67-year-old woman comes to the office due to progressive fatigue and anorexia over the last 6 months. She has
lost 4 kg (8.8 lb), which she attributes to early satiety. She has had no abdominal pain, night sweats, or fevers.
The patient’s past medical history is significant for hypothyroidism, hypertension, and gout. She does not use
tobacco, alcohol, or illicit drugs and is compliant with her medications. Temperature is 37.3 C (99.2 F), blood
pressure is 128/82 mm Hg, and pulse is 88/min. The patient is slightly thin but well nourished. Mild mucosal pallor
is present. There is no lymphadenopathy in the cervical or supraclavicular chains. Cardiopulmonary examination
is normal. A spleen tip is palpable with deep exhalation. Laboratory results are as follows:
Hemoglobin 8.6 g/dL
Platelets 285,000/mm3
Leukocytes 42,800 /mm3
Florescence in situ hybridization reveals an abnormality in chromosome 22. Which of the following is the most
important target in treating this patient’s disease?
- 0 A. DNA methylation mutations
- O B. Felic acid metabolism
- 0 C. Retinoic acid receptor
- O D. Thymidine synthesis
- 0 E. Tyrosine kinase
0 voters