Hematology

A 76-year-old, overweight female patient with anaemia and type II diabetes noted by her family doctor presents with fatigue, forgetfulness and yellowish pallor in a neglected state. Moreover, she shows an increasingly unsteady gait. How do you proceed?

A 63-year-old man presents for work-up of pancytopenia with recurrent fever. He presents in reduced general condition, with hepatosplenomegaly but without palpable lymph nodes. Laboratory diagnosis reveals bicytopenia, hyperferritinaemia, elevated levels of soluble interleukin 2 receptor (sIL2-R) and C-reactive protein (CRP). How do you proceed?

A 66-year-old female patient with pre-existing osteoporosis and rheumatoid arthritis reported large haematomas all over her body, especially on the extremities, which had been increasing for about five days. No trauma is remembered. She also complains of marked fatigue. What is your tentative diagnosis?

A 45-year-old female patient complains that she has been getting weaker and weaker for several months. She has no appetite and suffers from diarrhoea. Immunofixation shows monoclonal lambda light chains in the serum. What is your tentative diagnosis?

A 58-year-old female patient presents to the haematology outpatient department with pronounced fatigue and an unclear pancytopenia for further work-up. She also complains of a feeling of pressure in the upper abdomen and flushing symptoms in recent months. What diagnostics do you request?

A patient presents with a thrombocytosis of 900 G/l in a routine blood count. There was new onset of pain in both hands and feet, with redness. What are the most likely differential diagnoses of newly diagnosed thrombocytosis?

A 43-year-old patient reports pain in the area of the oral mucosa, brownish-livid nodules on the integument, weight loss and night sweats. In addition, his inguinal lymph nodes are reportedly enlarged. Which peripheral and non-peripheral lymph node stations are clinically relevant?

In the differential blood count of a 62-year-old female patient with normochromic, normocytic anaemia and mild thrombocytopenia, immature myeloid precursors as well as precursors of erythropoiesis are found. What are the possible causes?

A 48-year-old female patient feels listless and reports petechiae occurred for the first time. In the last 3 days, she had reportedly developed severe toothache and fever. The blood count shows severe pancytopenia. What are your first steps?

An 86-year-old male patient with long-standing seropositive rheumatoid arthritis is under regular rheumatological care. There is currently no systemic therapy, but the latest laboratory examination revealed persistent neutropenia. How do you proceed diagnostically?

A 64-year-old male patient was treated for multiple myeloma. Clinically, the patient presented in a weakened general condition and reported severe gastric, reflux complaints, dyspnoea and tingling paraesthesias in both lower extremities. How would you proceed from here?

A 31-year-old female patient presents with pronounced vertigo, hypaesthesia of both legs, gait disturbances and fluctuating visual disturbances. The previous medical record documents s/p spastic bronchitis and s/p pneumonia. What diagnostic steps do you initiate?