A 32-year-old woman presents to her General Practitioner with a 1-week history of epistaxis and bleeding gums. She recently recovered from influenza and has a history of hypothyroidism for which she takes levothyroxine. On examination, she has multiple bruises and petechiae over her lower limbs and trunk. Her investigations reveal a low platelet count and normal coagulation parameters. What is the most likely diagnosis?
A 35-year-old woman presents to her General Practitioner complaining of fatigue and lack of energy. She has a 1-year history of heavy menstrual bleeding with excessive blood loss. She is clinically anaemic.
Investigations:
Investigation Result Normal value
Haemoglobin (Hb) 102 g/l 115–155 g/l
Haematocrit 28% 36–47%
Mean corpuscular volume (MCV) 70 fl 80–100 fl
Mean cell haemoglobin (MCH) 25 pg 28–32 pg
Mean corpuscular haemoglobin volume (MCHC) 300 g/l 320–350 g/d
White cell count (WCC) 7.5 × 109/l 4.0–11.0× 109/l
Platelets (PLT) 400× 109/l 150–400× 109/l
What is the most appropriate dietary advice for this patient?
Select the SINGLE advice option from the list below.
A 25-year-old woman comes to the General Practitioner complaining of pallor, fatigue, weakness, palpitations and dyspnoea on exertion. Her symptoms have developed rapidly over the past two weeks. A blood test and bone marrow biopsy reveal a diagnosis of acute myeloid leukaemia (AML).
What is the most appropriate initial treatment for this patient’s condition?
A 30-year-old woman comes to her General Practitioner complaining of fatigue and sudden shortness of breath. An urgent full blood count is performed and the patient is diagnosed with acute lymphoblastic leukemia (ALL).
What is the most probable first-line treatment option for this patient’s leukemia?
A 55-year-old man is referred to the Haematology Clinic under the 2-week-wait rule with significant fatigue and frequent infections over the past six months. His blood results confirm a diagnosis of chronic lymphocytic leukaemia (CLL) with a 17p chromosome deletion.
Which of the following is the most appropriate first-line treatment?
A 55-year-old man is reviewed on the Oncology Ward. He has metastatic lung cancer and a potassium (K+) level of 6.1 mmol/l (normal range: 3.5–5.0 mmol/l). The lab report indicates that there was a delay in processing this sample. His last K+ level recorded two days ago was 4.2 mmol/l. An electrocardiogram (ECG), urine output and observations all provide normal results.
What is the most appropriate initial step in this patient’s management?
An 87-year-old woman presents to the Haematology Clinic to review her latest blood test results. These show that her international normalised ratio (INR) is 8.9 (normal range: 2–3). She usually takes warfarin for atrial fibrillation. The patient’s General Practitioner has telephoned her to advise that she stop taking the warfarin. The patient says that she feels well and is asymptomatic.
What is the most appropriate next step in this patient’s management?
A 35-year-old woman comes to her General Practitioner complaining of fatigue, weight loss, and palpable lymph nodes in the left supraclavicular fossa.
What is the most suitable location to investigate for a primary tumor in this patient?
A 57-year-old woman with a long history of sun exposure presents to the accident and emergency department after a fracture of her right femur associated with a minor fall. On reviewing the films with the on-call radiographer you are concerned about a lytic lesion possibly being related to the fracture.
Which of the following primary tumours most commonly metastasises to bone?
Among the following groups of malignant tumours, which one is known for frequently metastasizing to bone?