2. A 25 year old female complains of fever and
tiredness since 15 days.
Laboratory findings
Hemoglobin - 7 gm/dl
Hematocrit - 21 %
Reticulocyte count- 10%
Peripheral blood smear
Interpret the peripheral blood smear.
RBCs are normocytic normochromic, many
polychromatophilic RBCs and normoblasts are seen,
agglutination of RBCs and spherocytes are also seen.
• WBCs are normal in number, morphology and
distribution.
• Platelets are adequate
Hemolytic Anemia
3. What is the diagnosis?
Immune hemolytic Anemia
What are the causes?
1. Autoimmune Hemolytic Anemia (AIHA)
• Warm antibody type AIHA
➢ Idiopathic, drugs, viral infections, autoimmune disorders, lymphoproliferative disorders
• Cold antibody type AIHA
➢ Infections, autoimmune disorders, chronic lymphoproliferative disorders
2. Alloimmune
• Haemolytic transfusion reaction
• Haemolytic disease of newborn
Hemolytic Anemia
4. A 25 year old male complains of high fever,
chills, productive sputum.
On Examination: Signs of pneumonia
Interpret the peripheral blood smear.
Neutrophila
5. A 20 year old female complains of recurrent
cold.
Eosinophilia
6. A 5 year old boy presented with fever, sore throat and fatigue.
On Examination: Pallor and generalized lymphadenopathy were seen.
Laboratory findings:
Hemoglobin - 6 gm/dl
Total leucocyte count - 1,00,000 cells/cumm
Platelet count - 50,000 /cumm
Bleeding time – Prolonged
Clotting time - Normal
Acute Lymphocytic lukemia
7. A 35 year old boy complains of bleeding gum
and fever.
Hemoglobin - 6 gm%
Total leucocyte count - 32,000cells/cumm
Platelet count - 62,000cells/cumm
Peripheral Blood Smear
Acute Myeloid lukemia
8. A 40 year old lady complains of distension of
abdomen
On examination: marked splenomegaly present
Laboratory findings:
Hemoglobin 10 gm/dl
Total leucocyte count 1.8 lakhs/cumm
Platelet count 3.1 lakhs /cumm
Peripheral Blood Smear
Acute Myeloid lukemia
9. A. Interpret the WBC findings in peripheral smear. What is your diagnosis?
WBCs are markedly increased in number and show myeloid series of cells with shift to left consisting of neutrophils, band
forms, metamyelocytes, myelocytes, promyelocytes and blasts. Basophilia seen
Diagnosis: Chronic Myeloid Leukemia
B. What chromosomal abnormality is frequently seen in this condition?
95% of patients demonstrate Philadelphia chromosome which is the reciprocal translocation between chromosome 9 and
22 [rt (9;22)]
C. What is Leukemoid reaction?
It is a reactive leucocytosis seen in few infections. WBCs are moderately increased in number and show myeloid series of
cells with shift to left consisting of neutrophils, band forms, metamyelocytes, myelocytes and promyelocytes. Blasts are
rare and lack basophilia.
Acute Myeloid lukemia
10. A 12 year old boy complains of bleeding gum,
epistaxis and petechial spots over the arms.
Laboratory Findings
Bleeding Time : 8 minutes
Clotting Time : 6 minutes 30 seconds
Platelet count : 55,000 cells/cumm
Interpret the above findings and give your
diagnosis
Bleeding Disorders
11. A. Interpret the hematological parameters.
• Thrombocytopenia
• Prolonged bleeding time
B. What is your diagnosis?
Suggestive of Idiopathic Thrombocytopenic Purpura
C. Mention two platelet function disorders.
1. Bernard- Soulier Syndrome
2. Glanzmann’s Thrombasthenia
3. Von – Williebrand’s disease
4. Storage pool disease
Bleeding Disorders
12. A 15 year old boy with swollen knee joints
presented with delayed bleeding following tooth
extraction
Laboratory Findings
Hb : 9 gm/dl
Total leukocyte count : 6900 cells/cmm
Platelet count : 1.9 lakhs/cmm
Bleeding Time : 3 mins
Clotting Time : 12 mins
Partial Thromboplastin Time - 55 secs
Interpret the above findings and give your
diagnosis
Clotting Disorders
13. A. Interpret the above findings and give your diagnosis.
A young boy with swollen knee joints (hemarthrosis), delayed bleeding following tooth extraction, prolonged clotting time
and prolonged partial thromboplastin time
Diagnosis: Coagulation disorder
B. Mention two inherited and two acquired coagulation disorders
1. Inherited coagulation disorders
• Hemophilia A (Factor VIII deficiency)
• Hemophilia B (Factor IX deficiency)
• Von-Williebrand disease
• Hypofibrinogenemia
2. Acquired coagulation disorders
• Deficiency of Vitamin K dependent factors
• Disseminated Intravascular Coagulation
• Chronic liver disease
Clotting Disorders
14. A 10 year old boy presented with puffiness of
face
Urinary findings
Volume : 500 ml for 24 hours
Urine protein :1.9 gms(24 hrs)
Microscopy : shows many RBCs and RBC casts
Interpret the above findings and give your
diagnosis
Nephritic Syndrome
15. A. Interpret the above findings.
10-year-old boy having puffiness of face and hypertension with decreased urinary output, moderate proteinuria and red
cell casts in the urine.
