Hematology Flashcards
(88 cards)
1
Q
Please select from the list which contains the four classic myeloproliferative neoplams.
A) Hodgkin disease, chronic myeloid leukaemia, polycythaemia vera, hairy cell leukaemia
B) myelofibrosis, chronic myeloid leukaemia, polycythaemia vera, thrombocythaemia
C) thrombocythaemia, chronic myeloid leukaemia, polycythaemia vera, hairy cell leukaemia
D) polycythaemia vera, hairy cell leukaemia, agranulocytosis, myelofibrosis
A
B) myelofibrosis, chronic myeloid leukaemia, polycythaemia vera, thrombocythaemia
2
Q
The most common hereditary thrombophilia:
A) antithrombin deficiency
B) protein C deficiency
C) activated protein C resistence/Leiden-mutation
D) protein S deficiency
A
C) activated protein C resistence/Leiden-mutation
3
Q
You take care for a patient with deep vein thrombosis, which occured also previously too. Baseline aPTT prolonged with 12 seconds, which can not be corrected with addition of normal plasma. The most likely diagnosis:
A) dysfibrinogenaemia
B) lupus-anticoagulant/antiphospholipid syndrome
C) F XIII deficiency
D) antithrombin deficiency
A
B) lupus-anticoagulant/antiphospholipid syndrome
4
Q
Which form of acute myeloid leukemia is most likely, if there is a severe general easy bruising, signs of acute DIC, Marrow smear contains Auer rods in myeloid precursory cells, and cytogenetics reveal translocation 15/17?
A) M1 undifferentiated myeloblastic
B) M2 differentiated myeloblastic
C) M3 promyelocytic
D) M4 myelomonocytic
E) M5 monocytic
A
C) M3 promyelocytic
5
Q
Only one of the lists fits to so called classical hemolytic uremic syndrome (HUS):
A) school aged kid, fever following couple of day a recent diarrhoea, moderate jaundice, mild renal failure, leukocytosis, thrombocytopenia, neurological signs and cognitive dysfunction
B) elderly lady, hypofibrinogenaemia, splenomegaly, acut DIC, thrombocytopenia, direkt bilirubin accumulation, oligo-anuria, apathy
C) gastric cancer patient, hyperfibrinogenaemia. low LDH activity, positive direct Coombs
A
A) school aged kid, fever following couple of day a recent diarrhoea, moderate jaundice, mild renal failure, leukocytosis, thrombocytopenia, neurological signs and cognitive dysfunction
6
Q
Which alteration associates frequently with a moderate to severe form of congenital spherocytosis?
A) arteriosclerosis obliterans
B) immunodeficiency
C) gallstone disease
D) hypertension
E) diarrhoea
F) constipation
A
C) gallstone disease
7
Q
Which means Hodgin III/A Ann Arbor stage?
A) pathological lymph nodes on both sides of the neck, axillary without fever and weight loss
B) pathological lymph nodes at the neck and inguinal region with fever and weight loss
C) pathological lymph nodes at the neck and inguinal region without fever and weight loss
D) pathological lymph nodes at the neck and supraclavicular region with fever and weight loss
A
C) pathological lymph nodes at the neck and inguinal region without fever and weight loss
8
Q
Please identify the first line chemotherapy protocol of Hodgkin’s lymphoma.
A) CVP (cyclophosphamid + vincristin + prednisolon)
B) CAF (cyclophosphamid + adriablastin + fluorouracil)
C) TAD/HAM (thioguanin + Ara-C + daunorubicin/high dose Ara-C + mitoxantron)
D) ABVD (adriamycin + bleomycin + vinblastin + dacarbazin)
A
D) ABVD (adriamycin + bleomycin + vinblastin + dacarbazin)
9
Q
Please identify a non-Hodgkin’s lymphoma in which lymphadenopathy und splenomegaly are not characteristic findings.
A) hairy cell leukemia
B) Waldenström-macroglobulinaemia
C) Burkitt-lymphoma
D) multiple myeloma
E) mantle-cell lymphoma
A
D) multiple myeloma
10
Q
The most probable background of hypochromic microcyctic anemia:
A) pernicious anemia
B) anemia sideropenica
C) hyperthyreodism
D) agranulocytosis
A
B) anemia sideropenica
11
Q
Hypersplenic hemopoesis can be characterised as:
A) leukocytosis with left shift splenomegaly
B) pancytopenia, portal hypertension, normal or increased reticulocyte count
C) thrombocytosis, splenomegaly
D) erythrocytosis, thrombocytosis, leukocytosis, splenomegaly
A
B) pancytopenia, portal hypertension, normal or increased reticulocyte count
12
Q
Which hemolytic disorder is associated with pancytopenia?
A) spherocytosis
B) immunhemolytic anemia
C) sickle cell trait
D) paroxysmal nocturnal hemoglobinuria
E) thalassaemia minor
A
D) paroxysmal nocturnal hemoglobinuria
13
Q
Non pegylated factor concentrate half life in Hemophilia A
A) 2 hours
B) 6 hours
C) 12 hours
D) 24 hours
E) 48 hours
A
C) 12 hours
14
Q
Mild von Willebrand case with moderate bleeding or prevention only one of the agents efficient
A) pentoxyphyllin
B) calcium dobesilat
C) DDAVP- (desamino-D-arginin-vasopressin-) infusion
D) somatostatin
A
C) DDAVP- (desamino-D-arginin-vasopressin-) infusion
15
Q
In chilhood acute ITP prognosis:
A) If thrombocytopenia severe, spontaneous improvement is uncommon.
B) Spontaneous recovery is the most common.
C) Improvement might be achieved only with 1 mg/kg prednisone.
A
B) Spontaneous recovery is the most common.
16
Q
In chronic ITP (non post infectious event) the prognosis:
A) Spontaneous remissions are the rule
B) Spontaneous remissions are uncommon, but after a short course of 1 mg/kg Prednisolon 80% achieves durable remissions
C) In chronic ITP spontaneous remissions are uncommon, first line 1 mg/kg Prednisolon achieves durable remissions in 10-15%
D) Any kind of remission needs combined immunsuppressive therapy
A
C) In chronic ITP spontaneous remissions are uncommon, first line 1 mg/kg Prednisolon achieves durable remissions in 10-15%
17
Q
Please identify the antidote of unfractionated (Na) heparin.
