LabCe IV

The normal Myeloid-to-erythroid ratio (M:E ratio) ranges from: Please select the single best answer 2:1 to 7:1 1.2:1 to 5:1 2:1 to 4:1 0.5:1 to 1:1

2:1 to 4:1 The M : E reference range is between 1.5:1 to 3:1. If segmented neutrophils are included, the M : E reference range is between 2:1 to 4:1.

Approximately how many doses are required to obtain a steady-state oscillation allowing for peak and trough levels to be evaluated? Please select the single best answer 1 to 2 3 to 4 5 to 7 > 10

5 to 7 Approximately five to seven doses are required before a steady-state oscillation is achieved. After the first dose, absorption and distribution occur, followed only by elimination. Before the concentration of the drug drops significantly, the second dose is given and the peak of the second dose is additive to what remains of the first dose. The third through the seventh scheduled doses all have the same effect, increasing the serum concentration and the amount eliminated. By the end of the seventh dose, the amount of the drug administered is equal to the amount eliminated during the dosage period. At this point, a steady-state is established and peak and trough concentrations can be evaluated.

A 38-year-old male presented to the E.R. complaining of severe cough, chest pain, shortness of breath, and fatigue. Microscopic examination of a bloody sputum specimen revealed this suspicious form. The patient is most likely suffering from: Please select the single best answer Fasciola hepatica Clonorchis sinensis Paragonimus westermani Echinococcus multilocularis

Paragonimus westermani Paragonimus westermani is the only helminth egg routinely recovered in sputum samples. The condition associated with is known as paragonimiasis after the scientific name and pulmonary distomiasis which literally means a pulmonary fluke infection. Eggs resemble those of Diphyllobothrium latum but may be differentiated by the operculum, opercular shoulders, and thickened shell at the end opposite the operculum. Eggs are unembryonated when they leave the body. Fasciola hepatica, the sheep liver fluke, may present with fever, abdominal pain, nausea, diarrhea, enlargement and tenderness of the liver, jaundice, and nonproductive cough. Eggs are operculated and unembryonated when they leave the body. The eggs of F. hepatica are virtually indistinguishable from Fasciolopsis eggs, but the correct identification must be done because the treatment is different. Clonorchis sinensis, the Chinese liver fluke, generally causes light infections; however, heavier infections may present with fever, abdominal pain, and jaundice. Eggs have shouldered opercula and a small knob at the end opposite the operculum. They are embryonated when they leave the body. Echinococcus multilocularis causes alveolar hydatid disease, which is a fatal form of echinococcosis. Cysts are extremely dangerous because they lack a laminated membrane and develop a series of connected chambers containing little to no fluid and rarely a scolex. Morphology is similar to E. granulosus.