AAFP Board Review – HemOnc questions well
answered to pass
1. A 43-year-old female complains of easy bruis- B. Corticosteroids - Immune
(idiopathic)
ing. She is otherwise asymptomatic. A thrombocytopenic purpura
CBC reveals a platelet count of -acquired immune-mediated
23,000/mm3 (N 150,000-450,000). A disorder with
peripheral smear reveals giant isolated thrombocytopenia not
platelets. A workup is negative for found to have another cause
autoim- mune causes, including Graves -Treat severe thrombocytopenia
disease, HIV, Epstein-Barr virus, (platelet count <50,000/mm3)
cytomegalovirus, varicella zoster, unless there is evidence of acute
hepatitis C, and Helicobacter pylori. bleeding.
She -Corticosteroids first-line therapy or
is on no prescription or over-the- In- travenous immunoglobulin and
counter medications and denies alcohol ritux- imab
-thrombopoietin-receptor agonists
or drug use. 2nd
Which one of the following would be the most line or splenectomy.
appropriate initial management? remarkable for the
(check one) presence of an
A. Platelet transfusion enlarged spleen.
B. Corticosteroids He has a
C. Thrombopoietin-receptor agonists hemoglobin level
D. A bone marrow biopsy of 21 g/dL (N 12-
E. Splenectomy 16) and a
hematocrit of 63% (N
2. A 55-year-old white male comes to 36-48). To confirm
your of- fice with weakness and a your clinical
headache. He also describes an diagnosis, you
annoying pruritus that occurs obtain additional
frequently after he takes a hot stud- ies.
shower. The physical examination is
,AAFP Board Review – HemOnc questions well
answered to pass
-bone marrow biopsy, to rule out myelodysplastic
syndrome and lymphoproliferative dis- orders is indicated in
patients over the age of 60
-no platelet transfusion
A. A low serum erythropoietin level - polycythemia vera.
-Pruritus after a hot shower (aquagenic pruritus) and
splenomegaly distinguish polycythemia vera from other causes
of erythrocytosis (hematocrit >55%).
-Specific criteria: elevated red cell mass, a normal arterial
oxygen satura- tion (>92%)
-a low serum erythropoietin level
-thrombocytosis (platelet count
, AAFP Board Review – HemOnc questions well
answered to pass
Which one of the following would be >400,000/mm3 ), leukocytosis
most consistent with the most likely (WBC>12,000/mm3 )
diagnosis in this patient? (check one) -high leukocyte alkaline
A. A low serum erythropoietin level phosphatase score
B. A low platelet count -High carboxyhemoglobin levels
C. A low arterial oxygen are as- sociated with secondary
concentration polycythemia.
D. An elevated carboxyhemoglobin
level
A. A platelet count
3. A 62-year-old African-American
>400,000/mm3 Major
female un- dergoes a workup for
criteria
pruritus. Laboratory findings include -increased red cell mass, a normal
a hematocrit of 55.0% (N O2
36.0-46.0) and a hemoglobin level of 18.5 g/dL saturation, splenomegaly
(N 12.0-16.0). Minor criteria
Which one of the following additional findings -high vitamin B 12, elevated
leuko-
would help establish the diagnosis of B. Iron deficiency
poly- cythemia vera? (check one) C. β-Thalassemia
A. A platelet count >400,000/mm3 trait
B. An O2 saturation <90% D. Sideroblastic
C. A WBC count <4500/mm (N 4300- anemia
10,800)3 E. Myelofibrosis
D. An elevated uric acid level
4. Which one of the following causes of
anemia is associated with a normal red
cell distribu- tion width? (check one)
A. Vitamin B12 deficiency
answered to pass
1. A 43-year-old female complains of easy bruis- B. Corticosteroids - Immune
(idiopathic)
ing. She is otherwise asymptomatic. A thrombocytopenic purpura
CBC reveals a platelet count of -acquired immune-mediated
23,000/mm3 (N 150,000-450,000). A disorder with
peripheral smear reveals giant isolated thrombocytopenia not
platelets. A workup is negative for found to have another cause
autoim- mune causes, including Graves -Treat severe thrombocytopenia
disease, HIV, Epstein-Barr virus, (platelet count <50,000/mm3)
cytomegalovirus, varicella zoster, unless there is evidence of acute
hepatitis C, and Helicobacter pylori. bleeding.
She -Corticosteroids first-line therapy or
is on no prescription or over-the- In- travenous immunoglobulin and
counter medications and denies alcohol ritux- imab
-thrombopoietin-receptor agonists
or drug use. 2nd
Which one of the following would be the most line or splenectomy.
appropriate initial management? remarkable for the
(check one) presence of an
A. Platelet transfusion enlarged spleen.
B. Corticosteroids He has a
C. Thrombopoietin-receptor agonists hemoglobin level
D. A bone marrow biopsy of 21 g/dL (N 12-
E. Splenectomy 16) and a
hematocrit of 63% (N
2. A 55-year-old white male comes to 36-48). To confirm
your of- fice with weakness and a your clinical
headache. He also describes an diagnosis, you
annoying pruritus that occurs obtain additional
frequently after he takes a hot stud- ies.
shower. The physical examination is
,AAFP Board Review – HemOnc questions well
answered to pass
-bone marrow biopsy, to rule out myelodysplastic
syndrome and lymphoproliferative dis- orders is indicated in
patients over the age of 60
-no platelet transfusion
A. A low serum erythropoietin level - polycythemia vera.
-Pruritus after a hot shower (aquagenic pruritus) and
splenomegaly distinguish polycythemia vera from other causes
of erythrocytosis (hematocrit >55%).
-Specific criteria: elevated red cell mass, a normal arterial
oxygen satura- tion (>92%)
-a low serum erythropoietin level
-thrombocytosis (platelet count
, AAFP Board Review – HemOnc questions well
answered to pass
Which one of the following would be >400,000/mm3 ), leukocytosis
most consistent with the most likely (WBC>12,000/mm3 )
diagnosis in this patient? (check one) -high leukocyte alkaline
A. A low serum erythropoietin level phosphatase score
B. A low platelet count -High carboxyhemoglobin levels
C. A low arterial oxygen are as- sociated with secondary
concentration polycythemia.
D. An elevated carboxyhemoglobin
level
A. A platelet count
3. A 62-year-old African-American
>400,000/mm3 Major
female un- dergoes a workup for
criteria
pruritus. Laboratory findings include -increased red cell mass, a normal
a hematocrit of 55.0% (N O2
36.0-46.0) and a hemoglobin level of 18.5 g/dL saturation, splenomegaly
(N 12.0-16.0). Minor criteria
Which one of the following additional findings -high vitamin B 12, elevated
leuko-
would help establish the diagnosis of B. Iron deficiency
poly- cythemia vera? (check one) C. β-Thalassemia
A. A platelet count >400,000/mm3 trait
B. An O2 saturation <90% D. Sideroblastic
C. A WBC count <4500/mm (N 4300- anemia
10,800)3 E. Myelofibrosis
D. An elevated uric acid level
4. Which one of the following causes of
anemia is associated with a normal red
cell distribu- tion width? (check one)
A. Vitamin B12 deficiency
