Haematology – Oncology Question Bank

 

Results

Share your score!
Tweet your score!
Tweet your score!
Share to other

#1. A 13-year-old boy presents with persistent pain involving the pelvis. Radiography demonstrates an onion-skin periosteal reaction. What is the most likely diagnosis?

#2. A 9-year-old boy with newly diagnosed Burkitt lymphoma develops vomiting and muscle cramps 12 hours after chemotherapy. Investigations: Potassium 6.9 mmol/L, Phosphate elevated, Calcium low, Creatinine rising. What is the most likely diagnosis?

#3. A 13-year-old boy presents with progressive pain around the distal femur for two months. The pain is worse at night. Radiography demonstrates a sunburst periosteal reaction. What is the most likely diagnosis?

#4. A 15-year-old boy presents with fever, bruising and gingival hypertrophy. Peripheral blood demonstrates circulating blasts. Which feature most strongly suggests acute myeloid leukaemia rather than acute lymphoblastic leukaemia?

#5. A 6-year-old girl presents with fever, petechiae and recurrent infections. Bone marrow demonstrates hypocellularity. Chromosomal breakage studies are normal. Which diagnosis is most likely?

#6. A 7-month-old infant has recurrent skin abscesses and pneumonia since birth. Investigations: ANC 0.1 x10^9/L. Bone marrow examination demonstrates maturation arrest of neutrophil precursors. What is the most likely diagnosis?

#7. A 5-year-old boy presents with severe anaemia after eating fava beans. Peripheral blood film demonstrates bite cells. Which enzyme deficiency is responsible?

#8. A 7-year-old boy has recurrent epistaxis, fatigue and easy bruising. He has short stature, cafe-au-lait pigmentation and absent thumbs. Investigations show pancytopenia. Which inherited disorder is the most likely diagnosis?

#9. A 10-year-old girl presents with fever, pallor and diffuse bone pain. Investigations: Hb 6.4 g/dL, Platelets 24 x10^9/L, WCC 78 x10^9/L. Flow cytometry demonstrates CD10-positive lymphoblasts. What is the most likely diagnosis?

#10. A 4-year-old boy has recurrent bacterial infections, eczema and persistent neutropenia. Bone marrow examination is normal. Neutrophil count increases following administration of G-CSF. What is the most appropriate long-term management?

#11. A 6-year-old child presents with fever, thrombocytopenia and acute kidney injury after a bloody diarrhoeal illness. Blood film demonstrates fragmented red blood cells. Which diagnosis is most likely?

#12. A 9-year-old girl receiving chemotherapy develops facial swelling, distended neck veins and increasing respiratory distress. What is the most likely oncological emergency?

#13. A 3-year-old boy presents with pallor and recurrent infections. Bone marrow examination demonstrates ring sideroblasts and vacuolated erythroid precursors. Which diagnosis is most likely?

#14. A 15-year-old girl presents with fatigue, bruising and recurrent infections. Investigations: Hb 6.4 g/dL, WCC 1.4 x10^9/L, Platelets 18 x10^9/L. Bone marrow biopsy demonstrates a markedly hypocellular marrow without malignant infiltration. What is the most likely diagnosis?

#15. A 9-year-old child receiving chemotherapy develops severe mucositis and persistent fever despite broad-spectrum antibiotics. Blood cultures grow Candida albicans. What is the most appropriate treatment?

#16. A 7-year-old boy with acute myeloid leukaemia develops bleeding from venepuncture sites. Investigations: Platelets 18 x10^9/L, PT prolonged, aPTT prolonged, Fibrinogen low, D-dimer markedly elevated. What complication has occurred?

#17. A 2-month-old infant presents with profound anaemia requiring repeated transfusions. Examination demonstrates craniofacial abnormalities and triphalangeal thumbs. Which gene abnormality is most commonly associated with this condition?

#18. A 10-year-old girl develops progressive fatigue and recurrent bacterial, fungal and HPV infections. Bone marrow examination demonstrates monocytopenia. Which inherited disorder is most likely?

#19. A 5-year-old boy develops fever, lethargy and rapidly enlarging cervical lymph nodes. Chest radiograph demonstrates a large anterior mediastinal mass. What is the most important initial concern?

#20. A 2-year-old boy presents with abdominal distension. Examination reveals a firm abdominal mass that crosses the midline. He has periorbital bruising and hypertension. Urinary VMA levels are elevated. What is the most likely diagnosis?

#21. A 6-year-old girl presents with fatigue and jaundice. Examination demonstrates splenomegaly. Investigations: Hb 8.4 g/dL, MCHC elevated, Blood film shows numerous spherocytes, Direct Coombs test negative. What is the most likely diagnosis?

