumin level (C) are not directly related to foscarnet therapy or its potential side effects.

Correct Answer: C

Rationale: The correct answer is C: Refer for chemotherapy. Chemotherapy is the best next step for bronchioalveolar adenocarcinoma to target and shrink the tumor, control metastasis, and improve symptoms. It is a standard treatment for advanced-stage lung cancer. Option A (Refer to hospice) is premature as chemotherapy can improve quality of life and survival. Option B (Refer for lobectomy) is not suitable for advanced-stage cancer. Option D (Refer for radiation therapy) may be used in combination with chemotherapy but is not the initial treatment of choice.

Correct Answer: D

Rationale: The correct answer is D: GnRH analogue. In a 75-year-old man with prostate cancer and elevated PSA levels, GnRH analogues are the treatment of choice to suppress testosterone production and inhibit tumor growth. Observation (A) is not recommended due to the aggressive nature of prostate cancer. Radiation therapy (B) may be used as adjuvant therapy but is not the primary treatment for advanced disease. Estrogen therapy (C) is not recommended in men due to its side effects. Choosing GnRH analogues (D) is supported by guidelines for advanced prostate cancer management.