Question 1

A patient diagnosed with myelodysplastic syndrome (MDS) and presenting with severe neutropenia and anemia is given erythropoietin (EPO) with improvement in hemoglobin. Which intervention has been shown to prevent infection in patients with MDS who have severe neutropenia?

A) Anti-thymocyte globulin and cyclosporine
B) Granulocyte-macrophage colony-stimulating factor (GM-CSF)
C) Intravenous immunoglobulin infusions
D) Prophylactic treatment with fluoroquinolones

D

Accepted Answer

Prophylactic treatment with fluoroquinolones has been shown to prevent infection in patients with MDS who have severe neutropenia. While the other options may be used in the treatment of MDS or to prevent infections in different patient populations, they have not been specifically shown to prevent infection in MDS patients with severe neutropenia.

Question 2

A 70-year-old patient reports frequent infections, shortness of breath, fatigue, and palpitations. An exam reveals pallor and petechiae. The provider orders a peripheral blood smear and bone marrow biopsy. Which findings are consistent with a diagnosis of myelodysplasia? (Select all that apply.)

A) Anisocytosis and poikilocytosis of erythrocytes on peripheral smear
B) Defects in cellular maturation in all cell lines in bone marrow aspirate
C) Hypercellular bone marrow with peripheral cytopenia
D) Larger than normal megakaryocytes in bone marrow
E) Smaller than normal granulocytes in the peripheral blood smear

A, B, C, D

Accepted Answer

Myelodysplasia, or myelodysplastic syndromes (MDS), are a group of disorders caused by poorly formed or dysfunctional blood cells. The findings consistent with MDS include anisocytosis and poikilocytosis of erythrocytes on peripheral smear (A), which indicate abnormal shapes and sizes of red blood cells; defects in cellular maturation in all cell lines in bone marrow aspirate (B), reflecting the dysplastic changes affecting erythroid, myeloid, and megakaryocytic lineages; hypercellular bone marrow with peripheral cytopenia (C), indicating an increased number of immature cells in the bone marrow but decreased numbers in the peripheral blood; and larger than normal megakaryocytes in bone marrow (D), which is a characteristic finding in MDS reflecting abnormal megakaryocyte development.

Deck 220: Myelodysplastic Syndromes