A) Vitamin K 20 mg iv.
B) Dicynon 20 mg iv.
C) ε-aminocapronic acid 4–8 g iv.
D) protamine sulphate
E) Styptanon
F) DDAVP
A
D) protamine sulphate
18
Q
Megaloblastic (pernicious) anemia characteristics:
1) Weak gastric acid output, only after pentagastrin stimulation.
2) Pentagastrin refractory achlorhydria in manifest anemia cases.
3) Normoblast accumulation in bone marrow.
4) Presence of giant metamyelocytes in the marrow and blood.
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct
A
C) 2nd and 4th answers are correct
19
Q
True feature(s) of megaloblastic anemia:
1) mild hemolysis with moderately increased indirect bilirubin
2) leukocytosis and trombocytosis
3) mild leukopenia and thrombocytopenia
4) normal LDH activity and hypocellular bone marrow
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct
A
B) 1st and 3rd answers are correct
20
Q
The definition of severe hemophilia:
1) FVIII activity is 5–10%.
2) FVIII activity is less than 1%.
3) Petechiae and Rumpell-Leede test positivity are frequently observed.
4) Spontaneous haemarthros, joint bleedings are developing.
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct
A
C) 2nd and 4th answers are correct
21
Q
Identify the correct response combinations in hemophilia A.
1) Plasma von Willebrand is normal.
2) Plasma von Willebrand-factor is decreased.
3) Prolonged aPTT which can be corroected with normal plasma mixing.
4) aPTT is prolonged, but thrombin time is even more prolonged.
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct
A
B) 1st and 3rd answers are correct
22
Q
True features of agranulocytosis (febrile neutropenia):
1) mostly drug associated
2) mostly idiopathic
3) no erythropoietic or thrombopoietic abnormalities are present, myeloid maturation is blocked at early stage
4) there is a pancytopenia and severe bone marrow hypocellularity
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct
A
B) 1st and 3rd answers are correct
23
Q
Characteristics of FVII deficiency:
1) rare condition, not inducing bleeding events
2) rare condition with severe bleedings
3) prolonged aPTT, thrombin time, along with prothrombin time, which all can be corrected by addition of normal plasma
4) Isolated prothrombin time prolongation which can not be corrected by iv, vitamin K
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct
A
C) 2nd and 4th answers are correct
24
Q
Typical attribute(s) of chronic lymphocytic leukemia:
1) long disease course with good therapeutic responses, no refractory cases
2) durable course, rather indolent features, sometimes only partial responses to therapies, CD5/CD19 coexpressed cell count exceeds 5 g/L in peripheral blood
3) immunglobulins are elevated
4) low immunoglobulin levels
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct
A
C) 2nd and 4th answers are correct
25
What is/are diagnostic criterium of chronic lymphocytic leukemia?
1) Fever, painful lymphadenopathy, elevated CRP
2) Leukocytosis with left shift
3) Monoclonal gammopathy
4) CD5/CD19 coexpression cell count exceeds 5 G/L in peripheral blood
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct
D) only 4th answer is correct
26
Therapies which are able to prolong multiple myeloma survival:
1) per os melphalan plus prednisolon
2) bortezomib, proteasome inhibitors
3) vincristine
4) dexamethasone
5) high dose melphalan with autologous stem cell transplantation
6) thalidomide, revlimide
7) antracyclines
8) methotrexate
A) 2nd, 5th and 6th answers are correct
B) 3rd, 6th and 8th answers are correct
C) 2nd, 4th and 7th answers are correct
A) 2nd, 5th and 6th answers are correct
27
ITP attributes:
1) isolated thrombocytopenia
2) pancytopenia and thrombocytopenia
3) significant splenomegaly
4) splenomegaly is usually absent, however, steroid refractory cases may respond with 60-70% durable remission rate to splenectomy
5) template bleeeding time prolonged
6) prolonged clotting times
A) 1st, 4th and 5th answers are correct
B) 2nd and 3rd answers are correct
C) 2nd, 3rd and 6th answers are correct
A) 1st, 4th and 5th answers are correct
28
Heparin complications:
1) Heparin induced thrombocytopenia (HIT) is a mild complication, may induce some easy bruising, injection site reactions
2) HIT is frequently severe complication, runs high mortality, serious bleeding and simultaneous progressive thrombosis may develop
3) HIT is more common with low molecular weight heparins
4) HIT is more common with unfractionated heparin derivatives.
5) Heparin may induce cholestatic enzyme elevations
6) Heparin may induce transaminase elevation.
A) 1st., 2nd and 3rd answers are correct
B) 1st., 3rd and 5th answers are correct
C) 2nd., 4th and 6th answers are correct
C) 2nd., 4th and 6th answers are correct
29
Poor prognostic moments in Hodgkin lymphoma:
1) Lymphoid depletion type
2) Lymphoid predominant
3) Ann Arbor IV stage
4) Ann Arbor I stage
5) Age over 45
6) Age under 45
7) Interim PET CT shows progression
8) Stagnation or moderate improvement on interim PET CT
A) 1st, 3rd, 5th and 7th answers are correct
B) 2nd and 4th answers are correct
C) 6th and 8th answers are correct
D) 2nd, 4th, 6th and 8th answers are correct
A) 1st, 3rd, 5th and 7th answers are correct
30
Please select agents convenient to treat acute or subacute arterial thrombosis.
