ABPS ABPS Diagnostic Testing & Interpretation 2 — Questions and Answers
Question 1: Which finding on a complete blood count (CBC) is most characteristic of iron deficiency anemia?
- Macrocytic, normochromic red cells
- Microcytic, hypochromic red cells with low ferritin (Correct answer)
- Normocytic, normochromic cells with elevated reticulocyte count
- Hypersegmented neutrophils
Correct answer: Microcytic, hypochromic red cells with low ferritin
Iron deficiency anemia is characterized by microcytic (low MCV) and hypochromic (low MCHC) red blood cells, accompanied by depleted iron stores (low ferritin).
Question 2: A patient has an elevated serum creatinine and a urine sodium of 8 mEq/L with a fractional excretion of sodium (FeNa) of 0.4%. What type of acute kidney injury does this suggest?
- Intrinsic renal failure (ATN)
- Post-renal obstruction
- Pre-renal azotemia (Correct answer)
- Chronic kidney disease
Correct answer: Pre-renal azotemia
A FeNa < 1% and low urine sodium indicate the kidney is avidly retaining sodium, consistent with pre-renal azotemia due to decreased renal perfusion.
Question 3: Which imaging modality is preferred for initial evaluation of acute appendicitis in a pregnant patient?
- CT abdomen with contrast
- Abdominal X-ray
- MRI abdomen without contrast (Correct answer)
- Nuclear medicine scan
Correct answer: MRI abdomen without contrast
MRI is preferred in pregnant patients for suspected appendicitis because it avoids ionizing radiation while providing excellent soft tissue detail for diagnosis.
Question 4: A 24-hour urine protein collection shows 4.5 grams of protein. Combined with hypoalbuminemia, hyperlipidemia, and edema, which syndrome is this diagnostic of?
- Nephritic syndrome
- Nephrotic syndrome (Correct answer)
- Hepatorenal syndrome
- Fanconi syndrome
Correct answer: Nephrotic syndrome
Nephrotic syndrome is defined by proteinuria > 3.5 g/day, hypoalbuminemia, edema, and hyperlipidemia due to massive glomerular protein loss.
Question 5: Which test is considered the gold standard for diagnosing Helicobacter pylori infection in a patient currently taking a proton pump inhibitor?
- Urea breath test
- Serology (IgG antibody)
- Stool antigen test
- Upper endoscopy with biopsy (CLO test) (Correct answer)
Correct answer: Upper endoscopy with biopsy (CLO test)
In patients on PPIs (which can cause false-negative non-invasive tests), upper endoscopy with biopsy and CLO (rapid urease) testing or histology is the most accurate diagnostic approach.
Question 6: An ECG reveals ST-segment elevation in leads II, III, and aVF. Which coronary artery territory is most likely affected?
- Left anterior descending artery (LAD)
- Left circumflex artery (LCX)
- Right coronary artery (RCA) (Correct answer)
- Left main coronary artery
Correct answer: Right coronary artery (RCA)
ST elevation in leads II, III, and aVF indicates an inferior wall STEMI, which is supplied by the right coronary artery (RCA) in most patients.
ABPS ABPS Diagnostic Testing & Interpretation 2
Which finding on a complete blood count (CBC) is most characteristic of iron deficiency anemia?