ONCOLOGY/HEMATOLOGY PANCE EXAM QUESTIONS
AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
Reversal Agent Anticoagulants
Warfarin - Vitamin K, fresh frozen plasma (FFP), prothrombin complex concentrate
(PCC), or recombinant factor VIIa
Heparin - Protamine Sulfate
Dabigatran - Idraucizumab
Apixaban - Andexanet
Anemia Acute Sxs
Palpitations, Angina, Orthostatic hypotension
Chronic Anemia Sxs
Fatigue, headache, orthopnea, pallor
Hemoglobin
Protein contained in RBC responsible for delivery O2 to tissues
Hematocrit
Percentage of blood volume occupied by RBCs
MCV
Size of the RBC
,Microcytic Anemia (<80)
Thalassemia
Iron Deficiency
Chronic Disease
Sideroblastic
TICS are Small (Pneumonic)
Normocytic Aneima (80-100)
Chronic Disease
Sickle Cell
G6PD Deficiency
Hereditary Spherocytosis
Macrocytic anemia (>100)
Folate
B12 Deficiency
Fe Deficiency
MCC of ANEMIA!!!
Fe Deficiency Etiology
Blood loss
Decreased absorption of Fe
ELDERLY MALES WITH BLOOD LOSS GET COLONOSCOPY THINK COLON
CANCER!!!
,Fe Deficiency Patho
Decreased Fe leads to decrease RBC production
Fe Deficiency Labs
Microcytic
Hypochromic
Inc RBW
Ferritin DECREASED!! (Low storage of Fe)
Transferrin INCREASED! (Bind/moves Fe (high when Fe is low))
Fe Deficiency Tx
Iron (PO) - Ferrous Sulfate
- Can cause potential GI side effects
RECHECK IRON IN 3-4 WEEKS
Continue therapy for 3-6 months
Iron (IV) - Venofer
- Use in IBD, CKD, Chemo patients
TAKE IRON WITH ORANGE JUICE!!!!
Fe Deficiency Clinical Manifestations
Koilonychia, Pica, Glossitis
Plummer-vinson syndrome
, - Cheilosis
- Dysphagia secondary to esophageal wens
Sideroblastic anemia
inherited and acquired disorder due to abnormalities in heme synthesis and
mitochondrial function!
LEAD IS A COMMON CAUSE!!! TREAT WITH EDTA!!!!
- LOOK FOR LEAD LINE!!!
Sideroblastic anemia Patho
Defect in porphyrin pathway leads to abnormal heme production and accumulation of
Fe in the mitochondria
Sideroblastic anemia Labs
Microcytic
Fe INCREASED
Ferritin INCREASED
Tranferrin DECREASED
BASOPHILIC STIPPLING (Seen on SMEAR)
Thalassemia
Abnormality in globin production
Thalassemia Patho
The normal ratio of alpha globin to beta globin production is altered due to a problem in
the globin genes
AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
Reversal Agent Anticoagulants
Warfarin - Vitamin K, fresh frozen plasma (FFP), prothrombin complex concentrate
(PCC), or recombinant factor VIIa
Heparin - Protamine Sulfate
Dabigatran - Idraucizumab
Apixaban - Andexanet
Anemia Acute Sxs
Palpitations, Angina, Orthostatic hypotension
Chronic Anemia Sxs
Fatigue, headache, orthopnea, pallor
Hemoglobin
Protein contained in RBC responsible for delivery O2 to tissues
Hematocrit
Percentage of blood volume occupied by RBCs
MCV
Size of the RBC
,Microcytic Anemia (<80)
Thalassemia
Iron Deficiency
Chronic Disease
Sideroblastic
TICS are Small (Pneumonic)
Normocytic Aneima (80-100)
Chronic Disease
Sickle Cell
G6PD Deficiency
Hereditary Spherocytosis
Macrocytic anemia (>100)
Folate
B12 Deficiency
Fe Deficiency
MCC of ANEMIA!!!
Fe Deficiency Etiology
Blood loss
Decreased absorption of Fe
ELDERLY MALES WITH BLOOD LOSS GET COLONOSCOPY THINK COLON
CANCER!!!
,Fe Deficiency Patho
Decreased Fe leads to decrease RBC production
Fe Deficiency Labs
Microcytic
Hypochromic
Inc RBW
Ferritin DECREASED!! (Low storage of Fe)
Transferrin INCREASED! (Bind/moves Fe (high when Fe is low))
Fe Deficiency Tx
Iron (PO) - Ferrous Sulfate
- Can cause potential GI side effects
RECHECK IRON IN 3-4 WEEKS
Continue therapy for 3-6 months
Iron (IV) - Venofer
- Use in IBD, CKD, Chemo patients
TAKE IRON WITH ORANGE JUICE!!!!
Fe Deficiency Clinical Manifestations
Koilonychia, Pica, Glossitis
Plummer-vinson syndrome
, - Cheilosis
- Dysphagia secondary to esophageal wens
Sideroblastic anemia
inherited and acquired disorder due to abnormalities in heme synthesis and
mitochondrial function!
LEAD IS A COMMON CAUSE!!! TREAT WITH EDTA!!!!
- LOOK FOR LEAD LINE!!!
Sideroblastic anemia Patho
Defect in porphyrin pathway leads to abnormal heme production and accumulation of
Fe in the mitochondria
Sideroblastic anemia Labs
Microcytic
Fe INCREASED
Ferritin INCREASED
Tranferrin DECREASED
BASOPHILIC STIPPLING (Seen on SMEAR)
Thalassemia
Abnormality in globin production
Thalassemia Patho
The normal ratio of alpha globin to beta globin production is altered due to a problem in
the globin genes
