Page 487 - Clinical Hematology_ Theory _ Procedures ( PDFDrive )

CHAPTER 23 ■ Myeloproliferative Neoplasms 471

CASE STUDIES (continued)
CASE STUDIES (continued)

■ Critical Thinking Group Discussion Questions Case Study 23. 5
1. Wh t isor er is suggeste by the peripher l bloo f l ?

A 21-ye r-ol le thlete visite the sports e icine

2. Wh t other he tologic l test coul i erenti te be- clinic er noting th t his knee w s swollen. He h no

tween v rious types o leukocytosis? history o recent injuries. He reporte h ving requent,

bil ter l nose blee s, blee ing ro his gu s when brush-

ing his teeth, n so e bloo in the stool. T e tten ing
Case Study 23. 4
orthope ic surgeon or ere CBC n CA sc n o the
A 58-ye r-ol n went to see his ily physici n bec use swollen knee.

o 3- onth history o izziness. On physic l ex in -
tion, he h ushe ppe r nce. He h spleno eg ly ■ Laboratory Data

but no hep to eg ly. A CBC w s or ere . RBC 4.40 × 10 /L
12
He tocrit 43%

■ Laboratory Data He oglobin 14.8 g/ L
RBC 5.82 × 10 /L WBC 12.5 × 10 /L
12
9
He tocrit 58% Pl telets 955 × 10 /L
9
He oglobin 20 g/ L

WBC 17.4 × 10 /L T e CA sc n o his knee reve le l rge e usion, which
9
Pl telets 855 × 10 /L w s bloo y when t ppe .
9

A ollow-up bone rrow ex in tion reve le hyper-

cellul r rrow with triline ge hyperpl si n gi nt ■ Critical Thinking Group Discussion Questions

eg k ryocytes. T e Prussi n blue iron st in e on- 1. Wh t is the prob ble i gnosis, b se on the p tient’s

str te bsent iron stores. history?

2. B se on the initi l n ollow-up stu ies, how oes this
■ Critical Thinking Group Discussion Questions ise se present tion i er ro PRV?
1. B se on the l bor tory t , wh t is the suggeste i g-

nosis or this p tient?
3. Is this thro bocytosis re ctive thro bosis?

2. Wh t is the ost co on ther peutic ppro ch in this

isor er?
NOTE: This is a good time to write out the answers to the

Critical Thinking Group Discussion Questions.

3. Wh t is the ost co on c use o e th in this isor er?

REVIEW QUESTIONS

*Indicates ML (optional) and MLS advanced content. 3. Pri ry yelof brosis i ers ro other types o MPN

1. MPNs re ch r cterize by ll o the ollowing except in which o the ollowing w ys?

1
A. clon l isor ers A. Ph chro oso e is present.
B. they y evolve into cute leuke i B. M rrow f brosis is gre tly incre se .

C. initi l incre se o i ture cells C. LAP score is incre se .

D. incre se pro uction o ture cells D. Pl telet count is incre se .

2. In CML, the tot l leukocyte (WBC) count is 4. Which o the ollowing is re rk ble ch r cteristic o

A. extre ely incre se PRV co p re with other types o MPNs?

B. slightly incre se A. Extre ely incre se erythrocyte ss

C. extre ely v ri ble B. Extre ely incre se leukocyte count

D. usu lly nor l C. Extre ely incre se pl telet count
D. e r rop-sh pe erythrocytes

(continued)