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Internal Medicine > All Questions 401-600 > Flashcards

All Questions 401-600 Flashcards

1
Q

Type 1 RTA (distal)

A

H secretion. Low K. pH > 5.3. Rx: HCO2 + K. Hereditary, amphotericin, collagen vascular disease, cirrhosis, nephrocalcinosis.

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2
Q

Type 2 RTA (proximal)

A

Bicarb reabsorption. Low K. pH < 5.3. Rx: HCO3 + K + thiazide. Hereditary, sulfonamides, carbonic anhydrase inhibitors, Fanconi syndromes.

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3
Q

Type 4 RTA (distal)

A

Aldosterone defiency. High K. pH < 5.3. Rx: Fludrocortisone, K restriction, HCO3. Hyporeninemic with diabetes, HTN, or chronic interstitial nephritis; aldosterone resistance.

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4
Q

Hyperchloremic metabolic acidosis (no anion gap)?

A

Diarrhea, RTA, spironolactone/acetazolamide, TPN

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5
Q

Respiratory acidosis?

A

Foreign body, pneumothorax, flail chest, hypoventilation d/t sedatives/narcs, obstructive/restrictive pulmonary disease, pleural effusion.

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6
Q

Metabolic alkalosis?

A

NaCl responsive = vomiting, villous adenoma, contraction alkalosis, diuretics. Rx IVF + K. Not NaCl responsive = Conn’s & Cushing’s, adrenal hyperplasia, licorice, Bartter’s syndrome. Rx: KCl and spironolactone or acetazolimide (enhance HCO3 excretion)

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7
Q

Respiratory alkalosis?

A

Hyperventilation (anxiety/pain), CVA, head trauma, asthma, PE, CHF, pneumonia, pregnancy, hepatic insufficiency, ASA toxicity, thyrotoxicosis, mechanical ventilation. Rx = treat underlying cause.

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8
Q

Hyponatremia?

A

High osmolality = hyperglycemia or hypertonic infusion. Normal osmolality = Pseudohyponatremia, hyperlipidema, hyperproteinemia. Low osmolality = hypotonic hyponatremia.

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9
Q

Hypotonic hyponatremia?

A

Check FeNa: > or < 1%.

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10
Q

Hypotonic hyponatremia with FeNa >1%.

A

Hypervolemic = renal failure; Euvolemic = SIADH, hypothyroidism, renal failure, drugs; Hypovolemic = diuretics, RTA, adrenal insufficiency, ACE inhibitors.

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11
Q

Hypotonic hyponatremia with FeNa <1%.

A

Hypervolemia = nephrosis, CHF, cirrhosis; Euvolemic = polydipsia; Hypovolemic = vomiting, diarrhea, third spacing, dehydration.

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12
Q

Treatment fo hypotonic hyponatremia?

A

Hypervolemic = salt & water restrict; Euvolemic = salt & water restrict; Hypovolemic = normal saline.

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13
Q

Hyperkalemia signs and symptoms?

A

Intestinal colic, areflexia, weakness, peaked T wave, prolonged QRS and PR, low P.

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14
Q

Causes of hyperkalemia?

A

Cellular shifts: (tissue injury, acidosis, insulin deficiency, drugs including succinylcholine, digitalis, beta-agonists, arginine); Decreased excretion: renal insufficiency, drugs (spirlonolactone, triamterene, ACE-I, trimethoprim, NSAIDs), mineralocorticoid deficiency; Iatrogenic and spurious: hemolysis, fist clenching, leukocytosis, thrombocytosis.

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15
Q

Treatment of hyperkalemia?

A

C BIG K = Calcium gluconate (cardiac membrane stabilization); Bicarb, Insulin, Glucose; Kayexalate and loop diuretics (furosemide).

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16
Q

Hypokalemia symptoms?

A

muscle weakness, cramps, ileus, hyporeflexia, parasthesias, flaccid paralysis.

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17
Q

Causes of hypokalemia?

A

Transcellular redistribution (alkalosis, insulin excess, beta-adrenergic agonists, hypokalemic peridodic paralysis, pseudohypokalemia), potassium depletion

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18
Q

Linear calcification on x-ray of the knee?

A

Pseudogout. Positive birefringent crystals. Associated with hemachromatosis.

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19
Q

58yo F with long history of RA develops splenomegaly and leukopenia.

A

Felty’s syndrome.

