Physiology: Production

Which of the following is NOT a way hemoglobinopathies can be caused?

Deletion of a globin chain.

Which of the following represent other hemoglobin gene loci that occur on the same chromosome as the beta chain loci?

Delta and gamma

Which hormone is produced by the kidney and influences erythrocyte production?

Erythropoietin

In which of the following situations would a bone marrow aspirate and biopsy be MOST LIKELY recommended to aid in diagnosis?

Evaluation of unexplained cytopenias

Which of the following are terms used to describe storage pool iron?

Ferritin and hemosiderin

Regarding hemoglobin synthesis, which of the following constitutes the alpha globin chain coding?

Four gene loci; two each on chromosome 16.

The bone marrow begins producing cells in the _____________ month of fetal life.

Fourth

Which of the following is responsible for the humoral immune response:

B lymphocytes

The percentage of red blood cells in whole blood is called:

Hematocrit

B lymphocytes and T lymphocytes are derived from:

Hematopoietic stem cells

Effusion fluids are classified as transudates or exudates. According to Light's criteria, all of the following is applicable to an exudate EXCEPT?

Pleural fluid lactate dehydrogenase (LDH) <2/3 the normal upper limit for serum

In which developmental stage do red blood cells begin forming hemoglobin in amounts large enough to be visualized on a Wright-stained bone marrow aspirate smear?

Polychromatic normoblast

Which of the following is an expected or common laboratory finding in patients with hereditary hemochromatosis (HH)?

Presence of HFE mutation

Which of the following stages of neutrophilic granulocyte cellular development is at the second stage from the least mature stage?

Promyelocyte

What is the correct order of erythrocyte maturaton in the bone marrow? (beginning from the most immature)

Pronormoblast? basophilic normoblast? polychromatophilic normoblast? orthochromic normoblast? polychromatophilic erythrocyte

In an adult, hematopoiesis occurs in which of the following listed sites?

Proximal ends of long bones

Which of the following statements are true for the hematopoietic cords?

Reticular cells (adventitial cells) provide support for developing hematopoietic cells within the hematopoietic cords

All of the following are present in normal bone marrow EXCEPT?

Ringed sideroblast

The gene loci for the alpha globin chains are adjacent to the locus for which other globin chain?

Zeta

Which of the following cells are of lymphoid lineage?

Plasma cell

What is the normal ratio of erythroid to myeloid cells found in the normal bone marrow?

1:3

What is the normal myeloid to erythroid (M:E) ratio in the bone marrow?

2:1 - 4:1

The normal Myeloid-to-erythroid ratio (M:E ratio) ranges from:

2:1 to 4:1

What is the expected life span of a normal red blood cell?

3-4 months

Whole blood if composed of approximately:

45% formed elements and 55% plasma

From the white blood cell values listed below, which is within the normal reference ranges?

5,500/mm3

The average bone marrow cellularity in a normal adult (50 years old) is:

50

What is the normal cellularity of an iliac crest bone marrow biopsy in a 50-year-old male:

50%

The radioactive method used to measure red cell survival uses which of the following isotopes?

51Cr

Adult (normal) Hemoglobin is made up of the following composition:

>95% HbA, <3.5% HbA2, <1-2% HbF

Which of the following is NOT considered necessary for making a diagnosis of hereditary hemochromatosis (HH)?

A positive family history

What are Howell-Jolly bodies composed of?

DNA

What is the cause of iron overload in hereditary hemochromatosis?

Absorption of excessive amounts of iron in the small intestine

What is the composition of the granules associated with basophilic stippling?

Aggregates of ribosomes

The following polypeptide chains are found in normal adult hemoglobin A:

Alpha and beta

Which of the following hemoglobins is replaced by hemoglobin H (HbH) after birth in individuals with HbH disease?

Bart's

Which of the following globin genes are found on Chromosome 11?

Beta, gamma, epsilon

Which of the following statements is correct regarding bone marrow evaluation?

Bone marrow cellularity is highest in young children compared to adults.

Which of the following is the proper designation for the pluripotential stem cell that is a precursor for both myeloid and lymphoid cell lines?

CFU-S

Which of the following statement is INCORRECT regarding the bone marrow biopsy specimen?

Cellular morphologic detail can be determined.

The production of and development of blood cells is called:

Hemopoiesis

A bone marrow biopsy from a 50-year-old patient that has an overall cellularity of 20% (i.e., 80% fat and 20% hematopoietic cells) is considered:

Hypocellular

What is the site used MOST frequently in the adult patient when performing a bone marrow biopsy?

Iliac crest

The abnormalities that are seen on this slide are probably associated with which of the following conditions?

Increased red cell production

What would you predict is the effect on iron absorption if erythopoietic activity is increased over a prolonged period of time?

It would increase.

Erythropoietin is mainly produced in:

Kidneys

All of the following are sites of active hematopoiesis in the adult EXCEPT:

Liver

Which of the following major cellular elements does not develop solely in the bone marrow?

Lymphocyte

What is the platelet precursor cell found in the bone marrow?

Megakaryocyte

What is the precursor of the platelet which is commonly only found in the bone marrow?

Megakaryocyte

Which of the following cells is the most common nucleated cell in normal adult bone marrow?

Metamyelocyte

If greater than 50% lymphocytes were found on the peripheral blood smear of a 5 month old child you would suspect which of the following conditions?

Normal finding

Which white blood cell is found in the largest numbers in the peripheral blood of a normal adult?

Segmented neutrophil

The bone marrow begins to produce blood cells in the ________ month of gestation.

Seventh

What morphologically abnormal red blood cell is associated with "hyperchromia"?

Spherocyte

Out of the choices below, which set of cells is arranged from least mature to most mature?

Stem Cell, Rubriblast, Prorubricyte, Rubricyte, Metarubricyte, Reticulocyte, Erythrocyte

Which of these is arranged from least mature to most mature?

Stem cell, lymphoblast, prolymphocyte, lymphocyte

In the process of thrombopoiesis, which is arranged from least mature to most mature?

Stem cell, megakaryoblast, promegakarocyte, megakarocyte, thrombocyte

An assessment of the myeloid to erythroid (M:E) ratio is part of every bone marrow evaluation. Which of the following does not apply to the M:E ratio?

The myeloid total used in calculating the M:E ratio is the sum of all non-RBC cell types found in the marrow.

Which of the following statements is correct regarding the bone marrow compartments?

The two main compartments of the bone marrow are the vascular sinuses and hematopoietic cords.

Aspirin ingestion prevents the synthesis of this signaling molecule in the platelet?

Thromboxane A2

In which organ or tissue do T-lymphocytes mature?

Thymus

All of the following bones contain active hematopoietic bone marrow in a normal adult, EXCEPT?

Tibia

To produce hemoglobin S (HbS), glutamic acid that is normally present in the sixth position on the beta globin chain is substituted with which of the following?

Valine