Keys:

• Key word of the Question

• Key word of the Answer

• Case Scenario

• Some Helpful Notes

Question No. 1

• Regarding red cell indices:

• Measurement of the amount of HB concentration per RBC is expressed by?

• ANSWER — MCHC test.

Question No. 2

• Bone marrow examination of aplastic anemia show?

• ANSWER — Loss of hematopoietic stem cells and replaced by fat cells.

Question No. 3

• Site of Vitamin B12 absorption?

• ANSWER — Ileum.

Question No. 4

• Test for pernicious anemia?

• ANSWER — Anti-parietal cell antibodies & anti-intrinsic factor antibodies.

Question No. 5

• HbF, characterized by?

• ANSWER — 2 alpha, 2 gamma.

• Feature of AML:

• ANSWER — Splenomegaly.

Question No. 7

• B-ALL indication for allogenic stem cell transplantation:

• ANSWER — BCA-ABL gene positive (t9;22).

Question No. 8

• AML prognostic factor:

• ANSWER — Cytogenetics, >60 yr. WBCs >100x10, FLT3 mutation positive,

Secondary AML.

• NOTE — One of them will be in the choices.

Question No. 9

• Accelerated phase of CML?

• ANSWER —

• From lecture —

1. Signs and Symptoms — Worsening B-symptoms. Bleeding. Infections. Progressive

splenomegaly. Refractory leucocytosis, thrombocytosis.

2. Blasts PB and/or BM — 10-19%.

3. Basophils — ≥ 20%.

4. Karyotypes — Second Ph chromosome.

Question No. 10

• Hodgkin lymphoma present with?

• ANSWER — CD15, CD30.

• Difference between hemophilia A and B?

• ANSWER —

Question No. 12

• Factor V Leiden mutation is hereditary thrombophilia due to?

• ANSWER — Protein C can’t cleave FVL.

Question No. 13

• Study of a thrombophilic state is appropriate when the patient has had one of the

following EXCEPT:

A. Idiopathic DVT and is younger than 50.

B. A family history of thrombosis.

C. Recurrent DVT

D. Pregnant woman.

E. Thrombosis in unusual sites

• NOTE —

Question No. 14

• Warfarin monitored by:

• ANSWER — INR.

Question No. 15

• Normocytic anemia?

• ANSWER — Sickle cells disease.

• Short term complications of DVT:

• ANSWER —

Question No. 17

• Tumor lysis syndrome?

• ANSWER — Hyperkalemia, hypocalcaemia, hyperphosphatemia.

Question No. 18 *

• TTT of DLBCL:

• ANSWER —

Question No. 19 *

• Splenomegaly syndrome?? (Not complete question)

• ANSWER —

Question No. 20 *

• Investigation results of DIC:

• ANSWER —

Question No. 21 *

• Best prognosis of ALI?

• ANSWER —

Question No. 22 *

• Which medication cause neutrophilia?

• ANSWER —
Question No. 23 *

• Symptom of CML?

• ANSWER —

Question No. 24 *

• Which of the following suggests Intravascular hemolysis?

• ANSWER —

Question No. 25 *

• Finding of megaloblastic anemia?

• ANSWER —

Question No. 26

• Hepato-splenectomy occurs in:

• ANSWER — Sickle cell anemia.

Question No. 27 *

• Most common cause of acute limb ischaemia in our locality:

• ANSWER —

Question No. 28 *

• Direct Coombs test positive for IgG the first line treatment is:

• ANSWER —

Question No. 29 *

• Best management Aplastic anemia?

• ANSWER —
Question No. 30 *

• Best treatment for IDA? (iron deficiency anaemia)

• ANSWER —

Question No. 31 *

• Management of Dynamically unstable pulmonary embolism?

• ANSWER —

Question No. 32 *

• Philadelphia chromosome number?

• ANSWER —

Question No. 33 *

• All of the following are characters of primary Raynaud disease EXCEPT:

• ANSWER —

Question No. 34 *

• In sickle cell anemia the B globin chain gene formed by substitution of .... for......

in position

• ANSWER —

Question No. 35

• Investigations required multiple myeloma:

• ANSWER — CBC , renal function , protein electrophoresis.

