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HematologyCertification Examination BlueprintPurpose of the examThe exam is designed to evaluate the knowledge, diagnostic reasoning, and clinical judgmentskills expected of the certified hematologist in the broad domain of the discipline. The ability tomake appropriate diagnostic and management decisions that have important consequences forpatients will be assessed. The exam may require recognition of common as well as rare clinicalproblems for which patients may consult a certified hematologist.Exam contentExam content is determined by a pre-established blueprint, or table of specifications. Theblueprint is developed by ABIM and is reviewed annually and updated as needed for currency.Trainees, training program directors, and certified practitioners in the discipline are surveyedperiodically to provide feedback and inform the blueprinting process.The primary medical content categories of the blueprint are shown below, with the percentageassigned to each for a typical exam:Medical Content Category% of ExamHematopoietic System25%Coagulation27%Hematologic Neoplastic Disorders35%Transfusion Medicine5%Hematopoietic Cell Transplantation (HCT)8%100%Exam questions in the content areas above may also address topics related to pregnancy andcontraception that are important to the practice of hematology (approximately 4% of theexam).

Exam formatThe exam is composed of multiple-choice questions with a single best answer, predominantlydescribing patient scenarios. Questions ask about the work done (that is, tasks performed) byphysicians in the course of practice: Making a diagnosisOrdering and interpreting results of testsRecommending treatment or other patient careAssessing risk, determining prognosis, and applying principles from epidemiologicstudiesUnderstanding the underlying pathophysiology of disease and basic science knowledgeapplicable to patient careClinical information presented may include patient photographs, radiographs,photomicrographs, and other media to illustrate relevant patient findings.A tutorial including examples of ABIM exam question format can be found on/hematology/exam-tutorial.aspx.The blueprint can be expanded for additional detail as shown below. Each of the medicalcontent categories is listed there, and below each major category are the content subsectionsand specific topics that may appear in the exam. Please note: actual exam content may vary.Hematopoietic SystemNormal hematopoiesisDisorders of red blood cells or ironRed blood cell production disordersNutritional deficienciesIron deficiencyNutritional anemia, non–iron deficiencyAnemia of chronic inflammationRed cell aplasia and hypoplasiaSideroblastic anemiaRed blood cell destruction disordersThalassemiasAlpha thalassemiaBeta thalassemiaHemoglobin E disorders25%of Exam 2%21%4%15%2

Sickle cell disorders4.5%Sickle cell traitSickle cell anemia (hemoglobin SS disease)Hemoglobin SC diseaseSickle cell-β0 and sickle cell-β -thalassemiasNon-sickle hemoglobinopathiesAutoimmune hemolytic anemias (AIHA)Warm antibody-mediated autoimmune hemolytic anemiaCold antibody-mediated autoimmune hemolytic anemiaDrug-induced hemolysisMetabolic abnormalities and enzyme deficiency hemolytic anemiasOxidant hemolysis, including glucose-6-phosphate dehydrogenase(G6PD) deficiencyPyruvate kinase deficiency and other metabolic deficienciesParoxysmal nocturnal hemoglobinuriaRed blood cell membrane disordersMicroangiopathic hemolytic anemias(other than TTP, HUS, or DIC)Non-autoimmune, acquired hemolytic e blood cell disorders 2%Granulocyte disordersQuantitative granulocyte disordersQualitative granulocyte disordersLymphocytopenia and lymphocyte dysfunction syndromesLeukocytosisEosinophiliaHemophagocytic syndromesBone marrow failure syndromes2%Aplastic anemiaInherited aplastic anemiaAcquired aplastic anemiaPancytopenia3

CoagulationPlatelet and megakaryocyte disordersInherited disorders of platelet functionAcquired disorders of platelet functionDrug-induced disordersNon-drug-induced disordersThrombocytopeniaInherited thrombocytopeniaAcquired thrombocytopeniaImmune thrombocytopenic purpura (ITP)Drug-induced thrombocytopeniaThrombotic thrombocytopenic purpura (TTP)Hemolytic uremic syndrome (HUS)Thrombocytopenia secondary to liverDisease and splenic disordersThrombocytosisHemostasisMolecular basis of coagulation and hemostatic agentsNormal hemostasisLaboratory evaluationHemostatic drugsInherited bleeding disorders (non-platelet)Von Willebrand diseaseTypes 1, 2A, 2M, 2N, and 3Type 2BModifiers of von Willebrand factor levelsHemophilias A and BHemophilia AHemophilia BFactor XI deficiencyFactor deficiencies other than factor XIInherited vascular abnormalitiesAcquired bleeding disorders (non-platelet)Factor inhibitorsDisseminated intravascular coagulation (DIC)Acquired vascular abnormalitiesSecondary acquired factor deficiencies27% of Exam7%4.5%10%6%4

