PANCE PANCE Hematology 2

Question 1

A patient with recurrent DVT has a prolonged aPTT that does not correct with a 1:1 mixing study. What is the most likely diagnosis?

Accepted Answer

Antiphospholipid syndrome

Answer

Failure to correct on mixing study indicates an inhibitor; lupus anticoagulant in antiphospholipid syndrome is the most common cause.

Question 2

A 52-year-old has splenomegaly, WBC of 85,000 with basophilia, and a Philadelphia chromosome on cytogenetics. What is the diagnosis?

Accepted Answer

Chronic myelogenous leukemia

Answer

CML is characterized by the BCR-ABL fusion gene (Philadelphia chromosome t(9;22)) and presents with leukocytosis, basophilia, and splenomegaly.

Question 3

A patient with multiple myeloma develops worsening renal function. Which renal complication is most directly caused by light chain deposition in tubules?

Accepted Answer

Cast nephropathy

Answer

Bence-Jones proteins (free light chains) precipitate in renal tubules, causing tubular injury and cast nephropathy (myeloma kidney).

Question 4

What is the first-line treatment for newly diagnosed warm autoimmune hemolytic anemia?

Accepted Answer

Corticosteroids

Answer

Corticosteroids suppress autoantibody production and are the initial treatment of choice for warm AIHA.

Question 5

Which finding on osmotic fragility testing is most characteristic of hereditary spherocytosis?

Accepted Answer

Increased osmotic fragility

Answer

Spherocytes lack the normal biconcave disc shape, causing increased osmotic fragility as they lyse more easily in hypotonic solutions.

PANCE Test Practice Test

PANCE Test Practice Test

PANCE PANCE Hematology 2