Pathology EMQ template.

Name: Daniel Neville

Candidate number:

Theme: Myeloproliferative disorders

OPTION LIST

A	Acute Myeloid Leukaemia	I	Imatinib
B	Hydroxycarbamide	J	Myelofibrosis
C	Chronic myeloid leukaemia	K	Autoimmune thrombocytopaenic purpura
D	Primary Polycythaemia Vera	L	Secondary polycythaemia vera
E	Venesection and aspirin	M	Dasatinib
F	Anagrelide	N
G	Essential thrombocythaemia	O
H	Transfusions followed by splenectomy	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 58 year old man presents to his G.P. with blurred vision, strange headaches and fatigue. Blood tests reveal a raised Haematocrit. His Serum EPO is low and he has also recently noticed that his toe is very painful. What is the diagnosis?

2. A 39 year old lady had a routine blood count at the subfertility clinic. It showed a markedly raised WCC 150x109/l with raised basophils and neutrophils. Her Hb and platelet count are normal. She just been diagnosed with gout and has noticed some welcome weight loss recently. What is the diagnosis?

3. What would be the first line treatment for this lady?

4. A woman has presented with distended veins on her abdomen and a massive splenomegaly. A blood film reveals a leucoerythroblastic picture, teardrop poikilocytes and anaemia. How would you treat this lady?

5. A 70 year old man presents with headaches and a large bruise on his arm after a recent fall. An urgent blood film shows a Hb of 13.5g/dl, WCC 5x109 and Platelets 1400 x 109/l. His ESR and CRP are also normal. He is a diabetic and on Ramipril. How would you treat him?

ANSWERS

1. D

2. C

3. I

4. H

5. B