CNL

Question 1

CLINICAL PRESENTATION

Answer 1

Hepatosplenomegaly 
Nausea
Abdominal pain
Afebrile
Mild to marked hemorrhage

Question 2

LABORATORY FINDINGS

PERIPHERAL BLOOD

Answer 2

Neutrophilic leukocytosis without a left shift (>100 X 109/L)

Toxic granulation and a few Dohle bodies are present

The B12 and B12 binding capacities are markedly elevated

Question 3

LAP scores are extremely high ranging from

Answer 3

340-400

Question 4

Neutrophils have the capacity to phagocytize bacteria but __ reduction in destruction is seen

Answer 4

70%

Reduction in both azurophilic and specific granulation