This is a 55 year old woman who has fatigue. Her only other symptom is a craving for chewing ice cubes. Apart from being pale her examination is normal. Test results Hgb 77 g/L MCV 66f/L RBC 3.2 x1012/L WBC 5.6 x106/L Plat 525 x109/L Blood film
Which one of the following tests would best define the type of anemia she has ? A. Hgb electropheresis B. Serum iron and iron-binding capacity C. Serum ferritin D. Serum transferrin E. Bone marrow iron
This is a 55 year old woman who has fatigue. Her only other symptom is a craving for chewing ice cubes. Apart from being pale her examination is normal. Test results Hgb 77 g/L MCV 66fL RBC 3.2 x1012/L WBC 5.6 x106/L Plat 525 x109/L Blood film microcytosis hypochromia ovals pencil thrombocytosis
A 44 year old executive is sent to you for an insurance examination. He is fit, but on examination he has mild hypertension. Test results Hgb 135 g/L MCV 65 fL RBC 5.4 x1012/L WBC 6.5 x106/L Plat 355 x109/L Blood film
Which test is likely to give a diagnosis in this case ? A. Serum ferritin B. Serum transferrin C. Sickle Cell screen D. Hgb electropheresis E. Liver function tests
A 44 year old executive is sent to you for an insurance examination. He is fit, but on examination he has mild hypertension. Test results Hgb 135 g/L MCV 65 fL RBC 5.4 x1012/L WBC 6.5 x106/L Plat 355 x109/L Blood film microcytosis hypochromia target teardrop basophilic stippling
What would you tell this executive ? A. You have Beta thalassemia minor B. You have alpha thalasemia minor C. You have Sickle cell trait D. You have hemoglobin C trait E. More tests are needed
This is an 18 year old boy who you are investigating for Jaundice. He has this intermittently for some time. His family are Christian Scientists. Physical exam shows jaundice and splenomegaly bili 35 mol/L blood film Test results Hgb 99 g/L MCV 100 fL RBC 3.7 x1012/L WBC 3.4 x106/L Plat 117 x109/L
Which of the following would be most helpful in identifying this young man’s problem ? A. Reticulocyte count B. Osmotic fragility test C. DAT (Coomb’s test) D. Bone marrow test E. Family studies
This is an 18 year old boy who you are investigating for Jaundice. He has this intermittently for some time. His family are Christian Scientists. Physical exam shows jaundice and splenomegaly bili 35 mol/L blood film polychromasia spherocytes Test results Hgb 99 g/L MCV 100 fL RBC 3.7 x1012/L WBC 3.4 x106/L Plat 117 x109/L
A 46 year old diplomat is referred to you because of abnormal blood results. On review of these you suspect the cause and order appropriate blood tests. Test results Hgb 142 g/L MCV 105 fL RBC 4.9 x1012/L WBC 6.7 x106/L Plat 105 x109/L Blood Film
What tests would you order on receiving these results ? A. Serum B12 and folate B. Bone marrow aspirate C. Serum lipid studies D. Liver function tests E. Thyroid function tests
A 46 year old diplomat is referred to you because of abnormal blood results. On review of these you suspect the cause and order appropriate blood tests. Test results Hgb 142 g/L MCV 105 fL RBC 4.9 x1012/L WBC 6.7 x106/L Plat 105 x109/L Blood Film Macrocytosis Target cells stomatocytes
A 65 year old woman is referred to you because of memory loss. Her family physician had received tests which included bilirubin of 28 mol/L and an LDH of 1560 U/L. He was puzzled by these results. Test results Hgb 85 g/L MCV 110 fL RBC 3.9 x1012/L WBC 2.4 x106/L Plat 89 x109/L Blood Film
Which one of the following tests is most appropriate ? A. Liver function B. Thyroid function C. RBC folate D. Serum B12 E. Bone marrow aspirate
A 65 year old woman is referred to you because of memory loss. Her family physician had received tests which included bilirubin of 28 mol/L and an LDH of 1560 U/L. He was puzzled by these results. Test results Hgb 85 g/L MCV 110 fL RBC 3.9 x1012/L WBC 2.4 x106/L Plat 89 x109/L Blood Film Macrocytosis oval macroytes hypersegmented neutrophils
A 65 year old woman complains of back pain. Her X-rays show diffuse osteoporosis. She also complains of increased thirst and drowsiness. Test results Hgb 103 g/L MCV 99 fL RBC 3.8 x1012/L WBC 3.4 x106/L Plat 125 x109/L Blood Film
Which one of these tests would most likely lead to the diagnosis ? A. Serum osmolarity B. Serum viscosity C. Serum protein electrophersis D. Serum TSH E. Serum PTH
