Check out today’s Step 2 CK Qmax Question Challenge.
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A 32-year-old man with trisomy 21 presents with fatigue and swollen, bleeding gums for the past 5 days. He lives in a group home, and was formerly employed in a factory manufacturing hair products. He has smoked 1 pack of cigarettes per day for the past 15 years. He denies use of alcohol or illicit drugs. Physical examination reveals pallor, diffuse petechiae, oozing oral mucosa, and splenomegaly. Bone marrow aspirate reveals the type of cell shown in the image.
Which of the following risk factors contributed most to the development of the patient’s condition?
A. Age <40 years
B. Down’s syndrome (trisomy 21)
C. Exposure to Epstein-Barr virus in his home
D. History of smoking
E. Prior lead exposure
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