20 Causes of anaemia A autoimmune haemolytic G thalassaemia anaemia H__ iron deficiency anaemia B_ spherocytosis 1 sickle-cell anaemia © pyruvate kinase deficiency J folate deficiency D aplastic anaemia K sideroblastie anaemia E thalassaemia minor L pernicious anaemia F glucose-6-phosphate dehydrogenase deficiency For each clinical scenario below, give the most likely cause for the clinical findings. Each option may be used only once. 1A 23-year-old man presents with recurrent nose-bleeds and infection after a course af chematherapy. 2A 24-year-old Cypriot man presents with a worsening anaemia and jaundice. A blood film taken several weeks after the incident shows the presence of Heinz bodies. 3A 50-year-old man presents with tiredness, dyspnoea and paraesthesia. On ‘examination he showed extensor plantars, brisk knee jerks and absent ankle Jerks. His blood film shows macrocytic anaemia. 4 A.23-year-old woman on trimethoprim for recurrent urinary tract infections (UTIs) presents with a macrocytic anaemia. 5 A 25-year-old woman with systemic lupus erythematosus (SLE) presents with an acute anaemia. She was successfully treated with steroids. Direct Coombs’ test was strongly positive; direct antiglobulin test was positive with IgG alone.21 Anaemia A sickle-cell disease G__ sideroblastic anaemia B pyruvate kinase deficiency H_ thalassaemia major © haemophilia A 1 aplastic anaemia D__ hereditary spherocytosis J iron deficiency anaemia E autoimmune haemolytic K thalassaemia minor anaemia L__ anaemia of chronic disease F vitamin By: deficiency anaemia For each clinical scenario below, give the most likely cause for the clinical findings. Each option may be used only once. 1A 70-year-old woman with rheumatoid arthritis presents with a normocytic ‘normochromic anaemia: Hb 10.1 g/dL. Haematinics normal, direct Coombs’ test negative. 2 A24-year-old woman with anaemia and splenomegaly is referred to the haematologist. Her direct Coombs’ test is negative. Her bload film shows the presence of reticulocytes and spherocytes. 3. A117-year-old tourist from the West Indies presents with pain in his abdomen and hands. He is pyrexial and anaemic. 4 Full blood count of a 65-year-old woman taking ibuprofen for her osteoarthritic knee pain for a number of years shows a microcytic anaemia. 5 Full blood count of a 45-year-old man treated for gastric carcinoma with total gastrectomy reveals a macrocytic anaemia.blood fil 22 The peripher: A vitamin By, deficiency anaemia G_—_hyposplenism B thalassaemia B H_ hypersplenism hypothyroidism 1 bone marrow failure D__ haemophilia B J iron deficiency anaemia E uraemia K anaemia of chronic disease F sickle-cell anaemia L_— none of the above For each finding from a peripheral blood film below, suggest the most likely cause for the result observed. Each option may be used only once. 11 Presence of Burr cells in a patient being treated in the intensive care unit (ICU) with multiple organ fallure. Howell-Jolly bodies in a patient with coeliac disease. ‘Neutrophil hypersegmentation in a patient with paraesthesia in the fingers and toes. Microcytic hypochromic film in a 24-year-old woman presenting with lethargy. Film of a 3-month-old baby boy shows a hypochromic micracytic anaemia with target cells and nucleated red blood cells. There are markedly high HbF levels.