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Question 1
Incorrect
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A child with jaundice and pale stools would most likely be evaluated by which of the following tests?
Your Answer: LFT
Correct Answer: US
Explanation:Blood tests do not help in the diagnosis of jaundice except of course by telling the level of jaundice (bilirubin) and providing some corroborative evidence such as autoantibodies, tumour markers or viral titres in the case of hepatitis. Classifying causes of jaundice on the basis of ultrasound provides a quick and easy schema for diagnosing jaundice which is applicable in primary care as well as hospital based practice.
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This question is part of the following fields:
- Haematology And Oncology
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Question 2
Correct
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A 14 year-old girl is found to have haemophilia B. What pathological problem does she have?
Your Answer: Deficiency of factor IX
Explanation:Haemophilia B (also known as Christmas disease) is due to a deficiency in factor IX. Haemophilia A is due to a deficiency in factor VIII.
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This question is part of the following fields:
- Haematology And Oncology
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Question 3
Correct
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A 15-year-old male presents complaining of gradually increasing fatigue. He says that he turned vegan a year ago. He explains that he takes vitamin B12 supplements every day. Considering iron deficiency anaemia as a possible cause, you order some blood tests to confirm. Which of the following would increase the ability of the body to absorb dietary iron?
Your Answer: Consuming iron in its ferrous (Fe2+) form
Explanation:Consuming iron in its Fe2+ (ferrous form) form can improve the ability to absorb dietary iron in patients with iron deficiency anaemia (IDA). Clinical features of IDA include:- Koilonychia- Atrophic glossitis- Post-cricoid webs- Angular stomatitisThe peripheral blood smear shows the following abnormal RBC morphologies:- Target cells- Pencil poikilocytes- Microcytic-hypochromic cells
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This question is part of the following fields:
- Haematology And Oncology
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Question 4
Incorrect
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A 6 year old boy presented in the emergency department with a cough and knee swelling after falling on the road. He had a non-blanching rash on his buttocks and investigations revealed: PT=13, APTT=71, Hgb=11, WBC=8, Plt=200. Which is the most likely diagnosis?
Your Answer: HSP
Correct Answer: Haemophilia
Explanation:From the options mentioned here, the closest diagnosis is haemophilia. This is a mixed picture, as a purpuric rash on the buttocks does not correlate with this diagnosis. However, the most appropriate diagnosis is haemophilia.
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This question is part of the following fields:
- Haematology And Oncology
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Question 5
Correct
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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:19.6x109/l, neutrophils:15.3x109/l, PLT:350x109/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?
Your Answer: Sickle cell chest crisis
Explanation:The child is suffering from acute sickle cell crisis, a complication of sickle cell disease. It is characterised by a new segmental pulmonary infiltrate consistent with consolidation together with one or more new respiratory symptoms.The mainstay of treatment is oxygen support, (ventilation if required), hydration, antibiotics and analgesia.
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This question is part of the following fields:
- Haematology And Oncology
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Question 6
Incorrect
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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?
Your Answer:
Correct Answer: Total bilirubin: 40, conjugated bilirubin < 5%
Explanation:Breast milk jaundice is a type of jaundice associated with breast-feeding. It typically occurs one week after birth. The condition can sometimes last up to 12 weeks, but it rarely causes complications in healthy, breast-fed infants. The exact cause of breast milk jaundice isn’t known. However, it may be linked to a substance in the breast milk that prevents certain proteins in the infant’s liver from breaking down bilirubin. The condition may also run in families. Breast milk jaundice is rare, affecting less than 3 percent of infants. When it does occur, it usually doesn’t cause any problems and eventually goes away on its own. It’s safe to continue breast-feeding.
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This question is part of the following fields:
- Haematology And Oncology
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Question 7
Incorrect
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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?
