Clinical management scenarios for anemia workup, cancer screening decisions, and oncologic emergency recognition tested on USMLE Step 2 CK.
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- What is the first laboratory test used to classify the etiology of anemia?
- Mean corpuscular volume (MCV)
- Microcytic anemia is defined as an MCV less than ____ fL.
- 80
- Macrocytic anemia is defined as an MCV greater than ____ fL.
- 100
- What is the most common cause of microcytic anemia worldwide?
- Iron deficiency anemia
- In iron deficiency anemia, is serum ferritin typically low or high?
- Low
- In iron deficiency anemia, is total iron-binding capacity (TIBC) typically low or high?
- High
- In anemia of chronic disease, is serum ferritin typically low, normal, or high?
- Normal or high
- In anemia of chronic disease, is TIBC typically low or high?
- Low
- Vitamin B12 deficiency classically causes which neurologic syndrome?
- Subacute combined degeneration (loss of vibration and proprioception, spasticity)
- Does folate deficiency cause the same neurologic symptoms as B12 deficiency?
- No, folate deficiency does not cause neurologic symptoms
- Autoimmune destruction of gastric parietal cells causing B12 deficiency is called what?
- Pernicious anemia
- Which lab value distinguishes a hypoproliferative anemia from one caused by hemolysis or acute blood loss?
- Reticulocyte count (reticulocyte index)
- In hemolytic anemia, is serum haptoglobin typically low or high?
- Low
- What does a positive direct Coombs (direct antiglobulin) test detect?
- Antibodies bound to the patient's own red blood cells, indicating autoimmune hemolytic anemia
- Fragmented red blood cells seen in TTP, HUS, and DIC are called what on peripheral smear?
- Schistocytes