HEMAT IMED PAPER Year 4 Internal Medicine Notes OmpathStudy

HEMAT IMED PAPER Year 4 · Internal Medicine Collection: 4TH YEAR ALL NOTES / IMED / internal medicine revision / papers -- 1% 10 fesT @5'5/37 65 ek Mount Kenya University N’ \D OF SEMESTER CAT FOR MBChB 4 F) r\‘li? ‘flo: TIME: 2 HOURS 1. Which of the following statements on anaemia is INCORRECT? A. A patient with a reticulocyte count of 5% has hemolysis. -~ B, Hypoproliferative anaemia is characterized by a reticulocyte count of less than 2.5%. ’Acute blood loss is associated with reticulocyte changes.» D. Sideroblastic anaemia is associated with microcytic anaemia.~ E. Anaemia of chronic disease is associated with reduced erythropoietin responsiveness. 2. Which of the following statements is FALSE? A. In iron deficiency anaemia the soluble transferrin receptor is increased.” In anaemia of chronic disease the transferrin saturation is increaseds C. Transferrin levels may be reduced in anemia of chronic illness..~ D. Ferritin level is reduced in iron deficiency anemia., E. None of the above. 3. The following conditions are associated with megaloblastic anaemia EXCEPT. . Haemolysis . Anticonvulsants. C.ARVs. ) D. Primary bone marrow disorders. E. Atrophic gastritis 4. Which of the following statements is TRUE? A. Alcoholic macrocytosis is associated with neutrophil hypersegmentation B. Liver disease is typically associated with megaloblastic macrocytosis . Ferritin level of 200mceg/l is likely with iron deficiency anemia ). In cobalamin deficiency homocysteine level rises E.None of the above 5. The following are findings consistent with haemolysis EXCEPT one. A. Raised serum haptoglobin. B. Increased level of serum unconjugated bilirubin. C. Microspherocytes. D. Increased serum LDH. Decreased urine urobilinogen 6. Which of the following statements is the odd one out concerning haemochromatosis? A. May be associated with thyroid dysfunction. Itis an autosomal dominant disorder. C. Association with HFE.\n\nD. Low level of Hepeidin is associated with severe iron overload. E. Sepsis is a likely feature 7. A 15 year old girl has bilateral hacmarthrosis of elbow joins. She has a W {hat is tender. She has bled from a venepuncture site for the past 24 hours. ) following is the MOST likely diagnosis? A Classical hemophilia. Von Willebrand’s disease. inated intravascular Coagulopathy (DIC). C deficiency exertional dyspnea and pallor. P lar volume(MCV) is egetarian presents with general malaise, ows segmented neutrophils and the mean corpuscu the following statements is TRUE? ophy occurs 1 levels are low.. Prussian blue stain is negative. are common. invariably fatal. statements on haemostasis are true EXCEPT. function. extrinsic pathway. ‘evaluates the extrinsic pathway:x nboplastin Tim saluates conversion of fibrinogen to fibrin. common in coagulation factor disorders than in platelet di small cuts is more common in platelet disorders than in coagulat s extremely rare in platelet disorders. associated with both platelet and coagulation factor disorders. 7-year-old teacher complains of difficulty maintaining her concentration at work teaching school children. She states that over the last four months she has become increasingly and easily fatigued. She has noticed it has become more difficult for her to lift books, rise 5 her chair and she has also noticed a tingling sensation in her fingers. Examination shows a positive babinski sign and absent reflexes. A blood test reveals the following: Haemoglobin 10 /dI, MCV 103 {L.The MOST likely diagnosis is: thyroidism BI2 deficiency ic acid deficiency 1 toxicity s year-old man complains of a 4-week history of general malaise and fatigue, he has also ousers have become more loose fitting. A blood test shows the following results: /dL MCV 90 L,Platelet count 250 x 109/L WBC 10 x 109/L Seru iron 10\n\npmol/L. low Total iron-binding capacity of 40 pmol/L Serum ferritin 160 ug/L Thé MOST likely diagnosis is: A. Thalassaemia ) Iron deficiency anaemiayAnaemia of chronie disease D. Macrocytic anaemia E. Aplastic anaemiay. 13. A 29-year-old woman complains of a 1-week history of weakness and malaise, she has recently b;mmc a vegelarian and eats mostly green vegetables and drinks lots of tea during the day. She is apyrexial and has a C-reactive protein (CRP) <5. You suspect an abnormality of the patient’s iron stores. What is the most appropriate investigation to determine iron store levels? . Bone marrow biopsy Serum ferritin C. Serum transferrin D. Total iron binding capacity E. Serum iron 14. A 65-year-old man presents with a chronic history of malaise, shortness of breath and paraesthesia in his hands. He appears tired and pale while speaking and on examination his heart rate is 115, respiratory rate 16. A Schillings test is positive while blood tests reveal a macrocytic anaemia and a Coombs test is negative. The MOST likely diagnosis is: A. Tron deficiency anaemia B. Haemorrhage . Anaemia of chronic disease ) Penicious anaemia E. Autoimmune haemolytic anaemia 15. A 21-year-old woma