1) Coumarol
2) Pentoxyphyllin
3) Aspirin
4) Clopidogrel
5) tissue plasminogen activator
6) low molecular weight heparin
7) ε-aminokapron acid
8) DDAVP (desamino-D-arginin-vasopressin)
A) 1st and 2nd answers are correct
B) 3rd, 4th, 5th and 6th answers are correct
C) 7th and 8th answers are correct
D) all of the answers are correct
B) 3rd, 4th, 5th and 6th answers are correct
31
Identify typical coumarol complications:
1) thrombocytopenia
2) skin or intestinal necrosis
3) diarrhoea, abdominal distension
4) agranulocytosis
5) if INR over 5, spontaneous bleedings
6) spontaneous bleedings with INR over 2
A) 1st, 3rd and 4th answers are correct
B) 2nd and 5th answers are correct
C) 4th and 6th answers are correct
B) 2nd and 5th answers are correct
32
Unfractionated heparin monitoring feasible tools
1) prothrombin time
2) aPTT
3) global clotting time measured with appropriate bedside device
4) urea lysability test
5) APC- resistance
A) 1st and 4th answers are correct
B) 1st and 5th answers are correct
C) 2nd and 3th answers are correct
D) 4th and 5th answers are correct
C) 2nd and 3th answers are correct
33
Please select condition predisposing to arterial thrombosis
1) FV. Leiden mutation
2) hyperhomocysteinaemia
3) lupus-anticoagulant/antiphospholipid-antibody syndrome
4) antithrombin deficiency
5) unstable angina
6) Prinzmetal angina
7) long lasting thrombocytosis
8) reduced blood viscosity
9) immobilisation
A) 1st, 4th and 6th answers are correct
B) 2nd, 3rd, 5th and 7th answers are correct
C) 4th, 6th, 8th and 9th answers are correct
B) 2nd, 3rd, 5th and 7th answers are correct
34
Acute DIC characteristics:
1) thrombocytopenia
2) normal platelet count
3) shortened PT/aPTT
4) prolonged PT/aPTT
5) hypofibrinogenaemia
6) elevated antithrombin
A) 1st, 4th and 5th answers are correct
B) 2nd, 3rd and 6th answers are correct
A) 1st, 4th and 5th answers are correct
35
The features of Chronic DIC are:
1) prolonged aPTT
2) slightly shortened aPTT
3) thrombotic events
4) severe bleedings
5) hypofibrinogenaemia
6) elevated D-dimer
7) severe thrombocytopenia
A) 1st and 4th answers are correct
B) 1st, 5th and 7th answers are correct
C) 2nd, 3rd and 6th answers are correct
C) 2nd, 3rd and 6th answers are correct
36
Typical backgrounds of acute DIC:
1) thrombotic thrombocytopenic purpura acute DIC is always present
2) major cranial trauma
3) intrauterin fetal death
4) prostatic cancer
5) Romano–Ward-syndrome
6) multiple myeloma
7) acute promyelocytic leukemia
A) 1st and 5th answers are correct
B) 2nd, 3rd, 4th and 7th answers are correct
C) 5th and 6th answers are correct
B) 2nd, 3rd, 4th and 7th answers are correct
37
FXIII deficiency typically cause
1) severe bleeding tendency
2) predisposing to thrombosis
3) prolonged bleeding time
4) repeated spontanous abortions
5) increased keloid scars at surgical wounds
6) inreased likelyhood of glaucoma
A) 1st, 4th and 5th answers are correct
B) 2nd., 3rd and 6th answers are correct
A) 1st, 4th and 5th answers are correct
38
Characteristics of chronic myeloid leukemia
1) survival without specific treatment is around 5 years
2) survival without specific treatment is around 12 years
3) untreated cases average survival is 1 years
4) Cromosome 12 trisomy is a hallmark finding
5) 15,19 translocation is typical
6) By definition Philadelphia chromosome and bcr/abl rearrangerment is present
7) A chronic, accelerated, and blastic phase typicallly develops without specific treatment
8) the disease remains in chronic phase during the entire clinical course
9) blastic phase is a typical finding in early accelerated cases, but very uncommon with early chronic phase cases
A) 1st, 6th and 7th answers are correct
B) 2nd, 4th and 8th answers are correct
C) 3rd, 5th and 9th answers are correct
A) 1st, 6th and 7th answers are correct
39
Typical features of chronic myeloid leukemia
1) Modest splenomegaly
2) Major splenomegaly
3) The entire granulocyte maturation stages cells are represented in peripheral blood
4) Only blasts and matured neutrophils can be seen in peripheral blood smears, intermediary forms are absent
5) Imatinib or second third generation tyrosike kinase inhibitors achieve a complete haematological, cytogenetic and even molecular remission in the majoritiy of chronic phase patients, resulting in huge survival benefit
6) Optimal treatment of chronic phase is prednisolon + cyclophosphamid
A) 1st, 4th and 6th answers are correct
B) 2nd, 3rd and 5th answers are correct
B) 2nd, 3rd and 5th answers are correct
40
Reactive leukocytosis might be expected in:
1) Bacterial bronchopneumonia
2) B virus hepatitis
3) Monoucleosis infectiosa
4) Exsiccosis
5) Anaemia perniciosa
6) Cholecystitis acuta
A) 1st, 2nd and 5th answers are correct
B) 1st, 5th and 6th answers are correct
C) 1st, 3rd, 4th and 6th answers are correct
C) 1st, 3rd, 4th and 6th answers are correct
41
Leukopenia might be expected in:
1) hyperthyreodism
2) purulent meningitis
3) abscedent pneumonia
4) AIDS premanifest stage
5) acute viral hepatitis
6) autoimmune diseases
7) endocarditis infectiva
A) 1st, 2nd and 6th answers are correct
B) 2nd, 6th and 7th answers are correct
C) 1st, 4th, 5th and 6th answers are correct
C) 1st, 4th, 5th and 6th answers are correct
42
Eosinophilia might be expected in:
1) Churg-Strauss syndrome
2) Loeffler-endocarditis
3) sphaerocytosis
4) chronic myeloid leukemia, accelerated phase
5) plasmocytoma
6) aplastic anemia
A) 1st, 3rd and 5th answers are correct
B) 1st, 2nd and 4th answers are correct
C) 2nd, 3rd and 5th answers are correct
D) 3rd, 5th and 6th answers are correct
B) 1st, 2nd and 4th answers are correct
43
Bleeding time will be prolonged in:
1) ITP (immune thrombocytopenic purpura)
2) aspirin treatment
3) Coumarol administration
4) haemophilia A
5) haemophilia B
6) von Willebrand-disease
A) 1st, 2nd and 6th answers are correct
B) 3rd, 4th and 5th answers are correct
A) 1st, 2nd and 6th answers are correct
44
Clotting time will prolonged
1) Glanzmann-thrombasthenia
2) aspirin user
3) coumarol treatment
4) haemophilia A
5) Willebrand-disease
