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

Anemia of chronic disease

Answer

Thalassemia minor

Answer

Sideroblastic 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

Folate

Answer

Thiamine

Answer

Pyridoxine

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

Pyruvate kinase deficiency

Answer

Hereditary spherocytosis

Answer

Methemoglobin reductase deficiency

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

Emergent exchange transfusion

Answer

Hydroxyurea initiation

Answer

Bone marrow transplant referral

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

Iron deficiency

Answer

Vitamin B12 deficiency

Answer

Hemolysis

Question 6

A patient has petechiae, mucosal bleeding, and a platelet count of 8,000. PT and aPTT are normal. What is the most likely diagnosis?

Accepted Answer

Immune thrombocytopenic purpura

Answer

DIC

Answer

Thrombotic thrombocytopenic purpura

Answer

Bernard-Soulier syndrome