Test
HAEMATOLOGY_2008
Preguntas del test (8)
1An 81-year-old female has atrial fibrillation and osteoarthritis, treated with warfarin, digoxin and paracetamol. She recently complained of depressive symptoms and was commenced on the selective serotonin reuptake inhibitor, fluoxetine. Two weeks later she is brought to casualty with an extradural haematoma and her international normalised ratio (INR) is 6.9.
The most likely mechanism by which fluoxetine contributed to the haemorrhage is by its effect on:- AA. cytochrome P-450.
- BB. glucuronidation.
- CC. platelets.
- DD. vitamin K.
- EE. compliance.
2A previously healthy 67-year-old man presents with spontaneous muscle bleeds. Coagulation tests reveal the following:
Activated partial thromboplastin time (APTT) 81 sec [26 - 38 sec]
APTT correction (immediate mix) 37 sec [26 - 38 sec]
APTT correction (2 hour incubation) 76 sec [26 - 38 sec]
Thrombin Clotting Time 12 sec [10 - 12 sec]
Fibrinogen 3.2 g/L [2.0 - 4.0 g/L]
Which of the following best accounts for the coagulation test results?- AA. Haemophilia A.
- BB. Von Willebrand disease.
- CC. Acquired factor VIII inhibitor.
- DD. Lupus anticoagulant.
- EE. Disseminated intravascular coagulation.
3A 30-year-old female presents with a painful swollen left calf. Duplex study demonstrates a proximal deep vein thrombus extending into the ileofemoral venous system. The following laboratory results are obtained:
Prothrombin time (PT) 16 sec [11 – 18 sec]
Activated partial thromboplastin time (APTT) 43 sec [25 – 36 sec]
Dilute Russell Viper venom test Lupus anticoagulant detected
Anticardiolipin IgG negative
Anticardiolipin IgM negative
Anti-beta 2 glycoprotein 1 moderate positive
Treatment with anticoagulation with heparin followed by warfarin therapy is commenced. Repeat testing at 12-weeks confirms a positive anti-beta 2 glycoprotein 1. What is the most appropriate duration of anticoagulation?- AA. 3 months.
- BB. 6 months.
- CC. 12 months.
- DD. 24 months.
- EE. Lifelong
4A 37-year-old male is found to have some persistently enlarged lymph nodes (<2 cm diameter) in the left posterior triangle. A biopsy reveals follicular, Grade 1, B-cell non-Hodgkin lymphoma. Staging procedures including computed tomography (CT) scan, positron emission tomography (PET) scan and bone marrow biopsy confirm the disease is confined to a single lymph node region in the neck.
Which of the following management strategies is most appropriate?- AA. Watch and wait.
- BB. Oral chlorambucil.
- CC. Radiotherapy.
- DD. Multiagent chemotherapy.
- EE. Combined modality therapy.
5A 29-year-old woman is referred for evaluation after she was found to be heterozygous for
factor V Leiden mutation on screening. This screening was initiated when her great aunt sustained a calf vein thrombosis following hip arthroplasty. She is currently 16-weeks pregnant and has no personal history of venous thromboembolic disease.
Which of the following should be recommended for the remainder of her pregnancy?- AA. Low molecular weight heparin.
- BB. Aspirin.
- CC. No thromboprophylaxis.
- DD. Surveillance ultrasonography of the lower limbs.
- EE. Warfarin.
6A 67-year-old diabetic man with atrial fibrillation is taking warfarin for primary prophylaxis and is scheduled for inguinal hernia repair. His echocardiogram shows no structural abnormality. His international normalised ratio (INR) is 2.9. Which of the following preoperative anticoagulant management strategies is most appropriate?
- AA. Withhold warfarin therapy for four days before surgery and administer low-molecular-weight heparin (LMWH) for these four days, ceasing 24 hours prior to surgery.
- BB. Withhold warfarin therapy four days before surgery and administer vitamin K1 on the evening prior to surgery if his INR> 1.5.
C. Withhold warfarin for two days prior to surgery.
D. Continue warfarin up until the time of surgery then administer prothrombin complex concentrate on the day of surgery.
E. Withhold warfarin therapy for four days before surgery. Commence intravenous infusion of
unfractionated heparin two days prior to surgery, ceasing four hours prior to surgery.
B. Withhold warfarin therapy four days before surgery and administer vitamin K1 on the evening prior to surgery if his INR> 1.5. - CC. Withhold warfarin for two days prior to surgery.
- DD. Continue warfarin up until the time of surgery then administer prothrombin complex concentrate on the day of surgery.
- EE. Withhold warfarin therapy for four days before surgery. Commence intravenous infusion of
unfractionated heparin two days prior to surgery, ceasing four hours prior to surgery.
7A 46-year-old man with hypertension and previous end stage renal failure due to glomerulonephritis, received a kidney transplant 15 years ago. His creatinine has been stable at 110-130 μmol/L [60 - 120 μmol/L] for the last five years. During this time his immunosuppression has been unchanged and consists of azathioprine 100 mg daily and prednisolone 5 mg daily. His general practitioner is concerned about his reported mean corpuscular volume (MCV) of 106 fL
[80 – 96 fL]. Which of the following is the most likely cause?- AA. Folate deficiency.
- BB. Azathioprine.
- CC. Myelodysplasia.
- DD. Haemolysis.
- EE. Hypothyroidism.
8A 57-year-old man has known chronic kidney disease due to mesangio-capillary glomerulonephritis. He presents now, relatively asymptomatic but with the following parameters:
His anaemia is most likely due to:
- AA. worsening of his renal function.
- BB. haemolysis associated with his glomerulonephritis.
- CC. haematuria associated with his glomerulonephritis.
- DD. gastro-intestinal bleeding.
- EE. folate deficiency.
Información
- Descripción
- RACP Haematology Test sobre HAEMATOLOGY_2008, creado por Jeku Jacob el 11/01/2017.
- Autor
- Jeku Jacob
- Idioma
- English
- Visitas
- 4
- Etiquetas
- Valoración
- Aún sin valoraciones Valora este test