PART XXXI: the skin & PART XXI: Diseases of the Blood
Skin and Blood Disorders Quiz
Test your knowledge on common skin conditions and blood disorders affecting children with our comprehensive quiz. This quiz consists of 46 carefully crafted questions that cover essential topics, such as treatments, diagnoses, and risk factors.
Topics covered include:
- Scabies and Acne Treatments
- Hemolytic Anemias
- Folic Acid and Iron Deficiencies
- Sickle Cell Anemia Risks
The treatment of choice for scabies is
Oral ivermectin
Lindane 1% cream
Sulfur ointment 5-10%
Permethrin 5% cream
Crotamiton 10% cream
All topical preparations for acne vulgaris must be used for 6-8 wk before their effectiveness can be assessed. Of the following, the primary topical preparation should be
Azelaic acid
Salicylic acid
Topical retinoid
Benzoyl peroxide
Topical clindamycin
Approximately 20% of normal neonates demonstrate acne in the 1st mo of life.Treatment is usually unnecessary. If desired, the lesions can be treated effectively with
Azelaic acid
Salicylic acid
Topical retinoid
Benzoyl peroxide
Topical clindamycin
The nodules MOST commonly seen in children are
Fibrofolliculomas
Epidermoid cysts
Pilar cyst
Pilomatricoma
Trichoepithelioma
The replacement of elemental zinc for individuals with inherited acrodermatitis enteropathica is equal to
1 mg/kg/24 hr
3 mg/kg/24 hr
5 mg/kg/24 hr
7 mg/kg/24 hr
10 mg/kg/24 hr
The MOST common risk factor for scurvy in children is
Prolonged antibiotics use
Psychiatric disease
Exclusive breast feeding
Chronic diarrhea
Cow milk protein allergy
The hematologic features of congenital hypoplastic anemia (Diamond-Blackfan Anemia) include all the following EXCEPT
Normocytic anemia
Reticulocytopenia
Deficiency or absence of red blood cell bone marrow precursors
Elevated fetal hemoglobin (Hb F)
Elevated serum iron levels
The MOST specific test that is helpful to differentiate Diamond-Blackfan anemia from transient erythroblastopenia of childhood is
Hemoglobin electrophoresis
Polyhydramniosreticulocytes count
Erythrocyte adenosine deaminase (ADA) enzyme level assay
Bone marrow examination
Mean corpuscular volume (MCV)
Anemia and reticulocytopenia that occur in the 2nd half of infancy period is LEAST likely due to
Congenital hypoplastic anemia (Diamond-Blackfan anemia)
Transient erythroblastopenia of childhood
A protracted, prolonged course of the anemia of hemolytic disease of the newborn
Aplastic crises complicating various types of chronic hemolytic anemias
Fanconi anemia
The main stay of treatment for congenital hypoplastic anemia is
Corticosteroids
Androgen
Antithymocyte globulin (ATG)
Fully matched-related stem cell transplantation
Fully matched-unrelated stem cell transplantation
The valuable diagnostic feature that differentiate anemia of chronic disorder from iron deficiency anemia is
Low serum iron
Low or normal serum transferrin
Normal bone marrow cellularity
Normochromic normocytic RBC
Leukocytosis
All the following are true regarding physiologic anemia of infancy EXCEPT
It is exaggerated in premature infants
The hemoglobin concentration range is between 9-11 g/dL
The hemoglobin concentration rarely falls below 10 g/dL in healthy infants
Vitamin E deficiency does not play a role
Iron deficiency is a contributing factor
Folic acid deficiency may develop in the following children EXCEPT
A term infant fed on goat`s milk
An infant fed on unfortified powdered milk
An infant fed on pasteurized cow's milk
A child with chronic use of phenytoin anticonvulsant
A child with trimethoprim prophylaxis for recurrent urinary tract infection
A 1-year-old child has folic acid deficiency since the age of 4 months, the best indicator of this deficiency is
Significant increment of mean corpuscular volume MCV
Significant fall of reticulocytes count
High level of lactate dehydrogenase LDH
Increase number of hypersegmented neutrophils
Decrease level of RBC folate
The first laboratory marker in progressive iron deficiency anemia is
Depletion of bone marrow hemosiderin
Falling of serum ferritin
Decrease of serum iron and increase of the iron-binding capacity
Decrease hemoglobin synthesis
An extremely high RBC distribution width (RDW) is MOST likely consistent with
Iron deficiency anemia
Megaloblastic anemia
Sideroblastic anemia
Thalassemia
Sickle cell anemia
The laboratory finding that is MOST likely consistent with the diagnosis of spherocytosis is
High reticulocytes count of more than 10%
Normal mean corpuscular volume MCV
Low mean corpuscular hemoglobin MCH
High mean corpuscular hemoglobin concentration MCHC
Indirect hyperbilirubinemia
In hereditary spherocytosis, all the following will resolve postsplenectomy EXCEPT
Osmotic fragility
Anemia
Reticulocytosis
Hypoplastic/aplastic crises
Hyperbilirubinemia
Splenectomy is recommended in all the following conditions EXCEPT
A 6-year-old child with hereditary spherocytosis and significant hemolysis
A 7-year-old child with hereditary elliptocytosis and a hemoglobin level of 7 g/dL and corrected reticulocytes count of more than 15%
An 8-year-old child with hereditary stomatocytosis with hemolysis
A 6-year-old child with thalassemia major with splenomegaly and frequent blood transfusion requirement
A 12-year-old child with chronic immune thrombocytopenia not responding to all modalities of medical treatment
The best diagnostic test for paroxysmal nocturnal hemoglobinuria (PNH) is
Acidified serum hemolysis (HAM) test
Sucrose lysis test
Complement assay
Flow cytometry
Bone marrow study
All the following may occur as a renal manifestation in a child with sickle cell anemia EXCEPT
Polyuria
Hyposthenuria
Nephrotic syndrome
Hematuria
Acute renal injury
The least common infection that may occur in a 6-year-old child with sickle cell anemia is
Pneumococcus sepsis
Haemophilus influenzae meningitis
Salmonella osteomyelitis
E.coli urinary tract infection
Parvovirus B19 aplastic episode
Blood transfusion therapy in a child with sickle cell anemia is indicated in all the following conditions EXCEPT
Acute chest syndrome
Stroke
Chronic intolerable pain syndrome
Avascular necrosis of the hip joint
Splenic sequestration
The best assessment of iron overload for patients with thalassemia major is achieved by
Liver MRI
Bone marrow biopsy
Serum iron
Serum ferritin
Total iron binding capacity
A healthy 5-mo-old boy appears pale. Examination is unremarkable. Lab findings include: Hb 8.1 g/dl; WBC 4,800/mm3; platelets 144,000/mm3; MCV, 111 fl; blood film showed hypersegmented neutrophils; serum B12, 65 pg/mL (low). The infant is vigorously breast fed. Of the following, the NEXT step of the management is
Performing Schilling test
Check serum B12 of the mother
Parenteral administration of vitamin B12
Administration of both folic acid and vitamin B12
Transfuse packed RBCs
A 9-month-old child with a hemoglobin concentration of 10 gm/dL and marked microcytosis; serum iron and total iron binding capacity are within normal limits; serum ferritin and hemoglobin electrophoresis are also normal. Of the following, the MOST likely diagnosis is
Iron deficiency anemia
Sideroblastic anemia
ß-thalassemia minor
α-thalassemia trait
Anemia due to chronic disease
All the following may cause autoimmune hemolytic anemia EXCEPT
Systemic lupus erythematosus (SLE)
Immunodeficiency
Mycoplasma pneumoniae infection
Lymphoproliferative disorder
Penicillin drug administration
Fragmentation hemolysis by mechanical injury may be seen in all the following EXCEPT
Extensive burns
Kasabach-Merritt syndrome
After cardiac surgery for prosthetic heart valve replacement
Thrombotic thrombocytopenic purpura (TTP)
Hemolytic uremic syndrome (HUS)
All the following conditions may be associated with iron deficiency EXCEPT
Hookworm infestation
Prolonged intravascular hemolysis
Celiac disease
Congenital heart disease with right to left shunt
Prolonged use of isoniazid (INH)
Fresh frozen plasma (FFP) transfusion is the best treatment for which of the following conditions
Hemophilia a
Hemophilia b
Factor vii deficiency
Immunoglobulin replacement therapy
Bleeding due to warfarin therapy
Transfusion of fresh frozen plasma (FFP) is efficacious for the treatment of deficiency of all the following coagulation factors EXCEPT
Factor V
Factor X
Factor XI
Factor XIII
Protein C
Fresh frozen plasma (FFP) transfusion/replacement is indicated in all the following conditions EXCEPT
Transfusion-related bacterial infections
Transfusion-related viral infections
Graft-versus-host disease (GVHD)
Allergic reactions
Transfusion-related acute lung injury (TRALI)
CMV-transmitted infection is least likely occurring in transfusion of which of the following blood products?
Whole blood
Packed RBCs
Granulocytes
Platelets
Fresh frozen plasma
A prolonged thrombin time with normal reptilase time is consistent with
Dysfibrinogenemia
Afibrinogenemia
Factor XIII deficiency
Disseminated intravascular coagulopathy (DIC) with high level of fibrin split products
Heparin overdose
Spontaneous intracranial hemorrhage is more likely to occur in
Factor VII deficiency
Factor VIII deficiency
Factor IX deficiency
Factor XI deficiency
Factor XIII deficiency
Systemic amyloidosis may be associated with deficiency of
Factor VII
Factor VIII
Factor IX
Factor X
Factor XI
In which of the following conditions you should use a plasma that is frozen within 24 hours after collection?
Factor V deficiency
Factor VII deficiency
Factor IX decifiency
Factor X deficiency
Factor XI deficiency
In severe liver disease with prolongation of the bleeding time, the best effective treatment before doing liver biopsy is
Intravenous vitamin K
Intramuscular vitamin K
Oral vitamin K
Fresh frozen plasma
Intravenous DDAVP
Vitamin K-dependent clotting factors include all the following EXCEPT
Factor I
Factor II
Factor VII
Factor IX
Protein S
A 16-year-old female is found to have multiple bruising and hypochromic microcytic anemia; during her first pregnancy she noticed disappearance of the bruises; she has a past history of uncomplicated emergency appendectomy at the age of 10 year. Of the following, the drug MOST likely beneficial for alleviation of her symptoms is
Ferrous sulphate
Desmopressin acetate (DDAVP)
Recombinant factor VIII
Recombinant factor IX
Aminocaproic acid
Low platelets count may be encountered in all the following EXCEPT
Von Willebrand disease (VWD) type 2 B
VWD type 2 N
Platelet type pseudo VWD
Bernard Soulier syndrome
Wiskott Aldrich syndrome
Which of the following is FALSE regarding standard unfractionated heparin therapy?
It acts by enhancing the antithrombin III activity
It can be used safely during pregnancy
It should not be given for a child with bacterial endocarditis
It can be given intramuscularly
It needs monitoring by PTT test
All the following are true regarding low molecular weight heparin (LMWH) in comparison with unfractionated heparin (UFH) EXCEPT
It is more stable
It is ease to titrate
It is monitored by activated PTT
It can be used subcutaneously
It can be used as an outpatient
A previously healthy 10-month-old boy develops pallor over 2 weeks. Examination is unremarkable except for pallor. Lab tests includes: hemoglobin, 4.9 g/dL; WBC, 6700/mm3; platelets count, 180000/mm3; MCV, 79 fL; reticulocyte count 0.8%; hemoglobin electrophoresis, normal. Of the following, the MOST likely cause for these findings is
Pure red cell aplasia
Transient erythroblastopenia of childhood
Thalassemia minor
Aplastic anemia
Parvovirus infection
Both quantitative and qualitative platelets defects are seen in
Generalized vasculitis
Bernard-Soulier syndrome
Glanzmann's Thrombasthenia
Type I von Willebrand disease
Uremia
Which of the following viruses is more likely to be associated with chronic immune thrombocytopenia?
Cytomegalovirus
Parvovirus
Influenza virus
Parainfluenza virus
Human immune deficiency virus
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