Benign Hematology: RBC Disorders

Week 1: 6/05/18 Q1.The following test is recommended for mass screening of beta thalassemia due to its low cost and simplicity. Not True about the following test is:-

NESTROFT HEMATOLOGY INDIA

  1. NESTROFT
  2. The test result shown here is positive
  3. Based on decreased red cell osmotic fragility
  4. The test result shown here is negative

Q2.What next test will you order in a case with above findings?

  1. Complete osmotic fragility test
  2. Hemoglobin electrophoresis

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Week 2: 13/05/18 Patient recovering from an febrile illness, presents with pallor, mild icterus and increased serum LDH. Have a look at hemogram output of this patient.

image challange 2 Picture1

Which of the following is likely diagnosis in this case ?

  1. Microangiopathic Hemolytic anemia
  2. G-6-P-D deficiency
  3. Autoimmune Hemolytic Anemia
  4. Hereditary Spehrocytosis

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Week 3: 20/05/2018: Q3A. A 13-year-old girl presented with transfusion dependent normocytic anemia with moderate splenomegaly, mild icterus, cholelithiasis and features s/o hemochromatosis. Peripheral blood smear features include anisocytosis, poikilocytosis, basophilic stippling, and some irregularly contracted cells. The bone marrow aspirate image is given below. The karyotype from bone marrow aspirate sample was normal. Which of the following is true about diagnosis ?

  1. BMA reveals marked erythroid hyperplasia with megaloblastosis
  2. Lysis of the patient’s red cells can be documented by own serum
  3. SDS-PAGE of red cell membrane proteins can be of help in diagnosis
  4. RBCs show very high agglutinability by anti-p sera

Q3B:- Which of the following electron microscopy image would be consistent with your diagnosis ?

Q3C:-Optimal Management of this child would include. 

  1. Splenectomy
  2. Iron chelation
  3. Genetic counselling
  4. All of these

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01/07/2018: Author Ekta Jajodia

Q4A. Image 1 represents PBS of a 10 days old African baby presenting with severe anemia and hyberbilirubinemia . Coombs test is negative -ve.

Q4B. Image 2 represents PBS of the same child at 7 months of age; No anemia and no increase in bilirubin. What is diagnosis??

Options Are

  1. South Asian ovalocytosis
  2. Hereditary pyropoikilocytosis
  3. Infantile poikilocytosis
  4. Rh deficiency syndrome

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07/07/2018: Author Ekta Jajodia

Q5. Case Scenario: 47/M complains of chronic thrombocytopenia (80 × 109/L), was treated for ITP without any response. O/E: Splenomegaly and xanthomas on the extensor surface of hands
Lab Investigations: Hb 12gm%, Indirect bilirubin 3 mg/dl, Retic 4% Cholesterol: increased.

Image above shows xanthomas on the extensor surface of hands. The image below shows peripheral smear from same patient. What is your diagnosis??

 

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