MN 551 Quiz 1 latest 2020 – Kaplan University
Question 1.
1. A nurse practitioner student is familiarizing herself with the overnight admissions to
an acute medical unit of a university hospital. Which of the following patients would the
student recognize as being least likely to have a diagnosis of antiphospholipid syndrome
in his or her medical history? (Points : 0.4)
A 66-year-old obese male with left-sided hemiplegia secondary to a
cerebrovascular accident
A 90-year-old female resident of a long-term care facility who has been
experiencing transient ischemic attacks
A 30-year-old female with a diagnosis of left leg DVT and a pulmonary embolism
A 21-year-old male with a diagnosis of cellulitis and suspected endocarditis
secondary to intravenous drug use
Question 2.
2. Which of the following statements most accurately conveys an aspect of lymphatic
system activity? (Points : 0.4)
B and T lymphocyte development begins in the bone marrow and ends in the
peripheral lymphoid structures.
B cells and macrophages are released from the bone marrow in their completed
state.
Stem cells in the lymph nodes initiate and regulate the process of white cell
synthesis.
Leukocytes bypass vascular circulation and are distributed instead by the
lymphatic system.
Question 3.
3. A 30-year-old man has spent 5 hours on a cross-country flight seated next to a
passenger who has been sneezing and coughing, and the man has been inhaling viral
particles periodically. Which of the following situations would most likely result in the
stimulation of the man's T lymphocytes and adaptive immune system? (Points : 0.4)
Presentation of a foreign antigen by a familiar immunoglobulin
Recognition of a foreign MHC molecule
Recognition of a foreign peptide bound to a self MHC molecule
Cytokine stimulation of a T lymphocyte with macrophage or dendritic cell
mediation
Question 4.
4. Following a course of measles, a 5-year-old girl developed scattered bruising over
numerous body surfaces and was diagnosed with immune thrombocytopenic purpura
(ITP). As part of her diagnostic workup, blood work was performed. Which of the
following results is most likely to be considered unexpected by the health care team?
(Points : 0.4)
Increased thrombopoietin levels
Decreased platelet count
Normal vitamin K levels
Normal leukocyte levels
Question 5.
5. A 24-year-old woman presents with fever and painful, swollen cervical lymph nodes.
Her blood work indicates neutrophilia with a shift to the left. She most likely has:
(Points : 0.4)
A mild parasitic infection
A severe bacterial infection
A mild viral infection
A severe fungal infection
Question 6.
6. A nurse practitioner is providing prenatal care and education for a first-time
expectant mother, 22 weeks' gestation, who has a diagnosis of a sexually transmitted
infection. Which of the following statements by the expectant mother demonstrates an
adequate understanding of vertical disease transmission and congenital infections?
(Points : 0.4)
“Gonorrhea and chlamydia pose the greatest risks of transmission from mother
to child.”
“I know that my baby will need observation for HIV signs and symptoms in the
weeks following my delivery.”
“My baby could become infected either across the placenta or during the birth
itself.”
“Prophylactic immunization will reduce my baby's chance of being born with an
illness.”
Question 7.
7. A 16-year-old female has been brought to her primary care nurse practitioner by her
mother due to the girl's persistent sore throat and malaise. Which of the following facts
revealed in the girl's history and examination would lead the nurse practitioner to rule
out infectious mononucleosis? (Points : 0.4)
The girl has a temperature of 38.1°C (100.6°F) and has enlarged lymph nodes.
Her liver and spleen are both enlarged.
Blood work reveals an increased white blood cell count.
Chest auscultation reveals crackles in her lower lung fields bilaterally.
Question 8.
8. Which of the following phenomena would be least likely to result in activation of the
complement system? (Points : 0.4)
Recognition of an antibody bound to the surface of a microbe
The binding of mannose residues on microbial glycoproteins
Activation of Toll-like receptors (TLRs) on complement proteins
Direct recognition of microbial proteins
Question 9.
9. Which of the following patients is most likely to benefit from transplantation of
thymic tissue or major histocompatibility complex (MHC)-compatible bone marrow?
(Points : 0.4)
A 12-year-old girl with a history of epilepsy and low IgG levels secondary to
phenytoin use
A 7-year-old boy whose blood work indicates decreased IgA and IgG with
increased IgM
A 6-year-old boy whose pre-B cells are incapable of translation to normal B cells
A 9-year-old girl who has a diagnosis of IgA deficiency
Question 10.
