Heme/Onc

Question 1

4 y/o male with bone pain and pallor. Labs reveal WBC 16,000, Hgb 6.1, and platelets of 36,000. Blood smear shows blastic cells. Diagnosis?

A. ALL
B. CLL
C. CML
D. AML

Answer 1

A. ALL

Question 2

88 y/o male presents for annual exam. History and physical are negative. CBC reveals leukocytosis of 80,000 with lymphocytic predominance. Blood smear shows many mature lymphocytes. Diagnosis?

A. ALL
B. CLL
C. CML
D. AML

Answer 2

B. CLL

Question 3

55 y/o male presents for annual exam. CBC reveals leukocytosis with neutrophilic predominance. Diagnosis?

A. ALL
B. CLL
C. CML
D. AML

Answer 3

C. CML

Question 4

60 y/o male presents with bone pain, fever, and pancytopenia. Blood smear reveals blasts and a bone marrow biopsy shows blastic neutrophils. Diagnosis?

A. ALL
B. CLL
C. CML
D. AML

Answer 4

D. AML

Question 5

62 y/o male presents with blurred vision, fatigue, and gingival bleeding for the past 1 month. Vitals are normal and peripheral neuropathy is noted on physical exam. Blood smear shows rouleaux formation and electrophoresis is positive for an M-spike. Bone marrow biopsy shows predominance of lymphocytes. Dx?

A. CLL
B. Multiple myeloma
C. Waldenstrom macroglobulinemia
D. Monoclonal gammopathy of undetermined significance
E. ALL

Answer 5

C. Waldenstrom macroglobulinemia

[MM presents with different sxs — renal failure, hypercalcemia, anemia. MGUS is asymptomatic]