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20
Q

meningococcemia

A

septic shock, pustules, organisms on gram stain

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21
Q

gonnococcemia

A

prositutes, urethritis, joint pain with effusion

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22
Q

typhoid fever

A

poor sanitation, prolonged fever, constipation, bradycardia, rose spots

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23
Q

staph sepsis

A

vesicles and bullae, IVDA

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24
Q

vibrio vulnificus

A

raw seafood, lesions on legs > arms, cirrhotics most susceptible

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25
Q

folliculitis

A

hot tubs: pseudomonas; swimmer’s itch: schistosomes

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26
Q

streptococcal infection

A

scarlet fever: sandpaper texture of rash, cellulitis, palms peeling

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27
Q

staph

A

Toxic shock = palmar desquamation

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28
Q

rocky mountain spotted fever

A

ascending purpuritic rash on palms and soles

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29
Q

HIV

A

maculopapular rash, viral syndrome

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30
Q

Diagnosis of amyloidosis?

A

Biopsy of abdominal fat pat or rectal biopsy.

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31
Q

ATPW hypocalcemia?

A

Serum Ca and Mg. Serum PTH, 25 and 1,25-D, phosphate, Cl, creatinine, amylase & lipase. Obtain EKG to look for prolonged QT.

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32
Q

Causes of hypocalcemia?

A

HIPOCAL: Hypo-PTH, Infection, Pancreatitis, Overload (rapid IV volume expansion), Chronic renal failure, Absorption abnormality, Loop diuretics.

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33
Q

Causes of hypercalcemia?

A

MISHAP-F: Meds/malignancy, Intox (vit D or A) or Immobilization, Sarcoidosis, Hyper-PTH or Hyperthyroid, Addison’s or milk-Alkali, Paget’s or Pheochromctoma. Familial hypocalciuric hypercalcemia (benign autosomal dominant condition)

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34
Q

Symptoms of hypercalcemia?

A

abdominal moan, psychiatric groan, kidney stone, and urination zone.

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35
Q

Most common cause of hypercalcemia?

A

malignancy or hyperparathyroidism.

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36
Q

Sideffect of lithium?

A

Hyperparathyroidism: alters setpoint for PTH secretion.

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37
Q

Thiazide diuretic sideffect?

A

hypercalcemia d/t increased renal reabsorption.

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38
Q

PTH-related peptide secreting tumors?

A

breast, lung, renal cell

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39
Q

Why does sarcoid and other granulomatous disease cause hypercalcemia?

A

increased conversion of 25-hydroxyvitamin D to 1,25 in macrophages. Occurs in TB, berylliosis, and lymphoma.

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40
Q

Most common hyperparathyroidism?

A

Solitary adenoma > 80% of cases. Four-gland hyperplasia 10%, multiple adenomas 5%, MENI or II.

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41
Q

50M dilated cardiomyopathy after travel to South America

A

Chagas - CM–> SOB, swelling + weight gain, trypanosome cruzii, reflux + megacolon

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42
Q

25M midsystolic murmur, louder with Valsalva

A

HOCM -

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43
Q

65M drug for NYHA class 2 systolic dysfunction

A

ACE -

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44
Q

55F AA restrictive cardiomyopathy, arrhythmia, wheezing

A

Sarcoidosis -

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45
Q

25M CP on recumbency, diffuse 2 mm ST elevations on EKG

A

Pericarditis - Most commonly viral

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46
Q

58M hyperlipidemia, diffuse weakness

A

Statin induced myopathy - increased CPK, LDH, aldolase, maybe AST and ALT

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47
Q

70 M orthopnea, PND, BP 160/90, HR 110, crackles, sinus tach, LVH, normal EF, what drugs to give?

A

diuretic, B blocker, Ca blocker - stiff LV with normal EF is diastolic dysfunction, from long standing HTN

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48
Q

72F CHF, EF 25%, blurry yellow vision

A

dig toxicity -

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49
Q

45M a fib, hospitalized, sudden SOB, afebrile, HR 110, RR 28, BP 95/60, new R axis deviation and RBBB

A

PE - Most common EKG with PE is sinus tach, classic is R axis deviation, S1 Q3 T3

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50
Q

25M hepatitis C, develops CHF, what hx?

