Single Best Answers and EMQs in Clinical Pathology

407 Pages·2013·3.95 MB·English

by  Sukhpreet Dubb

SBAs and EMQs in
CLINICAL
PATHOLOGY
© 2013 by Taylor & Francis Group, LLC
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© 2013 by Taylor & Francis Group, LLC
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SBAs and
EMQs in
CLINICAL
PATHOLOGY
Sukhpreet Singh Dubb MBBS Bsc (Hons) FY1 Doctor,
Imperial College London, UK
Neeral Patel MBBS BSc (Hons) Academic FY1 Doctor,
West Midlands Deanery, Imperial College London, UK
Nishma Manek MBBS BSc (Hons) Oxford Deanery,
Imperial College London, UK
Dhruv Panchal MBBS Bsc (Hons) FY1 Doctor, Oxford Deanery,
Imperial College London, UK
Shams Shamoon BSc (Hons) Final Year Medical Student,
Imperial College London, UK
Editorial Advisor:
Karim Meeran, Professor of Endocrinology, Imperial College London, UK
Boca Raton London New York
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Version Date: 20130114
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Dedication
To my parents and brother, who during the darkest of nights have forever
remained the brightest stars
Sukhpreet Singh Dubb
To my parents, family, and friends – thank you for your invaluable support
Neeral Patel
To my parents, brother, and late aunty Usha- I wouldn’t be where I am without
you. And a special thank you to all the inspiring teachers I came across at
Imperial.
Nishma Manek

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Contents
Preface xiii
Acknowledgements xv
Reference intervals xvii
SECTION 1 – CHEMICAL PATHOLOGY EMQs
1. Sodium handling 2
2. Potassium handling 3
3. Acid–base balance 4
4. Liver function tests 5
5. Endocrine chemical pathology 6
6. Calcium handling 7
7. Plasma proteins 8
8. Vitamin deficiencies 8
9. Inborn errors of metabolism 9
10. Therapeutic drug monitoring 9
Answers 11
SECTION 2 – CHEMICAL PATHOLOGY SBAs
1. Arterial blood gas sample 27
2. Paradoxical aciduria 27
3. Hyponatraemia 28
4. Hypercalcaemia 28
5. Vitamin deficiency tests 29
6. Hyperkalaemia 29
7. Hypernatraemia 30
8. Water deprivation test 30
9. Acute abdominal pain 31
10. Exacerbating factors for gout 31
11. Anion gap 32
12. Estimated plasma osmolarity 32
13. Biochemical abnormalities in chronic renal failure 32
14. Thyroid function tests 33
15. Biochemical abnormalities of metabolic bone disease 33

16. Inherited metabolic disorders 34
17. Neonatal jaundice 34
18. Vitamin D deficiency 34
19. Raised alkaline phosphatase 35
20. Nutritional deficiency 35
21. Therapeutic drug monitoring 35
22. Hypoglycaemia 36
23. Acute pancreatitis 36
24. Treatment of hyperkalaemia 37
25. Myocardial infarction 37
Answers 38
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viii Contents
SECTION 3 – HAEMATOLOGY EMQs
1. Anaemia 74
2. Haemolytic anaemia 75
3. The peripheral blood film 76
4. Bleeding disorders 76
5. Thrombophilia 77
6. Complications of transfusion 78
7. Haematological neoplasms (1) 79
8. Haematological neoplasms (2) 79
9. Haematological neoplasms (3) 80
10. Haematology of systemic disease 81
Answers 82
SECTION 4 – HAEMATOLOGY SBAs
1. Blood transfusion (1) 99
2. Blood transfusion (2) 99
3. Blood transfusion (3) 99
4. Haemolytic anaemia (1) 100
5. Haemolytic anaemia (2) 100
6. Infectious mononucleosis 100
7. Haemoglobinopathies in children (1) 100
8. Haemoglobinopathies in children (2) 101
9. Anaemia (1) 101
10. Anaemia (2) 101
11. Anaemia (3) 102
12. Anaemia (4) 102
13. Anaemia (5) 102
14. Macrocytic anaemia 102
15. Hepatomegaly 103
16. Plasma cell disorders (1) 103
17. Plasma cell disorders (2) 103
18. Platelet count (1) 104
19. Platelet count (2) 104
20. Obstetric haematology 104
21. Vitamin K dependent clotting factors 105
22. Deep vein thrombosis 105
23. Thrombocytopenia 105
24. Erythrocyte sedimentation rate 106
25. Polycythaemia 106
26. Haemolysis 106
27. Secondary polycythaemia 107
28. von Willebrand’s disease (1) 107
29. Myeloproliferative disease 107
30. Lymphoma 108
31. Hodgkin’s lymphoma 108
32. Glucose-6-phosphate dehydrogenase deficiency 108
33. Anaemia (6) 109
34. Splenomegaly 109
35. Hodgkin’s lymphoma staging 109
36. Acute leukaemia 110
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Contents ix
37. Treatment of chronic myeloid leukaemia 110
38. von Willebrand’s disease (2) 110
39. Myelodysplastic syndrome 111
40. Factor V Leiden 111
Answers 112
SECTION 5 – IMMuNOLOGY EMQs
1. Immunodeficiency (1) 151
2. Immunodeficiency (2) 151
3. Transplantation 152
4. Autoimmune antibodies (1) 153
5. Autoimmune antibodies (2) 154
6. Hypersensitivity (1) 154
7. Hypersensitivity (2) 155
8. Immune-based therapies 156
9. Nephritic disorders 156
10. Diagnostic immunology 157
Answers 159
SECTION 6 – IMMuNOLOGY SBAs
1. Innate immunity (1): Physical barriers 176
2. Innate immunity (2): Complement investigations 176
3. Innate immunity (3): Cellular response 176
4. Adaptive immunity: Antibodies 177
5. Human leukocyte antigen 177
6. Immune tolerance 177
7. Mechanisms of autoimmunity 177
8. Primary immunodeficiency (1): Phagocyte deficiency 178
9. Primary immunodeficiency (2): Complement deficiency 178
10. Primary immunodeficiency (3): T-cell deficiency 178
11. Primary immunodeficiency (4): B-cell deficiency 179
12. Secondary immunodeficiency 179
13. Hypersensitivity reactions (1) 179
14. Hypersensitivity reactions (2) 179
15. Hypersensitivity reactions (3) 180
16. Hypersensitivity reactions (4) 180
17. Hypersensitivity reactions (5) 180
18. Hypersensitivity reactions (6) 181
19. Hypersensitivity reactions (7) 181
20. Hypersensitivity reactions (8) 181
21. Hypersensitivity reactions (9) 181
22. Transplantation and rejection (1) 182
23. Transplantation and rejection (2) 182
24. Transplantation and rejection (3) 182
25. Human immunodeficiency virus 183
26. Vaccines 183
27. Immune-based therapies (1) 183
28. Immune-based therapies (2) 183
29. Immune-based therapies (3) 184
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x Contents
30. Immune-based therapies (4) 184
31. Immune-based therapies (5) 184
32. Rheumatic diseases (1) 185
33. Rheumatic diseases (2) 185
34. Rheumatic diseases (3) 185
35. Rheumatic diseases (4) 185
36. Autoantibodies in type 1 diabetes mellitus 186
37. Autoimmune thyroid disease 186
38. Autoimmune polyendocrine syndromes 186
39. Autoantibodies in liver disease 187
40. Autoimmune gastrointestinal disease 187
41. Skin disease (1) 187
42. Skin disease (2) 188
43. Non-proliferative glomerulonephritis 188
44. Proliferative glomerulonephritis 188
45. Lupus nephritis 189
46. Vasculitis 189
47. Neurological disease (1) 189
48. Neurological disease (2) 190
49. Eye disease 190
50. Diagnostic immunology 190
Answers 191
SECTION 7 – MICrOBIOLOGY EMQs
1. Respiratory tract infections 228
2. Gastrointestinal infections 228
3. Central nervous system infections 229
4. Sexually transmitted infections 230
5. Anti-microbials 230
6. Viral infections 231
7. Anti-virals 232
8. Fungal infections 232
9. Zoonoses 233
10. Neonatal and childhood infections 234
Answers 235

SECTION 8 – MICrOBIOLOGY SBAs
1. Sputum culture 252
2. Mantoux test 252
3. Pneumonia (1) 252
4. Pneumonia (2) 252
5. Endocarditis 253
6. Anti-virals 253
7. Vaccine schedule 253
8. Urinary tract infections 253
9. Diarrhoea (1) 254
10. Diarrhoea (2) 254
11. Protozoal disease 254
12. Investigation of an ulcer 255
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