Hematology

Question 1

What solid cancer are patients with allogeneic hematopoietic cell transplants at risk of developing?

Answer 1

Oral cancers

Question 2

Phenytoin use causes anemia due to deficiency of what substance?

Answer 2

Folic Acid

Question 3

Chronic isoniazid use causes deficiency of what vitamin?

Answer 3

Vitamin B 6

Question 4

What are the levels of MCV, homocysteine and methylmalonic acid in Vitamin B6 deficiency?

Answer 4

MCV is normal, homocysteine levels are elevated and methylmalonic acid levels are normal

Question 5

Which myeloproliferative disorder has the highest risk of transformation into acute leukemia?

Answer 5

Chronic myeloid leukemia. May accelerate and transform to AML or ALL (blast crisis)

Question 6

What is the single most accurate test for diagnosing alpha thalassemia?

Answer 6

Genetic studies (DNA PCR)

Question 7

Which is the best initial test to diagnose sickle cell disease?

Answer 7

Peripheral blood smear

Question 8

What is the treatment of choice for M3 subtype of AML (aPML)?

Answer 8

ATRA + Daunorubicin

Question 9

What is the standard post-remission monitoring of acute promyelocytic leukemia?

Answer 9

Sequential monitoring of RT-PCR for t(15;17)

Question 10

DIC is a common presentation of which subtype of AML?

Answer 10

AML M3 (APL)

Question 11

What does the iron panel (Iron, Ferritin, Transferrin saturation, TIBC) look like in anemia of chronic disease ?

Answer 11

Low iron, high ferritin, high transferrin

saturation, low TIBC

Question 12

What kind of anemia is common in chronic inflammatory conditions ?

Answer 12

Anemia of chronic disease

Question 13

What does the iron panel (Iron, Ferritin, Transferrin saturation, TIBC) look like with iron deficiency anemia ?

Answer 13

Low iron, Low ferritin, Low transferrin saturation, High TIBC

Question 14

What condition is associated with ATP7B gene?

Answer 14

Wilson’s Disease

Question 15

True or False: Wilson’s disease is an exacerbating condition for porphyria cutanea tarda (PCT).

Answer 15

False; Wilson’s disease is not an exacerbating condition for PCT.

Question 16

True or False: Estrogen use, Chronic alcohol use, Hemochromatosis, and Hepatitis C infection are all exacerbating conditions for PCT.

Answer 16

True

Question 17

Patients whose lab results show either elevated PT or PTT levels and who are not on anticoagulation should have a ____________ study completed

Answer 17

1:1 mixing study

Question 18

If the mixing study corrects the PT or PTT, what would this indicate?

Answer 18

This would indicate that the patient has a factor deficiency.

Question 19

What condition is described here? “Condition that is associated with BCR/ABL fusion gene on cytogenetic testing”

Answer 19

Chronic myelogenous leukemia (CML)

Question 20

Chronic myelogenous leukemia (CML) will usually cause an (elevated or depressed?) LAP level

Answer 20

Chronic myelogenous leukemia (CML) will usually cause a depressed LAP level

Question 21

How long should heparin be continue to be used for at least __ hours until two consecutive INR readings are greater than or equal to __?

Answer 21

48 hours; 2.0

Question 22

What are the most common and second most common forms of porphyria?

Answer 22

Porphyria cutanea tarda (PCT) and Acute intermittent porphyria (AIP)

Question 23

This most common porphyria is characterized by onycholysis and blistering of the skin generally in areas that are exposed to higher levels of sunlight.

Answer 23

Porphyria cutanea tarda (PCT)

Question 24

This second most common porphyria is a rare autosomal dominant metabolic disorder in which the porphobilinogen deaminase enzyme is deficient.

Answer 24

Acute intermittent porphyria (AIP)

Question 25

What electrolyte is low with syndrome of inappropriate antidiuretic hormone (SIADH)?

Answer 25

Sodium; Low sodium levels is known as hyponatremia

Question 26

What electrolyte is low with primary hypoparathyroidism?

Answer 26

Calcium; Low calcium levels is known as hypocalcemia.

Question 27

What electrolyte is low with renal tubular acidosis type 1 and 2?

Answer 27

Potassium; Low potassium levels is known as hypokalemia.

Question 28

What electrolyte is low with primary hyperparathyroidism?

Answer 28

Phosphorous; Low phosphorous levels is known as hypophosphatemia.

Question 29

Late hemolytic reactions tend to have a (negative or positive?) Coomb’s test result

Answer 29

Negative

Question 30

Early hemolytic reactions due to ABO incompatibility generally result in a (negative or positive?) Coomb’s test.

Answer 30

Positive

Question 31

Which is the only type of microcytic anemia associated with increased iron levels?

Answer 31

Sideroblastic anemia

Question 32

Microcytic anemia associated with an abnormal or slightly increased erythrocyte count is seen with which disease?

Answer 32

Beta thalassemia

Question 33

What is the treatment for myelodysplasia with 5q syndrome?

Answer 33

Lenalidomide

Question 34

What kind of anemia (microcytic or macrocytic or normocytic) does myelodysplasia present with?

Answer 34

Macroctyic anemia

Question 35

What is the treatment for myelodysplasia without 5q syndrome?

Answer 35

Azacitidine

Question 36

Which kind of macrocytic anemia does alcohol abuse more commonly result in?

Answer 36

Macrocytic anemia due to folate deficiency

Question 37

Environmental exposure to nitrous oxide/laughing gas can cause which kind of macrocytic anemia?

Answer 37

Macrocytic anemia due to B12 deficiency. Nitrous oxide inactivates Vitamin B12

Question 38

What is the target hemoglobin level while treating patients of anemia of chronic kidney disease with EPO?

Answer 38

11-12 g/dL

Question 39

Which is the most common infection preceeding aplastic anemia?

Answer 39

Hepatitis

Question 40

What cause is suggested by aplastic anemia associated with Café au lait spots and short stature?

Answer 40

Fanconi's anemia

Question 41

What is the best therapy for aplastic anemia in a young patient?

Answer 41

Hematopoietic stem cell transplantation

Question 42

What is the most accurate test for diagnosing beta thalassemia?

Answer 42

Hemoglobin electrophoresis

Question 43

What is the cause of microcytic anemia with normal iron studies?

Answer 43

Thalassemia

Question 44

How is Cooley's anemia managed?

Answer 44

Chronic transfusion lifelong

Question 45

Which of the following therapies for sickle cell disease is contraindicated in pregnancy? Hydroxyurea, folic acid, oxycodone, acetaminophen, exchange transfusion

Answer 45

Hydroxyurea

Question 46

What is the most common manifestation of HbSC disease?

Answer 46

Visual problems like retinopathy

Question 47

Which of the following is not associated with increased reticulocyte count? Acute blood loss, PNH, Iron deficiency anemia, Hereditary spherocytosis

Answer 47

Iron deficiency anemia

Question 48

How much time is required by reticulocytes in circulation to transform into mature RBCs?

Answer 48

1 day

Question 49

How does metformin affect vitamin B12?

Answer 49

Metformin may hinder absorption of vitamin B12 in the terminal ileum

Question 50

Alcohol use can lead to which deficiency associated with elevated MCV?

Answer 50

Folate deficiency