Anaemias

1.Define anemia. Classify anemias. Discuss etiopathogenesis and laboratory findings of megaloblastic anemia

2.A 45-year-old lady with menorrhagia for 5-6 months presented with fatigue and loss of appetite. Lab investigations showed Hb - 9gm% and peripheral smear showed small RBCs with enhanced central pallor

• a) What is the likely diagnosis
• b) What lab investigations would confirm your diagnosis
• c) Describe the peripheral smear findings with a labelled diagram
• d) List other causes that can lead to this condition

3.A 38-year-old pregnant woman with history of multiple, closely spaced pregnancies, develops fatigue, pallor, koilonychia, alopecia, and atrophic changes of the tongue of one-month duration

• a) What is your provisional diagnosis
• b) Describe the peripheral smear and Bone marrow finding
• c) What are the other laboratory investigations to be done for confirming the diagnosis in this patient
• d) Describe the pathogenesis and complications of this condition

4.A seven-year-old boy presented to the hospital with breathlessness and severe pallor. On examination he had stunted growth, frontal bossing, mild icterus and moderate splenomegaly. History of repeated blood transfusions was present. Investigations revealed Hb- 3gm%, TLC – 5600/cu.mm, platelets –

• a) 0 lakhs/cu.mm. Peripheral smear showed microcytic hypochromic blood picture with marked anisopoikilocytosis, many target cells and reticulocyte count of 5%.
• b) What is the likely diagnosis and why
• c) What is the pathogenesis of this condition
• d) What are the laboratory investigations needed in such a case to diagnose the disease and the expected results
• e) How do you classify this disease based on its clinicohematological profile

1.Lab diagnosis and Pathogenesis of β thalassemia major

2.40 yrs old female complained of easy fatigue and dyspnea. PCV 25% and Hb 5gm/dl. MCV 40 fl, MCH 10 pg, MCHC 18 g/dL. Reticulocyte count 0.5%. Answer the following: • What is your diagnosis • What is the etio-pathogenesis of this condition • What are the laboratory findings

3.A 50 year old farmer presented with easy fatiguability. On examination- Pallor++, Koilonychia was seen. Stool examination showed ova of ankylostoma duodenale.

• a) What is the most probable diagnosis
• b) Discuss the etiopathogenesis of this condition
• c) Enumerate the laboratory findings of the same

4.Laboratory Diagnosis of Thalassemia

5.A 70-year-old woman admitted with worsening anemia and pathological fracture of the Humerus, had an ESR of 120mm in 1 hour. Her peripheral smear showed increased rouleaux formation. X-ray of skull showed multiple punched out osteolytic lesions.

• a) What is the most probable diagnosis.
• b) Write briefly on the etiopathogenesis of this disease.
• c) Enumerate the common laboratory investigations for this disease

6.A 55-year-old lady presented with progressive fatigue and tiredness for last one month. She also complained of tingling and numbness in the lower limbs. On examination she had pallor and her tongue had a glossy appearance.  What is your diagnosis  What is the cause for neurological symptoms in this condition  What are the peripheral smear and bone marrow findings in this condition

7.Laboratory diagnosis of megaloblastic anaemia

8.A 60- year old male presented with history of fever, cough and weight loss since two months. Chest X-ray showed cavitary lesion in the right apical lobe and ESR 120 mm / hr. Answer the following.  What is the provisional diagnosis.  Discuss etiopathogenesis and morphology of the same.  Mention the laboratory investigations

9.A young boy aged 3 years was admitted for compliants of yellowish discoloration of eyes.He has past history of repeated blood transfusions.On examination severe pallor and splenomegaly present.X ray showed crew cut appearance.Peripheral smear showed microcytic hypochromic RBCs. Answer the following : • What is the most probable diagnosis. • Describe the various lab investigations to establish the diagnosis. • What is the pathogenesis of the disease

10.An 18 years old lady presented with fatigue. Investigations: Hb5 g/dl TC 10,000 /cmm platelet count 1.8 lakh/cmm. MCV 60 fl MCH 20 pg. Answer the following: • What is your morphological diagnosis. • Describe the peripheral blood picture • Name the conditions in which this blood picture is seen • How will you differentiate the above two conditions with laboratory tests

11.A 30 years old man presented with tiredness and numbness of feet. Investigations showed Hb 6 g/dl TC 3500/c.mm. MCV 104fl . Answer the following: • What is your diagnosis • Describe the peripheral blood picture • What are the causes of this condition

1.Erythrocyte sedimentation rate

2.Factors affecting Erythrocyte Sedimentation rate

3.Immune hemolytic anemias

4.Bone marrow findings in megaloblastic anemia

5.Erythroblastosis foetalis

6.Hematocrit

7.Etiology of aplastic anemia

8.Coomb’s test

1.Mention two common complications of sickle cell anemia

2.The anticoagulant of choice for packed cell volume estimation is …………

3.Megaloblast

4.What is a reticulocyte. Enumerate Two causes of reticulocytosis Answer in single sentence: (4x½=2)

5.Blood picture in megaloblastic Anemia

6.Confirmatory test for hereditary spherocytosis

7.Methods of PCV estimation

8.RBC indices

9.Sodium metabisulphite test is done to demonstrate what

10.Name two conditions in which ESR is more than 100 mm in 1st hr

11.Two causes for megaloblastic anemia

12.Osmotic fragility test

13.Spherocyte

14.What is Direct Coomb’s test

15.Macropolycyte