A

IV drug use, HIV -

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51
Q

30W 34 weeks pregnant, tearing sensation in chest radiates to back

A

aortic dissection - secondary to HTN

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52
Q

58M hx of v tach, on meds, develops SOB, fatigue, and cold intolerance

A

amiodorone - check PFTs, TFTs, and LFTs for patients on amiodorone

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53
Q

25M intermittent palpitations, baseline ECG his wide QRS and short PR

A

WPW - delta wave, early contraction of ventricle

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54
Q

45F palpitations, HR 190, narrow QRS, no P waves

A

SVT -

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55
Q

80M chest pain, 3/6 harsh murmur at RUSB, diagnosis and other sx?

A

Aortic stenosis - assoc with angina (35-50%), syncope, and HF, delayed carotid upstroke, soft S2, S4, may reflect to mitral area- Gallavardin’s phenom

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56
Q

36 IV drugs LLSB systolic murmur, louder with inspiration, what wave most prominent in JVP

A

v wave - tricuspid regurgitation

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57
Q

58F decrescendo diastolic murmur LSB, uvula pulsations, wide pulse pressure

A

aortic insufficiency -

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58
Q

70M ST elevation in 2,3,avf, what additional ECG analysis?

A

R sided EKG for RV infarcts -

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59
Q

35F Raynaud’s, GERD, increasing DOE

A

pulm HTN 2ndary to CREST -

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60
Q

55F diabetes, arthritis, cirrhosis, arrhythmia, runs in family

A

hemochromatosis -

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61
Q

30 fatigue, weight gain, cold intolerance

A

hypothyroid -

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62
Q

40F obesity, HTN, new hyperglycemia

A

metabolic syndrome -

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63
Q

60F hypercalcemia, hyperphosphatemia, health food junkie

A

vitamin D toxicity -

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64
Q

50 HTN, tachycardia, flushing

A

pheochromocytoma - HTN may be intermittent

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65
Q

65M diarrhea, weight loss, a fib

A

hyperthyroid -

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66
Q

60M fasting blood sugar 130 on 2 different ocassions

A

diabetes - fbs>126 two times

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67
Q

60M galactorrhea

A

prolactinoma -

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68
Q

50M thyroid ca and neurofibromas

A

MEN 2b - also includes pheo, MEN2a= thyroid, parathyroid, pheo, MEN1= parathyroid, pancreatic, pituitary

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69
Q

75 hypercalcemia, long tobacco hx

A

squamous cell lung ca -

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70
Q

18F hypoglycemia, mom has DM2

A

factitious -

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71
Q

40F proptosis and palpitations

A

Graves -

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72
Q

30F has 8 month old, increased fatigue

A

postpartum thyroiditis -

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73
Q

50F hypokalemia, HTN

A

Conns - aka primary hyperaldo

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74
Q

25F hirsutism, amenorrhea

A

polycystic ovarian dz -

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75
Q

55M bilat visual field loss, headache

A

pituitary tumor -

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76
Q

60M meningococcemia, severe hypotension and hyperkalemia

A

Waterhouse Friderichsen - due to meningococcemia, hemorrhage into adrenal glands

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77
Q

35M wheezing while working on assembly line

A

occupational asthma -

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78
Q

65M heavy tobacco, sputum each morning for 3 months each year

A

chronic bronchitis -

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79
Q

55M, thin smokes 1ppd, pursed lip breathing

A

emphysema -

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80
Q

45M large bullae at bases on CXR, fam hx of lung dz

A

alpha 1 antitrypsin deficiency -

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81
Q

30F tender nodules on shins, intermittent wheezing, arthralgias

A

sarcoidosis - see cardio 4

82
Q

66M sinus tenderness, 2+ blood on UA, caviation on CXR

A

Wegeners - positive c-ANCA

83
Q

50 severe wheezing, peripheral eosinophilia

A

Churg-Strauss - aka allergic asthma or angiitis

84
Q

30M nonsmoker, hemoptysis, hematuria

A

Goodpastures -

85
Q

45F ulnar deviation, MCP stiffness, SOB, pleural effusion and lung nodules

A

rheumatoid lung dz -

86
Q

35 IVDA cannonball lesions peripherally on cxr

A

septic pulmonary emboli -

87
Q

65 nephritic syndrome, acute SOB, tachypnea, tachycardia, normal cxr

A

PE - nephritic syndrome –> decreased protein c and s

88
Q

35F comm acquired pneumonia, bilateral infiltrates, Na 130, transaminases slightly high, diarrhea