6) unfractionated heparin therapy
A) 1st and 2nd answers are correct
B) 2nd and 4th answers are correct
C) 3rd, 4th and 6th answers are correct
C) 3rd, 4th and 6th answers are correct
45
aPTT will be prolonged
1) immune thrombocytopenic purpura
2) acute DIC
3) Unfractionated heparin therapy
4) Low molecular weight heparin administration
5) lupus-anticoagulant case
6) clopidogrel therapy
7) Antithrombin deficiency
A) 1st and 4th answers are correct
B) 2nd, 3rd and 5th answers are correct
C) 6th and 7th answers are correct
B) 2nd, 3rd and 5th answers are correct
46
Typical findings in hemolysis:
1) direct bilirubin elevated
2) indirect bilirubin elevated
3) ubg reaction increased in urine
4) bilirubin positivity in urine
5) high reticulocyte count
6) low reticulocyte count
A) 1st and 4th answers are correct
B) 4th and 6th answers are correct
C) 1st, 4th and 6th answers are correct
D) 2nd, 3rd and 5th answers are correct
D) 2nd, 3rd and 5th answers are correct
47
Hemolysis suggestive findings:
1) Coombs-positivity
2) pruritus
3) hypocellular hemopoiesis
4) elevated LDH activity
5) high GOT/GPT ratio
6) pleiochrom, dark stool
A) 1st, 4th and 6th answers are correct
B) 2nd, 3rd and 5th answers are correct
C) 2nd and 3rd answers are correct
D) 3rd and 5th answers are correct
A) 1st, 4th and 6th answers are correct
48
Diseases associted with hemolysis:
1) plasmocytoma
2) acute ITP (immun thrombocytopenic purpura)
3) paroxysmal nocturnal haemoglobinuria
4) aplastic anemia
5) sphaerocytosis
6) Dubin–Johnson-syndrome
7) anemia perniciosa
8) thrombotic thrombocytopenic purpura/Moschcowitz-syndrome
9) Glanzmann-thrombasthenia
A) 1st and 4th answers are correct
B) 4th, 6th and 9th answers are correct
C) 3rd, 5th, 7th and 8th answers are correct
C) 3rd, 5th, 7th and 8th answers are correct
49
Two of the following conditions may be associated with hemolysis:
1) ulcerative colitis
2) Crohn-disease
3) blood group mismatched blood transfusion
4) severe preecclampsia (HELLP)
5) myelofibrosis
6) polycythaemia vera
7) thrombocythaemia essentialis
A) 1st and 7th answers are correct
B) 2nd and 6th answers are correct
C) 3rd and 4th answers are correct
D) 5th and 6th answers are correct
C) 3rd and 4th answers are correct
50
Identify chronic myeloproliferative neoplasm among the listed conditions:
1) hemochromatosis
2) Waldenström-macroglobuliemia
3) polycythaemia vera
4) myelofibrosis
5) megaloblastic anemia
6) chronic myeloid leukemia
7) thombocythemia essentialis
8) mycosis fungoides
9) Sezary-syndrome
A) 1st and 2nd answers are correct
B) 3rd, 4th, 6th and 7th answers are correct
C) 5th, 8th and 9th answers are correct
B) 3rd, 4th, 6th and 7th answers are correct
51
Macrocytic anemia can be found in:
1) hyperthyroidism
2) anemia perniciosa
3) anemia sideropenica
4) hypothyroidism
5) spherocytosis
A) 1st and 2nd answers are correct
B) 2nd and 4th answers are correct
C) 3th and 5th answers are correct
B) 2nd and 4th answers are correct
52
Normocytic anemia should be expected
1) chronic iron deficiency
2) B12-malabsorption
3) folic acid impaired absorption
4) recent major bleeding
5) some cancers
A) 1st and 2nd answers are correct
B) 2nd and 3th answers are correct
C) 4th and 5th answers are correct
C) 4th and 5th answers are correct
53
Severe anemia signs and complaints
1) central cyanosis
2) peripheral cyanosis
3) accidental ejection type systolic murmur
4) tinnitus
5) dizzyness
6) high fever
7) dyspnea
8) hypotension
9) vomiting
A) 1st, 2nd, 6th and 8th answers are correct
B) 2nd, 6th, 8th and 9th answers are correct
C) 3rd, 4th, 5th and 7th answers are correct
C) 3rd, 4th, 5th and 7th answers are correct
54
Immuno-hemolytic characteristic findings
1) Coombs positivity
2) GOT elevated
3) alcaline phosphatase elevated
4) LDH elevated
5) splenectomy helps in 50%
6) splenectomy helps in most instances
7) a splenectomy clearly useless
A) 1st, 4th and 5th answers are correct
B) 3rd and 7th answers are correct
C) 3rd, 6th and 7th answers are correct
A) 1st, 4th and 5th answers are correct
55
Which statements are correct in diffuse large B cell lymphoma?
1) indolent lymphoma
2) aggressive lymphoma
3) antiCD20 based immunochemotherapy achieves definitive cure in substantial part of patients
4) antiCD20 based immunochemotherapy should be applied, but it never achieves final cure
5) In refractory/relapsed cases high dose chemotherapy/autologous transplant should be performed
6) Diffuse large B cell lymphoma is CD20 negative, so anti CD20 therapy is not applicable
A) 2nd, 3th and 5th answers are correct
B) 3rd and 5th answers are correct
C) 4th and 5th answers are correct
D) 2nd and 6th answers are correct
A) 2nd, 3th and 5th answers are correct
56
You can find elevated iron plasma levels in:
1) myeloma multiplex
2) hemochromatosis
3) Willebrand disease in females
4) hemolytic crisis
5) aplastic anemia
6) agranulocytosis
A) 1st and 6th answers are correct
B) 1st, 5th and 6th answers are correct
C) 2nd and 4th answers are correct
C) 2nd and 4th answers are correct
57
Feasible methods to detect empty iron stores
1) serum iron level
2) Prussian blue stain, bone marrow
3) Shilling-test
4) Ham-test
5) serum-ferritin
6) β2-microglobulin
7) PAS-reaction, bone marrow
A) 1st, 3rd and 7th answers are correct
B) 3rd, 4th and 6th answers are correct
C) 2nd and 5th answers are correct
C) 2nd and 5th answers are correct
58
Important viruses in aplastic anemia etiopathogenesis:
1) Epstein–Barr-virus
2) cytomegalovirus
3) parvovirus
4) hepatitis A virus
5) HIV virus
6) hepatitis B, C virus
7) mumps virus
A) 1st, 2nd and 4th answers are correct
B) 2nd, 4th and 7th answers are correct
C) 3rd, 5th and 6th answers are correct
C) 3rd, 5th and 6th answers are correct
59
Select correct features of agranulocytosis (febrile neutropenia)
1) Bone marrow aplasia, involving all cell lines
2) Bone marrow: Large number of early myeloid precursors, blocked in maturation, other cell lines are preserved
3) Normal hemopoiesis in bone marrow
4) Agranocytosis improves with the cessation of provocative drug.
