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Flashcards in Rita's Hematology Questions Deck (14):
1

What is the tx of jaundice at home?
a) breastfeed
b) offer glucose water
c) home phototherapy
d) stop breastfeeding for 24 hours

a) breastfeed

2

A 4yo was recently diagnosed with immune thrombocytopenia. The PNP notes multiple purpura and petechiae, but no mucocutaneous bleeds. A repeat CBC shows platelets at 55,000/mm3, no anemia, and no abnormalities of the RBC/WBC. What is the next best step?
a) Discuss safety concerns and see the child regularly for platelet counts
b) Recommend that the child be hospitalized as the platelet count is dangerously low
c) explain that most children with ITP need their spleen removed at some point
d) discuss the need for platelet transfusions in the majority of children with ITP

a) Discuss safety concerns and see the child regularly for platelet counts

Recommend that the child be hospitalized as the platelet count is dangerously low
--> 55000 is NOT dangerously low!

explain that most children with ITP need their spleen removed at some point
--> NOT true!

discuss the need for platelet transfusions in the majority of children with ITP
--> doesn't help!

3

A 3yo presents with increased bruising in the past 48 hours following a viral illness. A CBC reveals a platelet count of 80000/mm3. What is the most likely dx?
a) Immune thrombocytopenia
b) acute lymphocytic leukemia
c) hemolytic uremic syndrome
d) meningococcemia

a) Immune thrombocytopenia


meningococcemia --> see v. high white counts!

4

What do you need to tell parents of a child with sickle cell disease?
a) other children need to get tested
b) 50% of all children will have sickle cell
c) using folic acid will prevent sickle cell in future children

a) other children need to get tested

5

What test is used to dx sickle cell disease?
a) CBC
b) Liver function test
c) Sickle cell prep
d) Hemoglobin electrophoresis

d) Hemoglobin electrophoresis

6

You suspect leukemia in a 3yo. What is the most common presenting symptom?
a) bone pain
b) splenomegaly
c) bruising
d) cough

a) bone pain

7

A sick 3yo presents with a mass that crosses the midline. What is the most likely dx?
a) neuroblastoma
b) Wilms tumor
c) Non-Hodgkin's lymphoma
d) Sarcoma

a) neuroblastoma

8

A 2yo presents for well childcare. Her history reveals that she has a good appetite and drinks only a few bottles/day. Her CBC reveals hgb 11.5, HCT 34, MCV 81, reticulocyte .5%. The most appropriate management for this patient would be:
a) Complete a hemoglobin electrophoresis
b) Start iron and reevaluate in 3 months
c) Provide diet counseling and continue with routine care
d) Check stool guiac

c) Provide diet counseling and continue with routine care
--> normal!

MCV 81 = normocytic

9

Which of the following would be associated with a normocytic and normochromic anemia?
a) lead poisoning
b) G-6PD
c) iron deficiency anemia
d) Thalassemia trait

b) G-6PD
--> causes hemolytic anemia

Normocytic and normochromic caused by:
1) hemolysis
2) bleeding
3) non-production of bone marrow

10

During a 12 month old visit, a CBC shows the following: HCT 27%, MCV 63, RBC 3.45, reticulocyte of 1.8% with a 500,000-platelet count. Which of the following is the most helpful in making the dx?
a) serum ferritin
b) lead level
c) hemoglobin electrophoresis
d) total iron binding capacity

a) serum ferritin
--> microcytic anemia
--> high platelet count --> Fe deficiency

11

A child has a platelet count of 45,000 and is diagnosed with Idiopathic Thrombocytopenia purpura. Which of the following is the most appropriate thing to counsel parents?
a) counsel regarding safety concerns
b) recommend immediate hospitalization for the low platelet count
c) explain that a splenectomy is likely tx option
d) discuss the likelihood of platelet transfusions in the majority of patients

a) counsel regarding safety concerns

platelets less than 20,000 --> admit

12

A 4yo with CP has slow writing movements of the limbs with fanning of the fingers and extension of wrist, which is called...?
a) dyskinesia
b) chorea
c) spastic rigidity
d) athetosis

d) athetosis

--a condition in which abnormal muscle contractions cause involuntary writhing movements. It affects some people with cerebral palsy, impairing speech and use of the hands.

13

Which of the following is an example of a silent disorder that needs to be picked up on early so it can be treated?
a) Krabbe disease
b) Tay-Sachs disease
c) Metachromic luekodystrophy
d) Phenylketonuria

d) Phenylketonuria

--other diseases are untreatable and manifest as progressive neuro deterioration

14

A 10yo is noted to have myotonia, cardiomyopathy, arrhythmias, and weakness. What is the most likely dx?
a) Mitochondrial myopathy
b) SMA type 3
c) Duchenne muscular dystrophy
d) Myotonic muscular dystrophy

d) Myotonic muscular dystrophy