Haematology Prometric Style Questions – 50 Cases with Answers

What this deck covers

Haematology Prometric Style Questions in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. A toddler on too much milk
2. Two causes of a small cell
3. The value that misleads
4. Looking down the microscope
5. Is the treatment working?
6. Sore tongue and numb feet
7. Big cells and no numbness
8. Pale, yellow and a big spleen
9. Sudden pallor with jaundice
10. Dark urine after a meal
11. Swollen hands and feet
12. Small cells with normal iron
13. Eighteen months of transfusions
14. Pale with no young cells
15. A big tender spleen
16. Bone infection in sickle disease
17. Repeated severe infections
18. Empty marrow, low everything
19. Three lines down at once
20. Bruises in a well child
21. A very low count in a well boy
22. Bleeding gums and family periods
23. Giant platelets that will not stick
24. Big platelets and odd neutrophils
25. A swollen knee in a baby boy
26. What the father passes on
27. Working out the dose
28. Factor that stopped working
29. Which ones need the vitamin
30. Bleeding on day four at home
31. Oozing from every needle
32. Raising it without the volume
33. Plethoric and thick blood
34. Who runs out of iron first
35. New shadow after a pain crisis
36. Sudden weakness down one side
37. Four admissions in a year
38. Pain like every other time
39. After the spleen comes out
40. Fever on chemotherapy
41. Loin pain fifteen minutes in
42. Peeling paint and stippled cells
43. A low count at eight weeks
44. Yellow in the first twelve hours
45. Petechiae with a well mother
46. Short with absent thumbs
47. Both parents carry the gene
48. Four hours and not settling
49. Why the blood is treated
50. Small cells and a normal A2

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Iron deficiency anaemia, Sickled cells and target cells, Iron deficiency, Pyruvate kinase in the glycolytic pathway, Iron chelation, Salmonella species, Bone marrow aspiration and trephine, In the extrinsic pathway, Bleeding time, A mixing study for an inhibitor, Disseminated intravascular coagulation, Term babies exclusively breastfed to four months, Long-term oral corticosteroids, Cultures then intravenous antibiotics within an hour.

Clinical pearls from this deck

• Ask how much milk a pale toddler drinks before you order anything. The history usually makes the diagnosis the laboratory then confirms.
• Serum iron is low in both. Only the ferritin tells you whether the store is empty or merely locked.
• Read a ferritin next to the C-reactive protein, never alone. A normal ferritin in an inflamed child is one of the commonest missed diagnoses in paediatrics.
• Compare the red cell with a small lymphocyte nucleus on the same field. Smaller than that nucleus is genuinely microcytic, whatever the machine reports.
• Check a reticulocyte count at one week when iron does not seem to be working. It separates non-adherence from a wrong diagnosis before you have wasted a month.
• Never give folate alone to a macrocytic patient before excluding B12. It fixes the blood count and lets the spinal cord damage advance unnoticed.

This deck is open to everyone with no sign-in. Work through it once for recognition, then again a week later to test yourself.

More from this system: all haematology case decks · pediatric reference values.