SHERPATH: Anemias

Which factors lead to the development of iron deficiency anemia? Select all that apply. A. Chronic blood loss B. Severe kidney failure C. Poor absorption of iron D. Decreased intake of iron E. Increased alcohol consumption

A. Chronic blood loss Chronic blood loss from problems such as stomach ulcers, hemorrhoids, or heavy menstrual flow can lead to iron deficiency anemia. C. Poor absorption of iron Malabsorption of iron can cause iron deficiency anemia. D. Decreased intake of iron Decreased intake of iron from food can cause the development of iron deficiency anemia.

Which describes the development and presentation of koilonychia in individuals with iron deficiency anemia? A. Degenerative changes that cause disfigurement of the nails B. Gastric mucosa changes leading to a decrease in hydrochloric acid C. Poor absorption of nutrients causing a red, shiny, and sore tongue D. Hemolysis causing a buildup of debris from the destruction of RBCs

A. Degenerative changes that cause disfigurement of the nails Iron deficiency anemia often results in degenerative changes that lead to koilonychia, which is a disfigurement of the nails (brittle and concave in shape).

Which treatments may result in the development of hemolytic anemia? Select all that apply. A. Hemodialysis B. Peritoneal dialysis C. Blood transfusions D. Cardiopulmonary bypass E. Cardiopulmonary resuscitation

A. Hemodialysis Hemodialysis destroys RBCs by trauma or force. The destruction of RBCs leads to hemolytic anemia. D. Cardiopulmonary bypass In cardiopulmonary bypass, blood is circulated outside the body where it is filtered and then delivered back into the circulatory system. The force of removing the blood and then pushing it back into circulation can damage the RBCs and lead to hemolytic anemia.

Which is a causative factor in the development of sickle cell anemia? A. Inherited genes B. Decreased intake of minerals C. Excessive destruction of hemoglobin D. Alteration of stem cells in the bone marrow

A. Inherited genes Sickle cell anemia is the result of an inherited autosomal recessive genetic disorder, which causes RBCs to become sickled in shape.

Which statement describes the leading cause of thalassemia? A. It is a genetic disorder. B. It results from a vitamin B12 deficiency. C. It is due to decreased intake of folic acid. D. It is due to a problem with iron absorption.

A. It is a genetic disorder. Thalassemia is a microcytic-hypochromic anemia resulting from a genetic disorder.

Anemias are classified by the size, shape, and color of the erythrocytes. Which classifications describe the three groups of anemias? Select all that apply. A. Microcytic-hypochromic B. Macrocytic-hypochromic C. Microcytic-normochromic D. Macrocytic-normochromic E. Normocytic-normochromic

A. Microcytic-hypochromic Microcytic-hypochromic is a correct classification, describing small cells that are pale in color. D. Macrocytic-normochromic Macrocytic-normochromic is a correct classification, describing large cells of normal color. E. Normocytic-normochromic Normocytic-normochromic is a correct classification, describing cells of normal size and color.

Which clinical manifestations are associated with mild anemia? Select all that apply. A. Ataxia B. Jaundice C. Dyspnea D. Tachypnea E. Tachycardia

C. Dyspnea Dyspnea is shortness of breath and is associated with anemia as individuals attempt to meet the body's demand for oxygen. D. Tachypnea Tachypnea is an increase in respiratory rate and is associated with anemia as individuals attempt to compensate for the decrease in available oxygen to the tissues. E. Tachycardia Tachycardia is an increased heart rate and is associated with anemia as individuals attempt to compensate for the decrease in available oxygen to the tissues.

Which process leads to an enlarged spleen and liver in sideroblastic anemia? A. Hemolysis B. Pancytopenia C. Hemosiderosis D. Angular stomatitis

C. Hemosiderosis In sideroblastic anemia, there is an overload of iron (hemosiderosis) that results in an enlargement of the spleen and liver.

Which anemia can result in dysphagia, or swallowing difficulty? A. Aplastic B. Sideroblastic C. Iron deficiency D. Folate deficiency

C. Iron deficiency In iron deficiency anemia, inflammation of the oral mucosa is common. This can lead to a web of mucous forming at the opening of the esophagus, causing swallowing difficulty.