5) This improvement can be slightly quicker with bone marrow cytokin administration
6) Agranulocytosis is not a drug induced condition, so cessation of previous drugs is unnecessary.
7) Large dose fresh frozen plasma administration helps agranulocytotic patients
A) 1st, 6nd and 7th answers are correct
B) 2nd, 4th and 5th answers are correct
C) 3rd, 6th and 7th answers are correct
B) 2nd, 4th and 5th answers are correct
60
You should apply perioperative anticoagulant prophylaxis:
1) all surgery lasting more than 20 minutes
2) 45 minutes or longer operation, even if laparoscopic
3) all cases with general anaesthesia
4) neoplasm surgery
5) hip joint or fracture surgery
6) all upper limb bone surgery
A) 1st, 3rd and 6th answers are correct
B) 2nd, 4nd and 5th answers are correct
B) 2nd, 4nd and 5th answers are correct
61
Correct statements in mantle cell lymphoma:
1) Dense CD 20+ lymphoma so anti CD20 based intensive immunochemotherapy should be applied
2) CD20 negative, so anti CD 20 therapy is not necessary
3) Autologous transplant should be performed in first remission
4) Indolent course is frequent in which watch and wait approach is enough
5) indolent lymphoma
6) Aggressive course is typical in vast majority
A) 1st, 3rd and 6th answers are correct
B) 2nd, 4th and 5th answers are correct
A) 1st, 3rd and 6th answers are correct
62
Coumarol overdose induced major bleeding can be stopped by only three of the choices:
1) protamine sulphate
2) low molecular weight heparin
3) ε-aminocaproic acid
4) fresh frozen plasma
5) DDAVP
6) Novoseven (rFVIIa) iv.
7) prothrombin complex concentrate
A) 1st, 2nd and 5th answers are correct
B) 2nd, 3rd and 4th answers are correct
C) 4th, 6th and 7th answers are correct
C) 4th, 6th and 7th answers are correct
63
Which is the most likely disease?
A 16-year-old girl admitted to your ward, looks really sick. History: no meaningful previous event, she had regular sports activity, but 8 days ago she had transient mild fever and diarrhoea for 2 days. She has had fever again, headache, dizziness, mild confusion for a day, she could not even recognize her sister. Small petechiae and suffusions appeared. You observe somnolence, mild jaundice. No meningeal signs. Liver, spleen, lymphnodes are normal sized. Platelet count 10 G/L, hemoglobin 101g/L, WBC 15 G/L, urea 11 mmol/l, hemostasis screening tests are normal.
A) acute myeloid leukemia
B) acute lymphoid leukemia
C) acute immune thrombocytopenic purpura (ITP)
D) thrombotic microangiopathia, HUS (hemolytic uremic syndrome)
E) acute viral hepatitis
F) acute DIC
D) thrombotic microangiopathia, HUS (hemolytic uremic syndrome)
64
Which are the most appropriate examination in this case to prove suggested diagnosis
A 16-year-old girl admitted to your ward, looks really sick. History: no meaningful previous event, she had regular sports activity, but 8 days ago she had transient mild fever and diarrhoea for 2 days. She has had fever again, headache, dizziness, mild confusion for a day, she could not even recognize her sister. Small petechiae and suffusions appeared. You observe somnolence, mild jaundice. No meningeal signs. Liver, spleen, lymphnodes are normal sized. Platelet count 10 G/L, hemoglobin 101g/L, WBC 15 G/L, urea 11 mmol/l, hemostasis screening tests are normal.
1) Bone marrow – myeloblast accumulation
2) Bone marrow – lymphoblast accumulation
3) Bone marrow – accumulation
4) GOT-/GPT
5) HbsAg screening
6) LDH-activity
7) peripheral blood smear, leukocytosis analysis
8) peripheral blood smear, lymphoblast search
9) peripheral blood smear, fragmentocyte (fragmented sred blood cells) screen
10) Platelet surface immunglobulin detection
11) kidney function analysis
A) 1st, 4th and 11th answers are correct
B) 2nd, 5th and 10th answers are correct
C) 6th, 9th and 11th answers are correct
D) 7th, 8th and 10th answers are correct
C) 6th, 9th and 11th answers are correct
65
Which are the most useful disease specific diagnostic tools
A 16-year-old girl admitted to your ward, looks really sick. History: no meaningful previous event, she had regular sports activity, but 8 days ago she had transient mild fever and diarrhoea for 2 days. She has had fever again, headache, dizziness, mild confusion for a day, she could not even recognize her sister. Small petechiae and suffusions appeared. You observe somnolence, mild jaundice. No meningeal signs. Liver, spleen, lymphnodes are normal sized. Platelet count 10 G/L, hemoglobin 101g/L, WBC 15 G/L, urea 11 mmol/l, hemostasis screening tests are normal.
1) Bone marrrow myeloblast flow cytometry
2) t15,17 translocation, suggesting acute promyelocytic leukemia, to indicate retinooid therapy
3) Durable increment of platelet counts after platelet transfusion, a sin ITP foreign platelets are not affected by antibodies
4) test if patient plasma provokes platelet aggregation in control specimen
5) verotoxin ELISA
6) ADAM TS13 activity or complementactivation measurement
7) TFPI measurement (tissue Factor inhibitor)
A) 1st and 7th answers are correct
B) 5th and 6th answers are correct
C) 3rd and 7th answers are correct
D) 4th and 5th answers are correct
E) all of the answers are correct
B) 5th and 6th answers are correct
66
Which therapeutic approach is the most appropriate
A 16-year-old girl admitted to your ward, looks really sick. History: no meaningful previous event, she had regular sports activity, but 8 days ago she had transient mild fever and diarrhoea for 2 days. She has had fever again, headache, dizziness, mild confusion for a day, she could not even recognize her sister. Small petechiae and suffusions appeared. You observe somnolence, mild jaundice. No meningeal signs. Liver, spleen, lymphnodes are normal sized. Platelet count 10 G/L, hemoglobin 101g/L, WBC 15 G/L, urea 11 mmol/l, hemostasis screening tests are normal.
