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AMC MCQ - Key points > Haematology > Flashcards

Haematology Flashcards

1
Q

What is the treatment for a patient with anemia (any type) and hemoglobin level < 7?

A

Packed RBCs.

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2
Q

Pt with anemia (any type) develops severe symptoms ….

A

Packed RBCs

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3
Q

MCV 80-100………………………….
MCV <80 …………………………..
MCV >100 ………………………..

A

MCV 80-100…………………………. Normal
MCV <80 ………………………….. microcytic anemia
MCV >100 ……………………….. macrocytic anemia

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4
Q

What is the most common cause of iron deficiency anemia in infants?

A

Prolonged breast feeding (start weaning at 4 months with iron-fortified cereal).

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5
Q

What is the most common cause of iron deficiency anemia in adults?

A

GIT bleeding (PUD) - Upper GI endoscopy.

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6
Q

MCC of iron deficiency anemia in old: …….…

A

MCC of iron deficiency anemia in old: cancer colon… colonoscopy.

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7
Q

What is the specific manifestation of iron deficiency anemia?

A

Pica.

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8
Q

What are the side effects of oral iron sulfate medication?

A

Black stool, abdominal pain.

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9
Q

What are the important lab findings in hemolytic anemia?

A

++ reticulocyte count & – haptoglobin.

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10
Q

Other lab findings in hemolytic anemia:

A

Other lab findings in hemolytic anemia: ++ billirubin, ++ LDH.

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11
Q

Anemia since birth………………….
MC affected organ in HS»> marked splenomegaly»>
pt with HS develops severe symptoms, lab shows hemolytic anemia& – reticulocyte count… Dx: inf…
TTT: packed RBCs
Inv of choice of HS:

A

Anemia since birth…………………. Hereditary spherocytosis (HS)
MC affected organ in HS»> marked splenomegaly»> splenectomy is a must
pt with HS develops severe symptoms, lab shows hemolytic anemia& – reticulocyte count… Dx: aplastic crisis DT parvo-virus inf… TTT: packed RBCs
Inv of choice of HS: osmotic fragility test

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12
Q

What is the confirmatory test for thalassemia?

A

Hb electrophoresis.

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13
Q

What is the first step in the treatment of hand-foot syndrome in patients with sickle cell anemia?

A

Strong analgesic.

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14
Q

What is the definitive treatment for vaso-occlusive crisis in patients with sickle cell anemia?

A

Exchange transfusion.

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15
Q

Describe the management of aplastic crisis in a patient with sickle cell anemia due to parvovirus infection.

A

Treatment with packed RBCs.

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16
Q

pt with SCA develops severe symptoms, lab shows hemolytic anemia& – reticulocyte count… Dx: aplastic crisis DT parvo-virus inf…

pt with SCA develops severe symptoms, lab shows hemolytic anemia& ++ reticulocyte count… Dx: hyperhemolytic crisis …

sickle cell anemia + marked pallor + marked spleen enlargement……crisis….TTT»»
Confirmatory test of SCA:

A

pt with SCA develops severe symptoms, lab shows hemolytic anemia& – reticulocyte count… Dx: aplastic crisis DT parvo-virus inf… TTT: packed RBCs
pt with SCA develops severe symptoms, lab shows hemolytic anemia& ++ reticulocyte count… Dx: hyperhemolytic crisis … TTT: packed RBCs
sickle cell anemia + marked pallor + marked spleen enlargement……sequestration crisis….TTT»»splenectomy
Confirmatory test of SCA: Hb electrophoresis.

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17
Q

What is the investigation of choice for hereditary spherocytosis?

A

Osmotic fragility test.

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18
Q

Describe the presentation of sequestration crisis in sickle cell anemia.

A

Sickle cell anemia + marked pallor + marked spleen enlargement.

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19
Q

Describe the confirmatory test for sickle cell anemia.

A

Hemoglobin electrophoresis.