A

Legionella -

89
Q

30F photosensitivity, alopecia, pleuritic chest pain

A

SLE -

90
Q

50M obese bilateral 2+ pitting edema, wife claims he is “lazy”

A

cor pulmonale due to OSA - other serious OSA complications- arrhythmias, pulmonary HTN

91
Q

25F progressive chest pain and SOB over months

A

primary pulmonary HTN -

92
Q

65M diffuse basilar crackles despite diuresis, interstitial infiltrates on baseline cxr

A

interstitial pulmonary fibrosis -

93
Q

60M methotrexate therapy for psoriasis, progressive sob

A

pulmonary fibrosis -

94
Q

35M homeless, pleural effusion

A

TB -

95
Q

55M recent CABG, L sided pleural effusion on cxr one month post-op

A

Dressler’s Syndrome - aka post MI syndrome, 1-12 weeks after infarction, autoimmune, pericarditis and possible effusion

96
Q

25M HIV, chest pain, pneumothorax

A

PCP -

97
Q

23F photosensitivity, arthralgias, pleuritic chest pain

A

SLE -

98
Q

50M dry mouth, arthralgias, peripheral neuropathy

A

Sjogrens -

99
Q

60F one hour of morning stiffness in bilateral wrists, effusion on CXR

A

rheumatoid arthritis -

100
Q

70M alcohol abuse, tender warm left ankle, no fevers

A

gout -

101
Q

20 student R knee swelling and warmth

A

gonorrhea -

102
Q

50M new heart murmur, red warm L elbow

A

septic emboli -

103
Q

73F swollen DIP joints for months

A

OA -

104
Q

45M sausage digits, scaly skin plaques

A

psoriasis -

105
Q

25 eye irritation, ankle swelling, dysuria

A

Reiters - conjunctivitis, arthritis, urethritis

106
Q

50 oral and genital ulcers, arthralgias

A

Behcets - a type of vasculitic syndrome

107
Q

35F purpuric lesions on shins, renal insufficiency

A

HSP or cryoglobulinemia - cryo- many pts have HCV in the immune complexes

108
Q

40F reflux, digits get painful in cold, sob

A

scleroderma/ CREST -

109
Q

50F difficulty brushing hair, rash around eyes

A

dermatomyositis -

110
Q

50F dermatomyositis, what further eval?

A

malignancy -

111
Q

60F lupus, pain out of proportion to abdominal exam

A

mesenteric ischemia - due to vasculitis

112
Q

25F 3 pregnancies with 3 miscarriages

A

antiphospholipid ab syndrome - coagulation abnormalities

113
Q

30F depression, multiple tender areas

A

fibromyalgia -

114
Q

35F angioedema, hx in father

A

C1 esterase deficiency -

115
Q

50M low back pain, sacroiliitis on pxr

A

ankylosing spondylitis -

116
Q

70M h/o iron overload, joint pains in wrists

A

pseudogout -

117
Q

65F painless jaundice

A

pancreatic head tumor -

118
Q

45F pruritis, xanthelasmas, AP 8x normal

A

primary billiary cirrhosis -

119
Q

50M ulcerative colitis, newly elevated AP

A

primary sclerosing cholangitis -

120
Q

40M IVDA purpuric lesions on shins, jaundice, arthralgias

A

cryoglobulinemia - assoc with Hep C

121
Q

60M tan, arrhythmia, mild elevation of liver enzymes, blood glucose 200, arthralgias

A

hemochromatosis -

122
Q

25F new liver dz, no alcohol, fam hx

A

autoimmune hepatitis -

123
Q

25M homosexual, new jaundice, dark urine, mild RUQ discomfort, vaccinated for Hep B with proven Ab

A

Hep A -

124
Q

18M elevated liver enzymes, new gait dysfunction

A

Wilsons -

125
Q

35M homosexual, severe odynophagia, white plaques in oral cavity

A

esophageal candidiasis, thrush -

126
Q

70M LLQ cramping pain, similar episodes in past, heme positive

A

diverticulitis -

127
Q

70 pencil thin stools

A

rectal mass around anus -

128
Q

45F Roux-en-Y for weight loss, greasy malodorous stools

A

malabsorption - aka dumping

129
Q

50M copious diarrhea, skin flushing

A

carcinoid -

130
Q

65F 30# weight loss in past year, iron deficiency anemia, heme pos stools, no abd pain

