LabCE 5

All of the following are characteristic findings in patients with iron deficiency anemia EXCEPT? a) Microcytic, hypochromic red cell morphology b) Decreased serum iron level c) Decreased total iron-binding capacity (TIBC) d) Decreased ferritin

c) Decreased total iron-binding capacity (TIBC)

In which of the following conditions would you NOT expect to find Howell-Jolly bodies? a) Sickle cell anemia b) Iron deficiency anemia c) Post splenectomy d) Megaloblastic anemia

b) Iron deficiency anemia

Anemia of chronic inflammation, also known as anemia of chronic disease, can be caused by all of the following mechanisms EXCEPT: a) EPO production inhibited by cytokines b) Direct cytokine inhibition of erythropoiesis c) Decreased ferritin d) Shortened erythrocyte survival

c) Decreased ferritin

Which of the following conditions is frequently associated with the white blood cell shown? a) Hemolytic anemia b) Iron deficiency anemia c) Megaloblastic anemia d) Sickle cell anemia

c) Megaloblastic anemia

Which of the following is the most common condition associated with a nonmegaloblastic macrocytic anemia? a) Liver disease b) Aplastic anemia c) Chronic blood loss d) Folic Acid deficiency

a) Liver disease

What are the expected results of the laboratory markers in iron deficiency anemia? a) Decreased serum iron, increased transferrin, decreased ferritin, decreased percent saturation, and increased total iron-binding capacity. b) Decreased serum iron, decreased transferrin, decreased ferritin, variable percent saturation, and decreased total iron-binding capacity. c) Decreased serum iron, decreased transferrin, increased ferritin, decreased percent saturation, and decreased total iron-binding capacity. d) Decreased serum iron, normal or decreased transferrin, normal or increased ferritin, decreased percent saturation, and normal or decreased total iron-binding capacity.

a) Decreased serum iron, increased transferrin, decreased ferritin, decreased percent saturation, and increased total iron-binding capacity.

For which of these conditions or procedures there may be an increased number of megakaryocytes in the bone marrow, but a decreased number of circulating platelets? a) Folic acid deficiency b) Aplastic anemia c) Radiation Therapy d) Wiskott-Aldrich syndrome

a) Folic acid deficiency

Single erythrocyte inclusions which are large, round, smooth, and purplish-blue staining are most likely: a) Howell-Jolly bodies b) Heinz bodies c) Basophilic stippling d) Cabot rings

a) Howell-Jolly bodies

Which of the following is necessary for the absorption of Vitamin B12: a) Intrinsic factor b) Folic acid c) Gastrin d) Insulin

a) Intrinsic factor

Which of these conditions could result in a microcytic anemia? a) Iron deficiency b) Vitamin B12 deficiency c) Spherocytosis d) Folate deficiency

a) Iron deficiency

In which of the following conditions are Cabot rings most likely to be observed on a Wright-stained peripheral blood smear? a) Megaloblastic anemia b) Moderate iron deficiency anemia c) Sickle cell trait d) Plasma cell myeloma

a) Megaloblastic anemia

Pernicious anemia refers to cobalamin deficiency that results from a lack of which of the following? a) Vitamin B12 b) Intrinsic Factor c) Folate d) Vitamin C

b) Intrinsic Factor

All of the following are causes of hemolytic anemia, EXCEPT? a) Thermal injury b) Iron deficiency anemia c) Brown recluse spider bite d) Plasmodium infection

b) Iron deficiency anemia

Which of the following is associated with macrocytic anemia? a) Iron deficiency b) Fish tapeworm c) Sickle cell disease d) Beta thalassemia minor

b) Fish tapeworm

The anemia seen in anemia of chronic disease (also known as anemia of chronic infection) is characterized by low serum iron levels. Which of the following contributes to the low serum iron levels seen in persons with anemia of chronic disease? a) Decreased erythropoietin b) Hepcidin c) Decreased dietary intake d) Decreased ferritin levels

b) Hepcidin

The condition which is highly associated with the oval-macrocytes and hypersegmented neutrophils found in this image is? a) Sideroblastic Anemia b) Megaloblastic Anemia c) Iron Deficiency Anemia d) Malarial Infection

b) Megaloblastic Anemia

Which of the following red cell inclusions are often found in peripheral blood smears of patients with sideroblastic anemia? a) Howell-Jolly bodies b) Pappenheimer bodies c) Heinz bodies d) Cabot rings

