Question 1

Causes of the inflammatory process include all of the following EXCEPT:

Accepted Answer

Psychosocial factors do not directly cause the inflammatory process. However, they can indirectly affect the immune response and inflammation through stress and other psychological factors.

Question 2

You suspect that your patient is having a transfusion reaction. The patient's care plan should include:

Accepted Answer

In a suspected transfusion reaction, the patient should receive dopamine, diphenhydramine, and an IV fluid bolus to manage symptoms such as fever, chills, hypotension, and dyspnea. Dobutamine and albuterol are not typically used in the management of transfusion reactions. IV fluids alone may not be enough to manage symptoms, and diphenhydramine alone may not be sufficient for severe reactions.

Question 3

A patient complains of atraumatic bleeding of the gums. You suspect:

Accepted Answer

Bleeding of the gums without trauma could be a sign of a hematologic disorder, such as a deficiency in platelets or a clotting factor. Halitosis is bad breath, dentalgia is tooth pain, and gingivitis is inflammation of the gums that can cause bleeding, but it is usually caused by poor oral hygiene rather than a hematologic disorder.

Question 4

Hemophilia A is an example of a ________ disorder.

Accepted Answer

Hemophilia A is a genetically acquired disorder caused by a mutation in the F8 gene on the X chromosome.

Question 5

Fibrinolytics are effective against:

Accepted Answer

Fibrinolytics are enzymes that dissolve clots by specifically breaking down fibrin, which is a protein found in blood clots. Therefore, they are particularly effective against clots that contain fibrin. They can be used in the treatment of various conditions such as deep vein thrombosis, pulmonary embolism, and ischemic stroke. However, they are not effective against all types of clots, such as those caused by platelet aggregation.

Question 6

What ethnicity is most likely to suffer from sickle cell disease?

Accepted Answer

Sickle cell disease is more common in individuals of African descent. It is estimated that about 1 in 13 African Americans carry the sickle cell trait, and 1 in 365 African American births result in sickle cell disease. Sickle cell disease is less common in other ethnic groups.

Question 7

The organ that is most responsible for producing erythropoietin is the:

Accepted Answer

Erythropoietin is primarily produced in the kidneys, with a small amount also produced in the liver and bone marrow. The spleen does not play a significant role in erythropoietin production.

Question 8

Your patient is an 18-year-old female suffering from sickle cell crisis. Which of the following is the best course of treatment for this patient?

Accepted Answer

Sickle cell crisis is characterized by severe pain due to sickle-shaped red blood cells obstructing blood vessels. The management of sickle cell crisis should focus on relieving pain and maintaining organ perfusion. High-concentration oxygen is given to improve oxygenation and decrease sickling. IV NS KVO is given to maintain hydration, but additional boluses are only given if the patient is hypotensive or in shock. Diphenhydramine is not indicated for sickle cell crisis. Morphine sulfate is the drug of choice for pain relief in sickle cell crisis. Therefore, the best course of treatment for this patient is high-concentration oxygen, IV bolus of NS, and morphine sulfate.

Question 9

You respond to a patient complaining of shortness of breath. Upon your arrival, the patient tells you that she has been experiencing headaches, vertigo, and now itching. She says her doctor had called with a lab result of her latest test. Her hematocrit is reported as 60. You suspect:

Accepted Answer

A hematocrit level of 60 indicates an abnormally high level of red blood cells, which is consistent with polycythemia. Symptoms of polycythemia can include shortness of breath, headaches, dizziness or vertigo, and itching. It is important to rule out other possible causes, but based on the patient's lab result and symptoms, polycythemia is the most likely diagnosis.

Question 10

The study of blood and blood-forming organs is called:

Accepted Answer

Hematology is the study of blood and blood-forming organs, including blood cells, hemoglobin, blood proteins, bone marrow, and coagulation. Oncology is the study and treatment of cancer. Homeostasis is the maintenance of a stable internal environment in the body through physiological processes. Palliative care focuses on providing relief from symptoms and improving the quality of life for individuals with serious illnesses.

Question 11

Which of the following statements regarding hemophilia is most accurate?

