CLT Treatment Protocols & Procedures 3 — Questions and Answers
Question 1: Which procedure is used to remove antibody-coated red blood cells from a patient with warm autoimmune hemolytic anemia?
- Plasmapheresis
- Red cell exchange transfusion
- Therapeutic plasma exchange
- Erythrocytapheresis (Correct answer)
Correct answer: Erythrocytapheresis
Erythrocytapheresis (red cell apheresis) selectively removes abnormal red blood cells, while plasmapheresis removes plasma components.
Question 2: A diabetic patient has a fasting blood glucose of 52 mg/dL and is unconscious. What is the FIRST-LINE treatment?
- Oral glucose tablets
- Subcutaneous glucagon injection
- IV 50% dextrose (D50W) (Correct answer)
- IM insulin injection
Correct answer: IV 50% dextrose (D50W)
In an unconscious hypoglycemic patient unable to take oral glucose, IV dextrose (D50W) is the immediate treatment of choice.
Question 3: Which culture technique is MOST appropriate for detecting anaerobic bacteria from a wound specimen?
- Blood agar in ambient air
- Chocolate agar with CO2
- Thioglycolate broth incubated anaerobically (Correct answer)
- MacConkey agar at 37°C
Correct answer: Thioglycolate broth incubated anaerobically
Thioglycolate broth creates a reduced oxygen environment suitable for anaerobic bacterial growth.
Question 4: A patient on heparin therapy develops heparin-induced thrombocytopenia (HIT). What is the correct treatment protocol?
- Reduce heparin dose by half
- Switch to warfarin immediately
- Discontinue heparin and start a direct thrombin inhibitor (Correct answer)
- Add aspirin to current heparin regimen
Correct answer: Discontinue heparin and start a direct thrombin inhibitor
In HIT, heparin must be stopped immediately and an alternative anticoagulant (such as argatroban or bivalirudin) must be initiated to prevent thrombosis.
Question 5: Which anticoagulation protocol is MOST appropriate for a patient with renal failure requiring anticoagulation?
- Low molecular weight heparin (enoxaparin)
- Unfractionated heparin (Correct answer)
- Dabigatran
- Rivaroxaban
Correct answer: Unfractionated heparin
Unfractionated heparin is preferred in renal failure because it is not renally cleared, whereas LMWHs and DOACs accumulate in renal insufficiency.
Question 6: In polycythemia vera, which treatment reduces the risk of thrombotic complications most directly?
- Iron supplementation
- Therapeutic phlebotomy to target hematocrit below 45% (Correct answer)
- High-dose aspirin therapy
- Erythropoietin injections
Correct answer: Therapeutic phlebotomy to target hematocrit below 45%
Maintaining hematocrit below 45% via therapeutic phlebotomy reduces blood viscosity and thrombotic risk in polycythemia vera.
Question 7: Which gram stain and culture result would warrant immediate contact precautions and notification of infection control?
- Gram-positive cocci in clusters — MSSA
- Gram-negative rods — E. coli sensitive to ciprofloxacin
- Gram-positive cocci in clusters — MRSA (Correct answer)
- Gram-positive rods — Bacillus subtilis
Correct answer: Gram-positive cocci in clusters — MRSA
MRSA (methicillin-resistant Staphylococcus aureus) is a reportable multidrug-resistant organism requiring immediate contact precautions and infection control notification.
CLT Treatment Protocols & Procedures 3
Which procedure is used to remove antibody-coated red blood cells from a patient with warm autoimmune hemolytic anemia?