CHAPTER 7_CLASSIFICATION AND LABORATORY ASSESSMENT OF ANEMIAS Flashcards

1
Q
  1. The causes of anemia include

A. blood loss
B. impaired red cell production
C. accelerated red cell destruction
D. all of the above.

A

D. all of the above.

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2
Q
  1. The clinical signs and symptoms of anemia can result
    from

A. diminished delivery of oxygen to the tissues
B. lowered hemoglobin concentration
C. increased blood volume
D. both A and B

A

D. both A and B

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2
Q
  1. If you are grading changes in erythrocytic size or
    shape using a scale of 0 to 4+ and many erythrocytes
    deviate from normal per microscopic field, the typical
    score would be

A. 1+
B. 2+
C. 3+
D. 4+

A

C. 3+

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2
Q
  1. Anemias can be categorized into

A. hemolytic types
B. blood loss types
C. impaired production types
D. all of the above

A

D. all of the above

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3
Q

Questions 1 through 5: Match the following
characteristics with either A or B.

A. Acute blood loss
B. Chronic blood loss

A
  1. __B___ Disorders of the GI system or heavy
    menstruation
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4
Q

Questions 1 through 5: Match the following
characteristics with either A or B.

A. Acute blood loss
B. Chronic blood loss

A
  1. __B___ Does not disrupt the blood volume
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4
Q
  1. Which of the following is a significant laboratory
    finding in anemia?

A. Decreased hemoglobin
B. Increased packed cell volume
C. Increased erythrocyte count
D. Normal erythrocyte indices

A

A. Decreased hemoglobin

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5
Q

Questions 1 through 5: Match the following
characteristics with either A or B.

A. Acute blood loss
B. Chronic blood loss

A
  1. __A___ Increased thrombocytes (platelets)
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5
Q

Questions 1 through 5: Match the following
characteristics with either A or B.

A. Acute blood loss
B. Chronic blood loss

A
  1. __A___ Traumatic conditions
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6
Q

Questions 1 through 5: Match the following
characteristics with either A or B.

A. Acute blood loss
B. Chronic blood loss

A
  1. __B___ Results in an iron deficiency and a
    hypochromic/microcytic erythrocyte morphology on a
    peripheral blood smear
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7
Q
  1. The erythrocyte morphology associated with anemia
    in an otherwise healthy individual caused by acute
    blood loss is usually

A. microcytic
B. megaloblastic
C. normochromic
D. hypochromic

A

C. normochromic

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7
Q
  1. If a patient with aplastic anemia is referred to as
    exhibiting pancytopenia, which cell lines are affected?

A. Erythrocytes
B. Leukocytes
C. Thrombocytes
D. All of the above

A

D. All of the above

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8
Q
  1. Aplastic anemia can occur years before a diagnosis of
    ____ is made.

A. paroxysmal nocturnal hemoglobinuria
B. myelodysplasia
C. acute myelogenous leukemia
D. all of the above

A

D. all of the above

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8
Q
  1. Acquired aplastic anemia may be caused by

A. benzene or benzene derivatives
B. ionizing radiation and vitamin B12
C. purine or pyrimidine analogues
D. all of the above

A

D. all of the above

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9
Q
  1. Anemia caused by chronic blood loss is characterized
    by

A. hypochromic, microcytic erythrocytes
B. decreased packed cell volume
C. increased platelets
D. both A and B

A

D. both A and B

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10
Q
  1. The sudden appearance of aplastic anemia or pure
    red cell aplasia is often caused by

A. a hemolytic process
B. an immune process
C. acute leukemias
D. chronic leukemias

A

B. an immune process

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11
Q
  1. Fanconi anemia is associated with abnormal genes
    located on chromosomes __q___, __q___.

