Pathology EMQ template.

Name: Tanya Indrakumar

Candidate number: 00408490

Theme: Haemolytic anaemia

OPTION LIST

A	ABO incompatible blood haemolytic transfusion reaction	I	Paroxysmal nocturnal haemoglobinuria
B	Allergic reaction	J	Pyruvate kinase deficiency
C	Cold autoimmune haemolytic anaemia	K	Sickle cell anaemia
D	Drug induced haemolytic anaemia	L	Thalassaemia
E	Febrile non-haemolytic transfusion reaction	M	Warm autoimmune haemolytic anaemia
F	Glucose-6-phosphate dehydrogenase deficiency	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 West-African male develops jaundice and severe anaemia. He has taken ciprofloxacin for a chest infection. A reticulocyte preparation shows the presence of Heinz bodies.

2. A 60 year old male feels a ‘sense of doom’ on the ward 2 hours after an appendectomy in which he lost a lot of blood. He is short of breath, with a headache and a progressively falling BP.

3. A teenage girl presents with jaundice on Christmas day. She has a purplish skin discolouration on the tips of her fingers and toes. The Coombs’ test reveals complement only on the red cell surface.

4. A middle-aged English man presents with jaundice and anaemia. He recalls his father had to have his spleen removed. Coombs’ test is normal. Osmotic fragility is increased.

5. A 45 year old man is tired all the time. He has red urine and intermittent abdominal pain. Coombs’ test is negative. Ham’s test shows the red cells are sensitive to lysis by complement.

ANSWERS

1. F

2. A

3. C

4. G

5. I