1. A young woman, 14 years, with complaints of gums bleeding gums, and a history of menorrhagia in the last 2 months. Blood tests obtained prolongation of clotting time (bleeding Time and PTT). Platelets and PT were normal. Examination of factor VII and factor I no results yet. What is the most likely diagnosis is: A. Von Willebrand Disease B. Hemolytic uremic syndrome C. Acquired platelet dysfunction D. Drug-induced thrombocytopenia E. Immune trombositopenipurpura 2. Patient 4 years old , with hepatosplenomegaly and thrombocytopeni has recently been diagnosed with a Acute Lymphoblastic Leukemia (ALL). Prognostic indicators at diagnosis in ALL include age and biologic properties of the leukemic blasts. Which of the following is another prognostic indicator at diagnosis for ALL? A. Gender B. The presence of Down syndrome C. The presence of fever D. Bleeding E. Initial white blood cell count 3. Wilm’s tumor has been recognized for its association with a number of congenital malformations that include cryptorchidism, hypospadias, and hemihypertrophy. Another congenital malformation that has also been associated with Wilms tumor is: A. Tetralogy of fallot B. Horsehoe kidney C. Club foot D. Congenital Cataracts E. Abscent radii 4. A 3-month-old hemophilic boy is suffering from bleeding. The blood examination revealed: PTT 75 seconds, Factor VIII level <1%, and Factor IX level 62%. What is the blood’s product should be given to stop the bleeding? A. Recombinant Factor VIII concentrate B. Fresh frozen plasma C. Cryoprecipitate D. Recombinant Factor IX concentrates E. Whole blood 5. four-year-old with newly diagnosed acute lymphoblastic leukemia (weight 20 kg) has a hemoglobin concentration of 5.5 gm/dl. How many packed RBC should be given to increase Hb up to 10 gm/dl? A. 300 ml B. 425 ml C. 600 ml D. 900 ml E. 1000ml 6. A 7 years old boy presented to Emergency room with history of fever, pallor and nose bleeding, 4 weeks duration. On examination: febrile, pale, petechie, subconjuctival bleeding, hepatosplenomegaly. Laboratory finding : Complate Blood Count: Hb 5 gr/dl : WBC 50,000/uL. Platelet 15,000/uL; Lymphocyte count 78%; The most likely clinical diagnosis is: A. Acute Lymphoblastic leukemia B. Limphoma Malignan Non Hodgkins C. Anemia aplastic D. Nasopharyngeal tumor E. Neuroblastoma stage IV 7. Five years following successful treatment for acute lymphoblastic leukemia (ALL), the parents report that the patient, who is now 8 year old, is experiencing serious difficulties with school performance. Areas of particular concern relate to reading, language and mathematics. What component of ALL therapy would a possible cause of cognitive dysfunction? A. IT Methotrexate B. IT Cytarabin C. Cranial radiation D. High dose Cyclophosphamide E. High dose IV Methotrexate 8. Four year old boy known case of hemophilia A coming to Emergency Room with first time right side knee joint swelling in order to control bleeding at the joint, , it is necessary to raise the serum level of factor VIII to about: A. 1-2% of normal B. 5-10% of normal C. 10-25% of normal D. 25-50% of normal E. 75-100% of normal 9. The most urgent complication in a patient with Non – Hodgkin’s Lymphoma that needs to evaluated at diagnosis and followed closely is : A. An Elevated WBC > 50.000 B. Elevated urine production C. A uric Acid level of 6.0 D. A large of mediastinal mass E. Complaints of left flank pain 10. Prognostic indicators at diagnosis in Patient with Acute Lymphoblastic Leukemia (ALL) in childhood include age, biologicproperties of the leukemic blasts bone marrow and pheripheral blood. A. Gender B. Down Syndrom C. Prolonged fever D. Initial White blood count E. Hepatosplenomegli 11. 15 years-old boy presented with 4 days ago history of bleeding gums, subconjuctival bleeding and petechie. Complate Blood Count: Hb 6.5 g/dL, Leucocyte count 86.000 /mm3; Platelet 24.000/mm3; blast 30%. Uric Acid 7.2 mg/L, hyperphospatemia. Which of the following is the most likely: A. Leukostasis B. Tumor Lysis Syndrome C. Septicemia D. Superior vena cava syndrome E. Disseminated Intravasculair Coagulation 12.