B. What is the name of the syndrome?
Nephritic Syndrome
C. Mention the causes for the same.
Post infectious glomerulonephritis
Haemolytic uremic syndrome
IgA nephropathy/Henoch-Schonlein purpura
Membranoproliferative glomerulonephritis
Systemic lupus erythematosus
Nephritic Syndrome
16. A 12 year old boy presented with generalised edema
Urine examination
Volume : 1100ml for 24 hrs
Urine protein : 3.8 gms (24 hrs)
Microscopy : fatty casts seen
Nephrotic Syndrome
17. A. What is the diagnosis?
Diagnosis: Nephrotic syndrome
6-year- old child presented having massive edema and puffiness of face with low serum albumin and high serum
cholesterolHas nephrotic range proteinuria (>3.5gm/day) with fatty cats and fat droplets in urine.
B. Name three primary causes for the above syndrome.
Minimal change disease
Focal and Segmental glomerulosclerosis
Membranoproliferative glomerulonephritis
Nephrotic Syndrome
18. A 16 yr old boy complains of fever with increased frequency of micturition and dysuria
Urinary findings
Volume : 1200ml for 24hrs
Urine protein : 0.8 gms (24 hrs)
Microscopy : 200-300pus cells/hpf
pus cell casts seen
Acute Pylonephritis
19. A. Interpret the above findings and give your diagnosis.
A 16 -year-old boy having fever, increased frequency of micturition and dysuria with normal urinary volume, mild
proteinuria, numerous pus cells and pus cell casts.
Diagnosis: Acute pyelonephritis
B. What are the different types of casts?
1. Hyaline casts
2. Fatty casts
3. Granular casts
4. Cellular casts - Pus cell casts, Red cell casts, Epithelial cell casts
5. Waxy casts
Acute Pylonephritis
20. A 30 yrs old lady complains of fever with increased frequency of micturition and dysuria
Urinary findings
Volume : 1000 ml for 24 hrs
Urine protein : 0.4 gms (24 hrs)
Microscopy : 200-300 pus cells/ hpf
Cystitis
21. A. Interpret the above findings and give your diagnosis
A 30-year-old lady having fever, increased frequency of micturition and dysuria with slight reduction in volume of urine,
mild proteinuria and numerous pus cells.
Diagnosis: Lower urinary tract infection
B. Mention the common causative agents
1. E. Coli
2. Proteus
3. Klebsiella
4. Enterobacter
5. Streptococcus faecalis
6. Staphlococci
Cystitis
22. A 60 year male, complains of severe vomiting, diarrhea, low urine output
On examination: Low volume pulse, hypotension
Laboratory Findings:
Blood urea : 150 mg/dl
Serum creatinine : 4.2 mg/dl
Kidney biopsy shows acute tubular injury
Acute Renal Failure
23. A 70 year old male, Known diabetic and hypertensive since 30 years
On examination: Diabetic retinopathy +
Laboratory Findings:
Proteinuria : +++
Blood urea :170 mg/dl
Serum Creatinine : 7 mg/dl
Kidney biopsy- shows sclerosed glomeruli, hypertensive changes, and chronic tubulointerstitial changes
Chronic Renal Failure
24. A 50 year lady was brought to the hospital in an unconscious state
Urinary findings:
Benedicts test: : Brick red precipitate
Rothera’s test: : Positive
Random Blood Sugar : 412 mg%
Diabetic Keto-acidosis
25. A. What is the diagnosis?
Diagnosis : Diabetic ketoacidosis
Patient has altered sensorium with vomiting and abdominal pain. Random blood glucose is 412mg and has glucosuria with
urine sugar of 3+Ketonuria is present with urine ketone bodies of 2+
B. Mention the other causes of ketonuria.
Diabetes mellitus
Starvation
Toxaemia of pregnancy
Clinical condition with severe vomiting
Glycogen storage disorder
C. Mention four complications of diabetes mellitus.
Diabetic neuropathy
Diabetic retinopathy
Diabetic nephropathy
Accelerated atherosclerosis
Diabetic Keto-acidosis
