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Treatment Planning & Management Flashcards

7 cards from real MLS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A patient with multiple myeloma shows a CRAB pattern (hypercalcemia, renal insufficiency, anemia, bone lesions). Which laboratory marker is MOST useful for monitoring treatment response?

    Answer: M-protein (serum protein electrophoresis)

    M-protein quantification by SPEP or immunofixation directly reflects tumor burden and is the primary marker for monitoring response in multiple myeloma.

  2. In a patient receiving aminoglycoside therapy, which pharmacokinetic monitoring parameter is MOST critical to prevent nephrotoxicity?

    Answer: Trough drug level

    Elevated trough levels indicate drug accumulation and correlate strongly with aminoglycoside nephrotoxicity; troughs should be drawn just before the next dose.

  3. A patient with autoimmune hemolytic anemia (AIHA) is being treated with prednisone. Which CBC trend confirms a positive treatment response?

    Answer: Rising hemoglobin with decreasing LDH and indirect bilirubin

    Hemoglobin recovery accompanied by falling LDH and indirect bilirubin indicates reduced hemolysis, confirming steroid effectiveness in AIHA.

  4. A patient on long-term phenytoin therapy has a total phenytoin level of 7 µg/mL (therapeutic range: 10–20 µg/mL) but no seizure breakthrough. Albumin is 2.1 g/dL. The BEST interpretation is:

    Answer: Free phenytoin level may be adequate due to reduced protein binding

    Phenytoin is highly protein-bound; hypoalbuminemia increases free (active) drug fraction, so total levels appear low while free levels may be therapeutic or toxic.

  5. Therapeutic drug monitoring of cyclosporine in a renal transplant patient uses which specimen type and timing?

    Answer: Whole blood trough collected just before the next dose

    Cyclosporine distributes extensively into red blood cells; whole blood trough levels (C0) collected 12 hours post-dose are the standard for transplant monitoring.

  6. A critically ill patient has an ionized calcium of 0.78 mmol/L (reference: 1.15–1.35 mmol/L) after massive transfusion. The MOST likely cause and treatment is:

    Answer: Citrate-chelation of calcium from preservative in blood products; administer IV calcium

    Citrate in blood product preservatives chelates ionized calcium; massive transfusion can cause clinically significant hypocalcemia requiring IV calcium gluconate or chloride.

  7. A patient with CML on imatinib therapy achieves a major molecular response (BCR-ABL1 IS ≤0.1%). The monitoring frequency recommendation changes to:

    Answer: Every 3–6 months PCR for BCR-ABL1

    Once major molecular response is confirmed, international guidelines recommend BCR-ABL1 PCR monitoring every 3–6 months to detect loss of response early.