EMQs in Clinical Medicine.pdf - Peshawar Medical College

Haematological diseases 55
23 Haematological diseases
A
B
C
D
E
F
myeloma
Hodgkin’s lymphoma
polycythaemia rubra vera
amyloidosis
chronic lymphocytic leukaemia
Waldenström’s macroglobulinaemia
G
H
I
J
K
L
acute lymphoblastic leukaemia
Burkitt’s lymphoma
paroxysmal nocturnal haemoglobinuria
essential thrombocythaemia
chronic myeloid leukaemia
antiphospholipid syndrome
For each clinical scenario below, give the most likely cause for the clinical
findings. Each option may be used only once.
1 A 25-year-old man presents with enlarged painless lymph nodes in the neck. His
peripheral blood film shows Reed–Sternberg cells.
2 A 45-year-old man presents with fever, weight loss, tiredness and gout. On
examination there is splenomegaly. White blood cell count is 112 10 9 /l. The
Philadelphia chromosome is detected.
3 A 70-year-old woman complains of weight loss, headache, blurry vision, lethargy
and haematuria. Positive findings on examination include cervical
lymphadenopathy, splenomegaly and numerous retinal haemorrhages. Bone
marrow biopsy shows lymphoplasmacytoid cell infiltrate.
4 A 27-year-old man presents with haemolytic anaemia after surgery. He reports a
history of recurrent abdominal pains. The Ham’s test is positive.
5 A 60-year-old man presents with headaches, blurred vision and itching over the
whole body (the last after a hot bath). Positive findings on examination include
plethoric facies and moderate splenomegaly. Haematocrit: 65 per cent.
Answers: see page 64.