Hematology - random topics

Question 1

INR 4.5-10 without bleeding in a patient on warfarin

Answer 1

hold warfarin

Question 2

INR >10 without bleeding in a patient on warfarin

Answer 2

hold warfarin, give oral vitamin K

Question 3

Any INR + life threatening bleeding in a patient on warfarin

Answer 3

hold warfarin, give IV vitamin K + PCC (Kcentra) OR IV vitamin K + FFP

Question 4

qualifications for when antibiotics can be discontinued on a patient with neutropenic fever

Answer 4

full antibiotic course completed
ANC recovered >500

Question 5

qualifications for when a patient being treated for neutropenic fever can be discharged

Answer 5

ANC >200
Afebrile > 24 hours
Negative blood cultures

Question 6

What makes prostate cancer high risk?

Answer 6

PSA >20
Gleason score 8-10
Extraprostatic extension

Question 7

What makes prostate cancer lower risk?

Answer 7

PSA <10
Gleason <6

Question 8

Treatment/management of low risk prostate cancer?

Answer 8

active surveillance

Question 9

Treatment of high risk prostate cancer?

Answer 9

radiation + gonadotropin-releasing hormone agonist for a total of 2-3 years

Question 10

Management of chronic anemia in CKD

Answer 10

iron supplementation (to maintain ferritin >100, transferrin saturation 20%)

Erythropoetin stimulating agents (after above goals are reached, to maintain Hgb goal >10)

Question 11

Most common causes of secondary polycythemia

Answer 11

renal neoplasm
Chronic hypoxia

Question 12

High hematocrit, low EPO

Answer 12

primary polycythemia (polycythemia vera, JAK2 mutation)

Question 13

High hematocrit, high or normal EPO

Answer 13

secondary polycythemia

Question 14

Resistance to heparin, unable to get to therapeutic PTT levels on heparin gtt

Answer 14

antithrombin deficiency