ATI RN
ASCP Hematology Questions Questions
Question 1 of 5
A healthy 5-day-old male neonate develops bruising and melena. The pregnancy, and delivery course were unremarkable. The mother received heparin therapy for recurrent abortions secondary to lupus anticoagulants. The infant is vigorously breastfeeding. Examination reveals only multiple bruises. Lab tests reveals: hemoglobin, 8.4 g/dL; WBC, 8600/mm3; platelets count, 200000/mm3; PTT, 74 seconds; PT, 28 seconds; serum fibrinogen is normal. Of the following, the MOST likely cause of this bleeding is
Correct Answer: C
Rationale: Neonatal bruising, melena, and prolonged PT/PTT with normal platelets and fibrinogen suggest vitamin K deficiency (C), common in newborns without prophylaxis. DIC (A) lowers fibrinogen, hemophilia (B) is sex-linked, heparin (D) isn’t transferred via breast milk, and lupus anticoagulants (E) don’t cause bleeding.
Question 2 of 5
A 9-month-old boy appears pale. Examination reveals a palpable liver $3 \mathrm{~cm}$ below the right costal margin and palpable spleen $4 \mathrm{~cm}$ below the left costal margin. Lab findings include: hemoglobin concentration, 6.4 g/dl; mean corpuscular volume (MCV), 67 fL; and WBC, 15,000/mm3. Of the following, The MOST valuable test to confirm the diagnosis is
Correct Answer: C
Rationale: Microcytic anemia (MCV 67 fL), hepatosplenomegaly, and severe anemia at 9 months suggest thalassemia major. Hemoglobin electrophoresis (C) confirms elevated Hb F and absent Hb A, more specific than smear (A), iron studies (B), marrow (D), or US (E).
Question 3 of 5
Which of the following is not a feature of Wiskott-Aldrich Syndrome (WAS)
Correct Answer: D
Rationale: WAS includes thrombocytopenia (A), eczema (B), infections (C), and autoimmunity (D), but features small platelets, not giant (E), unlike Bernard-Soulier.
Question 4 of 5
Of the following, the LEAST likely feature of acute immune thrombocytopenia (ITP) is
Correct Answer: D
Rationale: Acute ITP features viral trigger (A), thrombocytopenia (B), bleeding (C), and marrow megakaryocytes (E). Isolated splenomegaly (D) is rare, suggesting other causes like hypersplenism.
Question 5 of 5
Inherited thrombocytopenias include all the following EXCEPT
Correct Answer: C
Rationale: CAT (A), TAR (B), Bernard-Soulier (D), and WAS (E) are thrombocytopenias. Glanzmann’s (C) is a qualitative defect with normal counts.