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MRCPCH Part 1 > Hematology Recalls > Flashcards

Hematology Recalls Flashcards

1
Q

Term baby born at home presented by bleeding from umbilicus, home
delivery, PT prolonged:

A

VITAMIN K DEF

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2
Q

Child with her grandparents suddenly developed petechiae on her body. She
was well, had fever last week given paracetamol. investigations : prolonged APTT ,PT , high D dimer

A

DIC

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3
Q

Child under protection plan with bruises platlets 18,000

A

ITP

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4
Q

HbF is characterized by what compared to HbA?

A

Low affinity to DPG

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5
Q

ABO incombatibility senario blood film finding

A

spherocytosis

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6
Q

Origin of macrophages

A

Monocytes

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7
Q

3 months infant on cow milk with pallor. CBC showing normocytic normochromic anemia

A

Physiological aneamia.

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8
Q

baby with bruises with umbilical bleed ,home birth

A

Vit. K Deficiency

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9
Q

Patient with petechial hemorrhage

A

Immune Complex

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10
Q

PT and PTT of Haemorrhagic Disease of Newborn

A

PT & PTT Prolonged

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11
Q

Diseases that should be given irradiated blood

A
  • Hodgkin lymphoma
  • SCID
  • NEUROBLASTOMA TYPE4
  • DONER AND RECPIENT OF BONEMAROW TRANSPLANT
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12
Q

Skin biopsy in HSP (Henoch-Schonlein purpura)

A

IgA vasculitis (igA mediated vasculities)

HSP isn’t toxin mediated

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13
Q

Pedigree with 2 affected males XLR

A

G6PD

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14
Q

8 days delivered at home bleeding from umbilicus

A

HDN (haemolytic
disease of newborn)

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15
Q

3 weeks baby bleeding after circumcission PT normal prolonged APTT

A

haemophilia

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16
Q

Blood Parameters of DIC

A
  • high PT
  • high APTT
  • high INR
  • LOW fibrinogen
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17
Q

Mode of action of anaemia in HUS (Hemolytic Uremic System)

A

RBCs destruction in altered vessels

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18
Q

Causes of anaemia in prematurity

A

low iron absorption from immature
gut

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19
Q

Oxygen dissociation Curve is shifted to the left due to:

A

decrease binding in 2,3 DPG

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20
Q

Mechanism of phsiological anemia of newborn

A

decrease EPO (erythropoietin)

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21
Q

What is the pathophysiology of HbC

A

Qualitative defect in beta chain of Hb

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22
Q

What is the pathophysiology of HbH

A

Deficiency of alpha chain

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23
Q

What is the pathophysiology of Hereditary spherocytosis

A

RBC membrane reduced
ability for oxidative stress

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24
Q

Hb; 10, MCV; 85, Hct; 33

A

Physiological anemia of infancy

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25
Q

child need urgent blood transfusion his parent told u that his blood group is A +ve, what type of blood group u will use?

A

O -ve

26
Q

case with heamolytic ureamic syndrome what u will find in blood film

A

fragmented RBS schistocyte

27
Q

Child with UTI prophylactic drug & developed jaundice

A

G6PD

28
Q

Mechanism of anemia in parvovirus

A

RBS progenator in bone marrow (red cell aplasisa)

29
Q

baby taking cow milk .. serum ferittin or iron low and TIBC high.. What the diagnosis?

A

iron deficiency anemia

30
Q

baby with HUS blood film

A

look for fragments cell

31
Q

baby and his sister have pica, what to investigate?

A

lead level or abd X-ray

32
Q

baby have testicular enalargment and inguinal lymph node

A

ALL or testicular malignancy

33
Q

aPTT high,
ratio 2.5
platelets 15
K 5.9
high renal function test
fibronegen 0.5
low platelets

A

DIC

34
Q
A

prolonged aPTT and prolonged PT

35
Q
  • Platelet 18
  • normal pt, ptt
  • extensive ecchymosis over chin and forehead and epistaxis
    Diagnosis?
A

Non Accidental Injury
( ITP was in the answers but abnormal bruising sites leads to excluding it)

36
Q

Fever + prolonged pt , ptt , D-dimers > 500 ….diagnosis?

