Multiple Choice Questions (MCQ)

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Category: Medicine--->Hematology and Oncology
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Question 1# Print Question

A 55-year-old man is being evaluated for constipation. There is no history of prior gastrectomy or of upper GI symptoms. Hemoglobin is 10 g/dL, mean corpuscular volume (MCV) is 72 fL, serum iron is 4 µg/dL (normal 50-150 µg/dL), iron-binding capacity is 450 µg/dL (normal 250-370 µg/dL), saturation is 1% (normal 20%-45%), and ferritin is 10 µg/L (normal 15-400 µg/L).

Which of the following is the best next step in the evaluation of this patient’s anemia?

A. Red blood cell folate
B. Serum lead level
C. Colonoscopy
D. Bone marrow examination
E. Hemoglobin electrophoresis with A2 and F levels

Question 2# Print Question

A 50-year-old woman complains of pain and swelling in her proximal interphalangeal joints, both wrists, and both knees. She complains of morning stiffness. She had a hysterectomy 10 years ago. Physical examination shows swelling and thickening of the PIP joints. Hemoglobin is 10.3 g/dL, MCV is 80 fL, serum iron is 28 µg/dL, iron-binding capacity is 200 µg/dL (normal 250-370 µg/dL), and saturation is 14%.

Which of the following is the most likely explanation for this woman’s anemia?

A. Occult blood loss
B. Vitamin deficiency
C. Anemia of chronic disease
D. Sideroblastic anemia
E. Occult renal disease

Question 3# Print Question

A 35-year-old woman presents with several days of increasing fatigue and shortness of breath on exertion. She was recently diagnosed with Mycoplasma pneumoniae. Physical examination reveals BP 113/67, HR 114 beats/minute, and respiratory rate 20 breaths/minute. She appears icteric and in mild respiratory distress. Her hemoglobin is 9.0 g/dL and MCV is 110.

Which of the following is the best next diagnostic test? 

A. Serum protein electrophoresis
B. Flow cytometry
C. Peripheral blood smear
D. Glucose-6-PD level
E. Bone marrow biopsy

Question 4# Print Question

A 70-year-old man complains of 2 months of low back pain and fatigue. He has developed fever with purulent sputum production. On physical examination, he has pain over several vertebrae and rales at the left base. Laboratory results are as follows:

  • Hemoglobin: 7 g/dL
  • MCV: 89 fL (normal 86-98)
  • WBC: 12,000/mL
  • BUN: 44 mg/dL
  • Creatinine: 3.2 mg/dL
  • Ca: 11.5 mg/dL
  • Chest x-ray: LLL infiltrate
  • Reticulocyte count: 1%

The definitive diagnosis is best made by which of the following? 

A. 24-hour urine protein
B. Bone scan
C. Renal biopsy
D. Rouleaux formation on blood smear
E. Greater than 30% plasma cells in the bone marrow

Question 5# Print Question

A 64-year-old man complains of cough, increasing shortness of breath, and headache for the past 3 weeks. He has mild hypertension for which he takes hydrochlorothiazide; he has smoked 1 pack of cigarettes a day for 40 years. On examination you notice facial plethora and jugular venous distension to the angle of the jaw. He has prominent veins over the anterior chest and a firm to hard right supraclavicular lymph node. Cardiac examination is normal and lungs are without rales. Peripheral edema is absent.

What is the most likely cause of his condition?

A. Long-standing hypertension
B. Gastric carcinoma
C. Emphysema
D. Lung cancer
E. Nephrotic syndrome

Category: Medicine--->Hematology and Oncology
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