Question

A 68-year-old man comes to the physician because of a 2-month history of mild abdominal pain and feeling full after eating only a couple of bites of food; he also has had a 4.5-kg (10-lb) weight loss during this period. The use of over-the-counter antacids has not resolved his symptoms. He has not had fever, nausea, or vomiting. Four years ago, he had a cerebral infarction. He has no family history of cancer. Current medications are amlodipine, aspirin, and hydrochlorothiazide. His vital signs are within normal limits. Abdominal examination shows mild left upper quadrant tenderness; the spleen is palpated 5 cm below the left costal margin. Laboratory studies show: Hemoglobin: 10.3 Hematocrit: 30% 10.3 g/dL 30% Leukocyte count: 48,600/mm3 Segmented neutrophils: 69% Bands: 10% Eosinophils: 2% Basophils: 2% Lymphocytes: 6% Myelocytes: 8% Metamyelocytes: 3% Platelet count: 120,000/mm3 Karyotype analysis of the patient's leukocytes shows a translocation from chromosome 9 to chromosome 22. Which of the following is the most appropriate initial pharmacotherapy for this patient? A) Anakinra B) Cytarabine C) Etanercept D) Imatinib E) Prednisone

          A 68-year-old man comes to the physician because of a 2-month history of mild abdominal pain and feeling full after eating only a couple of bites of food; he also has had a 4.5-kg (10-lb) weight loss during this period. The use of over-the-counter antacids has not resolved his symptoms. He has not had fever, nausea, or vomiting. Four years ago, he had a cerebral infarction. He has no family history of cancer. Current medications are amlodipine, aspirin, and hydrochlorothiazide. His vital signs are within normal limits. Abdominal examination shows mild left upper quadrant tenderness; the spleen is palpated 5 cm below the left costal margin. Laboratory studies show:

Hemoglobin: 10.3 
Hematocrit: 30%
10.3 g/dL 30%
Leukocyte count: 48,600/mm3
Segmented neutrophils: 69% 
Bands: 10% 
Eosinophils: 2%
Basophils: 2%
Lymphocytes: 6%
Myelocytes: 8% Metamyelocytes: 3% 
Platelet count: 120,000/mm3

Karyotype analysis of the patient's leukocytes shows a translocation from chromosome 9 to chromosome 22. Which of the following is the most appropriate initial pharmacotherapy for this patient?
A) Anakinra
B) Cytarabine
C) Etanercept
D) Imatinib
E) Prednisone

Added by The Real E.

Question

Please give Ace some feedback