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Haematology exam for FCPS part 1 with Dr Sohrab
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Haematology exam for FCPS part 1 with Dr Sohrab
Haematology and oncology exam for FCPS part 1 with Dr Sohrab
1
Personal infomations
2
True and false
3
multiple choice
Name
*
Phone number
*
Email
Haemopoetic stem cells -- a) 0.1% of bone marrow b) Can form non-haematological cells c) Proliferate to produce cells of different line age d) Influenced by growth factors from and outside bone marrow e) Primitive progenitor cells can be identified morphologically
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
Warfarin action potentiated by which drugs? a) Indomethacin b) Miconazole c) Phenytoin d) Phenylbutazone e) Metronidazole
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
A patient came to you with MCV 65% MCHC 23%, Hb-8 g/dL, which are the C/F you found - a) Gum bleeding b) Anaemia c) Koilonychia d) Jaundice e) Lymphadenopathy
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
A female of 20 years patient in OPD 2 month history lethargy. CBC shows: Hb 8.2 g/l, RDW-13%, OMCHC: 30. Which clinical features will you search? a) Glossitis b) Kolionychia c) Smooth tongue d) Gum bleeding e) Lymphadenopathy
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
Fragmented RBC found in a) Post splenectomy b) HUS c) TTP d) MAHA e) Liver failure
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
O₂ hemoglobin dissociation curve shift to the right a) ↑ H⁺ b) High pH c) ↑ PCO₂ d) ↑ Temperature e) ↑ 12,3 PPG
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
Patient came to you with polycythaemla rubra vera feature, which are the clinical features-- a) Thrombosis b) Hypertension c) Thrombophilia d) Extensive pruritus with hyperpigmentation e) Itching during bath
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
Confirmatory test for acute myeloid leukemia a) CBC b) Flow cytometry c) Bone marrow morphology d) B Trephine biopsy e) ESR
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
Erythropoietin levels are increased in - a) High altitude b) Anemia c) Renal cell carcinoma d) Asthma e) Hypertension
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
Bleeding time is increased in -- a) Von Will brand disease b) Christmas disease c) Hemophilia d) Thrombocytopenia e) Warfarin use
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
Erythropoietin levels are increased in -- a) High altitude b) Anaemia c) Renal cell carcinoma d) Asthma e) Hypertention
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
Hereditary Spherocytosis - a) AD disorder b) Always associated with anemia c) Old aged patient affected. d) Increased Reticulocyte e) Howell-Jolly Body
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
During treatment of CKD with injection erythropoietin, which of the following side effect may occur-- a) Hypertension b) Hypotension c) Thromboembolism d) Diarrhea e) Hirsutism
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
Immune thrombocytopenic purpura (ITP) is characterized by - a) Splenomegaly b) Anemia c) Shortened lifespan of platelets d) Decreased megakaryocytes in the bone marrow e) Increased level of anti-platelet antibodies
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
Bleeding & clotting time both are affected in a) DIC b) Hemophilia A c) VWD d) Christmas disease e) Liver disease
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
Nocturnal Hemoglobinuria may be found in a) Multiple sclerosis b) CML c) Aplastic anemia d) Pernicious anemia e) Haemoglobinopathies
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
A football player faced vigorous injury to the spleen in the field. Doctor suggests for splenectomy. He should take vaccine against - a) H. influenza b) Salmonella c) N. gonorrkea d) Pneumococcus e) Staph. Aureus
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
Pernicious anaemia associated with autoimmune chronic gastritis a) Macrocytic anaemia b) Glossitis c) Cheilosis d) Oesophageal web e) Adenocarcinoma
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
Plasma ferritin decrease in a) Liver disease 'b) IDA c) Vitamin C Deficiency d) Hypothyroidism e) Alkalosis
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
Thalassemia [FCPS-Medicine-January-2009] Ca) Microcytic anemia b) Peptides are normal in structure c) Globin gene defective d) Polymerize in low O, tension e) Iron therapy is indicated
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
In megaloblastic anemia: : a) LDH increased b) MCHC decreased c) MCH increased d) PCV increased e) Ferritin decreased
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
What are the primary anti-phospholipid syndrome - a) Atrial thromboembolic disease b) Recurrent pregnancy failure c) Behcet's syndrome d) Temporal arteritis e) Sterile endocarditis
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
Dissolution of fibrin clot by a) Streptokinase b) Urokinase с) Нерarin d) Fibrinolysin e) Factor IX complex
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
Hypo-plastic bone marrow is found in a) Rifampicin b) Methotrexate c) Insecticide d) Vit B12 deficiency e) Pregnancy
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
A 54-year-old man comes to the haematology clinic for review. He has recently been diagnosed with hairy cell leukaemia. Which of the following fits best with the diagnosis?