A. 9, 20
B. 5, 22
C. 9, 12
D. 8, 23

A

A. 9, 20

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11
Q

Questions 5 to 8: Match the following. (Use an answer
only once)

A. A subset of Fanconi anemia
B. A rare congenital form of red cell aplasia
C. Is characterized by selective failure of red blood cell
production
D. The best-described congenital form of aplastic
anemia

A
  1. __D___ Fanconi anemia
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11
Q
  1. The etiology of IDA is

A. nutritional deficiency
B. faulty iron absorption
C. excessive loss of iron
D. all of the above

A

D. all of the above

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12
Q

Questions 5 to 8: Match the following. (Use an answer
only once)

A. A subset of Fanconi anemia
B. A rare congenital form of red cell aplasia
C. Is characterized by selective failure of red blood cell
production
D. The best-described congenital form of aplastic
anemia

A
  1. __A___ Familial aplastic anemia
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12
Q

Questions 5 to 8: Match the following. (Use an answer
only once)

A. A subset of Fanconi anemia
B. A rare congenital form of red cell aplasia
C. Is characterized by selective failure of red blood cell
production
D. The best-described congenital form of aplastic
anemia

A
  1. __C___ Pure red cell anemia
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12
Q
  1. Hematopoietic cell targets in aplastic anemia are
    affected by

A. activated cytotoxic T lymphocytes
B. activation of the Fas receptor
C. direct cell–cell interactions between lymphocytes and
target cells
D. all of the above

A

D. all of the above

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13
Q
  1. Iron deficiency is still common in

A. toddlers
B. adolescent girls
C. women of childbearing age
D. all of the above

A

D. all of the above

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13
Q

Questions 5 to 8: Match the following. (Use an answer
only once)

A. A subset of Fanconi anemia
B. A rare congenital form of red cell aplasia
C. Is characterized by selective failure of red blood cell
production
D. The best-described congenital form of aplastic
anemia

A
  1. __B___ Diamond-Blackfan syndrome
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14
Q

Questions 3 through 7: Match the following categories
with an appropriate example. (Use an answer only
once)

A. Sprue
B. Colon cancer
C. Adolescent growth spurt
D. Menstruation
E. Meat-poor diet

A
  1. _A____ Faulty iron absorption
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14
Q

Questions 3 through 7: Match the following categories
with an appropriate example. (Use an answer only
once)

A. Sprue
B. Colon cancer
C. Adolescent growth spurt
D. Menstruation
E. Meat-poor diet

A
  1. _E____ Decreased iron intake
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15
Q

Questions 3 through 7: Match the following categories
with an appropriate example. (Use an answer only
once)

A. Sprue
B. Colon cancer
C. Adolescent growth spurt
D. Menstruation
E. Meat-poor diet

A
  1. _D____ Physiological iron loss
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16
Q

Questions 3 through 7: Match the following categories
with an appropriate example. (Use an answer only
once)

A. Sprue
B. Colon cancer
C. Adolescent growth spurt
D. Menstruation
E. Meat-poor diet

A
  1. _B____ Pathological iron loss
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17
Q

Questions 3 through 7: Match the following categories
with an appropriate example. (Use an answer only
once)

A. Sprue
B. Colon cancer
C. Adolescent growth spurt
D. Menstruation
E. Meat-poor diet

A
  1. _C____ Increased iron utilization
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17
Q
  1. The average adult has _____ g of total iron.

A. 0.2 to1.4
B.1.5 to3.4
C.3.5 to5.0
D.5.1 to10.0

A

C.3.5 to5.0

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18
Q

Questions 10 and 11: Approximately (10) _____% of
iron from food is in the form of (11) _____ iron.

  1. A. Nonheme
    B. Heme
A

A. Nonheme

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18
Q

Questions 10 and 11: Approximately (10) _____% of
iron from food is in the form of (11) _____ iron.

  1. A. 25
    B. 50
    C. 70
    D. 90
A

D. 90

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19
Q
  1. Most functional iron in humans is found in

A. the bone marrow
B. the liver
C. hemoglobin molecules of erythrocytes (RBCs)
D. the free hemoglobin in the circulation

A

C. hemoglobin molecules of erythrocytes (RBCs)

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19
Q
  1. Most ingested iron is readily absorbed into the body
    in the

A. stomach and duodenum
B. duodenum and upper jejunum
C. ileum and duodenum
D. upper jejunum and ileum

A

B. duodenum and upper jejunum

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20
Q
  1. Transferrin represents a

A. storage form of iron
B. beta globulin that moves iron
C. glycoprotein that moves iron
D. both B and C

A

D. both B and C

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20
Q
  1. The peripheral blood smear demonstrates _____
    red blood cells in IDA.