A 65 year old woman complains of back pain. Her X-rays show diffuse osteoporosis. She also complains of increased thirst and drowsiness. Test results Hgb 103 g/L MCV 99 fL RBC 3.8 x1012/L WBC 3.4 x106/L Plat 125 x109/L Blood Film rouleaux background staining
You admit a 36 year old woman with pneumonia. She has fever, shortness of breath and requires oxygen. She is also noted to be anemic. Test results Hgb 115 g/L MCV 115 fL RBC 2.2 x1012/L WBC 8.4 x106/L Plat 246 x109/L Blood Film
These test results would help you choose which one of these antibiotics ? A. Cephalexin B. Penicillin G C. Erythromycin D. Sulfamethoxazole E. Ciprofloxacin
You admit a 36 year old woman with pneumonia. She has fever, shortness of breath and requires oxygen. She is also noted to be anemic. Test results Hgb 115 g/L MCV 115 fL RBC 2.2 x1012/L WBC 8.4 x106/L Plat 246 x109/L Blood Film RBC agglutination
An 18 year old woman has symptoms of cystitis. After urine cultures are taken she is given Sulfamethoxazole. Her urinary symptoms improve but she becomes short of breath. A week later on follow-up her investigation shows. Test results Hgb 75 g/L MCV 107fL RBC 2.8 x1012/L WBC 8.9 x106/L Plat 377 x109/L Blood Film
What type of anemia is causing this problem ? A. An idiosyncratic drug reaction B. An allergic drug reaction C. Marrow suppressive effect D. Immune hemolysis E. Oxidative hemolysis
An 18 year old woman has symptoms of cystitis. After urine cultures are taken she is given Sulfamethoxazole. Her urinary symptoms improve but she becomes short of breath. A week later on follow-up her investigation shows. Test results Hgb 75 g/L MCV 107fL RBC 2.8 x1012/L WBC 8.9 x106/L Plat 377 x109/L Blood Film ploychromasia blister bite cells
You are called to see this 29 year old primip in the case room. The obstetrician is concerned about her platelet count. She is well but a bit hypertensive. Test results Hgb 115 g/L MCV 91 fL RBC 4.1 x1012/L WBC 14.5 x106/L Plat 52 x109/L Blood Film
What diagnosis is most likely ? A. ITP ( immune thrombocytopenia ) B. TTP ( thrombotic thrombocytopenic purpura) C. PIH (pre-eclampsia) D. Benign thrombocytopenia of pregnancy E. DIC (disseminated intravascular coagopathy)
You are called to see this 29 year old primip in the case room. The obstetrician is concerned about her platelet count. She is well but a bit hypertensive. Test results Hgb 115 g/L MCV 91 fL RBC 4.1 x1012/L WBC 14.5 x106/L Plat 52 x109/L Blood Film polychromasia rbc fragments thrombocytopenia
This 35 year old man is sent to you because of unusual blood results. His complaints are of fatigue and an episodic itchy rash. Test results Hgb 115 g/L MCV 105 fL RBC 3.8 x1012/L WBC 9.2 x106/L Plat 420 x109/L Blood Film
What condition do you think is responsible for these results ? A. Pernicious anemia B. Sickle cell anemia C. Hyposplenism D. Leaky prosthetic valve E. Liver cirrhosis
This 35 year old man is sent to you because of unusual blood results. His complaints are of fatigue and an episodic itchy rash. Test results Hgb 115 g/L MCV 105 fL RBC 3.8 x1012/L WBC 9.2 x106/L Plat 420 x109/L Blood Film targets acanthocytes fragments howell jolly bodies
What is the most likely cause ? A. Blind loop syndrome B. Coeliac disease C. Ulcerative colitis D. Crohn’s disease E. Wilson’s disease
You are asked to asses a 72 year old woman for anemia and splenomegaly. She has been losing weight for 1 year. She has had 2 episodes of gout. Test results Hgb 99 g/L MCV 96 fl RBC 3.4 x1012/L WBC 3.65 x106/L Plat 560 x109/L Blood Film
What test would give a definitive diagnosis ? A. LAP score B. Osmotic fragility C. Hgb electropheresis D. Bone scan E. Bone marrow biopsy
You are asked to asses a 72 year old woman for anemia and splenomegaly. She has been losing weight for 1 year. She has had 2 episodes of gout. Test results Hgb 99 g/L MCV 96 fl RBC 3.4 x1012/L WBC 3.65 x106/L Plat 560 x109/L Blood Film thromboytosis tear drop cells leukoerythroblstic
This 24 year old man has acute abdominal pain. He has not been feeling well for 5 days. After a baseball game he had acute upper abdominal pain and was quite tender in the upper abdomen. The surgeon asks you to see the patient. Test results Hgb 136 g/L MCV 88 fL RBC 4.9 x1012/L WBC 17.3 x106/L Plat 110 x109/L Blood Film
What is the disorder most likely responsible for his condition ? A. Acute leukemia B. Pancreatitis C. Malaria D. Infectious mononucleosis E. Liver abcess