10. A 29-year-old construction worker got a sliver under his fingernail four days ago.
The affected finger is now reddened, painful, swollen, and warm to the touch. Which of
the following hematological processes is most likely occurring in response to the
infection? (Points : 0.4)
Proliferation of immature neutrophils
High circulatory levels of myeloblasts
Increased segmented neutrophil production
Phagocytosis by myelocytes
Question 11.
11. The blood work of a 44-year-old male patient with a diagnosis of liver disease
secondary to alcohol abuse indicates low levels of albumin. Which of the following
phenomena would a clinician be most justified in anticipating? (Points : 0.4)
Impaired immune function
Acid-base imbalances
Impaired thermoregulation
Fluid imbalances
Question 12.
12. A 2-year-old girl has had repeated ear and upper respiratory tract infections since
she was born. A pediatrician has determined a diagnosis of transient
hypogammaglobulinemia of infancy. What is the physiological origin of the child's
recurrent infections? (Points : 0.4)
Antibody production by plasma cells is compromised because of impaired
communication between B and T cells.
The child had a congenital absence of immunoglobulin G (IgG) antibodies and
her body is only slowly beginning to produce them independently.
The child was born with immunoglobulin A (IgA) and immunoglobulin (IgM)
antibodies, suggesting intrauterine infection.
The child lacks the antigen presenting cells integral to normal B-cell antibody
production.
Question 13.
13. A 22-year-old female who adheres to a vegan diet has been diagnosed with irondeficiency anemia. Which of the following components of her diagnostic blood work
would be most likely to necessitate further investigation? (Points : 0.4)
Decreased mean corpuscular volume (MCV)
Decreased hemoglobin and hematocrit
Microcytic, hypochromic red cells
Decreased erythropoietin levels
Question 14.
14. A 66-year-old female patient has presented to the emergency department because of
several months of intermittently bloody stools that has recently become worse. The
woman has since been diagnosed with a gastrointestinal bleed secondary to overuse of
nonsteroidal anti-inflammatory drugs that she takes for her arthritis. The health care
team would realize that which of the following situations is most likely? (Points : 0.4)
The woman has depleted blood volume due to her ongoing blood loss.
She will have iron-deficiency anemia due to depletion of iron stores.
The patient will be at risk for cardiovascular collapse or shock.
She will have delayed reticulocyte release.
Question 15.
15. A 60-year-old woman is suspected of having non-Hodgkin lymphoma (NHL). Which
of the following aspects of her condition would help to rule out Hodgkin lymphoma?
(Points : 0.4)
Her neoplasm originates in secondary lymphoid structures.
The lymph nodes involved are located in a large number of locations in the
lymphatic system.
The presence of Reed-Sternberg cells has been confirmed.
The woman complains of recent debilitating fatigue.
Question 16.
16. A child has been diagnosed with thalassemia. Which of the following other health
problems is the child at risk for? (Points : 0.4)
Hypocoagulation
Iron and ferritin deficiencies
Splenomegaly and hepatomegaly
Neutropenia
Question 17.
17. A tourist presented to a primary care health clinic complaining of malaise, fever, and
headache. She has subsequently been diagnosed with Rocky Mountain spotted fever, a
pathology caused by Rickettsiaceae. Which of the followed statements best captures a
characteristic trait of Rickettsiaceae? (Points : 0.4)
They are eukaryotic.
They have both RNA and DNA.
They have a distinct spiral-shaped morphology.
They are neither gram-negative nor gram-positive.
Question 18.
18. A 60-year-old male patient with an acute viral infection is receiving interferon
therapy. The nurse practitioner is teaching the family of the patient about the diverse
actions of the treatment and the ways that it differs from other anti-infective therapies.
Which of the following teaching points should the nurse practitioner exclude? (Points :
0.4)
“Interferon can help your father's unaffected cells adjacent to his infected cells
produce antiviral proteins that limit the spread of the infection.”
“Interferon can help limit the replication of the virus that's affecting your father.”
“Interferon helps your father's body recognize infected cells more effectively.”
“Interferon can bolster your father's immune system by stimulating natural killer
cells that attack viruses.”
Question 19.
