RBC Pathology Quiz

A 45-year-old male is discovered to have a chronic gastrointestinal bleed. This patient would most likely also have: a. Elevated blood levels of erythropoietin b. Elevated blood normoblasts c. Elevated hematocrit d. Hematopoiesis in the liver and spleen e. Splenomegaly

A

A 5-year-old boy with hereditary spherocytosis presents to the emergency department complaining of extreme lethargy for three days. His hemoglobin is 5.8 g/dL (normal 10.5-13.5 g/dL) and his reticulocyte count is 14.1 x 109/L (normal 55-120 x 109/L). What most likely caused this? a. Dramatic decrease in red cell production b. Dramatic increase in red cell destruction

A

Apoptosis of erythroid precursor cells in the bone marrow causing significant ineffective erythropoiesis is most likely associated with: a. Beta-thalassemia major b. Beta-thalassemia minor c. Megaloblastic anemia d. Sickle cell anemia e. Sickle cell trait

A

Hereditary spherocytosis is a hemolytic anemia. Hemolysis of spherocytes occurs: a. Mainly in the spleen (extravascular) b. In blood vessels (intravascular)

A

In a normal person, if there was an increase in hemoglobin levels in the blood, it would most likely trigger a homeostatic response that will: a. Lower the hematocrit b. Raise the hematocrit

A

A 72-year-old male has been feeling tired for the past 8 months. He has a history of hypertension. On physical examination there are no abnormal findings. Laboratory studies show a hemoglobin 10.4 g/dL (normal male 14-17 g/dL), hematocrit 30.3% (normal male 41-53%), mean cell volume (MCV) (mean volume of the red cells) 72 fL (normal 80-100 fL). His total bilirubin is 1.0 mg/dL (normal 0.3-1.2 mg/dL). Which of the following morphologic findings is most likely to be seen on his peripheral blood smear? a. Bite cells b. Hypochromic cells c. Megaloblasts d. Normoblasts e. Spherocytes

B

A 9-year-old boy with sickle cell anemia is taken to the emergency department with severe pain in his abdomen and extremities. The pain started suddenly about an hour ago. He had been playing outside. It was very hot and he had not been drinking any water. What is most likely causing his pain? a. Acute decreased erythropoiesis b. Increased red cell sickling c. Massive sequestration of red cells in the spleen

B

Clotting factors are obtained from which of the following substances to treat hemophilia? a. Buffy coat b. Plasma c. Serum

B

Destruction of old or damaged red blood cells will most likely occur by: a. Macrophages in red bone marrow b. Macrophages in the spleen c. Macrophages in yellow bone marrow d. Neutrophils in red bone marrow e. Neutrophils in the spleen f. Neutrophils in yellow bone marrow

B

In a patient with a microcytic anemia (the red blood cells are smaller than normal), the hematocrit would most likely be: a. Elevated b. Reduced c. Not affected

B

In a patient with anemia, the amount of hemoglobin in the blood would most likely be: a. Elevated b. Reduced c. Not affected

B

One complication of kidney failure would most likely be: a. Anemia with elevated blood levels of reticulocytes b. Anemia with reduced or normal blood levels of reticulocytes c. Polycythemia with elevated blood levels of reticulocytes d. Polycythemia with reduced or normal blood levels of reticulocytes

B

The hormone erythropoietin would most likely increase the proliferation and differentiation of which of the following cells? a. Platelets b. Red blood cells c. White blood cells d. All 3 types of cells

B

What would be the body's response to the increased erythropoietin? a. Decreased reticulocytes in the blood b. Increased reticulocytes in the blood c. No change in reticulocytes in the blood

B

What would be the kidney's response to the decreased red cell mass from the abnormally high hemolysis of red cells? a. Decreased erythropoietin production b. Increased erythropoietin production c. No change in erythropoietin production

B

What would most likely happen to erythropoietin levels and reticulocyte count with either iron deficiency, folic acid deficiency or vitamin B12 deficiency anemia? a. Erythropoietin - elevated; Reticulocyte count - elevated b. Erythropoietin - elevated; Reticulocyte count - normal or low c. Erythropoietin - normal or low; Reticulocyte count - elevated d. Erythropoietin - normal or low; Reticulocyte count - normal or low

B

A 24-year-old male has no organomegaly and no deformities. A hemoglobin electrophoresis shows 1% hemoglobin A2, 7% hemoglobin F, and 92% hemoglobin S. He most likely has an increased risk for the development of: a. A microcytic hypochromic anemia b. A sequestration crisis c. A vaso-occlusive crisis d. Neurological problems e. None of the above - he has no significant health issues

C

If a person had an accident which caused a significant loss of blood, this would most likely cause which of the following symptoms? a. Gallstones b. Jaundice c. Pallor d. Splenomegaly

C

Most hemolytic anemias are associated with: a. Apoptosis of erythroid precursors b. Autosplenectomy c. Elevated blood reticulocyte count d. Iron deficiency e. Reduced erythropoiesis

C

While the incidence of sickle cell disease is higher in African Americans, all newborns are screened with a blood test looking for: a. Hemoglobin A (HbA) b. Hemoglobin F (HbF) c. Hemoglobin S (HbS)

C

A 34-year-old male stated he had always felt tired and lethargic, and that his father had some form of anemia. On physical exam, his skin appeared pale with a slight yellowish color, and his spleen appeared enlarged. A peripheral blood smear revealed small red cells which lacked central pallor. The most likely cause of his problem is: a. A deficiency in the beta-globin chain of hemoglobin b. A mutation in the gene for glucose-6-phosphate dehydrogenase (G6PD) c. A mutation in the gene for hepcidin d. A mutation in the gene for one of the cytoskeletal proteins e. A mutation in the gene for the beta-globin chain of hemoglobin

D

Which *organ/tissue* is mainly responsible for the destruction of old or damaged red blood cells? a. Red bone marrow b. Liver c. Macrophages d. Spleen

D

A 43-year-old female states that for the past several months she has experienced easy fatigability and overall tiredness. A peripheral blood smear reveals large red cells or macro-ovalocytes. A neurologic exam reveals numbness in her hands and feet. What is the most likely cause of her condition? a. Chronic alcoholism with a poor diet b. Heart failure with pulmonary and peripheral edema c. Kidney disease with loss of erythropoietin d. Leiomyomas causing heavy menstrual bleeding e. Pernicious anemia

E