Hematology Made Simple – High‑Yield PANCE Study Questions
1. A 39 yo female presents to ED with lower leg pain and Factor V
swelling, a doppler of the lower extremities reveals
a DVT. She admits this is her third DVT in the last Notes: Factor V Leiden,
few years. She also has a history of several miscar- most common cause of
riages and recalls her mother had similar problems inherited hypercoagulable
with blood clots. Genetic testing in this patient would state
likely reveal a mutation in which clotting factor?
2. A 59 yo female recently started on warfarin for DVT Protein C
prophylaxis begins to develop necrotic lesions on her
legs and feet. A deficiency in which vitamin K depen- Notes: Warfarin induced
dent plasma protein likely led to this presentation? skin necrosis due to pro-
tein C deficiency
, Hematology Made Simple – High‑Yield PANCE Study Questions
3. A 68 yo male with a hx of rheumatoid arthritis presents Anemia of chronic dis-
to the office to review his recent lab results from his an- ease
nual physical. His Hgb, Hct, and RBCs are all decreased.
Iron studies show decreased TIBC, decreased serum Notes: Pt has a chron-
Fe, and elevated ferritin. What type of anemia does this ic inflammatory condition,
patient most likely have? labs show anemia with
decreased Hgb, Hct, and
RBCs, body is trying to
"hide iron" because it
sees inflammation and as-
sumes infection
4. A 47 yo female presents to the office due to fatigue and Vitamin B12 deficiency
tingling in her lower legs. Pt has a hx of HTN, hyper- most likely caused by
lipidemia, Crohn's, and disease any past surgical hx. Crohn's
She denies alcohol use and states she is fairly healthy.
She eats plenty of fruits, veggies, and lean proteins. Notes: B12 absorbed in
Lab work shows MCV of 111, decreased Hgb, and in- the ileum and Crohn's
most commonly attects
, Hematology Made Simple – High‑Yield PANCE Study Questions
creased homocysteine and increased methylmalonic terminal ileum, no recent
acid. What is the likely diagnosis and etiology? surgery or diet restriction
that would cause it. Ho-
mocysteine is elevated in
folate and B12 deficiency
but MMA is only elevated
in B12 deficiency
5. Sickle cell disease is due to a point mutation in which Valine
glutamic acid is substituted by which amino acid on the
Notes: Remember "Val
beta chain?
kicks butt with her big
glutes" to remember that
valine kicks out glutamic
acid in sickle cell disease
6. A 57 yo male in ICU being treated for sepsis begins to Disseminated Intravascu-
develop excessive bleeding from his foley catheter and lar Coagulation (DIC)
IV site. Labs are drawn which show a thrombocytope-
nia, elevated PT, elevated PTT, and elevated d-dimer as Notes: Widespread mi-
well as a peripheral smear that displays schistocytes. crothrombi which causes
What diagnosis should be suspected in this patient? deficiency in coagulation
factors
7. What pentad of clinical manifestations can potential- Fever, anemia, thrombocy-
ly be seen in a patient with thrombotic thrombocy- topenia, renal failure, neu-
topenic purpura (TTP)? rologic symptoms
Notes: Remember "FAT
RN" and many patients will
not have the entire pentad
8. Factor VIII
1. A 39 yo female presents to ED with lower leg pain and Factor V
swelling, a doppler of the lower extremities reveals
a DVT. She admits this is her third DVT in the last Notes: Factor V Leiden,
few years. She also has a history of several miscar- most common cause of
riages and recalls her mother had similar problems inherited hypercoagulable
with blood clots. Genetic testing in this patient would state
likely reveal a mutation in which clotting factor?
2. A 59 yo female recently started on warfarin for DVT Protein C
prophylaxis begins to develop necrotic lesions on her
legs and feet. A deficiency in which vitamin K depen- Notes: Warfarin induced
dent plasma protein likely led to this presentation? skin necrosis due to pro-
tein C deficiency
, Hematology Made Simple – High‑Yield PANCE Study Questions
3. A 68 yo male with a hx of rheumatoid arthritis presents Anemia of chronic dis-
to the office to review his recent lab results from his an- ease
nual physical. His Hgb, Hct, and RBCs are all decreased.
Iron studies show decreased TIBC, decreased serum Notes: Pt has a chron-
Fe, and elevated ferritin. What type of anemia does this ic inflammatory condition,
patient most likely have? labs show anemia with
decreased Hgb, Hct, and
RBCs, body is trying to
"hide iron" because it
sees inflammation and as-
sumes infection
4. A 47 yo female presents to the office due to fatigue and Vitamin B12 deficiency
tingling in her lower legs. Pt has a hx of HTN, hyper- most likely caused by
lipidemia, Crohn's, and disease any past surgical hx. Crohn's
She denies alcohol use and states she is fairly healthy.
She eats plenty of fruits, veggies, and lean proteins. Notes: B12 absorbed in
Lab work shows MCV of 111, decreased Hgb, and in- the ileum and Crohn's
most commonly attects
, Hematology Made Simple – High‑Yield PANCE Study Questions
creased homocysteine and increased methylmalonic terminal ileum, no recent
acid. What is the likely diagnosis and etiology? surgery or diet restriction
that would cause it. Ho-
mocysteine is elevated in
folate and B12 deficiency
but MMA is only elevated
in B12 deficiency
5. Sickle cell disease is due to a point mutation in which Valine
glutamic acid is substituted by which amino acid on the
Notes: Remember "Val
beta chain?
kicks butt with her big
glutes" to remember that
valine kicks out glutamic
acid in sickle cell disease
6. A 57 yo male in ICU being treated for sepsis begins to Disseminated Intravascu-
develop excessive bleeding from his foley catheter and lar Coagulation (DIC)
IV site. Labs are drawn which show a thrombocytope-
nia, elevated PT, elevated PTT, and elevated d-dimer as Notes: Widespread mi-
well as a peripheral smear that displays schistocytes. crothrombi which causes
What diagnosis should be suspected in this patient? deficiency in coagulation
factors
7. What pentad of clinical manifestations can potential- Fever, anemia, thrombocy-
ly be seen in a patient with thrombotic thrombocy- topenia, renal failure, neu-
topenic purpura (TTP)? rologic symptoms
Notes: Remember "FAT
RN" and many patients will
not have the entire pentad
8. Factor VIII
