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Questions and Answers
What is the likelihood of iron deficiency anemia given the patient has a hemoglobin level of 5 g/dL and severe pallor?
What is the likelihood of iron deficiency anemia given the patient has a hemoglobin level of 5 g/dL and severe pallor?
What does the presence of massive splenomegaly and a total leukocyte count of 240,000 cells/cmm suggest?
What does the presence of massive splenomegaly and a total leukocyte count of 240,000 cells/cmm suggest?
A 60-year-old man presents with normocytic and normochromic red blood cells and a leukocyte differential showing 90% lymphocytes. What is the most likely diagnosis?
A 60-year-old man presents with normocytic and normochromic red blood cells and a leukocyte differential showing 90% lymphocytes. What is the most likely diagnosis?
What is the significance of blast cells constituting 68% of the differential count in a patient with nosebleed and menorrhagia?
What is the significance of blast cells constituting 68% of the differential count in a patient with nosebleed and menorrhagia?
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What does the reticulocyte count of 1% in a patient with anemia indicate?
What does the reticulocyte count of 1% in a patient with anemia indicate?
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Given the patient’s family history of similar bleeding symptoms, which condition should be considered?
Given the patient’s family history of similar bleeding symptoms, which condition should be considered?
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In the context of a high leukocyte count and massive splenomegaly, which finding is most critical for diagnosis?
In the context of a high leukocyte count and massive splenomegaly, which finding is most critical for diagnosis?
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What is the likely cause of a low MCV of 50 fl in a patient with severe anemia and pallor?
What is the likely cause of a low MCV of 50 fl in a patient with severe anemia and pallor?
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What is the most likely diagnosis for the 8-year-old female child who developed nausea, vomiting, altered consciousness, and ultimately coma after a respiratory tract infection?
What is the most likely diagnosis for the 8-year-old female child who developed nausea, vomiting, altered consciousness, and ultimately coma after a respiratory tract infection?
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What condition is indicated by the deep yellow coloration of the eyes, colicky pain, clay-colored stools, and positive bile pigment in urine?
What condition is indicated by the deep yellow coloration of the eyes, colicky pain, clay-colored stools, and positive bile pigment in urine?
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What diagnosis is suggested by the 18-year-old male's symptoms of yellowish discoloration of skin, intermittent jaundice, and increased osmotic fragility?
What diagnosis is suggested by the 18-year-old male's symptoms of yellowish discoloration of skin, intermittent jaundice, and increased osmotic fragility?
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What is the most likely diagnosis for the 68-year-old male with lower back pain, weakness, lethargy, and marked rouleaux formation in blood tests?
What is the most likely diagnosis for the 68-year-old male with lower back pain, weakness, lethargy, and marked rouleaux formation in blood tests?
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What finding in the urine of the 68-year-old male suggests significant protein loss?
What finding in the urine of the 68-year-old male suggests significant protein loss?
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Which test result would support the diagnosis of diabetic ketoacidosis in the young child?
Which test result would support the diagnosis of diabetic ketoacidosis in the young child?
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Which symptom is least likely to be associated with obstructive jaundice as seen in the 40-year-old female?
Which symptom is least likely to be associated with obstructive jaundice as seen in the 40-year-old female?
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What would be an expected finding in the peripheral blood smear of the 18-year-old male with hereditary spherocytosis?
What would be an expected finding in the peripheral blood smear of the 18-year-old male with hereditary spherocytosis?
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What is the most likely diagnosis for the 53-year-old lady presenting with numerous RBCs and RBC casts?
What is the most likely diagnosis for the 53-year-old lady presenting with numerous RBCs and RBC casts?
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For the 21-year-old medical student with abdominal pain and jaundice, what is the most likely diagnosis?
For the 21-year-old medical student with abdominal pain and jaundice, what is the most likely diagnosis?
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What condition is most likely indicated by the thyroid function tests of the 30-year-old lady with emotional instability?
What condition is most likely indicated by the thyroid function tests of the 30-year-old lady with emotional instability?
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Which symptom best correlates with the diagnosis of the 9-year-old boy with spontaneous bleeding and high fever?
Which symptom best correlates with the diagnosis of the 9-year-old boy with spontaneous bleeding and high fever?
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What is the primary concern for a patient with a blood sugar level of 292 mg% and significant renal impairment?
What is the primary concern for a patient with a blood sugar level of 292 mg% and significant renal impairment?
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In the case of the 30-year-old lady with tachycardia and cardiomegaly, which underlying condition is most likely?
In the case of the 30-year-old lady with tachycardia and cardiomegaly, which underlying condition is most likely?
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For the 21-year-old patient with icterus and elevated liver enzymes, which investigation would be essential next?
For the 21-year-old patient with icterus and elevated liver enzymes, which investigation would be essential next?
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What is a common characteristic finding in the urine of a patient with significant renal dysfunction?
What is a common characteristic finding in the urine of a patient with significant renal dysfunction?
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What condition is most likely diagnosed in the 12-year-old male child with swelling and pallor?
What condition is most likely diagnosed in the 12-year-old male child with swelling and pallor?
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What is the most likely diagnosis for the 6-year-old female with a turbid CSF and increased neutrophils?
