Pathology EMQ template.

Name:

Candidate number:

Theme: Leukaemia

 

OPTION LIST

 

A

Acute Myeloid Leukaemia

I

Acute Lymphocytic Leukaemia

B

Plasma Cell Myeloma

J

 

C

Hodgkins Lymphoma

K

 

D

Chronic Myeloid Leukaemia

L

 

E

Chronic Lymphocytic Leukaemia

M

 

F

Non-Hodgkins Lymphoma

N

 

G

Hairy Cell Leukaemia

O

 

H

Multiple Myeloma

P

 

 

 

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

 

1. A 40 year old woman presents with a 5 week history of painful enlargement of her cervical and axillary lymph nodes. She also complains of lethargy and has several mouth ulcers. On examination you find splenomegaly. A blood film shows occasional blast cells and you then proceed to take a lymph node biopsy which confirms your diagnosis.

 

 

2. A 45 year old man presents with increasing lethargy, ‘tummy ache’ and a chest infection that ‘keeps coming back’. On examination he looks pale, has multiple areas of bruising all over his body and has splenomegaly. A blood film shows pancytopenia with atypical B-cell lymphocytes with spiky projections.

 

 

3. A 44 year old woman presents with a 3 month history of tiredness, abdominal pains and occasional fever. On examination she has splenomegaly. Blood tests suggest anaemia with an extremely high WCC. You order a bone marrow trephine which shows a hypercellular marrow with an increase in myeloid precursors. Cytogenic analysis detects t(9;22).

 

 

4. A 90 year old man presents to A&E with a chest infection and general malaise. Blood tests reveal a Haemoglobin of 11.1 g/dl, MCV 80 fl, WCC 126x10^9/l, platelets 347x10^9/l. A blood film shows predominantly lymphocytes with no blast cells seen. You start him on Chlorambucil.

 

 

5. A 25 year old woman complains of tiredness, dyspnoea on exercise and easy bruising which has been going on for about 1 month. Blood tests show pancytopenia and a blood film shows 50% myoblasts. Bone marrow trephine shows increased cellularity with predominance of myeloblasts and profoundly reduced platelet and red cell precursors.

 

 

 

ANSWERS

1. A

2. G

3. D

4. E

5. A