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20
Q

Thalassemia:
Confirmatory test of thalassemia:
1st step in TTT of hand- foot $ in pt with sickle cell anemia:
1st step in TTT of priapism in pt with sickle cell anemia:
Definitive TT of hand- foot $, priapism or any presentation of vaso-occlusive crisis in pt with sickle cell anemia:

A

Thalassemia: AR disease
Confirmatory test of thalassemia: Hb electrophoresis.
1st step in TTT of hand- foot $ in pt with sickle cell anemia: strong analgesic.
1st step in TTT of priapism in pt with sickle cell anemia: strong analgesic.
Definitive TT of hand- foot $, priapism or any presentation of vaso-occlusive crisis in pt with sickle cell anemia: exchange transfusion.

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21
Q

What is the investigation of choice for G6PD deficiency?

A

G6PD enzyme activity one month after an attack.

People with G6PD deficiency are normally healthy, but must avoid these triggers. Certain triggers can cause red blood cells to be destroyed faster than they can be replaced (known as acute haemolytic anaemia or AHA). G6PD deficiency is diagnosed with a blood test.

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22
Q

Define the investigation of choice for autoimmune hemolytic anemia.

A

Coombs test.

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23
Q

What is the most common drug causing iron deficiency anemia?

A

Aspirin.

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24
Q

What is the most common drug causing aplastic anemia?

A

Diclofenac.