19. A nurse practitioner is explaining to a 40-year-old male patient the damage that
Mycobacterium tuberculosis could do to lung tissue. Which of the following phenomena
would underlie the nurse practitioner's explanation? (Points : 0.4)
Tissue destruction results from neutrophil deactivation.
Nonspecific macrophage activity leads to pulmonary tissue destruction and
resulting hemoptysis.
Macrophages are unable to digest the bacteria, resulting in immune granulomas.
Neutrophils are ineffective against the Mycobacterium tuberculosis antigens.
Question 20.
20. A patient presented to the emergency department of the hospital with a swollen,
reddened, painful leg wound and has been diagnosed with methicillin-resistant
Staphylococcus aureus cellulitis. The patient's nurse practitioner has ordered a complete
blood count and white cell differential. Which of the following blood components would
the nurse practitioner most likely anticipate to be elevated? (Points : 0.4)
Basophils
Eosinophils
Platelets
Neutrophils
Question 21.
21. A 14-year-old boy has been diagnosed with infectious mononucleosis. Which of the
following pathophysiological phenomena is most responsible for his symptoms? (Points
: 0.4)
The Epstein-Barr virus (EBV) is lysing many of the boy's neutrophils.
Viruses are killing some of his B cells and becoming incorporated into the
genomes of others.
The EBV inhibits the maturation of white cells within his peripheral lymph
nodes.
The virus responsible for mononucleosis inhibits the maturation of myeloblasts
into promyelocytes.
Question 22.
22. A couple who are expecting their first child have been advised by friends to consider
harvesting umbilical cord blood in order to have a future source of stem cells. The
couple have approached their nurse practitioner with this request and are seeking
clarification of exactly why stem cells are valuable and what they might expect to gain
from harvesting them. How can the nurse practitioner best respond to the couple's
inquiry? (Points : 0.4)
“Stem cells can help correct autoimmune diseases and some congenital defects.”
“Stem cells can be used to regenerate damaged organs should the need ever
arise.”
“Stem cells can be used as a source of reserve cells for the entire blood production
system.”
“Stem cells can help treat some cancers and anemias, but they must come from
your child himself or herself.”
Question 23.
23. A 40-year-old woman who experiences severe seasonal allergies has been referred
by her family physician to an allergist for weekly allergy injections. The woman is
confused as to why repeated exposure to substances that set off her allergies would
ultimately benefit her. Which of the following phenomena best captures the rationale for
allergy desensitization therapy? (Points : 0.4)
Repeated exposure to offending allergens binds the basophils and mast cells that
mediate the allergic response.
Exposure to allergens in large, regular quantities overwhelms the IgE antibodies
that mediate the allergic response.
Repeated exposure stimulates adrenal production of epinephrine, mitigating the
allergic response.
Injections of allergens simulate production of IgG, which blocks antigens from
combining with IgE.
Question 24.
24. A nurse practitioner is teaching her colleagues about the role of cytokines in a
variety of pathologies. Which of the following teaching points best captures an aspect of
the functions and nature of cytokines? (Points : 0.4)
“A particular cytokine can have varied effects on different systems, a fact that
limits their therapeutic use.”
“Cytokine production is constant over time, but effects are noted when serum
levels cross a particular threshold.”
“Most cytokines are produced by granular leukocytes, and different cells are
capable of producing the same cytokine.”
“Cytokine actions are self-limiting in that activation of one precludes activation of
other cytokines with similar actions.”
Question 25.
25. As part of his diagnostic workup, a 77-year-old man's nurse practitioner has ordered
blood work that includes ferritin levels. The man is very interested in the details of his
health care and is unfamiliar with ferritin and its role. He asks his nurse practitioner to
explain the significance of it and the rationale for testing it. Which of the following
explanations by the nurse practitioner is most accurate? (Points : 0.4)
“Ferritin is the activated and usable form of iron that your red blood cells can use
to transport oxygen.”
“Ferritin is a stored form of iron that indirectly shows me whether you would
benefit from iron pills.”
“Ferritin is a protein-iron complex that allows your red blood cells to make use of
the iron that you consume in your diet.”
“Ferritin is the form of iron that is transported in your blood plasma to the red
blood cells that need it.”
