Monday, September 14, 2009

Clinical gems....Hematology

We'll review some of the likely topics asked on the boards.



Q: What is the BEST diagnostic test for detecting iron deficiency anemia?

A: Serum Ferritin level... (serum iron test is mainly for screening)



Q: What physical SIGNS are highly specific for iron deficiency anemia?

A: Both.... Blue Sclera and Koilonychia...(spoon shaped fingernails)



Q: What infectious agent can cause sudden Aplastic Anemia in a young adult?

A: Parvovirus-B19 infection



Q: What disorder is the most common cause of vitamin B12 deficiency?

A: Pernicious Anemia... (due lack of gastric intrinsic factor)



Q: What peripheral smear finding is associated with Lead Poisoning?

A: Basophilic Stippling...(small granules in RBC's)



Q: What is the BEST test for definitive diagnosis of vitamin B12 deficiency?

A: Serum Methylmalonic Acid...( serum B12 level used mainly for screening).



Q: What is the MOST frequent blood transfusion reaction?

A: FNHTR (Febrile Non-Hemolytic Transfusion Reaction). Use Leukocyte reduced RBC's.



Q: Which type of anemia presents with paresthesias/ataxia/prominent NEURO symptoms?

A: Cyanocobalamin deficiency(B12). Causes demyelination of the dorsolateral portion
of the spinal cord. Foot burning...numbness are often the FIRST symptoms.


Q: Does deficiency of Folic Acid alone cause neurologic abnormalities?

A: No....only B12 deficiency.



More topics soon to follow...

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