Medicine
Hematology
Which complication or major adverse outcome is particularly associated with Sickle cell vaso-occlusive crisis?
A. Potentially irreversible neurologic dysfunction
B. Severe symptomatic anemia
C. Acute chest syndrome
D. Intracranial hemorrhage
Correct Answer: C
Acute chest syndrome is a major cause of morbidity and mortality in sickle cell disease.
Medicine
Hematology
A patient is diagnosed with Sickle cell vaso-occlusive crisis. Which is the most appropriate management principle?
A. Replace iron and investigate and treat the cause of deficiency
B. Provide rapid analgesia, appropriate hydration and evaluate for complications such as infection or acute chest syndrome
C. Replace vitamin B12 and address the underlying cause
D. Treat the cause and use corticosteroid therapy for typical warm autoimmune hemolytic anemia
Correct Answer: B
Pain control and supportive care are central; overhydration should be avoided.
Medicine
Hematology
In a patient with suspected Sickle cell vaso-occlusive crisis, which investigation or diagnostic approach is most appropriate at this stage?
A. Clinical assessment plus targeted testing for serious triggers or complications
B. Serum or urine monoclonal-protein testing plus bone marrow evaluation and appropriate skeletal imaging
C. Serum ferritin and evaluation for the source of iron loss
D. Serum vitamin B12 with further testing for cause when needed
Correct Answer: A
Uncomplicated vaso-occlusive crisis is primarily clinical, but fever, chest symptoms or neurologic signs require focused investigation.
Medicine
Hematology
A patient has sickle cell disease with acute severe bone pain after dehydration but no focal neurologic deficit. What is the most likely diagnosis?
A. Acute leukemia
B. Multiple myeloma
C. Iron deficiency anemia
D. Sickle cell vaso-occlusive crisis
Correct Answer: D
Acute painful episodes from microvascular vaso-occlusion are common in sickle cell disease.
Medicine
Hematology
Which laboratory pattern best supports active hemolysis?
A. Low LDH with high haptoglobin
B. Isolated low ferritin
C. High LDH, high indirect bilirubin and low haptoglobin
D. Normal reticulocyte response in brisk hemolysis
Correct Answer: C
Hemolysis releases LDH and heme products while free hemoglobin consumes haptoglobin.
Medicine
Hematology
Which complication or major adverse outcome is particularly associated with Autoimmune hemolytic anemia?
A. Intracranial hemorrhage
B. Severe symptomatic anemia
C. Bleeding with simultaneous microvascular thrombosis
D. Tumor lysis syndrome
Correct Answer: B
Rapid red-cell destruction can cause profound anemia and tissue hypoxia.
Medicine
Hematology
A patient is diagnosed with Autoimmune hemolytic anemia. Which is the most appropriate management principle?
A. Treat the cause and use corticosteroid therapy for typical warm autoimmune hemolytic anemia
B. Provide rapid analgesia, appropriate hydration and evaluate for complications such as infection or acute chest syndrome
C. Observe selected low-risk patients or use corticosteroid or IVIG-based therapy when indicated by bleeding risk and platelet level
D. Treat the underlying trigger and provide component support for bleeding or procedures when indicated
Correct Answer: A
Warm autoimmune hemolytic anemia is commonly treated initially with glucocorticoids.
Medicine
Hematology
In a patient with suspected Autoimmune hemolytic anemia, which investigation or diagnostic approach is most appropriate at this stage?
A. Serum vitamin B12 with further testing for cause when needed
B. Clinical assessment plus targeted testing for serious triggers or complications
C. Peripheral blood smear and evaluation to exclude secondary causes
D. Direct antiglobulin (Coombs) test
Correct Answer: D
The direct antiglobulin test detects antibody or complement bound to red blood cells in immune hemolysis.
Medicine
Hematology
A patient has anemia, jaundice, reticulocytosis, elevated LDH and reduced haptoglobin. What is the most likely diagnosis?
A. Iron deficiency anemia
B. Vitamin B12 deficiency anemia
C. Autoimmune hemolytic anemia
D. Sickle cell vaso-occlusive crisis
Correct Answer: C
Laboratory evidence of increased red-cell destruction supports hemolytic anemia.
Medicine
Hematology
Which finding is more typical of vitamin B12 deficiency than isolated folate deficiency?
A. Macrocytosis
B. Neurologic deficits
C. Hypersegmented neutrophils
D. Glossitis
Correct Answer: B
Both deficiencies can cause megaloblastic anemia, but neurologic involvement is characteristic of B12 deficiency.
