AGNP BOARD EXAM: Hematology Prescription (17 Questions with Answers and Explanations)
AGNP BOARD EXAM: Hematology Prescription (17 Questions with Answers
... [Show More] and Explanations)
Question:
Folic acid (vitamin B9) is used to treat:
microcytic anemia.
anemia of chronic disease.
macrocytic anemia. Correct
normochromic anemia.
Explanation:
Folic acid (vitamin B9) is used to treat macrocytic anemia secondary to folic acid deficiency. Folic acid is necessary for purine and pyrimidine synthesis, and is required for nucleoprotein synthesis and maintenance in erythropoiesis. It stimulates WBC and platelet production in folate deficiency anemia.
Question:
When taking corticosteroids for the treatment of immune thrombocytopenia, stopping them abruptly could result in:
hypertension.
hyperkalemia.
Cushing's syndrome.
an adrenal crisis. Correct
Explanation:
Corticosteroids should not be stopped suddenly after prolonged use. This can result in adrenal crisis because of the body's inability to secrete enough cortisol to make up for the withdrawal. Nausea, vomiting, and shock are the reported side effects of adrenal crisis. Cushing's syndrome is just the opposite. It results from excessive amounts of cortisol.
Question:
The most common side effect of ferrous sulfate is:
headache.
dizziness.
fatigue.
constipation. Correct
Explanation:
The most common side effect of ferrous sulfate is constipation. Headache, dizziness and fatigue may be signs and symptoms of anemia.
Question:
Another name for vitamin B12 is:
biotin.
cyanocobalamin. Correct
riboflavin.
thiamin.
Explanation:
Another name for vitamin B12 is cyanocobalamin. Biotin is vitamin B7; riboflavin is vitamin B2; and thiamin is vitamin B1.
Question:
Folic acid (vitamin B9) is:
beneficial in the treatment of pernicious anemia.
administered only in conjunction with vitamin B12.
may correct neurologic manifestations of anemia.
a water-soluble vitamin. Correct
Explanation:
Folic acid (vitamin B9) is a water-soluble vitamin and is excreted when stores are adequate. It can be administered orally, intramuscularly, intravenously, or subcutaneously. Doses of folic acid above 0.1 mg daily may obscure pernicious anemia. This condition is discovered when hematologic remission occurs as neurologic manifestations remain progressive. Administration of folic acid alone is improper therapy for pernicious anemia and other megaloblastic anemias in which vitamin B12 is deficient.
Question:
After correcting a decreased hemoglobin in a patient who has iron deficiency anemia, oral iron supplementation should be continued for at least:
2 weeks.
4 weeks.
8 weeks.
12 weeks. Correct
Explanation:
To replete iron stores, treat for 3 to 6 months after hemoglobin has normalized. Initial treatment of iron deficiency anemia is usually with oral iron (ferrous sulfate, ferrous gluconate, or ferrous fumarate). The reticulocyte count should peak at 1 to 2 weeks, hemoglobin after 2 to 4 months, and replacement of iron stores after 6 months.
Question:
Folic acid is also known as:
vitamin B1.
vitamin B6.
vitamin B9. Correct
vitamin B12.
Explanation:
Folic acid is also known as vitamin B9. Vitamin B12 is also known as cyanocobalamin; vitamin B1 is thiamin; and vitamin B6 is pyridoxine.
Question:
Which one of the following actions is LEAST likely to improve GI symptoms in a patient who is taking iron by mouth?
Switching to a lower elemental iron-containing pill
Taking the iron supplementation in a liquid form
Taking iron supplementation just before bed Correct
Taking iron supplementation with food
Explanation:
Taking an iron supplement with food will decrease absorption of the iron taken by mouth. Up to 10% of patients may have gastrointestinal intolerance when taking iron supplementation for iron deficiency anemia. Gastrointestinal symptoms may be minimized by switching to a formulation with lower elemental iron content per pill, taking a liquid formulation, or taking pills with food.
Question:
Iron-containing medications should:
be stored in a dark area.
be properly secured from children. Correct
be taken with food.
be avoided in pregnancy.
Explanation:
The Consumer Product Safety Commission requires that iron-containing medicines and vitamins be packaged in child-resistant containers. Parents should always properly resecure safety closures. Taking an iron supplementation with food will decrease the absorption of the iron and greatly diminish its benefit for the treatment of iron deficiency anemia.
