FCP2 Category: Haematology & Oncology

FCP2-682

A 60-year-old man has consistently elevated levels of white blood cells in the blood, despite several courses of antibiotics.

His full blood count done (FBC) today shows:
Hb: 9.1 g/dL
Plts: 250 x 10^9/L
WCC: 32.2 x 10^9/L
Neutrophils: 28.1 x 10^9/L

However, he has at no point shown signs of any infection. The consultant suggests contacting the haematology department for ascertaining the leukocyte alkaline phosphatase (LAP) score.

Out of the following, which related condition would have a high LAP score?

FCP2-683

A 60-year-old man presents with asymptomatic enlargement of his cervical lymph nodes. Full blood count shows low-grade anaemia, leukocytosis, and thrombocytopenia. Lymph node biopsy is suggestive of a low-grade non-Hodgkin lymphoma.

Which two of the following statements fit best with this condition?

FCP2-684

A 60-year-old man with a history of chronic lymphocytic leukaemia is admitted to the acute medical unit for pneumonia. This is his fourth admission for pneumonia in the past six months.

Which of the following factors is most likely to be responsible?

FCP2-685

A 60-year-old woman presents to the oncology clinic with a general feeling of being unwell and temperature of 38.1°C. She is a known case of neuroendocrine cancer of the cervix, treated with carboplatin and etoposide. Her last treatment was eight days ago.
Blood cultures are taken and she is started on neutropenic sepsis protocol.

What will gram-staining of the blood cultures most likely show?

FCP2-686

A 62-year-old man presents with haematuria. Cystoscopy is carried out which reveals transitional cell carcinoma of the bladder.

Occupational exposure to which of the following is a recognised risk factor for bladder cancer?

FCP2-687

A 63-year-old man, known to have small cell lung cancer and ischaemic heart disease (IHD), presents with increasing shortness of breath for the past 7 days. It becomes worse at night and is associated with an occasional non-productive cough. He has also noticed that his wedding ring feels tight. His cancer was diagnosed five months ago and he has recently completed a course of chemotherapy. From a cardiac point of view, he had a myocardial infarction (MI) two years ago following which he had primary angioplasty with stent placement. He has had no episode of angina since then.

Clinical examination of his chest is unremarkable. He does, however, have distended neck veins and periorbital oedema.

What is the most likely diagnosis?

FCP2-688

A 64-year-old woman with metastatic breast cancer has developed progressive back pain over the last 2 days. She also reports of weakness of her lower limbs and difficulty in walking. On examination, she has reduced power in both legs and increased tone associated with brisk knee and ankle reflexes. There is some sensory loss in the lower limbs and feet but perianal sensation is normal.

What is the most likely diagnosis?

FCP2-689

A 65-year-old male patient is found to have an elevated serum paraprotein level of 35 g/L. Bone marrow aspirate reveals 32% monoclonal plasma cell infiltrate. He has no evidence of anaemia, renal impairment, hypercalcaemia, or lytic lesions.

What should be the next step in management?

FCP2-690

A 65-year-old man having small cell lung cancer is admitted onto the ward for chemotherapy. He has a history of severe nausea and vomiting secondary to chemotherapy, in the past.

The consultant asks you to prescribe a neurokinin 1 (NK1) receptor blocker. Which agent, out of the following, will you choose?

FCP2-691

A 65-year-old man is referred to the oncology clinic with progressively worsening lower back pain for the last three months and history of weight loss for the past eight months. MRI lumbar spine confirms the suspicion of bone metastasis.

What is the most likely primary tumour?