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Category: Q&A Medicine--->Hematology and Oncology
Page: 2

Question 6#Print Question

The physician treating the 9-year-old girl in Question 5 is surprised that a medication was not administered to this patient prior to the initiation of chemotherapy to prevent tumor lysis syndrome.

Which of the following medications might have prevented this patient’s renal failure?

a. Kayexalate
b. Insulin
c. Allopurinol
d. Albuterol


Question 7#Print Question

A 29-year-old woman is brought to the emergency room after falling off her third floor apartment balcony. The patient suffered blunt abdominal trauma, a right femur fracture, and a left humeral fracture. On physical examination, her blood pressure is 70/30 mmHg and her heart rate is 120 beats per minute. After the administration of 5 units of packed red blood cells, the patient reports a “pins and needles”  sensation on her distal toes and around her mouth. Laboratory testing confirms a calcium level of 6.9 mg/dL and a magnesium level of 1.1 mEq/L.

Which of the following is the underlying cause of this patient’s hypocalcemia and hypomagnesemia?

a. Exacerbation of previous hypoparathyroid state
b. Loss of intracellular red blood cell electrolytes during blood storage
c. Chelation of calcium by an anticoagulant component of packed red blood cells
d. Intrinsic renal failure causing hypersecretion of calcium


Question 8#Print Question

A 38-year-old obese man presents with fatigue. The patient reports several bouts of daytime sleepiness in the past 6 months. He is accompanied by his wife who reports that he snores excessively each night, and that this is causing a strain on their relationship. On physical examination, the patient has a blood pressure of 158/92 mmHg and a BMI of 34 kg/m2 . The rest of the physical examination is unremarkable. Laboratory studies reveal the following:

  • Leukocyte count   8,500/mm3
  • Hemoglobin   17.9 g/dL
  • Hematocrit   58%
  • Platelets   290,000/mm3

Which of the following explains this patient’s laboratory abnormalities?

a. Hypoxemia-induced increase in erythropoietin
b. Myeloproliferative disorder causing myeloid cell clonal proliferation
c. Abnormal BCR–ABL fusion gene
d. Cobalamin deficiency


Question 9#Print Question

A 24-year-old woman with a history of asthma presents with fatigue. She does not have a family history as she was adopted in Albania and came to the United States when she was born. The patient reports regular menstrual cycles and denies taking any medications. Laboratory studies reveal the following:

  • Leukocyte count   8,500/mm3
  • Hemoglobin   9.8 g/dL
  • Hematocrit   30%
  • Mean corpuscular volume   70 fL
  • Mean corpuscular hemoglobin concentration   27%
  • Platelets   290,000/mm3

The patient is treated with iron supplementation and returns 8 weeks later without improvement in laboratory values.

Which of the following is the likely cause of this patient’s condition?

a. Folic acid deficiency
b. Red blood cell enzyme deficiency
c. Anti-RBC antibodies
d. Point mutation in one of the β-hemoglobin genes


Question 10#Print Question

A 59-year-old man with a history of benign prostatic hyperplasia (BPH) presents with fatigue, decreased appetite, and a lump in his neck. The patient has smoked 1 to 2 packs of cigarettes per day for the past 30 years. On physical examination, a 2.5 cm firm and fixed nontender left submandibular mass is palpated. The rest of the examination is unremarkable. A complete blood count and comprehensive metabolic panel are within normal limits.

Which of the following is likely to be the underlying diagnosis?

a. Hodgkin lymphoma
b. Infectious mononucleosis
c. Squamous cell carcinoma
d. Papillary thyroid carcinoma




Category: Q&A Medicine--->Hematology and Oncology
Page: 2 of 4