Chapter 27: Hematologic Disorders and Oncologic Emergencies

Chapter 27: Hematologic Disorders and Oncologic Emergencies

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The intrinsic coagulation pathway is activated when

ANS:  B

The extrinsic pathway begins when vascular injury causes the release of tissue factor. The intrinsic pathway begins when damaged endothelium comes into contact with circulating blood. The two pathways converge when fibrinogen and prothrombin are converted to their active forms and a clot is established.

2. The most common cause of disseminated intravascular coagulation (DIC) is

ANS:  B

Although all of these answers can cause DIC, sepsis, particularly that caused by gram-negative organisms, can be identified as the culprit in as many as 20% of cases, making it the most common cause of DIC.

3. A patient was admitted to the critical care unit with gram-negative sepsis 5 days ago. Today there is continual oozing from his intravenous sites, and ecchymosis of the skin is noted beneath his automatic blood pressure cuff. On his laboratory work, his platelets are normal, and his international normalized ratio is elevated. What other laboratory value would be most valuable in definitively diagnosing the patient’s condition?

ANS:  B

D-Dimers are exclusively indicative of clot degradation and assist in determining the degree of coagulopathy.

4. A patient was admitted to the critical care unit with gram-negative sepsis 5 days ago. Today there is continual oozing from his intravenous sites, and ecchymosis of the skin is noted beneath his automatic blood pressure cuff. On his laboratory work, his platelets are normal, and his international normalized ratio is elevated. The primary treatment goal for this patient is to

ANS:  A

The primary intervention in disseminated intravascular coagulation (DIC) is prevention. Being aware of the conditions that commonly contribute to the development of DIC and treating them vigorously and without delay provide the best defense against this devastating condition. After DIC is identified, maintaining organ perfusion and slowing consumption of coagulation factors are paramount to achieving a favorable outcome.

5. Sickle cell anemia is not prevalent in persons of which descent?

ANS:  D

This genetic trait is primarily found in people of West African descent. The disease has also been linked to persons of sole European or Middle Eastern ancestry; however, this is extremely rare. The disease is not prevalent in persons of Asian or Pacific Islander descent.