What is the most likely diagnosis for the 6-year-old female with a turbid CSF and increased neutrophils?
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What is the most significant finding indicating diabetes mellitus in the 60-year-old female patient?
What is the most significant finding indicating diabetes mellitus in the 60-year-old female patient?
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What does a decreased urine output combined with a history of sore throat in the 16-year-old male most likely indicate?
What does a decreased urine output combined with a history of sore throat in the 16-year-old male most likely indicate?
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In the 12-year-old male child, what level of total plasma proteins would be expected in nephrotic syndrome?
In the 12-year-old male child, what level of total plasma proteins would be expected in nephrotic syndrome?
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What laboratory finding is most indicative of bacterial infection in the 6-year-old with meningitis?
What laboratory finding is most indicative of bacterial infection in the 6-year-old with meningitis?
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What is the most likely primary cause of edema in the 12-year-old male child?
What is the most likely primary cause of edema in the 12-year-old male child?
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Which symptom in the 60-year-old female patient is most correlated with her high blood sugar level?
Which symptom in the 60-year-old female patient is most correlated with her high blood sugar level?
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Study Notes
Case 1 - Anemia
- A female patient presents with irregular and heavy menstrual cycles for the past 6 months
- She also has severe pallor
- Blood test results show low hemoglobin (5 gm%), elevated ESR (70 mm after 1 hour), low reticulocyte count (1%), low platelet count (3.5 lakh/cumm), low MCV (50 fl), low MCH (18 pg), and low MCHC (25 gm%)
- This suggests a diagnosis of anemia, potentially iron deficiency anemia due to heavy bleeding
Case 2 - Chronic Myeloid Leukemia
- A 40-year-old male presents with fatigue and weakness
- He has massive splenomegaly and pallor
- Blood count results showed low hemoglobin (8 gm%), high total count (2,40,000 cells/cumm), and an abnormal differential count with a high percentage of myelocytes (35%)
- Diagnosis: Chronic myeloid leukemia
Case 3 - Chronic Lymphocytic Leukemia
- A 60-year-old male with no health complaints presents for a general checkup
- Blood count shows a normal Hb level (12 gm%) with a low total count (80,000 cells/cmm) and a high percentage of lymphocytes (90%)
- Peripheral smear shows normocytic and normochromic red blood cells (RBCs) and mature small lymphocytes
- Platelets are within normal limits
- These findings suggest a diagnosis of Chronic lymphocytic leukemia
Case 4 - Acute Lymphoblastic Leukemia
- A 15-year-old female with a history of 15 days of nosebleeds, menorrhagia, and pallor
- Examination reveals a palpable liver
- Blood results show low hemoglobin (6.1 gm%), low total count (81,000 cells/cmm), high percentage of blast cells (68%), low platelet count (40,000 cells/cumm), and abnormal MCV (83 fl), MCH (25.8 pg), and MCHC (31%)
- Cytochemistry shows myeloperoxidase-positive blasts
- Diagnosis: Acute lymphoblastic leukemia
Case 5 - Diabetic Ketoacidosis
- An 8-year-old female with insulin-dependent diabetes mellitus (IDDM) for 4 years
- She develops respiratory tract infection followed by nausea, vomiting, altered consciousness and coma
- Blood tests show high blood glucose (480 mg/dl), normal blood urea, a high total leukocyte count (15,000/cumm) with a high percentage of neutrophils (89%)
- Urine analysis shows positive Benedict's and Rothera's tests
- Cerebrospinal fluid (CSF) is within normal limits
- Diagnosis: Diabetic ketoacidosis
Case 6 - Obstructive Jaundice
- A 40-year-old female presents with deep yellow sclera, colicky right hypochondrium pain, vomiting, and pruritis for the past 4 months
- She has clay-colored stools
- Urine tests show deep yellow color, positive albumin, absent sugar, absent urobilinogen, and present bile salts and bile pigments
- Diagnosis: Obstructive jaundice
Case 7 - Hereditary Spherocytosis
- An 18-year-old male presents yellowish discoloration of skin and fatigue
- He has a history of intermittent jaundice and his father had similar complaints
- Examination reveals icterus and splenomegaly
- Blood test results show low hemoglobin (8 gm%), high MCV (70 fl), high MCH (30 pg), high MCHC (40 gm/dl), increased reticulocyte count (8%), and increased osmotic fragility
- Peripheral smear shows spherocytes
- Diagnosis: Hereditary spherocytosis
Case 8 - Multiple Myeloma
- A 68-year-old male presents with lower back pain, weakness, and lethargy
- Examination shows multiple localized tender areas in the bones
- Blood test results show low hemoglobin (6 gms%), high ESR (150 mm at the end of 1 hour), and marked rouleaux formation
- Urine test shows positive protein and negative sugar
- X-ray of the skull shows lytic lesions
- Diagnosis: Multiple myeloma
Case 9 - Anemia
- A 32-year-old female presents with dyspnea on exertion, palpitations, and generalized weakness for the last 3 months
- This is a case of possible anemia, but further investigations are needed to understand the specific type and cause of the anemia.
