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ABIM IM Recert > Board Vitals Hematology > Flashcards

Board Vitals Hematology Flashcards

1
Q

Patient has low serum iron, low total iron-binding capacity, and increased ferritin - what type of anemia do they have?

A

Anemia of chronic disease

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2
Q

What stimulates megakaryocytes and gives rise to platelets?

A

Thrombopoietin

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3
Q

Does folate deficiency cause neurologic symptoms?

A

No

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4
Q

What should you do if you suspect a blood transfusion reaction?

A

Stop the transfusion and investigate the cause.

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5
Q

Which anticoagulant works by inhibiting epoxide reductase?

A

Warfarin

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6
Q

What does rivaroxaban inhibit?

A

Factor Xa

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7
Q

Where does dabigatran bind to exert its action?

A

Active site of both free and bound thrombin

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8
Q

Bone marrow biopsy shows hypocellular bone marrow with fatty infiltration.

Diagnosis?

A

Aplastic anemia

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9
Q

Bone marrow biopsy shows hypercellular bone marrow with lymphoblastic infiltration.

Diagnosis?

A

Acute lymphocytic leukemia (ALL)

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10
Q

Bone marrow biopsy shows hypercellular bone marrow with myeloblastic infiltration.

Diagnosis?

A

Acute myeloblastic leukemia (AML)

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11
Q

Bone marrow biopsy shows fibrotic bone marrow.

Diagnosis?

A

Myelofibrosis

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12
Q

Schistocytes are associated with which condition?

A

Disseminated Intravascular Coagulation (DIC)

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13
Q

Dacrocytes (teardrop cells) are associated with which condition?

A
  • Bone marrow infiltration and fibrosis
  • Thalassemia
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14
Q

Echinocytes (burr cells) are associated with which condition?

A
  • End stage renal disease
  • End stage liver disease
  • Pyruvate kinase deficiency
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15
Q

What is the first line treatment for polycythemia vera?

A

Hydroxyurea

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16
Q

How do you diagnose paroxysmal nocturnal hemoglobinuria?

A

Flow cytometry

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17
Q

Is glucose-6-phosphate-dehydrogenase deficiency associated with thrombosis?

A

No

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18
Q

Is paroxysmal nocturnal hemoglobinuria associated with thrombosis?

A

Yes

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19
Q

What is the treatment of paroxysmal nocturnal hemoglobinuria?

A

Eculizumab

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20
Q

Does paroxysmal nocturnal hemoglobinuria cause renal impairment?

A

Yes

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21
Q

In obese patients, which anti-coagulation agent is preferred? Unfractionated heparin or low molecular weight heparin?

A

Unfractionated heparin

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22
Q

Which intrinsic endothelial cell property keeps blood from clotting inside human arteries?

A

Expression of heparin or thrombomodulin

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23
Q

Transfusion related acute lung injury occurs within how many hours of blood transfusion?

A

6 hours

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24
Q

Patient presents with heart failure, diabetes mellitus, joint pain, darkening of skin, and cirrhosis of the liver with portal hypertension.

Diagnosis?

A

Hemochromatosis

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25
Q

Is lupus anticoagulant associated with an increased risk of venous thromboembolism?

A

Yes

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26
Q

Do patients with factor V Leiden have prolonged aPTT?

A

No

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27
Q

Does hereditary hemophilia A increase risk of venous thromboembolism?

A

No

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28
Q

Is lupus anticoagulant associated with increased aPTT?

A

Yes

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29
Q

Do patients with factor VIII inhibitors experience correction of aPTT on mixing?

A

No

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30
Q

Peripheral smear shows microcytic, hypochromic red cells, with occasional target cells.

Diagnosis?

A

Thalassemia

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31
Q

What is the treatment of an asymptomatic ITP patient with platelet above 30,000?

A

Observation

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32
Q

What does the platelet count need to be to consider steroids for ITP?

A

Less than 10,000

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33
Q

Which one - folate or vitamin B12 deficiency - causes neurological symptoms?

A

Vitamin B12 deficiency

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34
Q

Folate replacement can correct cobalamin deficiency-induced megaloblastic anemia without altering neurological symptoms.

True or false?

A

True

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35
Q

Is there any role for iron replacement in case of megaloblastic anemia?

A

No

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36
Q

Smudge cells in peripheral smear.

Diagnosis?

A

Chronic lymphocytic leukemia (CLL)

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37
Q

Does hypogammaglobulinemia occur in up to 25% of patients with CLL or CML?

A

CLL

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38
Q

Which is the most common inherited hypercoagulable condition in Americans of European descent?

A

Factor V Leiden

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39
Q

What is the treatment of uremic bleeding?

A

Desmopressin

40
Q

Are fibrin degradation products affected by Von Willebrand disease?

A

No

41
Q

Is the plasma volume high, normal or low in polycythemia vera?

A

High

42
Q

Is the RBC mass high, normal or low in polycythemia vera?

A

High

43
Q

Is the EPO high, normal or low in polycythemia vera?

A

Low

44
Q

Is the SaO2 high, normal or low in polycythemia vera?

A

Normal

45
Q

What kind of anemia occurs in glucose-6-phosphate deficiency?

A

Hemolytic anemia

46
Q

What’s the first line treatment for acute chest syndrome in sickle cell disease?

A

Exchange or simple transfusion

47
Q

What is the paraneoplastic syndrome, pure red cell aplasia associated with?

A

Thymoma

48
Q

Which anemia has RBCs that are sensitive to osmotic stress (positive osmotic fragility test)?

A

Hereditary spherocytosis

49
Q

What is the treatment of mild hereditary spherocytosis?