Medicine
Hematology
Which complication or major adverse outcome is particularly associated with Vitamin B12 deficiency anemia?
A. Potentially irreversible neurologic dysfunction
B. Tumor lysis syndrome
C. Pathologic fracture
D. Symptomatic reduced exercise tolerance and cardiac strain when severe
Correct Answer: A
Long-standing B12 deficiency can cause persistent neuropathy and posterior-column dysfunction.
Medicine
Hematology
A patient is diagnosed with Vitamin B12 deficiency anemia. Which is the most appropriate management principle?
A. Treat the underlying trigger and provide component support for bleeding or procedures when indicated
B. Urgent hematology referral for subtype-specific induction therapy and supportive care
C. Refer for specialist myeloma therapy and treat complications such as hypercalcemia, renal injury and bone disease
D. Replace vitamin B12 and address the underlying cause
Correct Answer: D
B12 replacement treats hematologic disease and may prevent progression of neurologic injury.
Medicine
Hematology
In a patient with suspected Vitamin B12 deficiency anemia, which investigation or diagnostic approach is most appropriate at this stage?
A. Peripheral blood smear and evaluation to exclude secondary causes
B. Platelets, PT/INR, aPTT, fibrinogen and D-dimer
C. Serum vitamin B12 with further testing for cause when needed
D. Peripheral smear followed by bone marrow examination with immunophenotyping
Correct Answer: C
B12 measurement supports diagnosis, and etiologic evaluation may identify pernicious anemia or malabsorption.
Medicine
Hematology
A patient has macrocytosis, glossitis, paresthesia and impaired vibration sense. What is the most likely diagnosis?
A. Sickle cell vaso-occlusive crisis
B. Vitamin B12 deficiency anemia
C. Immune thrombocytopenia (ITP)
D. Disseminated intravascular coagulation (DIC)
Correct Answer: B
Macrocytic anemia with neurologic abnormalities strongly suggests vitamin B12 deficiency.
Medicine
Hematology
Which laboratory value is typically reduced in uncomplicated iron deficiency anemia?
A. Ferritin
B. Vitamin B12
C. Troponin
D. D-dimer
Correct Answer: A
Low ferritin reflects depleted iron stores and is a key diagnostic feature of iron deficiency.
Medicine
Hematology
Which complication or major adverse outcome is particularly associated with Iron deficiency anemia?
A. Potentially irreversible neurologic dysfunction
B. Severe symptomatic anemia
C. Acute chest syndrome
D. Symptomatic reduced exercise tolerance and cardiac strain when severe
Correct Answer: D
Severe anemia reduces oxygen delivery and can precipitate cardiopulmonary symptoms.
Medicine
Hematology
A patient is diagnosed with Iron deficiency anemia. Which is the most appropriate management principle?
A. Refer for specialist myeloma therapy and treat complications such as hypercalcemia, renal injury and bone disease
B. Replace vitamin B12 and address the underlying cause
C. Replace iron and investigate and treat the cause of deficiency
D. Treat the cause and use corticosteroid therapy for typical warm autoimmune hemolytic anemia
Correct Answer: C
Iron replacement corrects the deficiency, but the source of chronic blood loss must be addressed.
Medicine
Hematology
In a patient with suspected Iron deficiency anemia, which investigation or diagnostic approach is most appropriate at this stage?
A. Peripheral smear followed by bone marrow examination with immunophenotyping
B. Serum ferritin and evaluation for the source of iron loss
C. Serum or urine monoclonal-protein testing plus bone marrow evaluation and appropriate skeletal imaging
D. Serum vitamin B12 with further testing for cause when needed
Correct Answer: B
Ferritin assesses iron stores, and adults require evaluation for the underlying cause such as gastrointestinal or menstrual blood loss.
Medicine
Hematology
A patient has fatigue and pica with microcytic hypochromic anemia and low ferritin. What is the most likely diagnosis?
A. Iron deficiency anemia
B. Disseminated intravascular coagulation (DIC)
C. Acute leukemia
D. Multiple myeloma
Correct Answer: A
Microcytosis with low ferritin is strongly supportive of iron deficiency.
Medicine
Geriatrics & Psychiatry
Which medication characteristic should particularly trigger a review in an older adult with recurrent falls?
A. Topical skin moisturizer use
B. Routine saline nasal spray
C. Occasional artificial tears
D. Sedating or blood-pressure-lowering effects
Correct Answer: D
Sedatives and medicines causing orthostatic hypotension are common modifiable contributors to falls.