heme quiz 3

A patient with a vitamin B12 anemia is given a high dosage of folate. Which of the following is expected as a result of this treatment? A. An improvement in neurological problems B. An improvement in hematological abnormalities C. No expected improvement D. Toxicity of the liver and kidneys

B. An improvement in hematological abnormalities

The osmotic fragility test result in a patient with thalassemia major would most likely be: A. Increased B. Decreased C. Normal D. Decreased after incubation at 37°C

B. Decreased

Which of the following parameters may be similar for the anemia of inflammation and iron deficiency anemia? A. Normocytic indices B. Decreased serum iron concentration C. Ringed sideroblasts D. Pappenheimer bodies

B. Decreased serum iron concentration

All of the following are characteristics of megaloblastic anemia except: A. Pancytopenia B. Elevated reticulocyte count C. Hypersegmented neutrophils D. Macrocytic erythrocyte indices

B. Elevated reticulocyte count

Which of the following electrophoretic results is consistent with a diagnosis of sickle cell trait? A. Hgb A: 40% Hgb S: 35% Hgb F: 5% B. Hgb A: 60% Hgb S: 40% Hgb A2: 2% C. Hgb A: 0% Hgb A2: 5% Hgb F: 95% D. Hgb A: 80% Hgb S: 10% Hgb A2: 10%

B. Hgb A: 60% Hgb S: 40% Hgb A2: 2%

What red cell inclusion may be seen in the peripheral blood smear of a patient postsplenectomy? A. Toxic granulation B. Howell-Jolly bodies C. Malarial parasites D. Siderotic granules

B. Howell-Jolly bodies

Which of the following conditions may produce spherocytes in a peripheral smear? A. Pelger-Huët anomaly B. Pernicious anemia C. Autoimmune hemolytic anemia D. Sideroblastic anemia

C. Autoimmune hemolytic anemia

All of the following are characteristic findings in a patient with iron deficiency anemia except: A. Microcytic, hypochromic red cell morphology B. Decreased serum iron and ferritin levels C. Decreased total iron-binding capacity (TIBC) D. Increased RBC protoporphyrin

C. Decreased total iron-binding capacity (TIBC)

"Bite cells" are usually seen in patients with: A. Rh null trait B. Chronic granulomatous disease C. G6PD deficiency D. PK deficiency

C. G6PD deficiency

Which of the following is a common finding in aplastic anemia? A. A monoclonal disorder B. Tumor infiltration C. Peripheral blood pancytopenia D. Defective DNA synthesis

C. Peripheral blood pancytopenia

The morphological classification of anemias is based on which of the following? A. M:E (myeloid:erythroid) ratio B. Prussian blue stain C. RBC indices D. Reticulocyte count

C. RBC indices

What is the basic hematological defect seen in patients with thalassemia major? A. DNA synthetic defect B. Hgb structure C. β-Chain synthesis D. Hgb phosphorylation

C. β-Chain synthesis

In which of the following conditions is Hgb A2 elevated? A. Hgb H B. Hgb SC disease C. β-Thalassemia minor D. Hgb S trait

C. β-Thalassemia minor

Which antibody is associated with paroxysmal cold hemoglobinuria (PCH)? A. Anti-I B. Anti-i C. Anti-M D. Anti-P

D. Anti-P

Which antibiotic(s) is (are) most often implicated in the development of aplastic anemia? A. Sulfonamides B. Penicillin C. Tetracycline D. Chloramphenicol

D. Chloramphenicol

All of the following are usually found in Hgb C disease except: A. Hgb C crystals B. Target cells C. Lysine substituted for glutamic acid at the sixth position of the β-chain D. Fast mobility of Hgb C at pH 8.6

D. Fast mobility of Hgb C at pH 8.6

Which of the following disorders has an increase in osmotic fragility? A. Iron deficiency anemia B. Hereditary elliptocytosis C. Hereditary stomatocytosis D. Hereditary spherocytosis

D. Hereditary spherocytosis

Which is the major Hgb found in the RBCs of patients with sickle cell trait? A. Hgb S B. Hgb F C. Hgb A2 D. Hgb A

D. Hgb A

Which of the following is the primary Hgb in patients with thalassemia major? A. Hgb D B. Hgb A C. Hgb C D. Hgb F

D. Hgb F

All of the following are associated with sideroblastic anemia except: A. Increased serum iron B. Ringed sideroblasts C. Dimorphic blood picture D. Increased RBC protoporphyrin