A 30-year-old man has spent 5 hours on a cross-country flight seated next to a
passenger who has been sneezing and coughing, and the man has been inhaling
viral particles periodically. Which of the following situations would most likely
result in the stimulation of the man's T lymphocytes and adaptive immune
system? (Points : 0.4)
Presentation of a foreign antigen by a familiar immunoglobulin
Recognition of a foreign MHC molecule
Recognition of a foreign peptide bound to a self MHC molecule
Cytokine stimulation of a T lymphocyte with macrophage or dendritic cell
mediation
Question 2.2. A 22-year-old female who adheres to a vegan diet has been
diagnosed with iron-deficiency anemia. Which of the following components
of her diagnostic blood work would be most likely to necessitate further
investigation? (Points : 0.4)
Decreased mean corpuscular volume (MCV)
Decreased hemoglobin and hematocrit
Microcytic, hypochromic red cells
Decreased erythropoietin levels
Question 3.3. A child has been diagnosed with thalassemia. Which of the
following other health problems is the child at risk for? (Points : 0.4)
Hypocoagulation
Iron and ferritin deficiencies
Splenomegaly and hepatomegaly
Neutropenia
Question 4.4. The blood work of a 44-year-old male patient with a
diagnosis of liver disease secondary to alcohol abuse indicates low
levels of albumin. Which of the following phenomena would a
clinician be most justified in anticipating? (Points : 0.4)
Impaired immune function
Acid-base imbalances
Impaired thermoregulation
Fluid imbalances
Question 5.5. As part of his diagnostic workup, a 77-year-old
man's nurse practitioner has ordered blood work that includes
ferritin levels. The man is very interested in the details of his
health care and is unfamiliar with ferritin and its role. He asks his
nurse practitioner to explain the significance of it and the
rationale for testing it. Which of the following explanations by the
nurse practitioner is most accurate? (Points : 0.4)
“Ferritin is the activated and usable form of iron that your red blood
cells can use to transport oxygen.”
“Ferritin is a stored form of iron that indirectly shows me whether you
would benefit from iron pills.”
“Ferritin is a protein-iron complex that allows your red blood cells to
make use of the iron that you consume in your diet.”
“Ferritin is the form of iron that is transported in your blood plasma to
the red blood cells that need it.”
Question 6.6. A 24-year-old woman presents with fever and
painful, swollen cervical lymph nodes. Her blood work
indicates neutrophilia with a shift to the left. She most likely
has: (Points : 0.4)
A mild parasitic infection
A severe bacterial infection
A mild viral infection
A severe fungal infection
Question 7.7. A nurse practitioner is providing prenatal
care and education for a first-time expectant mother, 22
weeks' gestation, who has a diagnosis of a sexually
transmitted infection. Which of the following statements by
the expectant mother demonstrates an adequate
understanding of vertical disease transmission and
congenital infections? (Points : 0.4)
“Gonorrhea and chlamydia pose the greatest risks of transmission
from mother to child.”
“I know that my baby will need observation for HIV signs and
symptoms in the weeks following my delivery.”
“My baby could become infected either across the placenta or during
the birth itself.”
“Prophylactic immunization will reduce my baby's chance of being
born with an illness.”
Question 8.8. A 71-year-old male patient with a history
of myocardial infarction and peripheral vascular disease
has been advised by his nurse practitioner to begin
taking 81 mg aspirin once daily. Which of the following
statements best captures an aspect of the underlying
rationale for the nurse practitioner's suggestion? (Points
: 0.4)
Platelet aggregation can be precluded through inhibition of
prostaglandin production by aspirin.
Aspirin helps to inhibit adenosine disphosphate (ADP) action and
minimizes platelet plug formation.
Aspirin can reduce unwanted platelet adhesion by inhibiting
thromboxane A2 (TXA2) synthesis.
Aspirin inhibits the conversion of fibrinogen into fibrin and
consequent platelet plug formation.
Question 9.9. A 29-year-old construction worker got
a sliver under his fingernail four days ago. The
affected finger is now reddened, painful, swollen, and
warm to the touch. Which of the following
hematological processes is most likely occurring in
response to the infection? (Points : 0.4)
Proliferation of immature neutrophils
High circulatory levels of myeloblasts
Increased segmented neutrophil production
Phagocytosis by myelocytes
Question 10.10. Sputum samples from a patient
with pneumonia contain an infective agent that
has a peptidoglycan cell wall, expresses
endotoxins, replicates readily in broth and on
agar, grows in clusters, has pili, and does not stain
when exposed to crystal violet. This pneumonia is
most likely: (Points : 0.4)
Chlamydial
Viral
Mycoplasmal
Bacterial
Question 11.11. A 16-year-old female has been
brought to her primary care nurse practitioner
by her mother due to the girl's persistent sore
throat and malaise. Which of the following
facts revealed in the girl's history and
examination would lead the nurse practitioner
to rule out infectious mononucleosis? (Points :
0.4)
The girl has a temperature of 38.1°C (100.6°F) and has
enlarged lymph nodes.
