Advanced Hematology Exam #2
An 80-year-old woman with Lupus Erythematosus has increasing complaints of being "tired all the time". Her blood work results are as follows: RBC: 3.30 X 10^6/cmm, Hgb: 8.2 g/dL, Hct: 26.0 %, Serum Iron; 45 mg/dL, TIBC: 150 µg/dL. What is the percent transferrin saturation? A. 10 % B. 30 % C. 50 % D. 75 %
30 %
The marrow serves as an iron trap. It receives ___________ % of the total cardiac output, but it extracts __________% of the plasma iron. A. 25%; 50% B. 50%; 50% C. 50%; 90% D. 5%; 85%
5%; 85%
Serum iron levels in Sideroblastic anemia are: A. 0 - 50 µg/dl B. 50 - 150 µg/dl (normal) C. > 150 µg/dl D. Cyclic in a 24 hour period
> 150 µg/dl
Match the porphyria with the enzyme deficient (C) in the pathway below. Porphobilinogen deaminase
Acute Intermittent Porphyria (AIP)
Acute intermittent porphyria is due to: A. An inherited defect in the amount of porphobilinogen (PBG) B. An inherited deficiency of the enzyme uroporphyrinogen synthetase C. An acquired inhibition of the enzymes Ala-dehydrase, ferrochelatase, and coproporphyrinogen D. A defect in iron metabolism
An inherited deficiency of the enzyme uroporphyrinogen synthetase
An 80-year-old woman with Lupus Erythematosus has increasing complaints of being "tired all the time". Her blood work results are as follows: RBC: 3.30 X 10^6/cmm, Hgb: 8.2 g/dL, Hct: 26.0 %, Serum Iron; 45 mg/dL, TIBC: 150 µg/dL. This patient's medical history, lab results, and transferrin saturation values are characteristic of: A. Anemia of hypothyroidism B. Iron deficiency anemia C. Sideroblastic anemia D. Anemia of chronic disorders
Anemia of chronic disorders
Which of the following anemias would present with RBC target cells? A. Anemia of liver disease B. Anemia of renal disease C. Aplastic anemia D. Anemia of chronic disorders
Anemia of liver disease
A characteristic and distinguishing RBC-morphological finding found in lead poisoning is __________________. A. Howell Jolly Bodies B. Polychromatophilia C. Basophilic Stippling D. Dacrocytes
Basophilic Stippling
Hemochromatosis can occur from all of the following causes, EXCEPT: A. Multiple transfusions B. Chronic blood loss C. Sideroblastic anemia D. Overdose of iron pills
Chronic blood loss
Match the porphyria with the enzyme deficient (D) in the pathway below. Uroporphyrinogen III Cosynthetase
Congenital Erythropoietic Porphyria
Match the porphyria with the enzyme deficient (E) in the pathway below. Uroporphyrinogen I Oxidase
Cutaneous Hepatic Porphyria
The earliest laboratory indication of developing IDA is which of the following results? A. Microcytic RBCs B. Decrease in plasma ferritin C. Decrease in plasma iron D. Decrease in marrow iron stores
Decrease in plasma ferritin
The molecular form of iron most efficiently absorbed from digested food across the mucosal cell barrier is: A. Ferric B. Fe2+ C. Ferritin D. Fe3+
Fe2+
A serum iron of 227 µg/dl and a transferrin saturation of 85% is related to which disease? A. Polycythemia vera B. Aplastic anemia C. Hemochromatosis D. Refractory anemia
Hemochromatosis
Match the porphyria with the enzyme deficient (A) in the pathway below. Coporphyrinogen-III Oxydase
Hereditary Coproporphyria
A 26-year-old female presented with a moderate anemia and persistent mouth ulcers and sore tongue. The peripheral blood smear represented by image below, is an example of her blood picture (Hypochromic bloodcells). Based on her symptoms and blood picture, this patient most likely has which of the following disorders? A. IDA B. Anemia of Chronic disorders C. Aplastic anemia D. Anemia of hypothyroidism
IDA
The differential diagnosis of microcytic/hypochromic anemias includes Iron Deficiency Anemia, Anemia of Chronic Disorders, Sideroblastic anemia, and Thalassemia. Of the four disorders, which one typically presents with an increased TIBC and serum ferritin values below normal? A. Iron Deficiency Anemia B. Anemia of Chronic Disorders C. Sideroblastic anemia D. Thalassemia
Iron Deficiency Anemia
A 26-year-old female presented with a moderate anemia and persistent mouth ulcers and sore tongue. The peripheral blood smear represented by image below, is an example of her blood picture (Hypochromic bloodcells). What would be the next lab test ordered to give a definitive diagnosis? A. Bone marrow B. Erythropoietin C. Iron and TIBC D. Prussian blue stain
Iron and TIBC
All of the following statements are TRUE concerning iron metabolism, EXCEPT: A. Iron is stored in all normoblasts and macrophages as hemopexin B. Dietary iron is absorbed in the duodenum in the ferrous (Fe 2+) form but transported in the circulation and stored in the ferric form (Fe3+) C. The majority of iron used in Heme synthesis is "recycled" iron from degraded Hgb from intravascular and extravascular hemolysis pathways D. 2/3 of the body iron is found in normoblasts and RBCs
Iron is stored in all normoblasts and macrophages as hemopexin
An 80-year-old woman with Lupus Erythematosus has increasing complaints of being "tired all the time". Her blood work results are as follows: RBC: 3.30 X 10^6/cmm, Hgb: 8.2 g/dL, Hct: 26.0 %, Serum Iron; 45 mg/dL, TIBC: 150 µg/dL. Morphologically, the anemia you identified on this particular patient, can be classified as: A. Normocytic/Normochromic B. Normocytic/Hypochromic C. Microcytic/Hypochromic D. Macrocytic/Normochromic
Microcytic/Hypochromic
Which one of the following lists of laboratory findings would be most characteristic of an anemia of chronic inflammation? A. Normocytic/hypochromic, high serum iron, increased TIBC, decreased ferritin levels, decreased Hgb. & Hct. B. Microcytic/hypochromic, normal serum iron, decreased TIBC, normal ferritin levels, decreased Hgb. & Hct. C. Normocytic/normochromic, low serum iron, decreased TIBC, increased ferritin levels, decreased Hgb. & Hct. D. Macrocytic/normochromic, low serum iron, normal TIBC, decreased ferritin levels, normal Hgb. & Hct.
Normocytic/normochromic, low serum iron, decreased TIBC, increased ferritin levels, decreased Hgb. & Hct.
A genetic abnormality in a gene on chromosome 6 associated with an increased iron absorption by the small intestinal mucosal cell is: A. Pyridoxine (B6) deficiency B. Iron deficiency anemia C. Primary Familial Hemochromatosis D. Diamond-Blackfan anemia
Primary Familial Hemochromatosis
All of the following agents have been known to cause Hypersensitive Aplastic Anemia, EXCEPT: A. Chloramphenicol B. Radiation C. DDT D. Some antihistamines
Radiation
In general, Porphyrias result in the following conditions, EXCEPT: A. Result from an inherited deficiency in ALA-synthetase B. Can often be clinically related to peripheral neuritis, psychosis, and photosensitive skin C. Are often inherited disorders of a certain enzyme in the heme biosynthetic pathway, resulting in an increase in ALA-synthetase and the porphyrin intermediates prior to the enzyme block D. Result in a microcytic/hypochromic anemia
Result from an inherited deficiency in ALA-synthetase
Match the porphyria with the enzyme deficient (B) in the pathway below. Ferrochetalase
Variegate Porphyria