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Clinical Case 18
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A 63-year-old woman presents to your office with complaint of fatigue. She states she felt like she spent the winter taking antibiotics because she developed "one infection after the other." Prior to this past winter, she had been well and did not take any prescription drugs regularly. Physical examination demonstrates a slightly pale, thin woman. Her temperature is 37.5 C, pulse 90, blood pressure 120/58, respirations 12. Her oropharynx demonstrates purpuric lesions. Her abdominal exam shows no organomegaly, and the remainder of the physical exam is unremarkable.

You obtain blood tests: WBC 2,100/mm3, hemoglobin 8.4 g/dl, and platelet count 20,000/mm3. A bone marrow aspirate and biopsy are obtained, which demonstrate a hypercellular marrow with 4% blasts, 4% ringed sideroblasts, and megakaryocytes. You talk to the hematologist, who suspects that your patient has a myelodysplastic syndrome.



1

Which of the following statements is INCORRECT?
A)The small number of blasts in the bone marrow indicates a better prognosis.
B)The diagnosis of myelodysplastic syndrome is incorrect as the patient has pancytopenia.
C)The patient may benefit from administration of erythropoietin.
D)The patient may develop acute myeloid leukemia.
E)The patient's gender may result in a better prognosis.







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