Hematology / Oncology

Question 1

Hemophilia A is characterized by factor ____ deficiency.

Answer 1

Factor VIII

Question 2

Hemophilia B is characterized by factor ____ deficiency.

Answer 2

Factor IX

Question 3

What is the antidote for warfarin overdose?

Answer 3

Vitamin K

Question 4

What is the antidote for heparin overdose?

Answer 4

Protamine sulfate

Question 5

True or False:

Enoxaparin is a low-molecular-weight heparin (LMWH) that inhibits factor Xa and does not have to be monitored in most situations.

Answer 5

True

Question 6

True or False:

Warfarin activates antithrombin III which inactivates thrombin leading to decreased fibrinogen levels & increased PTT.

Answer 6

False

Heparin activates antithrombin III which inactivates thrombin leading to decreased fibrinogen levels & increased PTT.

Question 7

What are the Vitamin K dependent clotting factors?

Answer 7

Factors II, VII, IX, X

Protein C and S

Question 8

This is measured by PT which is initiated by endothelium-produced tissue factor.

Answer 8

Extrinsic Pathway

Question 9

This is measured by PTT which is initiated by exposure of collagen following vascular trauma.

Answer 9

Intrinsic Pathway

Question 10

What is the most common inherited bleeding disorder?

Answer 10

Von Willebrand’s Disease

Question 11

True or False:

Von Willebrand’s Disease is an autosomal dominant condition in which patients have deficient or defective vWF with low levels of factor VII, which is carried by vWF.

Answer 11

False

Von Willebrand’s Disease is an autosomal dominant condition in which patients have deficient or defective vWF with low levels of factor VIII, which is carried by vWF.

Question 12

What measures the ability of vWF to agglutinate platelets in vitro?

Answer 12

Ristocetin cofactor assay

Question 13

A polymorphism in this factor renders it resistant to inactivity by activated protein C and is the most common inherited cause of hereditary thrombotic disease or hypercoagulable states.

Answer 13

Factor V Leiden

Question 14

True or False:

A clotting factor is likely if mixing the patient’s plasma with normal plasma corrects the aPTT. If the aPTT does not correct, the patient may have a factor deficiency.

Answer 14

False

A factor deficiency is likely if mixing the patient’s plasma with normal plasma corrects the aPTT. If the aPTT does not correct, the patient may have a clotting factor inhibitor.

Question 15

This clinical syndrome is characterized by 5 signs/symptoms:
🔲 low platelet count
🔲 microangiopathic hemolytic anemia
🔲 neurologic changes (delirium, seizure, stroke)
🔲 impaired renal function
🔲 fever

Answer 15

Thrombocytic Thrombocytopenic Purpura (TTP)

Question 16

What are the 3 causes of microangiopathic hemolytic anemia?

Answer 16

HUS
TTP
DIC

Question 17

This is characterized by renal failure, hemolytic anemia, and low platelet count. Severe elevations in creatinine levels are more typical of this condition than of TTP. This is also one of the most common cause of acute renal failure in children.

Answer 17

Hemolytic-uremic syndrome (HUS)

Question 18

True or False:

Platelet transfusion is recommended for patients with TTP.

Answer 18

False

Platelet transfusion is contraindicated, as it often worsens the patient’s condition secondary to added platelet aggregation and microvascular thrombosis.

Question 19

This is the most common immunologic disorder in women of childbearing age characterized by increased bone marrow production of platelets, with increased megakaryocytes in the marrow and IgG antibodies formed against the patient’s platelets.

Answer 19

Idiopathic Thrombocytopenic Purpura (ITP)

Question 20

Anemia is a disorder of low hematocrit and hemoglobin.

Mean corpuscular volume (MCV):

\_\_\_\_\_\_\_\_ = microcytic anemia
\_\_\_\_\_\_\_\_ = normocytic anemia
\_\_\_\_\_\_\_\_ = macrocytic anemia

Answer 20

Mean corpuscular volume (MCV)

100 fL = macrocytic anemia

Question 21

Causes of microcytic anemia (TICS)

Answer 21

Thalassemia
Iron deficiency
Chronic disease
Sideroblastic anemia

Question 22

What parasitic infection can cause cobalamin or vitamin B12 deficiency?

Answer 22

Diphyllobothrium latum (tapeworm)

Question 23

What test measures the absorption of cobalamin by having the patient ingest radiolabeled cobalamin both with and without added intrinsic factor?

Answer 23

Schilling test

Question 24

These RBCs lack areas of central pallor and are seen in autoimmune hemolysis and in hereditary spherocytosis.

Answer 24

Spherocytes

Question 25

A ________ test is used to detect autoimmune hemolysis.

The indirect _______ test detects antibodies to RBCs in the patient’s serum.

The direct ______ test detects sensitized erythrocytes.

Answer 25

Coombs’ test

Question 26

High LDH, elevated indirect bilirubin, and decreased haptoglobin levels are consistent with a diagnosis of ____________. This normocytic anemia occurs when bone marrow production is unable to compensate for increased destruction of circulating blood cells.

Answer 26

Hemolytic anemia

Question 27

A hereditary type of aplastic anemia that may be identified on physical examination by café au lait spots, short stature, and radial/thumb hypoplasia/aplasia.

Answer 27

Fanconi’s anemia

Question 28

Bone marrow biopsy shows hypocellularity and space occupied by fat.

Answer 28

Aplastic anemia

Question 29

An autosomal recessive disorder most commonly caused by a mutation of adult hemoglobin (the beta chain has glu replaced by val).

Answer 29

Sicke Cell Disease

Question 30

True or False:

Sickle cell disease represents a quantitative defect in the beta-globin chain.

Answer 30

False

Sickle cell disease represents a qualitative defect in the beta-globin chain.

Question 31

The gold standard diagnostic test for sickle cell disease.

Answer 31

Quantitative hemoglobin electrophoresis

Question 32

This drug is used to treat sickle cell disease which stimulates the production of fetal hemoglobin but contraindicated in pregnancy due to its teratogenicity.

Answer 32

Hydroxyurea

Question 33

This results from clonal proliferation of a pluripotent marrow stem cell due to JAK2 mutation.

Answer 33

Polycythemia vera