A) AML induction chemoterapy
B) ALL induction chemotherapy
C) retinoic acid administration
D) Antibiotics
E) high dose plasma administration/plasmaapheresis
F) aspirin
E) high dose plasma administration/plasmaapheresis
67
What interventions are contraindicated in the acute phase of this disease?
A 16-year-old girl admitted to your ward, looks really sick. History: no meaningful previous event, she had regular sports activity, but 8 days ago she had transient mild fever and diarrhoea for 2 days. She has had fever again, headache, dizziness, mild confusion for a day, she could not even recognize her sister. Small petechiae and suffusions appeared. You observe somnolence, mild jaundice. No meningeal signs. Liver, spleen, lymphnodes are normal sized. Platelet count 10 G/L, hemoglobin 101g/L, WBC 15 G/L, urea 11 mmol/l, hemostasis screening tests are normal.
1) thrombocyte transfusion
2) colony stimulators (GCSF, GM-CSF)
3) prednisolon
4) antibiotics
5) diuretics
6) clopidogrel
7) aspirin
A) 1st, 6th and 7th answers are correct
B) 2nd, 6th and 7th answers are correct
C) 3rd, 4th and 5th answers are correct
A) 1st, 6th and 7th answers are correct
68
Which more recent therapy can also be helpful
A 16-year-old girl admitted to your ward, looks really sick. History: no meaningful previous event, she had regular sports activity, but 8 days ago she had transient mild fever and diarrhoea for 2 days. She has had fever again, headache, dizziness, mild confusion for a day, she could not even recognize her sister. Small petechiae and suffusions appeared. You observe somnolence, mild jaundice. No meningeal signs. Liver, spleen, lymphnodes are normal sized. Platelet count 10 G/L, hemoglobin 101g/L, WBC 15 G/L, urea 11 mmol/l, hemostasis screening tests are normal.
A) heparin
B) autologous bone marrow transplantation
C) allogeneous bone marrow transplantation
D) iv. anti cd20 monoclonal antibody
E) high dose interferon
D) iv. anti cd20 monoclonal antibody
69
With adequate diagnosis and therapy what is the correct prognosis
A 16-year-old girl admitted to your ward, looks really sick. History: no meaningful previous event, she had regular sports activity, but 8 days ago she had transient mild fever and diarrhoea for 2 days. She has had fever again, headache, dizziness, mild confusion for a day, she could not even recognize her sister. Small petechiae and suffusions appeared. You observe somnolence, mild jaundice. No meningeal signs. Liver, spleen, lymphnodes are normal sized. Platelet count 10 G/L, hemoglobin 101g/L, WBC 15 G/L, urea 11 mmol/l, hemostasis screening tests are normal.
A) 90% mortality remains unchanged- in spite of therapeutic efforts
B) 5 years survival 15–30%
C) with steroids+splenectomy you can achieve definitive cure, sometimes with residual easy bruising
D) defintive cure rate is 90–95%, some cases meay have recidive episodes
E) Spontaneous improvement 80%, with treatment it is almost 100%
D) defintive cure rate is 90–95%, some cases meay have recidive episodes
70
This disease might have recidives more likely in
A 16-year-old girl admitted to your ward, looks really sick. History: no meaningful previous event, she had regular sports activity, but 8 days ago she had transient mild fever and diarrhoea for 2 days. She has had fever again, headache, dizziness, mild confusion for a day, she could not even recognize her sister. Small petechiae and suffusions appeared. You observe somnolence, mild jaundice. No meningeal signs. Liver, spleen, lymphnodes are normal sized. Platelet count 10 G/L, hemoglobin 101g/L, WBC 15 G/L, urea 11 mmol/l, hemostasis screening tests are normal.
A) pneumococcus-pneumonia
B) Philadelphia-chromosome anomaly present
C) lg H gene rearrangement is persistent
D) pregnancy
E) aspirin use
F) Taking coumarols
D) pregnancy
71
Dominant pathogentic factor in this disease
A 16-year-old girl admitted to your ward, looks really sick. History: no meaningful previous event, she had regular sports activity, but 8 days ago she had transient mild fever and diarrhoea for 2 days. She has had fever again, headache, dizziness, mild confusion for a day, she could not even recognize her sister. Small petechiae and suffusions appeared. You observe somnolence, mild jaundice. No meningeal signs. Liver, spleen, lymphnodes are normal sized. Platelet count 10 G/L, hemoglobin 101g/L, WBC 15 G/L, urea 11 mmol/l, hemostasis screening tests are normal.
A) retinoin receptor anomaly
B) previous alkylator therapy
C) previous irradiation
D) hypertension
E) ADAMTS13 or complement alteration
F) multidrug-resistane
E) ADAMTS13 or complement alteration
72
Which intervention is strictly contraindicated in this disease?
A 16-year-old girl admitted to your ward, looks really sick. History: no meaningful previous event, she had regular sports activity, but 8 days ago she had transient mild fever and diarrhoea for 2 days. She has had fever again, headache, dizziness, mild confusion for a day, she could not even recognize her sister. Small petechiae and suffusions appeared. You observe somnolence, mild jaundice. No meningeal signs. Liver, spleen, lymphnodes are normal sized. Platelet count 10 G/L, hemoglobin 101g/L, WBC 15 G/L, urea 11 mmol/l, hemostasis screening tests are normal.
A) Red blood cell-transfusion
B) Platelet transfusion
C) splenectomy
D) colony stimulators, due to leukemogenicity
B) Platelet transfusion
73
What is the most likely diagnosis suspected?
You see a 62 years old male, with cherry sized neck, axillary, inguinal painless lymphadenopathy. Moderate weakness and weightloss. He had some mild fever and upper airway infections recently. Spleen enlarged by 6 cm. White Blood cell count 23 G/L, 76% small matured lymphocyte, other forms are normal. Hemoglobin 105 g/l, platelet count normal. Reduced IgG.
