Hematologic Malignancies USMLE Step 1 Practice Question
A 70-year-old man presents with progressive early satiety, weight loss, and abdominal fullness. Vital signs show BP 138/82, HR 92, RR 18, temperature 37.2°C, SpO2 98% on room air. Examination reveals massive splenomegaly. Laboratory studies demonstrate hemoglobin 9.2 g/dL, WBC 7,500/mm³, platelets 110,000/mm³, and leukoerythroblastic peripheral smear with teardrop-shaped erythrocytes. Bone marrow aspiration yields a dry tap. No fever or lymphadenopathy noted. Which of the following is the most likely diagnosis?
Answer choices
- AAplastic anemia
- BHairy cell leukemia
- CPrimary myelofibrosisCorrect answer
- DChronic myelogenous leukemia
- EMultiple myeloma
- FSplenic lymphoma with villous lymphocytes
See the full explanation
Get the correct-answer rationale, why each distractor is wrong, the underlying mechanism, and high-yield associations — plus adaptive practice that targets your weak areas — with a free MedBoardPRO account.