Hematologic Malignancies USMLE Step 1 Practice Question
A 45-year-old woman presents with progressive fatigue and early satiety. Vital signs: BP 128/82, HR 102, RR 18, Temp 37.2°C, SpO2 98%. Physical exam reveals massive splenomegaly; lymph nodes are not enlarged. CBC shows WBC 85,000/μL with left shift (70% myelocytes, 15% metamyelocytes, 8% basophils, 6% eosinophils). LDH is elevated. Cytogenetics demonstrates Philadelphia chromosome positivity. Which diagnosis best explains these findings?
Answer choices
- AChronic myelomonocytic leukemia
- BChronic myeloid leukemia in chronic phaseCorrect answer
- CAcute myeloid leukemia
- DAcute leukemoid reaction
- EPolycythemia vera
- FChronic lymphocytic leukemia with prolymphocytic transformation
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.