Lectus

An 18-month-old toddler is brought to a pediatric hematologist by his father. The boy was referred to a specialist for prolonged neutropenia. He has had several blood tests showing normal hemoglobin, hematocrit, platelet count, and an isolated low neutrophil count. He was born at 39 weeks' gestation via spontaneous vaginal delivery and is currently up to date on all vaccines and meeting all developmental milestones. Today, his complete blood count (CBC) with differential shows:

His pulse is 90/min, respirations are 22/min, blood pressure is 110/65 mm Hg, and temperature is 37.0°C (98.6°F). He appears healthy and is within expected growth parameters for his age and sex on physical examination. A bone marrow biopsy shows normal bone marrow with 95% cellularity and trilineage maturation. Flow cytometry is normal, with no abnormal markers noted. Which of the following is the most probable diagnosis?Deselect Answer

A 45-year-old patient with diabetes mellitus is admitted to the hospital for elective cholecystectomy. The patient receives insulin as ordered, but due to a medication administration error involving multiple system failures, receives 10 times the prescribed dose and develops severe hypoglycemia requiring intensive care. The attending physician is determining how to approach this adverse event. According to current best practices in medical error management, which of the following approaches most effectively addresses both patient safety and organizational learning?Deselect Answer

A 72-year-old woman presents to her primary care physician for her annual wellness visit. Her daughter, who accompanies her, reports that the patient has been less interested in her usual activities like gardening and attending church for the past 3 months. The patient has lost 5 pounds unintentionally during this time and often complains of feeling tired. She has a history of hypertension and osteoarthritis. Her laboratory values, including thyroid function tests, complete blood count, and comprehensive metabolic panel, are within normal limits. Which of the following is the most appropriate initial screening tool to assess this patient's emotional health?Deselect Answer

A 45-year-old farmer in Colorado presents to the emergency department in late summer with a 3-day history of high fever, severe headache, and altered mental status. His wife reports that he has been working long hours in the fields and frequently sleeps in a barn near irrigated pastures. He appears disoriented, and physical examination is significant for nuchal rigidity. Lumbar puncture shows pleocytosis with lymphocytic predominance. The working diagnosis is Western equine encephalitis. Which of the following best describes the typical transmission cycle of this pathogen?Deselect Answer