White Blood Cell Abnormalities (Management) — 46yo Man | Hematology | MCCQE1 Q#13266

MCCQE1 Question #13266

Dimension of Care

Chronic Care

Activity

Management

Objective

White Blood Cell Abnormalities

Section

Medicine / Family Medicine

Subject

Hematology

Last updated: February 2026
A 46-year-old man is referred after workplace bloodwork repeatedly shows leukocytosis. He reports several months of mild fatigue and intermittent night sweats. He has no recent infections and takes no medications, including corticosteroids. Examination shows pallor and a palpable spleen tip 3 cm below the left costal margin without lymphadenopathy. Laboratory studies reveal marked leukocytosis with myelocytes, metamyelocytes, and basophilia, normocytic anaemia, thrombocytosis, and elevated LDH. What is the most appropriate next step to confirm the diagnosis and guide initial management?
Full answer analysis and choices are available inside the practice session.