Pathology EMQ template.

Name: Sarah Grover

Theme: Haemolytic Anaemias

 

OPTION LIST

 

A	Blood transfusion reaction	I	Haemolytic Uraemic Syndrome
B	β-thalassaemia	J	Paroxysmal Nocturnal Haemoglobinuria
C	CLL Induced Autoimmune Haemolytic Anaemia	K	Sickle Cell Disease
D	DIC	L
E	G6PD Deficiency	M
F	Hereditary Elliptocytosis	N
G	Hereditary Spherocytosis	O
H	Malaria	P

 

 

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

 

1.  A 15-year old Afro-Caribbean girl presents to A&E with bone pain and shortness of breath. Her oxygen saturation is 87% on air. The FBC reveals: haemoglobin 6.1g/dl, MCV 121, platelets 199 x 10⁹/L.

 

 

2. A 3-day old boy presents with jaundice and a high fever. Blood film shows presence of Heinz bodies. The mother reports that his brother had similar problems when he was born.

 

 

3. A 5-year old Cypriot boy presents to the outpatient department with severe anaemia. On examination he is anaemic and has frontal and parietal bossing of the skull. You also find a palpable lower liver edge and enlarged spleen.

 

 

4.  A 19-year old Danish man presents to his GP complaining of yellowing of his skin, saying it has been getting worse for 3 days. On examination, you note conjunctival pallor and splenomegaly. The osmotic fragility test is strongly positive and the Coomb’s test is negative.

 

 

5. A 57-year old woman returns from Nigeria to attend her niece’s wedding in Oxford. She complains of a headache and her nephew, a local GP, notes that she has a swinging fever. As he is calling for an ambulance she starts to vomit.

 

 

 

ANSWERS

1. K

2. E

3. B

4. G

5. H