Haematology SEQ

(1). 
A chronic alcoholic was brought to the Anuradhapura teaching hospital with profuse bleeding following a minor cut injury.

His investigations showed the following:
Bleeding time 4 minutes
Clotting time 13 minutes
Prothrombin time 2 minutes
Clot retraction time Normal
What is the possible cause of bleeding in the above patient?
Explain the physiological basis of the above investigation results.



(2).
A 30 year old woman from a tea estate in Nuwara Eliya presented with dyspnoea on exertion for two months. On examination she was pale.



Calculate the red cell indices (MCV, MCH and MCHC) and comment on them.
What are the most probable causes of anaemia in this patient?
Explain the blood picture you would expect to see in this patient.

(3).
 Compare and contrast innate immunity and acquired immunity.

(4).
 An Rh negative mother gave the following history regarding her previous pregnancies.



  1. Explain why the first baby was normal and the subsequent pregnancies were affected with haemolytic disease of the newborn.
  2. Explain the term erythroblastosis fetalis.
  3. Explain how this patient could have been managed so as to enable her to deliver normal children.


(5).
5.1 List the functions of lymphocytes.
5.2 A man had a clotting time of 35 mins, a prothrombin time of 17 secs and a bleeding time of 2 mins.
5.3 What is the defect in haemostasis in this man?
5.4 Explain the physiological basis of your answer.


(6) .

Discuss the heamostatic and fibrinolytic system in man

(7).
Discuss the compensatory mechanisms taking place in a body following rapid loss of 2L of blood

(8).
A 20 year old medical student presented with a history of sore throat and fever . on further evaluation he was found to have bacterial tonsillitis.

White blood cell and differential count showed


8.1 State the abnormality seen in his blood count.
8.2 Outline the role of neutrophils in the defense mechanism.
8.3 Outline the acquired immune response seen in this condition.
8.4 Outline the pathophysiology of fever in him.


(9)
 9.1. Name two tests of haemostatic function.
9.2. Indicate which components of the haemostatic system are being tested by the tests you have mentioned in 9.1
9.3. Explain the physiological basis of the tests you have mentioned above.
9.4. An Rh-negative mother gave birth to her first baby who was severely jaundiced. She gave a history of having had a blood transfusion previously following a road traffic accident. What is the likely cause of baby being born with jaundice? Explain your answer with physiological basis.

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