؟Chronic hemolytic anemia إزاي تشخص
• General symptoms of anemia (Pallor / fatigue / hemic murmur)
• Jaundice
• Iron overload (hepatosplenomegaly / bronze diabetes)
• Mongoloid features (BM expansion)
؟Acute & chronic hemolysis إزاي تفرق بين
Chronic hemolytic anemia Acute hemolytic anemia
Site of hemolysis Mainly spleen Intravascular
Presentation Anemia / jaundice / Anemia / jaundice / Red
hemosiderosis urine
RBCs transfusion Every month Just Once
MCQ: what differs acute hemolysis from chronic hemolysis
a. Jaundice
b. Reticulocyte count
c. Low hemoglobin
d. Dark Red urine
)؟Thalassemia / Sickle cell / spherocytosis( إزاي تفرق بين
• Onset
• Hb electrophoresis
• VOC symptoms
• Sickling & osmotic fragility test
MCQ: Complication of sickle cell anemia one of the following is NOT correct:
a. Vaso-occlusive crisis
b. bleeding tendency
c. Aplastic crisis
d. Infection
Hb electrophoresis is the ONLY diagnostic test for hemolytic anemias
(False)
Hb electrophoresis is the MOST diagnostic test for hemolytic anemias
(TRUE)
MCQ: Auto hemolysis test is seen in
a. Spherocytosis
b. Sickle cell anemia
c. Thalassemia
Indication of splenectomy
• Huge splenomegaly
• Hypersplenism
• Splenectomy AVOIDED till the age of 4
• No need for splenectomy in sickle cell anemia (Auto splenectomy)
DD of Microcytic Hypochromic Anemia
• Iron Def Anemia
• B-thalassemia Trait (Minor)
• Anemia of Chronic Infection
• Lead poisoning
DD of Acute hemolytic anemia
• G6PD
• Autoimmune hemolytic anemia
• Hemolytic uremic syndrome
• Malaria
• Sepsis
؟Iron Def anemia إزاي تشخص
• General symptoms of anemia
• CBC (Microcytic anemia) / nail spooning / Pica
• ttt by FERROUS Iron
MCQ: The biochemical parameter for diagnosis of iron deficiency anemia
a. Total iron binding capacity
b. Serum Iron
c. Ferritin
؟Aplastic anemia & Leukemia إزاي تفرق بين
• Infiltration (Hepato-splenomegaly) → Leukemia
• Bone marrow:
o Blast or myeloid precursor cells → Leukemia
o Hypocellular BM → Aplastic anemia
؟ITP إزاي تشخص
• Acute form: after viral infection
• Chronic form: Hx of autoimmune disease
MCQ: Non-immune thrombocytopenic purpura is seen in all of the following
except
a. Idiopathic thrombocytopenic purpura
b. Hemolytic uremic syndrome
c. DIC
d. thrombotic thrombocytopenic purpura
أزاي تفرق ن
بالتحاليل ؟Intrinsic / extrinsic / common pathways / plateletsبي ال
• Bleeding time → platelets
• PTT → intrinsic pathway
• PT → extrinsic pathway
• Thrombin time → Common pathway
MCQ: Both PT & PTT are prolonged in
a. VII def
b. VIII def
c. Liver cell failure
Conditions in which bleeding time is normal but partial thromboplastin time is
prolonged occurs in deficiency of factor:
a. VII
b. X
c. XI
d. V
Which of the following is true about henoch schonlien purpura
a. platelet defect in the bone marrow
b. skin lesion characteristically starts in the face
c. nephrotic syndrome is a common association
d. abdominal pain is a common finding
؟Neonatal Hypothyroidism إزاي تشخص
• Wide open ant & post fontanelle
• Prolonged jaundice
• Umbilical hernia
➢ Usually appears NORMAL in early neonatal life & it’s only found by newborn
screening
TSH
• In screening, it’s Done on a filter paper
• In blood sample
o Free T3 & T4 is accurate than total T3 & T4
o Free T4 is accurate than T3
؟DMإزاي تشخص ال
• Polyurea / polydipsia / Weight loss
• DKA may be first presentation
؟DKAإزاي تشخص ال
• Blood glucose > 300
• Hx of DM (Triad presentation)
• Dehydration, vomiting, abd pain
MCQ: About diabetic ketoacidosis all of the following are true except
a. PH less than 7.3
b. ketonuria
c. tachycardia
d. bicarb less than 15 mmol/L
إزاي تفرق ن
؟True & pseudo precocious puberty بي
• Both have high estrogen or testosterone
• High FSH & LH → True precocious puberty
إزاي تفرق ن
؟Hypogonadotropic & hypergonadotropic delayed pubertyبي
• Both have low estrogen or testosterone
• High FSH & LH → hypergonadotropic
