Pathology EMQ template.

Name: Pramitha Chinduluri

Candidate number:

Theme: Chronic Myeloid Leukaemia

OPTION LIST

A	Blood transfusion	I	Rituximab
B	BMT	J	Splenectomy
C	BMT and chemotherapy	K
D	Chemotherapy	L
E	Hydroxyurea	M
F	Imatinib and chemotherapy	N
G	Mercaptopurine	O
H	Nilotinib	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 37 year old woman presents with a history of weight loss and night sweats. Examination revealed massive splenomegaly. FBC: Hb 13g/dl, WCC 150 x 10⁹ /l, platelets 200 x 10⁹. A blood film showed some blasts and fluorescent in situ hybridisation revealed a 9:22 chromosomal translocation. What treatment do you suggest?

2. A 37 year old woman presents with a history of weight loss and night sweats. Examination revealed massive splenomegaly. FBC: Hb 13g/dl, WCC 150 x 10⁹ /l, platelets 200 x 10⁹. A blood film showed some blasts and FISH revealed NO 9:22 chromosomal translocation. What treatment do you suggest?

3. A 43 year old man, diagnosed with CML 4 years ago has been offered a potentially curative treatment for his condition. What is this treatment?

4. A 38 year old man diagnosed with CML, currently treated with interferon, presents with bruises on his legs. He is tired and pale. His blood film shows that >20% of cells are blasts. What treatment do you suggest?

5. An antimetabolite treatment of CML in those who are resistant to Imatinib.

ANSWERS

1. H

2. E

3. C

4. F

5. E