MLPAO Hematology and Coagulation Case Studies

Question 1

A patient has hemoglobin 85 g/L, MCV 65 fL, RDW 18%, and serum ferritin 5 µg/L. What is the most likely diagnosis?

Accepted Answer

Iron deficiency anemia

Answer

Beta-thalassemia trait

Answer

Anemia of chronic disease

Answer

Sideroblastic anemia

Question 2

A 70-year-old patient has WBC 85 × 10⁹/L with 90% mature lymphocytes and numerous smudge cells. What is the most likely diagnosis?

Accepted Answer

Chronic lymphocytic leukemia

Answer

Acute lymphoblastic leukemia

Answer

Infectious mononucleosis

Answer

Chronic myeloid leukemia

Question 3

A patient on warfarin has an INR of 8.5 with no active bleeding. What is the recommended management?

Accepted Answer

Hold warfarin and administer oral vitamin K

Answer

Continue warfarin at the same dose

Answer

Give fresh frozen plasma immediately

Answer

Increase warfarin dose

Question 4

A patient has prolonged PT and aPTT that both correct on mixing with normal plasma. Which condition is most likely?

Accepted Answer

Multiple factor deficiency (such as liver disease or DIC)

Answer

Lupus anticoagulant

Answer

Factor VIII inhibitor

Answer

Antiphospholipid syndrome

Question 5

A newborn has hemoglobin F 90%, hemoglobin A 0%, and hemoglobin A2 2%. What is the most likely diagnosis?

Accepted Answer

Either normal newborn or beta-thalassemia major — requires follow-up

Answer

Normal newborn hemoglobin pattern

Answer

Beta-thalassemia major

Answer

Sickle cell disease

Question 6

A patient has platelet count 15 × 10⁹/L, normal PT/aPTT, and large platelets on the smear. Anti-platelet antibodies are positive. What is the most likely diagnosis?

Accepted Answer

Immune thrombocytopenia (ITP)

Answer

Thrombotic thrombocytopenic purpura

Answer

Disseminated intravascular coagulation

Answer

Aplastic anemia