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  • Question 1 - Which of the following is NOT a typical clinical feature of beta-thalassaemia major:...

    Correct

    • Which of the following is NOT a typical clinical feature of beta-thalassaemia major:

      Your Answer: Increased bleeding tendency

      Explanation:

      Features include:
      – severe anaemia (becoming apparent at 3 – 6 months when the switch from gamma-chain to beta-chain production takes place)
      – failure to thrive
      – hepatosplenomegaly (due to excessive red cell destruction, extramedullary haemopoiesis and later due to transfusion related iron overload)
      – expansion of bones (due to marrow hyperplasia, resulting in bossing of the skull and cortical thinning with tendency to fracture)
      – increased susceptibility to infections (due to anaemia, iron overload, transfusion and splenectomy)
      – osteoporosis
      – hyperbilirubinaemia and gallstones
      – hyperuricaemia and gout
      – other features of haemolytic anaemia
      – liver damage and other features of iron overload

    • This question is part of the following fields:

      • Haematology
      • Pathology
      15.2
      Seconds

  • Question 2 - Regarding disseminated intravascular coagulation (DIC), which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding disseminated intravascular coagulation (DIC), which of the following statements is INCORRECT:

      Your Answer: There is depletion of fibrinogen and all coagulation factors.

      Correct Answer: Thrombocytosis results in widespread platelet aggregation.

      Explanation:

      DIC is characterised by a widespread inappropriate intravascular deposition of fibrin with consumption of coagulation factors and platelets. This may occur as a consequence of many disorders that release procoagulant material into the circulation or cause widespread endothelial damage or platelet aggregation. Increased activity of thrombin in the circulation overwhelms its normal rate of removal by natural anticoagulants. In addition to causing increased deposition of fibrin in the microcirculation and widespread platelet aggregation to the vessels, intravascular thrombin formation interferes with fibrin polymerisation. Intense fibrinolysis is stimulated by thrombi on vascular walls and the release of fibrin degradation products again interferes with fibrin polymerisation. The combined action of thrombin and plasmin causes depletion of fibrinogen and all coagulation factors, compounded by thrombocytopaenia caused by platelet consumption.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      25.9
      Seconds

  • Question 3 - Aplastic crises in sickle cell anaemia is classically precipitated by which of the...

    Correct

    • Aplastic crises in sickle cell anaemia is classically precipitated by which of the following infections:

      Your Answer: Parvovirus B19

      Explanation:

      A serious complication in sickle cell disease (SCD) is the aplastic crisis. This may be caused by infection with Parvovirus B-19 (B19V). This virus causes fifth disease, a normally benign childhood disorder associated with fever, malaise, and a mild rash. This virus infects RBC progenitors in bone marrow, resulting in impaired cell division for a few days.
      Healthy people experience, at most, a slight drop in hematocrit, since the half-life of normal erythrocytes in the circulation is 40-60 days. In people with SCD, however, the RBC lifespan is greatly shortened (usually 10-20 days), and a very rapid drop in Hb occurs. The condition is self-limited, with bone marrow recovery occurring in 7-10 days, followed by brisk reticulocytosis.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      13.9
      Seconds

  • Question 4 - A 20-year-old male receives a small cut over his hand while climbing a...

    Correct

    • A 20-year-old male receives a small cut over his hand while climbing a fence causing it to bleed. Upon applying pressure for a few minutes, the bleeding stops. Which one of the following physiological components of the blood is responsible for the primary haemostasis reaction, such as in this case?

      Your Answer: Platelet plug formation

      Explanation:

      Haemostasis is your body’s defence against an injury that causes bleeding. It stops bleeding in three main steps:

      1) Primary haemostasis – formation of a weak platelet plug
      – The primary reaction of the body is to cause local vasoconstriction at the site of injury and decrease blood flow to the affected area
      – the release of cytokines and inflammatory markers lead to adhesion of platelets and aggregation at the site of injury forming a platelet plug
      – the injured vessel wall has exposed subendothelial collagen that releases von Willebrand factor

      Any damage to the vessel wall causes the release of the Von Willebrand factor, which is necessary for platelet adhesion. Tissue Thromboplastin is also released, which activates the coagulation pathway, a component of secondary haemostasis. The coagulation cascade ultimately results in the conversion of fibrinogen to fibrin.

      2) Secondary haemostasis
      3) Fibrinolysis

      Fibrin (factor Ia) is a long, thin protein with branches produced at the end of the coagulation cascade when fibrinogen (factor I) is converted to fibrin, which stabilizes the blood clot.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      40.7
      Seconds

  • Question 5 - A dermatological examination of a patient who has presented with a lump shows...

