Welcome to your 3. 🔬 Myeloid Neoplasms, Myelodysplastic Syndromes & Myeloproliferative Disorders Arena
1.
A patient with polycythemia vera has a markedly increased platelet count but nevertheless develops recurrent mucosal bleeding. Which explanation is most appropriate?
2.
Which statement best describes the difference between granulocyte colony-stimulating factor and granulocyte-monocyte colony-stimulating factor?
3.
A patient receiving myelosuppressive chemotherapy is treated with filgrastim for neutropenia. Several days later he develops diffuse aching pain over the pelvis and long bones without evidence of infection. Which mechanism best explains this adverse effect?
4.
Bone-marrow examination of a patient with MDS shows an increasing proportion of blasts compared with previous studies, although the findings do not yet meet criteria for overt acute leukemia. Which interpretation is most appropriate?
5.
Which FAB subtype of acute myeloid leukemia corresponds to acute promyelocytic leukemia?
6.
A patient with acute leukemia has predominantly abnormal cells showing monocytic differentiation. According to the FAB classification of AML, which subtype best corresponds to this pattern?
7.
A patient with chronic myeloid leukemia is started on imatinib. What is the main therapeutic target of this drug?
8.
A 61-year-old man with persistent erythrocytosis complains of headache, dizziness and visual disturbance. Examination shows facial plethora and splenomegaly. Which pathophysiological consequence most directly produces these neurological and visual symptoms?
9.
A 58-year-old woman presents with fatigue, fever and mucosal bleeding. Peripheral blood contains numerous blasts, but their lineage is uncertain on morphology alone. Which investigation would most directly establish that the abnormal cells belong to the myeloid lineage?
10.
A patient is suspected of having acute myeloid leukemia after blasts are identified on peripheral smear. Which investigation is most useful for confirming marrow blast accumulation and assessing hematopoietic morphology?
11.
A 72-year-old man presents with persistent anemia and thrombocytopenia. Bone marrow is hypercellular and shows abnormal erythroid, granulocytic and megakaryocytic maturation. Which interpretation best fits these combined findings?
12.
A patient with suspected myelodysplastic syndrome has cytopenias and dysplastic marrow cells, but nutritional deficiency and other non-neoplastic causes have not yet been assessed. What is the most appropriate diagnostic principle?
13.
Which morphological finding may be seen in certain forms of myelodysplastic syndrome due to abnormal mitochondrial iron accumulation in erythroid precursors?
14.
Which molecular abnormality is central to the pathogenesis of chronic myeloid leukemia?
15.
A 35-year-old woman with acute leukemia develops widespread bruising and abnormal coagulation studies soon after presentation. Bone marrow shows abnormal promyelocytes. Which underlying abnormality best explains this leukemia subtype?
16.
A man with myelodysplastic syndrome develops fever and recurrent bacterial infections. His hemoglobin is moderately reduced, platelet count is near normal, and neutrophils are markedly decreased. Which hematological abnormality best explains his infections?
17.
A 57-year-old woman with polycythemia vera reports intense generalized itching after taking a warm shower. Which interpretation best fits this finding?
18.
A 63-year-old man has anemia, thrombocytopenia and circulating blasts. Bone-marrow examination confirms acute leukemia. Flow cytometry is requested after the morphological assessment. What is its most important role in this setting?
19.
A 68-year-old woman who previously received cytotoxic chemotherapy develops persistent anemia and neutropenia several years later. Bone-marrow examination reveals dysplastic hematopoiesis. Which factor in her history is most relevant to the development of this disorder?
20.
The anemia and thrombocytopenia seen in acute myeloid leukemia are primarily caused by which process?
21.
Which peripheral-blood pattern is most characteristic of chronic-phase chronic myeloid leukemia?
22.
A patient with CML has progressive disease despite appropriate BCR::ABL1-directed therapy and enters an advanced phase. Which management option becomes particularly relevant in a suitable patient?
23.
A 70-year-old patient has fatigue and recurrent infections. Blood counts show anemia and neutropenia, while the bone marrow is hypercellular with abnormal maturation of several cell lines. Which diagnosis is most likely?
24.
A patient with chronic myeloid leukemia initially responds well to targeted therapy but later develops increasing blasts and progressive clinical deterioration. Which change best explains this evolution?
25.
A peripheral smear from a patient with suspected myelodysplastic syndrome shows neutrophils with abnormally hyposegmented nuclei. These cells are best described as:
26.
Bone-marrow examination in polycythemia vera commonly demonstrates increased proliferation of erythroid, granulocytic and megakaryocytic lineages. This finding is termed:
27.
A 62-year-old man presents with fatigue, recurrent infections and easy bruising. Peripheral blood shows numerous immature myeloid cells, and several blasts contain needle-shaped cytoplasmic inclusions. Which finding is most characteristic of this disorder?
28.
A patient receiving myelosuppressive therapy develops significant neutropenia. Which drug is most appropriate for stimulating neutrophil production?
29.
A 52-year-old man with established chronic myeloid leukemia has received targeted therapy for several months. His blood counts have improved substantially. Which investigation is most useful for assessing the remaining molecular disease burden?
30.
The Philadelphia chromosome in chronic myeloid leukemia is produced by a translocation involving which chromosomes?
31.
Which statement best explains peripheral cytopenias in myelodysplastic syndromes despite a cellular or hypercellular bone marrow?
32.
A 46-year-old man with chronic myeloid leukemia has marked splenomegaly and complains of early satiety. Which process most directly contributes to enlargement of the spleen in this disorder?
33.
A patient with treatment-related leukopenia requires stimulation of both granulocytic and monocyte/macrophage progenitors rather than predominantly the neutrophil lineage. Which agent best matches this therapeutic objective?
34.
A 58-year-old patient has persistent erythrocytosis, headache, facial plethora and splenomegaly. Which molecular abnormality most strongly supports polycythemia vera?
35.
A patient with polycythemia vera develops sudden unilateral leg swelling and later pleuritic chest pain. Which feature of the underlying disorder most directly predisposes to this complication?
36.
A bone-marrow specimen contains numerous cells with eccentric nuclei, deeply basophilic cytoplasm and specialization for immunoglobulin secretion. Which normal leukocyte lineage gives rise to these cells?
37.
A 48-year-old man has marked leukocytosis and splenomegaly. His peripheral smear shows neutrophils along with myelocytes and metamyelocytes. Which additional finding would most strongly support chronic myeloid leukemia?
38.
A patient with myelodysplastic syndrome is being followed over time. Progression of this disorder is particularly associated with development of which condition?
39.
Which group contains only classic myeloproliferative neoplasms?
40.
Which serum finding is most consistent with polycythemia vera rather than secondary erythrocytosis?
