Answer 40

40.  Choice D is the correct answer.  Multiple myeloma presents with lytic lesions that causes hyperglycemia.  The patients also have proteinuria and renal sequelae as a result.  Typically osteoporosis and osteopenia would not cause weight loss, renal failure, and proteinuria.  Hyperparathyroidism  doses not cause multiple unexplained back fractures and proteinuria.

Question 40

40.   Your patient is a 56 year old that presents with low back pain, a calcium of elevated at 13, weight loss, a high creatinine, protein in the urine, and multiple unexplained back fractures.  Which of the following is the most likely diagnosis?

A.  Osteoporosis
B.  Osteopenia
C.  Hyperparathyroidism
D.  Multiple myeloma

Answer 39

39.  Choice B is the correct answer.  Iron levels are usually high because of the high rate of turnover of the RBC.  Thalassemias present as microcytic hypochromic anemias.  Transferrin and TIBC are elevated.  Increased levels of LDH and bilirubin, and lower levels of haptoglobin are seen.

Question 39

39.  All of the following are laboratory findings with Thalassemias except:

A.  Microcytic hypochromic anemia

B.  Iron levels are low

C.  Tranferrin and TIBC are elevated

D.  Increased bilirubin, LDH and lower levels of haptoglobin are seen

Answer 38

38.  Choice B is the correct answer.  Patients with sickle cell are susceptible to strep pneumonia, H.Influenza type B, N. Meningitis, and osteomyelitis

Question 38

38.  All of the following are potentially life threatening infections in children with sickle cell disease except:

A.  Strep Pneumonia
B.  Herpes Zoster
C.  H. Influenza Type B
D.  N. Meningitis

Answer 37

37.  Choice D is the correct answer.  Hypertension, tachypnea, fever, swelling, tenderness, and vomiting may be seen in half of the patients with vasooclusive crisis is sickle cell disease.

Question 37

37.  All of the following are objective findings that may be found in over half of the patients with vasooclusive crisis except:

A.  Hypertension
B.  Tachypnea
C.  Fever
D.  Low oxygen saturation

Answer 36

36.  Choice A is the correct answer.  Patients with a HgB less than 7 should be transfused and is not an indication for IV iron in and of itself.  The patients listed in choices C and D are poor candidates for oral iron therapy mostly secondary to absorption issues as well as lack of respond to EPO with chronic kidney disease.

Question 36

36.  Your patient is a 43 year old male that presents with a microcytic hypochromic anemia.  Your working diagnosis is iron deficiency anemia.  Which of the following is true regarding to the response to treatment with oral iron supplements?

A.  A positive response to treatment should see a RBC increase after 5-7 days and should increase at a rate of 2-4 gram/dL every 3-4 weeks until a normal hemoglobin is achieved
B.  Patients with a lower hemoglobin under 6 should be started on IV treatments of iron
C.  Patients sprue, atrophic gastritis, gastrectomy, or gastric bypass will likely have a favorable response to oral iron therapy
D.  Patients with cancer, chronic kidney disease, and inflammatory bowel disease usually respond well to oral iron therapy