Pathology EMQ template.

Name: Euiseok Kim

Candidate number:

Theme: Diagnosis of Leukaemia

 

OPTION LIST

 

A	Acute lymphoblastic leukaemia	I	Acute promyelocytic leukaemia
B	Acute myeloid leukaemia	J	T cell prolymphocytic leukaemia
C	Chronic lymphocytic leukaemia	K	B cell prolymphocytic leukaemia
D	Chronic myeloid leukaemia	L	Batman syndrome
E	Hairy cell leukaemia	M	Tumour Lysis syndrome
F	Prolymphocytic leukaemia	N	Fanconi Anaemia
G	Hodgkin’s disease	O	DIC
H	Burkitt’s lymphoma	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 45 year-old man complains of recent weight loss and tiredness. On examination, he is found to have splenomegaly. Blood tests reveal WCC >100X10⁹/L, Hb 12 g/dl, Platelets 140 X10⁹/L, and high Vitamin B12. FISH shows t(9:22).

 

2. A 72 year-old Caucasian man presents with recurrent fungal infections. He is found to be anaemic. Blood film shows small lymphocytes, and Coomb’s test is positive. Immunophenotyping shows co-expression of CD5 and CD19, indicative of intermediate B-cells.

 

3. A 65 year-old man with a history of polycythaemia vera treated with hydroxyurea presents with anaemia, recurrent infections and bruises in the lower limbs. Auer rods are seen on blood film.

 

4. A 7 year-old boy presents with anaemia, fever and severe bleeding, and is promptly started on treatment, which results in disseminated intravascular coagulation. The boy is found to have t(15:17). The boy likes Batman.

 

5. Richter transformation denotes the transformation into non-Hodgkin lymphoma (Diffuse large B-cell lymphoma) from …

 

 

 

ANSWERS

1. D

2. C

3. B

4. I

5. C