Hematology Part 1: Key Concepts

Which of the following is TRUE concerning sickle cell anemia?

a. It is a hereditary disease involving abnormal hemoglobin.
b. It is a hereditary disease involving lack of intrinsic factor.
c. It is an autoimmune disease in which the body destroys its own hemoglobin
d. It is an acquired disease in which the body cannot absorb iron.

Your patient is undergoing chemotherapy and s complaining of bleeding from the gums and blood in his stool. Which of the following will best address the patient's problem?

a. Stopping the chemotherapy
b. Administering platelets
c. Administering erythropoietin
d. Administering vitamin K

In an emergency situation if you administer blood to a patient whose blood type is unknown, you should administer type __________ blood.

a. O positive
b. O negative
c. AB positive
d. AB negative

Prehospital treatment for a hemophiliac patient who is bleeding is to:

a. Contact online medical control for factor VIII infusion
b. Provide aggressive IV therapy with isotonic crystalloids
c. Control bleeding with direct pressure
d. Administer IV colloid solutions.

Humoral and cell-mediated immunity differ in hat cell-mediated immunity uses:

a. B cells, which generate effector cells to combat such invaders as intracellular organisms, while cellular immunity uses T cells that reside in the lymph tissue and produce antibodies to combat foreign invaders.
b. T cells, which generate effector cells to combat such invaders as intracellular organisms, while cellular immunity uses B cells that reside in the lymph tissue and produce antibodies to combat foreign invaders.
c. B cells, which generate effector cells to combat such invaders as intracellular organisms, while humoral immunity uses T cells that reside in the lymph tissue and produce antibodies to combat foreign invaders.
d. T cells, which reside in lymph tissue and produce antibodies combat foregin invader, while humoral immunity uses B cells that generate effector cells to combat such invaders as intracelluar organisms.

Which of the following sitiuations would NOT result in Anemia?

a. Blood loss
b. Destruction of red blood cells
c. Increased produciton of erythropoetin
d. Irion deficiency

Which of the following situations would result in a right shift of the oxygen-hemoglobin dissociation curve?

a. Hypothermia
b. Hyperventilation
c. Sepsis
d. Increase in 2,3-BPG

Which of the following statements about sickle cell disease is FALSE?

a. Patients with chronic sickle cell disease have chronic hemolytic anemia
b. Sickled red blood cells have longer life spans that normal red blood cells.
c. Sickle hemoglobin has a flawed chemical structure that results in erythrocyte deformity when oxygen levels are low.
d. Splenomegaly is a common problem of sickle cell disease

A patient with hemophilia has suffered a large and deep laceration to the right forearm after cutting it on a mirror, which fell while he was hanging it. The wood is hemorrhaging a steady amount of dark red blood. Given the history of hemophilia, you immediate action on reaching the patient's side and putting on gloves would be to:


a. Request that the ED have Factor VIII standing by on your arrival.
b. Sarta nadn IV and administer 1 L NS bolus
c. Apply a tourniquet proximal to the wound.
d. Apply direct pressure with a bulky dressing.

You patient is an 18-year-old female suffering from sickle cell crisis. Which of the following is the best course of treatment for this patient?

a. High-flow oxygen, IV NS KVO, diphenhydramine
b. High flow-oxygen, IV bolus of NS
c. High flow-oxygen, IV bolus of NS, morphine sulfate
d. High flow-oxygen, IV NS KVO

For a patient with hemophilia B, which of the following statements is TRUE?

a. The patient's father had hemophilia B, and the mother was a carrier of the defective gene.
b. The patient's father had hemophilia B, and the mother was unaffected.
c. The patient's father was a carrier for the defective gene, and her mother did not carry the defective gene.
d. The patient's mother was a carrier for the defective gene, and her father did not carry the defective gene.

Your patient is a 26-year-old African-American male who is alert but in severe distress, complaining of pain in his hands and feet, as well as abdominal pain. The pain began the morning but has progressed from an initial rating of 5/10 to a 9/10 at the present time. The patient has a history of sickle cell anemia and denies any trauma. Physical examination reveals cool, diaphoretic skin; splenomegaly; and a priapism. HR =132, BP = 140/90, RR = 16. Select the most appropriate acute diagnosis and treatment for this patient.

a. Sickle cell occlusive crisis; administer oxygen by nonrebreather mask, isotonic crystalloids, and morphine
b. Sickle cell trait; administer oxygen according to pulse oximetry readings, and give a 500 mL bolus of isotonic crystalloid solution
c. Sickle cell occlusive crisis; administer oxygen by nonrebreather mask, isotonic crystalloids and aspirin.
d. Sickle cell disease; administer oxygen according to pulse oximetry readings, start an IV of normal saline and administer ketorolac of pain.

In the presence of calcium, thrombin will encourage:

a. Fibrin clot formation
b. Prothrombin activation
c. Platelet aggregation
d. Plasminogen release

When a patient receives a laceration, the clotting process that occurs is primarily mediated by the __________ pathway.

a. Platelet
b. Common
c. Extrinsic
d. Intrinsic

What is the underlying mechanism that causes pain in the patient with sickle cell crisis?

a. Hypoglycemia
b. Ischemia
c. Hyperthyroidism
d. Hypercapnia