Beruflich Dokumente
Kultur Dokumente
What do each of the following measure? Which type of anemia show the results below?
MCV raised Macrocytic
Megaloblastic anemia B12 deficiency Folic acid deficiency
What is needed for the transport of iron in the blood? What is needed for the absorption of vit. B12?
Iron
Transferrion for transport
B12
Intrinsic factor + transcobalamin II
Menstruation Childbirth Pulmonary: haemoptysis Urinary: renal disease Rapid growth with insuffiecient Fe: premature infants, children, teenagers Pregnancy Lactation
What complication is seen in vit. B12 deficiency and not in folate deficiency?
Match the following RBC antigens with the appropriate added sugars
Antigen O A B AB
Sugar Added
What does Fresh Frozen Plasma contain? Give 3 conditions where FFP is used
Give 2 causes of Disseminated Intravascular Coagulation? What are the effects of IDC?
Hematinics
Thalassemia
B-thalassemia is cause by mutations in the genes of the affected individuals. Name one type of gene mutation that can lead to b-thalassemia.
Regarding b-thalassemia: explain why the red blood cells are hypochromatic
State 3 clinical features b-thalassemia. Explain why iron overlaod may occur in b-thalassemia patients.
Gice 2 investigations and their expected findings for patients with bthalassemia.
Deletions of the a-globin gene loci result in a-thalassemia. State the number of a-globin genes deleted in the following conditions:
Silent carrier state A-thalassemia trait HbH HbBart
True/ false
Patients with CFS suffer severe fatigue that can be reduced with sufficient rest Disturbed sleep, muscle pain, & impaired memory are among the diagnostic criteria for CFS Anti-depressant & anxiolytic agents are among the medication treatment for CFS Cognitive behavioural therapy can be used to cure patients with CFS A doctor can facilitate the treatment outcome of CFS by being empathetic to the patient and educate them about this condition
Aplastic anemia
Describe the morphology of the bone marrow in a patient with aplastic anemia
What occurs during myelodysplastic syndromes & what medical condition can it predispose to?
Hemoglobinopathies
State the pathogenesis of sickle cell anemia. Include the changes that happen to the haemoglobin and blood flow in response to low oxygen
State 6 investigations that can be carried out other than RBC smear. Include positive and negative findinds
Why homozygous sickle cell trait is more ganderous that the heterozygous cell trait?
Apart from the patient experiencing tiredness and breathlessness due to anemia, what other clinically important signs and symptoms that can be picked up?
Name ove virus that can cause aplastic crisis in sickle cell anemia
Haemopoiesis II
Name 3 chemicals that influence platelet production and elaborate on how each chemical affects platelet production
In which form are neutrophil granulocytes seen in the bone marrow and in peripheral blood
Describe the roles of thromboxane A2 and Prostacyclin in the process of platelet aggregation
What are the factors that will trigger the following pathway?
Intrinsic pathway Extrinsic pathway
Abnormalities of haemostasis
Write down the effects of Hemophilia A and von Willebrand Factor deficiency
Hemophilia A Bleeding time Platelet count Clotting time APTT Prothrombin time Von Willebrand Factor deficiency
Hemolytic Anemia
A young boy, aged 6, was admitted into the hospital for lethargy. The doctor who examined him found the patient to be slightly jaundiced and pale. Splenomegaly was also present. The following are a few of the test results:
Peripheral blood smear: microcytic, hyperchromic RBCs. Presence of spherocytes Reticulocyte count: increased Plasma bilirubin: increased Mean cell hemoglobin concentration: inceased
On further questioning, the doctor discovered that the boy s uncle and two other cousings also had the same condition. The doctor later concluded that the boy has hereditary spherocytosis
Name another important test which is used to diagnose the pathology. What would the results be if the person has such condition, and what would you say?
The following statements make up the pathogenesis of hereditary spherocytosis. Arrange them in the proper chronological order.
The cells assume the smallest possible diameter for a given volume. They become spheres Mutations in the ankyrin molecule cause a secondary deficiency of spectrin, which results in reduced membrane stability of the red blood cells The affected cells consequently lose membrane fragments as they are exposed to the sheer stresses in the blood circulation The spherocytes are later sequestered in the sleen and phagocytosed by splenic macrophages. Haemolytic anaemia occurs
In terms of treatment for hereditary spherocytosis, splenectomy is done when there is a markedly enlarged spleen, severe anemia or complications such as gall stone formation. Then why is such treatment usually delayed in patients below 5 years old?
