Approach to myeloproliferative neoplasms Quiz: Ace Your Exams

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A 45-year-old man presents to his primary care physician with a 3-month history of fatigue, 10-lb weight loss, and night sweats. He reports a feeling of fullness in his left abdomen, which he notes has become more prominent. Temperature is 37°C (98.6°F), heart rate is 90/min, respiratory rate is 16/min, blood pressure is 124/77 mm Hg, and oxygen saturation is 98% on room air. The spleen tip is palpable on abdominal examination. Laboratory results are shown below. Which of the following additional tests should be performed next to confirm the diagnosis?  

 Test     Result    
 Leukocytes     39,180 mm3   
 Hemoglobin     13.0 g/dL   
 Hematocrit     40.%   
 Platelets     216,000 /mm³   
 Differential         
 Neutrophils     67%   
 Bands     9%   
 Lymphocytes     7%   
 Monocytes     2%   
 Eosinophils     3%   
 Basophils     4%   
 Metamyelocytes     3%   
 Myelocytes     5%    

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