Your Answer:
Correct Answer: von Willebrand disease type II
Explanation:Von Willebrand disease (VWD), a congenital bleeding disorder caused by deficient or defective plasma von Willebrand factor (VWF), may only become apparent on haemostatic challenge, and bleeding history may become more apparent with increasing age. Type 1 VWD (,30% of VWD) typically manifests as mild mucocutaneous bleeding. Type 2 VWD accounts for approximately 60% of VWD. Type 2 subtypes include: Type 2A, which usually manifests as mild-to-moderate mucocutaneous bleeding; Type 2B, which typically manifests as mild-to-moderate mucocutaneous bleeding that can include thrombocytopenia that worsens in certain circumstances; Type 2M, which typically manifests as mild-moderate mucocutaneous bleeding; Type 2N, which can manifest as excessive bleeding with surgery and mimics mild haemophilia A. Type 3 VWD (<10% of VWD) manifests with severe mucocutaneous and musculoskeletal bleeding.
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This question is part of the following fields:
- Haematology And Oncology
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Question 8
Incorrect
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What is most likely to occur in lead poisoning?
Your Answer:
Correct Answer: Delayed developmental milestones
Explanation:Lead can be found in material used for mining, leaded paints and gasoline, glassware, toys, and even cosmetics. Lead poisoning is rare nowadays as the use of lead has been banned from many products. Lead is toxic and in certain concentrations can cause irreversible damage. Children are especially vulnerable as they absorb 4 times as much ingested lead as adults. The typical features of lead poisoning include developmental delay and behavioural disorders, microcytic anaemia, constipation and vomiting. Pulmonary fibrosis, Osteomalacia and cardiomyopathy are not known features of lead poisoning.
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This question is part of the following fields:
- Haematology And Oncology
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Question 9
Incorrect
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A 12-year-old boy presents with severe abdominal pain, bloody faeces, haematuria and painful, swollen joints. Physical examination revealed petechiae on his legs. Blood investigations were found to be normal.What is the most probable diagnosis?
Your Answer:
Correct Answer: Henoch-Schonlein purpura
Explanation:The presentation of the child is highly suggestive of Henoch-Schonlein purpura (HSP). It is an IgA-mediated, autoimmune hypersensitivity vasculitis that targets the small vessels of the skin, GI tract, kidneys, and joints.It is most commonly seen in children aged 3 – 6 years old and is twice as common in boys than girls. Preceding viral URTI with low-grade pyrexia is common. The most common organism associated with HSP is, however, Group A streptococcal infection.A purpuric rash is seen on the back of the legs and buttocks and can less frequently affect the arms. Arthralgia is common (usually knees/ankles) in these patients.Abdominal pain and bloody diarrhoea may occur. And half of the children with HSP have renal involvement. Rarely, it can lead to end-stage renal failure.Treatment includes adequate hydration, occasionally steroids, and other immunosuppressants. The disease can recur in 1 in 3 children.
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This question is part of the following fields:
- Haematology And Oncology
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Question 10
Incorrect
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A 15 month old girl from Greece presents with pallor. Her mother complains that she always seems tired. However, she has no problems with eating and has a fairly balanced diet. She was born in a rural part of the Greece and just recently moved to the UK with her parents. She hasn't had any previous blood tests or investigations done since her birth. She has been on the second centile since her first check up in the UK, but has not lost any weight. The following are the results of her investigations. Hb 5.5g/dlMCV 62 flWBC 4.3 x 109/lPLT 430 x 109/lReticulocyte count 490 x 109/l (normal range 20-100 x 109/lFerritin 260 ng/ml (normal range: 20-300 ng/ml)Blood film: hypochromic microcytic red cells, polychromasia, fragmented red cells, nucleated red cellsWhat is the most likely diagnosis?
Your Answer:
Correct Answer: Thalassaemia
Explanation:The differentials of the child’s condition are likely to include an Iron deficiency anaemia, or a hemoglobinopathy such as sickle cell disease or thalassemia based on the presentation of pallor, growth failure and easy fatiguability. While the full blood count and film present a hypochromic microcytic anaemia with reticulocytosis, the normal serum ferritin levels rule out iron deficiency anaemia. Thalassemia is to be suspected over sickle cell disease as the patient comes from the Mediterranean region known for a high incidence of thalassemia. Sickle cell anaemia also tends to present with normocytic normochromic red blood cells, with many sickled cells. Vitamin B12 deficiency and Aplastic anaemia are ruled out as they present with a macrocytic anaemia, and a decrease in white blood cells, platelets and red blood cells respectively.