A

Folic acid supplementation

50
Q

What is the treatment of severe hereditary spherocytosis?

A

Splenectomy

51
Q

What is the treatment of paroxysmal nocturnal hemoglobinuria (PNH)?

A

Corticosteroids

52
Q

What sequence contains the AUG start codon for initiation of mRNA start codon?

A

Kozak consensus sequence

53
Q

What should you use for monitoring heparin therapy in patients who have lupus anticoagulant?

A

Anti-factor Xa levels

54
Q

What is the treatment of thrombotic thrombocytopenic purpura (TTP)?

A

Plasma exchange

55
Q

The classic cardinal “pentad” indicates which disease?

Pentad: fever, thrombocytopenia, hemolytic anemia, renal and neurological dysfunction.

A

Thrombotic thrombocytopenic purpura (TTP)

56
Q

What happens to the lactate dehydrogenase (LDH) in essential thrombocythemia?

A

Increases

57
Q

What happens to the uric acid in essential thrombocythemia?

A

Increases

58
Q

What prevents thromboembolism in essential thrombocythemia?

A

Low dose aspirin

59
Q

What is the treatment of essential thrombocythemia?

A

Hydroxyurea
Interferon-alpha

60
Q

What are the four variables (4 Ts) used to diagnose possible heparin-induced thrombocytopenia (HIT) that are widely used in clinical practice?

A
  • Thrombocytopenia
  • Timing (of falls of platelets)
  • Thrombosis and sequelae
  • Other causes of Thrombocytopenia
61
Q

Patients with which condition have a higher risk of allergic transfusion reactions?

A

IgA deficiency

62
Q

What type of anemia do patients with chronic alcohol use disorder typically have?

A

Macrocytic anemia (deficiency of folate and vitamin B12).

63
Q

What is the characteristic peripheral smear finding in megaloblastic anemia?

A

Hypersegmented polymorphonuclear neutrophils (PMNs)

64
Q

Burr cells on peripheral smear.

Diagnosis?

A

Intravascular hemolytic anemia

65
Q

The PF4/heparin ELISA test is a quantitative immunoassay with a sensitivity of near 100%. Thus a negative test is useful in excluding HIT.

True or false?

A

True

66
Q

Hemophilia A is a deficiency of which factor?

A

Factor VIII

67
Q

Hemophilia B is a deficiency of which factor?

A

Factor IX

68
Q

Is the PTT or the PT prolonged in von Willebrand disease?

A

PT

69
Q

Is the PTT or the PT prolonged in hemophila?

A

PTT

70
Q

Which condition is more severe, hemophilia A or hemophilia B?

A

Hemophilia A

71
Q

How is hemophilia genetically transmitted?

A

X-lined autosomal disorder

72
Q

Which score is used to estimate the likelihood of thrombocytopenic purpura (TTP)?

A

PLASMIC score

73
Q

What is the next step when thrombocytopenic purpura (TTP) is suspected?

A

Peripheral smear

74
Q

What is the immediate treatment of thrombocytopenic purpura (TTP)?

A

Plasma exchange

75
Q

What does severe ADAMT13 deficiency (<10%) cause?

A

Thrombocytopenic purpura (TTP)

76
Q

Can you have anemia of chronic disease with a normal MCV?

A

Yes

77
Q

Is folate deficiency likely if the folate levels are normal?

A

No

78
Q

How do you prevent hemophilic arthropathy?

A

Factor VIII or IX concentrate replacement therapy

79
Q

What is the preferred anti-coagulant in renal failure?

A

Warfarin
Heparin

80
Q

What condition has tear drop cells on peripheral smear?

A

Thalassemia

81
Q

What is the most common cause of neutropenia?

A

Drug-induced

82
Q

What is the treatment of skin necrosis secondary to warfarin?

A

Fresh frozen plasma or protein C concentrate

83
Q

Patient presents with fever, hypercalcemia, renal failure, anemia, bone lesions, and pain.

DIagnosis?

A

Multiple myeloma

84
Q

What is the most specific test to establish the diagnosis of polycythemia vera?

A

Sequential analysis of JAK2, CALR, or LNK mutations

85
Q

Does factor V Leiden increase risk of venous or arterial thromboembolism?

A

Venous

86
Q

Does antiphospholipid antibody syndrome increase risk of venous or arterial thromboembolism?

A

Both

87
Q

What kind of microangiopathic hemolytic anemia is caused by placental abruption?

A

Disseminated intravascular clotting (DIC)

88
Q

What is the pathogenesis of DIC?

A

Release of tissue factor

89
Q

What is the difference between disseminated intravascular clotting (DIC) and thrombotic thrombocytopenic purpura (TTP) on blood tests?

A

The PT and PTT are normal in TTP and prolonged in DIC

90
Q

Does thalassemia result in insufficient translation or transcription?

A

Transcription

91
Q

What should you think of in patients with both hemolytic anemia and thrombosis?

A

Paroxysmal nocturnal hemoglobinuria (PNH)

92
Q

Can APS give a false negative VDRL/RPR test?

A

Yes

93
Q

t(15;17)

A

AML

94
Q

Is the direct antiglobulin test positive or negative in G6PD deficiency?

A

Negative

95
Q

Reactive leukemoid reactions have more granulocyte production (metamyelocytes, myelocytes, immature bands).

True or false?

A

True

96
Q

Patient treated for APML with all-trans retinioc acid presents with volume overload, respiratory failure, hypotension, elevated bilrubin.

Diagnosis?

A

Differentiation syndrome

97
Q

What is the treatment of differentiation syndrome that occurs in patients treated for APML with all-trans retinioc acid?

A

Dexamethasone

ABIM IM Recert (42 decks)

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