Pathology EMQ

Name: Jennifer Hart

Candidate number: 00394979

Theme: Haemolytic Anaemias

OPTION LIST

A	Alpha Thalassaemia	I	Sickle Cell Disease
B	Beta Thalassaemia	J	Warm Autoimmune Haemolytic Anaemia
C	Cold Autoimmune Haemolytic Anaemia	K
D	G6PD Deficiency	L
E	Hereditary elliptocytosis	M
F	Hereditary spherocytosis	N
G	Malaria	O
H	Pyruvate Kinase Deficiency	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 20 year old Asian male currently taking Ofloxacin for a UTI presents with mild scleral icterus. Full Blood Count yields an Hb of 9.6 g/dl, with irregularly contracted cells and ghost cells seen on peripheral blood film.

2. A 44 year old Afro-Caribbean female presents with lethargy and splenomegaly. Upon further questioning she also reveals a long history of arthritis and ‘kidney problems’. Haematological investigations reveal microspherocytes and a positive DAT.

3. A 6 month old Greek baby is rushed into A and E after falling from her high chair and being knocked unconscious. Skull X-ray shows a ‘hair on end appearance’ and prominent maxilla, but no obvious fractures. Further tests indicate an Hb of 4.1 g/dl.

4. An 18 year old Caucasian male is referred to a haematologist after his GP discovers moderate splenomegaly and an Hb of 11.5 g/dl. At the hospital a peripheral blood film is taken which shows microspheroctyes. To confirm the diagnosis a Coombs test is also performed, which proves to be negative.

5. A 24 year old Japanese male presents to Casualty with mild jaundice and RUQ pain. After a week long stay on the surgical ward a blood film is finally taken, which reveals the presence of irregularly contracted cells and acanthocytes.

ANSWERS

1. D

2.J

3. B

4. F

5. H