Pathology EMQ template.

Name: Christopher Ng

Theme: Myelodysplastic syndromes

OPTION LIST

A	5q syndrome	I	Refractory anaemia with excess blasts-2
B	Acute lymphoid leukaemia	J	Refractory Anaemia with ring sideroblasts
C	Acute myeloid leukaemia	K	Unclassified myelodysplasic syndrome
D	Dyskeratosis congenita	L
E	Fanconi anaemia	M
F	Aplastic anaemia	N
G	Refractory Anaemia	O
H	Refractory anaemia with excess blasts-1	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. Male complaining of chronic tiredness. RBC 2.6 x10¹²/L, WBC 3.0 x10⁹/L. Blasts visible in the peripheral blood. Marrow blasts 17%.

2. 7 year old boy appears in clinic with short stature, hypo-pigmented spots and abnormal thumb development. He has been getting repeatedly tired recently, so you run a full blood count to find he is pancytopoenic. A chromosomal breakage test returns positive.

3. Male complaining of tiredness. RBC 3.4 x10¹²/L, but rest of FBC appears normal. Many ringed sideroblasts noted in peripheral blood. Marrow blasts 3%.

4. Female complaining of repeated infections and easy bruising. RBC 4.0 x10¹²/L, WBC 1.0 x10⁹/L. Marrow biopsy showed few cells, but large fatty regions.

5. Male complaining of repeated infections. WBC 1.0 x10⁹/L, all other FBCs, including RBC, normal. Marrow blasts 1%.

ANSWERS

1. I

2. E

3. J

4. F

5. K