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Answer
Hyperhydration
According
to the presenting history, the case is acute lymphoblastic leukemia because
the blood film reveals anemia, leukocytosis, thrombocytopenia, and blast
in the peripheral film. The initial management is hyper hydration, although
she is normotensive, to avoid renal shut down because the large tumor
mass (leukocytosis) will produce hyperuricaemia especially after initiation
of cytotoxic therapy. Moreover we should avoid blood or its derivatives
transfusion until the diagnosis is well settled.
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