MCQ#01
A 9-year-old boy is brought to ER with high fever, poor appetite, and irritability. His heart rate is 140/min and his blood pressure is 80/60 mmHg. He has been hospitalized several times before for poorly localized abdominal pain. He also has a history of hematuria. The boy has not received several routine vaccinations because his mother is afraid that they will cause autism. His hematocrit is 22% and the reticulocyte count is 12%. The patient dies several hours after the admission.
This patient's death may have been prevented by:
A Folic acid supplementation
B. Vaccination with a live attenuated virus
C. Vaccination with a bacterial toxoid
D. Vaccination with a conjugate capsular polysaccharide
E. Periodic blood transfusions
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MCQ#02
A 4-month-old male infant is brought to the office by his parents due to progressive lethargy, poor feeding, fatigue and increasing pallor for the past four weeks. His antenatal and birth histories are unremarkable. His diet consists mainly of breast milk. His immunizations are up-to-date. His mother's blood type is 0 +. Physical examination reveals a webbed neck, cleft lip, shielded chest, triphalangeal thumbs, and pale mucous membranes and conjunctivae. Cardiac auscultation reveals mild tachycardia and a systolic ejection murmur over the left upper sternal border.
The initial investigations reveal the following:
Hb 8 g/dl
Ht 26 %
WBCs 7,000/cmm
Platelets 300,000 /cmm
Reticulocytes 0.4%
MCV 104 fl
Blood type A-
Bilirubin direct 0.1 mg/dl
Bilirubin total 1.0 mg/dl
What is the most likely diagnosis?
A. Wiskott-Aidrich syndrome
B. Transient erythroblastopenia of childhood
C. Fanconi's anemia
D. Diamond-Biackfan anemia
E. Rhesus incompatibility
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MCQ#03
An 8-year-old child is brought to the office for the evaluation of a 1-day history of fever and back pain. He has sickle cell disease, and has had 5 hospitalizations
for similar painful crises. His laboratory report shows normocytic anemia, reticulocytosis and leukocytosis.
What finding is most likely to be present on this patient's peripheral smear?
A. Bite cells
B. Helmet cells
C. Howell Jolly bodies
D. Heinz bodies
E. Basophilic stippling
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MCQ#04
A 7-week-old boy is brought to the clinic for the first time since discharge from the neonatal intensive care unit (NICU). The infant was born at 32 weeks gestation weighing 1800 g (4 1b) following a pregnancy complicated only by preterm labor. In the NICU, he initially had difficulty feeding. By age 6 weeks, he was taking an appropriate volume of fortified preterm formula and was gaining weight well. His parents report no problems since discharge. On examination, the infant is slightly pale. Cardiac auscultation reveals a 2/6 systolic flow murmur, but no tachycardia or gallop. Laboratory results are as follows:
Hemoglobin 7.8 g/dl
Hematocrit 24.1%
White blood cells 7,000/cmm
Platelets 230,000/cmm
Reticulocytes 0.8%
The peripheral smear shows normocytic, normochromic red blood cells.
Which of the following is the most likely diagnosis?
A. Alpha thalassemia
B. Anemia of prematurity
C. Beta thalassemia
D. Glucose 6-phosphate dehydrogenase deficiency
E. Hemolytic disease of the newborn
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MCQ#05
A 7-year-old boy is brought to the emergency department due to abdominal pain and fatigue. He developed abdominal pain, vomiting. and diarrhea a week ago. A few days later. he noticed significant blood in the diarrhea. which has since resolved. His mother believed the patient was improving until he developed diffuse abdominal pain today and "didn't want to get off the couch." Despite drinking a normal amount. he has not urinated in 24 hours. Multiple family members had similar initial gastrointestinal symptoms after attending a family cookout last week, but the mother says that everyone else has recovered. On physical examination. scleral icterus. diffuse abdominal tenderness. and 2+ pedal edema are present.
Which of the following laboratory values is most likely to be seen in this patient?
A. Decreased ferritin level
B. Decreased platelet count
C. Decreased reticulocyte count
D. Increased prothrombin time
E. Positive direct Coombs test
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MCQ#02
A 4-month-old male infant is brought to the office by his parents due to progressive lethargy, poor feeding, fatigue and increasing pallor for the past four weeks. His antenatal and birth histories are unremarkable. His diet consists mainly of breast milk. His immunizations are up-to-date. His mother's blood type is 0 +. Physical examination reveals a webbed neck, cleft lip, shielded chest, triphalangeal thumbs, and pale mucous membranes and conjunctivae. Cardiac auscultation reveals mild tachycardia and a systolic ejection murmur over the left upper sternal border.
The initial investigations reveal the following:
Hb 8 g/dl
Ht 26 %
WBCs 7,000/cmm
Platelets 300,000 /cmm
Reticulocytes 0.4%
MCV 104 fl
Blood type A-
Bilirubin direct 0.1 mg/dl
Bilirubin total 1.0 mg/dl
What is the most likely diagnosis?
A. Wiskott-Aidrich syndrome
B. Transient erythroblastopenia of childhood
C. Fanconi's anemia
D. Diamond-Biackfan anemia
E. Rhesus incompatibility
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MCQ#03
An 8-year-old child is brought to the office for the evaluation of a 1-day history of fever and back pain. He has sickle cell disease, and has had 5 hospitalizations
for similar painful crises. His laboratory report shows normocytic anemia, reticulocytosis and leukocytosis.
What finding is most likely to be present on this patient's peripheral smear?
A. Bite cells
B. Helmet cells
C. Howell Jolly bodies
D. Heinz bodies
E. Basophilic stippling
FOR CORRECT OPTION, PLEASE CLICK HERE
MCQ#04
A 7-week-old boy is brought to the clinic for the first time since discharge from the neonatal intensive care unit (NICU). The infant was born at 32 weeks gestation weighing 1800 g (4 1b) following a pregnancy complicated only by preterm labor. In the NICU, he initially had difficulty feeding. By age 6 weeks, he was taking an appropriate volume of fortified preterm formula and was gaining weight well. His parents report no problems since discharge. On examination, the infant is slightly pale. Cardiac auscultation reveals a 2/6 systolic flow murmur, but no tachycardia or gallop. Laboratory results are as follows:
Hemoglobin 7.8 g/dl
Hematocrit 24.1%
White blood cells 7,000/cmm
Platelets 230,000/cmm
Reticulocytes 0.8%
The peripheral smear shows normocytic, normochromic red blood cells.
Which of the following is the most likely diagnosis?
A. Alpha thalassemia
B. Anemia of prematurity
C. Beta thalassemia
D. Glucose 6-phosphate dehydrogenase deficiency
E. Hemolytic disease of the newborn
FOR CORRECT OPTION, PLEASE CLICK HERE
MCQ#05
A 7-year-old boy is brought to the emergency department due to abdominal pain and fatigue. He developed abdominal pain, vomiting. and diarrhea a week ago. A few days later. he noticed significant blood in the diarrhea. which has since resolved. His mother believed the patient was improving until he developed diffuse abdominal pain today and "didn't want to get off the couch." Despite drinking a normal amount. he has not urinated in 24 hours. Multiple family members had similar initial gastrointestinal symptoms after attending a family cookout last week, but the mother says that everyone else has recovered. On physical examination. scleral icterus. diffuse abdominal tenderness. and 2+ pedal edema are present.
Which of the following laboratory values is most likely to be seen in this patient?
A. Decreased ferritin level
B. Decreased platelet count
C. Decreased reticulocyte count
D. Increased prothrombin time
E. Positive direct Coombs test
FOR CORRECT OPTION, PLEASE CLICK HERE
Thank you sir, very useful
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