A 10-month-old white male presents with a 1-day history of persistent bleeding after cutting his lip slightly. The family history is unremarkable, and the patient is receiving no medications. Laboratory data reveal a hemoglobin value of 11 g/dL, platelets of 350,000, a prothrombin time of 11.8 seconds, and a partial thromboplastin time (PTT) of 100 seconds, which is corrected by mixing of normal plasma. The most likely diagnosis is

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Question 1 of 5

A 10-month-old white male presents with a 1-day history of persistent bleeding after cutting his lip slightly. The family history is unremarkable, and the patient is receiving no medications. Laboratory data reveal a hemoglobin value of 11 g/dL, platelets of 350,000, a prothrombin time of 11.8 seconds, and a partial thromboplastin time (PTT) of 100 seconds, which is corrected by mixing of normal plasma. The most likely diagnosis is

Correct Answer: B

Rationale: Hemophilia A (B) causes prolonged PTT (factor VIII deficiency) corrected by mixing, with normal PT and platelets, fitting this bleeding profile.

Question 2 of 5

Matching: Hemolytic anemia - Thermal sensitivity

Correct Answer: C

Rationale: Hereditary pyropoikilocytosis (C) RBCs are thermally sensitive, fragmenting at high temperatures.

Question 3 of 5

Matching: Anemia - Orotic aciduria

Correct Answer: C

Rationale: Orotic aciduria (C) causes macrocytic anemia due to impaired pyrimidine synthesis.

Question 4 of 5

Matching: Red blood cell aplasia - X-linked recessive

Correct Answer: D

Rationale: Neither (D) is X-linked; Diamond-Blackfan is mostly autosomal, TEC is acquired.

Question 5 of 5

A blood smear taken from the patient described in Question 10 shows microcytic hypochromic anemia. Iron supplementation therapy is started. When will the reticulocyte response be at maximum?

Correct Answer: B

Rationale: Reticulocyte peak occurs 5-7 days (B) after iron therapy as erythropoiesis ramps up.

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