Match the answers given to the following statements. The answers can be used more than once or none at all
A: G6PD def. B: Extravascular hemolysis C: Hereditary spherocytosis D: Paroxysmal nocturnal hemoglobinuria E: Intravascular hemolysis F: hemolytic anemia No. I Statement Only form of haemolytic anemia that results from an acquired membrane defect secondary to mutation involving the phosphatidyl inositol glycan A (PIG-A) gene which affects myeloid stem cells Asymptomatic unless RBCs are subjected to oxidant injury by exposure to certain drugs, toxins or infections Schistocytes (made up of Burr cells, Helmet cells, triangle cells, microspherocytes) seen on peripheral blood smears Heinz bodies and bite cells Only disease associated with increased mean cell hemoglobin concentration (MCHC) Desttruction of RBCs within cells of mononuclear phagocyte system (MPS) Ans.
Ii Iii Iv v vi
Both intravascular and extravascular hemolysis occur in G6PD dieficiency. List 2 differences between intravascular and extravascular hemolysis
Intravascular hemolysis Extravascular hemolysis
Why are the serum haploglobin level characteristically low in hemolytic anemia?
A 45 year old man went to a hospital yesterday after he fell down in the park while taking his dog out for a walk. When examined, his right leg was a little swollen and quite tender. The patients also noted that he gets tires easily in the last 3 months. He can no longer play badminton continuously with his friends, not swin 40 laps like he used to. He also tends to bruise easily, and suffers from excruciating bond pains. A number of investigations were carried out:
X-ray of the right leg: numerous bone lesions noted Urine test: presence of Bence-jones proteins Serum electrophoresis: M spike absent Calcium levels in serum: elevated Peripheral blood smear: Normocytic, normochromic anemia. There is rouleaux formation Bone marrow aspiration: increased numbers of plasma cells
What is your probably diagnosis? What is bence-jones proteins? Why is the M spike not present in this case?
What is the contrasting feature of a leukaemoid reaction compared with chronic myeloid leukaemia?
Regarding leukemias
The Philadelphia chromosome can be onserved in CML and ALL The poorest prognosis for patients with CLL is associated with anemia and thrombocytopenia In hairy cell leukemia, there will be pancytopenia, splenomegaly, and clonal proliferation of b lymphoid cells There will be positive tartrate resistnace and phosphate test in AML Serum vitamin b12 level measurement can be used to differentiate AML & ALL
Lymphoma
What is specific name for the true neoplastic cell seen in Hidgkin disease? Describe how it looks like
Name the 2 types of Burkitt Lymphoma and give 2 differences between them
Between hidgkins and non-hidgkins lymphoma, in which is staging a useful guide to therapy?
Myeloproliferative Disorders
characteristic of its progenitor cells may be a possible explaintation for the increased production and proliferation?
Marked increase in marrow reticulin fibers Marked splenomegaly Normochromic normocytic anemia Increased tendency towards peptic ulcers Minimal reticulin fibrils Trephine biopsy to establish the diagnsosis Alkaline phosphatase levels are above normal Tear drop cells
Vitamin K is an important co-factr in the formation of clotting factors II, VII, IX, and X. Warfarin is an anticoagulant which is very similar in structure to vit. K. Explain how warfarin functions as an anticoagulant
Malaria
Hypnozoites are dormant malaria parasites in the liver. Name one species of malaria parasite which may result in hypnozoite production
Malaria parasites may be eradicated with drugs during certain stages in their life cycles. Name 2 drugs used to treat malaria
Give 2 morphological differences between the causative agents of babesiosis and malaria
Describe the problem with developing a vaccine for dengue hemorrhagic fever
Give one preventive measure that can be taken against dengue hemorrhagic fever directed against the vector and disrupting its life cycle
State one mode of transmission of the causative agent of Rift Valley Fever
If a patient is suspected of having onchocerciasis, what would be the clinical presentations that you would expect to find in this patient? Give 3
Match the following features of disease to the correct causative disease. The diseases given can be used once, more than once or not at all.
Japanese Encephalitis Leishmaniasis Features of disease Acute inflammatory vial disease of the brain, spinal cord & meninges Also known as the sleeping sickness The anopheles mosquito is a vector Vector is the tromboculid mite Vector is the Tsettse fly Transmitted through the bite of sandflies. Causes disfiguration and ulceration of the human host Trypanosomiasis Filariasis Malaria Plague Scrub Typhus Yellow fever Disease