PANCE/PANRE HEMATOLOGY EXAM QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
55-year-old non-smoking male presents with a hemoglobin of 18.5 g/dl and a
hematocrit of 56%. Which of the following physical examination findings is the
most likely to be noted with this patient?
A Splenomegaly
B Cheilosis
C Purpura
D Decreased vibratory sense
Splenomegaly
- Patients with polycythemia vera present with elevated hemoglobin and hematocrit. On
physical examination plethora, engorged retinal veins, and splenomegaly are common
Cheilosis is noted in iron deficiency anemia.
Purpura is typically noted in bleeding disorders.
Decreased vibratory sense is noted in vitamin B12 deficiency
An 8-year-old presents with splenomegaly. CBC results reveal the following:
WBC- 6,300/microliter, Hgb- 10.5 g/dl, Hct- 31%, MCV- 87 fL, MCHC- 39 g/dl, MCH-
28 pg, and platelets- 317,000/mL. Examination of the RBC morphology reveals
80% spherocytes. Which of the following would be most helpful in confirming the
,diagnosis?
A- Direct Coombs test
B- Osmotic fragility
C- G-6-PD level
D- Serum ferritin
B- Osmotic fragility
- Hereditary spherocytosis presents with a normocytic, normochromic anemia
and many spherocytes. Diagnosis is confirmed with a positive osmotic fragility
test.
D- Serum ferritin - Iron deficiency anemia typically presents with microcytic,
hypochromic red blood cells and is diagnosed with a serum ferritin.
G-6-PD deficiency presents with minimal or no RBC morphologic abnormalities and is
diagnosed by measuring G-6-PD enzyme activity level.
The direct Coombs test would be negative and would not be helpful in diagnosing
hereditary spherocytosis
A 60-year-old presents with fatigue and splenomegaly. CBC reveals the following:
WBC- 24,000/microliter, Hgb- 13.5 g/dl, Hct- 40%, MCV- 87 fL, MCHC- 34 g/dl,
MCH- 28 pg, and platelets- 380,000/mL. The differential reveals neutrophils- 11%,
lymphocytes- 80%, monocytes- 8%, and basophils- 1%. What is the most likely
diagnosis?
A Acute lymphocytic leukemia
B Acute myelogenous leukemia
, C Chronic lymphocytic leukemia
D Chronic myelogenous leukemia
C Chronic lymphocytic leukemia
- Chronic lymphocytic leukemia presents with a WBC count greater than
20,000/microliter and absolute lymphocyte count of greater than 5000/microliter.
Chronic myelogenous leukemia
- Chronic myelogenous leukemia presents with elevated WBC count, marked left shift in
the myeloid series of cells, and positive for Philadelphia chromosome.
Acute myelogenous leukemia
- Acute myelogenous leukemia presents with pancytopenia and presence of blasts in
the peripheral blood
Acute lymphocytic leukemia
- Acute lymphocytic leukemia is more common in children and presents with blasts in
the peripheral blood
A patient with multiple myeloma should be immunized against which of the
following organisms?
A Streptococcus pneumoniae
B Hepatitis C virus
C Listeria monocytogenes
D Epstein Barr virus
ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
55-year-old non-smoking male presents with a hemoglobin of 18.5 g/dl and a
hematocrit of 56%. Which of the following physical examination findings is the
most likely to be noted with this patient?
A Splenomegaly
B Cheilosis
C Purpura
D Decreased vibratory sense
Splenomegaly
- Patients with polycythemia vera present with elevated hemoglobin and hematocrit. On
physical examination plethora, engorged retinal veins, and splenomegaly are common
Cheilosis is noted in iron deficiency anemia.
Purpura is typically noted in bleeding disorders.
Decreased vibratory sense is noted in vitamin B12 deficiency
An 8-year-old presents with splenomegaly. CBC results reveal the following:
WBC- 6,300/microliter, Hgb- 10.5 g/dl, Hct- 31%, MCV- 87 fL, MCHC- 39 g/dl, MCH-
28 pg, and platelets- 317,000/mL. Examination of the RBC morphology reveals
80% spherocytes. Which of the following would be most helpful in confirming the
,diagnosis?
A- Direct Coombs test
B- Osmotic fragility
C- G-6-PD level
D- Serum ferritin
B- Osmotic fragility
- Hereditary spherocytosis presents with a normocytic, normochromic anemia
and many spherocytes. Diagnosis is confirmed with a positive osmotic fragility
test.
D- Serum ferritin - Iron deficiency anemia typically presents with microcytic,
hypochromic red blood cells and is diagnosed with a serum ferritin.
G-6-PD deficiency presents with minimal or no RBC morphologic abnormalities and is
diagnosed by measuring G-6-PD enzyme activity level.
The direct Coombs test would be negative and would not be helpful in diagnosing
hereditary spherocytosis
A 60-year-old presents with fatigue and splenomegaly. CBC reveals the following:
WBC- 24,000/microliter, Hgb- 13.5 g/dl, Hct- 40%, MCV- 87 fL, MCHC- 34 g/dl,
MCH- 28 pg, and platelets- 380,000/mL. The differential reveals neutrophils- 11%,
lymphocytes- 80%, monocytes- 8%, and basophils- 1%. What is the most likely
diagnosis?
A Acute lymphocytic leukemia
B Acute myelogenous leukemia
, C Chronic lymphocytic leukemia
D Chronic myelogenous leukemia
C Chronic lymphocytic leukemia
- Chronic lymphocytic leukemia presents with a WBC count greater than
20,000/microliter and absolute lymphocyte count of greater than 5000/microliter.
Chronic myelogenous leukemia
- Chronic myelogenous leukemia presents with elevated WBC count, marked left shift in
the myeloid series of cells, and positive for Philadelphia chromosome.
Acute myelogenous leukemia
- Acute myelogenous leukemia presents with pancytopenia and presence of blasts in
the peripheral blood
Acute lymphocytic leukemia
- Acute lymphocytic leukemia is more common in children and presents with blasts in
the peripheral blood
A patient with multiple myeloma should be immunized against which of the
following organisms?
A Streptococcus pneumoniae
B Hepatitis C virus
C Listeria monocytogenes
D Epstein Barr virus