A. microcytic, hypochromic
B. macrocytic, hypochromic
C. macrocytic and spherocytic
D. either A or B

A

A. microcytic, hypochromic

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21
Q
  1. In IDA, the erythrocytic indices are typically

A. MCV increased, MCH decreased, and MCHC
decreased
B. MCV decreased, MCH decreased, and MCHC
decreased
C. MCV decreased, MCH increased, and MCHC
decreased
D. MCV decreased, MCH decreased, and MCHC normal

A

B. MCV decreased, MCH decreased, and MCHC
decreased

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21
Q
  1. In IDA, the

A. serum iron is severely decreased and the TIBC is
increased
B. serum iron is decreased and the TIBC is normal
C. serum iron is normal and the TIBC is normal
D. serum iron is increased and the TIBC is normal

A

A. serum iron is severely decreased and the TIBC is
increased

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22
Q
  1. Anemias of inflammation/chronic diseases can be
    caused by

A. inflammation
B. infection
C. malignancy
D. all of the above

A

D. all of the above

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22
Q
  1. Sideroblastic anemia can be caused by

A. congenital (chromosomal) defect
B. drugs (e.g., chloramphenicol)
C. association with malignant disorders (e.g., acute
myelogenous leukemia)
D. all of the above

A

D. all of the above

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23
Q
  1. Leukoerythroblastosis can appear as _____ on a
    peripheral blood smear.

A. immature leukocytes
B. immature erythrocytes
C. immature thrombocytes
D. both A and B

A
23
Q
  1. The typical peripheral blood film of a patient with
    AOI typically reveals _____ erythrocytes.

A. microcytic, hypochromic
B. macrocytic, hypochromic
C. normocytic, normochromic
D. many spherocytes

A

C. normocytic, normochromic

23
Q
  1. Storage iron in the human body is

A. found in hepatocytes
B. found in macrophages
C. sequestered as ferritin
D. all of the above

A

D. all of the above

24
Q
  1. AOI can result from

A. inappropriately decreased erythropoietin
B. suppression of erythropoiesis by cytokines from
activated macrophages and lymphocytes
C. impaired iron metabolism
D. all of the above

A

D. all of the above

25
Q
  1. A common feature of sideroblastic anemia is

A. ringed sideroblasts
B. decreased serum iron
C. decreased serum ferritin
D. macrocytic red blood cells

A

A. ringed sideroblasts

25
Q
  1. What is the most appropriate treatment for AOI?

A. Red blood cell transfusion
B. Iron therapy
C. Erythropoietin injections
D. Treatment of the inflammatory condition

A

D. Treatment of the inflammatory condition

26
Q
  1. The greatest portion of operational body iron is
    normally contained in what compound?

A. Hemoglobin
B. Ferritin
C. Cytochromes
D. Myoglobin

A

A. Hemoglobin

26
Q
  1. The most sensitive assay for the diagnosis of
    hereditary hemochromatosis (HH) is

A. serum iron
B. serum iron–binding capacity
C. transferrin
D. transferrin saturation

A

D. transferrin saturation

27
Q
  1. Megaloblastic anemias can be caused by

A. tapeworm infestation
B. gastric resection
C. nutritional deficiency
D. all of the above

A

D. all of the above

28
Q
  1. Megaloblastic anemia related to folic acid deficiency
    is associated with

A. abnormal absorption
B. increased utilization
C. nutritional deficiency
D. all of the above

A

D. all of the above

29
Q
  1. Cobalamin transport is mediated by

A. IF
B. TC II
C. R proteins
D. all of the above

A

D. all of the above

30
Q
  1. The underlying type A gastritis that causes pernicious
    anemia is immunologically related to

A. autoantibody to IF
B. low serum gastrin
C. autoantibody to parietal cells
D. both A and C

A

D. both A and C

31
Q
  1. In megaloblastic anemia, the typical erythrocytic
    indices are

A. MCV increased, MCH increased, and MCHC normal
B. MCV increased, MCH variable, and MCHC normal
C. MCV increased, MCH decreased, and MCHC normal
D. MCV normal, MCH increased, and MCHC normal

A

A. MCV increased, MCH increased, and MCHC normal

31
Q
  1. The peripheral erythrocyte morphology in folate
    deficiency is similar to pernicious anemia, and the RBCs
    are

A. small
B. normal size
C. large

A

C. large

31
Q

Questions 9 through 15: Match the following clinical
chemistry assays with their expected value in pernicious
anemia: (An answer can be used more than once.)

