USMLE PRACTICE QUESTION OF THE WEEK

Question for March 20, 2026

A 28-year-old woman presents with progressive fatigue, easy bruising, and recurrent nosebleeds for 1 month. She takes no medications. Exam shows pallor, scattered ecchymoses, and petechiae.

CBC shows:

Hemoglobin: 8.5 g/dL
WBC: 2,200/µL
Platelets: 28,000/µL
Platelets: 28,000/µL
Bone marrow biopsy reveals >30% blasts.

Which of the following is the most appropriate diagnosis?

A. Acute lymphoblastic leukemia

B. Acute myeloid leukemia

C. Aplastic anemia

D. Chronic lymphocytic leukemia

E. Myelodysplastic syndrome

Get Detailed Explanation

Correct Answer:

B. Acute myeloid leukemias

Correct Answer Explanation:

Pancytopenia with >20% blasts in an adult strongly suggests acute myeloid leukemia. Auer rods may be seen. ALL is more common in children. Aplastic anemia shows hypocellular marrow without blasts. CLL affects older adults with lymphocytosis, not pancytopenia.

Further Insight:

AML subtypes include acute promyelocytic leukemia (risk of DIC).
Treatment involves induction chemotherapy and, in some cases, stem cell transplantation.