Her liver and spleen are both enlarged.
Blood work reveals an increased white blood cell count.
Chest auscultation reveals crackles in her lower lung fields
bilaterally.
Question 12.12. A 2-year-old girl has had
repeated ear and upper respiratory tract
infections since she was born. A pediatrician
has determined a diagnosis of transient
hypogammaglobulinemia of infancy. What is
the physiological origin of the child's
recurrent infections? (Points : 0.4)
Antibody production by plasma cells is compromised
because of impaired communication between B and T cells.
The child had a congenital absence of immunoglobulin G
(IgG) antibodies and her body is only slowly beginning to
produce them independently.
The child was born with immunoglobulin A (IgA) and
immunoglobulin (IgM) antibodies, suggesting intrauterine
infection.
The child lacks the antigen presenting cells integral to
normal B-cell antibody production.
Question 13.13. A couple who are
expecting their first child have been
advised by friends to consider harvesting
umbilical cord blood in order to have a
future source of stem cells. The couple
have approached their nurse practitioner
with this request and are seeking
clarification of exactly why stem cells are
valuable and what they might expect to
gain from harvesting them. How can the
nurse practitioner best respond to the
couple's inquiry? (Points : 0.4)
“Stem cells can help correct autoimmune diseases and
some congenital defects.”
“Stem cells can be used to regenerate damaged organs
should the need ever arise.”
“Stem cells can be used as a source of reserve cells for the
entire blood production system.”
“Stem cells can help treat some cancers and anemias, but
they must come from your child himself or herself.”
Question 14.14. A patient presented to
the emergency department of the
hospital with a swollen, reddened,
painful leg wound and has been
diagnosed with methicillin-resistant
Staphylococcus aureus cellulitis. The
patient's nurse practitioner has
ordered a complete blood count and
white cell differential. Which of the
following blood components would the
nurse practitioner most likely
anticipate to be elevated?(Points : 0.4)
Basophils
Eosinophils
Platelets
Neutrophils
Question 15.15. A tourist presented
to a primary care health clinic
complaining of malaise, fever, and
headache. She has subsequently
been diagnosed with Rocky
Mountain spotted fever, a pathology
caused by Rickettsiaceae. Which of
the followed statements best
captures a characteristic trait of
Rickettsiaceae? (Points : 0.4)
They are eukaryotic.
They have both RNA and DNA.
They have a distinct spiral-shaped morphology.
They are neither gram-negative nor gram-positive.
Question 16.16. A 23-year-old
man has received a recent
diagnosis of appendicitis
following 24 hours of acute
abdominal pain. The nurse
practitioner providing care for the
man is explaining that while it is
unpleasant, the inflammation of
his appendix is playing a role in
his body's fight against the
underlying infectious process.
Which of the following teaching
points should the nurse
practitioner eliminate from his
teaching for the patient? (Points :
0.4)
“Inflammation can help to remove the body tissue
cells that have been damaged by infection.”
“Inflammation will start your body on the path to
growing new, healthy tissue at the site of infection.
“Inflammation helps your body to produce the
right antibodies to fight the infection.”
“Inflammation ultimately aids in eliminating the
initial cause of the cell injury in your appendix.”
Question 17.17. A 60-year-old
male patient with an acute viral
infection is receiving interferon
therapy. The nurse practitioner
is teaching the family of the
patient about the diverse
actions of the treatment and
the ways that it differs from
other anti-infective therapies.
Which of the following
teaching points should the
nurse practitioner exclude?
(Points : 0.4)
“Interferon can help your father's unaffected cells
adjacent to his infected cells produce antiviral
proteins that limit the spread of the infection.”
“Interferon can help limit the replication of the
virus that's affecting your father.”
“Interferon helps your father's body recognize
infected cells more effectively.”
“Interferon can bolster your father's immune
system by stimulating natural killer cells that attack
viruses.”
