MRCP UK EXAMINATIONS

NEUROLOGY

SURGERY

Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
The nurse is performing an assessment for a patient with acute myeloid leukemia (AML) and observes multiple areas of ecchymosis and petechiae. Which laboratory study will the nurse be most concerned about?
A
WBC count of 4200 cells/mcL
B
Hematocrit of 38%
C
Platelet count of 9000/mm3
D
Creatinine level of 1.0 mg/dL
Explanation: 

Detailed explanation-1: -The percentage of blasts in the bone marrow or blood is particularly important. Having at least 20% blasts in the marrow or blood is generally required for a diagnosis of AML. (In normal bone marrow, the blast count is 5% or less, while the blood usually doesn’t contain any blasts.)

Detailed explanation-2: -Once the biopsy and aspiration are obtained the hematologist, oncologist or pathologist examines the samples under the microscope. AML is diagnosed when the bone marrow contains 20 percent or more immature cells called blasts-a normal bone marrow has less than 5 percent blasts-determined to be myeloid in nature.

Detailed explanation-3: -AML is diagnosed with blood and bone marrow tests. Blood Cell Counts. The doctor orders a test called a CBC (complete blood count) to count the numbers of red cells, white cells and platelets. Usually, patients with AML have lower-than-expected numbers of red blood cells and platelets.

Detailed explanation-4: -To confirm a diagnosis of AML, a small sample of your bone marrow will be taken to examine under a microscope. This procedure is known as a bone marrow biopsy. The doctor or nurse will numb an area of skin at the back of your hip bone, before using a thin needle to remove a sample of liquid bone marrow.

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