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This question is part of the following fields:
- Haematology And Oncology
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Question 11
Incorrect
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A 14 year old girl suffers from haemophilia A and chronic knee pain with progressive swelling and deformity over the last 4 years. Test results reveal a significantly reduced factor VIII activity. Which of the following is seen in the knee joint space after an acute painful episode?
Your Answer:
Correct Answer: Cholesterol crystals
Explanation:Due to breakdown of the red blood cell membrane in haemophilic patients, cholesterol crystals are formed by the lipids. On the other hand lipofuscin deposition does not occur in haemolysis or haemorrhage. Neutrophil accumulation suggests acute inflammation. Anthracotic pigment is an exogenous carbon pigment that deposits in the lung from dust. Russell bodies are intracellular accumulations of immunoglobins in plasma cells. Curschmann’s spirals and Charcot Leyden crystals are pathognomonic of asthma.
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This question is part of the following fields:
- Haematology And Oncology
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Question 12
Incorrect
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A 6-year-old male was brought to the OPD with complaints of weight loss and fatigue for the last few months. On examination he was pale and had hepatosplenomegaly. A full blood count was ordered and it revealed immature white blood cells. Which of the following is the most likely diagnosis?
Your Answer:
Correct Answer: Leukaemia
Explanation:The age of the patient and the presence of immature white blood cells are suggestive of leukaemia. Hodgkin’s disease is unlikely in this age group and it usually presents with lymphadenopathy. In HIV, immature white blood cells are not present in the blood.
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This question is part of the following fields:
- Haematology And Oncology
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Question 13
Incorrect
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A 12-year-old boy is brought to the hospital following a road traffic accident. A diagnosis of splenic laceration was made, and a splenectomy was performed. Which among the following blood film findings is not a feature associated with hyposplenism?
Your Answer:
Correct Answer: Thrombocytopenia
Explanation:Hyposplenism is associated with thrombocytosis. Other features of hyposplenism are: – Howell-Jolly bodies and acanthocytosis, occurring secondary to haemolysis.- Pappenheimer bodies: These are granular deposits of iron found within the RBCs.- Lymphocytosis and monocytosis.Causes for hyposplenism include:- Congenital asplenia- Iatrogenic splenectomy: Following trauma or treatment for ITP, thalassemia or spherocytosis).- Autosplenectomy: Secondary to sickle cell anaemia, coeliac disease, dermatitis herpetiformis, essential thrombocythemia or splenic arterial thrombosis).
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This question is part of the following fields:
- Haematology And Oncology
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Question 14
Incorrect
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A 14 year old girl suffers from haemophilia A and chronic knee pain with progressive swelling and deformity over the last 4 years. Test results reveal a significantly reduced factor VIII activity. Which of the following is seen in the knee joint space after an acute painful episode?
Your Answer:
Correct Answer: Cholesterol crystals
Explanation:Due to breakdown of the red blood cell membrane in haemophilic patients, cholesterol crystals are formed by the lipids. On the other hand lipofuscin deposition does not occur in haemolysis or haemorrhage. Neutrophil accumulation suggests acute inflammation. Anthracotic pigment is an exogenous carbon pigment that deposits in the lung from dust. Russell bodies are intracellular accumulations of immunoglobins in plasma cells. Curschmann’s spirals and Charcot Leyden crystals are pathognomonic of asthma.
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This question is part of the following fields:
- Haematology And Oncology
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Question 15
Incorrect
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A 4 year old boy presented with bruises on bilateral buttocks and thighs. His mother denied any history of trauma. The boy had a sore throat few weeks ago. What is the most appropriate management of this patient?
Your Answer:
Correct Answer: Coagulation profile
Explanation:This history is suggestive of Henoch-Schonlein Purpura following a respiratory infection. A typical rash involving thighs and buttocks is often seen in this age group. Coagulation profile is the suitable answer from the given answers.
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This question is part of the following fields:
- Haematology And Oncology
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Question 16
Incorrect
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Which of the following changes can be seen on a blood film post-splenectomy?
