EMQs in Clinical Medicine.pdf - Peshawar Medical College

Anaemia 53
21 Anaemia
A
B
C
D
E
F
sickle-cell disease
pyruvate kinase deficiency
haemophilia A
hereditary spherocytosis
autoimmune haemolytic
anaemia
vitamin B 12 deficiency anaemia
G
H
I
J
K
L
sideroblastic anaemia
thalassaemia major
aplastic anaemia
iron deficiency anaemia
thalassaemia minor
anaemia of chronic disease
For each clinical scenario below, give the most likely cause for the clinical
findings. Each option may be used only once.
1 A 70-year-old woman with rheumatoid arthritis presents with a normocytic
normochromic anaemia: Hb 10.1 g/dl. Haematinics normal, direct Coombs’ test
negative.
2 A 24-year-old woman with anaemia and splenomegaly is referred to the haematologist.
Her direct Coombs’ test is negative. Her blood film shows the presence
of reticulocytes and spherocytes.
3 A 17-year-old tourist from the West Indies presents with pain in his abdomen
and hands. He is pyrexial and anaemic.
4 Full blood count of a 65-year-old woman taking ibuprofen for her osteoarthritic
knee pain for a number of years shows a microcytic anaemia.
5 Full blood count of a 45-year-old man treated for gastric carcinoma with total
gastrectomy reveals a macrocytic anaemia.
Answers: see page 61.