A 53yo man presents complaining of weight loss, lethargy, increasing abdominal discomfort and
gout for the pat yr. Exam: spleen palpated 5cm below left costal margin, no fluid wave. CBC:
Hgb=10.5g/dL, WBC=200 – 85% neutrophils, plts=100, Na+=140mmol/L, K+ 4mmol/L,
create=151umol/L, urea=7mmol/L. Serum B12 increased. Philadelphia chromosome +ve. What
is the most likely dx?
a. CML
b. CLL
c. AML
d. ALL
e. Lymphoma
answer: A
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