#22. A 10-year-old boy with sickle cell disease develops sudden pallor and lethargy after a viral illness. Investigations: Hb has fallen from 8.7 g/dL to 3.9 g/dL, Reticulocyte count is markedly reduced. What is the most likely cause?

#23. A 6-year-old child develops fever, bone pain and gingival swelling. Investigations: Hb 6.8 g/dL, Platelets 34 x10^9/L, WCC 62 x10^9/L. Peripheral smear demonstrates myeloblasts with Auer rods. What is the most likely diagnosis?

#24. A 7-year-old boy with beta-thalassaemia major attends clinic for routine review. He has received monthly blood transfusions since infancy. His serum ferritin is 2,800 ug/L. What is the most appropriate long-term management?

#25. A 5-year-old boy presents with recurrent diarrhoea, poor growth and repeated bacterial infections. Investigations reveal neutropenia. Pancreatic elastase is markedly reduced. What is the most likely diagnosis?

#26. A 9-year-old boy develops severe back pain and progressive weakness of both legs. MRI demonstrates an epidural tumour compressing the thoracic spinal cord. What is the best immediate management?

#27. A 4-year-old boy with acute lymphoblastic leukaemia suddenly develops severe headache, vomiting and confusion. CT brain demonstrates an intracranial haemorrhage. His platelet count is 6 x10^9/L. What is the most urgent treatment?

#28. A 12-year-old boy presents with fever, pallor and bleeding gums. Investigations: Hb 5.9 g/dL, Platelets 16 x10^9/L, WCC 118 x10^9/L. Bone marrow demonstrates greater than 25% lymphoblasts. Which diagnosis is most likely?

#29. A 2-year-old child presents with an enlarging abdominal mass. Ultrasound demonstrates a renal tumour confined to one kidney. Which diagnosis is most likely?

#30. A 3-year-old boy develops jaundice and cola-coloured urine one day after receiving trimethoprim-sulfamethoxazole. Blood film demonstrates bite cells and Heinz bodies. What is the most likely diagnosis?

#31. A 6-year-old girl is receiving induction chemotherapy for acute lymphoblastic leukaemia. She develops a temperature of 39.3C. She is alert and haemodynamically stable. Investigations: ANC 0.1 x10^9/L, Hb 8.4 g/dL, Platelets 76 x10^9/L. What is the best initial management?

#32. A previously healthy 4-year-old boy is brought to the emergency department because of increasing fatigue over 3 weeks. His mother reports intermittent fever, refusal to walk because of leg pain, and bruises appearing after minimal trauma. On examination he is pale with petechiae, cervical lymphadenopathy and hepatosplenomegaly. Investigations: Hb 5.8 g/dL, WCC 38 x10^9/L, Platelets 18 x10^9/L. What is the most likely diagnosis?

#33. A 12-year-old boy with relapsed acute lymphoblastic leukaemia is being evaluated for curative treatment. Which treatment offers the greatest chance of long-term cure?

#34. A 3-year-old boy presents with progressive abdominal distension and weight loss. Examination reveals a large right-sided abdominal mass that does not cross the midline. Urinalysis demonstrates microscopic haematuria. What is the most likely diagnosis?

#35. A 14-year-old girl presents with recurrent epistaxis and heavy menstrual bleeding. Examination is otherwise normal. Investigations: Hb 11.9 g/dL, WCC 6.8 x10^9/L, Platelets 9 x10^9/L. Blood film shows isolated thrombocytopenia with large platelets. What is the most likely diagnosis?

#36. A previously healthy 5-year-old girl develops widespread petechiae one week after recovering from influenza. She is otherwise well. Investigations: Hb normal, WCC normal, Platelets 7 x10^9/L. What is the most likely diagnosis?

#37. A 3-year-old boy presents with fever, irritability and refusal to walk. Examination demonstrates marked hepatosplenomegaly and generalized lymphadenopathy. Investigations: Hb 7.1 g/dL, WCC 2.8 x10^9/L, Platelets 42 x10^9/L. Peripheral blood film shows no circulating blasts. What is the next best investigation?

#38. A 5-month-old infant has severe pallor since birth. Examination demonstrates triphalangeal thumbs. Investigations: Hb 5.2 g/dL, Reticulocyte count very low, WCC normal, Platelets normal. What is the most likely diagnosis?

#39. A 5-year-old boy develops persistent neutropenia, extensive viral warts and recurrent bacterial infections. Bone marrow examination demonstrates neutropenia without maturation arrest. Which inherited syndrome is most likely?

#40. A 4-year-old child with acute lymphoblastic leukaemia develops persistent headache and repeated vomiting during maintenance chemotherapy. Neurological examination reveals bilateral papilloedema. What is the most appropriate next investigation?

Previous
Finish

Hello,

Welcome

We hope you enjoy this site.

Let’s connect

Join the fun!

Stay updated with our latest tutorials and ideas by joining our newsletter.

Recent posts