A 9-month-old child with a hemoglobin concentration of $10 \mathrm{gm} / \mathrm{dL}$ and marked microcytosis; serum iron and total iron binding capacity are within normal limits; serum ferritin and hemoglobin electrophoresis are also normal. Of the following, the MOST likely diagnosis is

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Question 1 of 5

A 9-month-old child with a hemoglobin concentration of $10 \mathrm{gm} / \mathrm{dL}$ and marked microcytosis; serum iron and total iron binding capacity are within normal limits; serum ferritin and hemoglobin electrophoresis are also normal. Of the following, the MOST likely diagnosis is

Correct Answer: D

Rationale: Microcytosis with normal iron studies and electrophoresis in a 9-month-old suggests α-thalassemia trait (D), common and mild. IDA (A) has low ferritin, sideroblastic (B) shows ringed sideroblasts, B-thal (C) alters electrophoresis, and ACD (E) is normocytic.

Question 2 of 5

Fresh frozen plasma (FFP) transfusion/replacement is indicated in all the following conditions EXCEPT

Correct Answer: C

Rationale: FFP is indicated for liver disease (A), protein S deficiency (B), preterm clotting issues (D), and vitamin K deficiency (E). TTP (C) requires plasma exchange, not FFP transfusion.

Question 3 of 5

A 9-year-old male child is about to do elective tonsillectomy; preoperative investigations are all normal except for a significant prolonged partial thromboplastin time PTT; there was no previous bleeding after circumcision and emergency appendectomy. Of the following, the MOST likely diagnosis is

Correct Answer: D

Rationale: Prolonged PTT without prior bleeding (circumcision, appendectomy) suggests prekallikrein deficiency (D), a benign condition not affecting hemostasis, unlike hemophilias (A, B, C) or factor XIII (E).

Question 4 of 5

In severe liver disease with prolongation of the bleeding time, the best effective treatment before doing liver biopsy is

Correct Answer: D

Rationale: FFP (D) corrects multiple factor deficiencies and thrombocytopenia in severe liver disease before biopsy, more effective than vitamin K (A, B, C, slow) or DDAVP (E, for platelet dysfunction only).

Question 5 of 5

Arterial thrombosis is the least likely cause of

Correct Answer: D

Rationale: Pulmonary embolism (E) is venous thrombosis-related, unlike stroke (A), limb ischemia (B), renal infarction (C), and MI (D), which are arterial.

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