WBC

UnFiNiShEd CaSe CoMe BaCk LaTeR

History of Present Illness: a woman in her late 80’s with a history of lymphoma and last chemo 3 months ago presents with one week of gradually worsening malaise and loss of apetite.  She denies fever, pain, vomiting, diarrhea or other complaints

Vital Signs & Physical Exam:

Vital signs are normal except for pulse of 103 and SPB of 108

Physical exam is otherwise normal except for slight slurred speech

Initial Diagnostic Testing:

  • CBC: WBC 175, Hb 12, Plt 36, 60% blasts
  • Chem 7: normal except for BUN/Cr 33/2.3 and Na 125
  • Trop: 0.11
  • Imaging: CXR and head CT nl

What is the most likely diagnosis?

  • A)
  • B)
  • C)
  • D)
  • E)

SCROLL DOWN FOR ANSWERS & 1-MINUTE CONSULT

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ANSWER:

  • A)
  • B)
  • C)
  • D) Leukostasis – CORRECT
  • E)

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CASE CONCLUSION: Acute myelogenous leukemia with suspected acute blast crisis. Peripheral flow cytometry suggestive of AML. 92% circulating blasts.  Expired 3 days after admission from AML and renal failure

CASE LESSONS: