Heme Exam 1 Practice Style Questions

For which of the following reasons would you prescribe desferrioxamine (DFO)?

A. Prevention of neural tube defects

B. To treat splenic sequestration of sickle cell disease

C. For chelation of iron overload

D. Prevention of hemolytic disease of the newborn

C. For chelation of iron overload

Theoretically, how would excess factor VII affect the PTT?

A. Increase PTT

B. Decrease PTT

C. No effect on PTT

C. No effect on PTT

VII would affect PT/INR

Which of the following tests was historically used in the disorder that has intrinsic factor

antibodies?

A. Schilling test

B. Ferritin level

C. Reticulocyte count

D. Hemogloblobin electrophoresis

A. Schilling test

An infant presents with multiple ecchymosis. History review shows that his mother declined all vaccinations and the vitamin K shot at birth. You are not concerned about abuse. There is no family history of bleeding disorders. Which of the following is the most likely diagnosis?

A. Lack of Tissue factor, VII, VIII, fibrinogen

B. Lack of II, VII, IX, X

C. Protein C &S, factor V leiden, antithrombin III deficiency

D. ABO antibody-antigen reaction

B. Lack of II, VII, IX, X

The clinical pathology lab examines a pediatric patient's RBC cells and notes RBC lysis in a hypotonic

solution indicating abnormalities in osmotic fragility. Which is your suspected diagnosis?

A. Alpha thalassemia minor

B. Beta thalessemia major

C. Hereditary spherocytosis

D. Sickle cell trait

E. Iron deficiency anemia

C. Hereditary spherocytosis

Which of the following is the most common cause of thromboctyopenia?

A. ITP

B. TTP

C. HUS

D. HIT

E. DIC

A. ITP

A G5P4 gravid female at 32 weeks presents to the ED with dizziness. Your top differential diagnosis is a severe variant of preeclampsia which also has hematologic consequences. Which of the following lab findings would be consistent with that diagnosis?

A.

LDH - Inc

LFTs - Inc

Platelets - Inc

B.

LDH - Inc

LFTs - Inc

Platelets - Dec

C.

LDH - Normal

LFTs - Inc

Platelets - Dec

B.

LDH - Inc

LFTs - Inc

Platelets - Dec

HELLP

H = hemolysis -> LDH inc

A 40-year-old woman has had a week long course of fever and mental confusion. Physical examination shows T 102.9F, P 100/minute, RR 20/minute, and BP 100/60 mm Hg. She has widespread petechiae. Her condition deteriorates rapidly following platelet transfusion.

Lab - Result - Range

BUN (renal) 52 - high

Cr (renal) 5.3 - High

Hb - 12.2

Hct - 36

MCV - 93 - normal

WBC - 8180 - normal

Smear - fragment cells - abnormal

Anti-platelet antibodies - negative

Which of the following is the most likely diagnosis?

A. Hemolytic uremic syndrome (HUS)

B. Thrombotic thrombocytopenia purpura (TTP)

C. Idiopathic thrombocytopenia purpura (ITP)

D. Henoch Schönlein Purpura (HSP)

B. Thrombotic thrombocytopenia purpura (TTP)