I-HUMAN CASES EXAM HEMATOLOGY 70 QUESTIONS EXAM 2026 QUESTIONS LATEST VERSION QUESTIONS AND ANSWERS

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I-HUMAN CASES EXAM HEMATOLOGY 70 QUESTIONS
EXAM 2026 QUESTIONS LATEST VERSION QUESTIONS AND
ANSWERS




70 Questions with Detailed Rationales
Based on Common i-Human Virtual Simulation Scenarios


CASE 1: 54-Year-Old Female with Fatigue and Night Sweats – Anemia and
Polycythemia Vera (Questions 1-12)
Question 1
A 54-year-old female presents with fatigue, severe headaches, night sweats, and
generalized pruritus. Physical exam reveals ruddy complexion and splenomegaly. What
is the most likely diagnosis?
A) Anemia of chronic disease
B) Polycythemia vera
C) Chronic myeloid leukemia
D) Iron deficiency anemia
Answer: B
Rationale: Polycythemia vera is a myeloproliferative disorder characterized by elevated red
blood cell mass, ruddy complexion, splenomegaly, and symptoms of hyperviscosity
(headaches, pruritus). Fatigue and night sweats are also common. The JAK2 V617F mutation
is present in >95% of cases.


Question 2
What is the most important diagnostic test for polycythemia vera?
A) Complete blood count
B) JAK2 V617F mutation testing
C) Serum erythropoietin level
D) Bone marrow biopsy

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Answer: A
Rationale: An elevated hemoglobin, hematocrit, and red blood cell count is the hallmark of
polycythemia vera. Serum erythropoietin is typically low. JAK2 V617F mutation testing
confirms the diagnosis. Bone marrow biopsy may be performed.


Question 3
The patient's hemoglobin is 18 g/dL, hematocrit 60%, WBC 14,000/mcL, and platelets
800,000/mcL. What is the most appropriate initial intervention?
A) Phlebotomy
B) Hydroxyurea
C) Aspirin
D) All of the above may be indicated
Answer: D
Rationale: Initial management of polycythemia vera includes phlebotomy to maintain
hematocrit <45%, low-dose aspirin for thrombosis prevention, and hydroxyurea for high-risk
patients (age >60 or history of thrombosis). All interventions may be indicated.


Question 4
What is the most important complication of polycythemia vera?
A) Thrombosis (venous and arterial)
B) Hemorrhage
C) Progression to acute leukemia
D) All of the above
Answer: D
Rationale: Polycythemia vera is associated with an increased risk of thrombosis (stroke, MI,
DVT, PE), hemorrhage, and progression to acute leukemia or myelofibrosis. Thrombosis is
the most common cause of death.


Question 5
The patient has a history of deep vein thrombosis. What is the most important
intervention for this patient?
A) Aspirin therapy
B) Anticoagulation

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C) Phlebotomy
D) All of the above
Answer: D
Rationale: Patients with polycythemia vera and a history of thrombosis require
anticoagulation, aspirin, and phlebotomy to reduce hyperviscosity. All interventions are
important for preventing recurrent thrombosis.


Question 6
What is the target hematocrit for a patient with polycythemia vera?
A) <45%
B) <50%
C) <55%
D) <40%
Answer: A
Rationale: The target hematocrit for patients with polycythemia vera is <45% to reduce the
risk of thrombosis. Phlebotomy is performed to achieve this target. Regular monitoring of
hematocrit is essential.


Question 7
What is the most important education regarding phlebotomy?
A) "Phlebotomy reduces the risk of thrombosis."
B) "You may need phlebotomy every 1-2 weeks initially."
C) "You should monitor for signs of iron deficiency."
D) All of the above
Answer: D
Rationale: Education includes the purpose of phlebotomy (thrombosis prevention),
frequency of treatment, and monitoring for iron deficiency. Patients should be educated about
the signs of thrombosis.


Question 8
The patient also has pruritus that worsens after a hot shower. What is the most
appropriate treatment?
A) Antihistamines
B) Aspirin