Pathology EMQ template.

Name:   

Candidate number:

Theme: Leukaemia

 

OPTION LIST

 

A	ALL	I	Myelofibrosis
B	AML	J	Essential thromobythaemia
C	Hairy Cell Leukaemia	K	MGUS
D	Lymphoblastic lymphoma	L	CLL
E	Waldenstrom's macroglobulinaemia	M
F	CML	N
G	Chronic myelomonocytic leukaemia	O
H	Polycythemia vera	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 30 year old man presents with weight loss, night sweats and itching. Examination reveals a massive splenomegaly.  Raised WCC, neutrophilia, basophilia. Peripheral blood film reveals myelocytes and metamyelocytes.

 

 

2. A 70-year old man presents with tiredness. Low WCC, neutropaenia, monocytosis. Peripheral blood film reveals pseudo-Pelger cells.

 

 

 

3. A 3 year-old girl presents with a 1-month history of abnormal bruising. Cytogenetic analysis reveals the presence of a Philadelphia chromosome. Bone marrow smear shows heavy blast cell infiltration.

 

 

4. A 70 year old man presents with tiredness. Anaemia, monoclonal lymphocytosis, hypogammaglobulinaemia, thrombocytopaenia. Immunophenotyping show lymphocytes expressing CD5, CD19, CD20 and IgM (weak).

 

 

5. A 70 year old man presents with tiredness and headaches. Lymphocytosis, cold agglutinins.

 

 

 

ANSWERS

1. F

2. G

3. A

4. L

5. E