HAEMATOLOGICAL BLOCK A 28-year-old woman who is at 33 weeks of gestation presents to emergency ward with heavy vaginal bleeding.

She was diagnosed to have abruptio placentae. As she is being prepared for the surgery, you notice that there is blood seeping from her IV and venupuncture sites and that she has petechial rash. 1. 2. 3. 4. 5. 6. State your diagnosis What are other causes of disease you stated above? Explain the pathogenesis of the disease you stated above List 2 expected findings from this patients peripheral blood smear List 4 investigations and expected findings in this case State the treatment

A 73 years old woman brought to your office complaining of swollen, painful left calf. She denies any sort of trauma, but does admit that she is relatively inactive. PE reveals positive Homan sign 1. 2. 3. 4. 5. 6. State your diagnosis State the pathogenesis of the disease you stated above (with the aid of diagram) State other precipitating factors for your diagnosis What is Homan sign? State 2 complications that may arise from this condition State the treatment

A 7 years old girl is brought to the emergency department due to uncontrollable bleeding following laceration to her palm. Further questioning reveals that she has been taking aspirin following a viral illness, and that her mother and brother both suffer from a bleeding disorder. Following lab investigations, she was diagnosed to have von Willebrand disease 1. 2. 3. 4. 5. Draw the coagulation cascade Explain the pathophysiology of uncontrollable bleeding in this patient State the investigations and expected findings in order to make the diagnosis in this patient State other signs and symptoms that you expect to find out in this patient State briefly how aspirin may worsen this patient condition

A 6 years old boy presented to your office complaining of fatigue, fever and history of recurrent epistaxis and urinary tract infections. He has enlarged liver, spleen, swollen testicle and a petechial rash over his entire body. Blood test reveals pancytopenia and presents of multiple blast. He was diagnosed to have leukaemia 1. 2. 3. 4. 5. 6. Define leukaemia Classify leukaemia (based on Myeloid and lymphoid) and state 4 differences base on blood smear What do you understand by leukaemogenesis? State the relevant cause State the pathophysiology of recurrent epistaxis, recurrent UTI, swollen testicle and fatigue in this patient State common types of drugs used in chemotherapy Explain briefly how do you measure liver and spleen and state the normal size (how do you differentiate the mass is arise from the spleen then kidney?)

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THALASSAEMIA CASE 1. 2. 3. 4. Define thalassaemia Classify a-thalassaemia based on clinical classification Classify B-thalassaemia based on pathological classification Explain the pathophysiology of increasing haemolysis in a-thalassaemia and skeletal deformity in Bthalassaemia

An 8 years old boy presented to emergency department with uncontrollable bleeding into his right knee joint. Upon taking family history, you learn that two of the boys maternal uncles suffer from bleeding disorder. After series of investigations, he was diagnosed to have haemophilia 1. 2. 3. Classify and define haemophilia State the investigations been made and how the findings may differentiate between types of haemophilia State the treatment in haemophilia A and B

4 y/o girl on a regular blood transfusion presented with lethargy. Her brother also face the same condition. On examination, she appeared pale and tachypnoeic. On abdominal examination, the liver is palpable 5cm below subcostal margin and the spleen is palpable 3cm below subcostal margin. Hb electrophoresis - HbA2 (3.5%) - HbF (92%) - HbA (4.5%) 1) Possible condition based on electrophoresis 2) Explain the findings of her abdominal examination 3) List the 2 possible long-term complications of the blood transfusion 4) Outline the principles of cross matching(GXM) 5) Give 2 advantages and 3 indications for GSH

Soalan basic 1. 2. Differentiate intravascular with extravascular haemolysis (ALL THE POINTS!) Diagnose, define and state the pathogenesis, clinical findings and pathological findings in the peripheral blood smear below:

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