Hematology

Question 1

How long will physiologic anemia of infancy lasts?

Answer 1

8 to 12 weeks

not lower than 11g/dL

Question 2

Minimal level of Hgb in Physiologic anemia of prematurity

Answer 2

7-9 g/dL

More extreme and rapid decline

Question 3

[Anemia: Causes]

Low Hgb
Retic <2.5
Normocytic

Answer 3

Bone marrow damage

1. Infiltration
2. Aplasia

Question 4

[Anemia: Causes]

Low hgb
Retic <2.5
Micro/Macrocytic

Answer 4

1. IDA
2. Thalassemia
3. Folate deficiency
4. B12 deficiency

Question 5

[Anemia: Causes]

Low Hgb
Retic > 2.5
Hemolysis/Hemorrhage

Answer 5

1. Autoimmune
2. Membrane defect
3. Metabolic
4. Hemoglobinopathy

Question 6

[Anemia: Causes]

Microcytic anemia
MCV <80

Answer 6

1. Thalassemia
2. Iron deficiency
3. Lead poisoning
4. Sideroblastic anemia

Question 7

[Anemia: Causes]

Normocytic
MCV 80-100

Answer 7

1. Hypothyroidism
2. Uremia
3. Bone marrow failure (aplastic anemia)
4. Anemia of chronic
   Disease

HUBAd

Question 8

[Anemia: Causes]

Macrocytic
MCV>100

Answer 8

1. Folate deficiency
2. Vitamin B12 deficiency
3. Drug and alcohol-induced anemia

Question 9

[IDA vs Thalassemia]

Microcytic
Hypochromic
Normal RDW
Retic <2.5

Answer 9

Thalassemia

Question 10

[IDA vs Thalassemia]

Microcytic
Hypochromic
Elecated RDW
Retic <2.5

Answer 10

IDA

Question 11

Most common hematologic disease of infancy and childhood

Answer 11

IDA

Question 12

Most common age group affected by IDA

Answer 12

9-24 months of age

Question 13

What is the most important sign of IDA

Answer 13

Pallor

Question 14

[IDA]

level of Hgb that compensatory mechanisms start to appear, but no symptoms

Answer 14

6-10mg/dL

Question 15

[IDA]

Level of Hgb at which irritability and anorexia appears along with compensator ymechanisms

Answer 15

5mg/dL

Question 16

What is the laboratory feature of IDA?

Answer 16

Microcytic
Hypochromic
low retic
high RDW
low serum iron
Low serum ferritin
high TIBC

Question 17

[Prevention of anemia]

Premature infants

Answer 17

7.5mg OD for 3 months

Question 18

[Prevention of anemia]

4-11 months

Answer 18

15mg OD for 3 months

Question 19

[Prevention of anemia]

1-5 years old

Answer 19

30mg OD for 3 months

Question 20

[Prevention of anemia]

Adolescents

Answer 20

Iron 60mg + Folic acid 400mcg

Question 21

[Treatment of anemia]

How will you treat anemia

Answer 21

3-6 mg/kg/day elemental iron in 2-3 divided doses

Max 150 to 200mg/day

For 2-3 months until blood value normalizes

Question 22

[Treatment of anemia]

What is the expected rise in Hgb after treatment?

Answer 22

Hgb 0.1 to 0.4 g/dL/day

Question 23

[Response to iron therapy]

subjective improvements in patients happen in

Answer 23

12-24 hours

Question 24

[Response to iron therapy]

Initial bone marrow response

Answer 24

26 to 28 hours

Question 25

[Response to iron therapy] Reticulocytosis

Answer 25

28 to 72 hours

Question 26

[Response to iron therapy] Increasing Hgb

Answer 26

4 to 30 days

Question 27

[Response to iron therapy] repletion of iron stores

Answer 27

1-3 months

Question 28

What are the composition of the normal tetramer of Hgb?

Answer 28

1. 2 alpha | 2. Beta

Question 29

[Alpha Thalassemia] 1/4 foci

Answer 29

asymptomatic

Question 30

[Alpha Thalassemia] 2/4 foci

Answer 30

mild anemia (thalassemia trait)

Question 31

[Alpha Thalassemia] 3/4 foci

Answer 31

hemoglobin H splenomegaly, increased B4

Question 32

[Alpha Thalassemia] 4/4 foci

Answer 32

hydrops fetalis

Question 33

What is the clinical picture of alpha thalasemia

Answer 33

1. Decreased Retic 2. Microcytic, hypochromic RBCs 3. Normal RDW 4. Target cells and Heinz bodies on PBS

Question 34

[Beta thalassemia] no beta globin production anemia at 6 months

Answer 34

Beta thalassemia major

Question 35

What is the test to definitely diagnose electrophoresis?

Answer 35

Hemoglobin electrophoresis Result: increased HbF, HbA2

Question 36

What is the characteristic PBS result in Hemolytic anemia?

Answer 36

Normocytic Normochromic increased retic

Question 37

What blood test will be useful to establish spherocytosis

Answer 37

osmotic fragility test confirms the presence of fragile sphere

Question 38

What surgical procedure can cure spherocytosis?

Answer 38

Splenectomy Folate supplementation can be also helpful

Question 39

What are the complications of Sickle cell disease

Answer 39

1. Vasoocclusive crisis 2. Aplastic crisis 3. Splenic sequestration crisis 4. Priapism 5. Stroke 6. Leg ulcers 7. Acute chest syndrome

Question 40

Diagnostic cranial xray in patients with Sickle cell disease

Answer 40

Crew cut hair or hair on end appearance

Question 41

What are the drugs used to treat Sickle Cell disease

Answer 41

Hydroxyurea analgesic + hydration for acute crises Folate stimulation

Question 42

Most common hereditary bleeding disorder

Answer 42

von Willebrand disease

Question 43

Most common and most serious congenital coagulation factor deficiency

Answer 43

Hemophilia A

Question 44

Most common hereditary hypercoaguable disorder

Answer 44

Factor V Leiden

Question 45

Hallmark of hemophilia

Answer 45

Prolonged bleeding

Question 46

Earliest joint hemorrhages in children

Answer 46

Ankles

Question 47

____ assay that measures vWF antigen levels and activity

Answer 47

Ristocetin cofactor assay

Question 48

Treatment for mild vWF disease

Answer 48

Desmopressin causes release of vWF from endothelial stores

Question 49

Treatment for severe vWF disease

Answer 49

Factor VIII concentrates which contain high vWF Ag

Question 50

[Diagnose] PT: Normal PTT: increased BT: Normal PC: Normal

Answer 50

Hempophilia A and B

Question 51

[Diagnose] PT: Normal PTT: inc BT: inc PC: Normal or dec

Answer 51

vWD

Question 52

[Diagnose] PT: Normal PTT: Normal BT: Increased PC: Normal

Answer 52

ITP

Question 53

[Diagnose] PT: increased PTT: normal to inc BT: Normal PC: Normal

Answer 53

VitK deficiency

Question 54

[Diagnose] PT: inc PTT: inc BT: inc PC:dec

Answer 54

DIC