Internal Medicine Exam Hematology 3

Question 1

A 70-year-old man has a WBC of 45,000/µL with small mature lymphocytes on smear. Flow cytometry shows CD5+/CD19+/CD23+. What is the most likely diagnosis?

Accepted Answer

Chronic lymphocytic leukemia (CLL)

Answer

Acute lymphoblastic leukemia

Answer

Mantle cell lymphoma

Answer

Hairy cell leukemia

Question 2

Reed-Sternberg cells on lymph node biopsy are pathognomonic for which hematologic malignancy?

Accepted Answer

Hodgkin lymphoma

Answer

Diffuse large B-cell lymphoma

Answer

Multiple myeloma

Answer

Burkitt lymphoma

Question 3

Which set of clinical features best describes the CRAB criteria used to diagnose symptomatic multiple myeloma?

Accepted Answer

HyperCalcemia, Renal failure, Anemia, and Bone lesions

Answer

Cytopenias, Rash, Arthritis, and Bone pain

Answer

Cachexia, Recurrent infections, Adenopathy, and Bleeding

Answer

Confusion, Renal stones, Abdominal pain, and Bone pain

Question 4

Which finding on serum protein electrophoresis (SPEP) is characteristic of multiple myeloma?

Accepted Answer

M-spike representing a monoclonal protein

Answer

Polyclonal hypergammaglobulinemia

Answer

Isolated beta-2 microglobulin elevation

Answer

Hypoalbuminemia with diffusely low globulins

Question 5

A patient develops fever, chills, flank pain, and hemoglobinuria 30 minutes into a blood transfusion. What is the most likely cause?

Accepted Answer

Acute hemolytic transfusion reaction due to ABO incompatibility

Answer

Febrile non-hemolytic transfusion reaction

Answer

Transfusion-related acute lung injury (TRALI)

Answer

Allergic anaphylactic transfusion reaction

Question 6

What is the first-line treatment for iron deficiency anemia in a hemodynamically stable patient?

Accepted Answer

Oral ferrous sulfate supplementation

Answer

Red blood cell transfusion

Answer

Subcutaneous erythropoietin injections

Answer

Intramuscular vitamin B12 injections

Question 7

The JAK2 V617F mutation is present in approximately what percentage of polycythemia vera cases?

Accepted Answer

Greater than 95% of cases

Answer

10-20% of cases

Answer

30-40% of cases

Answer

50-60% of cases