PANRE Hematology

Question 1

A 28-year-old woman presents with fatigue, pallor, and pica. Labs show Hgb 9.2 g/dL, MCV 72 fL, low ferritin, and low serum iron with elevated TIBC. What is the most appropriate initial treatment?

Accepted Answer

Ferrous sulfate 325 mg orally three times daily

Answer

IV iron dextran infusion

Answer

Folate supplementation 1 mg daily

Answer

Erythropoietin injections

Question 2

A 65-year-old male presents with peripheral neuropathy, glossitis, and megaloblastic anemia. Serum B12 is 98 pg/mL. Anti-intrinsic factor antibodies are positive. What is the most likely diagnosis?

Accepted Answer

Pernicious anemia

Answer

Folate deficiency anemia

Answer

Celiac disease

Answer

Alcoholic liver disease

Question 3

A 22-year-old Black male with sickle cell disease presents with severe bone pain in his legs and back for 12 hours. Temperature is 37.2°C, SpO2 is 97%. What is the most appropriate immediate management?

Accepted Answer

IV morphine and IV fluids

Answer

Urgent exchange transfusion

Answer

Hydroxyurea administration

Answer

Emergent bone marrow biopsy

Question 4

A patient on warfarin for atrial fibrillation has an INR of 9.2 with active major bleeding. Which intervention is most appropriate?

Accepted Answer

Administer 4-factor prothrombin complex concentrate (PCC) and IV vitamin K

Answer

Hold warfarin and recheck INR in 24 hours

Answer

Administer vitamin K 10 mg orally

Answer

Fresh frozen plasma alone

Question 5

A 35-year-old woman has recurrent mucosal bleeding, easy bruising, and prolonged bleeding after dental extraction. PTT is mildly prolonged, PT is normal, platelet count is 210,000/μL. What is the most likely diagnosis?

Accepted Answer

Von Willebrand disease

Answer

Hemophilia A

Answer

Immune thrombocytopenic purpura

Answer

Bernard-Soulier syndrome

Question 6

A 45-year-old patient with immune thrombocytopenic purpura (ITP) has a platelet count of 8,000/μL and is actively bleeding from the gums. Which is the most appropriate initial management?

Accepted Answer

IV immunoglobulin (IVIG) and high-dose corticosteroids

Answer

Splenectomy

Answer

Rituximab infusion

Answer

Platelet transfusion alone

Question 7

A 58-year-old man is diagnosed with a proximal DVT after knee replacement surgery. He has normal renal function and no active cancer. What is the preferred anticoagulation therapy?

Accepted Answer

Rivaroxaban 15 mg twice daily for 21 days, then 20 mg daily

Answer

Warfarin with a target INR of 2-3

Answer

Aspirin 81 mg daily

Answer

Unfractionated heparin infusion for 3 months