Hematology-Oncology Q50

An 81-year-old woman is evaluated for a 1-year history of headaches, redness of the face, and itching. She indicates being otherwise capable of performing her daily activities on her farm. She reports no shortness of breath, chest pain, or difficulty sleeping. Medical history is significant for hypertension; she has never smoked and does not drink alcohol. Her only medication is hydrochlorothiazide.

On physical examination, vital signs are normal except for a blood pressure of 160/90 mm Hg; BMI is 19. Abdominal examination shows splenomegaly.

Which of the following is the most appropriate diagnostic test to perform next?

 

 

Laboratory studies:

Erythropoietin 

Undetectable

Hemoglobin 

17.5 g/dL (175 g/L)

Leukocyte count 

11,000/µL (11 × 109/L)

Platelet count 

400,000/µL (400 × 109/L)

 

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