Professional and Linguistic Assessments Board (PLAB) Practice Exam

What might you observe in a patient suffering from CML?

1. Big ass spleen

2. Swollen lymph nodes

3. Small red spots on skin

4. Neurological deficits

The correct answer is: Big ass spleen

In a patient suffering from Chronic Myeloid Leukemia (CML), one of the hallmark findings is splenomegaly, which refers to an enlarged spleen. This occurs due to the accumulation of leukemic cells in the spleen, causing it to become enlarged and sometimes palpable. Patients may experience discomfort or a feeling of fullness in the abdomen due to this enlargement. CML is characterized by a proliferation of myeloid cells, most notably the presence of the Philadelphia chromosome, which results from a translocation between chromosomes 9 and 22. This genetic alteration leads to the uncontrolled growth of immature blood cells. As the spleen becomes progressively larger, it can lead to various clinical symptoms, including abdominal pain, early satiety, and even complications such as splenic rupture in severe cases. Other symptoms associated with CML might include fatigue, weight loss, and increased susceptibility to infections; however, the significant enlargement of the spleen specifically stands out as a prominent finding in these patients. While lymphadenopathy, skin manifestations, and neurological symptoms can occur in various hematological conditions, they are not the primary observations associated with CML compared to splenomegaly. Hence, the presence of a notably large spleen is a