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

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Question 1 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 2 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.

Question 3 of 5

A previously healthy 10-month-old boy develops pallor over 2 weeks. Examination is unremarkable except for pallor. Lab tests includes: hemoglobin, 4.9 g/dL; WBC, 6700/mm3; platelets count, 180000/mm3; MCV, 79 fL; reticulocyte count 0.8%; hemoglobin electrophoresis, normal. Of the following, the MOST likely cause for these findings is

Correct Answer: B

Rationale: Severe anemia (Hb 4.9 g/dL), low reticulocytes (0.8%), and normal MCV at 10 months suggest TEC (B), a common self-limiting condition. Pure red cell aplasia (A) is rarer, thalassemia (C) is microcytic, aplastic anemia (D) affects all lines, and parvovirus (E) typically affects hemolytic states.

Question 4 of 5

Which of the following drugs is least likely to cause thrombocytopenia in children?

Correct Answer: B

Rationale: Phenytoin (B) rarely causes thrombocytopenia, unlike valproic acid (A), sulfonamides (C), TMP-SMX (D), and heparin (E), which are well-known culprits.

Question 5 of 5

You are explaining the risk of sepsis after splenectomy to medical students. An important statement that should be included during this discussion is that risk is especially high in children

Correct Answer: C

Rationale: Sepsis risk post-splenectomy is highest in chronic ITP (C) due to underlying immune dysfunction, more than age (A), HS (B), trauma (D), or Hodgkin (E), though all carry risk.

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