Ten years ago, a previously healthy 20-year-old woman presented to her physician with a 2-month history of pruritis, drenching night sweats, unintentional weight loss, and nonproductive cough. On examination, she had 2-cm cervical lymphadenopathy. A computed tomographic scan showed a 12-cm-diameter anterior mediastinal mass. An excisional biopsy of a cervical lymph node showed nodular sclerosing Hodgkin lymphoma. After she was treated with ABVD (doxorubicin [Adriamycin], bleomycin, vinblastine, and dacarbazine) combination chemotherapy followed by involved field radiotherapy, the disease was in complete remission. Now you see her for the first time for an annual physical examination. The disease remains in complete remission. Compared to her peers, this patient is at increased risk of which of the following conditions?

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Hematology Final Exam Questions Pdf Questions

Question 1 of 5

Ten years ago, a previously healthy 20-year-old woman presented to her physician with a 2-month history of pruritis, drenching night sweats, unintentional weight loss, and nonproductive cough. On examination, she had 2-cm cervical lymphadenopathy. A computed tomographic scan showed a 12-cm-diameter anterior mediastinal mass. An excisional biopsy of a cervical lymph node showed nodular sclerosing Hodgkin lymphoma. After she was treated with ABVD (doxorubicin [Adriamycin], bleomycin, vinblastine, and dacarbazine) combination chemotherapy followed by involved field radiotherapy, the disease was in complete remission. Now you see her for the first time for an annual physical examination. The disease remains in complete remission. Compared to her peers, this patient is at increased risk of which of the following conditions?

Correct Answer: D

Rationale: Hodgkin lymphoma survivors post-ABVD and radiotherapy have elevated risks of breast cancer (chest radiation), coronary artery disease (radiation/cardiotoxic drugs), hypothyroidism (neck radiation), and skin cancer (radiation), making E correct.

Question 2 of 5

Ten years later, the patient described in Questions 3 and 4 experiences recurrent hemarthroses that become refractory to standard doses of factor VIII. The most likely cause of this is

Correct Answer: B

Rationale: Factor VIII inhibitors (B) are a common complication in hemophilia A, causing resistance to replacement therapy and recurrent bleeds.

Question 3 of 5

Matching: Hemolytic anemia - Spectrin deficiency

Correct Answer: A

Rationale: Spectrin deficiency is a hallmark of hereditary spherocytosis (A), leading to membrane instability.

Question 4 of 5

Matching: Anemia - Aplastic anemia

Correct Answer: B

Rationale: Aplastic anemia (B) is normocytic due to marrow failure without RBC size alteration.

Question 5 of 5

Matching: Anemia - Hypothyroidism

Correct Answer: B

Rationale: Hypothyroidism (B) typically causes normocytic anemia due to reduced erythropoiesis.

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