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A 28 year old male presents with ecchymoses in all over the body and bleeding gums. Physical examination reveals enlargement of his spleen and liver. Laboratory examination of his peripheral blood reveals a normochromic, normocytic anemia, along with a decreased number of platelets and an increased number of white blood cells. Coagulation studies reveal prolonged prothrombin and partial thromboplastin times and increased fibrinogen degradation products. Examination of the patient’s bone marrow reveals the presence of numerous granular blast cells with numerous Auer rods. These immature cells make up about 36% of the nucleated cells in the marrow.

Which of the following is the most likely diagnosis?
a. Acute lymphoblastic leukemia
b. Acute erythroid leukemia
c. Acute myelomonocytic leukemia
d. Acute promyelocytic leukemia
e. Acute monocytic leukemia
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Young boy 9 year old with abdominal pain

A patient is brought to your office, he is a young boy 9 year old. He looks good and he came with his mother. She was scared for her boy because she thought he has something serious. The problem is that the boy suffer from the abdominal pain for almost 2 years. The pain was not severe but bother a lot the child and his mother because he left the school a lot of time.the pain get worse during the week and during weekends he feels better. Even the summer is more quite from this abdominal pain. The development of the patient is normal, also the growth.physical He eats well and does not have problem of defecating. He did some laboratory exams that includes blood test, urinalysis, and chemistry panel and all came out normal.

Which is the next step?
a. Ultrasound of the abdomen
b. CT of abdomen
c. Observe the patient
d. Fibrogastroscopia
e. Suggest a lactose free diet
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[Solved] 71 year old patient female for routine examination

A 71 year old patient female comes to your office for a simple examination. She moved on lately, and doesnt have a family doctor. The last time she did a routine control, everything was normal. But it was a lot of time ago. She think she has a healthy body because her lifestyle is undercontrol with diets and physical activity. She does not smoke and drink alchohol, she doesnt have any complaints. Her family history doesnt reveals something important. She had three children and now she lives alone. Blood pressure 135/80 mmHg.

Which, do you think, is the less useful examination to do?
a. The density of bone
b. Examination of the colon
c. Pap test
d. Mammography
e. Tuberculosis test
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[Solved] Male 61 years old with weakness, nausea, vomitting and diarrhea

A patient male 61 years old, was admitted to the emergency department with weakness, nausea, vomitting and diarrhea. He reported that he was eating pizza in a dinner last night, in a restaurant with his friends. The simptoms appeared to him the morning after, with pain in the upper area of the abdomen. During the day, he was feeling not so good with headache and kind of disorientation sometimes. In the afternoon, after approximately 30 hours, the simptoms get worse with the clinic that he shows in emergency room. None of his friends have the same history.

Which of the following tests is most likely to be abnormal?
a. Shigelosis
b. Acute liver failure
c. Gastroenteritis
d. Cervical spondylosis
e. Ulcus duodeni
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The Importance of Recover Insurance for All

As parents we want the best for our children. That is what Neil and Diana managed to do for their children unknowingly to them.

Neil and Diana had three children - their son Michael and twin girls Stacy and Kayla. When the twins were born they decided they needed a much bigger home. They moved to a rural area where they could get more home for their money. They both worked locally, Neil as an auto mechanic and Dianna as a telemarketing agent. With the birth of their girls and the move they decided to meet with their financial planner to discuss their budgeting plan again.

Their agent went over many insurance options and explained how it was important to have insurance for their entire family. Since Neil and Diana were fairly young they discussed term life insurance, income protection, bill protection, total and permanent disability, and recovery insurance options.

Three years later Diana noticed Kayla constantly would complain her stomach ached. As a month went on she developed fevers, had a loss of appetite, and would throw up often. After 3 days of this she took Kayla in to see her pediatrician. He discovered her stomach felt odd and seemed as though it were swelling. He referred her to a specialist in the city which was more than 75 miles from home.

Diana and Neil took Kayla to the specialist and after a few tests the startling news was that Kayla had a Wilms tumor, a rare cancer that is reported as 5 percent of children’s cancers. They were all devastated. There was hope though as they discovered 9 out of every 10 children diagnosed are cured. They caught it in time. Kayla was transferred to the Children’s Cancer Center division and under constant care of a pediatric urologist, oncologists, and radiation oncologist. Because it was still rather small they opted for surgery first to remove it. There was some cancer cells left so they treated her with radiation. She was under treatment off and on for four months.

The family decided Diana should be there to support Kayla every minute. She took a leave from work and stayed at a nearby hotel. Neil would bring the kids every weekend to visit their sister and encourage her.

Neil discussed the situation with his insurance agent who helped him file a claim right away. He’d forgotten about the recovery insurance option they signed up for. In a few days they received a $60,000 claim check and were able to use the money for accommodations, travel, and the bills at home.

Kayla was released from the cancer center with a clean bill of health. After her 1 year anniversary Neil and Diana asked the kids what they wanted to do to celebrate. The kids all shouted Disney World! They fortunately put the remainder funding into a savings account.
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