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25
How would you describe the bone marrow biopsy findings in aplastic anemia?
Hypocellular fatty tissue.
26
Describe the most common cause of vitamin B12 deficiency.
Vegetarian diet.
27
MC of folic acid deficiency:
MC of folic acid deficiency: alcohol
28
What is the most common neurological manifestation in vitamin B12 deficiency?
Loss of posterior column function (loss of vibration and position sensation).
29
CBC of megaloblastic anemia:
CBC of megaloblastic anemia: large RBCs, MCV>100& large WBCs (hypersegmented neutrophils
30
What is the Schilling test used for in relation to vitamin B12 deficiency?
To diagnose the cause of the deficiency.
31
How would you treat megaloblastic anemia? neurological
Replacement of vitamin B12 and folic acid.
32
Define the diagnosis of pernicious anemia.
Detection of anti-intrinsic factor antibodies.
33
What specific test is used for anemia of chronic disease?
Increased ferritin levels. ### Initial and Best Test for Anemia of Chronic Disease **Initial Test**: 1. **Complete Blood Count (CBC)**: - The initial test for evaluating anemia is a CBC, which provides information on hemoglobin levels, hematocrit, and red blood cell indices. This helps to determine the presence and severity of anemia. **Best Test**: 2. **Serum Ferritin**: - The best test for diagnosing anemia of chronic disease is serum ferritin. Ferritin levels are typically normal or elevated in anemia of chronic disease, in contrast to iron deficiency anemia where ferritin levels are low. Elevated ferritin levels indicate adequate iron stores and help differentiate anemia of chronic disease from other types of anemia. ### Additional Relevant Tests: - **Serum Iron and Total Iron-Binding Capacity (TIBC)**: Low serum iron and low TIBC are characteristic of anemia of chronic disease. - **C-Reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR)**: These inflammation markers are often elevated in chronic diseases contributing to anemia. For further detailed information, refer to the RACGP guidelines and relevant clinical resources: - [RACGP Clinical Guidelines](https://www.racgp.org.au/clinical-resources)
34
Describe the cause of anemia in end-stage renal disease.
Decreased erythropoietin production.
35
How would you diagnose and investigation immune thrombocytopenic purpura (ITP)?
Bone marrow biopsy showing increased megakaryocytes with defective budding. Child with H/O URTI 1-2 Ws develops generalized petechial Hge… Dx: ITP.
36
Other inv of ITP:
Other inv of ITP: -- platelets count, ++ Bleeding Time.
37
What is the treatment of choice for mild cases of ITP?
Observation.
38
What is the first-line treatment for moderate cases of ITP?
Corticosteroids.
39
40
Describe the most common factor deficiency in hemophilia.
Factor 8 deficiency (Hemophilia A).
41
What type of hereditary condition is hemophilia?
X-linked.
42
How is hemophilia typically treated?
Factor 8 replacement (fresh frozen plasma if factor 8 is unavailable).
43
What is the first step when a child with bruises and petechiae is encountered?
FBC is the 1st step.
44
Kid with bruises…..>>>>>>>>>child abuse shouldbe excluded 1st even if scenario is very clear to be Child with bruises and petechiae……… Hemophilia will do a surgery……….. Von-willebrand will do a surgery……….
Kid with bruises…..>>>>>>>>>child abuse shouldbe excluded 1st even if scenario is very clear to be hemophilia Child with bruises and petechiae………FBC is the 1st step Hemophilia will do a surgery………..factor 8 before the surgery Von-willebrand will do a surgery……….factor 8 before the surgery
45
++ BT, normal aPTT……………. Normal BT, ++ aPTT…………… ++ BT, ++ aPTT…………………… Girl with bleeding tendency>>>>>mostly von-willebrand Pt with Von- Willbrad Disease undergoes emergent operation, which is important to give… answer: coagulation factors (not platelets). Pt headache, blurring of vision, severe pruritis after bathing… Dx: P-vera.>>>> Lab of P-vera: ++RBCs, marked high hematocrit.
++ BT, normal aPTT……………. ITP Normal BT, ++ aPTT…………… hemophilia ++ BT, ++ aPTT…………………… Von-Willbrand Disease Girl with bleeding tendency>>>>>mostlyvon-willebrand Pt with Von- Willbrad Disease undergoes emergent operation, which is important to give… answer: coagulation factors (not platelets). Pt headache, blurring of vision, severe pruritis after bathing… Dx: P-vera.>>>>TTT is phlebotomy Lab of P-vera: ++RBCs, marked high hematocrit.
46
47
Describe the pre-surgery treatment for a patient with hemophilia.
Factor 8 before the surgery.
48
What is the diagnosis for a child with a bleeding disorder and lab results showing ++BT & ++aPTT?
Dx: Von-Willebrand Disease.
49
What is the treatment of choice for Hodgkin lymphoma? And for non-Hodgkin lymphoma?
Hodgkin lymphoma: chemo, non-Hodgkin lymphoma: chemo, radio.
50
What is the investigation of choice for Hodgkin lymphoma and non-Hodgkin lymphoma?
Excisional biopsy.
51
What is the next step if a patient with enlarged lymph nodes not relieved after antibiotic treatment?
