MKSAP HemeOnc IV

Question 1

Patients identified as low risk and meeting the Pulmonary Embolism Rule-Out Criteria do not require ____ to eliminate the need for further diagnostic imaging.

Answer 1

D-dimer testing

Question 2

Chemotherapy with ____ is used for patients with CML in blast crisis with more than __ blasts and is not intended for the chronic phase

Answer 2

idarubicin and cytarabine; 20%

Question 3

What is imatinib/dasatinib/nilotinib?

Answer 3

tyrosine kinase inhibitor; targets CML with BCR-ABL fusion gene

Approximately 90% of patients with CML present in the chronic phase with less than 10% blasts in the blood and bone marrow.

Question 4

Pt presents with pancytopenia with significant intravascular hemolysis and hemoglobinuria. Nonspecific abdominal pain and fatigue.

Answer 4

Paroxysmal nocturnal hemoglobinuria

Caused by a mutation in the gene that regulates production of glycophosphatidylinositol-anchoring proteins.

Question 5

Diagnosis of paroxysmal nocturnal hemoglobinuria is based on ____ which can detect CD55 and CD59 deficiency on the surface of peripheral erythrocytes or leukocytes.

Answer 5

flow cytometry

Question 6

Patients with coagulopathy of liver disease and low fibrinogen levels who are experiencing bleeding should receive immediate ____ transfusion.

Answer 6

cryoprecipitate

Question 7

Fibrinogen levels less than ____ associated with active bleeding should be corrected.

Answer 7

100

Question 8

It is often difficult to distinguish between disseminated intravascular coagulation (DIC) and the coagulopathy of liver disease, but ___ level points to liver disease instead of DIC.

Answer 8

a normal or increased factor VIII

Question 9

chronic microcytic anemia with hemoglobin levels of approximately 10 g/dL (100 g/L) and a normal hemoglobin electrophoresis pattern

Answer 9

alpha thal trait

Question 10

chronic microcytic anemia with elevated Hgb A2 and Hgb F

Answer 10

B thal minor

Question 11

Patients with asymptomatic INR elevation between ___ and ___ are managed by simply withholding warfarin.

Answer 11

4.5 and 10

The 30-day risk of major bleeding is less than 1% with an INR between 5 and 9.

Question 12

For patients with an INR greater than ___, oral vitamin K, ___ mg, should be given.

Answer 12

10; 2.5

Question 13

How is pre-eclampsia defined?

Answer 13

hypertension, edema, and proteinuria after the 20th week of gestation.

Question 14

pre-eclampsia vs HELLP vs thrombotic thrombocytopenic purpura-HUS

Answer 14

Pre-eclampsia: SBP >140/DBP>90 after 20th week with edema and proteinuria, can have DIC parameters

HELLP: RUQ pain elevated LFTs, DIC parameters

TTP-HUS: MAHA and low plt in 1st or 2nd trimester with neuro findings and fever; no DIC

Question 15

A history of mucosal or endometrial bleeding, normal prothrombin and activated partial thromboplastin times, and normal platelet count with evidence of a qualitative platelet defect suggest ____.

Answer 15

von Willebrand disease

Question 16

Prolonged aPTT that corrects with mixing studies and a normal PT is suggestive of ___

Answer 16

Congenital hemophilia (Assay of individual factor levels would confirm factor deficiency)

Question 17

aPTT is prolonged and does not correct when mixed with normal plasma

Answer 17

lupus anticoagulant

Question 18

HgbS trait vs HbSB-thal

Answer 18

HbS trait- HbS levels ~30% with more HgbA, usually normal Hgb levels and no pain crises

HbSB-thal: milder disease than HbSS, HbA 5-30%; Hbs 60%, chronic anemia (the more HbA, the less disease (HbSS have HbS >90% and no HbA, increased HbF)