CHAPTER 19: 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?

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) 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 x 10^9/L and an MCV of 65 fL.

Refer to: https://drive.google.com/file/d/1bnmv50DOQiWVTo7m_onQz9vOMYVkV03C/view

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: https://drive.google.com/file/d/1RpaLo5XsbbM-1XckEezF-MAqIVGLhHIZ/view

a. Aplastic anemia
b. Sickle cell anemia
c. Iron deficiency
d. Vitamin B12 deficiency

Answer 11

d. Vitamin B12 deficiency