Name: Neil Mangrolia

Theme: Interactive cases

OPTION LIST

A	Acute lymphoblastic leukaemia	I	Liver disease
B	Acute myeloid leukaemia	J	Lymphoma
C	Chronic lymphocytic leukaemia	K	Myelofibrosis
D	Chronic myeloid leukaemia	L	Polycythaemia rubra vera
E	Essential thrombocythaemia	M	Thalassaemia
F	Folate deficiency	N	Vitamin B12 deficiency
G	Hypothyroidism	O
H	Iron deficiency	P

Choose the most likely diagnosis from the list above. Each option may be used once, more than once or not at all.

1. A patient presents with painless cervical lymphadenopathy and night sweats. Full blood count (FBC) reveals a normochromic, normocytic anaemia but otherwise appears normal. ESR and uric acid levels are raised.

2. A patient presents with shortness of breath on exertion and tingling in the feet. FBC reveals a macrocytic anaemia.

3. A 65-year old male presents with abnormal bruising, shortness of breath and a fever. FBC reveals anaemia, thrombocytopenia and a raised white cell count. Bone marrow biopsy reveals the presence of 35% blasts.

4. A 30-year old female presents with lethargy, weakness and weight loss. Examination reveals massive splenomegaly. FBC reveals anaemia and a white cell count of 110x10⁹/L (Normal: 4-11x10⁹). The Philadelphia chromosome is absent.

5. A 70-year old male presents with tiredness, tinnitus, easy bruising and intermittent claudication, and reports itching after a hot bath. Examination reveals hepatosplenomegaly and the full blood count reveals a raised haemoglobin level, a raised platelet count and a raised white cell count.

ANSWERS

1. J

2. N

3. B

4. K

5. L