Hematology

Question 0

Lead poisoning

Clinical presentation

Answer 0

1-Behavioral changes
2-Cognitive/development dysfunction
3-Anorexia, pain, vomiting, constipation ( at 20 mcg/dL )
4-CNS- related to cerebral edema, ICP ( 70-100 mcg/dL )

Question 1

Iron Deficinecy

Treatment

Answer 1

• Oral ferrous salts
• Within 3-4 days Reticulocytosis.
• Increase Hb over first month
• Repletion of iron 1-3 months after start .

Question 2

Lead poisoning

Diagnosis

Answer 2

• Screen for high risk at 12 and 24 months age
• Confirmatory venous sample- gold standard blood lead level
• Microcytic hypochromic anemia
• Basophilic stippling

Question 3

Lead poisoning

Management

Answer 3

1-10-14mcg/dL Evaluate source, recheck in 3 months
2-15-19mcg/dL Health department referral, BLL in 2 months
3-20-44mgc/dL Same , repeat in one month
4-45-70 mcg/dL Same , single drug chelation ( DMSA )
5- _>70mcg/dL Hospitalisation + two drugs

Question 4

Blackfan-Diamond Syn

Presentation

Answer 4

1-Severe anemia by 2-3 months
2-Short stature
3-Craniofacial deformities
4-Triphalangeal thumb

Question 5

Blackfan-Diamond Syn

Lab

Answer 5

1-Macrocytosis
2-Increased HbF
3-Increased RBC ADA
4-Low Reticulocytosis 
5-Marrow with Decreased RBC precursors

Question 6

Blackfan-Dismond Syn

Treatment

Answer 6

1-Corticosteroid

2-Spleenoctomy

Question 7

Congenital Pancytopenia
( Fanconi ) anemia
Presentation

Answer 7

1-Short stature 
2-Absent or Hypoplastic thumbs
3-Hyperpigmentation and cafe-au-lait spots
Lab : 
1-Macrocytosis , high HbF
2-Pancytopenia , bone marrow hypoplasia

Question 8

Fanconi Anemia

Diagnosis

Answer 8

1-Bone marrow aspiration

2-Cytogenic studies

Question 9

Fanconi

Complication

Answer 9

AML

Bone marrow failure

Question 10

Fanconi

Treatment

Answer 10

1-Corticosteroid
2-Transfusion, antibiotics
3-Bone marrow transplant

Question 11

B12 Deficiency

Causes

Answer 11

1-Inadequate production
2-Congenital or juvenile pernicious anemia
3-Gastric surgery
4-Terminal ileum disease

Question 12

Spherocytosis

Diagnosis

Answer 12

Osmotic fragility test

Question 13

G6PD Deficinecy

Genitic

Answer 13

X-Linked

Heinz body in blood smear

Question 14

Sickle Cell

Lab

Answer 14

1-Reticulocytosis
2-Anemia ( moderate )
3-Nucleated RBC
4-Target cell, Howell-Jolly bodies (smear)

Question 15

Sickle Cell

Management

Answer 15

Penicillin from 2 months to 5 years

Hydroxyurea ( decrease HbF )

Question 16

Wiskott-Aldrish Syndrome

Answer 16

1-X-Linked
2-Immunodeficiency ( IgM )
3-Eczema
4-Thrombocytopenia 
5-Pyogenic infection

Question 17

Kasabsch-Marritt Syndrome

Answer 17

1-Benign neoplasm
2-Intense platelet sequestration in the lesion
3-Peripheral thrombocytopenia
4-Lesion may compresses the vital structure

Question 18

Thrombocytopenia absent radius syndrome

Answer 18

1-AR
2-Thrombocytopenia 
3-Absent radius 
4-Congenital heart disease
5-Renal anomalies

Question 19

Eosinophilia

Answer 19

1-Asthma
2-Recurrent urticaria 
3-Infantile eczema 
4-Drug reaction 
5-Helminth infection
6-Collagen vascular disease 
7-Neoplasms

Question 20

Where u see Spherocytosis?

Answer 20

1-Hyperthermia
2-G6-PD
3-ABO incompatibility

Question 21

PT test : responsible

Answer 21

Factors: 1-2-5-7-10

Question 22

VitaminK

Answer 22

Factors : 2-7-9-10
Prolonged PT and aPTT
Normal thrombine time ( conversion of fibrinogen to fibrin )

Question 23

vWD

Treatment ( moderate )

Answer 23

Desmopressin : increase vWF and shortens aPTT , bleeding time .

Question 24

Folic acid Deficinecy

Answer 24

Polymorphonuclear neutrophil on blood smear