Your Answer:
Correct Answer: Target cells
Explanation:The diagnosis of a post-splenectomy/hyposplenism blood picture can be made reliably by identifying Howell Jolly bodies in routine Wright-Giemsa stained blood and target cells. These are round basophilic bodies in red blood cells that represent residual nuclear material from marrow nucleated red cell precursors that are usually culled out by the spleen.These do not occur in individuals with normally functioning splenic tissue and their presence indicates either 1) an asplenic state or 2) hypofunctioning splenic tissue as might be seen in a patient with late-stage sickle cell anaemia. Their presence in an individual with splenomegaly leads to a narrow differential diagnosis and their absence in a splenectomised individual indicates accessory splenic Heinz bodies and poikilocytosis typically increase in a splenectomised individual and care must be taken not to overdiagnose haemolysis in such an individual.
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This question is part of the following fields:
- Haematology And Oncology
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Question 17
Incorrect
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A patient has been diagnosed with severe haemophilia B (factor IX level <1%).What is the mode of inheritance?
Your Answer:
Correct Answer: X-linked recessive
Explanation:Haemophilia A and haemophilia B are inherited in an X-linked recessive pattern. The genes associated with these conditions are located on the X chromosome, which is one of the two sex chromosomes. In males (who have only one X chromosome), one altered copy of the gene in each cell is sufficient to cause the condition.
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This question is part of the following fields:
- Haematology And Oncology
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Question 18
Incorrect
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Which of the following is NOT a recognized form of bone marrow failure syndrome?
Your Answer:
Correct Answer: Kostmann syndrome
Explanation:Bone marrow failure syndromes are characterized by the bone marrow’s inability to produce cells of different lineage. They can be classified as those affecting one or two cell lineages or those affecting all three of them. Fanconi syndrome, along with dyskeratosis congenita, is one of the inherited bone marrow failure syndromes that causes pancytopenia. Other inherited disorders affecting hematopoietic lineage include Diamond-Blackfan anaemia, Schwachman-Diamond syndrome, congenital amegakaryocytic thrombocytopenia (CAMT) and Thrombocytopenia absent radii (TAR) syndrome. Acquired causes of bone marrow failure that lead to pancytopenia include aplastic anaemia, drugs, nutritional deficiencies, and viral infections. Kostmann syndrome is an autosomal recessive form of severe neutropenia, most likely due to excessive neutrophil apoptosis.
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This question is part of the following fields:
- Haematology And Oncology
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Question 19
Incorrect
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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?
Your Answer:
Correct Answer: Bone marrow
Explanation:Hematopoietic stem cells (HSCs) are a rare population of cells residing in the bone marrow (BM) and continuously replenish all mature blood cells throughout their life span.
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This question is part of the following fields:
- Haematology And Oncology
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Question 20
Incorrect
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A 11-year-old boy is referred to you following his seventh course of antibiotics in the last six years for lower respiratory tract infections. He also has a history of eczema for which he is currently on a topical steroid cream. His full blood count (FBC) report shows:Hb: 13.9 g/dLPlts: 65 x 10^9/LWCC: 12.3 x 10^9/L.Which of the following genes should you expect an abnormality in?
Your Answer:
Correct Answer: WASP
Explanation:The combination of frequent infections, eczema, and thrombocytopaenia are characteristic of Wiskott-Aldrich syndrome, which is due to an abnormality in the WASP gene. It is an X-linked recessive disorder that causes primary immunodeficiency owing to a combined B- and T-cell dysfunction.The other listed options are:1. PKD1: polycystic kidney disease2. CFTR: cystic fibrosis3. HFE1: haemochromatosis4. RET: multiple endocrine neoplasia, Hirschsprung’s disease
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This question is part of the following fields:
- Haematology And Oncology
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Question 21
Incorrect
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A 3-year-old girl presents with pallor and marked gland enlargement. She has been unwell for the past three weeks. She had a full term normal delivery with no neonatal problems. Her immunisations are up to date. There is no family or social history of note. On examination, her temperature is 37.6°C, and she looks pale and unwell. She has a few petechiae on the neck and palate, with moderate generalised lymphadenopathy and a 3 cm spleen. Which is the most likely diagnosis?