A) lymphogranulomatosis
B) chronic lymphoid leukemia
C) acute lymphoid leukemia
D) chronic myeloid leukemia
E) mononucleosis infectiosa
B) chronic lymphoid leukemia
74
What are the most helpful diagnostic tools in this case
You see a 62 years old male, with cherry sized neck, axillary, inguinal painless lymphadenopathy. Moderate weakness and weightloss. He had some mild fever and upper airway infections recently. Spleen enlarged by 6 cm. White Blood cell count 23 G/L, 76% small matured lymphocyte, other forms are normal. Hemoglobin 105 g/l, platelet count normal. Reduced IgG.
1) lymph node biopsy
2) Gumprecht shadows in peripheral blood smears
3) Bone marrow examination
4) citogenetics screening for Philadelphia-chromosome
5) peripheral blood flowcytometry. CD5/CD19 coexpressed cell count measurement
A) 1st and 3rd answers are correct
B) 2nd and 4th answers are correct
C) 2nd and 5th answers are correct
D) 4th and 5th answers are correct
E) all of the answers are correct
C) 2nd and 5th answers are correct
75
What diagnostic tool is the most useful in this condition to define prognosis
You see a 62 years old male, with cherry sized neck, axillary, inguinal painless lymphadenopathy. Moderate weakness and weightloss. He had some mild fever and upper airway infections recently. Spleen enlarged by 6 cm. White Blood cell count 23 G/L, 76% small matured lymphocyte, other forms are normal. Hemoglobin 105 g/l, platelet count normal. Reduced IgG.
A) Epstein–Barr-víral serology
B) Epstein–Barr-vírus genomic analysis in malignant cells
C) Bcr-Abl rearrangement analysis, even if cytogenetics are negative
D) Philadelphia chomosome detection
E) PAS and acid phosphatase citochemistry
F) peripheral blood FISH analysis
F) peripheral blood FISH analysis
76
What clinical signs, complications you should check and foresee for longer period
You see a 62 years old male, with cherry sized neck, axillary, inguinal painless lymphadenopathy. Moderate weakness and weightloss. He had some mild fever and upper airway infections recently. Spleen enlarged by 6 cm. White Blood cell count 23 G/L, 76% small matured lymphocyte, other forms are normal. Hemoglobin 105 g/l, platelet count normal. Reduced IgG.
1) slowly progressing lymphadenomegaly
2) splenic rupture
3) hepatitis like symptoms
4) myocarditis like symptoms
5) increased likelyhood of infections
6) transformation into accelerated or blastic phase
7) transformation into myelofibrosis
8) After the cure of lymphogranulomatosis secondary cancer might develop
A) 2nd and 4th answers are correct
B) 6th and 7th answers are correct
C) 3rd and 8th answers are correct
D) 1st and 5th answers are correct
D) 1st and 5th answers are correct
77
How much is the average survival of the disease while treating?
You see a 62 years old male, with cherry sized neck, axillary, inguinal painless lymphadenopathy. Moderate weakness and weightloss. He had some mild fever and upper airway infections recently. Spleen enlarged by 6 cm. White Blood cell count 23 G/L, 76% small matured lymphocyte, other forms are normal. Hemoglobin 105 g/l, platelet count normal. Reduced IgG.
A) spontaneous cure in all
B) One or two years in spite of therapeutic efforts
C) Four years chronic phase, followed by one year accelerated phase
D) Fove year survival is 55–60% in Hodgkin lymphoma
E) 8–15 average survivial, however final cure can be achieved even with modern therapies
E) 8–15 average survivial, however final cure can be achieved even with modern therapies
78
Which alteration carries important prognostic relevance
You see a 62 years old male, with cherry sized neck, axillary, inguinal painless lymphadenopathy. Moderate weakness and weightloss. He had some mild fever and upper airway infections recently. Spleen enlarged by 6 cm. White Blood cell count 23 G/L, 76% small matured lymphocyte, other forms are normal. Hemoglobin 105 g/l, platelet count normal. Reduced IgG.
1) histological subtype, as lymphoid depletion cases run poor prognosis
2) In ALL Philadelphia chromosome means very bad prognosis
3) lymphocyte doubling time shorter than 6 month
4) anemia, thrombocytopenia, medullary infiltration
5) male sex in itself has worse prognosis in Hodgkin
6) In chronic lymphocytic leukemia FISH p53 positivity especaillay bad prognosis
A) 1st and 3rd answers are correct
B) 3rd and 6th answers are correct
C) 4th and 6th answers are correct
B) 3rd and 6th answers are correct
79
What is the adequate therapy in this case?
You see a 62 years old male, with cherry sized neck, axillary, inguinal painless lymphadenopathy. Moderate weakness and weightloss. He had some mild fever and upper airway infections recently. Spleen enlarged by 6 cm. White Blood cell count 23 G/L, 76% small matured lymphocyte, other forms are normal. Hemoglobin 105 g/l, platelet count normal. Reduced IgG.
A) hydroxyurea first line, may consider interferons which might induce cytogenetic response of Phildelphia abnormality
B) ALL-standard agents: antracyclin, steroid, vincristine, methotrexate polychemotherapy
C) in mononucleosis observation is enough without any intervention mononucleosis
D) COPP (cyclophosphamide + vincristine + procarbazin + prednisolone) protocoll, 6 cycles
E) watch and wait, if progression (quick doubling of white blood cell count, gross lymphadenopathy, B signs) first line should be Fludarabine-Cyclophosphamid-MabThera immunchemotherapy, in elderly, moderately frail patients MabThera+bendamustin
E) watch and wait, if progression (quick doubling of white blood cell count, gross lymphadenopathy, B signs) first line should be Fludarabine-Cyclophosphamid-MabThera immunchemotherapy, in elderly, moderately frail patients MabThera+bendamustin
80
Which 3 alteration may help the most during followup
You see a 62 years old male, with cherry sized neck, axillary, inguinal painless lymphadenopathy. Moderate weakness and weightloss. He had some mild fever and upper airway infections recently. Spleen enlarged by 6 cm. White Blood cell count 23 G/L, 76% small matured lymphocyte, other forms are normal. Hemoglobin 105 g/l, platelet count normal. Reduced IgG.
