MD Hematology and Oncology 3

Question 1

A 25-year-old man with hemophilia A requires surgery. His factor VIII level is 2%. Which product replaces the deficient factor and is the treatment of choice?

Accepted Answer

Recombinant factor VIII concentrate

Answer

Recombinant factor VIII concentrate is first-line for severe hemophilia A; DDAVP is only effective for mild hemophilia A (factor VIII >5%).

Question 2

A 60-year-old man has lymphadenopathy, hepatosplenomegaly, WBC 80,000/μL with 95% mature small lymphocytes, and positive CD5/CD23 by flow cytometry. What is the diagnosis?

Accepted Answer

Chronic lymphocytic leukemia

Answer

CLL is characterized by clonal proliferation of mature CD5+/CD23+ B lymphocytes with absolute lymphocytosis; mantle cell lymphoma is CD5+ but CD23−.

Question 3

An 8-year-old child presents with pallor, jaundice, and splenomegaly. Peripheral smear shows spherocytes and reticulocytosis. The osmotic fragility test is positive. What is the inheritance pattern?

Accepted Answer

Autosomal dominant

Answer

Hereditary spherocytosis is most commonly autosomal dominant (spectrin or ankyrin mutations), though autosomal recessive forms exist; autosomal dominant accounts for ~75% of cases.

Question 4

Which staging system is used for Hodgkin lymphoma and defines Stage III as involvement of lymph node regions on both sides of the diaphragm?

Accepted Answer

Ann Arbor staging

Answer

The Ann Arbor staging system (with Cotswolds modification) classifies Hodgkin and non-Hodgkin lymphomas; Stage III involves nodes on both sides of the diaphragm.

Question 5

A patient with multiple myeloma shows a serum M-spike on SPEP. Which immunoglobulin heavy chain is most commonly involved in multiple myeloma?

Accepted Answer

IgG

Answer

IgG myeloma is the most common subtype, accounting for approximately 50–60% of multiple myeloma cases.

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MD Hematology and Oncology 3