skip to main content

Hyperviscosity Syndrome — SCE Medical Oncology MCQ

Instant feedback + full explanation. One question, done properly.

HardOncological EmergenciesHyperviscosity SyndromeSCE Medical Oncology

A patient with Waldenstrom macroglobulinaemia has IgM 68 g/L, headache, blurred vision and retinal venous engorgement. Rituximab-containing systemic therapy is planned. What is the best immediate sequence?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Perform urgent plasma exchange first, then commence cytoreductive therapy with care over rituximab-associated IgM flare

Option A is correct: symptomatic hyperviscosity requires urgent plasma exchange as a temporary measure before disease-directed therapy, and rituximab can transiently raise IgM. Option B risks worsening hyperviscosity through flare. Option E does not treat the emergency. Option C uses the wrong exchange product, and option D risks neurological or visual injury.

Reference: ESMO Clinical Practice Guideline: Waldenstrom macroglobulinaemia. https://www.sciencedirect.com/science/article/pii/S0923753419315583