A. Decreased
B. Normal
C. Increased
D. Significantly increased

A
  1. _C____ Serum iron
32
Q
  1. In a case of classic pernicious anemia, the patient has

A. leukopenia
B. hypersegmented neutrophils
C. anemia
D. all of the above

A

D. all of the above

33
Q
  1. The reticulocyte count in a patient with untreated
    pernicious anemia is characteristically

A. 0%
B. 0.3%
C. <1.0%
D. approximately1.8%

A

C. <1.0%

33
Q

Questions 9 through 15: Match the following clinical
chemistry assays with their expected value in pernicious
anemia: (An answer can be used more than once.)

A. Decreased
B. Normal
C. Increased
D. Significantly increased

A
  1. _B____ Folate
34
Q

Questions 9 through 15: Match the following clinical
chemistry assays with their expected value in pernicious
anemia: (An answer can be used more than once.)

A. Decreased
B. Normal
C. Increased
D. Significantly increased

A
  1. __A___ Serum haptoglobin–binding capacity
34
Q

Questions 9 through 15: Match the following clinical
chemistry assays with their expected value in pernicious
anemia: (An answer can be used more than once.)

A. Decreased
B. Normal
C. Increased
D. Significantly increased

A
  1. _A____ Serum B12
35
Q

Questions 9 through 15: Match the following clinical
chemistry assays with their expected value in pernicious
anemia: (An answer can be used more than once.)

A. Decreased
B. Normal
C. Increased
D. Significantly increased

A
  1. _D____ Serum LDH
35
Q
  1. Hemolytic disruption of the erythrocyte involves

A. an alteration in the erythrocyte membrane
B. a defect of the hemoglobin molecule
C. an antibody coating the erythrocyte
D. physical trauma

A

A. an alteration in the erythrocyte membrane

36
Q

Questions 9 through 15: Match the following clinical
chemistry assays with their expected value in pernicious
anemia: (An answer can be used more than once.)

A. Decreased
B. Normal
C. Increased
D. Significantly increased

A
  1. _C____ Percent transferrin
37
Q

Questions 9 through 15: Match the following clinical
chemistry assays with their expected value in pernicious
anemia: (An answer can be used more than once.)

A. Decreased
B. Normal
C. Increased
D. Significantly increased

A
  1. _C____ Unconjugated bilirubin
38
Q

Questions 2 and 3: Match the following.

A. Destruction of RBCs outside the circulatory blood
B. Destruction of RBCs within the circulatory blood

A
  1. _B____ Intravascular hemolysis
39
Q
A
39
Q

Questions 2 and 3: Match the following.

A. Destruction of RBCs outside the circulatory blood
B. Destruction of RBCs within the circulatory blood

A
  1. _A____ Extravascular hemolysis
40
Q

Questions 5 through 8: Match the following disorders
with the appropriate category of defect (an answer may
be used more than once):

A. Structural membrane defect
B. Erythrocytic enzyme defect
C. Defect of the hemoglobin molecule

A
40
Q

Questions 5 through 8: Match the following disorders
with the appropriate category of defect (an answer may
be used more than once):

A. Structural membrane defect
B. Erythrocytic enzyme defect
C. Defect of the hemoglobin molecule

A
40
Q
  1. Which of the following tests is not useful in
    determining increased erythrocyte destruction?

A. Reticulocyte count
B. Total leukocyte count
C. Serum haptoglobin
D. Unconjugated bilirubin

A

B. Total leukocyte count

41
Q

Questions 5 through 8: Match the following disorders
with the appropriate category of defect (an answer may
be used more than once):

A. Structural membrane defect
B. Erythrocytic enzyme defect
C. Defect of the hemoglobin molecule

A
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