Chapter 28: Alterations of Hematologic Function in Children

Question 1

Question 8: the blood disorder of infancy and childhood caused by poor dietary iron intake:

a. a microcytic-hypochromic anemia
b. pernicious anemia
c. folate deficiency anemia
d. siderblastic anemia

Answer 1

a. a microcytic-hypochromic anemia

Question 2

a first time pregnancy may initiate Rh sensitization in which conditions?

a. Rh positive mother, Rh negative fetus
b. Rh negative mother, Rh-positive fetus
c. Rh negative father, Rh positive mother
d. Rh negative father, Rh negative mother

Answer 2

b. Rh negative mother, Rh-positive fetus

Question 3

Beta thalassemia is:

a. common among italians
b. an x linked recessive disorder
c. an autosomal dominant disorder
d. common in the chinese
e. both a & c are correct

Answer 3

a. common among italians

Question 4

sickle cell disease is an

a. autosomal dominant disorder
b. x linked recessive disorder
c. x linked dominant disorder
d. autosomal recessive disorder

Answer 4

d. autosomal recessive disorder

Question 5

idiopathic thrombocytopenia purport (ITP) involves:

a. neutrophilic destruction
b. eosinophilic destruction
c. a platelet/antibody complex
d. thrombocytosis

Answer 5

c. a platelet/antibody complex

Question 6

Which are associated with inherited thrombophilic conditions?

a. antithrombin III deficiency
b. Factor III deficiency
c. Decreased platelet adhesiveness
d. Both a & c are correct

Answer 6

a. antithrombin III deficiency

Question 7

which is the most likely cause of idiopathic thrombocytopenia purpura:

a. Stress & fatigue
b. high levels of IgG on platelets
c. Prolonged occult bleeding
d. Viral sensitization

Answer 7

d. Viral sensitization

Question 8

Hodgkin disease has:

a. extensive extranodal involvement
b. rare extra nodal involvement
c. painful cervical lymphadenopathy
d. a mediastinal mass

Answer 8

b. rare extra nodal involvement

Question 9

in sickle cell disease, faso occlusive crisis is the result of:

a. damage to platelets due to IgG
b. the “plugging” of peripheral blood vessels by “stiff” sickled erythrocytes
c. the ingestion of sulfa drugs
d. sequestration of large numbers of erythrocytes in the spleen

Answer 9

b. the “plugging” of peripheral blood vessels by “stiff” sickled erythrocytes

Question 10

Which factors may play a part in the development of childhood leukemia?

a. genetic predisposition
b. environmental factors
c. viral infections
d. radiation
e. all of the above

Answer 10

e. all of the above

Question 11

Which characteristic is true about acute lymphocytic leukemia?

a. It is the most common childhood leukemia
b. it usually occurs in non white children
c. it is uniformly fatal
d. it is easily predicted through genetic testing

Answer 11

a. It is the most common childhood leukemia

Question 12

1. Which of the following is TRUE regarding fetal and adult hemoglobin?
   A. Fetal hemoglobin is composed of two α- and two γ-chains.
   B. Adult hemoglobin is composed of two α- and one γ-chain.
   C. Adult hemoglobin is HbF and HbA.
   D. Three of the embryonic hemoglobins are Gower 1, 2, and 3.

Answer 12

A. Fetal hemoglobin is composed of two α- and two γ-chains

Question 13

2. Which of the following is TRUE regarding anemia in children?
   A. The most common cause is sickle cell disease.
   B. Anemia is the most common blood disorder in children.
   C. There is only one cause of hemolytic anemia.
   D. Children rarely present with iron deficiency anemia.

Answer 13

B. Anemia is the most common blood disorder in children.

Question 14

3. Which of the following statements is TRUE regarding iron deficiency anemia?
   A. Whites are more commonly affected.
   B. Incidence is most common in those children older than 2 years.
   C. It is common in children due to their extremely high need for iron for normal growth.
   D. There is decreased risk in children of homeless women.

Answer 14

C. It is common in children due to their extremely high need for iron for normal growth.

Question 15

4. Which of the following is TRUE regarding iron deficiency?
   A. Splenomegaly is present in 90% of those affected.
   B. Hemoglobin of less than 5 g/dl may be accompanied by pallor.
   C. Hemoglobin of 10 g/dl is generally accompanied by tachycardia.
   D. Widening of sutures is an early sign of iron deficiency.

Answer 15

B. Hemoglobin of less than 5 g/dl may be accompanied by pallor.

Question 16

5. Which of the following is a TRUE statement regarding maternal antibodies?
   A. Placental detachment does not result in fetal erythrocytes crossing the placenta.
   B. The first Rh-incompatible pregnancy usually presents with severe complications.
   C. Anti-Rh antibodies are formed only in the response to transfusion.
   D. ABO incompatibility can cause hemolytic disease without erythrocytes escaping maternal circulation.

Answer 16

D. ABO incompatibility can cause hemolytic disease without erythrocytes escaping maternal circulation.

Question 17

6. Which of the following is the appropriate term for an alloimmune disease in which maternal blood and fetal blood are antigenically incompatible? 
A. Erythroblastosis fetalis 
B. Hydrops fetalis 
C. Icterus neonatorum 
D. Icterus gravis neonatorum

Answer 17

A. Erythroblastosis fetalis

Question 18

7. Which of the following is TRUE regarding the Coombs test?
   A. Indirect Coombs confirms the diagnosis of antibody-mediated hemolytic disease.
   B. Indirect Coombs measures antibodies to the mother’s circulation.
   C. Direct Coombs indicates if the fetus is at risk for hemolytic disease.
   D. Direct Coombs measures free antibodies

Answer 18

B. Indirect Coombs measures antibodies to the mother’s circulation.

Question 19

8. Which of the following is TRUE regarding G6PD deficiency?
   A. Most commonly found in females
   B. Most common manifestation is polycythemia
   C. Associated with icterus neonatorum
   D. Associated with green bean ingestion

Answer 19

C. Associated with icterus neonatorum

Question 20

9. Which of the following is associated with hereditary spherocytosis?
   A. Autosomal recessive trait
   B. 25% are new mutations
   C. Results in Heinz bodies
   D. Another name for this disease is kernicterus

Answer 20

B. 25% are new mutations

Question 21

10. Which of the following terms describes a person with Hb(s) and another type of abnormal Hgb? 
A. Sickle cell anemia 
B. Sickle cell thalassemia 
C. Sickle cell trait 
D. Hereditary spherocytosis

Answer 21

B. Sickle cell thalassemia

Question 22

11. Which of the following is a TRUE statement regarding sickle cell disease?
    A. Sickle cell trait is the homozygous form of the disease.
    B. Sickle cell disease means a person has HbA genes.
    C. It is most common in European descent.
    D. It is an autosomal recessive disease.

Answer 22

D. It is an autosomal recessive disease.

Question 23

12. Which of the following is the most common trigger for sickling? 
A. Hypoxemia 
B. Decreased hydrogen ions 
C. Decreased plasma osmolality 
D. High temperature

Answer 23

A. Hypoxemia

Question 24

13. Which of the following is the appropriate term for a transient cessation in red blood cell production resulting in acute anemia? 
A. Vaso-occlusive crisis 
B. Aplastic crisis 
C. Sequestration crisis 
D. Hyperhemolytic crisis

Answer 24

B. Aplastic crisis

Question 25

14. Which of the following hemophilias is autosomal recessive and is found equally in males and females? 
A. Hemophilia A 
B. Hemophilia B 
C. Hemophilia C 
D. von Willebrand disease

Answer 25

C. Hemophilia C