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Sample questions

The major part of the questions contains a stem with a clinical scenario. In addition, some questions without a clinical scenario are asked, testing basic knowledge of facts or theory. Each question has 4 or 5 multiple choice answer options.

Below are examples of the type of questions that you can expect from the exam. Note that this is not a full exam, therefore, your results in answering these questions will not predict your exam score. The final exam consists of 100 multiple choice questions, covering all 8 sections of the European Hematology Curriculum.

Example 1:

Stem:
A 55-year old woman with rheumatoid arthritis (RA) was referred to the outpatient hematology clinic because of anemia. She has had RA for 5 years and her Hb level has gradually gone down from 140 g/L at debut to 95 g/l at her last visit to the RA outpatient clinic. You have ordered samples before the visit to your clinic and her lab results were the following: Hb 96 g/L, WBC 8.5x10⁹/L, platelets 450x10⁹/L, S-ferritin 240 ug/L, transferrin saturation 14%, MCV 79, CRP 50

Question: What is the pathophysiologic mechanism behind her anemia?

Answer options:

1. Cytokine-induced hepcidin increase has increased ferroportin and reduced iron absorption and transferrin saturation
2. Ineffective erythropoiesis has increased red blood cell breakdown, decreased hepcidin, lowered ferroportin and transferrin saturation
3. Cytokine-induced hepcidin increase has decreased ferroportin, reduced iron absorption, and transferrin saturation
4. Cytokine-induced hepcidin increase, decreased ferroportin, increased iron absorption
5. A bleeding has reduced her iron deposits and she has an iron deficiency anemia

Example 2:

Stem:
A 32-year old woman had a deep vein thrombosis (DVT) 3 years ago after receiving a leg plaster for an Achilles tendon rupture. She was treated with warfarin for 6 weeks after removal of leg plaster. No problems from the leg since. Now she is expecting her first child, being pregnant in week 10. She raises the question about thrombosis prophylaxis and says that a doctor friend of hers has recommended low molecular heparin. 

Question: What would your advice be?

Answer options:

1. No, no prophylaxis necessary
2. Yes, from delivery and 6 weeks on
3. Yes, the whole pregnancy and 6 weeks after delivery
4. Yes, the last trimester and 6 weeks after delivery
5. No, low dose aspirin during the whole pregnancy

Example 3:

Stem:
A 64-year old woman was diagnosed with Essential thrombocythemia (ET). She has had a psoriasis for 10 years which has given mild symptoms during the last few years. Hypertension was found and treated with beta-blocker. She was classified as high-risk ET and treated with Hydroxycarbamide. After six months of treatment, anagrelide was added because of insufficient platelet lowering. She now has a good platelet control but reports that her psoriasis has become intolerable.

Question: Which of her medications is most likely to have caused a worsening of her psoriasis?

Answer options:

1. Anagrelide
2. Aspirin
3. Bisoprolol
4. Hydroxycarbamide
5. Nitrazepam

Example 4: 

Paroxysmal nocturnal hemoglobinuria (PNH) may be a life-threatening disease. Which is the most common cause of death in PNH?

1. Renal insufficiency
2. Thrombosis
3. Hemorrhage
4. Liver failure
5. Myocardial infarction