Hematologic Malignancies USMLE Step 1 Practice Question
A 67-year-old man presents with progressive fatigue, unintentional weight loss, and early satiety. Vital signs show BP 138/82, HR 92, RR 18, temp 37.2°C, SpO2 98% on room air. Examination reveals massive splenomegaly. Laboratory studies demonstrate hemoglobin 9.2 g/dL, platelet count 145,000/μL, and peripheral smear shows teardrop erythrocytes with nucleated red blood cells. Bone marrow aspiration yields a dry tap. Abdominal imaging confirms marked splenic enlargement without lymphadenopathy. Which of the following is the most likely diagnosis?
Answer choices
- APure red cell aplasia
- BHairy cell leukemia
- CPrimary myelofibrosisCorrect answer
- DSideroblastic anemia
- EWarm autoimmune hemolytic anemia
- FChronic myeloid leukemia in chronic phase
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