Haematology and Oncology

A 29-year-old woman presents with headache, confusion and reduced urine output. She is pale and has scattered petechiae; investigations show haemoglobin 78 g/L…

A 7-year-old boy has complained of pain in both thighs and an intermittent limp for one month. He is pale but afebrile, and there is no joint swelling; both hip…

A 26-year-old woman has painless enlargement of several cervical lymph nodes, night sweats and generalised itch. She has no recent dental infection, cat exposur…

A 46-year-old man develops jaundice, dark urine and exertional dyspnoea over several weeks. He has splenomegaly, a haemoglobin concentration of 78 g/L (130–170)…

A 58-year-old woman presents with tiredness, a sore tongue and difficulty judging the position of her feet in the dark. She has a macrocytic anaemia, a low seru…

A 67-year-old woman with long-standing rheumatoid arthritis reports increasing fatigue and reduced exercise tolerance. Her haemoglobin is 92 g/L (115–155), mean…

A 7-year-old boy receiving chemotherapy for acute lymphoblastic leukaemia develops a temperature of 38.6°C at home. In hospital he is alert, has normal perfusio…

A 41-year-old woman has been stable on clozapine for 18 months but presents with fever, painful swallowing and malaise. Her temperature is 38.5°C and her absolu…

A 24-year-old woman of Greek background is found to have abnormal results on a pre-employment blood count. She feels well, her periods are not heavy, and she re…

A 59-year-old man has an eGFR of 52 mL/min/1.73 m² on repeated testing over 4 months. His urine albumin:creatinine ratio is 12 mg/mmol, and there is no haematur…

A 64-year-old woman has had an estimated glomerular filtration rate of 26 mL/min/1.73 m² on two measurements 4 months apart. Her urine albumin:creatinine ratio…

A 66-year-old man with diffuse large B-cell lymphoma is receiving chemotherapy through a tunnelled central venous catheter. On day 8 he develops fever of 38.6°C…

A 29-year-old woman has painless cervical and mediastinal lymphadenopathy that has progressed over 2 months. She reports drenching night sweats and pruritus but…

A 71-year-old man presents with headache, blurred vision and spontaneous bruising. Blood tests show haemoglobin 86 g/L (reference range 130–170), total protein…

A 58-year-old man receiving induction chemotherapy for acute myeloid leukaemia presents with a temperature of 39.1°C. His absolute neutrophil count is 0.05 × 10…

A 67-year-old woman develops a temperature of 38.3°C and rigors 30 minutes after a red-cell transfusion begins. She is haemodynamically stable and has no dyspno…

A 68-year-old man reports persistent thoracic back pain and fatigue for 3 months. His haemoglobin is 92 g/L (reference range 130–170), creatinine is 180 micromo…

A 59-year-old man has a painless left cervical mass that has enlarged over 6 weeks. He reports drenching night sweats and has no dental infection, pharyngitis o…