Hematology Cases – KFP public report review 2016-2024 topics in exam

Hematology – Diagnostic and Management Approaches

1. Investigation of Raised Hemoglobin and Mean Cell Volume

• Key Topics Discussed:
  • Differential diagnoses for hematologic abnormalities
  • Relevant examination findings
  • Further investigative steps
• Candidate Performance:
  • Gaps in interpreting hematologic results
  • Difficulty connecting results with potential differential diagnoses
• Improvement Areas:
  • Improve hematologic knowledge, specifically the implications of abnormal blood results
  • Tailor further investigations to these findings

2. Deterioration in Health with Hematological Signs

• Key Topics:
  • Differential diagnoses for systemic symptoms
  • Management of gout secondary to hematological conditions
• Candidate Performance:
  • Not recognizing signs of hematological malignancy
  • Inappropriate gout management
• Improvement Areas:
  • Early recognition and management of hematological conditions and their complications

3. Chronic Hematological Condition

• Topic Discussed:
  • New symptoms in a patient with a previously stable chronic hematological condition, requiring further investigation
• Candidates Did Well On:
  • Identifying additional necessary information for diagnosis
• Improvement Areas:
  • Recognizing the potential rapid progression of chronic conditions
  • Providing specific, targeted answers rather than vague or general responses

4. Macrocytic Anemia

• Topic Discussed:
  • Investigation and management of macrocytic anemia with low B12 levels, indicating potential pernicious anemia
• Candidates Did Well On:
  • Identifying possible underlying causes based on history
• Improvement Areas:
  • Progressing with investigations to confirm pernicious anemia
  • Recognizing outdated tests like the Schilling test and avoiding inappropriate initial investigations

Hematology – Thrombosis and Vascular Conditions

1. Postpartum Thrombophlebitis

• Key Topics:
  • Diagnosis of thrombophlebitis
  • Impact of medical history on management
• Candidate Performance:
  • Misidentification of superficial thrombophlebitis
  • Inadequate use of case information
• Improvement Areas:
  • Recognition of clinical signs
  • Tailored management considering past history

2. Upper-limb Venous Thromboembolism

• Specifics:
  • Failure to specify the investigation site
  • Adaptation of initial management to the patient’s medication history, especially concerning anticoagulation
• Improvement Areas:
  • Specify investigations clearly
  • Adjust management plans based on comprehensive patient history, including medication use and risk factors

3. Deep Venous Thrombosis in an Elderly Resident

• Medical Heading: Geriatrics, Vascular Medicine
• Key Topics:
  • Examination for DVT confirmation
  • Initial investigations
  • Urgent management considerations in an elderly patient with a complex medical history
• Candidate Performance:
  • Some candidates failed to focus on specific examination and investigation for DVT
  • Offering generalized management plans
  • Urgent referral for anticoagulation management was often overlooked
• Improvement Areas:
  • Prioritize urgent and specific management for suspected DVT, considering patient history
  • Tailor investigation requests explicitly and recognize the need for immediate specialist input