An activating BRAF mutation is implicated
CD103 expression rules out the condition
Cells lack expression of CD20
Cells always express CD5
Hypocellularity is most likely on bone marrow examination
A 16-year-old young man with sickle cell anaemia is admitted with recent breathlessness. He is febrile and has a clear chest with saturations of 98% on air. From his outpatient notes his usual Hb is 90 g/l. FBC taken in the Emergency Department shows WCC 8.6 × 103 /mm3 , Hb 47 g/l, platelets 573 × 103 /mm3 with a bilirubin 25 mmol/l. Which investigation is the most useful to perform next to identify the most likely underlying cause of this drop in heamoglobin levels?
Chest X-ray
Parvovirus serology
Reticulocyte count
Serum haptoglobin
Urinary haemosiderin
A 38-year-old patient is being investigated for his anaemia. He has had a normal upper and lower GI endoscopy and renal function testing is unremarkable. A bone marrow biopsy shows a reduction of haematopoietic cells and a trephine biopsy shows mainly fatty bone marrow. Which one of the following is the most likely diagnosis?
Aplastic anaemia
Chronic myeloid leukaemia
Erythropoietin deficiency
Folate deficiency
Vitamin B12 deficiency
A 65-year-old patient has noticed worsening tiredness, weight loss and shortness of breath over the last 6 months. Lymphadenopathy and splenomegaly are present. His peripheral lymphocyte count is 60 × 109 /l ((1.0–3.0) × 109 /l). Which one of the following is the most appropriate next step in obtaining the diagnosis?
Abdominal ultrasound
Blood smear examination with immunophenotyping
Bone marrow biopsy
CT abdomen
Lymph node biopsy
A 57-year-old woman is referred to you as an emergency with severe nose bleeds and skin petechiae. You suspect she has thrombocytopenia. She is currently receiving second-line carboplatin-based chemotherapy for a relapsed ovarian carcinoma. There is no organomegaly. Which one of the following is the most likely cause of the thrombocytopenia?
Carcinomatosis
Disseminated intravascular coagulation
Myelofibrosis
Myelosuppression
Secondary leukaemia
Which one of the following is the MOST common cause of aplastic crisis in a patient with sickle cell disease?
Dehydration
Respiratory syncytial virus infection
Human parvovirus B19 infection
Repeated blood transfusion
Repeated blood transfusion
A 35-year-old woman had a bone marrow transplant, for acute myeloid leukaemia in second remission, 14 days ago from her HLA-identical sibling. She has been pyretic for the last 3 days and is on second-line antibiotics. Nothing has been grown in blood cultures. Over the last 48 hours she has developed tenderness in the right hypochondrium, jaundice and has gained 6 kg in weight. Her liver function tests have been deteriorating and are now AST 205 U/l, ALT 134 U/l, ALP 95 U/l, bilirubin 184 µmol/l, LDH 850 U/l. Which one of the following is the most likely cause of her hepatic dysfunction?
Acute graft-versus-host disease
Ciclosporin toxicity
Invasive aspergillosis
Infectious hepatitis
Veno-occlusive disease
A 58-year-old Greek man is found to have a microcytic anaemia on routine screening at his general practitioner. Red cells have low mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH). Serum ferritin is normal. Which one of the following would be the next management step?
Barium enema
Haemoglobin electrophoresis
Iron therapy
Labelled red-cell scan
Upper and/or lower endoscopy
A 40-year-old patient has been complaining of headache, weakness, dizziness and pruritus for the last 2 months. He has also noticed a 2-stone (12.7 kg) weight loss. Gout was diagnosed some 6 months earlier. On examination he is cyanosed, has hepatosplenomegaly and his blood pressure is 170/100 mmHg. Which one of the following is the most likely diagnosis?
Acute myeloblastic leukaemia
Chronic lymphocytic leukaemia
Chronic myeloid leukaemia
Myeloma
Polycythaemia vera
A 38-year-old man presents to the Emergency Department with rapidly worsening shortness of breath, extreme lethargy and jaundice. He has recently begun a course of primaquine prior to travelling to the Far East for a holiday. On examination he looks pale and jaundiced, his BP is 110/60 mmHg, pulse is 95/min and regular. There are bilateral crackles on auscultation of the chest. Which of the following would you expect to see on examination of the blood film?