An individual presents with a complaint of extreme fatigue. Upon assessment, the hemoglobin level is 8.0 g/dL, and the individual's skin tone is yellowish in color. Which issue would lead to the change in skin color? A. Jaundice from hepatitis B. Jaundice from kidney failure C. Jaundice from RBC hemolysis D. Jaundice from increased RBC production

C. Jaundice from RBC hemolysis As RBCs hemolyze, the debris from their destruction remains in the circulation, leading to a yellow cast to the skin (jaundice).

Which circumstances are associated with the three pathophysiological processes that lead to anemia? Select all that apply. A. Renal failure B. Ruptured aortic aneurysm C. Cerebral vascular accident D. Transfusion of incompatible blood E. Decreased intake of certain nutrients

A. Renal failure Renal failure causes deficient production of erythropoietin, which in turn decreases the production of RBCs in the bone marrow. This can lead to anemia. B. Ruptured aortic aneurysm A ruptured aortic aneurysm causes internal hemorrhage, which causes anemia from severe blood loss. D. Transfusion of incompatible blood The administration of incompatible blood products causes hemolysis, which can lead to anemia. E. Decreased intake of certain nutrients A decreased intake of certain nutrients, such as iron or folic acid, decreases the production of RBCs that can cause anemia.

Which situations might trigger a sickling event in the individual with sickle cell anemia? Select all that apply. A. Viral pneumonia B. Diabetic ketoacidosis C. Picnicking on a cool spring day D. Consuming a large steak dinner E. Snow skiing in the mountains of Colorado

A. Viral pneumonia Viral and bacterial infection can initiate a sickling episode. B. Diabetic ketoacidosis Acidosis is often an initiating event for a sickling episode. E. Snow skiing in the mountains of Colorado High altitudes can often initiate a sickling episode; therefore, skiing in Colorado could be risky.

The chief complaint of individuals with sickle cell anemia is pain. Which is the cause of pain in these individuals? A. Hemorrhage from blood loss B. A blockage of blood flow to tissues C. Muscle cramping from CNS stimulation D. Stiffness from inactivity resulting from fatigue

B. A blockage of blood flow to tissues The sickled RBCs obstruct blood flow to the tissues. The resulting hypoxia leads to severe pain.

Aplastic anemia is characterized as a pancytopenia. Which causative factor does this refer to? A. Destruction of RBCs B. Bone marrow failure C. Abnormally shaped RBCs D. An inherited genetic disorder

B. Bone marrow failure In aplastic anemia, there is generalized bone marrow failure, resulting in decreased production of a variety of blood cells, including RBCs, leukocytes, and thrombocytes.

Which statement describes the way macrocytic-normochromic anemias are classified? Select all that apply. A. Erythrocytes are pale in color. B. Erythrocytes are normal in color. C. Erythrocytes are smaller than normal. D. Erythrocytes are much larger than normal. E. Erythrocytes contain an abnormally low amount of hemoglobin.

B. Erythrocytes are normal in color. Macrocytic-normochromic anemia is classified by the large size and normal color of erythrocytes. D. Erythrocytes are much larger than normal. Macrocytic-normochromic anemia is classified by the large size and normal color of the erythrocytes.

Which statement accurately describes all forms of anemia? A. A condition in which there is blood loss B. A condition in which there in increased RBC destruction C. A condition in which there is decreased RBC production D. A condition in which there is a reduction in the hemoglobin

D. A condition in which there is a reduction in the hemoglobin Anemia is a condition in which there is a reduction in the hemoglobin in the RBCs.

Which pathophysiological circumstance leads to pernicious anemia? A. Lack of oxygen-carrying hemoglobin B. Lack of protein, reducing the utilization of vitamin B12 C. Lack of hydrochloric acid necessary for digestion of B12 D. Lack of required intrinsic factor needed for absorption of B12

D. Lack of required intrinsic factor needed for absorption of B12 In pernicious anemia, the body lacks an intrinsic factor (IF) necessary for the absorption of vitamin B12.

Pernicious anemia is seen in 20%-50% of adults with deficiency of which substance? A. Iron B. Folic acid C. Vitamin B6 D. Vitamin B12

D. Vitamin B12 Pernicious anemia is seen as a result of a vitamin B12 deficiency.