A

colorectal cancer -

131
Q

68M CAD, PVOD, post prandial pain 30 minutes after eating

A

mesenteric ischemia -

132
Q

55M rheumatoid arthritis, gnawing pain radiating to back, improves with eating

A

PUD - duodenal ulcers usually feel better with food

133
Q

35 alcoholic severe epigastric pain after recent binge episode

A

acute pancreatitis -

134
Q

18 3 days of abd pain, shifted from umbilicus to RLQ

A

appendicitis -

135
Q

18F LLQ pain, vaginal discharge, sexually active

A

PID -

136
Q

80M h/o nocturia, suprapubic tenderness, rising creatinine, hydronephrosis

A

obstruction - eg. BPH, prostate ca

137
Q

30F fevers to 102, renal failure, thrombocytopenia, schistocytes

A

DIC - may see mental status changes

138
Q

65M CAD, PVOD, started on lisinopril, Cr from 1 to 4.5

A

renal artery stenosis -

139
Q

65F unstable angina, rising Cr, microscopic hematuria, 2 blue toes

A

atheroemboli - see decreased complement levels

140
Q

70M LE edema to waist, lost weight over 18 months, intermittent BRBPR

A

membranous glomerulopathy - assoc with carcinoma, also with infection, autoimmune dz or drugs, most common primary nephrotic syndrome in adults

141
Q

16F recent URI, Cr 3.0 three weeks later, red cells on UA

A

poststrep GN -

142
Q

67M CAD, 4 drugs to get bp control, what will renal US show?

A

renal artery stenosis -

143
Q

55M DM, retinopathy, nephropathy, neuropathy, Cr 1.7, what antihypertensive should he get?

A

ACE I -

144
Q

60M unasyn for pneumonia, 10 days later pyuria and peripheral eosinophilia, Cr from 1.1 to 2.5

A

Allergic Interstitial Nephritis -

145
Q

60M s/p MVA, hypernatremia, UA specific gravity 1.002

A

diabetes insipidus -

146
Q

55 diabetic, non-anion gap hyperchloremic metabolic acidosis and hyperK

A

Type 4 renal tubular acidosis - hyporeninemic hypoaldo

147
Q

25F fever to 102, R flank pain, pyuria

A

pyelonephritis -

148
Q

55M primary hyperparathyroidism, left flank pain, hematuria

A

nephrolithiasis -

149
Q

17M abdominal pain, arthralgias, hematuria, elevated serum IgA

A

HSP -

150
Q

65M pancytopenia, back pain, rising Cr, elevated protein/albumin ratio

A

multiple myeloma -

151
Q

55F neuropathy, arthralgias, renal failure, pANCA positive

A

PAN -

152
Q

25 microscopic hematuria becomes macroscopic after flu like illness

A

IgA nephropathy - aka Bergers

153
Q

35F 3rd trimester, hyperreflexia, edema, proteinuria

A

pre-eclampsia -

154
Q

70M 3 days IV piperacillin and gent for pneumonia, oral cipro, Cr at discharge was 1.2, Now Cr 2.5 one wk later, BUN unchanged

A

Aminoglycoside toxicity -

155
Q

15 diarrhea, renal failure, after eating at Jack in the Box

A

HUS - 0:157 H:7 E Coli

156
Q

35 resident of UP, epigastric discomfort and copious diarrhea, neg fecal leukocytes

A

Giardia - treat with flagyl, stool ova and parasites, from well water, kids in day care

157
Q

50 alcoholic fatigue, gradual increase sob, fevers, pleural fluid that doesn’t layer on decubitus films

A

aspiration pneumonia - think anaerobes, treat by drainage, empyema doesn’t layer

158
Q

18 new hematuria and rising Cr 2 weeks after severe URI

A

post strep GN - low complement

159
Q

21 LUQ discomfort, sore throat, fatigue, post cervical LAN

A

mono -

160
Q

parasitic cause of vit B12 deficiency

A

fish tapeworm - Diphyllobothrium

161
Q

2 infections by Ixodes tick vector

A

Lyme dz, Babesiosis - treat Lyme with doxy, treat Babesiosis with clinda

162
Q

40M severe R flank pain, 100+RBC/HPF, ph9.0, what org?

