BCPS Oncology & Hematology Pharmacotherapy 3

Question 1

Hydroxyurea reduces the frequency of vaso-occlusive crises in sickle cell disease primarily by:

Accepted Answer

Increasing fetal hemoglobin (HbF) production

Answer

Hydroxyurea induces HbF production, which dilutes HbS within red blood cells and inhibits the polymerization responsible for sickling.

Question 2

A patient on unfractionated heparin develops a platelet count drop from 240,000 to 85,000 on day 7 of therapy. Heparin-induced thrombocytopenia (HIT) is suspected. The most appropriate management is:

Accepted Answer

Discontinue all heparin products and start a non-heparin anticoagulant

Answer

In suspected HIT, all heparin (including flushes and LMWH) must be discontinued immediately and replaced with a non-heparin anticoagulant such as argatroban or bivalirudin.

Question 3

A patient with iron deficiency anemia has failed oral iron therapy due to GI intolerance. What is the most appropriate next step?

Accepted Answer

Initiate IV iron infusion

Answer

IV iron is indicated when oral iron fails due to intolerance, malabsorption, or insufficient response, as it bypasses the GI tract entirely.

Question 4

A patient with pernicious anemia requires vitamin B12 replacement. Which treatment approach is most appropriate?

Accepted Answer

High-dose oral cyanocobalamin (1000–2000 mcg/day) or IM cyanocobalamin injections

Answer

High-dose oral B12 (1000–2000 mcg/day) exploits passive diffusion to overcome the intrinsic factor deficiency, or IM injections bypass GI absorption entirely; both are effective.

Question 5

A patient with severe hemophilia A requires perioperative hemostasis for elective surgery. Which product is most appropriate?

Accepted Answer

Recombinant or plasma-derived factor VIII concentrate

Answer

Factor VIII concentrate (recombinant or plasma-derived) is the preferred treatment for hemophilia A to achieve targeted factor levels perioperatively with precision dosing.

(BCPS) Board Certified Pharmacotherapy Specialist Practice Test

(BCPS) Board Certified Pharmacotherapy Specialist Practice Test

BCPS Oncology & Hematology Pharmacotherapy 3