Myeloid and MDS
This BCR-ABL1–driven myeloproliferative neoplasm presents with marked leukocytosis, basophilia, splenomegaly, and a peripheral smear showing granulocyte maturation.
What is chronic myelogenous leukemia (CML)?
Macrocytic anemia, glossitis, paresthesias, and impaired proprioception and vibration sense (subacute combined degeneration) point to this vitamin deficiency.
What is B12 deficiency
Sulfa drugs, dapsone, rasburicase, and primaquine all share this same histology in patients with an X-linked enzyme deficiency.
What are bite cells/howell jolly odies
Headache, cranial neuropathies, and altered mental status in a patient with a known solid-tumor malignancy should raise concern for this diagnosis, confirmed by contrast MRI and CSF cytology.
What is carcinomatous (leptomeningeal) meningitis?
treatment of negative node rectal cancer
Local excision or transanal endoscopic microsurgery — without neoadjuvant chemoradiation — is generally sufficient for this early, node-negative stage of rectal cancer.
In a patient in their 70s or 80s, this JAK2-mutated myeloproliferative neoplasm requires a bone marrow biopsy to exclude MDS before the diagnosis can be made, since reactive and other clonal causes of thrombocytosis are more common at this age.
What is thrombocytosis
Mucocutaneous bleeding with a prolonged PTT that may or may not correct, Negative ristocetin test
What is von Willebrand disease?
Increased reticulocytes with venous thrombosis, abdominal pain intravascular hemolysis leads to a loss of this complement protein
CD55, CD59
A single lytic bone lesion with a monoclonal protein and clonal plasma cells on biopsy — but no CRAB criteria and no additional lesions on skeletal survey, MRI, or PET — defines this entity, which requires excluding systemic multiple myeloma before diagnosis.
What is a solitary plasmacytoma?
acute venous thromboembolism in pregnancy?
Low-molecular-weight heparin, rather than a DOAC or warfarin, is the anticoagulant of choice for this clinical scenario,
This clonal bone marrow disorder features cytopenias, dysplastic hematopoiesis, and an increased risk of transformation to acute myeloid leukemia — occurring with no prior cytotoxic exposure.
What is MDS
An older patient with no personal or family bleeding history develops sudden, severe soft-tissue or mucosal bleeding, an isolated prolonged aPTT that fails to correct on a mixing study
What is an acquired factor VIII inhibitor (acquired hemophilia A)?
Phlebotomy to a hematocrit goal under 45%, low-dose aspirin, and cytoreduction with hydroxyurea in high-risk patients make up first-line therapy for this JAK2-driven disorder.
What is treatment of polycythemia vera?
A new lung mass with mediastinal or hilar adenopathy warrants tissue biopsy, PET/CT, brain MRI, and molecular driver-mutation testing as part of the workup for this suspected malignancy.
non–small cell lung cancer?
management of classic familial adenomatous polyposis (FAP)?
Colonoscopy starting in adolescence, with consideration of prophylactic colectomy once polyps are found, defines management of this autosomal dominant syndrome caused by an APC mutation.
This treatment ccan be used for younger, more fit patients with MDS
What is stem cell transplant
An elevated platelet count found alongside microcytosis and a low ferritin should first prompt consideration of this benign process
What is reactive thrombocytosis secondary to iron deficiency anemia?
Bisphosphonates or denosumab plus aggressive IV isotonic saline hydration are first-line therapy for this oncologic emergency
What is treatment of hypercalcemia of malignancy?
A young man with gynecomastia, small testes, and a mediastinal mass should be evaluated for this tumor type, keeping in mind its association with an underlying XXY karyotype.
What is a germ cell tumor (in a patient with probable Klinefelter syndrome)?
surveillance in low-risk bladder cancer?
Cystoscopy at regular surveillance intervals, without routine upper-tract imaging in every patient, is the recommended follow-up strategy
For a lower-risk MDS patient with symptomatic anemia and an isolated del(5q) cytogenetic abnormality, this immunomodulatory drug is the preferred first-line therapy.
What is Luspatercept (as management of low-risk MDS)?
Mild, stable microcytic anemia with a normal RDW, a normal iron panel, and a normal hemoglobin electrophoresis suggests this hemoglobinopathy, with elevation in fetal hemoglobin
What is beta-thalassemia (minor)?
Aggressive IV hydration, rasburicase or allopurinol, and close monitoring of potassium, phosphate, uric acid, and calcium are used to manage this metabolic emergency
What is treatment of tumor lysis syndrome?
Cervical lymphadenopathy with squamous histology on biopsy but no primary tumor found on exam should prompt endoscopy of the upper aerodigestive tract, PET/CT, and HPV/p16 and EBV testing as part of this workup
What is the evaluation of squamous cell carcinoma of unknown primary?
New-onset watery diarrhea or increased stool frequency in a patient recently started on pembrolizumab or nivolumab should prompt evaluation for this
What is checkpoint inhibitor–associated diarrhea (colitis)?