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Hematology > Hematology: Multiple Choice & Other Questions > Flashcards

Hematology: Multiple Choice & Other Questions Flashcards

1
Q

How long should a patient with IDA receive iron supplements?

  1. 4 weeks
  2. About 8 - 12 weeks
  3. 4 - 6 months
  4. Lifelong
A
  1. 4 - 6 months
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2
Q

Which normal lab result indicate that iron supplementation should be stopped? Why?

  1. Hemoglobin and hematocrit
  2. Serum iron level
  3. Serum ferritin level
  4. Reticulocyte count
A
  1. Serum ferritin level

Reason: Serum ferritin level indicates when iron storage is “full”

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3
Q

What kind of anemia do the following labs inidcate?

WBC 14.9 (4 - 11)
RBC 4.08 (4.2 - 4.9)
HGB 10.0 (12 - 15)
HCT 30.0 (37 - 51)
MCV 70.4 (73 - 85)
MCH 21.2 (23.7 - 28.4)
RDW 19.6 (12 - 17)
PLT 315 (150 - 375)
Polys 76 (55 - 75)
Lymphs 10 (30 - 40)
Monos 11.9 (0 - 11)
Eos 0.1 (0 - 6)
Bands 2.0 n/a

List associated anemia differential diagnoses.

What is the associated anemia duration?

What other diagnosis/es can be gleaned from these labs?

A

Type of anemia:
Microcytic hypochromic anemia

Anemia differential diagnoses:
- IDA
- Thalassemia
- Lead toxicity

Anemia duration: < 4 - 6 months

Additional diagnosis/es:
Bacterial infection > 24 hours

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4
Q

What is the interpretation of the following labs?

WBC 3.2 (4 - 15)
RBC 4.01 (4.5 - 5.6)
HGB 11.4 (13.7 - 17.3)
HCT 34.8 (37.5 - 51)
MCV 103.7 (83.4 - 96)
MCH 28.1 (27.8 - 32.5)
RDW 18 (12 - 17)
PLT 316 (150 - 375)
Polys 47.5 (55 - 75)
Lymphs 42.1 (30 - 40)
Monos 9.8 (0 - 9)
Eos 0.3 (0 - 6)
Bands 0.3 (0 - 6)

What follow-up labs, if any, should be ordered?

A

Interpretation:
- Recent macrocytic normochromic anemia
- Viral infection > 24 hours

Follow-up labs:
- B-12
- Folate

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5
Q

What lab result would you expect in a patient with non-blanching petechia/purpura thrombocytopenia?

  1. Decreased platelets
  2. Increased INR
  3. Decreased thrombin
  4. Increased PT/PTT
A
  1. Decreased platelets
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6
Q

Select all symptoms associated with petechia/purpura thrombocytopenia (non-blanching rash)?

  1. Itching leg
  2. Both legs itch
  3. Neither leg itches
  4. The affected leg feels warm to the touch
  5. He feels well otherwise
  6. He has a headache
  7. He feels tired
A
  1. Neither leg itches
  2. The affected leg feels warm to the touch
  3. He feels well otherwise
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7
Q

A 72 year-old male has normocytic, normochromic anemia. His stool is positive for occult blood. What is the likely etiology?

  1. Iron deficiency anemia
  2. Anemia secondary to GI bleed
  3. Anemia secondary to malignancy
  4. B-12 deficiency anemia

What is the rationale for ruling out the incorrect choices?

A
  1. Anemia secondary to malignancy

Rationale:

  1. Iron deficiency anemia and
  2. B-12 deficiency anemia:
    • These are NOT normocytic, normochromic anemias
  3. Anemia secondary to GI bleed:
    - A GI bleed would likely consist of frank blood, not occult bleeding.
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8
Q

What might be most helpful in determining the etiology of a normocytic, normochromic anemia?

  1. RDW
  2. Patient history
  3. Reticulocyte count
  4. Stool for occult blood
A
  1. Patient history
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9
Q

A 70 year-old presents with intermittent LLQ ABD pain for the past month, which he rates 2/10 when present. It is partially relieved after a BM. CBC indicates IDA. What diagnostic is most likely?

  1. Diverticulitis
  2. Constipation
  3. Irritable bowel syndrome
  4. Colorectal cancer
A
  1. Colorectal cancer
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10
Q

What effect would anemia be expected to have on reticulocyte counts?

What would cause the opposite of expected effects?

A

Increased reticulocyte counts

Non-functioning or poorly functioning bone marrow

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11
Q

Which symptom is not common in a young adult who has IDA?

  1. Muscle cramps
  2. Fatigue
  3. Weakness
  4. Exercise intolerance
A
  1. Muscle cramps
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12
Q

Select all choices below that are good sources of iron for a patient who has IDA.

  1. Liver
  2. Lentil soup
  3. Spinach
  4. Clams
  5. Red beans
  6. Rice
  7. Oysters
A

ALL:

  1. Liver
  2. Lentil soup
  3. Spinach
  4. Clams
  5. Red beans
  6. Rice
  7. Oysters
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13
Q

Which Rx iron source is usually most well tolerated?

  1. Ferrous fumarate
  2. Ferrous gluconate
  3. Ferrous sulfate
  4. All are similarly well tolerated
A
  1. Ferrous sulfate
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14
Q

The following CBC results are for a 25 year-old woman. What is your diagnosis? Why?

RBC 3.5 (4.2 - 4.9)
HGB 9.5 (12 - 15)
HCT 28.6 (37 - 51)
MCV 72 (80 - 96)
MCH 21.6 (23.7 - 28.4)
RDW 18.6 (12 - 17)
PLT 265 (150 - 375)
MPV 7.1 (6.5 - 12)
Serum Fe NORMAL
Serum Ferritin NORMAL
TIBC NORMAL

A

Diagnosis: Thalassemia

Reason:

  • Microcytic & hypochromic =>
    IDA, thalassemia or lead toxicity
    (most common microcytic anemias)
  • Iron studies WNL => thalassemia
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Hematology (7 decks)

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