Hematology — MCQs

Hemolytic crisis in hereditary spherocytosis is most commonly precipitated by which of the following?

A 20-year-old female swimmer presents with new-onset severe fatigue and left upper abdominal pain. She was recently treated for presumed typhoid fever. She has a past history of typhoid fever two years ago. On physical examination, her heart rate is 120 bpm and she has a palpable spleen. Stool is negative for heme. Laboratory investigations show a hemoglobin of 5 g/dL with normal TLC and platelets. Peripheral blood smear reveals an excess of spherocytes. Which of the following conditions can cause a similar presentation except?

Which of the following are characteristic features of secondary polycythemia?

Which of the following is NOT seen in Paroxysmal Nocturnal Hemoglobinuria?

A 47-year-old man with a history of sickle cell disease has had numerous hospitalizations requiring the placement of intravenous lines. The patient has poor peripheral venous access, and a catheter is placed in the right subclavian vein. The patient subsequently develops right arm discomfort and swelling, and a temperature of 40.1°C with chills. Multiple blood cultures are taken, and gram-positive cocci are isolated. The organism is catalase-positive and grows on mannitol salt agar, but does not turn the agar yellow; the colonies are gamma-hemolytic on a sheep blood agar plate. Which of the following organisms is the most likely cause of this patient's symptoms?

A 57-year-old man, with a history of chronic alcohol ingestion, is admitted to the hospital with acute alcoholic intoxication and lobar pneumonia. Physical examination reveals pallor; a large, tender liver; and consolidation of the right lower lobe. Laboratory data include hemoglobin of 7 g/dL, WBC of 4000/mL, and platelet count of 85,000/mL. Which of the following is the most likely factor for the anemia?

A 45-year-old man complains of recurrent nausea and abdominal distress. A gastric biopsy shows atrophy of the mucosa in the fundus and body, with marked lymphocytic infiltration. Blood studies show severe macrocytic anemia with a mean corpuscular volume of 110 mm3. In addition, numerous hypersegmented neutrophils are appreciated on a blood smear. Which of the following is the MOST likely pathogenetic mechanism of this patient's anemia?

A patient diagnosed with deep vein thrombosis is being treated with heparin. Which of the following tests will you order to adjust its dosage?

What is the most serious complication of acute hemolytic anemia in G6PD deficiency?

A 70-year-old woman, previously in good health, is found to have an asymptomatic monoclonal immunoglobulin peak on serum electrophoresis. Her physical examination is normal, as is her CBC, electrolytes, renal function, and calcium level. A skeletal survey does not reveal any osteolytic lesions, and a bone-marrow aspirate reveals 5% plasma cells. Which of the following is the most likely diagnosis?