Excisional biopsy.
52
What is the treatment for Gastric Mucosa Associated Lymphoid Tissue (MALT) lymphoma?
Eradication of H.pylori.
53
Describe the diagnosis and treatment for tumor lysis syndrome (TLS) in a patient who developed arrhythmia after chemotherapy.
Dx: tumor lysis $ (TLS), TTT: allopurinol.
54
What is the management for a patient with Von-Willebrand Disease undergoing emergent surgery?
Coagulation factors (not platelets).
55
What are the characteristic lab findings in Polycythemia Vera?
++RBCs, marked high hematocrit.
56
Describe the bone marrow aspiration findings in myelofibrosis.
Fibrotic bone marrow, tear-dropped shaped cells.
57
What is the most common cause of hereditary hypercoagulopathy?
Factor 5 Leiden deficiency.
58
Which lymph nodes are most commonly affected in Hodgkin lymphoma?
Cervical lymph nodes.
59
Which virus is most commonly related to Hodgkin lymphoma?
HTLV virus.
60
Which organ is most commonly affected in non-Hodgkin lymphoma?
Intestine.
61
What are the characteristics of secondary polycythemia in terms of O2 saturation and erythropoietin levels?
Decrease O2 saturation, increase erythropoietin.
62
What are the typical symptoms and diagnosis of Polycythemia Vera?
Pt headache, blurring of vision, severe pruritis after bathing. Dx: P-vera.
63
What is the treatment for Polycythemia Vera?
Phlebotomy.
64
What should be given to a patient with Von-Willebrand Disease before surgery?
Factor 8 before the surgery.
65
What is the management for a patient with hemophilia undergoing surgery?
Factor 8 before the surgery.
66
What is the diagnosis for a patient with normal bleeding time and prolonged activated partial thromboplastin time (aPTT)?
Hemophilia.
67
What is the diagnosis for a patient with prolonged bleeding time and normal aPTT?
ITP.
68
What is the diagnosis for a patient with prolonged bleeding time and prolonged aPTT?
Von-Willebrand Disease.
69
What is the most common organ affected in non-Hodgkin lymphoma?
Intestine.
70
What is the most common lymph node affected in Hodgkin lymphoma?
Cervical lymph nodes.
71
What is the most common virus related to Hodgkin lymphoma?
HTLV virus.
72
What is the treatment of choice for Hodgkin lymphoma?
Chemo.
73
What is the treatment of choice for non-Hodgkin lymphoma?
Chemo, radio.
74
What is the management for a patient with Gastric Mucosa Associated Lymphoid Tissue (MALT) lymphoma?
Eradication of H.pylori.
75
What is the diagnosis and treatment for tumor lysis syndrome (TLS) in a patient who developed arrhythmia after chemotherapy?
Dx: tumor lysis $ (TLS), TTT: allopurinol.
76
Describe the diagnosis of a patient with sepsis/severe burn who develops bleeding from a peripheral line, showing decreased platelets, fibrinogen, increased PT, and aPTT.
DIC (Disseminated Intravascular Coagulation)
77
What is the treatment of choice for DIC?
FFP (Fresh Frozen Plasma)
78
What is the cause of peri-oral numbness and muscle twitches in a patient after receiving a blood transfusion?
Citrate intoxication
79
What are the initial symptoms of a hemolytic reaction in a patient after a blood transfusion?
Tachycardia, hypotension, chest pain
80
What is the first step in managing a hemolytic reaction after a blood transfusion?
Normal saline
81
What component is most decreased in stored blood?
Platelets (shortest half-life)
82
Describe the diagnosis of a patient with neutrophils less than 1500 and evidence of infection.
Febrile neutropenia
83
What is the common cause of infection in febrile neutropenia?
Pseudomonas aeruginosa
84
What is the next step for an old alcoholic, smoker patient with enlarged cervical lymph nodes?
Biopsy
85
What is the most common cancer that metastasizes to the brain?
Lung cancer (Breast cancer is the second most common)
86
What is the treatment of choice for pain in terminal cancer?
Short-acting morphine
87
What is the preferred treatment for nausea and vomiting caused by chemotherapy?
Ondansetron
88
Describe the most common clinical presentation of chronic lymphocytic leukemia.
Marked lymphadenopathy
89
What is the most common complication of chronic lymphocytic leukemia?
Autoimmune Hemolytic Anemia (treated with cortisone)
90
What is the prognosis for chronic lymphocytic leukemia?
Very good, usually requiring no treatment
91
What is the treatment of choice for chronic lymphocytic leukemia?
Chemotherapy only, no radiotherapy
92
What is the most common leukemia in older individuals?
Chronic lymphocytic leukemia
93
What is the most common leukemia in children?
Acute lymphoblastic leukemia
94
What is the most common clinical presentation of chronic myelogenous leukemia?
Splenomegaly
95
What is the most important feature in acute leukemia?
Blast cells
96
What is the significance of decreased leukocyte alkaline phosphatase in chronic myelogenous leukemia?
It is a characteristic finding
97
What genetic abnormality is associated with chronic myelogenous leukemia?
Philadelphia chromosome

AMC MCQ - Key points (49 decks)

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