Your Answer:
Correct Answer: Acute leukaemia
Explanation:Non-Hodgkin Lymphoma: The history is of enlarged reticuloendothelial system with abnormalities in all 3 cell lines of the bone marrow (pallor, fever and petechiae). The most likely diagnosis is therefore acute (lymphoblastic) leukaemia. Lymphadenopathy may be prominent: mediastinal nodes are characteristic of T-cell leukaemia. In lymphoma the marrow involvement tends to be much less.
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This question is part of the following fields:
- Haematology And Oncology
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Question 22
Incorrect
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A 5-year-old child was found to have orchidomegaly and splenomegaly. Blood tests show a WBC = 1.7 X 104/L, Hb = 7.1 g/dl and platelets = 44 X 104g/dl. His parents mention that he suffers from fatigue while at presentation he looks pale and has a fever. What is the most likely diagnosis?
Your Answer:
Correct Answer: Acute lymphoblastic leukaemia
Explanation:Acute lymphoblastic leukaemia (ALL) is an aggressive type of blood and bone marrow cancer which can appear in childhood. Signs of childhood ALL include: Fever, Easy bruising, Petechiae, Bone or joint pain, Painless lumps in multiple areas of the body, Weakness, fatigue or paleness, and Loss of appetite. Blood tests may show elevated white blood cells, decreased values of red blood cells and low platelet count.
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This question is part of the following fields:
- Haematology And Oncology
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Question 23
Incorrect
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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?
Your Answer:
Correct Answer: Bernard - Soulier syndrome
Explanation:Bernard- Soulier Syndrome results from a deficiency of platelet glycoprotein protein Ib, which mediates the initial interaction of platelets with the subendothelial components via the von Willebrand protein. It is a rare but severe bleeding disorder. Platelets do not aggregate to ristocetin. The platelet count is low, but, characteristically, the platelets are large, often the size of red blood cells, and may be missed on complete blood counts because most automatic counters do not count them as platelets.
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This question is part of the following fields:
- Haematology And Oncology
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Question 24
Incorrect
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A 5-year-old girl was admitted for fever, anaemia, thrombocytopenia and signs of pulmonary infection. She now presents a few days later with signs of meningism. What is the most probable diagnosis?
Your Answer:
Correct Answer: Acute lymphoblastic leukaemia (ALL)
Explanation:Acute lymphoblastic leukaemia (ALL) is a cancer of the lymphoid line of blood cells characterized by the development of large numbers of immature lymphocytes. Symptoms may include feeling tired, frequent infections with fever as well as anaemia with thrombocytopenia. As an acute leukaemia, ALL progresses rapidly and is typically fatal within weeks or months if left untreated. The patient’s age also favours the diagnosis of ALL as it occurs most commonly in children, particularly those between the ages of two and five.
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This question is part of the following fields:
- Haematology And Oncology
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Question 25
Incorrect
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A 17-year-old male undergoes an emergency appendectomy for perforated appendix. Postoperatively, he develops disseminated intravascular coagulation. Which one of the following clotting factors are most rapidly consumed in this process?
Your Answer:
Correct Answer: Factor V and VIII
Explanation:Factors V and VIII are consumed most rapidly in a patient with disseminated intravascular coagulation.Simultaneous coagulation and haemorrhage caused by initially formation of thrombi which consume clotting factors (factors 5,8) and platelets, ultimately leading to bleeding.Causes include:- Infection- Malignancy- Trauma e.g. major surgery, burns, shock, dissecting aortic aneurysm- Liver disease- Obstetric complicationsClinically bleeding is usually a dominant feature, bruising, ischaemia and organ failure.Blood tests reveal prolonged clotting times, thrombocytopenia, decreased fibrinogen and increased fibrinogen degradation products.Treatment of DIC involves treating the underlying cause and supportive management.Mnemonic:D-I-S-S-E-M-I-N-A-T-E-DD- D dimerI-Immune complexesS-Snakebite, shock, heatstrokeS-SLEE-Eclampsia, HELLP syndromeM-Massive tissue damageI-Infections: viral and bacterialN-NeoplasmsA-Acute promyelocytic leukaemiaT-Tumour products: Tissue Factor (TF) and TF-like factors released by carcinomas of pancreas, prostate, lung,colon, stomachE-Endotoxins (bacterial)D-Dead foetus (retained)
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This question is part of the following fields:
- Haematology And Oncology
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Question 26
Incorrect
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A male had a deep vein thrombosis (DVT) in his left calf. After investigation, it was discovered that this was caused by a genetic disease and his children may be affected.What is the most common heritable cause of DVT?
