Pathology EMQ template.

Name: Lau, Loretta

Candidate number:

Theme: Myelodysplastic syndromes

 

OPTION LIST

 

A	Refractory anaemia	I	Aplastic anaemia
B	Refractory anaemia with excess blasts	J	Blood transfusion
C	Chronic lymphocytic leukaemia	K	Cyclophosphamide
D	5q syndrome	L	Multilobed neutrophils
E	Refractory anaemia without ringed sideroblasts	M	Pelger-Huet anomaly
F	Acute lymphoblastic leukaemia	N	Radiotherapy
G	Acute myeloid leukaemia	O	Refractory anaemia with multilineage dysplasia
H	Chronic myeloid leukaemia	P	Topoisomerase II inhibitors

 

 

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 35 year old man presents with increasing tiredness and lethargy over the last x months. He has also noticed bleeding from the gums and pin prick bruises on his skin and recurrent UTIs over the same period of time. Blood film shows 15% blast cells.

 

2. A 62 year old man comes to your surgery complaining of tiredness and increasing fatigue over the last 2 months. He is quite concerned as he was able to run 5 miles each day but now is finding it somewhat difficult to complete a short run around the neighbourhood. A blood film result shows <5% blast cells. There are no other abnormalities observed with erythrocytes.

 

 

3. A 57 year old man has been diagnosed with refractory anaemia with excess blasts. What finding on the blood film is characteristic of this disease?

 

 

4.  What should be the first line treatment considered for patient in question 1?

 

 

5. The patient in question 1 is more likely to progress to which disease if their condition is not treated or is unresponsive to treatment?

 

 

 

ANSWERS

1. B

2. E

3. M

4. J

5. G