Hematology

Question 1

State 5 tests done to investigate hemolysis

Answer 1

Serum LDH
Coombs
Haptoglobin
Indirect bilirubin
Coagulation studies

Question 2

Lab evaluation of anemia x5

Answer 2

FBC with differential
Peripheral blood smear
Iron studies
Hemolysis
Bone marrow examination

Question 3

Causes of acute(3) and chronic(2) blood loss

Answer 3

Acute- trauma, melena, hematemesis
Chronic- colonic poly/carcinoma > occult bleeding

Question 4

Causes of megaloblastic anemia x2

Answer 4

B12 and folate deficiency
Abnormalities in nucleic acid

Question 5

2 causes of non megaloblastic anemia

Answer 5

Myelodysplasia
Abnormal RBC maturation

Question 6

Causes of reduced heme synthesis in microcytic anemia x2

Answer 6

Lead poisoning
Sideroblastic anemia

Question 7

Smear characteristics of reduced globin production x4

Answer 7

Hypochromia
Microcytosis
Target cells
Tear drops

Question 8

Causes of immune mediated hemolytic anemia 2x2 groups

Answer 8

Cold agglutin:
1. Paroxysmal nocturnal hemoglobinuria
2. Post mycoplasma hemolytic anemia

Warm agglutin:
1. Drug induced
2. Transfusion reaction
3. Autoimmune hemolytic anemia

Question 9

Causes of extravascular non immune mediated anemia x5

Answer 9

Macro circulatory- spleen, extra-corporeal circulation
Micro circulatory- DIC, TTP, HUS

Question 10

State 5 causes of prolonged bleeding time

Answer 10

Uremia
Thrombocytopenia
Von willebrand disease
Hereditary platelet dysfunction
Blood vessel disorders

Question 11

2 functions of von willebrand factor

Answer 11

Its a carrier protein for plasma factor VIII ie antihemophilic factor
Binds to gpIb receptor complex ie gp Ib-IX-V to initiate platelet adhesion

Question 12

Assessment of primary hemostasis x4

Answer 12

Platelet aggregation
Platelet number and morphology
Bleeding time
Von willebrand factor

Question 13

Assessment of secondary hemostasis x5

Answer 13

PT- Prothromin time
aPTT- activated partial thromboplastin times
Mixed study
Fibrinogen
Thrombin time
D dimer

Question 14

Bleeding disorders with normal PT and aPTT x5

Answer 14

Platelet disorders
Vascular disorders
Dsyfibrinogenemia
Factor VII deficiency
Alpha 2 antiplasmin deficiency

Question 15

Clotting factor abnormalities, congenital and acquired x5

Answer 15

Congenital- von willebrand disease, factor 8 and 9 deficiency
Acquired - vit k deficiency, oral anticoagulants

Question 16

Treatment of von willebrand diasese x3

Answer 16

Cryoprecipitate ie a source of factor 8 and vWF
DDAVP stimulates secretion of of vWF from endothelium
Factor 8 concentrate

Question 17

Causes of acquired hemophilia x3

Answer 17

Malignancy
Post partum
Autoimmune disorders

Question 18

Indications of fresh frozen plasma x3

Answer 18

Deficiency of factor 5,7,9,10,13
Severe liver disease
DIC

Question 19

Indications of cryoprecipitate x3

Answer 19

vWF disease
Hemophilia A
Hypo/dysfibrinogenemia

Question 20

Causes of hematological changes in HIV

Answer 20

Marrow defects and immune cytopenias
Opportunistic infections or lymphomas
Side effects of drugs- HIV and opportunistic infections

Question 21

Causes of thrombosis in HIV patients x5

Answer 21

Age>45
HIV therapy- indinavir
Hospitalization
Advanced stage HIV
CMV/AIDS related opportunistic infections

Question 22

2 characteristics of hemophagocytic syndrome

Answer 22

Proliferation of histiocytes
Phagocytosis of marrow blood cell precursors