Test results Hgb 77 g/L MCV 66  f/L RBC 3.2 x10 12 /L WBC 5.6 x10 6 /L

1. Test results Hgb 77 g/L MCV 66f/L RBC 3.2 x1012/L WBC 5.6 x106/L Plat 525 x109/L Blood film This is a 55 year old woman who has fatigue. Her only other symptom is a craving for chewing ice cubes. Apart from being pale her examination is normal.

3. Which one of the following tests would best define the type of anemia she has ? A. Hgb electropheresis B. Serum iron and iron-binding capacity C. Serum ferritin D. Serum transferrin E. Bone marrow iron

4. Test results Hgb 77 g/L MCV 66fL RBC 3.2 x1012/L WBC 5.6 x106/L Plat 525 x109/L Blood film microcytosis hypochromia ovals pencil thrombocytosis This is a 55 year old woman who has fatigue. Her only other symptom is a craving for chewing ice cubes. Apart from being pale her examination is normal.

5. Test results Hgb 135 g/L MCV 65 fL  RBC 5.4 x1012/L WBC 6.5 x106/L Plat 355 x109/L Blood film A 44 year old executive is sent to you for an insurance examination. He is fit, but on examination he has mild hypertension.

7. Which test is likely to give a diagnosis in this case ? A. Serum ferritin B. Serum transferrin C. Sickle Cell screen D. Hgb electropheresis E. Liver function tests

8. Test results Hgb 135 g/L MCV 65 fL RBC 5.4 x1012/L WBC 6.5 x106/L Plat 355 x109/L Blood film microcytosis hypochromia target teardrop basophilic stippling A 44 year old executive is sent to you for an insurance examination. He is fit, but on examination he has mild hypertension.

9. What would you tell this executive ? A. You have Beta thalassemia minor B. You have alpha thalasemia minor C. You have Sickle cell trait D. You have hemoglobin C trait E. More tests are needed

10. Test results Hgb 99 g/L MCV 100 fL RBC 3.7 x1012/L WBC 3.4 x106/L Plat 117 x109/L bili 35 mol/L blood film This is an 18 year old boy who you are investigating for Jaundice. He has this intermittently for some time. His family are Christian Scientists. Physical exam shows jaundice and splenomegaly

12. Which of the following would be most helpful in identifying this young man’s problem ? A. Reticulocyte count B. Osmotic fragility test C. DAT (Coomb’s test) D. Bone marrow test E. Family studies

13. Test results Hgb 99 g/L MCV 100 fL RBC 3.7 x1012/L WBC 3.4 x106/L Plat 117 x109/L bili 35 mol/L blood film polychromasia spherocytes This is an 18 year old boy who you are investigating for Jaundice. He has this intermittently for some time. His family are Christian Scientists. Physical exam shows jaundice and splenomegaly

14. Test results Hgb 142 g/L MCV 105 fL RBC 4.9 x1012/L WBC 6.7 x106/L Plat 105 x109/L Blood Film A 46 year old diplomat is referred to you because of abnormal blood results. On review of these you suspect the cause and order appropriate blood tests.

16. What tests would you order on receiving these results ? A. Serum B12 and folate B. Bone marrow aspirate C. Serum lipid studies D. Liver function tests E. Thyroid function tests

17. Test results Hgb 142 g/L MCV 105 fL RBC 4.9 x1012/L WBC 6.7 x106/L Plat 105 x109/L Blood Film Macrocytosis Target cells stomatocytes A 46 year old diplomat is referred to you because of abnormal blood results. On review of these you suspect the cause and order appropriate blood tests.

18. Test results Hgb 85 g/L MCV 110 fL RBC 3.9 x1012/L WBC 2.4 x106/L Plat 89 x109/L Blood Film A 65 year old woman is referred to you because of memory loss. Her family physician had received tests which included bilirubin of 28  mol/L and an LDH of 1560 U/L. He was puzzled by these results.

20. Which one of the following tests is most appropriate ? A. Liver function B. Thyroid function C. RBC folate D. Serum B12 E. Bone marrow aspirate

21. Test results Hgb 85 g/L MCV 110 fL RBC 3.9 x1012/L WBC 2.4 x106/L Plat 89 x109/L Blood Film Macrocytosis oval macroytes hypersegmented neutrophils A 65 year old woman is referred to you because of memory loss. Her family physician had received tests which included bilirubin of 28  mol/L and an LDH of 1560 U/L. He was puzzled by these results.

22. Test results Hgb 103 g/L MCV 99 fL RBC 3.8 x1012/L WBC 3.4 x106/L Plat 125 x109/L Blood Film A 65 year old woman complains of back pain. Her X-rays show diffuse osteoporosis. She also complains of increased thirst and drowsiness.

24. Which one of these tests would most likely lead to the diagnosis ? A. Serum osmolarity B. Serum viscosity C. Serum protein electrophersis D. Serum TSH E. Serum PTH

25. Test results Hgb 103 g/L MCV 99 fL RBC 3.8 x1012/L WBC 3.4 x106/L Plat 125 x109/L Blood Film rouleaux background staining A 65 year old woman complains of back pain. Her X-rays show diffuse osteoporosis. She also complains of increased thirst and drowsiness.

