Chronic leukemia Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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A 60-year-old man comes to the office because of progressive weakness and a dragging sensation in the abdomen for the past 3 months. The patient is a retired farmer. Past medical history is noncontributory. He does not smoke or use illicit drugs. Temperature is 37.0°C (98.6°F), pulse is 96/min, respirations are 20/min, and blood pressure is 125/80 mmHg. Physical examination shows mucosal pallor, petechiae on the lower extremities, and splenomegaly crossing the midline. Laboratory results are as follows:  
A table shows complete blood count results. Hemoglobin: 9.3 g/dL (ref 13.5-17.5). Platelets: 70,000/mm³ (ref 150,000-400,000). Leukocytes: 6,000/mm³ (ref 4,500-11,000).

Peripheral blood smear reveals lymphocytes with cytoplasmic projections, as below:  
A microscopic image shows many circular red blood cells w/ fewer, larger, dark purple blood cells, some appearing clustered.
 Reproduced from: Wikimedia Commons  
Which of the following genes is most likely to be mutated in this patient?  

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