07-24-2007, 08:20 PM
15. A 40 year-old man presents with fever and weight loss. He has normocytic anemia with a corrected reticulocyte count (< 2 %) and a white blood cell count of 85, 000 cells/L with 1 % myeloblasts and the remainder of cells ranging from progranulocytes to mature segmented neutrophiles. Basophiles and eosinophils are increased. His platelet count is increased. Physical examination reveals hepatosplenomegaly and generalized, non-painful lymphadenopathy. A bone marrow reveals hypercellularity and a leukocyte differential similar to that in the peripheral blood. Which of the following test combinations would be MOST USEFUL in arriving at the diagnosis in this patient?
a. Arterial blood gas and red blood cell mass/plasma volume studies
b. Chromosome study and a leukocyte alkaline phosphatase score (LAP)
c. CT of the abdomen
d. Serum protein electrophoresis and CT of the abdomen
a. Arterial blood gas and red blood cell mass/plasma volume studies
b. Chromosome study and a leukocyte alkaline phosphatase score (LAP)
c. CT of the abdomen
d. Serum protein electrophoresis and CT of the abdomen