<prompt> A 5 year old child presents with history of fever off - and-on for past 2 weeks and petechial spots all over the body and increasing pallor for past 1 month. Examination reveals splenomegaly of 2 cm below costal margin. The most likely diagnosis is -Acute leukemiaIdiopathic thrombocytopenic purpuraHypersplenismAplastic anemia  <response>: Acute myeloid leukemia is a heterogeneous disease characterised by infiltration of malignant myeloid cells into the blood,bone marrow other tissues. It is characterised by anemiaproducing pallor,lethargy,dyspnoea, bleeding manifestationspetechiae,bruises,bleeding from gums, pain tenderness of bones, lymphadenopathy, splenomegaly, hepatomegaly, gum hyperophy, chloroma or granulocytic sarcoma, meningeal involvement causing raised intracranial pressure .Reference:Harsh mohan textbook of pathology sixth edition pg no 363. 