Oncology Medications

(M2.PH.16.4671) A 32-year-old male patient presents to your clinic with nontender unilateral testicular swelling which was first noted by his partner one week ago. After extensive workup and orchiectomy, the patient is diagnosed with testicular seminoma stage IIB. The patient undergoes three cycles of etoposide, bleomycin and cisplatin. In addition, the patient also decides to supplement his treatment regimen with vitamin D and garlic based upon his readings on the internet. Four months later, the patient develops a nonproductive cough, shortness of breath with exertion, and occasional fever. A chest x-ray is shown (Figure A). What is the likely cause for the patient’s current symptoms?

(M3.HE.15.55) A 64-year-old woman presents to her primary care physician with complaints of fatigue, a sore mouth, as well as occasional abdominal pain and diarrhea for the past several months. She denies any loss of balance, trouble walking, numbness, pain, or tingling in her hands or feet. She has a past medical history of morbid obesity, depression, rheumatoid arthritis, suicide, anxiety, hypertension, diabetes, and factor V Leiden being managed by her PCP. Her temperature is 99.4°F (37.4°C), blood pressure is 154/94 mmHg, pulse is 87/min, respirations are 18/min, and oxygen saturation is 98% on room air. Physical examination is significant for the finding in Figure A. The patient's creatinine is 2.0 mg/dL at this visit. Which of the following is most likely to be found in this patient?

(M3.ON.12.23) A 51-year-old woman presents to your office with 2 weeks of fatigue and generalized weakness. She has a past medical history of diabetes, hypertension, and hyperlipidemia. She was recently diagnosed with rheumatoid arthritis and started on disease-modifying therapy. She states she has felt less able to do things she enjoys and feels guilty she can't play sports with her children. Review of systems is notable for the patient occasionally seeing a small amount of bright red blood on the toilet paper. Laboratory studies are ordered as seen below.

Hemoglobin: 12 g/dL
Hematocrit: 36%
Leukocyte count: 7,700/mm^3 with normal differential
Platelet count: 207,000/mm^3
MCV: 110 fL

Which of the following is the most likely etiology of this patient's fatigue?