A 65-year-old man presents to the hospital with complaints of fatigue, nausea, vomiting, and diarrhea for the past five days. He also states numbness and tingling of the legs, joint pain, and decreased urination that developed around the same time. He was recently diagnosed with non-Hodgkin lymphoma and started on chemotherapy two weeks ago. Vital signs show a blood pressure of 95/65 mm Hg, a pulse of 98/min, a respiratory rate of 19/min, and a temperature of 100˚F. Physical examination reveals a pale and cachectic man. Laboratory investigations reveal serum potassium 6.0 mEq/L (normal: 3.5-5.0 mEq/L), serum creatinine 3.2 mg/dL (normal: 0.6-1.2 mg/dL), serum calcium 7.0 mg/dL (normal: 8.6-10.2 mg/dL), and serum uric acid 9 mg/dL (normal: 2.4-6.5 mg/dL). What could have been done to prevent this condition?

A 7-month old boy, born to immigrant parents from Greece, presents to the hospital with pallor and abdominal distention. His temperature is 98.7°F (37°C), blood pressure is 98/61 mmHg, pulse is 111/min, respirations are 28/min, and oxygen saturation is 98% on room air. On physical exam, the patient is found to have hepatosplenomegaly and frontal skull bossing. Hemoglobin electrophoresis reveals markedly increased HbF and HbA2 levels. What would be the most likely findings on a peripheral blood smear?

A 45-year-old woman presents to the emergency department with hematemesis. Her son said that the patient had complained of gnawing abdominal pain that worsened before and improved after meals for the past 3 weeks. She frequently travels for work and is often stressed. She drinks alcohol socially and does not smoke tobacco or marijuana. She has not had anything to eat or drink for the past 24 hours due to the pain, but coughed up “several cups” of frank red blood before arrival. Her temperature is 98°F (37°C), blood pressure is 80/50 mmHg, pulse is 140/min, respirations are 24/min, and oxygen saturation is 96% on room air. The patient is empirically started on 3 units of uncrossmatched O-negative blood transfusion and pantoprazole. In the meantime, the patient’s initial laboratory data results reveal the following:Hemoglobin: 6 g/dLHematocrit: 18 %Leukocyte count: 8,000 with normal differentialPlatelet count: 400,000Serum:Na+: 140 mEq/LCl-: 115 mEq/LK+: 3.2 mEq/LHCO3-: 26 mEq/LBUN: 60 mg/dLGlucose: 104 mg/dLCreatinine: 1.1 mg/dLBlood type: ABRh status: negativeAfter bedside upper endoscopy with stapling of several peptic ulcers, repeat labs are obtained in 2 hours. The patient now complains of “feeling hot” with intermittent shivering. She denies any other symptoms. Her temperature is 101°F (38.3°C), blood pressure is 100/55 mmHg, pulse is 100/min, respirations are 20/min, and oxygen saturation is 99% on room air. Her lungs are clear to auscultation bilaterally, and no accessory respiratory muscle use is observed. No rash is seen. What is the most likely diagnosis?

A 29-year-old female with PMH significant for Hashimoto thyroiditis presents with shortness of breath, fatigue, and jaundice. Initial lab results reveal the following: WBC and PLT normal; Hgb 6.2; HCT19%; MCV 102 AST, ALT, Alk Phos, Serum iron, TIBC, Ferritin, B12, Folate: normal TBili 5.0, DBili 0.2, LDH 800; Retic count: 15%; Direct Coombs Test (DAT): positive Based on this information, what is the diagnosis for this patient?

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 26-year-old male patient who completed treatment for Hodgkin lymphoma four years ago now presents for evaluation complaining of increased fatigue, dry skin, mild weight gain, cold intolerance, and constipation. The patient received mantle field radiation therapy during his treatment for Hodgkin lymphoma. Which of the following associated clinical findings would you expect to be present in this patient?

A 54-year-old man presents to his primary care physician. The man 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 (see image). Which of the following is the correct diagnosis?

An 8-month old male infant, born to immigrant parents from Greece, presents to the hospital with pallor and abdominal distention. His temperature is 98.7°F (37°C), blood pressure is 98/61 mmHg, pulse is 111/min, respirations are 28/min, and oxygen saturation is 98% on room air. On physical exam, the patient is found to have hepatosplenomegaly and frontal skull bossing (prominent forehead). Hemoglobin electrophoresis reveals markedly increased HbF and HbA2 levels. What would be the most likely findings on a peripheral blood smear?

A 42-year-old woman presents to the emergency department with complaints of recurrent shortness of breath for the past 2 weeks. She reports shortness of breath whenever she goes on her morning run. The symptoms last for approximately 5-10 minutes and improve with rest. She denies chest pain, syncope, nausea, or abdominal pain during these episodes. Her medical history is significant for rheumatoid arthritis which is treated with hydroxychloroquine. She denies any recent surgeries, oral contraceptive/estrogen use, malignancy, or personal history of deep vein thrombosis (DVT) or pulmonary embolism (PE). She endorses some rhinorrhea and sore throat that has since resolved. Physical examination demonstrates some joint swelling at the proximal interphalangeal joints bilaterally but is otherwise unremarkable. Rectal exam: Guaiac negative brown stool in rectal vault. Laboratory studies are shown below:Leukocyte count and differential: 7,600 with normal differentialHemoglobin: 9.8 g/dLPlatelet count: 180,000Mean corpuscular volume (MCV): 83Reticulocyte count: 0.2%Ferritin: 268 ng/mL (Normal: 12-150 ng/mL)Serum iron: 38 mcg/dL (Normal: 60-170 mcg/dL)Total iron binding capacity (TIBC): 240 mcg/dL (Normal: 240-450 mcg/dL) CXR: Clear costophrenic angle and no signs of consolidation or interstitial infiltrate. Cardiac silhouette is clear, and there are no signs of cardiomegaly.What is the most likely explanation for this patient’s symptoms?

When conducting a SWOT analysis, which factor is considered an internal “Weakness”?