Hard U4 Patho

A patient has fatigue, pallor, decreased ferritin, and small, pale red blood cells. Which condition is most likely?

Iron deficiency anemia

A patient has chronic gastrointestinal bleeding and develops decreased hemoglobin and microcytic, hypochromic red blood cells. Which condition is most likely?

Iron deficiency anemia

Decreased iron leads to decreased hemoglobin production and impaired oxygen delivery. Which condition does this describe?

Iron deficiency anemia

A patient has large red blood cells, numbness, tingling, and difficulty walking. Which deficiency is most likely?

Vitamin B12 deficiency

A patient has macrocytic anemia and neurologic changes caused by impaired absorption due to loss of intrinsic factor. Which condition is most likely?

Pernicious anemia

Which deficiency should be suspected when a patient has macrocytic anemia without neurologic symptoms?

Folate deficiency

A patient with chronic alcohol use develops fatigue and macrocytic anemia but has no numbness or tingling. Which condition is most likely?

Folate deficiency anemia

A patient develops fatigue, recurrent infections, petechiae, and bleeding. Laboratory testing shows decreased red blood cells, white blood cells, and platelets. Which condition is most likely?

Aplastic anemia

Bone marrow failure causes pancytopenia. Which condition does this describe?

Aplastic anemia

A patient has anemia, jaundice, increased bilirubin, increased lactate dehydrogenase, and an increased reticulocyte count. Which process is occurring?

Premature destruction of red blood cells in hemolytic anemia

Why does a patient with premature red blood cell destruction develop jaundice?

Destruction of red blood cells increases bilirubin production

A patient develops anemia following severe acute blood loss. The red blood cells are initially normal in size. Which condition is most likely?

Posthemorrhagic anemia

An inherited abnormality of hemoglobin causes red blood cells to become rigid during periods of low oxygen. Which condition does this describe?

Sickle cell disease

A dehydrated patient with an inherited hemoglobin disorder develops severe generalized pain. What is causing the pain?

Sickled red blood cells are obstructing small blood vessels and causing tissue ischemia

A patient with an inherited hemoglobin disorder suddenly develops chest pain, difficulty breathing, and low blood oxygen. Which serious complication should be suspected?

Acute chest syndrome

Why are patients with sickle cell disease at increased risk for infection?

Repeated splenic infarctions cause loss of normal spleen function

A patient has increased hemoglobin, increased hematocrit, headaches, dizziness, and a ruddy complexion. Which condition is most likely?

Polycythemia vera

Why does excessive red blood cell production increase the risk of stroke and myocardial infarction?

The increased number of red blood cells increases blood viscosity and promotes thrombosis

A patient has an extremely elevated white blood cell count but continues to develop infections. Why?

The abnormal white blood cells are immature or dysfunctional and cannot effectively fight infection

A patient with a blood cancer develops fatigue, infections, and bleeding. What single process explains all three findings?

Malignant white blood cells crowd out normal bone marrow production of red blood cells, functional white blood cells, and platelets

A rapidly progressing leukemia involving immature blast cells is classified as what type of leukemia?

Acute leukemia

A slowly progressing leukemia involving more mature but abnormal cells is classified as what type of leukemia?

Chronic leukemia

A child develops fever, bruising, bone pain, and fatigue due to rapid proliferation of immature lymphoid cells. Which leukemia is most likely?

Acute lymphoblastic leukemia

An adult develops a rapidly progressing cancer involving immature myeloid cells. Which leukemia is most likely?

Acute myeloid leukemia

An older adult has an elevated lymphocyte count discovered during routine laboratory testing and has few symptoms. Which leukemia is most likely?

Chronic lymphocytic leukemia

A patient has a leukemia associated with a translocation between chromosomes 9 and 22. Which leukemia is most likely?

Chronic myeloid leukemia

Which genetic abnormality is strongly associated with chronic myeloid leukemia?

The Philadelphia chromosome

A complete blood count and peripheral blood smear suggest leukemia. Which test is needed for definitive diagnosis?

Bone marrow aspiration and biopsy

A patient has painless lymph node enlargement, and biopsy reveals Reed-Sternberg cells. Which condition is most likely?

Hodgkin lymphoma

A lymphoma spreads predictably from one group of lymph nodes to the next. Which type is most likely?

Hodgkin lymphoma

A patient has a lymphoid malignancy without Reed-Sternberg cells that spreads in a less predictable pattern. Which condition is most likely?

Non-Hodgkin lymphoma

Which finding most clearly distinguishes Hodgkin lymphoma from non-Hodgkin lymphoma?

The presence of Reed-Sternberg cells

A patient has bone pain, anemia, increased calcium levels, and kidney dysfunction. Which malignancy is most likely?

Multiple myeloma

Cancerous plasma cells activate bone destruction, releasing calcium into the bloodstream and causing bone lesions. Which disease does this describe?

Multiple myeloma

A patient presents with increased calcium, renal dysfunction, anemia, and bone lesions. Which condition should be suspected?

Multiple myeloma

Why does multiple myeloma damage the kidneys?

Abnormal immunoglobulin proteins and increased calcium levels can cause renal injury

A patient develops petechiae, purpura, easy bruising, and mucosal bleeding. Laboratory testing shows a very low platelet count. Which condition is most likely?

Immune thrombocytopenic purpura

The immune system destroys circulating platelets. What type of bleeding would be expected?

Superficial bleeding such as petechiae, purpura, bruising, and mucosal bleeding

A patient has an excessive platelet count and develops a blood clot. Which condition is most likely?

Primary thrombocythemia

Why can a patient with primary thrombocythemia develop a stroke or myocardial infarction?

Excessive platelet production increases the risk of thrombosis

A male patient has recurrent bleeding into his joints but has a normal platelet count. Which condition is most likely?

Hemophilia A

A patient has normal platelets but cannot form a stable fibrin clot because of a missing clotting factor. Which factor is deficient?

Factor VIII

Which finding would help distinguish Hemophilia A from immune thrombocytopenic purpura?

Deep tissue and joint bleeding with a normal platelet count

A patient with sepsis develops widespread microthrombi followed by severe bleeding. Which condition is most likely?

Disseminated intravascular coagulation

Why can widespread activation of coagulation eventually cause severe bleeding?

Platelets and clotting factors are consumed faster than the body can replace them

A patient has decreased platelets, decreased fibrinogen, increased D-dimer, widespread clotting, and bleeding. Which condition is most likely?

Disseminated intravascular coagulation

Which condition should be suspected when a patient simultaneously develops thrombosis and hemorrhage?

Disseminated intravascular coagulation

A patient has petechiae and low platelets. Another patient has joint bleeding and normal platelets. What are the most likely conditions, respectively?

Immune thrombocytopenic purpura and Hemophilia A

Which condition involves platelet destruction, which involves Factor VIII deficiency, and which involves consumption of both platelets and clotting factors?

Immune thrombocytopenic purpura; Hemophilia A; disseminated intravascular coagulation

A patient has chronically elevated systemic arterial pressure without a single identifiable underlying cause. Which condition is most likely?

Primary hypertension