    Correct

    • A dermatological examination of a patient who has presented with a lump shows a collection of boils clustered together.

      Which one of these best describes the lump you have found on examination?

      Your Answer: Carbuncle

      Explanation:

      A furuncle, or boil, is a pyogenic infection of the hair follicle commonly caused by infection with Staphylococcus aureus.

      A carbuncle is a collection of individual boils clustered together.

      A bulla is a visible collection of clear fluid measuring greater than 0.5 cm in diameter.

      A vesicle is a visible collection of clear fluid measuring less than 0.5 cm in diameter.

      A pustule is a small visible skin elevation containing an accumulation of pus.

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      8
      Seconds

  • Question 6 - Fibrinoid necrosis is typically seen in which of the following: ...

    Correct

    • Fibrinoid necrosis is typically seen in which of the following:

      Your Answer: Malignant hypertension

      Explanation:

      Fibrinoid necrosis occurs in malignant hypertension where increased arterial pressure results in necrosis of smooth muscle wall. Eosinophilic and fibrinous deposits are seen.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      5.5
      Seconds

  • Question 7 - Detection of urinary Bence-Jones protein would be most suggestive of which of the...

    Correct

    • Detection of urinary Bence-Jones protein would be most suggestive of which of the following malignancies:

      Your Answer: Multiple myeloma

      Explanation:

      Bence Jones proteins are monoclonal immunoglobulin light chains found in urine (and plasma) of some patients with myeloma. Because of their relatively small size, light chains are readily excreted into the urine. The presence of significant amounts of Bence Jones proteins in urine is indicative of malignant B cell proliferation.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      7.4
      Seconds

  • Question 8 - A 40-year-old man with reduced urine output, nausea, and confusion also has a...

    Correct

    • A 40-year-old man with reduced urine output, nausea, and confusion also has a 150% rise of creatinine from baseline over the past 7 days. A diagnosis of acute kidney injury (AKI) is made after more tests are done.

      His AKI stage is?

      Your Answer: Stage 2

      Explanation:

      This patient with a 150% rise of creatinine above baseline within 7 days has stage 2 Acute kidney injury (AKI).

      AKI stages are as follows:
      Stage 1
      Creatinine rise of 26 micromole/L or more within 48 hours, or
      Creatinine rise of 50-99% from baseline within 7 days (1.5-1.99 x baseline),or
      Urine output <0.5 mL/kg/hour for more than 6 hours Stage 2
      Creatinine rise of 100-199% from baseline within 7 days (2.0-2.99 x baseline),or
      Urine output <0.5 mL/kg/hour for more than 12 hours Stage 3
      Creatinine rise of 200% or more from baseline within 7 days (3.0 or more x baseline), or
      Creatinine rise to 354 micromole/L or more with acute rise of 26 micromole/L or more within 48 hours or 50% or more rise within 7 days, or
      Urine output <0.3 mL/kg/hour for 24 hours or anuria for 12 hours

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      24.9
      Seconds

  • Question 9 - A 40-year-old male visits his family physician with the complaint of a high-grade...

    Correct

    • A 40-year-old male visits his family physician with the complaint of a high-grade fever for the past five days. A complete blood count report shows the presence of neutrophilia.

      Which one of the following facts regarding neutrophilia is accurate?

      Your Answer: It can be caused by eclampsia

      Explanation:

      A total neutrophil count of greater than 7.5 x 109/L is called neutrophilia. Typhoid fever usually causes leukopenia or neutropenia. Both localised and generalised bacterial infections can cause neutrophilia.

      Metabolic disorders such as
      – gout
      – eclampsia
      – uraemia
      can also cause neutrophilia.

      Acute neutrophilia, in which immature neutrophils can be seen, is referred to as a left shift and can be seen in conditions such as appendicitis.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      32.1
      Seconds

  • Question 10 - Regarding acute idiopathic thrombocytopaenic purpura (ITP), which of the following statements is CORRECT:...

    Correct

    • Regarding acute idiopathic thrombocytopaenic purpura (ITP), which of the following statements is CORRECT:

      Your Answer: Over 80% of children recover without treatment.

      Explanation:

      Acute ITP is most common in children. In approximately 75% of cases, the episode follows vaccination or infection such as chicken pox or glandular fever. Most cases are caused by non-specific immune complex attachment to platelets. Acute ITP usually has a very sudden onset and the symptoms usually disappear in less than 6 months (often within a few weeks). It is usually a self-limiting condition and over 80% of children recover without treatment; in 5 – 10% of cases a chronic form of the disease develops.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      16.2
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Haematology (5/6) 83%
Pathology (9/10) 90%
General Pathology (3/3) 100%
Inflammatory Responses (1/1) 100%
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