Heinz bodies
Inclusion bodies
Lewy bodies
Promyelocytes
Spindle cells
A 55-year-old woman presents with palpable lymphadenopathy in the left supraclavicular fossa (Troisier’s sign). Which primary tumour site is typically associated with this clinical sign?
Kidney
Lung
Prostate
Stomach
Uterus
A 62-year-old woman with breast cancer underwent a left modified radical mastectomy for an intraductal carcinoma 2 years ago. She now presents to the Emergency Department with confusion, lethargy and thigh pain. X-ray reveals a sclerotic lesion in the shaft of a femur. Which one of the following is the most likely blood abnormality?
Calcium decreased
Calcium increased
Glucose increased
Potassium decreased
Potassium increased
You review a 67-year-old man who has suffered from severe weight loss over the past few weeks. He also has epigastric pain that radiates to his back. On examination he is jaundiced and you wonder about a mass in the epigastrium. Your laboratory is able to check his tumour marker status, and you find a raised CA-19- 9 result. Which one of the following is the most likely source of his cancer?
Colon
Liver
Lung
Pancreas
Stomach
A 46-year-old patient has been referred because of pyrexia of unknown origin. He has had pyrexia for the last month interrupted by short afebrile episodes. Blood cultures and an infection screen were both negative. On examination his temperature is 38°C and he has palpable, non-tender neck lymph nodes. Which one of the following is the most important step in obtaining the diagnosis?
Blood cultures
Bone marrow biopsy
C-reactive protein
Erythrocyte sedimentation rate
Lymph node biopsy
A 54-year-old male presents to his GP with jaundice and is found to have a painless enlargement of the gallbladder (Courvoisier’s law). Which one of the following is the most likely diagnosis?
Carcinoma of the ampulla of Vater
Carcinoma of the gallbladder
Gallstones in the cystic duct
Liver cirrhosis
Progressive hepatitis B
Serum tumour markers are frequently utilised in the management of cancer patients. The determination of the carcinoembryonic antigen (CEA) in patients with carcinoma of the colon is most useful for which one of the following?
As a parameter for operability
As a screening method
For postoperative surveillance
For staging
The detection of an early stage tumour
What are the tumour cells called that are found in patients with Hodgkin’s disease?
Philadelphia cells
Cytotoxic lymphocytes
Reed–Sternberg cells
Activated lymphocytes
Langerhans’ cells
A 40-year-old woman is worried about her risk of bowel cancer. Her father and two of her brothers all died from colorectal cancer in their 40s and 50s. Which other cancer would you specifically ask about in female relatives?
Breast cancer
Cervical cancer
Endometrial cancer
Lung cancer
Vulval cancer
A 56-year-old Asian woman presents with weight loss, lethargy and night sweats. Her investigations show progressive kidney disease and 2.1 g/day of proteinuria. A renal biopsy shows glomerular and vascular deposition of a pink amorphous material, which shows apple-green birefringence under polarised light after Congo red staining. The deposits are positive for lambda light chains. Which one of the following diseases is she most likely to have?
Rheumatoid arthritis
Tuberculosis
Systemic lupus erythematosus
Multiple myeloma
Secondary amyloidosis
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is most commonly associated with which tumour type?
Bronchial carcinoid tumour
Pancreatic cancer
Prostate cancer
Small-cell carcinoma of the lung
Squamous-cell carcinoma of the lung
Intravascular haemolysis is most indicated by--
Reduced haptoglobin
Urinary haemosiderin
Haemaglobinuria
Schums test
Raised methamoglobin
Patient is fatigue and lethargic for a longer period of time. Which is the choice of Investigation?
Hb%
PT (Prothrombin time)
Serum Phospholipase
Thyroid function test
Anti HIV antibody
A patient came to you with aplastic anemia. Which clinical feature is not associated?
Jaundice
Gum bleeding
Fever
Bony tendermess
Generalized lymphadenopathy
Most important findings of B-thalassemia trait -
НЬ А2
HBF
НВА1
Bart
HbG
A 60 years old lady with RA is presented with anemia for 6 months. What is the most important investigation to confirm her iron deficiency anemia?
Serum ferritin
Serum iron
TIBC
Soluble transferrin receptor
Percentage saturation
Patient lethargic, fatigue, which one is not associated with Aplastic anemia-
Generalized lymphadenopathy
Body tenderness
Kolioychia
Anemia with jaundice
Gum bleeding