paeds664
A 14 year-old girl is found to have haemophilia B. What pathological problem does she have?
Archives: MRCPCH FOP/TAS
paeds665
A 6 month old infant has developed jaundice from breast milk. He is otherwise healthy with no signs of dehydration. His LFTs will most likely show which of the following pattern?
paeds666
A child with jaundice and pale stools would most likely be evaluated by which of the following tests?
paeds667
A 16-year-old female presents to the emergency department with recurrent epistaxis and a history of menorrhagia. The physician suspects Von Willebrand disease and requests for blood tests. Lab investigations reveal a prolonged bleeding time and thrombocytopenia. What is the most likely diagnosis?
paeds668
A 15-year-old boy is diagnosed with aplastic anaemia after presenting with fatigue, dyspnoea and headaches. He lives on a farm and would usually play hide and seek with his siblings in the barn where the family store pesticides and other chemicals. Lab investigations reveal a significant leukopenia. Aplastic anaemia results due to failure of hematopoietic stem cells that give rise to progenitors of immune cells. In which area of the body are these cells primarily located?
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A 16-year-old boy presents to the physician with a history of easy bruising and epistaxis since childhood. He recently had a dental extraction after which the bleeding lasted for 30 hours. His labs are sent and the reports are as follows: APTT: 36 secondsPT: 15 secondsFibrinogen: 2.5 g/lFactor VIIIC: 0.4 iu/ml (normal range 0.5-1.5)vWF antigen: 0.35 iu/ml (normal range 0.45-1.4)vWF ristocetin co-factor: 0.05 iu/ml (normal 0.45-1.35)PLT: 230 x 109/lBleeding time: 12 mins (normally up to 8 mins). Which of the following is the most likely diagnosis?
paeds670
An 11-year-old boy presents with complaints of deep pain in his right leg for the past four weeks. His mother describes him as ‘being off-colour’ of late. The physical examination of the child revealed no findings. Blood investigations reveal: Hb: 11.5 g/dL (13-18) WBC Count: 2.0 x 109/L (4-11) Differential Count: Neutrophils: 0.5 x 109/L (1.5-7.0) Lymphocytes: 1.4 x 109/L (1.5-4.0) Platelet count: 160 x 109/L (150-400) Erythrocyte Sedimentation Rate: 50 mm in the 1st hourUrea and electrolytes were found to be within the normal range. An MRI showed diffuse uptake in both femurs, which are highly suggestive of tumour infiltration. What is the most probable diagnosis for this patient?
paeds671
A 15-year-old boy is brought to the clinic with fever, cough, sore throat and bleeding gums. He has also noticed a rash on his legs. The coryzal symptoms started 3 weeks ago before which he was fit and well. He is currently not taking any medication and denies smoking, alcohol and using other illicit drugs. Examination reveals a pale child with bilateral subconjunctival haemorrhages, erythematous throat and some petechiae on his legs. there are no sign of lymphadenopathy or hepatosplenomegaly. investigations are as follows: Hb8.9 g/dlMCV: 110 flWBC: 2 x 109/lNeutrophils: 0.3 x 109/lLymphocytes:1.5 x 109/lPLT: 13 x 109/lReticulocytes: 30 x 109/l (normal range 20-100 x 109/l)Coagulation screen: normal. Bone marrow: hypoplastic. A urine dipstick reveals trace of blood in the urine. What is the patient most likely suffering from?
paeds672
A 6 year old child underwent an emergency splenectomy following trauma. After full recovery he is dismissed from the hospital and returns home. On re-examination, eight weeks later, the GP performs a full blood count with a film. What would you expect to see?
paeds673
A 6 year old Somalian boy is admitted to the emergency department with dyspnoea. He looks distressed and has a heart rate of 180 bpm and a blood pressure of 130/90 mmHg. His respiratory rate is 37/min and his O2 saturation is 83% in room air. His temperature is 38C. His mother cannot speak English and neither does the child. The doctors observe that the boy has marked recession and a tracheal tug. He is crying and holding his chest. You immediately put the child on high flow oxygen, perform a chest X-ray and blood tests. The x-ray reveals bilateral pulmonary infiltrates. The blood results show:Hb:6g/dl, MCV:85fl, MCHC:36.0g/dl, WBC:19.6×109/l, neutrophils:15.3×109/l, PLT:350×109/l, CRP:50. His mother shows you that the child has been taking folic acid, hydroxyurea and Penicillin V daily, by pulling some tablets from her bag. What is the most probable diagnosis?