Case 10 - Nephrotic Syndrome
- A 12-year-old male child presents with generalized swelling for 8 months, paleness, and puffiness of the face for 1 month
- Blood test results show low hemoglobin (8.2 gms%), low total count (9,200 cells/cumm), high ESR (35 mm after 1 hour), low total plasma protein (3.7 gms/dl), low plasma albumin (1.7 gms/dl), normal BUN (20 mg%), normal serum creatinine (0.6 mg%),
- Urine test shows ++++ albumin and negative sugar
- Diagnosis: Nephrotic syndrome
Case 11 - Bacterial Meningitis
- A 6-year-old female child with severe headache and fever for 5 days
- She has ear discharge on the left side
- Lumbar puncture revealed a greatly increased CSF pressure, turbid appearance, high protein (500 mg/dl), low glucose (20 mg/dl), and high cell count (5,000 cells/cmm) with 95% neutrophils
- Diagnosis: Bacterial meningitis
Case 12 - Diabetic Ketoacidosis
- A 60-year-old obese female presents with increased urination frequency, increased appetite for 1 month, and breathlessness for 2 days
- She is obese, afebrile, conscious and well-oriented with a rapid pulse (112/min), rapid respiratory rate (44/min), and normal blood pressure (130/80 mmHg)
- Examination also reveals pallor and bilateral basal crepts
- Blood results show normal hemoglobin (10 gm%), a high total leukocyte count (11,000/cumm), high percentage of polymorphonuclear leukocytes (80%), high ESR (25 mm at the end of 1 hour), and high random blood sugar (398 mg%)
- Urine analysis shows negative albumin, positive sugar, present ketones, and negative microscopy
- Diagnosis: Diabetic ketoacidosis
Case 13 - Acute Kidney Injury
- A 16-year-old male presents with decreased urine output for 8 days, nausea, vomiting, and swelling of the feet for 15 days
- He had sore throat 1 month ago
- He is conscious, febrile, well-oriented with a rapid pulse (102/min), rapid respiratory rate (26/min), and high blood pressure (140/90 mmHg)
- Examination reveals pallor and pitting edema of the feet
- Blood results show low hemoglobin (7.6 gm%), low total leukocyte count (7800/cumm), high blood urea (245 mg%), high serum creatinine (10.6 mg%), and normal serum protein (7.1 gm%)
- Urine results show positive albumin, negative sugar, pus cells, epithelial cells, numerous red blood cells with red blood cell casts
- Diagnosis: Acute kidney injury
Case 14 - Diabetic Ketoacidosis
- A 53-year-old lady presents in a semiconscious state with abnormal behavior since the last 15 days
- She is a known case of non-insulin-dependent diabetes mellitus (NIDDM) for 12 years
- She is unresponsive to oral commands, afebrile, with a rapid pulse (96/min), normal blood pressure (140/90 mmHg) and pallor
- Blood results show low hemoglobin (8 gm%), high ESR (60 mm at the end of 1 hour), high blood sugar (292 mg%), high blood urea (133.8 mg%), and high serum creatinine (8.7 mg%)
- Urine analysis shows positive albumin, positive sugar, and pus cells/epithelial cells
- Diagnosis: Diabetic Ketoacidosis
Case 15 - Viral Hepatitis
- A 21-year-old medical student presents with abdominal pain, vomiting, decreased appetite, and yellowish discoloration of urine for 15 days
- He is conscious, afebrile, with a normal pulse (90/min), normal respiratory rate (22/min), and normal blood pressure (110/70 mmHg)
- He has icterus and a palpable and tender liver
- Blood results show normal hemoglobin (11 gm%), a high total leukocyte count (22,000/cumm), high serum bilirubin (12.8 mg%), high SGOT (88 IU/L), high SGPT (92 IU/L), normal blood sugar (107 mg%), normal serum protein (8.9 gm%), and normal serum albumin (4.2 gm%)
- Diagnosis: Viral hepatitis (likely Hepatitis A due to age and absence of chronic liver disease)
Case 16 - Thyrotoxicosis
- A 30-year-old lady presents with emotional instability, nervousness, palpitations, and menstrual disturbances for 3 months
- She is poorly built and nourished with pallor and fine tremors in her hands
- Examination also shows tachycardia and cardiomegaly, with a moderately enlarged thyroid gland
- Thyroid function tests reveal high serum T4 (20 μg/dl), high serum T3 (260 ng/dl), and low serum TSH (0.2 μU/ml)
- Diagnosis: Thyrotoxicosis (Graves' disease)
Case 17 - Acute Lymphoblastic Leukemia
- A 9-year-old boy presents with spontaneous skin bleeding, weakness, and high fever
- Examination shows palpable lymph nodes in the cervical and axillary regions, oral thrush, and moderate hepatomegaly
- Blood test results show low hemoglobin (6 gms%), a high total count (1,10,000 cells/cmm)
- Diagnosis: Acute lymphoblastic leukemia
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Description
This quiz covers three clinical cases related to hematology, focusing on anemia and types of leukemia. It explores the symptoms, lab findings, and diagnoses associated with these blood disorders. Test your knowledge and enhance your understanding of these critical conditions.
