Anemias: Red Blood Cell Morphology and Approach to Diagnosis

Question 1

1. Which of the following patients would be considered anemic with a hemoglobin value of 14.5 g/dL? Refer to reference
   intervals inside the front cover of this text.
   a. An adult man
   b. An adult woman
   c. A newborn boy
   d. A 10-year-old girl

Answer 1

c. A newborn boy

Question 2

2. Common clinical symptoms of anemia include:
   a. Splenomegaly
   b. Shortness of breath and fatigue
   c. Chills and fever
   d. Jaundice and enlarged lymph nodes

Answer 2

b. Shortness of breath and fatigue

Question 3

3. Which of the following are important to consider in the
   in the patient’s history when investigating the cause of an
   anemia?
   a. Diet and medications
   b. Occupation, hobbies, and travel
   c. Bleeding episodes in the patient or in his or her family
   members
   d. All of the above

Answer 3

d. All of the above

Question 4

4. Which one of the following is reduced as an adaptation to
   long-standing anemia?
   a. Heart rate
   b. Respiratory rate
   c. Oxygen affinity of hemoglobin
   d. Volume of blood ejected from the heart with each
   contraction

Answer 4

c. Oxygen affinity of hemoglobin

Question 5

5. An autoimmune reaction destroys the hematopoietic stem
   cells in the bone marrow of a young adult patient, and the
   amount of active bone marrow, including RBC precursors, is
   diminished. The RBC precursors that are present are normal
   in appearance, but there are too few to meet the demand for
   circulating red blood cells, and anemia develops. The reticulocyte count is low. The mechanism of the anemia would be
   described as:
   a. Effective erythropoiesis
   b. Ineffective erythropoiesis
   c. Insufficient erythropoiesis

Answer 5

c. Insufficient erythropoiesis

Question 6

6. What are the initial laboratory tests that are performed for
   the diagnosis of anemia?
   a. CBC, iron studies, and reticulocyte count
   b. CBC, reticulocyte count, and peripheral blood film
   examination
   c. Reticulocyte count and serum iron, vitamin B12, and
   folate assays
   d. Bone marrow study, iron studies, and peripheral blood
   film examination

Answer 6

b. CBC, reticulocyte count, and peripheral blood film
examination

Question 7

7. An increase in which one of the following suggests a shortened life span of RBCs and hemolytic anemia?
   a. Hemoglobin
   b. Hematocrit
   c. Reticulocyte count
   d. Red cell distribution width

Answer 7

c. Reticulocyte count

Question 8

8. Which of the following is detectable only by examination of
   a peripheral blood film?
   a. Microcytosis
   b. Anisocytosis
   c. Hypochromia
   d. Poikilocytosis

Answer 8

d. Poikilocytosis

Question 9

9. Schistocytes, ovalocytes, and acanthocytes are examples of
   abnormal changes in RBC:
   a. Volume
   b. Shape
   c. Inclusions
   d. Hemoglobin concentration

Answer 9

b. Shape

Question 10

10. Refer to Figure 19-3 to determine which one of the following
    conditions would be included in the differential diagnosis of
    an anemic adult patient with an absolute reticulocyte count
    of 20 3 109/L and an MCV of 65 fL.
    a. Aplastic anemia
    b. Sickle cell anemia
    c. Iron deficiency
    d. Folate deficiency

Answer 10

c. Iron deficiency

Question 11

11. Which one of the following conditions would be included
    in the differential diagnosis of an anemic adult patient
    with an MCV of 125 fL and an RDW of 20% (reference
    interval 11.5% to 14.5%)? Refer to Table 19-4.
    a. Aplastic anemia
    b. Sickle cell anemia
    c. Iron deficiency
    d. Vitamin B12 deficiency

Answer 11

d. Vitamin B12 deficiency