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

Oral ferrous sulfate is the first-line treatment for iron deficiency anemia in a patient who can tolerate oral therapy, with IV iron reserved for those who cannot absorb or tolerate oral iron.

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

Pernicious anemia is caused by autoimmune destruction of gastric parietal cells leading to intrinsic factor deficiency and B12 malabsorption, confirmed by positive anti-intrinsic factor antibodies.

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

A vaso-occlusive pain crisis is managed with adequate analgesia (IV opioids) and IV hydration to reduce sickling and improve microvascular flow.

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

Life-threatening warfarin-associated bleeding requires 4-factor PCC for rapid reversal combined with IV vitamin K for sustained effect; PCC works faster than FFP 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

Von Willebrand disease is the most common inherited bleeding disorder, presenting with mucosal and skin bleeding, a normal platelet count, and a mildly prolonged PTT due to VWF's role in stabilizing factor VIII.

PANRE Test Practice Test

PANRE Test Practice Test

PANRE Hematology