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👉 To prevent a symptomatic IgM flare, rituximab should be withheld (or preceded by prophylactic plasmapheresis) in a Waldenström patient if the baseline serum IgM exceeds what threshold?

A. 4,000 mg/dL (40 g/L)
B. 2,000 mg/dL (20 g/L)
C. 1,000 mg/dL (10 g/L)
D. 6,000 mg/dL (60 g/L)

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👉 Q1: Identify this clinical sign and describe the physiological mechanism behind the movement.

Q2: List three distinct organ system failures that can lead to this presentation in a metabolic encephalopathy context.

Q3: What is the most appropriate management strategy for a patient presenting with this sign?

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👉 A splenomegalic patient has circulating hairy-appearing lymphocytes expressing CD11c and CD103, but lacking CD25 and CD123. Which mutation is most likely present?

A. BRAF V600E
B. MAP2K1
C. MYD88 L265P
D. JAK2 V617F

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👉 A CLL patient transforms to DLBCL (Richter’s). IGHV sequencing confirms the DLBCL is clonally unrelated to the original CLL. What is the clinical significance of this finding?

A. Prognosis is similar to de novo DLBCL
B. Median survival is under 6 months
C. Confirms an EBV-driven transformation
D. Dictates immediate autologous SCT

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