Pathology EMQ template.

Name: David George Lester

Theme: Leukaemia

 

OPTION LIST

 

A

Acute lymphoblastic leukaemia

I

Genital warts

B

Acute myeloid leukaemia

J

Hairy cell leukaemia

C

AIDS

K

Hodgkin’s lymphoma

D

Cerebral lymphoma

L

Hyperparathyroidism

E

Chronic lymphocytic leukaemia

M

Marfan’s syndrome

F

Chronic myeloid leukaemia

N

Neisseria meningitidis

G

Colles’ fracture

O

Non-Hodgkin’s lymphoma

H

Cushing’s disease

P

Retroperitoneal fibrosis

 

 

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. Yoko is an 80 year old woman referred to you for investigation after a blood test shows anaemia and marked lymphocytosis. Her only complaint is “tiredness”. Physical examination reveals painless lymphadenopathy and a blood smear shows smudge cells. What is the single most likely diagnosis?

 

 

2. John is a 40 year old man complaining of fatigue, night sweats and unintentional weight loss. A blood test shows anaemia and leucocytosis, and physical examination reveals splenomegaly. Bone marrow biopsy cytogenetic analysis indicates the presence of the Philadelphia chromosome. What is the single most likely diagnosis?

 

 

3. Paul is a 71 year old man with anaemia, fever and unintentional weight loss. Physical examination reveals splenomegaly. A blood test shows anaemia, neutropaenia and thrombocytopaenia, and a blood smear shows irregularly shaped cells exhibiting filament-like cytoplasmic projections. What is the single most likely diagnosis?

 

 

4. George is a 58 year old man found collapsed at home. Physical examination reveals pallor and hepatosplenomegaly. A blood test shows anaemia, leucocytosis and thrombocytopaenia, and a blood smear shows blast cells and Auer rods. His medical records indicate he was prescribed cyclophosphamide three years ago. What is the single most likely diagnosis?

 

 

5. Ringo is a four year old boy with Down syndrome who presents in A+E with pallor, tachycardia, petechiae and testicular enlargement. A blood test shows anaemia, thrombocytopaenia and leucocytosis, and a blood smear reveals blast cells. What is the single most likely diagnosis?

 

 

 

ANSWERS

1. E

2. F

3. J

4. B

5. A