• Most common Plasmodium in Egypt?.

• ANSWER — P. falciparum.

Question No. 37

• CML

• ANSWER — imatinib

Question No. 38

• DVT long term complication

• ANSWER — ulcers

Question No. 39

• best prognosis

• ANSWER — thrombosis

Question No. 40

• CLL

• ANSWER — CD5/20/23/200

Question No. 41

• Myeloma:

• ANSWER — m proteins / plasma cells / osteolytic lesion

Question No. 42

• Major risk for PE:

• ANSWER — orthopaedic
Question No. 43

• Test in microcytic case:

• ANSWER — ferritin

Question No. 44

• Test for prolonged aPTT :

• ANSWER — mixing study

Question No. 45

• Schistocytes + dead fetus :

• ANSWER — DIC

Question No. 46

• Which of the following aggravate acute chest syndrome in sickle disease:

• ANSWER — diuretics

Question No. 47

• Normal HB:

• ANSWER — 4(fe+2) / 4protoporphyrin / 4 polypeptide chains

Question No. 48

• DIC ?

• ANSWER — increase d dimer , decrease platelet, increase aPTT , increase

INR.
Question No. 49

• AML will have:

• ANSWER — Gum hypertrophy + splenomegaly

Question No. 50

• Which of the following is NOT characteristic of critical limb injury :

• ANSWER — Rest pain relived by analgesics

Question No. 51 *

• Intravascular hemolysis has more hemoglobinuria than extravascular one

• ANSWER —

Question No. 52

• Mechanical valve replacement :

• ANSWER — warfarin

Question No. 53

• NOT characteristic pf falciparum:

• ANSWER — relapse due to hypotonized parasites in liver

Question No. 54

• Complicated falciparum malaria. 1st or best drug is?.

• ANSWER — Artesunate
Question No. 55

• Protein C removes what factors?

• ANSWER — 5 and 8

Question No. 56

• Best immediate management for patient just now diagnosed with acute

ischemia is thrombolysis or heparinization?.

• ANSWER — Heparinization

Case No. 1

• Patient CBC show microcytic anemia

• What is the next step?

• Assessments of iron status?

• ANSWER — S. ferritin

Case No. 2

• Patient with HLA, positive sister.

• What should you do next?

• ANSWER — Allogenic stem cell transplantation

Case No. 3

• Patient with bite cells (/Heinz bodies) in blood film.

• What type is his anemia?

• ANSWER — G6PD deficiency

• Child hereditary spherocytosis requires blood transfusion more frequently and

missing out on school:

• What next?

• ANSWER — Splenectomy.

Case No. 5

• Patient with a healed ulcer.

• According to C.E.A.P he is considered which stage:

• ANSWER — C5

Case No. 6

• Patient with schistocytes in PB?

• ANSWER — DIC

Case No. 7

• Patient with acute leukaemia and has CNS symptom (intracranial tension).

• What to do next?

• ANSWER — MRI of brain

• NOTE — CT/MRI, before CSF exam.

Case No. 8

• Patient diagnosed with CML, (WBC = 80,000) with myeloid precursors

proliferation, (HB = 6 mg/L), (PLT = 260,000).

• What is the first line of treatment?

• ANSWER — Imatinib + interferon alpha (TKIs).

• Lymphocytosis with lymphadenopathy , normal Hb and normal platelets.

• The stage is:

• ANSWER —

Case No. 10

• Patient with CLL, Binet b.

• What do think u will find in physical examination?

• ANSWER — More than 3 lymphoid sites are involved.

Case No. 11

• Patient with rheumatoid arthritis, has fatigue, decreased iron, normal

ferritin, normal bone marrow, decreased MCV/MCH.

• What is type of anemia?

• ANSWER —

Case No. 12

• Patient old age with symptoms of MM and 40% plasma cells in his BM.

• What is the diagnosis?

• ANSWER — MM

Case No. 13

• Patient with fever and weight loss, Diffuse large b-cell lymphoma, left cervical

lymph nodes and multiple axillary lymph nodes.