b) Pappenheimer bodies

Which anemia is formed due to the inability to incorporate iron into the protoporphyrin ring? a) Iron Deficiency Anemia b) Sideroblastic Anemia c) Anemia of Chronic Inflammation d) Thalassemia

b) Sideroblastic Anemia

Conditions suggested by the macrocytes and the neutrophil in the photograph to the right include Folate deficiency and which other condition? a) Thalassemia b) Vitamin B12 deficiency c) Pelger-Huet anomaly d) Sickle cell anemia

b) Vitamin B12 deficiency

Which of the following microcytic anemia's is the most common anemia other than Iron Deficiency Anemia (IDA) and accounts for more than one-third of anemia in hospitalized patients without blood loss? a) Pernicious anemia b) Megaloblastic anemia c) Anemia of chronic disease/inflammation d) Immune hemolytic anemia

c) Anemia of chronic disease/inflammation

What is the mechanism that causes megaloblastic anemia? a) Defective stem cell production b) Interruption of hemoglobin production c) Interruption of DNA Synthesis d) Interruption of development of precursor cells

c) Interruption of DNA Synthesis

A patient is admitted to the emergency room with severe lethargy, glossitis, and muscle dysfunction. After the physician orders a complete blood count with differential, the hematology technologist observes cells matching the image to the right. Which condition is most consistent with the clinical and laboratory findings? a) Sickle cell anemia b) Megaloblastic anemia c) Iron deficiency anemia d) Aplastic anemia

c) Iron deficiency anemia

What is the condition most likely associated with the peripheral blood picture shown in the image on the right? a) Artifact of staining b) Congenital spherocytosis c) Iron deficiency anemia d) Autoimmune hemolytic anemia

c) Iron deficiency anemia

Note the iron-stained bone marrow preparation in the image to the right. The cells as shown can be associated with which type of anemia? a) Iron deficiency anemia b) Sickle cell anemia c) Sideroblastic anemia d) Megaloblastic anemia

c) Sideroblastic anemia

A mother brings in her 6-year-old son to the clinic with concerns of learning difficulties from his school and also states he seems very tired all the time. The family has been staying in an old, run-down motel recently as they try to find housing with no other significant family history. Testing was ordered to include a CBC. The CBC shows a microcytic anemia but otherwise normal results. Which of the following may be present upon manual differential review? a) Sickle cells b) Pappenheimer bodies c) Howell-Jolly bodies d) Basophilic stippling

d) Basophilic stippling

The decreased serum iron levels seen in anemia of chronic disease (also referred to as anemia of chronic infection or inflammation) is caused by which of the following? a) Increased total iron binding capacity (TIBC) b) Decreased serum ferritin c) Increased erythropoietin d) Decreased iron released from macrophages

d) Decreased iron released from macrophages

Which red cell morphological classification is characteristic of megaloblastic anemia? a) Normocytic b) Microcytic c) Hypochromic d) Macrocytic

d) Macrocytic

In which of the following conditions would you expect to find Howell-Jolly bodies? a) Iron deficiency anemia b) Splenomegaly c) Diabetes d) Megaloblastic anemia

d) Megaloblastic anemia

Which one of the following statements about iron deficiency anemia (IDA) is false: a) It is the most common cause of anemia. b) Described as a hypochromic and microcytic anemia with an increased RDW. c) The majority of total body iron is present as hemoglobin iron. d) On average, 25% to 35% of ingested iron is absorbed each day.

d) On average, 25% to 35% of ingested iron is absorbed each day.

When distinguishing megaloblastic from nonmegaloblastic macrocytic anemia, which of the following is a key difference in red blood cell morphology? a) The presence of target cells in nonmegaloblastic macrocytic anemia b) The presence of oval macrocytes in nonmegaloblastic anemia c) The presence of round macrocytes in megaloblastic anemia d) The presence of round macrocytes in nonmegaloblastic anemia.

d) The presence of round macrocytes in nonmegaloblastic anemia.

Which of the following conditions is hypersegmentation of granulocytes most commonly associated with? a) Inherited trait or lipid storage disease b) Iron deficiency c) Viral infection d) Vitamin B12 or Folate deficiency

d) Vitamin B12 or Folate deficiency