Name: Adli Metussin

Theme: Myeloproliferative disorders

 

OPTION LIST

 

A

Acute Lymphoblastic Leukaemia

I

Primary myelofibrosis

B

Acute Myeloid Leukaemia

J

Pseudopolycythaemia

C

Chronic Myeloid Leukaemia

K

 

D

Essential Thrombocytopenia

L

 

E

Hodgkin’s Lymphoma

M

 

F

Idiopathic thrombocytopenia

N

 

G

Microangiopathic haemolytic anaemia

O

 

H

Polycythaemia Vera

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 60 year old man came into hospital after an episode of transient weakness in his left arm which resolved after 12 hours. Clinical examination showed bruising in his limbs and he also had en enlarged spleen. Blood tests showed normal Hb and white cell counts were also normal. His platelets were about 850 X 109/L. Bone marrow aspiration showed an increase in megakaryocytes with clustering and minimal fibrosis.

 

2. A 55 year old man complains of itching that occurs after his baths. He has long standing history of gout. On examination, he was plethoric and had an enlarged spleen. Blood tests showed raised Hb with a raised Hct. His platelets were also raised but he had normal white cell count. Further blood tests also showed increase in packed cell volume but his erythropoietin values were low.

 

3. A 60 year old woman was referred by her GP because she was complaining of lethargy and weight loss. On examination, she looked pale and abdominal examination revealed a massive spleen. Blood tests showed low Hb, low white cell count as well as low platelets. Attempts to aspirate her bone marrow failed to yield much. A blood film was done and it showed a leucoerythroblastic picture with tear-drop shaped poikilocytes.

 

4. A 65 year old man with known primary polycythaemia came into hospital complaining of recurrent bruising on his limbs and fever. He has been treated via venesection since his diagnosis 4 years ago. His blood tests shows low Hb, low white cell count and low platelets. Bone marrow aspirate showed increased cellularity of myeloid blast cells and the presence of Auer rods.

 

 

ANSWERS

1. D

2. H

3. I

4. B

5.