Haematology

Question 1

5 month old boy with multiple bruises on back, abdomen, buttocks. His mum reports that he is always off balance and falling into things. Small burn on inner aspect of left arm. What is the likely diagnosis and why?

Answer 1

Age of child- unlikely to be walking and falling over, most won’t even be sitting up yet. When there is bruising on soft parts, this is a worry (bony parts can be accidental). Therefore non accidental injury.

Question 2

2 month old boy, appears more pale than usual. He is exclusively breast fed and mum has not started weaning. Both his parents are born in Glasgow. What do you expect on FBC and blood film and why?

Answer 2

Microcytic hypochromic anaemia with tear drop cells. After 6 months, child needs other nutrition to sustain diet. Thus iron deficiency anaemia.

Question 3

15 year old boy hx of night sweats, weight loss and fatigue. Enlarged painless lymph nodes in left axilla. Blood film shows reed sternberg cell. What is the diagnosis?

Answer 3

Hodgkin’s lymphoma

Question 4

3 year old presents with rash, characteristic of HSP (henoch-schonlein-purpura). Which symptom/feature is most commonly associated with this?

Answer 4

joint pain