PANCE PANCE Hematology

Question 1

A patient has microcytic anemia, low serum ferritin, low serum iron, and elevated TIBC. What is the diagnosis?

Accepted Answer

Iron deficiency anemia

Answer

Low ferritin, low serum iron, and elevated TIBC are the hallmark lab findings of iron deficiency anemia.

Question 2

A 70-year-old has macrocytic anemia, glossitis, and neurologic symptoms. Labs show elevated methylmalonic acid and homocysteine. What is the deficiency?

Accepted Answer

Vitamin B12

Answer

Elevated methylmalonic acid distinguishes B12 deficiency from folate deficiency, since only B12 is required in the MMA metabolic pathway.

Question 3

A 28-year-old African American male develops hemolytic anemia after starting primaquine for malaria prophylaxis. What is the underlying enzyme deficiency?

Accepted Answer

G6PD deficiency

Answer

G6PD deficiency causes episodic hemolysis triggered by oxidative stressors like primaquine, dapsone, or fava beans.

Question 4

A patient with sickle cell disease presents with acute bone pain, fever, and dactylitis. What is the most appropriate initial management?

Accepted Answer

IV fluids, oxygen, and analgesics

Answer

Acute vaso-occlusive crisis is managed with IV hydration, supplemental oxygen, and adequate analgesia.

Question 5

A patient with CKD has normocytic anemia and a reticulocyte count of 0.5%. What is the most likely pathophysiologic cause?

Accepted Answer

Decreased erythropoietin production

Answer

CKD causes anemia primarily through decreased renal erythropoietin production, leading to inadequate red cell stimulation.

PANCE Test Practice Test

PANCE Test Practice Test

PANCE PANCE Hematology