Progressive improvement followed, and by 4 months, the full blood count was normal. Two cycles of escalated BEACOPP (bleomycin, etoposide, Adriamycin, cyclophosphamide, vincristine, procarbazine, prednisone) followed by four cycles of ABVD if an interim PET scan is negative. In July, 20 days after the bone marrow procedure and AML diagnosis, the patient was scheduled to begin his first cycle of Azacitidine (Vidaza). What would not be considered a first line treatment for this patient? Hematology case studies with answers pdf full. A 61-year-old woman complained to her family doctor of pain in both knees on walking and having great difficulty, because of pain, in kneeling down and standing up again. Mutational analysis of the marrow aspirate revealed a MYD88 L256P mutation and a CXCR4 mutation.
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This patient was treated with daily oral cyclophosphamide at a dose of 100 mg/day. A baseline positron emission tomography/computerized tomography (PET/CT) scan shows hypermetabolic adenopathy in the right neck and mediastinum with no bulky disease sites and no evidence of disease below the diaphragm. A 69-year-old woman presented to her family physician with an infected ingrowing toenail. Hematology Questions and Answers | Mayo Clinic Internal Medicine Board Review Questions and Answers | Oxford Academic. What tests will you order next? Dx= Multiple Myeloma (CRABI symptoms + rouleaux).
At the end of the initial therapy, a discussion was held with the patient about the possibility of high-dose therapy consolidation with an autologous hematopoietic stem cell transplant, but she preferred the option of the resumption of watchful waiting. Musculoskeletal aches and pains are common and probably occur in about one-third of patients. The patient was referred to a hematologist at an amyloid center, and an abdominal fat biopsy was performed. The immunophenotype indicates a Ph-like B-cell ALL; there is no expression of myeloid or T-cell markers. Hematology case studies with answers pdf 1. E. All of the above are appropriate treatment options. This will be repeated on blood and marrow in 2 months.
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D. All of the above. Your patient presents with fever, chills, dyspnea, and hypotension post- blood transfusion. These findings were indicative of marginal zone lymphoma (MZL). The serum N-terminal B-type natriuretic peptide (NT-proBNP) and troponin-T were both raised (see below). 48-Year-Old Woman With Weight Loss, Hepatomegaly, and Splenomegaly. Which of the following systemic treatments would you usually offer? Presence of cytoplasmic CD3 despite surface CD3 negativity. Authors: Clémentine Sarkozy; Philippe Solal-Céligny; Guillaume Cartron. Hematology case studies with answers pdf.fr. He complains of "B symptoms" such as fever, night sweats, and weight loss. E. CD3- (surface), CD16-, CD56-. A 47-year-old man presented with a 2-month history of dysphagia and a "foreign body sensation" in the right side of his throat. Staining for anaplastic large cell lymphoma kinase (ALK) was negative.
She has no comorbidities and a good performance status. Although her rheumatoid factor is positive, she does not have rheumatoid arthritis. Translocations are rarely seen in WM and t(11;14), in particular, is highly suggestive of myeloma. His spleen is not palpable. 1 × 109/L in accord with the diagnostic criteria for MBL.
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Multiple biopsies of normal and abnormal mucosa were taken. Your 50 yo female patient is concerned about urinating blood in the mornings. SMZL involves the white pulp of the spleen. Normal female karyotype (46XY). When she returned to her family doctor, she reported that the pain was a little better but had not gone away. Her family doctor started her on a trial of a proton pump inhibitor (PPI) and arranged to see her 3 weeks later. Microangiopathic hemolysis (overactive clotting causing hemolytic anemia). Hematology and Hemostasis Customer Case Studies and White Papers. Start direct thrombin inhibitor therapy.
