Examples of multiple choice questions:
1. 58 year old male presented with hx. Of fatigue , palpitation , headache & exertional dyspnoea , on examination there is only anemia . His Hb is 8 g/l , wbc 10 * 10^9/l . Platelets 400, 000 , MCV is (60) fl , b.film show anisopoikilocytosis , ferritin is low , TIBC is high , his PMH is significant only for chronic dyspepsia & he noticed that the colour of his stool turned black recently .What is the best next step in the evaluation of this patient?
A. Treat him with ferrous sulphate 300 mg for 6 months
B. He need urgent blood transfusion with 3 units
C. Sent him for bone marrow examination
D. He need to be evaluated by OGD ( upper endoscopy)
E. It is better to give him parentral iron replacement therapy
2. 45 year old female presented with fatigue , palpitation & exertional dyspnea , she has history of hashimoto thyroiditis , HB 5 g/l , platelets 150 , wbc 4 , MCV 115 fl .
What is the most likely diagnosis ?
1. iron deficiency anemia
2. microangiopathic hemolytic anemia
3. pernicious anemia
4. anemia of chronic disease
3. 20 year old boy presented with sudden onset of pallor , fatigue & dark colour urine
His mother said that he ate fava beans yesterday night , which type of cells would u expect to see in blood film ?1. target cells
2. schistocytes
3. hypersegmented neutrophils
4. bite cells & blister cells
5. tear drop cells