Pediatric Hematologist/Oncologist MCQs

Pediatric Hematologist/Oncologist MCQs

1) 7 years old boy presented to ER with history of fever, pallor and nose bleeding, 4 weeks
duration.
On examination: febrile, pale,
hepatosplenomegaly
CBC: WBC 50,000
HB 3 g/dL
Platelet 15,000
Blast 80%
The most likely diagnosis is:
a) B cell ALL
b) T cell ALL
c) Pre B ALL
d) Early pre B ALL
e) Neuroblastoma stage IV

2) 5 years old girl known case of B-thalassemia major. The best test to monitor iron
overload is:
a) Serum ferritin
b) Myocardial iron estimation
c) Urinary iron estimation
d) Liver iron concentration (LIC)
e) Plasma non-transferrin bound iron (NTBI)

3) Five years following successful treatment for acute lymphoblastic leukemia, 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 not be a possible cause of
cognitive dysfunction?
a) IT Methotrexate
b) IT Cytarabine
c) Cranial radiation
d) High dose Cyclophosphamide
e) High dose IV Methotrexate

4) A full-term newborn infant is covered with petechiae. Platelet count is 5,000 per mm3.
The remainder of the CBC is normal. The pregnancy, labor and delivery were
uncomplicated, and the mother’s platelet is 370,000 per mm3. What is the correct
management?
a) Intravenous immunoglobulin
b) Platelet transfusion from a random donor
c) Platelet transfusion from the father
d) Cortocosteroids
e) Observation; no drug therapy necessary

5) 2-year-old boy known case of sickle cell disease admitted with severe pallor.
Examination revealed splenomegaly 12 cm/3 cm and HB 2.5 g/dL.
Which statement is correct:
a) Patient should have emergency splenectomy
b) Patient will not have similar attack in the future
c) The incidence of these attack happens in < 10%
d) Patient should be started on hypertransfusion program for a minimum of 3 years
e) All of the above

6) 4-year-old boy presented with right testicular mass. You suspected malignancy. Patient
performed radical archiectomy, the ideal time to repeat ∝ fetoprotein level is
a) 1 day post-operative
b) 5 days post-operative
c) 14 days post-operative
d) 30 days post-operative
e) No need to repeat

7) 4 year old boy known case of hemophilia A coming to ER 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

8) An 18-month-old girl is being evaluated because her mother thinks her abdomen seems
“full.” Physical examination reveals an abdominal mass. Ultrasonography identifies a
solid renal mass. At surgery, a stage I Wilms tumor is found.
The child’s chance of 4-year survival is closest to:
a) 30%
b) 45%
c) 60%
d) 75%
e) 95%

9) Which of the following statements is false regarding Fanconi anemia
a) It is usually macrocytic
b) It is inherited as autosomal recessive
c) Patient will have increased HBF
d) Serum erythropoietin level is decreased
e) Diagnosis is usually made by chromosome breakage analysis

10) In hereditary spherocytosis (HS), which statement is correct?
a) The clinical severity of (HS) parallel the measured quantitative defect in spectrin
b) Diagnosis in the neonatal period is easier than later
c) Mean corpuscular volume (MCV) is decreased
d) Autosomal recessive inheritance
e) Direct Comb’s test (DCt) is important in diagnosis

11) 4 years old girl with the following HB electrophaesis
50% - 80% S
% - 15% F
10% - 30% A
4 % - 6% A2
The diagnosis is
a) SS α thalassemia
b) Sβ° thalassemia
c) SSβ + thalassemia
d) SS disease
e) None of the above

12) Bone marrow transplantation has become an accepted treatment for several diseases
that may be otherwise fatal. The disease in which it is LEAST indicated for the newly
diagnosed patient is
a) Severe combined immune deficiency
b) Chronic myeloid leukemia
c) Severe aplastic anemia
d) Hurler’s disease
e) Acute lymphoblastic leukemia

13) Which statement is correct?
a) Bone is the most common organ affected in Langerhans cell histocytosis
b) Hyperdiploidy in Acute Lymphoblastic Leukemia (ALL) is a bad prognostic factor
c) Hodgkin’s disease is more common than non-Hodgkin’s lymphoma in children
d) 90% of AML children reach induction of remission
e) t (15, 17) is a bad prognostic factor in Acute Myeloid Leukemia (AML)

14) 6 years old boy diagnosed with acute lymphocytic leukemia. All of the following are
true regarding Tumor lysis syndrome except
a) Occurs primarily in patients with bulky β cell or Tcell leukemia
b) High potassium
c) High phosphate
d) High calcium
e) High uric acid

15) Which chromosome may be abnormal in patients with retinoblastoma?
a) 11
b) 13
c) 1
d) 16
e) None of the above

16) Bone marrow aspiration is most likely to confirm the diagnosis in a patient with
which of the following malignancies?
a) Hepatoblastoma
b) Neuroblastoma
c) Retinoblastoma
d) Rhabdomyosarcoma
e) Wilm’s tumor

17) 1 unit of random donor platelets may increase platelet count by about
a) 1,000
b) 7 ,000
c) 20,000
d) 30,000
e) 50,000

18) Partial thromboplastin time (PTT) is a function of all the following except:
a) Factor VIII
b) Factor VII
c) Factor X
d) Factor XI
e) Factor IX

19) All of the following are true regarding Diamond Blackfan anemia (pure red cell
aplasia) except:
a) 90% of cases present < 1 year of age
b) 25% of cases present with congenital anomalies
c) MCV > 90 μm3
d) 70% of patients respond initially to steroids
e) Hemoglobin F (for age) is low

20) All of the following can cause macrocytic anemia except:
a) Liver disease
b) Aplastic anemia
c) Sideroblastic anemia
d) Hypothyroidism
e) Down’s syndrome