MKSAP HemeOnc I

Question 1

Immune thrombocytopenic purpura can be idiopathic, triggered by medications, or associated with other disorders, such as (6)

Answer 1

1. SLE
2. CLL (chronic lymphocytic leukemia)
3. lymphoma
4. HIV
5. HCV
6. H pylori

(antiplatelet antibody testing is not recommended because of low sensitivity)

Question 2

Patients who present with symptoms of mucocutaneous bleeding and a normal platelet count should be evaluated for acquired platelet dysfunction using the _____.

Answer 2

Platelet Function Analyzer-100.

Question 3

_____ require bridging with parenteral anticoagulation, whereas apixaban and rivaroxaban can be used as monotherapy in the treatment of VTE.

Answer 3

Dabigatran and edoxaban

Question 4

Patients with a PESI score of less than ___ are at low risk of death and may be managed in the outpatient setting with a non–vitamin K antagonist oral anticoagulant, such as apixaban or rivaroxaban.

Answer 4

65

Question 5

low serum iron levels and total iron-binding capacity and elevated serum ferritin level

Answer 5

Inflammatory anemia (AoCD)

Question 6

In patients with myelodysplastic syndrome requiring frequent transfusions, supplemental treatments to help decrease transfusion requirements, such as ____, should be used to improve quality of life and decrease transfusion-associated iron overload and alloimmunization.

Answer 6

lenalidomide (directly inducing tyrosine phosphorylation of CD28 on T cells leading to activation of downstream targets such as PI3K, GRB-2-OS, and NF-κb, thus partially overcoming CTLA4 Ig blockade and leading to T cell clonal proliferation.)

Question 7

Hypereosinophilic syndrome is characterized by moderate eosinophilia and end-organ damage commonly involving the skin, lungs, gastrointestinal tract, and heart; secondary causes of eosinophilia should be excluded. CHINA

Answer 7

The numerous neoplastic and nonneoplastic causes of eosinophilia can be recalled using the mnemonic CHINA (Collagen vascular disease, Helminthic infection, Idiopathic, Neoplasia, Allergy/Atopy/Asthma)

Question 8

____ may trigger a transient aplastic crisis in patients with hereditary spherocytosis.

Answer 8

Acute viral infections; treated with observation, splenectomy only indicated chronic severe hemolytic anemia

Question 9

In the presence of normal Doppler studies of the lower extremities, ____ is the initial lung imaging study to evaluate for pulmonary embolism in pregnant patients; D-dimer testing has no diagnostic role.

Answer 9

ventilation-perfusion lung scanning

Question 10

Transferrin SATURATION less than ____ (or serum ferritin level less than ___) is consistent with iron deficiency anemia and should be treated with oral iron

Answer 10

15%; 15

Question 11

What is transferrin?

Answer 11

Blood-plasma glycoprotein, which plays a central role in iron metabolism and is responsible for ferric-ion delivery. High transferrin means the liver is producing more of the protein to use all the iron available in the body. (i.e. Fe def anemia)

Question 12

_____ should be used to reverse the effects of warfarin anticoagulation in patients experiencing severe bleeding and those requiring urgent surgery.

Answer 12

Four-factor prothrombin complex concentrate

4f-PCC should be avoided in patients with a history of heparin-induced thrombocytopenia because it contains residual heparin.

Question 13

What is Idarucizumab?

Answer 13

Idarucizumab is a monoclonal antibody that binds the non–vitamin K antagonist oral anticoagulant dabigatran and causes a rapid reduction in available dabigatran in the body for up to 24 hours.