Which of the following is wrong concerning Philadelphia chromosome:

Correct Answer: D

Rationale: The correct answer is D because the Philadelphia chromosome is found in myeloid (not lymphoid) cells in Chronic Myeloid Leukemia (CML). This is due to a reciprocal translocation between chromosomes 9 and 22, resulting in a shortened chromosome 22q, not chromosome 22 itself. Choice A is incorrect because the long arm of chromosome 22 is affected. Choice B is incorrect as Philadelphia chromosome-negative cases can have a favorable prognosis. Choice C is incorrect as the presence of the Philadelphia chromosome is diagnostic of CML.

Correct Answer: C

Rationale: Step-by-step rationale: 1. Hypersplenism is characterized by splenomegaly (A), causing sequestration and destruction of blood cells. 2. Pancytopenia (B) results from excessive destruction of blood cells in the enlarged spleen. 3. Hypercellular bone marrow (C) is not directly associated with hypersplenism; it is a compensatory response to increased blood cell destruction. 4. Splenectomy (D) can reverse the effects of hypersplenism by removing the source of blood cell destruction. Therefore, the correct answer is C as hypercellular bone marrow is a secondary response to hypersplenism, not a direct association.

Correct Answer: B

Rationale: The correct answer is B: gum bleeding. In immune thrombocytopenic purpura (ITP), the hallmark feature is low platelet count leading to easy bruising and bleeding, including gum bleeding. Fever (choice A) is not a typical feature of ITP. Moderate splenomegaly (choice C) is less common in ITP. Stema tenderness (choice D) is not a recognized feature of ITP. Therefore, gum bleeding is the outstanding feature of ITP due to the primary underlying mechanism of platelet destruction.

Correct Answer: C

Rationale: The correct answer is C: optic neuritis. Busulfan therapy is known to cause adverse effects such as hyperpigmentation, pulmonary fibrosis, and bone marrow suppression due to its cytotoxic effects. However, optic neuritis is not a reported side effect of busulfan therapy. Optic neuritis is more commonly associated with other medications or conditions affecting the optic nerve. Therefore, the absence of optic neuritis as a known side effect of busulfan therapy makes choice C the correct answer.

Correct Answer: B

Rationale: The best treatment modality for chronic myeloid leukemia (CML) is allogenic bone marrow transplantation (BMT) because it offers the potential for cure by replacing the abnormal cells with healthy donor cells. This is the only option that can provide long-term disease control and potential cure for CML. Hydroxyurea (choice A) is a cytotoxic drug used for symptom control but does not target the underlying cause. Interferon alpha (choice C) can help control the disease but is less effective in achieving long-term remission compared to BMT. Radiotherapy (choice D) is not a standard treatment for CML and is not curative.