1.4 Macrocytic and Normochromic Anemias

Question 1

Which morphological classification is characteristic of megaloblastic anemia?
A. Normocytic, normochromic
B. Microcytic, normochromic
C. Macrocytic, hypochromic
D. Macrocytic, normochromic

Answer 1

D. Macrocytic, normochromic

Question 2

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

Answer 2

D. Pernicious anemia

Question 3

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

Answer 3

B. Elevated reticulocyte count

Question 4

A patient with a vitamin B12 anemia is prescribed 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

Answer 4

B. An improvement in hematological abnormalities

Question 5

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

Answer 5

D. Megaloblastic anemia

Question 6

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)

Answer 6

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

Question 7

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

Answer 7

B. Macrocytes

Question 8

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

Answer 8

C. Oval shaped

Question 9

Which of the following are most characteristic of the RBC 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%

Answer 9

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

Question 10

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

Answer 10

B. Increased MCV