1) extent of splenomegaly
2) extent and progression of lymphadenomegalia
3) kinetics of white blood cell count increase
4) immunglobulin levels
5) progression of FISH alterations
6) EBV-antibody -titer changes
7) serum-copper levels
A) 1st, 5th and 7th answers are correct
B) 5th, 6th and 7th answers are correct
C) 2nd, 3rd and 5th answers are correct
D) 1st and 5th answers are correct
E) all of the answers are correct
C) 2nd, 3rd and 5th answers are correct
81
What other examinations should should be performed before starting anticoagulant therapy?
A 26-year-old pregnant lady in 16 weeks of pregnancy arrives to your office. Progressive swelling and pain developed in the right femoral region, four days ago. Pregnancy goes on normally otherwise. Doppler ultrasound reveals newly developed deep vein thrombosis in the right femoral vein and popliteal vein. The patient's mother and sister also had thrombotic episodes.
1) Iv. phlebography, as all types of anticoagulants are extremely dangerous during pregnancy, to ascertain more your diagnosis
2) aPTT
3) fibrinogen level
4) Factor VIII. activity
5) baseline platelet count
6) Bleeding time measurememnt
A) 1st and 3rd answers are correct
B) 2nd and 5th answers are correct
C) 4th and 6th answers are correct
D) 1st and 5th answers are correct
E) all of the answers are correct
B) 2nd and 5th answers are correct
82
Which anticoagulant is that does not cross placental barrier and can be administered safely during pregnancy?
A 26-year-old pregnant lady in 16 weeks of pregnancy arrives to your office. Progressive swelling and pain developed in the right femoral region, four days ago. Pregnancy goes on normally otherwise. Doppler ultrasound reveals newly developed deep vein thrombosis in the right femoral vein and popliteal vein. The patient's mother and sister also had thrombotic episodes.
A) low molecular weight heparin
B) coumarol derivatives
C) dabigatran
D) rivaroxaban
A) low molecular weight heparin
83
Wich antithrombotic therapy should be selected in this case?
A 26-year-old pregnant lady in 16 weeks of pregnancy arrives to your office. Progressive swelling and pain developed in the right femoral region, four days ago. Pregnancy goes on normally otherwise. Doppler ultrasound reveals newly developed deep vein thrombosis in the right femoral vein and popliteal vein. The patient's mother and sister also had thrombotic episodes.
A) only aspirin can be applied in pregnancy
B) Low molecular weight heparin, therapeutic dose
C) coumarin, as all heparins are contraindicated in pregnant patients
D) thrombolytic treatment
E) surgical thrombectomy
B) Low molecular weight heparin, therapeutic dose
84
Considering all this, what are the feasible options
A 26-year-old pregnant lady in 16 weeks of pregnancy arrives to your office. Progressive swelling and pain developed in the right femoral region, four days ago. Pregnancy goes on normally otherwise. Doppler ultrasound reveals newly developed deep vein thrombosis in the right femoral vein and popliteal vein. The patient's mother and sister also had thrombotic episodes.
1) aspirin
2) aspirin + coumarol
3) Unfractionated-heparin 1000–1200 U/hour, infusion
4) immobilisation, elastic bandage on the thrombotic leg
5) Low molecular weight heparin twice/day 100–120 U/kg subcutaneously.
6) streptokinase or tissue plasminogen activator
7) pentoxyphyllin
A) 1st and 3rd answers are correct
B) 2nd and 7th answers are correct
C) 4th and 5th answers are correct
D) 3rd and 5th answers are correct
E) all of the answers are correct
C) 4th and 5th answers are correct
85
Identify the most dangerous complication of your therapy:
A 26-year-old pregnant lady in 16 weeks of pregnancy arrives to your office. Progressive swelling and pain developed in the right femoral region, four days ago. Pregnancy goes on normally otherwise. Doppler ultrasound reveals newly developed deep vein thrombosis in the right femoral vein and popliteal vein. The patient's mother and sister also had thrombotic episodes.
A) erosion, gastric bleeding
B) heparin induced thrombocytopenia
C) coumarol-necrosis
D) hypofibrinogenemia
B) heparin induced thrombocytopenia
86
After the acute thrombotic period which type of anticoagulant prophylaxis should be applied in this case?
A 26-year-old pregnant lady in 16 weeks of pregnancy arrives to your office. Progressive swelling and pain developed in the right femoral region, four days ago. Pregnancy goes on normally otherwise. Doppler ultrasound reveals newly developed deep vein thrombosis in the right femoral vein and popliteal vein. The patient's mother and sister also had thrombotic episodes.
1) Coumarols
2) aspirin
3) Low molecular weight heparin profilactic dose once daily 1
4) elastic bandage
5) prophilaxis is not necessary
6) prohylaxis is dangerous in pregnancy, so not recommended
A) 1st and 3rd answers are correct
B) 3rd and 4th answers are correct
C) 5th and 6th answers are correct
D) 3rd and 5th answers are correct
E) all of the answers are correct
B) 3rd and 4th answers are correct
87
In her case suspicion of thrombophilic condition shoud be an issue. What is the most like hereditary thrombophilia based on statistics?
A 26-year-old pregnant lady in 16 weeks of pregnancy arrives to your office. Progressive swelling and pain developed in the right femoral region, four days ago. Pregnancy goes on normally otherwise. Doppler ultrasound reveals newly developed deep vein thrombosis in the right femoral vein and popliteal vein. The patient's mother and sister also had thrombotic episodes.
A) antithrombin deficiency
B) protein C deficiency
C) activated protein C resistance/F. V. Leiden-mutation
D) protein S deficiency
E) homozygous hyperhomocysteinemia
C) activated protein C resistance/F. V. Leiden-mutation
88
So the most common thrombophilia was proved. What prophylactic guideline is recommended in her case?
A 26-year-old pregnant lady in 16 weeks of pregnancy arrives to your office. Progressive swelling and pain developed in the right femoral region, four days ago. Pregnancy goes on normally otherwise. Doppler ultrasound reveals newly developed deep vein thrombosis in the right femoral vein and popliteal vein. The patient's mother and sister also had thrombotic episodes.
A) all cases whoi had once DVT lifelong anticoagulant prophylactic approach recommended.
B) All cases with previous DVT should receive couple of years anticoagulant prophylaxis, after some years may go for cautious dose reduction
C) In all such cases a 6 mont prophylaxis is enough
D) As all prophylactic efforts are ineffective, their use is not recommended
B) All cases with previous DVT should receive couple of years anticoagulant prophylaxis, after some years may go for cautious dose reduction
