Hematologic Malignancies USMLE Step 1 Practice Question
A 52-year-old man presents with progressive fatigue, early satiety, and unintentional 8-lb weight loss over 2 months. Vital signs: BP 138/82, HR 102, RR 18, Temp 37.2°C, SpO2 98% on room air. Examination reveals massive splenomegaly; no lymphadenopathy noted. Laboratory studies show WBC 87,000/μL with left shift (increased myelocytes and metamyelocytes), basophilia, and low leukocyte alkaline phosphatase score. Hemoglobin 10.2 g/dL. Which of the following is the most likely underlying abnormality?
Answer choices
- ADeletion of the p53 gene
- Bt(9;22) creating a constitutively active tyrosine kinaseCorrect answer
- Ct(8;14) causing c MYC overexpression
- Dt(14;18) causing BCL2 overexpression
- EJAK2 activating mutation
- FFLT3-ITD internal tandem duplication causing increased proliferation
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