HAEMATOLOGY + EYES MQ

Question 1

1. What could be an underlying cause for microcytic anaemia?
   a. Bowel cancer
   b. Acute severe blood loss
   c. Beta thalassaemia minor
   d. B12 deficiency
   e. Alcohol misuse

Answer 1

microcytic anaemia
Response Feedback:
Please note beta thalassaemia is a also a correct answer (iif it causes any anaemia it would be very mild)

Question 2

2. Which of the following are red flag symptoms/signs related to an enlarged lymph node?
   a. Persisting >2 weeks with associated large liver/spleen
   b. Skin infection in the nearby draining site of the lymph node
   c. Larger than 1cm
   d. Tenderness and firm to touch
   e. Associated weight gain

Answer 2

a. Persisting >2 weeks with associated large liver/spleen

Question 3

3. Which of the following is true about scleritis?
   a. Is associated with minimal pain
   b. Can be treated with antibacterial eye drops
   c. Is inflammation of the cornea
   d. Can be associated with inflammatory bowel disease
   e. Is less severe compared to iritis

Answer 3

-

Question 4

4. Which of the following is a cause for gradual visual loss over time?
   a. Congenital cataracts
   b. Glaucoma
   c. Optic neuritis
   d. Temporal arteritis
   e. Acute glaucoma

Answer 4

b. Glaucoma

Question 5

5. A lung tumour can cause ptosis in the eye lid on the same side

Answer 5

T

Question 6

7. Describe the cover/uncover test and how it detects strabismus.

Answer 6

• Eye movement capability, image formation and perception, foveal fixation in each eye, attention, and cooperation are all necessities for cover testing. If a patient is unable to maintain constant fixation on an accommodative target, the results of cover testing may not be valid, and this battery of tests therefore should not be used.
• There are 3 types of cover tests: the cover-uncover test, the alternate cover test, and the simultaneous prism and cover test. All can be performed with fixation at distance or near.
• The monocular cover-uncover test is the most important test for detecting the presence of manifest strabismus and for differentiating a heterophoria from a heterotropia (Fig 6-1). As 1 eye is covered, the examiner watches carefully for any movement in the opposite, noncovered eye; such movement indicates the presence of a heterotropia. With movement of the noncovered eye assumed to be absent, movement of the covered eye in one direction just after the cover is applied and a movement in the opposite direction (a fusional movement) as the cover is removed indicate a heterophoria that becomes manifest only when binocularity is interrupted. If the patient has a heterophoria, the eyes will be straight before and after the cover-uncover test; the deviation that appears during the test is a result of interruption of binocular vision. A patient with a heterotropia, however, starts out with a deviated eye and ends up (after the test) with either the same or the opposite eye deviated (if the opposite eye is the deviated one, the condition is termed alternating heterotropia). Some patients may have straight eyes and start out with a heterophoria prior to the cover-uncover test; however, after prolonged testing—and therefore prolonged interruption of binocular vision—dissociation into a manifest heterotropia can occur.

Question 7

8. What are the three main cell lines produced in the bone marrow, and what are their functions?

Answer 7

• Osteoblasts:
o Osteoblasts are bone-forming cells that descend from osteoprogenitor cells. They form a protein mixture known as osteoid, which mineralizes to become bone. Osteoid is primarily composed of Type I collagen. Osteoblasts also manufacture hormones, such as prostaglandins, to act on the bone itself. They robustly produce alkaline phosphatase, an enzyme that has a role in the mineralization of bone, as well as many matrix proteins. Osteoblasts are the immature bone cells, and eventually become entrapped in the bone matrix to become osteocytes, which are the mature bone cells. All bone lining cells are osteoblasts.
• Osteocytes:
o Osteocytes are mature bone cells that originate from osteoblasts, which have migrated into and become trapped and surrounded by bone matrix, produced by themselves. The spaces they occupy are known as lacunae. Osteocytes have many processes that reach out to meet osteoblasts and other osteocytes probably for the purposes of communication. Their functions include formation of bone, maintenance of matrix and homeostasis of Calcium.
• Osteoclasts:
o Osteoclasts are the cells responsible for bone resorption and remodelling. They are large, multinucleated cells located on bone surfaces in what are called Howship’s lacunae or resorption pits. These lacunae, or resorption pits, are left behind after the breakdown of the bone surface. Because the osteoclasts are derived from a monocyte stem-cell lineage, they are equipped with phagocytic-like mechanisms similar to circulating macrophages.