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USMLE Hematology Latest Exams| Latest Questions with 100% Correct Answers
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USMLE Hematology Latest Exams| Latest Questions with 100% Correct Answers
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USMLE Hematology Latest Exams|Latest Questions with 100% Correct
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A 35-year-old African-American woman on dialysis has had a 4-month history of
hemoglobin of 9 g/dL, despite erythropoietin and intravenous iron therapies.
Diagnostic studies have shown the following:
Transferrin saturation 30%
Ferritin 400 ng/mL
Parathyroid hormone level 700 pg/mL (normal for stage 5 kidney disease 150-
300 pg/mL)
Serum aluminum Normal
Total white blood cell count 5x10 3/mm3
Platelet count 200x10 3/mL
Question
What therapy should be used in addition to erythropoietin and iron to treat
anemia in this patient? - ✔ ✔ Vitamin D therapy
A 35-year-old man with stage 3 chronic kidney disease has had a decreasing
hemoglobin count from 12 g/dl to 10.5 g/dl over the past 18 months. He is
asymptomatic.
Work up shows:
Hemoglobin 10.5 g/dl
Iron 49 ug/dl (normal 50-150 ug/dl)
,Transferrin Saturation 18%
Ferritin 75 ng/ml
Stool occult blood Negative, 3 samples
B12 Normal
Folate Normal
TSH Normal
Reticulocytes Low
Question
What treatment is suggested? - ✔ ✔ Oral iron supplements
A 35-year-old man with known stage 3 chronic kidney disease due to diabetes
presents with fatigue. His blood sugars are acceptable; his mood is euthymic,
and he is sleeping and eating well. He does not smoke, and he has no known
toxic environmental exposures. Work up shows normochromic normocytic
anemia, with a hemoglobin of 11 g/dl, which is decreased from 12 g/dl 6 months
ago. Medications include lisinopril, furosemide, and insulin.
Iron 50 ug/dl (normal 50-150 ug/dl)
Ferritin 200 ng/ml
Ratio soluble transferrin receptor/log ferritin Reduced
Reticulocytes 0.25%
Platelets Normal
Total white blood cell count 5x103/mm3
B12 levels, serum Normal
,Question
What is the most likely diagnosis? - ✔ ✔ Anemia of chronic disease
A 42-year-old African-American woman presents with increased fatigue
and unusual cravings for chalk and raw potatoes over the past few months.
Question
What is the most likely diagnosis? - ✔ ✔ Iron deficiency anemia
An 11-year-old boy presents with a chronic history of mild hemolytic anemia,
intermittent jaundice, and right upper quadrant pain. He denies any shortness
of breath, muscle aches, or joint pain.
Question
Supplementation with what should be given to the patient as part of the
treatment plan? - ✔ ✔ Folic acid
A 56-year-old man presents to the outpatient clinic with increased fatigability,
purpura, weight loss, bone pain, and pallor. CBC was done and revealed marked
anemia, thrombocytopenia, and increased white blood cell count, and differential
showed marked increase in plasma cells. CT head was done and showed multiple
hypodense areas in the skull bone.
Question
A tissue biopsy was taken and stained positive with Congo red. What is the
protein stained in the specimen? - ✔ ✔ Amyloid light chain (AL)
, A 60-year-old man presents to the office for routine follow-up of hypertension.
A CBC reveals:
WBC 12.0 x 103/mm3 4.5 - 11
RBC 7.0 x 106/μl 4.6 - 6.2 (male)
Hematocrit 60 % 40 - 54 (male)
MCV 68 μ3 80 - 100
RDW 14.9 % 11.6 - 14.6
Platelets 550,000 mm3 150,000 - 450,000
On examination, blood pressure is 160/88 mm Hg, pulse is 86/min,
temperature 97.6°F, and respirations 18/minute. His skin appears ruddy and
the tip of the spleen is palpable. Pulse oximetry reveals a saturation of 99%.
Question
What distinguishing finding would you expect on history or physical exam? -
✔ ✔ Pruritis after a hot shower
A 2-year-old boy presents with his mother due to her concerns about his
paleness; she states that he used to be playful, but now looks tired and doesn't
even cry as he did previously. She first noticed this occuring 3 months after
moving to his grandmother's old house. CBC is ordered and shows the following
results: RBC 4 million/microliter, WBC 11,000/mm3, Hb 9 mg/dL, platelets
180,000/mm3, and hematocrit 31%. The image shown is of his blood film.
Question
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