Hematology Recalls Flashcards
Term baby born at home presented by bleeding from umbilicus, home
delivery, PT prolonged:
VITAMIN K DEF
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
DIC
Child under protection plan with bruises platlets 18,000
ITP
HbF is characterized by what compared to HbA?
Low affinity to DPG
ABO incombatibility senario blood film finding
spherocytosis
Origin of macrophages
Monocytes
3 months infant on cow milk with pallor. CBC showing normocytic normochromic anemia
Physiological aneamia.
baby with bruises with umbilical bleed ,home birth
Vit. K Deficiency
Patient with petechial hemorrhage
Immune Complex
PT and PTT of Haemorrhagic Disease of Newborn
PT & PTT Prolonged
Diseases that should be given irradiated blood
- Hodgkin lymphoma
- SCID
- NEUROBLASTOMA TYPE4
- DONER AND RECPIENT OF BONEMAROW TRANSPLANT
Skin biopsy in HSP (Henoch-Schonlein purpura)
IgA vasculitis (igA mediated vasculities)
HSP isn’t toxin mediated
Pedigree with 2 affected males XLR
G6PD
8 days delivered at home bleeding from umbilicus
HDN (haemolytic
disease of newborn)
3 weeks baby bleeding after circumcission PT normal prolonged APTT
haemophilia
Blood Parameters of DIC
- high PT
- high APTT
- high INR
- LOW fibrinogen
Mode of action of anaemia in HUS (Hemolytic Uremic System)
RBCs destruction in altered vessels
Causes of anaemia in prematurity
low iron absorption from immature
gut
Oxygen dissociation Curve is shifted to the left due to:
decrease binding in 2,3 DPG
Mechanism of phsiological anemia of newborn
decrease EPO (erythropoietin)
What is the pathophysiology of HbC
Qualitative defect in beta chain of Hb
What is the pathophysiology of HbH
Deficiency of alpha chain
What is the pathophysiology of Hereditary spherocytosis
RBC membrane reduced
ability for oxidative stress
Hb; 10, MCV; 85, Hct; 33
Physiological anemia of infancy
child need urgent blood transfusion his parent told u that his blood group is A +ve, what type of blood group u will use?
O -ve
case with heamolytic ureamic syndrome what u will find in blood film
fragmented RBS schistocyte
Child with UTI prophylactic drug & developed jaundice
G6PD
Mechanism of anemia in parvovirus
RBS progenator in bone marrow (red cell aplasisa)
baby taking cow milk .. serum ferittin or iron low and TIBC high.. What the diagnosis?
iron deficiency anemia
baby with HUS blood film
look for fragments cell
baby and his sister have pica, what to investigate?
lead level or abd X-ray
baby have testicular enalargment and inguinal lymph node
ALL or testicular malignancy
aPTT high,
ratio 2.5
platelets 15
K 5.9
high renal function test
fibronegen 0.5
low platelets
DIC
prolonged aPTT and prolonged PT
- Platelet 18
- normal pt, ptt
- extensive ecchymosis over chin and forehead and epistaxis
Diagnosis?
Non Accidental Injury
( ITP was in the answers but abnormal bruising sites leads to excluding it)
Fever + prolonged pt , ptt , D-dimers > 500 ….diagnosis?
DIC
Baby jaundice day 1 mechanism ?
RBCs destruction
HUS Mechanism?
oxins disrupt RBCs membrane integrity (Disrupt indotheleal vessel membrane)
Boy + skin allergy resistant to ttt + neutropenia …diagnosis?
Wiskott Aldrich
charachterstics of HbF
work on 2,3 DPG and decrease it so shifting the curve to Left and increasing the affinity to oxygen
alpha thalessemia trait pathology
2 or 1 deletion of alpha chain
PT normal APTT prolong boy with gum bleeding, mother the same condition.
von Willberan Disease
Anemia 6 month, mother think he is pale, infrequent diarrhea, low MCV, PLT 495, Retic. low , formula milk started
Iron Deficiency
protusion of the eye and kidney problem
Neuroblastoma
Hb dissociation curve which is the characteristic of HBF to HBA that cause its high affinity
HBF decrease binding to 2,3 DPG
Child 9 years , with ALL , What of these give bad prognosis o No options
for age / others
“cytogenetics” listed (mostly means philadelphia chromosome)
Case of recurrent infection +on ttt for eczema +cbc shows thrombocytopenia
Wiscot Aldrich sydrome
grandmother has give antipyretic .. child developed bleeding, incease APTT (53 sec) , febrin 0.5 , what the diagnosis
DIC
Which Aspirin doses cause increase in APTT
chronic doses not only one dose
Severe, rapid-onset DIC causes
- severe thrombocytopenia
- very prolonged PT and PTT
- a rapidly declining plasma fibrinogen level
- a high plasma D-dimer level.
Iron Deficiency Anemia CBC
Low MCV
Low HB
Low MHC
(micorcytic Hyperchromic)
Beta thalassema CBC
- Low Hb
- Low MCV
- Microcytic anemia
- Normal/high Serum Fe
- Normal TIBC
- Normal Ferretin
Sideroblastic anemia CBC
- Low Hb
- Low MCV
- Microcytic anemia
- High Serum Fe
- High TIBC
- High Ferretin
Vit. B12 Def. anemia
- Low Hb
- High MCV
- Macrocytic anemia
- Thrombocytopenia
- BM: Megaloblast
Which Malignancy needs radiated blood transfusion
Hodgkin’s Lymphoma
Child with hemorrhagic manifestations. There is family history of 2 relatives died from intracranial hemorrhage.
PT and APTT are normal.
What is the diagnosis
▪Check factor XIII
A small child with left testicular mass, prominent pallor and bruises.
What is your possible diagnosis?
ALL or Testicular malignancy
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?
ALL
What shifts O2 dissociation curve to the left (inc. O2 affinity of Hb)
- Low CO2
- Low H+ (inc. PH - Alkalosis)
- Low 2,3 DPG
- HbF
- Low Temperature
What shifts O2 dissociation curve to the left (inc. O2 affinity of Hb)
- high CO2
- high H+ (dec. PH - Acidosis)
- high 2,3 DPG
- high Temperature
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?
G6PD assay
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?
ALL
