Haematology

Question 1

List four things to ask about when taking a history from a child presenting with bruising

Answer 1

1. Spontaneous or after injury
2. Duration
3. Mucosal bleeding?
4. Recent history of infection

Question 2

Give 4 things to look for when examining a bruised child

Answer 2

• signs of infection
• raised ICP
• signs of trauma
• Hepatosplenomegaly

Question 3

Give 4 possible causes of bruising in a child

Answer 3

• Sepsis
• DIC
• HS purpura
• NAI

Question 4

What is the typical presentation of ITP?

Answer 4

1-5 year olds, platelets <20 + acute bruising

Question 5

What is found on examination of a child with ITP?

Answer 5

No atypical features found on examination

Question 6

Give 2 complications of ITP

Answer 6

Intracranial haemorrhage (rare)

Failure to resolve so becomes chronic ITP

Question 7

Give 4 treatment options in ITP

Answer 7

• Limit impact of activities
• Platelet transfusion in bleed
• IV immunoglobulins
• Consider steroids

Question 8

Define Henoch Schonlein Purpura

Answer 8

Vasculitis due to deposition of IgA containing immune complexes in capillaries, arterioles and venules

Question 9

How may Henoch Schonlein Purpura present in the skin?

Answer 9

Purpura over extensor aspects of lower limbs and buttocks

Question 10

How may Henoch Schonlein Purpura present in the joints?

Answer 10

Non erosive arthritis

Question 11

How may Henoch Schonlein Purpura present in the GI system?

Answer 11

Colicky abdominal pain
N&V
PR blood and mucus
Possible intussusception

Question 12

How may Henoch Schonlein Purpura present in the renal system?

Answer 12

Haematuria
Proteinuria
HTN

Question 13

What may a FBC show in Henoch Schonlein Purpura?

Answer 13

Raised platelets

Question 14

How is Henoch Schonlein Purpura managed?

Answer 14

Analgesia
Monitor U&Es
Urinalysis and BP

Question 15

Give 4 risks of iron deficiency anaemia

Answer 15

• Preterm
• LBW
• Exclusive breastfeeding >6 months
• Delayed weaning

Question 16

Give 2 ways iron deficiency anaemia can present in children

Answer 16

Restlessness

Reduced cognition

Question 17

Give 4 presenting features of leukaemia

Answer 17

• Bone pain/limp
• Lymphadenopathy
• Hepatosplenomegaly
• Testicular enlargement

Question 18

Give 3 tests involved in the diagnosis of leukaemia

Answer 18

• FBC/film
• BM aspirate
• LP

Question 19

Give 3 poor prognostic indications in leukaemia

Answer 19

<1/>10 years

WCC>50 at presentation

Philadelphia chromosome (9:22)

Question 20

Give 2 ways haemophilia may present

Answer 20

Spontaneous joint/muscle bleed due to minor trauma

Lumpy bruises

Question 21

Which blood test is abnormal in isolation in haemophilia?

Answer 21

Prolonged APPT

Question 22

How is haemophilia treated?

Answer 22

IV recombinant factor

Question 23

Name 3 ways Von Willebrand disease can present

Answer 23

Epistaxis
Mucosal bleeding
Menorrhagia

Question 24

Define lymphadenopathy and the two types

Answer 24

Node enlargement >1cm

Localised or general

Question 25

Give 4 things to examine when looking at enlarged lymph nodes

Answer 25

Site
Size and number
Tenderness
Fluctuance

Question 26

Name 3 things you may look for on a systemic examination in lymphadenopathy

Answer 26

• Bruising/petechiae
• Hepatosplenomegaly
• Palpable masses

Question 27

Give 3 malignant causes of Lymphadenopathy

Answer 27

ALL/AML
Lymphoma
Hodgkin’s

Question 28

Give 3 infectious causes of Lymphadenopathy

Answer 28

Bacterial lymphadenitis
Viral infection
Cat Scratch disease

Question 29

Give 3 autoimmune causes of Lymphadenopathy

Answer 29

Kawasaki’s disease
SLE
Sarcoidosis