A patient has visited his physician because he found an enlarged ...

[student77]

A patient has visited his physician because he found an enlarged lymph node along the mediastinal border. When questioned, the physician may be alerted to a possible diagnosis of Hodgkin lymphoma (HL) if the patient also displays: Select all that apply.
 
  A)
  yeast infection in the mouth.
  B)
  night sweats.
  C)
  unexplained pruritus.
  D)
  joint swelling.
  E)
  sore throat with pustules on tonsils.

Question 2

A 29-year-old construction worker got a sliver under his fingernail 4 days ago. The affected finger is now reddened, painful, swollen, and warm to touch.
 
  Which of the following hematological processes is most likely occurring in the bone marrow in response to the infection?
  A)
  Proliferation of immature neutrophils
  B)
  High circulatory levels of myeloblasts
  C)
  Increased segmented neutrophil production
  D)
  Phagocytosis by myelocytes

[xMRAZ]

Answer to Question 1

Ans:
B, C

Feedback:

Most people with HL present with painless enlargement of a single node or group of nodes. The initial lymph node involvement typically is above the level of the diaphragm. Mediastinal masses are frequent and discovered on routine chest x-ray. There may be complaints of chest discomfort with cough or dyspnea. Additional symptoms include fevers, chills, night sweats, and weight loss. Pruritus and intermittent fevers associated with night sweats are classic symptoms of HL. Yeast infections and joint swelling are not associated with HL. Sore throat with pustules on tonsils is associated with strep throat.

Answer to Question 2

Ans:
A

Feedback:

A part of the immune response is the proliferation of neutrophils in response to infectious organisms. Neutrophilia is an increase in immature neutrophils (bands) most commonly seen in acute infections and tissue injuries that promote the accelerated release of neutrophils and their precursors into the circulation. Myeloblasts are not normally found in circulation, and segmented neutrophils would not yet have reached maturity (takes approximately 2 weeks to mature). Myelocytes do not perform phagocytosis.