ThrombosisMolecular basis of natural anticoagulants, fibrinolyticpathway, and anticoagulant therapyNormal anticoagulant and fibrinolytic mechanismsLaboratory evaluationAnticoagulant drugsThrombotic disordersInherited thrombotic disordersFactor V Leiden and prothrombin G20210A10%5.5%4.5%Deficiencies of natural anticoagulants(antithrombin, proteins C and S)HyperhomocysteinemiaAcquired thrombotic disordersHeparin-induced thrombocytopenia (HIT)Anti-phospholipid antibody syndrome (APS)Cancer-related thrombotic disordersThromboembolism at unusual sitesThrombosis management (non-disease-specific)Complications of thrombotic disordersHematologic Neoplastic DisordersMyeloproliferative neoplasmsChronic myeloid leukemiaPolycythemia vera and secondary erythrocytosisPrimary myelofibrosisEssential thrombocythemiaMastocytosisChronic neutrophilic leukemiaAcute leukemias and myelodysplasiaAcute promyelocytic leukemiaAcute myeloid leukemia (non-promyelocytic)Therapy-related myeloid neoplasmsMyeloid sarcoma/extramedullary leukemiaMyelodysplastic syndromesChronic myelomonocytic leukemia andmyelodysplastic/myeloproliferativeneoplasm overlap syndromesB-cell acute lymphoblastic leukemia/lymphoma (B-ALL)T-cell acute lymphoblastic leukemia/lymphoma (T-ALL)35% of Exam4.5%8%5

B-cell neoplasms13%Chronic lymphoid leukemiasChronic lymphocytic leukemia/small lymphocyticlymphomaMonoclonal B-cell lymphocytosisHairy cell leukemiaPlasma cell neoplasmsMultiple myelomaPlasmacytomasAmyloidosisCastleman disease and POEMS syndrome(polyneuropathy, organ enlargement, endocrinopathy,Monoclonal plasma-proliferative disorder, skin changes)Monoclonal gammopathy of undeterminedsignificance (MGUS)Non-Hodgkin lymphomas, B-cell7%Diffuse large B-cell lymphomaFollicular lymphomaMantle cell lymphomaMarginal zone B-cell and mucosa-associatedlymphoid tissue (MALT) lymphomasBurkitt lymphomaPrimary central nervous system lymphomaLymphoplasmacytic lymphoma (including Waldenströmmacroglobulinemia)General lymphoma issues (not specific to lymphoma type)Immunodeficiency-associated lymphoproliferative disorders 2%Post-transplantation lymphoproliferative disorders (solid organ transplant)Lymphomas associated with human immunodeficiencyvirus (HIV) infection or primary immune disordersLymphoproliferative disorders associated with iatrogenicimmunodeficiencyT-cell and NK-cell neoplasms 2%Cutaneous T-cell lymphoma (mycosis fungoides andSézary syndrome)T-cell lymphomasAdult T-cell leukemia/lymphomaLarge granular lymphocyte leukemiaProlymphocytic leukemia6

Hodgkin lymphomaClassical Hodgkin lymphomaNodular lymphocyte-predominant Hodgkin lymphomaHistiocytic and dendritic cell neoplasmsMyeloid and lymphoid neoplasms with eosinophilia andAbnormalities of PDGFRA, PDGFRB, or FGFR1Complications of hematologic malignanciesTumor lysis syndromeSpinal cord compressionParaneoplastic disordersPharmacologyToxicities and complications, includingcytopenic complicationsDrug dosing and dose modificationsClinical trial design and interpretationTransfusion Medicine2% 2% 2% 2%2.5% 2%5%of ExamClinical indications for the use of blood products 2%Red blood cell preparationsPlatelet preparationsFresh frozen plasmaCryoprecipitateRisks associated with blood products4%Risks associated with administrationAllergic reactionsNonanaphylactic allergic reactionsIgA deficiencyAnaphylactic reactionsGraft-versus-host diseaseElectrolyte disturbancesInfectious organismsAlloimmunizationsTransfusion reactionsHemolytic reactionsFebrile reactionsTransfusion-related acute lung injury (TRALI)Transfusion-associated circulatory overload (TACO)Post-transfusion purpura and other risks associatedwith administration7

Risks associated with therapeutic apheresis proceduresManagement of patients who refuse transfusionHematopoietic Cell Transplantation (HCT)Hematopoietic cell biology and engraftmentBiology of hematopoietic cell transplantationBiologic and immunologic relationship betweendonor and hostHematopoietic cell transplantation in the management ofhematologic diseasesAutologous HCTAllogeneic HCTDonor selectionStem cell sourceConditioning regimensRegimen intensityToxicitiesSupportive carePreventing infectious diseaseTransfusion support, including graft compatibility andblood product issuesGraft-versus-host disease (GVHD)Acute GVHDChronic GVHDOther complications after hematopoietic cell transplantationEngraftment failure or rejectionInfectionsOrgan toxicityTransplant-associated thrombotic microangiopathyPost-transplant lymphoproliferative disorderLate effectsDisease relapse 2%8% of Exam 2%2% 2% 2% 2% 2% 2%January 20218

Red blood cell production disorders 4% . Nutritional deficiencies . Iron deficiency . Nutritional anemia, non–iron deficiency . Anemia of chronic inflammation . Red cell aplasia and hypoplasia . Sideroblastic anemia . Red blood cell destruction disorders 15% . Thalassemias . Alph

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