Question:
The administration of iron is the primary treatment for iron deficiency anemia (IDA). IDA is a:
microcytic anemia. Correct
anemia of chronic disease.
macrocytic anemia.
G6PD deficiency.
Explanation:
The administration of iron is indicated in the treatment of iron deficiency anemia evidenced by microcytic, hypochromic red blood cells. The primary treatment for anemia of chronic disease (ACD) is treatment of the underlying disorder. Iron may be administered in ACD as a supplemental therapy. Examples of macrocytic anemia are folate deficiency and vitamin B12 deficiency. G6PD is a hemolytic anemia that is typically normochromic and normocytic. If a patient develops G6PD and becomes symptomatic, treatment may include folic acid as a supportive therapy.
Question:
Patients taking corticosteroids long-term for the treatment of immune thrombocytopenia should be instructed to:
consume their normal diet.
limit sodium intake. Correct
limit potassium.
decrease protein intake.
Explanation:
Patients placed on long-term corticosteroid therapy should be instructed to limit their sodium intake to avoid retention of excessive fluid. They should increase their potassium and protein intake since potassium tends to be excreted and protein is needed to maintain healing.
Question:
Which food should be avoided when taking corticosteroids for the treatment of lymphoma?
Orange juice.
Grapefruit juice. Correct
Bananas.
Apples.
Explanation:
Grapefruit and grapefruit juice inhibit the action of CYP3A4 enzymes, which are necessary to metabolize prednisone. Without the action of these enzymes, prednisone levels increase. If grapefruit or grapefruit juice is ingested, the side effects of prednisone will be more pronounced.
Question:
Patients taking supplemental iron should be advised to take tetracycline antibiotics at least:
30 minutes before or after the iron.
1 hour before or after the iron.
2 hours before or after the iron. Correct
6 hours before or after the iron.
Explanation:
An oral tetracycline should be administered at least 2 hours before or after taking iron supplementation. The combination of oral iron tends to interfere with the absorption of tetracycline. Tetracyclines include demeclocycline, doxycycline (Vibramycin) and minocycline (Minocin).
Question:
The common side effect of corticosteroids that is LEAST likely to require medical attention is:
jitteriness Correct
fever.
purpura.
weight gain.
Explanation:
Corticosteroids are associated with a greater risk of infection, and fever should be monitored and reported. Weight gain may indicate the development of Cushing syndrome. Glucocorticoid-associated purpura often affects the sun-exposed areas of the dorsum and forearm and should be reported to the prescriber. A common side effect of corticosteroids that usually does NOT warrant medical attention is jitteriness. The other answer choices would require medical attention, especially if steroids have been used for a prolonged period.
Question:
Cyanocobalamin (vitamin B12) is primarily stored in the:
fat tissue.
gastrointestinal tissue.
liver. Correct
subcutaneous tissue.
Explanation:
Absorbed cyanocobalamin (vitamin B12) is transported via specific B12 binding proteins, transcobalamin I and II, to the various tissues. The liver is the main organ for vitamin B12 storage.
Question:
Cyanocobalamin (vitamin B12) is best absorbed via the:
intranasal route.
intramuscular route. Correct
oral route.
sublingual route.
Explanation:
Cyanocobalamin (vitamin B12) is best absorbed via intramuscular or subcutaneous routes. Cyanocobalamin is quantitatively and rapidly absorbed from intramuscular and subcutaneous sites of injection; the plasma level of the compound reaches its peak within 1 hour after intramuscular injection.
Question:
Neurologic manifestations related to vitamin deficiency must be corrected with:
biotin (vitamin B7).
cyanocobalamin (vitamin B12). Correct
riboflavin (vitamin B2)
thiamin (vitamin B1).
Explanation:
Neurologic manifestations of vitamin deficiency should be corrected with cyanocobalamin (vitamin B12). Vitamin B12 deficiency that is allowed to progress for longer than 3 months may produce permanent degenerative lesions of the spinal cord. Doses of folic acid greater than 0.1 mg/day may result in hematologic remission in patients with vitamin B12 deficiency. However, neurologic manifestations will not be prevented with folic acid, and if not treated with vitamin B 12, irreversible damage will result. [Show Less]