Dec XAM

Question 1

What are the lab findings most consistent with obstructive jaundice?

Answer 1

Elevated conjugated bilirubin and ALP

Obstructive jaundice causes elevated conjugated bilirubin and alkaline phosphatase due to bile duct obstruction.

Question 2

What is the most likely cause of microcytic hypochromic anemia in a 30-year-old male with low Hb and low MCV?

Answer 2

Iron deficiency

Microcytic hypochromic anemia is most commonly due to iron deficiency.

Question 3

What is the diagnosis for a 70-year-old female with chest pain and elevated troponin levels but normal ECG?

Answer 3

NSTEMI

NSTEMI causes elevated troponins without ST-segment elevation on ECG.

Question 4

What is the most likely cause of prolonged aPTT in a female with recurrent miscarriages?

Answer 4

Antiphospholipid syndrome

Prolonged aPTT can be indicative of antiphospholipid syndrome in the context of recurrent miscarriages.

Question 5

Which biochemical marker is most useful for monitoring treatment response in acute pancreatitis?

Answer 5

Serum lipase

Serum lipase is more specific and remains elevated longer than serum amylase.

Question 6

What is the underlying cause of febrile non-haemolytic transfusion reactions?

Answer 6

Cytokine release from donor leukocytes

Cytokine release causes febrile non-haemolytic reactions during blood transfusions.

Question 7

What explains the AST:ALT ratio of 3:1 in a patient with alcoholic liver disease?

Answer 7

AST is found in mitochondria and increases with alcohol-induced mitochondrial injury

This pattern is indicative of alcoholic liver disease.

Question 8

What best explains anaemia in a patient with chronic kidney disease?

Answer 8

Reduced erythropoietin production by the kidneys

Anaemia in CKD results primarily from reduced erythropoietin production.

Question 9

What is the most likely cause of hemolytic disease of the newborn (HDN)?

Answer 9

Maternal anti-D antibodies attacking fetal Rh-positive RBCs

Maternal anti-D antibodies can lead to hemolytic disease of the newborn.

Question 10

What is the cause of ST-segment elevation and elevated troponin levels in a 55-year-old male with chest pain?

Answer 10

Coronary artery thrombosis causing myocardial injury

ST-segment elevation indicates a myocardial infarction due to coronary artery blockage.

Question 11

Fill in the blank: Elevated _______ is a key marker for monitoring recovery in acute pancreatitis.

Answer 11

serum lipase

Serum lipase is preferred for assessing recovery in acute pancreatitis.

Question 12

What are the clinical features of antiphospholipid syndrome?

Answer 12

• Arterial and venous thrombosis
• Recurrent pregnancy loss

Antiphospholipid syndrome is associated with these clinical features.

Question 13

What management steps should be taken for a patient with febrile non-haemolytic transfusion reactions?

Answer 13

• Stop transfusion
• Use leukocyte-reduced blood products for future transfusions

These steps help manage febrile non-haemolytic reactions.

Question 14

What is the pathophysiology of iron deficiency anemia?

Answer 14

Iron deficiency impairs hemoglobin synthesis, leading to smaller, hypochromic RBCs

The lack of iron affects the production of hemoglobin in red blood cells.

Question 15

What is the treatment for anemia in chronic kidney disease?

Answer 15

• EPO-stimulating agents (e.g., darbepoetin)
• Iron supplementation if ferritin is low

Treatment includes addressing the underlying causes of anemia.

Question 16

What is the diagnostic feature of a myocardial infarction without ECG changes?

Answer 16

Elevated troponin levels

Elevated troponin indicates myocardial injury even if the ECG appears normal.

Question 17

What are the clinical features of hemolytic disease of the newborn?

Answer 17

• Neonatal jaundice
• Anemia
• Hydrops fetalis

These features are associated with hemolytic disease of the newborn.