EMQs in Clinical Medicine.pdf - Peshawar Medical College

Haematology and oncology – revision boxes 71
In an EMQ involving haematological malignancy as a possible option, it is particularly
important to be aware of classic features on blood film/bone marrow biopsy
(Box 4).
Box 4 Haematological malignancy
• Reed–Sternberg cells Hodgkin’s lymphoma [23]
• Auer rods
Acute myeloid leukaemia
• Middle age, ↑↑↑ WCC (white cell count), Chronic myeloid leukaemia
gout, Philadelphia chromosome
• Usually elderly patient Myeloma [45, 82]
Bone pain very common
Look out for renal failure
Hyperviscosity, e.g. retinal haemorrhages
Monoclonal Ig band on electrophoresis
Bone marrow biopsy: plasma cell infiltration
In exam EMQs certain drugs tend to be associated with particular side effects
(Box 5).
Box 5 Adverse effects of chemotherapy [27]
Drug
Doxorubicin
Bleomycin, methotrexate, busulphan
Cyclophosphamide
Vinca alkaloids, e.g. vincristine, platinum compounds,
e.g. cisplatin, taxanes, e.g. paclitaxel
Effect
Cardiotoxicity
Pulmonary fibrosis
Haemorrhagic cystitis
Peripheral neuropathy