OSCE PEDIATRICS HEMATOLOGY MCQs

OSCE PEDIATRICS
FOR PRACTICAL EXAMS
HEMATOLOGY
www.dnbpediatrics.com

A 12 yr old girl presents with progressive
pallor, lethargy and fatiguability. On examination apart
from pallor nothing significant. Her CBC shows a
pancytopenia.
a) What is the bone marrow diagnosis?
b) Which invest. will you ask for?
Q1

ANSWERS
A) Megaloblastic anaemia
B) CBC/PS
Bone marrow
Serum B12 level
Serum And Red Cell folate Levels
Urinary Excretion Of Orotic Acid To Exclude Orotic
Aciduria
Deoxy Uridine Supression Test to Dicrminate
between Folate and Cobalamine Deficiencies

A) Identify the abnormality on peripheral smear?
B) Name 4 conditions where these cells can be seen.
Q2

• 2 A) Target cell
• B) Thalassemia
• Hemoglobinopathies
• Hb AC or CC
• Hb SS, SC, S-thal
• Liver Disease
• Post Splenectomy or Hyposplenic states
• Severe Iron deficiency
• HbE(Hetro and Homozygous)
• LCAT deficiency
• A betalipoprotenemia

A 10 yr old girl ,having ITP since 6 months has ecchymotic
patch on her leg and has uncontrollable epistaxis. Her
platelet count is 4000.
A) Which 3 invest. would you advice in her?
B) What 4 measures either singly or in combination can
be used to treat life threatenig haemorrhage in ITP?
Q3

• 3A) ANA, ds DNA
• HIV,
• Ser. Immunoglobulin
• 3B) Platelet transfusion
• Methyl Prednisolone – 500mg/m2 IV /day x 3 days
• IV Ig 0.8 gm/kg
• Emergency splenectomy

A 10 yr old boy with fever and cough since 3
months, breathlessness since 15 days is being treated with
anti tuberculous drugs since the last 1.5 months without
relief.
A) Give the differential diagnosis of mediastinal
widening in anterior, middle and posterior
mediastinum?
Q4

• 4) Anterior medistinum-----
– Lymphoid tumors,NHL,HD,ALL
– Thyroid tumors
– Thymoma
– Bronchogenic cysts, Aneurysm, Lipoma
• Middle Mediastinum
– LN Masses
– Tertoma
– Angioma
– Diaphargmatic hernia, Pericardial cyst, Bronchogenic Cyst, Esophageal
lesions,
• Posterior mediastinum
– Neurologic tumors(neuroblastoma, ganglioneuroma)
– Lymphoma
– RMS
– Ewing’s sarcoma
– Bronchogenic Cysts, Enterogenous cysts, Thoracic meningocele

A) Which haematological condition is this boy with short
stature and double thumb suffering from?
B) What is the inheritance pattern?
C) Which is the commonest haematological malignancy
these children can develop?
Q5

• 5 A) Fanconis Anemia
• B) autosomal recessive
• C) MDS &/or AML

A) Which 1 inves would you advice?
B) What is the diagnosis?
C) Which type would he be categorized as?
D) What is the mode of inheritance?
1.5yr old boy with minor injury develops this
swelling?
Q6

• A) PT/PTTK
• B) hemophillia A or B
• C) moderate
• D) X linked Recessive

A) Identify the abnormality on peripheral smear?
B) What is the inheritance pattern?
Q7

• 7 A) Sickle Cells
• B) Autosomal dominant or spontaneous mutation

A) Name the tumor and the eye.
B) Name any 2 conditions associated with this tumor.
This 3 yr old girl with a solid tumor has developed a
periorbital haemorrhage.
Q8

• 8 A)Neuroblastoma and Raccoon eyes
• B) Neurofibromatosis
• Hirschprung’s Disease with aganglionic colon
• Phaeochromocytoma in family
• Fetal Hydantoin syndrome
• Fetal alcohol syndrome
• Nesidioblastosis

A) Identify the abnormality on the peripheral smear?
B) Name 4 conditions where this smear can be seen?
Q9

• 9 A) Spherocytes
• B) Hereditary spherocytosis,
• Burns,
• AIHA,
• ABO incompatibility
• Microangiopathic hemolytic anemia
• SS Disease
• Hypersplenism
• Post transfusion
• PK deficiency
• Water dilution hemolysis

A) What is the bone Marrow Diagnosis?
B) Give 5 poor prognostic factors associated with this
condition?
11 yr old male child presents with pallor, fatigue
and hepatosplenomegaly.His Cbc shows
pancytopenia
Q10

• 10 A) AML
• B) WBC > 100000/cumm
• Monosomy 7
• Secondary AML
• FLT3 ITD
• MRD present after induction

A) What is the most likely diagnosis?
B) Which 2 investigations will clinch the diagnosis?
C) What is the treatment of this condition?
A 3 month old infant exclusively breast fed presents with
loose motions since early neonatal period. On examination
she is pale and is failing to thrive. Her CBC shows a
pancytopenia. Her blood sugar is 200mg/dl.
Q11

• 11 A) Pearson marrow pancreas Syndrome
• B) Macrocytic anemia with increased HbF
• Ringed sideroblasts with vacuolization of marrow
precursors (erythroid and granulocytic series)
• C) packed cell with G CSF transfusion.

A 4 day old neonate with birth asphyxia was referred to the
haematology services for a very high WBC count in the range
of 60,000, the platelet count being 6 lakhs. Sepsis in the
newborn was ruled out. The baby was cyanosed on
examination.
A)What is the most likely diagnosis?
B)Is the condition primary or secondary?
C)Name tests to be performed to prove your
diagnosis?
Q12

• 12)a) Polycythaemia vera
• B) secondary
• C) CBC including differential WBC
• To diagnose secondary polycythaemia---
• Arterial O2 saturation
• Carboxyhaemoglobin
• Renal USG
• Abdominal/ Cranial CT
• Special studies for polycythaemia vera
• leucocyte alkaline phosphatase
• B12/B12 binding capacity
• Erythropoeitin level
• RBC colony formation

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