• What is stage and the management:

• ANSWER —
Case No. 14

• Woman 60 years 80% blasts cytochemistry positive for CD2, CD3, CD7.

• The clinical examination may reveal?

• ANSWER —

Case No. 15

• Patient with ITP , PLT is 30 x 10.

• What is best preoperative management?

• ANSWER —

Case No. 16

• Female with fracture underwent surgery then developed VTE.

• Administrate anticoagulant for ?

• ANSWER —

Case No. 17

• Minutes after transfusion present with 40 c, agitation, hypotension, urine

dipstick revealed HB presence.

• The cause is:

• ANSWER —

Case No. 18

• Patient with a Prolonged PT and prolonged aPTT with TT = 13.

• The deficiency is in factor:

• ANSWER —
Case No. 19

• Patient with high methylmalonic acid and homocysteine:

• ANSWER — Vitamin B12 Deficiency

Case No. 20

• Patient develop hypoxemia and hypotension after transfusion.

• Due to:

• ANSWER — anti leucocyte and anti-granulocytes in transfused blood.

Case No. 21

• Patient with pruritus and mediastinal mass:

• ANSWER — Hodgkin lymphoma

Case No. 22

• Patient chronic ischemia by occlusion at superficial femoral artery.

• Are his pulses decreased or increased in the femoral, popliteal, anterior tibial and

dorsalis pedis arteries?

• ANSWER — decreased in all of them EXCEPT for femoral pulse

Case No. 23

• Patient has anaemia haemolytic and has bite cells in blood film.

• What type is his anaemia?

• ANSWER — G6PD Deficiency

• Patient with DM and renal failure and he has normocytic anemia with

reticulocytopenia while his WBCs and platelets are normal.

• Best investigation is sickle solubility, or Coombs test, or HB electrophoresis, or

ferritin or erythropoietin?

• ANSWER — Erythropoietin

Case No. 25

• Patient with heart problems and takes warfarin prophylaxis then he developed

intracranial hemorrhage.

• In addition to Vita. K, what else is suitable for urgent management?.

• ANSWER — Fresh Frozen Plasma

Case No. 26

• Patient with Multiple myeloma has?

• ANSWER — Hypercalcemia, anemia, bone lesion and renal insufficiency.

Case No. 27

• Patient CML, his BM biopsy shows granulocyte hyperplasia and BM blasts 1%.

• What phase is he?

• ANSWER — Chronic phase

Case No. 28

• Female patient bleeding with ecchymosis and purpura mucocutanous and she

has ITP (not directly said but easily concluded from the CBC and others)

• So, best choice is?

• ANSWER — Corticosteroid
Case No. 29

• Patient CLL asymptomatic then later came with severe infections, repetitive

pneumonia and cough.

• What is Best management now?

• ANSWER — Antibiotic with IV immunoglobulins

Case No. 30

• Patient warm AIHA and she came to you with Hb 4 and severely anemic.

• Best management now?.

• ANSWER — transfusion

Case No. 31

• Patient took two RBCS packs and came after 1 week by fever and hyper bilirubin.

• The reaction happened due to RBCS ABO incompatibility or RBCS minor groups

incompatibility?

• ANSWER — RBCS Minor Groups Incompatibility

Case No. 32

• Patient has leg edema increase by working during day with bursting pain in his

leg. Best investigation is?

• ANSWER — Doppler

Case No. 33

• Patient with massive Pulmonary Embolism and has shock.

• What type of shock is that?

• ANSWER — Obstructive shock

• Patient with Hodgkin lymphoma.

• His treatment has a monoclonal antibody called?

• ANSWER — Brentuximab

Case No. 35

• Patient with toxemic manifestations and BM blasts 60% with gingiva

hyperplasia.

• His CD on flowcytometry is?

• ANSWER — CD 13, CD33 and CD117.

Case No. 36

• Patient bleeding and has normal APTT and prolonged PT.

• He could have deficiency in what of these factors?

• ANSWER — factor 7, as the rest were factors of intrinsic pathway.

Case No. 37

• Patient with megaloblastic anemia.

• His finding is.

• ANSWER — Low HB, Macrocytosis, and hyper bilirubin.