Hem/Onc Quiz #25: Myelodysplastic Syndromes

1. A 70-year-old man presents with fatigue and dyspnea on exertion. Complete blood count shows macrocytic anemia with a hemoglobin of 9 g/dL, white blood cell count within normal limits, and a platelet count of 100,000/μL. Bone marrow biopsy reveals dysplastic changes in the erythroid and myeloid lineages with ringed sideroblasts present. Which of the following is the most likely diagnosis? 

Question 1 of 5

2. A 65-year-old woman with a history of chemotherapy for breast cancer five years ago now presents with pancytopenia. Her bone marrow biopsy shows hypercellularity with multilineage dysplasia and 2% blasts. Which of the following is the most likely cause of her condition? 

Question 2 of 5

3. A 58-year-old man presents with generalized weakness and recurrent infections. Laboratory tests reveal anemia, neutropenia, and monocytosis. Bone marrow biopsy is hypercellular with 10% myeloblasts and evidence of dysplasia in more than one myeloid lineage. Which of the following factors most significantly worsens the prognosis of his condition? 

Question 3 of 5

4. During a routine health check-up, a 72-year-old asymptomatic man is found to have macrocytic anemia and thrombocytosis. Bone marrow biopsy shows dysplastic megakaryocytes and <5% myeloblasts. Cytogenetic analysis reveals del(5q). Which of the following treatments is most appropriate for this patient? 

Question 4 of 5

5. A 76-year-old man with a diagnosis of myelodysplastic syndrome (MDS) presents with worsening fatigue and shortness of breath. A complete blood count reveals hemoglobin of 7.8 g/dL, mean corpuscular volume of 105 fL, and a platelet count of 80,000/μL. His white blood cell count is normal. A recent bone marrow biopsy showed dysplastic changes in the erythroid and myeloid lineages without an increase in blasts. Which of the following is the most appropriate next step in management for this patient's anemia? 

Question 5 of 5


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