He was initially observed, and over several months, his neutrophil count declined further to 0. He was on no medications. An endobronchial ultrasound (EBUS)–guided biopsy of the mediastinal mass shows classic Hodgkin lymphoma. CD5 expression should raise a suspicion of mantle cell lymphoma but occurs in 10% to 20% of WM cases as does expression of CD10. FL cells typically express monoclonal surface immunoglobulin (IgM with or without IgD, IgG, or rarely IgA), B cell–associated antigens (CD19, CD20, CD22, and CD79a), BCL2, and usually BCL6 and CD10 but not CD5 or CD43. Immunophenotyping revealed that the lymphocytes were CD19+, CD20 dim +, CD5+, CD23+, CD10-, sIg weakly positive with κ light chain restriction. A del(13) occurs in at least half of patients with myeloma and is more common in nonhyperdiploid cases. What diagnostic test do you order for a patient with suspected neutropenia? Which of the following statements is true about the use of dabigatran in atrial fibrillation compared with the well-managed use of warfarin? The diagnosis of amyloid is easily missed or delayed, and a high index of suspicion is necessary. PTCL-NOS accounts for about 26% of cases. Mature follow-up of the HD10 trial confirmed the noninferiority of two cycles of ABVD + 20 Gy ISRT compared with four cycles of ABVD + 30 Gy ISRT for early stage favorable disease with excellent outcomes (10-year PFS and overall survival of 87% and 94%, respectively). 5 years, but the hemoglobin and platelet count are now again declining.
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The response rate is very high, but deep CRs are not usually achieved. A 42-year-old woman with a history of systemic lupus erythematosus (SLE) presents with fatigue. Which of the following statements about WM are not correct? Which of the following treatment options for this patient results in a higher probability of PFS? In view of the low serum albumin, a 24-hour urinary protein quantification was made, and this was 14. What treatment would be appropriate now? A. t(14;18), IGH–BCL2 fusion. A diagnosis of osteonecrosis of the jaw (ONJ) was made and confirmed by radiography. Authors: John C. Byrd; Adam S. Kittai; Farrukh T. Awan. A definitive diagnosis of AITL was made. Your patient presents with anemia, high reticulocytes, and is missing pyruvate kinase. 36-Year-Old Man with Severe Low Back Pain and BCP-ALL. 1 mmol/L), and the triglyceride level was 2.
Rituximab alone is also an option if the patient is not willing to undertake a WW strategy or has any contraindication to ISRT. Think: betas= fragile). R-CHOP is not indicated in this indolent condition. Polycythemia vera (PV). There is no reason to suspect familial predisposition in this case. It is of interest that on detailed questioning, the patient said that she had had a tooth extraction a few weeks before the oral symptoms developed, and this had not been covered with antibiotics. Decreased hepcidin, elevated ferritin, elevated TIBC, normal serum iron. After she was treated with ABVD (doxorubicin [Adriamycin], bleomycin, vinblastine, and dacarbazine) combination chemotherapy followed by involved field radiotherapy, the disease was in complete remission. Myeloproliferative Neoplasms (MPNS).
C. Immunohistochemistry staining for CD2, CD3, CD4, CD5, CD7, CD20, CD30. A diagnosis of myeloma was made with hypercalcemia, renal failure, and hypogammaglobulinemia. The family doctor had also requested a number of blood tests, and these showed a hemoglobin of 127 g/L, a WBC of 5. The following day he returned for his second treatment.
Light chain amyloidosis is rare in WM. A. MCL is twice as common in males as in females. The patient was treated with a combination of gemcitabine, L-asparaginase, and oxaliplatin and local radiotherapy. A marrow biopsy also showed involvement by low grade FL cells. Her CBC shows: - low Hg, Hct, and RBCs. B. Melphalan and prednisone.
