New patient with pancytopenia. Best roommate?

Correct Answer: A

Rationale: The correct answer is A: Patient with digoxin toxicity. In this scenario, the patient with pancytopenia is at risk for bleeding due to low blood cell counts. Digoxin toxicity can cause an increased risk of bleeding, making it important to monitor for signs of bleeding in the roommate. Viral pneumonia, shingles, and cellulitis do not directly increase the risk of bleeding, making them less ideal roommates for a patient with pancytopenia. Selecting the patient with digoxin toxicity as the roommate ensures appropriate monitoring and management of potential bleeding complications.

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: D

Rationale: The correct answer is D: Factor VII level. The patient presents with a prolonged PT, indicating a deficiency in the extrinsic pathway of the coagulation cascade, which is primarily mediated by Factor VII. Normal aPTT rules out von Willebrand factor deficiency (choice A). Platelet count (choice B) is not directly related to the PT results. The statement about X chromosomes (choice C) is irrelevant to the patient's condition. Choice D directly addresses the specific factor deficiency leading to the prolonged PT in this case.

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.