Question 18.18. A nurse
practitioner is teaching her
colleagues about the role of
cytokines in a variety of
pathologies. Which of the
following teaching points
best captures an aspect of
the functions and nature of
cytokines? (Points : 0.4)
“A particular cytokine can have varied effects
on different systems, a fact that limits their
therapeutic use.”
“Cytokine production is constant over time, but
effects are noted when serum levels cross a
particular threshold.”
“Most cytokines are produced by granular
leukocytes, and different cells are capable of
producing the same cytokine.”
“Cytokine actions are self-limiting in that
activation of one precludes activation of other
cytokines with similar actions.”
Question 19.19. Following
a course of measles, a 5year-old girl developed
scattered bruising over
numerous body surfaces
and was diagnosed with
immune
thrombocytopenic
purpura (ITP). As part of
her diagnostic workup,
blood work was
performed. Which of the
following results is most
likely to be considered
unexpected by the health
care team? (Points : 0.4)
Increased thrombopoietin levels
Decreased platelet count
Normal vitamin K levels
Normal leukocyte levels
Question 20.20. A
patient has been
admitted to an inpatient
medical unit of a
hospital with an acute
viral infection. The
health care team
providing care for the
patient would recognize
which of the following
statements as an
accurate description of
the role of viruses in
human infections?
(Points : 0.4)
Viruses have limited or absent genetic
material of their own.
Some viruses are capable of transforming
normal host cells into malignant cells.
Viruses are often implicated in cases of
transmissible neurodegenerative disease.
Viruses require stimulation after a latent
period before they are able to produce
symptoms.
Question 21.21.
Which of the following
patients is most likely
to benefit from
transplantation of
thymic tissue or major
histocompatibility
complex (MHC)compatible bone
marrow? (Points : 0.4)
A 12-year-old girl with a history of
epilepsy and low IgG levels secondary to
phenytoin use
A 7-year-old boy whose blood work
indicates decreased IgA and IgG with
increased IgM
A 6-year-old boy whose pre-B cells are
incapable of translation to normal B cells
A 9-year-old girl who has a diagnosis of
IgA deficiency
Question 22.22. A
40-year-old woman
who experiences
severe seasonal
allergies has been
referred by her
family physician to
an allergist for
weekly allergy
injections. The
woman is confused
as to why repeated
exposure to
substances that set
off her allergies
would ultimately
benefit her. Which
of the following
phenomena best
captures the
rationale for allergy
desensitization
therapy? (Points :
0.4)
Repeated exposure to offending
allergens binds the basophils and mast cells
that mediate the allergic response.
Exposure to allergens in large, regular
quantities overwhelms the IgE antibodies
that mediate the allergic response.
Repeated exposure stimulates adrenal
production of epinephrine, mitigating the
allergic response.
Injections of allergens simulate
production of IgG, which blocks antigens
from combining with IgE.
Question 23.23. A
66-year-old
female patient has
presented to the
emergency
department
because of several
months of
intermittently
bloody stools that
has recently
become worse.
The woman has
since been
diagnosed with a
gastrointestinal
bleed secondary to
overuse of
nonsteroidal antiinflammatory
drugs that she
takes for her
arthritis. The
health care team
would realize that
which of the
following
situations is most
likely? (Points :
0.4)
The woman has depleted blood
volume due to her ongoing blood loss.
She will have iron-deficiency anemia
due to depletion of iron stores.
The patient will be at risk for
cardiovascular collapse or shock.
She will have delayed reticulocyte
release.
Question 24.24.
A 44-year-old
female patient
presents to the
emergency
department with
abnormal
bleeding and
abdominal pain
that is later
attributed to
gallbladder
disease. Which
of the following
diagnoses would
the medical
team be most
justified in
suspecting as a
cause of the
patient's
bleeding?
(Points : 0.4)
Calcium deficiency
Vitamin K deficiency
Hemophilia B
Idiopathic ITP
Question
25.25. A 60year-old
woman is
suspected of
having nonHodgkin
lymphoma
(NHL). Which
of the
following
aspects of her
condition
would help to
rule out
Hodgkin
lymphoma?
(Points : 0.4)
Her neoplasm originates in
secondary lymphoid structures.
The lymph nodes involved are
located in a large number of locations
in the lymphatic system.
The presence of Reed-Sternberg
cells has been confirmed.
The woman complains of recent
debilitating fatigue.