All produce microcytic anemia except:

Correct Answer: C

Rationale: The correct answer is C: pernicious anemia. Pernicious anemia is a macrocytic anemia caused by vitamin B12 deficiency, leading to large red blood cells. Sideroblastic anemia (A) is a type of microcytic anemia due to ineffective iron utilization. Thalassemia (B) causes microcytic anemia due to decreased production of hemoglobin. Lead poisoning (D) can also lead to microcytic anemia by disrupting heme synthesis. Therefore, pernicious anemia is the only choice that does not produce microcytic anemia.

Correct Answer: B

Rationale: The correct answer is B: gum bleeding. In immune thrombocytopenic purpura (ITP), the hallmark feature is low platelet count leading to easy bruising and bleeding, including gum bleeding. Fever (choice A) is not a typical feature of ITP. Moderate splenomegaly (choice C) is less common in ITP. Stema tenderness (choice D) is not a recognized feature of ITP. Therefore, gum bleeding is the outstanding feature of ITP due to the primary underlying mechanism of platelet destruction.

Correct Answer: C

Rationale: The correct answer is C: optic neuritis. Busulfan therapy is known to cause adverse effects such as hyperpigmentation, pulmonary fibrosis, and bone marrow suppression due to its cytotoxic effects. However, optic neuritis is not a reported side effect of busulfan therapy. Optic neuritis is more commonly associated with other medications or conditions affecting the optic nerve. Therefore, the absence of optic neuritis as a known side effect of busulfan therapy makes choice C the correct answer.

Correct Answer: B

Rationale: The best treatment modality for chronic myeloid leukemia (CML) is allogenic bone marrow transplantation (BMT) because it offers the potential for cure by replacing the abnormal cells with healthy donor cells. This is the only option that can provide long-term disease control and potential cure for CML. Hydroxyurea (choice A) is a cytotoxic drug used for symptom control but does not target the underlying cause. Interferon alpha (choice C) can help control the disease but is less effective in achieving long-term remission compared to BMT. Radiotherapy (choice D) is not a standard treatment for CML and is not curative.

Correct Answer: C

Rationale: Splenectomy is contraindicated in bone marrow (BM) failure because the spleen plays a crucial role in hematopoiesis and immune function. Removing the spleen can worsen BM failure by disrupting hematopoiesis and exacerbating the existing condition. In pyruvate kinase deficiency, splenectomy can improve symptoms by reducing hemolysis. In immune thrombocytopenic purpura (ITP), splenectomy may be considered as a treatment option to increase platelet count. Angiogenic myeloid metaplasia does not have a direct contraindication for splenectomy, as the primary concern is the underlying disease pathology, not the surgical intervention.