Her most recent effort, enjoyed by D. C. audiences last year, was Fannie Lou Hamer, Speak On It!, presented outdoors at Arena Stage. Larry from Knoxville, Tennessee. Producer Bev Ragovoy said about the musical: "Armed with Sister Rosetta's inspiring story, West's engaging book and a talented creative team, Shout Sister Shout is guaranteed to bring audiences back to the theater for a joyful evening of music that celebrates an extraordinary woman whose scope of influence continues to this day. Shout sister shout seattle review magazine. Porscha has appeared in Justin Huertas' The Last World Octopus Champion; Nina Simone: Four Women; Seattle Children's Edward Tulane;12 Ophelias; By The Way; Meet Vera Stark; Sound Theatre's Hoodoo Love; As You Like It; Anne Washburn's The Octavia, Iphigenia, and Other Daughters; and Wooden O's Love's Labour's Lost and Force Continuum. It was hard to follow since most of the words in the songs were hard to make out. INCREDIBLE SHOW, DISRESPECTFUL CROWD. It is Broadway in Los Angeles not a home town show.
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The actors are extremely talented dancers and singers but due to the poor sound quality, many of the the jokes were missed and the show was not enjoyable. Safe & Secure Ticket Buying Experience. Reverend Tharpe/Ensemble. I am glad that I went to see what all the hype is about, I give Mirvish some extra stars for their advertising, but disappointed in the overall performance. Awards: Jonathan Larson, ASCAP/Richard Rodgers, LA Ovation, LA Drama Critics Circle, LA Stage Raw. Reviews of Shout Sister Shout! in Seattle, WA. Much of the singing was rap, with very loud music, making it difficult to understand, and follow the dialogue. I didn't know it was a rap.
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He received the AUDELCO award for outstanding set design for Tyrell McCraney's Head of Passes at the Public. Concerts: Kurt Elling's "The Big Blind" (Jazz at the Lincoln Center), My One and Only (Roundabout), sang at Stevie Wonder's Songs in the Key of Life (Toronto). Spent $$$ on great seats. The show takes you through her life from her years as a teenager all the way to her final days. I thought the actor playing TJefferson was a smidge over the top (but he isn't Daveed Diggs! HAMILTON ROBINSON CENTER MUSIC HALL LITTLE ROCK ARKANSAS. Impressive show with a stellar cast and sheer energy. I truly would not recommend this show to anyone but that is my opinion. William Carlos Angulo happily returns to Seattle Rep where he choreographed In the Heights last season. Kudos to all the staff and ushers as well - they make it run smoothly every night. I could not understand 85% of the words. Cheryl L. West on her Broadway-bound musical about Sister Rosetta Tharpe. I had listened to the soundtrack probably 100 times prior to the show and wondered how this cast would compare - they did not disappoint.
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Congratulation warmers and thank you Broadway Grand Rapids. We were very excited to see Hamilton for our first time at Mortensen Hall in the Bushnell Theatre. The standing ovation and the enthusiastic applause by the audience at the end was well deserved and received by the talented young cast. It's a very emotional and powerful song and the orchestra and actress didn't sound in sync in the first few lines, causing the actress to have to (like a pro!! ) It was an amazing way to watch a performance, which was the very first time we were ever this close to enjoy a show of any level. Shout at shout to. Great music, great acting, lighting set design. I felt sometimes like I was in a rock concert. Dive into Cheryl L. West's spirited, authentic and emotionally charged story about a charismatic music forerunner and the authentic roots of rock & roll. Never seen so much talent on one stage!!!
We have seen many shows and we are struggling to get this show in our top 10. My wife and I were fully engaged with the staging, the musical and lyrical genius of Lin Manuel Miranda, the emotions, and just the overall swagger of the performances. Film: four movies about Tinker Bell (Disney). There was only one person in the pit. Shout sister shout seattle review site. What would you like to relate about her? FABULOUS EXPERIENCE. The significance of live experience cannot be overstated—the group gathering, being in the same place and space, experiencing community and story together. It quickly and quietly puts the kibosh on that messy angle that plagued so much of Station 19 and allows Carina and Maya to focus on the bigger issues in their marriage on their own. Please note: The term Paramount Theatre and/or Hamilton as well as all associated graphics, logos, and/or other trademarks, tradenames or copyrights are the property of the Paramount Theatre and/or Hamilton and are used herein for factual descriptive purposes only.