D. Increased RBC protoporphyrin

Congenital dyserythropoietic anemias (CDAs) are characterized by: A. Bizarre multinucleated erythroblasts B. Cytogenetic disorders C. Megaloblastic erythropoiesis D. An elevated M:E ratio

A. Bizarre multinucleated erythroblasts

Iron deficiency anemia is characterized by: A. Decreased plasma iron, decreased % saturation, increased total iron-binding capacity (TIBC) B. Decreased plasma iron, decreased plasma ferritin, normal RBC porphyrin C. Decreased plasma iron, decreased % saturation, decreased TIBC D. Decreased plasma iron, increased % saturation, decreased TIBC

A. Decreased plasma iron, decreased % saturation, increased total iron-binding capacity (TIBC)

Sickle cell disorders are: A. Hereditary, intracorpuscular RBC defects B. Hereditary, extracorpuscular RBC defects C. Acquired, intracorpuscular RBC defects D. Acquired, extracorpuscular RBC defects

A. Hereditary, intracorpuscular RBC defects

Which of the following is most true of paroxysmal nocturnal hemoglobinuria (PNH)? A. It is a rare acquired stem cell disorder that results in hemolysis B. It is inherited as a sex-linked trait C. It is inherited as an autosomal dominant trait D. It is inherited as an autosomal recessive trait

A. It is a rare acquired stem cell disorder that results in hemolysis

All of the following are associated with intravascular hemolysis except: A. Methemoglobinemia B. Hemoglobinuria C. Hemoglobinemia D. Decreased haptoglobin

A. Methemoglobinemia

A patient has 80 nucleated red blood cells per 100 leukocytes. In addition to increased polychromasia on the peripheral smear, what other finding may be present on the CBC? A. Increased platelets B. Increased MCV C. Increased Hct D. Increased red blood cell count

B. Increased MCV

Which of the following may be seen in the peripheral blood smear of a patient with obstructive liver disease? A. Schistocytes B. Macrocytes C. Howell-Jolly bodies D. Microcytes

B. Macrocytes

Autoimmune hemolytic anemia is best characterized by which of the following? A. Increased levels of plasma C3 B. Spherocytic red cells C. Decreased osmotic fragility D. Decreased unconjugated bilirubin

B. Spherocytic red cells

Which of the following organs is responsible for the "pitting process" for RBCs? A. Liver B. Spleen C. Kidney D. Lymph nodes

B. Spleen

Which anemia has red cell morphology similar to that seen in iron deficiency anemia? A. Sickle cell anemia B. Thalassemia syndrome C. Pernicious anemia D. Hereditary spherocytosis

B. Thalassemia syndrome

Select the amino acid substitution that is responsible for sickle cell anemia. A. Lysine is substituted for glutamic acid at the sixth position of the α-chain B. Valine is substituted for glutamic acid at the sixth position of the β-chain C. Valine is substituted for glutamic acid at the sixth position of the α-chain D. Glutamine is substituted for glutamic acid at the sixth position of the β-chain

B. Valine is substituted for glutamic acid at the sixth position of the β-chain

Which of the following hemoglobins migrates to the same position as Hgb A2 at pH 8.6? A. Hgb H B. Hgb F C. Hgb C D. Hgb S

C. Hgb C

A patient's peripheral smear reveals numerous NRBCs, marked variation of red cell morphology, and pronounced polychromasia. In addition to a decreased Hgb and decreased Hct values, what other CBC parameters may be anticipated? A. Reduced platelets B. Increased MCHC C. Increased MCV D. Decreased red-cell distribution width (RDW)

C. Increased MCV

Which of the following is not associated with hereditary spherocytosis? A. Increased osmotic fragility B. An MCHC greater than 36% C. Intravascular hemolysis D. Extravascular hemolysis

C. Intravascular hemolysis

Hypersplenism is characterized by: A. Polycythemia B. Pancytosis C. Leukopenia D. Myelodysplasia

C. Leukopenia

Which of the following are most characteristic of the red cell indices associated with megaloblastic anemias? A. MCV 99 fl, MCH 28 pg, MCHC 31% B. MCV 62 fL, MCH 27 pg, MCHC 30% C. MCV 125 fL, MCH 36 pg, MCHC 34% D. MCV 78 fL, MCH 23 pg, MCHC 30%