This 24 year old man has acute abdominal pain. He has not been feeling well for 5 days. After a baseball game he had acute upper abdominal pain and was quite tender in the upper abdomen. The surgeon asks you to see the patient. Test results Hgb 136 g/L MCV 88 fL RBC 4.9 x1012/L WBC 17.3 x106/L Plat 110 x109/L Blood Film variant lymphocytes atypical reactive
This 55 year old man is referred for unexplained elevated White cell count. He feels well. Examination is normal. Test results Hgb 139 g/L MCV 93 fL RBC 5.1 x1012/L WBC 29 x106/L Plat 178 x109/L Blood Film
What test would confirm your diagnosis ? A. Mono spot test B. LAP score C. Bone marrow biopsy D. Immunophenotyping E. Skeletal survey
This 55 year old man is referred for unexplained elevated White cell count. He feels well. Examination is normal. Test results Hgb 139 g/L MCV 93 fL RBC 5.1 x1012/L WBC 29 x106/L Plat 178 x109/L Blood Film Lymphocytosis Smudge cells
This 36 year old man is admitted to hospital with generalized bruising and bleeding. He is febrile. There are many bruises and petichia present. Test results Hgb 92 g/L MCV 81 fL RBC 3.4 x1012/L WBC 5.2 x106/L Plat 13 x109/L Blood Film
What disease is most responsible for his condition ? A. Septicemia B. Drug reaction C. Infectious mononucleosis D. Chronic leukemia E. Acute leukemia
This 36 year old man is admitted to hospital with generalized bruising and bleeding. He is febrile. There are many bruises and petichia present. Test results Hgb 92 g/L MCV 81 fL RBC 3.4 x1012/L WBC 5.2 x106/L Plat 13 x109/L Blood Film Cytopenias Blasts
This is a 65 year old male who at retirement has his last regular work medical checkup. He is a bit fatigued but otherwise well. Test Results Hgb 11.0 g/L MCV 92 fL RBC 4.3x1012/L WBC 5.2x106/L Plat 565x109/L Blood film
What test would best establish the diagnosis ? A. Serum iron and iron binding capacity B. Serum B12 C. Urine hemosiderin D. Bone marrow aspirate E. Serum transferrin
This is a 65 year old male who at retirement has his last regular work medical checkup. He is a bit fatigued but otherwise well. Test Results Hgb 11.0 g/L MCV 92 fL RBC 4.3x1012/L WBC 5.2x106/L Plat 565x109/L Blood film Normocytic Normochromic Microcytic Hypochromic Dimorphic population
This is a 35 year old male who is found to have persistent leukocytosis. His family physician wants you to rule out a Chronic leukemia. Test Results HGB 146 g/L MCV 92 fL RBC 5.5x1012/L WBC 25X106/L Plat 465x109/L Blood Film
What test would be most cost effective in helping to establish a diagnosis ? A. Immunophenotyping B. Leukocyte alkaline phosphatase C. Bone marrow aspirate D. Cytogenetics E. Blood cultures
This is a 35 year old male who is found to have persistent leukocytosis. His family physician wants you to rule out a Chronic leukemia. Test Results HGB 146 g/L MCV 92 fL RBC 5.5x1012/L WBC 25X106/L Plat 465x109/L Blood Film Normocytic Normochromic Neutrophilia Metamyelocyte
A 75 year old woman is admitted to hospital because of pneumonia A 75 year old woman is admitted to hospital because of pneumonia. She has not been feeling well for some months. Test Results HGB 96 g/L MCV 103 fL RBC 3.8x1012/L WBC 2.4x106/L Plat 74x109/L Blood Film
A 75 year old woman is admitted to hospital because of pneumonia A 75 year old woman is admitted to hospital because of pneumonia. She has not been feeling well for some months. Test Results HGB 96 g/L MCV 103 fL RBC 3.8x1012/L WBC 2.4x106/L Plat 74x109/L Blood Film Macrocytes Mild pancytopenia
Which test would you do next ? A. Reticulocyte count B. Serum B12 and Folate C. Thyroid function tests D. Liver function tests E. Bone marrow aspirate and biopsy
Which do you think is the most likely ? A. RA - Refractory anemia B. RARS - Refractory anemia , ring sideroblasts C. RAEB - Refractory anemia excess blasts D. RAEBt - RAEB in transformation to Acute
A 25 year old female university student is found to have a very low hemoglobin. She in fact feels fairly well. Physical exam shows pallor only. Test Results HGB 7.1 g/L MCV 80 fL RBC 2.7x1012/L WBC 6.3x106/L Plat 345x109/L Blood Film
Which test do you think will give the diagnosis ? A. Iron studies B. Reticulocyte count C. Endocrine studies D. Liver function E. Renal function
A 25 year old female university student is found to have a very low hemoglobin. She in fact feels fairly well. Physical exam shows pallor only. Test Results HGB 7.1 g/L MCV 80 fL RBC 2.7x1012/L WBC 6.3x106/L Plat 345x109/L Blood Film Irreg contracted Burr cells