26. Test results Hgb 115 g/L MCV 115 fL RBC 2.2 x1012/L WBC 8.4 x106/L Plat 246 x109/L Blood Film You admit a 36 year old woman with pneumonia. She has fever, shortness of breath and requires oxygen. She is also noted to be anemic.

28. These test results would help you choose which one of these antibiotics ? A. Cephalexin B. Penicillin G C. Erythromycin D. Sulfamethoxazole E. Ciprofloxacin

29. Test results Hgb 115 g/L MCV 115 fL RBC 2.2 x1012/L WBC 8.4 x106/L Plat 246 x109/L Blood Film RBC agglutination You admit a 36 year old woman with pneumonia. She has fever, shortness of breath and requires oxygen. She is also noted to be anemic.

30. Test results Hgb 75 g/L MCV 107fL RBC 2.8 x1012/L WBC 8.9 x106/L Plat 377 x109/L Blood Film An 18 year old woman has symptoms of cystitis. After urine cultures are taken she is given Sulfamethoxazole. Her urinary symptoms improve but she becomes short of breath. A week later on follow-up her investigation shows.

32. What type of anemia is causing this problem ? A. An idiosyncratic drug reaction B. An allergic drug reaction C. Marrow suppressive effect D. Immune hemolysis E. Oxidative hemolysis

33. Test results Hgb 75 g/L MCV 107fL RBC 2.8 x1012/L WBC 8.9 x106/L Plat 377 x109/L Blood Film ploychromasia blister bite cells An 18 year old woman has symptoms of cystitis. After urine cultures are taken she is given Sulfamethoxazole. Her urinary symptoms improve but she becomes short of breath. A week later on follow-up her investigation shows.

34. Test results Hgb 115 g/L MCV 91 fL RBC 4.1 x1012/L WBC 14.5 x106/L Plat 52 x109/L Blood Film You are called to see this 29 year old primip in the case room. The obstetrician is concerned about her platelet count. She is well but a bit hypertensive.

36. What diagnosis is most likely ? A. ITP ( immune thrombocytopenia ) B. TTP ( thrombotic thrombocytopenic purpura) C. PIH (pre-eclampsia) D. Benign thrombocytopenia of pregnancy E. DIC (disseminated intravascular coagopathy)

37. Test results Hgb 115 g/L MCV 91 fL RBC 4.1 x1012/L WBC 14.5 x106/L Plat 52 x109/L Blood Film polychromasia rbc fragments thrombocytopenia You are called to see this 29 year old primip in the case room. The obstetrician is concerned about her platelet count. She is well but a bit hypertensive.

38. Test results Hgb 115 g/L MCV 105 fL RBC 3.8 x1012/L WBC 9.2 x106/L Plat 420 x109/L Blood Film This 35 year old man is sent to you because of unusual blood results. His complaints are of fatigue and an episodic itchy rash.

40. What condition do you think is responsible for these results ? A. Pernicious anemia B. Sickle cell anemia C. Hyposplenism D. Leaky prosthetic valve E. Liver cirrhosis

41. Test results Hgb 115 g/L MCV 105 fL RBC 3.8 x1012/L WBC 9.2 x106/L Plat 420 x109/L Blood Film targets acanthocytes fragments howell jolly bodies This 35 year old man is sent to you because of unusual blood results. His complaints are of fatigue and an episodic itchy rash.

42. What is the most likely cause ? A. Blind loop syndrome B. Coeliac disease C. Ulcerative colitis D. Crohn’s disease E. Wilson’s disease

43. Test results Hgb 99 g/L MCV 96 fl RBC 3.4 x1012/L WBC 3.65 x106/L Plat 560 x109/L Blood Film You are asked to asses a 72 year old woman for anemia and splenomegaly. She has been losing weight for 1 year. She has had 2 episodes of gout.

45. What test would give a definitive diagnosis ? A. LAP score B. Osmotic fragility C. Hgb electropheresis D. Bone scan E. Bone marrow biopsy

46. Test results Hgb 99 g/L MCV 96 fl RBC 3.4 x1012/L WBC 3.65 x106/L Plat 560 x109/L Blood Film thromboytosis tear drop cells leukoerythroblstic You are asked to asses a 72 year old woman for anemia and splenomegaly. She has been losing weight for 1 year. She has had 2 episodes of gout.

47. Test results Hgb 136 g/L MCV 88 fL RBC 4.9 x1012/L WBC 17.3 x106/L Plat 110 x109/L Blood Film This 24 year old man has acute abdominal pain. He has not been feeling well for 5 days. After a baseball game he had acute upper abdominal pain and was quite tender in the upper abdomen. The surgeon asks you to see the patient.

48. What is the disorder most likely responsible for his condition ? A. Acute leukemia B. Pancreatitis C. Malaria D. Infectious mononucleosis E. Liver abcess

50. Test results Hgb 136 g/L MCV 88 fL RBC 4.9 x1012/L WBC 17.3 x106/L Plat 110 x109/L Blood Film variant lymphocytes atypical reactive This 24 year old man has acute abdominal pain. He has not been feeling well for 5 days. After a baseball game he had acute upper abdominal pain and was quite tender in the upper abdomen. The surgeon asks you to see the patient.