Accepted Answer

Hemophilia is a hereditary lack of certain proteins needed in the clotting cascade. This results in prolonged bleeding and patients may experience bleeding into joints or muscles, which can be severe and lead to permanent damage. Platelet abnormalities and the inability to produce vitamin K are not associated with hemophilia. While fibrinolysis (the dissolution of fibrin clots) can occur in some cases of hemophilia, it is not a defining characteristic of the disease.

Question 12

Which of the following is TRUE concerning sickle cell anemia?

Accepted Answer

Sickle cell anemia is a hereditary disease caused by a mutation in the gene that encodes for the β-globin subunit of hemoglobin, leading to the production of abnormal hemoglobin. This results in the shape of the red blood cell becoming abnormal and rigid, causing them to form a sickle shape. This can lead to a number of health problems such as anemia, pain, and organ damage.

Question 13

You are caring for a patient who is complaining of diffuse musculoskeletal pain, shortness of breath, and atraumatic priapism. You suspect:

Accepted Answer

The symptoms of diffuse musculoskeletal pain, shortness of breath, and atraumatic priapism all point towards a sickle cell vaso occlusive crisis, which is a common complication in individuals with sickle cell disease. Sickle cell hematologic crisis may cause fatigue, pallor, tachycardia, and hypotension, but it would not explain the other symptoms presented. Acute lymphocytic leukemia (ALL) and AML may cause joint pain and shortness of breath, but would not cause priapism.

Question 14

Which of the following statements regarding polycythemia is most accurate?

Accepted Answer

Polycythemia is a condition in which there is an abnormal increase in the number of red blood cells in the blood. This increase in red blood cells can lead to an increased risk of thrombosis (blood clotting) which can result in conditions such as heart attack or stroke. It can also lead to congestive heart failure, a condition in which the heart cannot pump enough blood to meet the body's needs. It does not, however, decrease the patient's risk of infection.

Question 15

You are transporting a patient to a tertiary trauma center. The patient is receiving blood and has sustained trauma the local center cannot handle. You notice that the patient has begun to develop tachycardia, hives, and a fever. You suspect:

Accepted Answer

The symptoms described are indicative of a transfusion reaction, which can occur when a patient's immune system reacts to the transfused blood. It is important to immediately stop the transfusion and contact the receiving facility for further guidance.

Question 16

You are caring for a patient with a known history of sickle cell disease. The patient has severe abdominal and back pain. The patient is tachycardic and tachypneic. The blood pressure is normal. What should be one of the paramedic's first interventions?

Accepted Answer

The patient is presenting with symptoms of a sickle cell crisis, which can cause tissue ischemia and hypoxia. Administering oxygen can help alleviate some of these symptoms and improve oxygenation to the tissues. IV access and analgesics may also be necessary, but oxygen should be the first intervention. Putting the patient in a supine position may worsen their pain and should be avoided.

Question 17

Your patient has a history of pernicious anemia. If not treated, your primary concern for this patient should be:

Accepted Answer

Pernicious anemia is caused by a deficiency of vitamin B12, which is important for the production of red blood cells. Without treatment, the lack of red blood cells can lead to hypoxia, which is a serious concern. Hypovolemia, prolonged blood clotting, and infection are not typically associated with pernicious anemia, although they may be secondary complications in some cases.

Question 18

Hemostasis is maintained by which three mechanisms?

Accepted Answer

Hemostasis is maintained by three mechanisms: vascular spasm, platelet plugs, and fibrin clots. These mechanisms work together to stop blood loss from injured vessels. Von Willebrand's factor, factor VIII, VII, and III, fibrin, platelets, and hemoglobin are all involved in the process but do not represent the three main mechanisms of hemostasis.

Question 19

A complete hemoglobin molecule can carry up to:

Accepted Answer

A complete hemoglobin molecule can carry up to four oxygen molecules. Each hemoglobin molecule has four subunits, and each subunit can bind to one oxygen molecule. Thus, a complete hemoglobin molecule can bind to four oxygen molecules in total.

Quiz 9: Hematology