Hematology

1.    Physiologic Anemia.
???) A 2 months old infant brought to you because his hemoglobin was 9,5gm%. One of the following is true:
Give him iron
Give him blood
Assure the parents only
Do reticulocytes level
Do bilirubin level

Answer: 3* Assure the parents only

???) The normal platelet count per cubic millimeter in one month old infant is:
10 x 10
20 x 10
40 x 10
70 x 10
250 x 10

Answer: E* 250 x 10

???) A white blood cell count of 18,000/mm3 is normal for what age:
One day old full term
Two months
Six months
Twelve months
Six years

Answer: A* One day old full term

2.    Iron Deficiency Anemia.
***) The most common cause of anemia worldwide is:
A.    Folate deficiency
B.     Vitamin B12 deficiency
C.     Thalassemia major
D.    Iron deficiency
E.     Glucose 6 phosphate deficiency

Answer: D* Iron deficiency

***) A major health problem in Jordan is:
A.    Vitamin A deficiency
B.     Thalassemia
C.     Rickets     
D.    Iron deficiency anemia
E.     Pellagra

Answer: D* Iron deficiency anemia

***) The commonest type of anemia in pediatrics is :
Thalassemia
Sickle cell anemia
Hereditary spherocytosis
Iron deficiency anemia
Megaloblastic anemia

Answer: D* Iron deficiency anemia

***) Effects of iron deficiency anemia in children may include all of the following, except:
A.    Retardation of growth
B.     Compromised cellular immunity
C.     Direct effect on respiratory function
D.    Direct effect on muscle function
E.     Impaired intellectual function

Answer: D* Direct effect on muscle function

3.    Anemia of Chronic Disease.
???) All of the following about megaloblastic anemia in children are true, except:
Results from deficiency of folic acid or vitamin B12, or both
An important consideration in children fed exclusively with goat's milk
Considerable variation in red cell shape and size
More common in children than in adults
The neutrophils are large and hypersegmented

Answer: 4* More common in children than in adults

1.    Immune Thrombocytopenic Purpura.
***) One of the following is true regarding Idiopathic thrombocytopenic purpura ITP:
A.    Platelets count is less than 50,000
B.     Normal WBC count
C.     Normal PT and PTT
D.    Decreased megakaryocytes in bone marrow
E.     Normal RBC count

Answer: D* Decreased megakaryocytes in bone marrow (It is increased)

***) Which of the following statements about idiopathic thrombocytopenic purpura (ITP) in children is not true:
Most children with acute ITP recover within 2 months
Bone marrow examination is not helpful in diagnosis
Early use of steroids may enhance platelet recovery but has no effect on chronicity
Intracranial bleeding is a risk at any stage of the disease
For older children with chronic ITP splenectomy offer the best chance of remission

Answer: 2* Bone marrow examination is not helpful in diagnosis

***) Regarding ITP (idiopathic thrombocytopenic purpura) all are true, except:
High bleeding time
Decreased platelets count
Decreased megakaryocytes in bone marrow
Intracranial hemorrhage is the most serious complication
Steroid therapy is helpful

Answer: 3* Decreased megakaryocytes in bone marrow

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