Pathology EMQ template.

Name: Anthi Lavida

Theme: Myeloproliferative disorders

 

OPTION LIST

 

A	Acute Lymphoid Leukaemia	I	Myeloma
B	Acute Myeloid Leukaemia	J	Polycythaemia Rubra Vera
C	Aplastic anaemia	K	Reactive Thrombocytosis
D	Chronic Lymphocytic Leukaemia	L
E	Chronic Myeloid Leukaemia	M
F	Essential Thrombocytosis	N
G	Idiopathic Myelofibrosis	O
H	Myelodysplasia	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 55 year old man has a routine blood count at his GP. It reveals a WCC of 120x10(9)/l but a normal platelet count and Hb. On examination, there is massive splenomegaly and a blood film reveals mature WCC (particularly neutrophils and myelocytes).

 

 

2. A 60 year old woman goes to her GP complaining of unexplained itchiness following hot baths or showers. On examination, she appears plethoric and has engorged fundal vessels. An FBC revels increased HB and platelets.

 

 

3. A 65 year old man is presenting with bone pain, recurrent infections, loin to groin pain and confusion. Bloods show a high ESR and protein electrophoresis shows the presence of a monoclonal paraprotein.

 

 

4. A 52 year old woman presents with headaches. An FBC reveals a platelet count of 750x10(9)/l with normal HB and WCC and normal inflammatory markers. A bone marrow aspirate reveals an increase in megakaryocytes. The doctor tells her she is at increased risk to develop another disorder, known as acute myeloid leukaemia.

 

 

5. A 55 year old man presents with tiredness. On examination he looks pale and an enlarged spleen can be felt. Blood film is leukoerythroblastic and reveals tear drop poikilocytes, increased platelets and some giant forms. Bone marrow aspiration reveals a dry tap and diagnosis is confirmed with a bone trephine.

 

 

 

ANSWERS

1. E

2. J

3. I

4. F

5. G