Deck 218: Leukemias

Question 1

A patient is suspected of having leukemia and the provider orders biochemical studies and a bone marrow aspirate and biopsy. The results include white blood cells (WBCs) greater than 200,000 cells/mm³ normal red blood cells (RBCs), hyperplastic myeloid cells, and the absence of serum leukocyte alkaline phosphatase. Which test will the provider order to confirm a diagnosis in this patient?

A) Chest radiograph
B) Coagulation studies
C) Philadelphia chromosome test
D) Serum protein electrophoresis

Answer 1

C

Question 2

A patient with acute myelogenous leukemia (AML) who has a high white blood cell count and diffuse lymphadenopathy is hospitalized during the induction phase of chemotherapy. What monitoring and interventions are critical to assess for complications during this phase of care for this patient? (Select all that apply.)

A) Administration of sodium bicarbonate and allopurinol
B) Assessment for bruising and petechiae
C) Close monitoring of absolute neutrophil counts
D) Daily renal function and chemistry values
E) Meticulous assessment of hydration status

Answer 2

A, D, E

Question 3

A child has a recent history of leg pain, unexplained bruising, and nosebleeds. The provider notes petechiae and diffuse lymphadenopathy. A complete blood count reveals a white blood cell (WBC) of 30,000 cells/mm³ and near normal red blood cell (RBC) and platelet counts. What will the provider do next to manage this patient?

A) Order coagulation studies to evaluate for coagulopathies
B) Perform biochemical studies to look for hyperuricemia
C) Refer to a specialist for a bone marrow aspirate and biopsy
D) Repeat the complete blood count in 2 weeks

Answer 3

C