C. MCV 125 fL, MCH 36 pg, MCHC 34%

A patient has an Hct of 30%, a hemoglobin of 8 g/dL, and an RBC count of 4.0 × 1012/L. What is the morphological classification of this anemia? A. Normocytic normochromic B. Macrocytic hypochromic C. Microcytic hypochromic D. Normocytic hyperchromic

C. Microcytic hypochromic

Hereditary pyropoikilocytosis (HP) is a red cell membrane defect characterized by: A. Increased pencil-shaped cells B. Increased oval macrocytes C. Misshapen budding fragmented cells D. Bite cells

C. Misshapen budding fragmented cells

The anemia seen in sickle cell disease is usually: A. Microcytic, normochromic B. Microcytic, hypochromic C. Normocytic, normochromic D. Normocytic, hypochromic

C. Normocytic, normochromic

The macrocytes typically seen in megaloblastic processes are: A. Crescent-shaped B. Teardrop-shaped C. Ovalocytic D. Pencil-shaped

C. Ovalocytic

Spherocytes differ from normal red cells in all of the following except: A. Decreased surface to volume B. No central pallor C. Decreased resistance to hypotonic saline D. Increased deformability

D. Increased deformability

Which morphological classification is characteristic of megaloblastic anemia? A. Normocytic, normochromic B. Microcytic, normochromic C. Macrocytic, hypochromic D. Macrocytic, normochromic Hematology/Correlate clinical and laboratory

D. Macrocytic, normochromic Hematology/Correlate clinical and laboratory

Which of the following disorders is associated with ineffective erythropoiesis? A. G6PD deficiency B. Liver disease C. Hgb C disease D. Megaloblastic anemia

D. Megaloblastic anemia

An autohemolysis test is positive in all the following conditions except: A. Glucose-6-phosphate dehydrogenase (G6PD) deficiency B. Hereditary spherocytosis (HS) C. Pyruvate kinase (PK) deficiency D. Paroxysmal nocturnal hemoglobinuria (PNH)

D. Paroxysmal nocturnal hemoglobinuria (PNH)

Which anemia is characterized by a lack of intrinsic factor that prevents B12 absorption? A. Tropical sprue B. Transcobalamin deficiency C. Blind loop syndrome D. Pernicious anemia

D. Pernicious anemia

A 50-year-old patient is suffering from pernicious anemia. Which of the following laboratory data are most likely for this patient? A. RBC = 2.5 × 1012/L; WBC =12,500/μL (12.5 × 109/L); PLT = 250,000/μL (250 × 109/L) B. RBC = 4.5 × 1012/L; WBC = 6,500/μL (6.5 × 109/L); PLT = 150,000/μL (150 × 109/L) C. RBC = 3.0 × 1012/L; WBC = 5,000/μL (5.0 × 109/L); PLT = 750,000/μL (750 × 109/L) D. RBC = 2.5 × 1012/L; WBC = 2,500/μL (2.5 × 109/L); PLT = 50,000/μL (50 × 109/L)

D. RBC = 2.5 × 1012/L; WBC = 2,500/μL (2.5 × 109/L); PLT = 50,000/μL (50 × 109/L)

Reticulocytosis usually indicates: A. Response to inflammation B. Neoplastic process C. Aplastic anemia D. Red cell regeneration

D. Red cell regeneration

Hemolytic uremic syndrome (HUS) is characterized by all of the following except: A. Hemorrhage B. Thrombocytopenia C. Hemoglobinuria D. Reticulocytopenia

D. Reticulocytopenia

Microangiopathic hemolytic anemia is characterized by: A. Target cells and Cabot rings B. Toxic granulation and Döhle bodies C. Pappenheimer bodies and basophilic stippling D. Schistocytes and nucleated RBCs

D. Schistocytes and nucleated RBCs

Storage iron is usually best determined by: A. Serum transferrin levels B. Hgb values C. Myoglobin values D. Serum ferritin levels

D. Serum ferritin levels

In which of the following conditions will autosplenectomy most likely occur? A. Thalassemia major B. Hgb C disease C. Hgb SC disease D. Sickle cell disease

D. Sickle cell disease

Iron deficiency anemia may be distinguished from anemia of chronic infection by: A. Serum iron level B. Red cell morphology C. Red cell indices D. Total iron-binding capacity

D. Total iron-binding capacity