Internal Medicine Exam Hematology 2

Question 1

A patient has a prolonged PT but normal aPTT. Deficiency of which coagulation factor is most likely responsible?

Accepted Answer

Factor VII

Answer

Factor VIII

Answer

Factor IX

Answer

Factor XII

Question 2

Heparin-induced thrombocytopenia (HIT) typically develops at what time point after heparin initiation?

Accepted Answer

5-10 days after starting heparin

Answer

Within 24 hours

Answer

Only after 4 weeks of therapy

Answer

Immediately upon re-exposure regardless of timing

Question 3

Von Willebrand disease most characteristically presents with which bleeding pattern?

Accepted Answer

Mucocutaneous bleeding such as epistaxis and menorrhagia

Answer

Hemarthroses and deep muscle hematomas

Answer

Delayed bleeding after surgery only

Answer

Spontaneous intracranial hemorrhage

Question 4

Which laboratory test is used to monitor patients on warfarin therapy?

Accepted Answer

Prothrombin time/INR (PT/INR)

Answer

Activated partial thromboplastin time (aPTT)

Answer

Platelet count

Answer

Anti-Xa activity level

Question 5

Which combination of laboratory findings is most characteristic of disseminated intravascular coagulation (DIC)?

Accepted Answer

Elevated D-dimer, prolonged PT/aPTT, low fibrinogen, and thrombocytopenia

Answer

Isolated elevation of PT with normal platelet count

Answer

Normal fibrinogen with elevated D-dimer only

Answer

Elevated platelet count with isolated low fibrinogen

Question 6

A patient with antiphospholipid syndrome (APS) is at highest risk for which complication?

Accepted Answer

Arterial and venous thrombosis and recurrent pregnancy loss

Answer

Severe bleeding diathesis due to factor inhibitors

Answer

Aplastic anemia from bone marrow failure

Answer

Autoimmune hemolytic anemia as the primary manifestation

Question 7

Which anticoagulant requires NO dose adjustment in patients with severe renal failure?

Accepted Answer

Warfarin

Answer

Enoxaparin (LMWH)

Answer

Dabigatran

Answer

Rivaroxaban