HEME/ONC

Question 1

Which lab value is expected in iron deficiency anemia

Answer 1

Elevated TIBC (>450)

Question 2

Which vitamin is appropriate for a post-operative patient with alcoholism?

Answer 2

B1 (thiamine)

Question 3

Your patient is a 30 Greek F with microcytic anemia who has just returned from the middle east. What lab is not expected in her anemia?

Answer 3

Low serum ferritin (<15)

Question 4

What does allopurinol prevent in Non-Hodgkin Lymphoma?

Answer 4

tumor lysis syndrome

Question 5

Your patient is on 5FU for chemotherapy. What symptoms are most likely to cause discontinuation of treatment?

Answer 5

nausea/vomiting and mucosal irritation

Question 6

Which of the following is not associated with anemia of chronic disease?

Answer 6

COPD

Question 7

A 32-year-old patient who underwent an open splenectomy for a ruptured spleen is preparing for discharge. An adult-gerontology acute care nurse practitioner reviews the potential complications with the patient. The nurse practitioner emphasizes which instruction to the patient?

Answer 7

Follow up with primary care provider for vaccinations

Question 8

32 yo presents with c/o fever, night sweats and unexplained wt loss. Upon exam you note a swollen cervical lymph node. A subsequent CXR reveals mediastinal adenopathy. Which of the following is the dx?

Answer 8

Hodgkin’s lymphoma

Question 9

Your pt had an appendectomy+ chemo for symptomatic relief of cancer. Is this curative or adjuvant treatment?

Answer 9

Adjuvant

Question 10

macrocytic anemia

Answer 10

Megaloblastic

Question 11

Iron Deficiency Anemia

Answer 11

Ferritin < 15, TIBC >450

Question 12

What race is at highest risk for cancer:

Answer 12

Black men

Question 13

Pernicious anemia:

Answer 13

+ Babinski sign (toes fan up/out)

Question 14

if platelets lo, what to give

Answer 14

platelets

Question 15

if Clotting factors low give

Answer 15

FFP,(Factors V, VIII, PT: INR)

Question 16

if Fibrinogen low (if <170 mg/dL)

Answer 16

give Cryoprecipitate

Question 17

Hodgkins where is Lymphedema

Answer 17

Lymphedema in cervical chain

Question 18

Lymphoma present in R axilla and R neck. What stage

Answer 18

Stage II – same side of diaphragm

Question 19

Leukemia + COPD

Answer 19

low WBC, CXR and ABG pretty normal, lungs diminished and you give steroid: ventilate

Question 20

What is the DIC confirmatory test?

Answer 20

↑FDPs

Question 21

Passive immunity example

Answer 21

immunoglobulin injections

Question 22

ITP Tx:

Answer 22

steroids

Question 23

Sickle cell anemia crisis Tx:

Answer 23

IVF for hydration (most important), analgesics for pain, oxygen for hypoxemia

Question 24

Jehovah’s Witness needs sx but is refusing blood products.

Answer 24

Give Epogen or colony stimulating factor. When do you give alternative: before sx

Question 25

Von Willenbrand disease

Answer 25

lack of factor VIII. give DDAVP preoperatively (can consider VWF)