A

Proteus - struvite stone, treat with quinolone

163
Q

35M HIV fever, chills, rigors, LLL infiltrate on CXR

A

strep pneumo -

164
Q

55F HIV CD4 count 100, sudden onset sob, pneumothorax

A

PCP - treat with IV bactrim and steroids

165
Q

65M colon ca, fevers and chills, GPC in chains

A

strep bovis - gut gram positive bug

166
Q

20M interstitial infiltrates, fever, nonproductive cough

A

mycoplasma - treat with azithromycin

167
Q

40M exposure to prostitutes, maculopapular skin rash, sore on penis 2 months earlier

A

syphillis -

168
Q

parasitic cause of portal hypertension and bladder ca

A

schistosomiasis -

169
Q

35M sepsis, widespread purpura, DIC, adrenal insufficiency

A

meningococcemia - Waterhouse Friedrickson

170
Q

40M immunocompromised, respiratory complaints and skin lesions, broad based budding yeast in sputum

A

blasto -

171
Q

65F s/p BMT, new hemoptysis, cavitary lesion with fungus ball on cxr

A

aspergillus -

172
Q

60M 2 wks on Abx, watery diarrhea

A

C diff -

173
Q

45M duodenal ulcer bx

A

H pylori -

174
Q

55M homeless, weight loss, fatigue, sterile pyuria on UA persists despite Bactrim and Augmentin

A

tb -

175
Q

35M rash, arthralgias, Cape Cod

A

Lyme dz -

176
Q

Newly diagnosed diabetes, hepatomegaly, and arthropathy

A

Hemochromatosis

177
Q

Worsening postprandial pain that leads to food avoidance

A

Abdominal angina (atherosclerosis of the mesenteric arteries)

178
Q

low hgb, high bili, low haptoglobin, venus thrombosis

A

Paroxysmal nocturnal hemoglobinuria

179
Q

hypotension, JVD, muffled heart sounds (also pulsus paradoxus)

A

Cardiac tamponade

180
Q

action tremor, suppressed at rest, abssence of additional neurologic signs

A

Essential tremor

181
Q

pneumonia with loose stools, hyponatremia, and mildly elevated LFTs

A

Legionella pneumoniae

182
Q

diarrhea transmitted by seafood (bloody)

A

Vibrio parahaemolyticus

183
Q

diarrhea transmitted by seafood (watery)

A

Vibrio cholerae

184
Q

most frequent cause of hypercalcemia in pts w/ non-metastatic CA

A

PTHrP (parathyroid relate protein)

185
Q

most frequent cause of hypercalcemia in pts w/ metastatic CA to bone

A

Cytokines (e.g. IL1, TNF)

186
Q

hypertension, palpable bilateral abdominal masses, microhematuria, concern for berry aneurysm

A

ADPKD (autosomal dominant polycystic kidney disease)

187
Q

abnormal gait, incontinence, dementia

A

NPH (normal pressure hydrocephalus)

188
Q

flushing, valvular heart disease, diarrhea, elevated 5-HIAA (related to niacin synth)

A

Carcinoid syndrome

189
Q

altered mental status, temperature > 40, inadequate/failure of thermoregulation

A

Exertional heat stroke

190
Q

drug of choice for dementia in the elderly

A

Haloperidol (low dose)

191
Q

drug of choice for agitation in the young

A

Lorazepam

192
Q

bridges the exposure and the outcome of interest in case-control studies

A

Confounders

193
Q

thrombophlebitis of atypical sites (e.g. arm, chest) caused by an occult tumor

A

Migratory thrombophlebitis (aka Trousseau’s syndrome)

194
Q

fluid resuscitation followed by loop diuretics

A

Treatment of hypercalcemia

195
Q

stones, bones, abdominal groans, and psychiatric overtones

A

Sx of hypercalcemia

196
Q

presence of anti- Ro (SSA) and/or La (SSB) antibodies

A

Sjogren syndrome

197
Q

absent pain and temp sensation in a cape distribution

A

Syringomyelia

198
Q

loose, foul smelling stools within the context of antibiotic use

A

C.diff colitis

199
Q

gynecomastia, spider angiomata, abdominal distension, edema

A

Cirrhosis

200
Q

B-lymphocyte derived chronic leukemia, postive TRAP stain, treated by cladribine, dry bone marrow taps

A

Hairy cell leukemia

Internal Medicine (4 decks)

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