Approach to myelodysplastic syndromes Quiz: Ace Your Exams
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A 68-year-old woman presents to the emergency department with two days of dizziness, weakness and fatigue, and shortness of breath. Over the past week, the patient has also noticed easy bruising and bleeding while brushing her teeth. She has not had epistaxis, hematuria, hematochezia, or melena. Her past medical history is significant for lung cancer, which was treated fifteen years ago with chemotherapy and radiation. The patient does not currently take any medications. Temperature is 37.6ºC (99.7ºF), pulse is 108/min, respiratory rate is 18/min, blood pressure is 85/62 mmHg, and SpO2 is 100% on room air. On physical examination, there is conjunctival pallor. There are diffuse scattered petechiae and small ecchymoses on skin examination. Chest radiograph shows no acute abnormalities. Serum complete blood count shows white blood cells 2300/mm3 (50% neutrophils), hemoglobin 6.8 g/dL, and platelets 18,000/mm3. Which of the following is the best next step in management?
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