Your Answer:
Correct Answer: Factor V Leiden
Explanation:Based on the studies, genetic factors are responsible for approximately 60 % DVT cases. Factor V (FV) Leiden which is the most common cause of inherited thrombophilia, predisposes patients to DVT because of resistance to protein C.The heritable causes of deep vein thrombosis, from most to least common are:Factor V LeidenProthrombin G20210A variantProtein C deficiencyProtein S deficiencyAntithrombin deficiencyVon Willebrand disease and thalassaemia are not causes of DVT.
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This question is part of the following fields:
- Haematology And Oncology
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Question 27
Incorrect
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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?
Your Answer:
Correct Answer: Howell-Jolly bodies
Explanation:Howell-Jolly bodies are often seen in post-splenectomy cases, together with Pappenheimer bodies, target cells and irregular contracted red blood cells. The loss of splenic tissue results in the inability to readily remove immature or abnormal red blood cells from the circulation.
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This question is part of the following fields:
- Haematology And Oncology
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Question 28
Incorrect
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Which of the given statements is correct regarding carbon monoxide?
Your Answer:
Correct Answer: CO combines with haemoglobin to form carboxyhaemoglobin
Explanation:Carbon monoxide is a colourless gas, which is toxic to animals. It has a high affinity for haemoglobin (around 250 times greater than oxygen). It combines with haemoglobin forming carboxyhaemoglobin, which decreases the oxygen-carrying capacity of the blood, leading to a left-shift in the oxygen-dissociation curve. CO is produced endogenously in limited amounts (0.4ml per hour), but the toxic levels are higher.
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This question is part of the following fields:
- Haematology And Oncology
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Question 29
Incorrect
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What class of antibodies do the anti-B antibodies in a patient with blood group A belong to?
Your Answer:
Correct Answer: IgM
Explanation:The anti-B antibodies in a patient with blood group A belong to the IgM class of immunoglobulins.Note:IgM is the largest antibody formed of 5 antibodies attached together. This functions to agglutinate or clump antigens. The associated anti-A and anti-B antibodies are usually IgM produced in the first years of life by sensitisation to environmental substances such as food, bacteria, and viruses.Other options:- IgG is the most common antibody. It is a single antibody complex.- IgD is found on the surface of B-lymphocytes.- IgE is bound to tissue cells, especially mast cells and eosinophils.
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This question is part of the following fields:
- Haematology And Oncology
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Question 30
Incorrect
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An 8-year-old boy who recently migrated from Nigeria was seen in A&E department with a six-week history of progressive swelling of his jaw, fever, night sweats, and weight loss. His mother reported an episode of sore throat in the past which was treated with antibiotics, but he developed a rash subsequently. Other than that, there was no other significant past medical history. On examination, a painless, nontender 4x3cm mass was found that was fixed and hard. The only other examination finding of note was rubbery symmetrical cervical lymphadenopathy.Which of the following translocation would most likely be found on biopsy karyotyping?
Your Answer:
Correct Answer: t(8;14)
Explanation:Burkitt lymphoma is associated with the c-myc gene translocation, usually t(8;14). Burkitt lymphoma is a rare high-grade non-Hodgkin lymphoma endemic to west Africa and the mosquito belt. It has a close association with the contraction of Epstein-Barr virus (EBV). Burkitt lymphoma often presents with symmetrical painless lymphadenopathy, systemic B symptoms (fever, sweats, and weight loss), central nervous system involvement, and bone marrow infiltration. Classically in the textbooks, the patient also develops a large jaw tumour.Other aforementioned options are ruled out because:1. t(9;22)-Chronic myeloid leukaemia2. t(15;17)-Acute promyelocytic leukaemia3. t(14;18)-Follicular Lymphoma4. t(11;14)-Mantle Cell Lymphoma
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This question is part of the following fields:
- Haematology And Oncology
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