A

DIC

37
Q

Baby jaundice day 1 mechanism ?

A

RBCs destruction

38
Q

HUS Mechanism?

A

oxins disrupt RBCs membrane integrity (Disrupt indotheleal vessel membrane)

39
Q

Boy + skin allergy resistant to ttt + neutropenia …diagnosis?

A

Wiskott Aldrich

40
Q

charachterstics of HbF

A

work on 2,3 DPG and decrease it so shifting the curve to Left and increasing the affinity to oxygen

41
Q

alpha thalessemia trait pathology

A

2 or 1 deletion of alpha chain

42
Q

PT normal APTT prolong boy with gum bleeding, mother the same condition.

A

von Willberan Disease

43
Q

Anemia 6 month, mother think he is pale, infrequent diarrhea, low MCV, PLT 495, Retic. low , formula milk started

A

Iron Deficiency

44
Q

protusion of the eye and kidney problem

A

Neuroblastoma

45
Q

Hb dissociation curve which is the characteristic of HBF to HBA that cause its high affinity

A

HBF decrease binding to 2,3 DPG

46
Q

Child 9 years , with ALL , What of these give bad prognosis o No options
for age / others

A

“cytogenetics” listed (mostly means philadelphia chromosome)

47
Q

Case of recurrent infection +on ttt for eczema +cbc shows thrombocytopenia

A

Wiscot Aldrich sydrome

48
Q

grandmother has give antipyretic .. child developed bleeding, incease APTT (53 sec) , febrin 0.5 , what the diagnosis

A

DIC

49
Q

Which Aspirin doses cause increase in APTT

A

chronic doses not only one dose

50
Q

Severe, rapid-onset DIC causes

A
  • severe thrombocytopenia
  • very prolonged PT and PTT
  • a rapidly declining plasma fibrinogen level
  • a high plasma D-dimer level.
51
Q

Iron Deficiency Anemia CBC

A

Low MCV
Low HB
Low MHC
(micorcytic Hyperchromic)

52
Q

Beta thalassema CBC

A
  • Low Hb
  • Low MCV
  • Microcytic anemia
  • Normal/high Serum Fe
  • Normal TIBC
  • Normal Ferretin
53
Q

Sideroblastic anemia CBC

A
  • Low Hb
  • Low MCV
  • Microcytic anemia
  • High Serum Fe
  • High TIBC
  • High Ferretin
54
Q

Vit. B12 Def. anemia

A
  • Low Hb
  • High MCV
  • Macrocytic anemia
  • Thrombocytopenia
  • BM: Megaloblast
55
Q

Which Malignancy needs radiated blood transfusion

A

Hodgkin’s Lymphoma

56
Q

Child with hemorrhagic manifestations. There is family history of 2 relatives died from intracranial hemorrhage.
PT and APTT are normal.
What is the diagnosis

A

▪Check factor XIII

57
Q

A small child with left testicular mass, prominent pallor and bruises.
What is your possible diagnosis?

A

ALL or Testicular malignancy

58
Q

boy with severe pain during night and was crying excessively.
The parents can calm the baby with milk.
He was pale with bruises over the chin, but an active child.
What is the diagnosis?

A

ALL

59
Q

What shifts O2 dissociation curve to the left (inc. O2 affinity of Hb)

A
  1. Low CO2
  2. Low H+ (inc. PH - Alkalosis)
  3. Low 2,3 DPG
  4. HbF
  5. Low Temperature
60
Q

What shifts O2 dissociation curve to the left (inc. O2 affinity of Hb)

A
  1. high CO2
  2. high H+ (dec. PH - Acidosis)
  3. high 2,3 DPG
  4. high Temperature
61
Q

2 day old new-born who is pale and jaundiced. Heis of Afro Caribbean ethnicity.
Antenatal, mum had an uneventful pregnancy.
What next best test?

A

G6PD assay

62
Q

Child presents Unwell with shoulder and chest pain looks pale, investigations are as follows, Platelets 171
WCC 2.5
N 0.5
Hb 9.5
ESR 90
What is the most likely diagnosis?

A

ALL

MRCPCH Part 1 (3 decks)

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