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Pathology Tutorial 2014 – worksheet week 3: Bone marrow & metabolic bone disease

Group 1:
Quiz 01: Describe this marrow picture

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Discussion points:
• Normal development of haematopoiesis
• What is the normal M: E ratio?
• Types of Marrow
• What is extra-medullary haematopoiesis? Location?

Quiz 02) : A 49-year-old male has a Hb of 101 g/L, Hct 30.3%,
WBC count 1.6 X 109/L, and platelet count 48 X 109/L. On physical
examination he has no splenomegaly or lymphadenopathy. He was
treated with chloramphenicol for enteric fever a few months earlier.
Physical exam & BM biopsy pics are given. The most probable
diagnosis is:

Pathology Tutorial 2014 – worksheet week 3: Bone marrow & metabolic bone disease a) Iron deficiency anemia b) B -12 deficiency anemia c) Aplastic anemia d) Drug induced hemolytic anemia e) Chronic myeloid leukemia f) Acute leukemia Discussion points: • What are the terms to describe the lesions demonstrated in the picture? • What does the biopsy show? • List some causes for this disorder • Give some examples of bone marrow hyperplasia .

Pathology Tutorial 2014 – worksheet week 3: Bone marrow & metabolic bone disease .

Peripheral blood smear picture. Normocytic anaemia. Diagnosis? . to corresponding leukaemia • PIC 01: A 65 year old male presents with generalised nontender lymphadenopathy. Blood tests show hypogammaglobinemia. Thrombocytopenia.Pathology Tutorial 2014 – worksheet week 3: Bone marrow & metabolic bone disease Group 2: Quiz 03) Differentiating Leukemias – Fill the blanks ALL AML CML CLL Age onset symptoms Prognosis Match PIC 1 & 2. Blood count shows 90 X109/L.

Pathology Tutorial 2014 – worksheet week 3: Bone marrow & metabolic bone disease PIC 02: A 35 year old male presents with increasing tiredness and bleeding. Peripheral smear shows • Describe Pic 01. • Why is there hypogammaglobinemia? • Pic 02: Name the inclusions in the cells. What is it composed of? • How do you treat this Leukaemia (2A)? • List some differentials for the lesion in the gums . Blood count shows 110 X109/L.

Pathology Tutorial 2014 – worksheet week 3: Bone marrow & metabolic bone disease .

Hct 28. platelet count 74 X 109/L. A BM biopsy picture is given. The most likely diagnosis is . and WBC count 151 X109/L. A CBC which shows a Hb of 98 g/L.2%.Pathology Tutorial 2014 – worksheet week 3: Bone marrow & metabolic bone disease Group 3: Quiz 04) Differentiating Leukemias – Fill the blanks ALL AML CML CLL Age onset symptoms Prognosis Match PIC 3 & 4 to corresponding leukaemia PIC 03)A 7 year old previously healthy boy is noted by his teacher to be fatigued. He has not participated in games at recess for many weeks. He is also noted to have bleeding after trivial trauma.

Pathology Tutorial 2014 – worksheet week 3: Bone marrow & metabolic bone disease PIC 04): A 48 year old male with malaise and difficulty concentrating at work has a workup that includes a CBC that shows Hgb 102. Diagnosis? Discussion points: • Pic 03 & 04: Describe pics. . 5 lymphs. 20 bands. and 2 monos. Hct 35. There is marked splenomegaly. A peripheral blood smear pic is given below. 2 promyelo. platelet count 390 X 109 /L and WBC count 190 X 109 /L with a Differential count of 59 Seg Neutrophil. Name & describe a cytogenetic abnormality likely to be present. 4 myelo. • What do you mean by myeloproliferative disorders? List some disorders.8%. 8 meta.

Pathology Tutorial 2014 – worksheet week 3: Bone marrow & metabolic bone disease .

Pathology Tutorial 2014 – worksheet week 3: Bone marrow & metabolic bone disease Group 4: Quiz 05) The pics illustrate a disorder from a 60 /M with chronic back and difficulty walking with no history of trauma. ? Diagnosis • A) AML • B) CML • C) ALL • D) CLL • E) Myeloma .

Pathology Tutorial 2014 – worksheet week 3: Bone marrow & metabolic bone disease Discussion points: • What kind of fracture is this? • Comment on pics and suggest possible diagnoses. • What could you test for in the urine? • Could blood tests help with the diagnosis? • Does the raised immunoglobulin protect them from infections? • How is a definitive diagnosis made? What are the microscopic findings? • What are the two most common causes of death in these patients? .

Pathology Tutorial 2014 – worksheet week 3: Bone marrow & metabolic bone disease .

Autopsy pic of a resected rib is given below. Her past history includes treatment for abdominal pains due to peptic ulcer and treatment for depression.Pathology Tutorial 2014 – worksheet week 3: Bone marrow & metabolic bone disease Group 5 Quiz 06: A 45 year old female presents with recurrent renal stones and bone pains. Most likely diagnosis? a) Renal osteodystrophy b) Osteomalacia c) Osteoporosis d) Primary hyperparathyroidism e) Rickets Discussion points: • Name the skeletal changes that occur in this disorder • List other causes of hyercalcemia • How does renal disease affect the skeletal system ? .

Pathology Tutorial 2014 – worksheet week 3: Bone marrow & metabolic bone disease .

Pathology Tutorial 2014 – worksheet week 3: Bone marrow & metabolic bone disease Group 6 Quiz 07: An 8 yr old child from Birmingham during Victorian Britain. • Name this Vitamin deficient state Discussion points: • List the function and metabolism this vitamin • List some of the causes for this vitamin deficiency? • List other skeletal changes that can occur in children and adults .

The X-ray of the right hip revealed a # neck of the right femur. was brought to the emergency room after falling in her bathtub.e. despite leading a relatively sedentary lifestyle and having a 30-pack-year history of cigarette smoking. She was previously in good health. • Diagnosis? Discussion points: • Describe the picture • Risk factors • Pathogenesis • What parts of the skeleton (i. what bones) are most vulnerable to this disease? • Best test? • Treatment/Prevention .Pathology Tutorial 2014 – worksheet week 3: Bone marrow & metabolic bone disease Quiz 08): A 72-year-old caucasian female. Picture illustrates the disorder.