Deck 15: Hematological and Immune System Disorders

Question 1

Mrs.G,a 70-year-old patient,presents to you with a hemoglobin of 9.4 and a decreased MCV/MCV.You diagnose her with IDA and start her on ferrous sulfate 325 mg PO tid.The next step in your work-up would be:

A) Send Mrs.G for a GI consult
B) Obtain hemoglobin one week after oral therapy
C) Schedule Mrs.G for an upper GI series
D) Obtain stool for occult blood

Answer 1

Obtain stool for occult blood

Question 2

Education of patient and family regarding ACD includes discussion of all of the following except:

A) Early prevention of chronic conditions through healthy lifestyle measures
B) Importance of adherence to the treatment plan for management of chronic conditions
C) Explaining the ACD is mainly attributed to the aging process
D) Importance of regular follow-up to monitor responses to treatments

Answer 2

Explaining the ACD is mainly attributed to the aging process

Question 3

Iron Deficiency Anemia (IDA)is classified as a microcytic,hypochromic anemia.This classification refers to which of the following laboratory data?

A) Hemoglobin and hematocrit
B) Mean Corpuscular Volume (MCV)and Mean Corpuscular Hemoglobin (MCH)
C) Serum ferritin and serum iron
D) Total iron binding capacity and transferrin saturation

Answer 3

Mean Corpuscular Volume (MCV)and Mean Corpuscular Hemoglobin (MCH)

Question 4

When interpreting laboratory data,you would expect to see the following in a patient with Anemia of Chronic Disease (ACD):

A) Hemoglobin <12 g/dl,Mean Corpuscular Volume (MCV)decreased,Mean Corpuscular Hemoglobin (MCH)decreased
B) Hemoglobin >12 g/dl,Mean Corpuscular Volume (MCV)increased,Mean Corpuscular Hemoglobin (MCH)increased
C) Hemoglobin <12 g/dl,Mean Corpuscular Volume (MCV)normal,Mean Corpuscular Hemoglobin (MCH)normal
D) Hemoglobin >12 g/dl,Mean Corpuscular Volume (MCV)decreased,Mean Corpuscular Hemoglobin (MCH)increased

Question 5

The main focus of treatment of patients with ACD is:

A) Replenishing iron stores
B) Providing for adequate nutrition high in iron
C) Management of the underlying disorder
D) Administration of monthly vitamin B₁₂ injections

Question 6

You are prescribing oral iron therapy for a patient with IDA.In teaching your patient about iron therapy,all of the following instructions should be reviewed except:

A) Iron is best taken on an empty stomach one hour before meals
B) Meat,fish,poultry,beans,and green leafy vegetables are good dietary sources of iron
C) Adding vitamin D daily enhances absorption of iron
D) Common GI side effects of iron therapy include constipation,nausea,and black stools

Question 7

Symptoms in the initial HIV infection include all of the following except:

A) Sore throat
B) Fever
C) Weight loss
D) Headache

Question 8

Immune system changes that render older adults more susceptible to contracting HIV include all of the following except:

A) Hyper-responsive T cells
B) Age-related thymic involution
C) Depletion of naïve CD4 cells
D) Decline in B cell function

Question 9

The primary mode of HIV transmission in the U.S.is:

A) Blood transfusion
B) Men having sex with men
C) Heterosexual contact
D) Needle sharing

Question 10

Despite adherence to oral iron therapy of 2 weeks,your elderly patient with IDA demonstrates a drop in his hemoglobin from 8.4 to 7.4.He is complaining of fatigue,dyspnea,and heart racing.You would change his therapy by which of the following:

A) Schedule patient for outpatient parenteral iron infusion
B) Switch to a different form of oral therapy
C) Schedule patient for outpatient blood transfusion
D) Make no changes until evaluated by GI specialist

Question 11

In the older adult,which group comprises the highest rate of HIV/AIDS?

A) African American women
B) African American men
C) Hispanic women
D) Hispanic men

Question 12

Initial therapy for patients with IDA is:

A) Blood transfusion
B) Increasing dietary intake of green leafy vegetables
C) Ferrous sulfate 325 mg orally bid-tid
D) Parenteral administration of Venofer

Question 13

Contributing factors in HIV development in the older adult include all of the following except:

A) Older adults are less likely to be tested
B) Healthcare providers do not routinely ask older adults about HIV risks
C) Older adults are less likely to use condoms
D) Older adults are at low risk to contract HIV

Question 14

In addition to the CBC with differential,which of the following laboratory tests is considered to be most useful in diagnosing ACD and IDA?

A) Serum iron
B) Total iron binding capacity
C) Transferrin saturation
D) Serum ferritin

Question 15

The pathophysiological hallmark of ACD is:

A) Depleted iron stores
B) Impaired ability to use iron stores
C) Chronic uncorrectable bleeding
D) Reduced intestinal absorption of iron