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Hematology Flashcards

7 cards from real PANRE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 28-year-old woman presents with fatigue, pallor, and pica. Labs show Hgb 9.2 g/dL, MCV 72 fL, low ferritin, and low serum iron with elevated TIBC. What is the most appropriate initial treatment?

    Answer: Ferrous sulfate 325 mg orally three times daily

    Oral ferrous sulfate is the first-line treatment for iron deficiency anemia in a patient who can tolerate oral therapy, with IV iron reserved for those who cannot absorb or tolerate oral iron.

  2. A 65-year-old male presents with peripheral neuropathy, glossitis, and megaloblastic anemia. Serum B12 is 98 pg/mL. Anti-intrinsic factor antibodies are positive. What is the most likely diagnosis?

    Answer: Pernicious anemia

    Pernicious anemia is caused by autoimmune destruction of gastric parietal cells leading to intrinsic factor deficiency and B12 malabsorption, confirmed by positive anti-intrinsic factor antibodies.

  3. A 22-year-old Black male with sickle cell disease presents with severe bone pain in his legs and back for 12 hours. Temperature is 37.2°C, SpO2 is 97%. What is the most appropriate immediate management?

    Answer: IV morphine and IV fluids

    A vaso-occlusive pain crisis is managed with adequate analgesia (IV opioids) and IV hydration to reduce sickling and improve microvascular flow.

  4. A patient on warfarin for atrial fibrillation has an INR of 9.2 with active major bleeding. Which intervention is most appropriate?

    Answer: Administer 4-factor prothrombin complex concentrate (PCC) and IV vitamin K

    Life-threatening warfarin-associated bleeding requires 4-factor PCC for rapid reversal combined with IV vitamin K for sustained effect; PCC works faster than FFP alone.

  5. A 35-year-old woman has recurrent mucosal bleeding, easy bruising, and prolonged bleeding after dental extraction. PTT is mildly prolonged, PT is normal, platelet count is 210,000/μL. What is the most likely diagnosis?

    Answer: Von Willebrand disease

    Von Willebrand disease is the most common inherited bleeding disorder, presenting with mucosal and skin bleeding, a normal platelet count, and a mildly prolonged PTT due to VWF's role in stabilizing factor VIII.

  6. A 45-year-old patient with immune thrombocytopenic purpura (ITP) has a platelet count of 8,000/μL and is actively bleeding from the gums. Which is the most appropriate initial management?

    Answer: IV immunoglobulin (IVIG) and high-dose corticosteroids

    For acute severe ITP with bleeding, IVIG combined with high-dose corticosteroids provides the fastest platelet count rise and is the preferred initial treatment.

  7. A 58-year-old man is diagnosed with a proximal DVT after knee replacement surgery. He has normal renal function and no active cancer. What is the preferred anticoagulation therapy?

    Answer: Rivaroxaban 15 mg twice daily for 21 days, then 20 mg daily

    Direct oral anticoagulants such as rivaroxaban are preferred over warfarin for DVT treatment in patients without cancer or severe renal impairment due to their predictable dosing and no need for monitoring.