First Aid Review -- Part 2

Question 1

Sickle cells are seen in…

Answer 1

Sickle cell anemia.

Question 2

Sickling of RBCs in sickle cell anemia is precipitated by…

Answer 2

1. Dehydration
2. Deoxygenation
3. Ascension to high altitude

Question 3

Spherocytes are observed in…

Answer 3

1. Hereditary spherocytosis

2. Drug- and infection-induced hemolytic anemia

Question 4

Dacrocytes (“teardrop cells”) are characteristic of…

Answer 4

Bone marrow infiltration (e.g., myelofibrosis)

Question 5

Target cells are seen in…

Answer 5

1. HbC disease
2. Asplenia
3. Liver disease
4. Thalassemia

REMEMBER: “HALT” said the hunter to his target.

Question 6

Oxidation of Hb -SH groups results in Hb precipitation in the form of…

Answer 6

Heinz bodies.

Question 7

Heinz bodies are observed in…

Answer 7

G6PD deficiency. Heinz body-like inclusions are also seen in alpha-thalassemia.

Question 8

Basophilic nuclear remnants found in RBCs are called…

Answer 8

Howell-Jolly bodies.

Question 9

Howell-Jolly bodies are normally removed from RBCs by…

Answer 9

Splenic macrophages.

Question 10

Howell-Jolly bodies are seen in patients with…

Answer 10

Functional hyposplenia or asplenia.

Question 11

Causes of macrocytic, non-megaloblastic anemia

Answer 11

1. Liver disease
2. Alcoholism
3. Reticulocytosis

Question 12

Causes of macrocytic, megaloblastic anemia

Answer 12

1. Folate deficiency
2. B12 deficiency
3. Orotic aciduria

Question 13

Macrocytic anemia involves…

Answer 13

MCV > 100 fL

Question 14

Anemia of chronic disease and iron deficiency anemia may first present as…and then progress to…

Answer 14

Normocytic anemia; microcytic anemia

Question 15

Copper deficiency can cause…

Answer 15

Microcytic sideroblastic anemia.

Question 16

Microcytic anemia involves…

Answer 16

MCV

Question 17

Causes of microcytic anemia

Answer 17

1. Iron deficiency (late)
2. Anemia of chronic disease
3. Thalassemias
4. Lead poisoning
5. Sideroblastic anemia

Question 18

Causes of normocytic, nonhemolytic anemia

Answer 18

1. Anemia of chronic disease
2. Aplastic anemia
3. Chronic kidney disease
4. Iron deficiency (early)

Question 19

Intrinsic causes of normocytic, hemolytic anemia

Answer 19

1. RBC membrane defect: hereditary spherocytosis
2. RBC enzyme deficiency: G6PD, pyruvate kinase
3. HbC defect
4. Paroxysmal nocturnal hemoglobinuria
5. Sickle cell anemia

Question 20

Extrinsic causes of normocytic, hemolytic anemia

Answer 20

1. Autoimmune
2. Microangiopathic
3. Macroangiopathic
4. Infections

Question 21

Clinical findings in iron deficiency

Answer 21

1. Decreased serum iron
2. Increased TIBC
3. Decreased serum ferritin
4. Fatigue
5. Conjunctival pallor
6. Spoon nails (koilonychia)
7. Microcytosis and hypochromia

Question 22

Plummer-Vinson syndrome consists of a triad of:

Answer 22

1. Iron deficiency anemia
2. Esophageal webs
3. Atrophic glossitis

Question 23

Alpha-thalassemia is characterized by…

Answer 23

Decreased alpha-globin synthesis.

Question 24

Hb Barts

Answer 24

Excess gamma globin forms gamma4. Results from no alpha-globin production due to four allele deletion. Incompatible with life (causes hydrops fetalis).

Question 25

HbH disease involves…

Answer 25

three allele deletion of alpha globin. Very little alpha globin is produced. Excess beta globin forms beta4 (HbH).

Question 26

Beta thalassemia involves…

Answer 26

Decreased beta globin synthesis

Question 27

Beta thalassemia minor (pt is heterozygote)

Answer 27

Beta chain is underproduced. Usually asymptomatic. Diagnosis is confirmed by increased HbA2 (>3.5%) on electrophoresis.

Question 28

Schistocytes “helmet cells” are observed in…

Answer 28

1. DIC
2. TTP/HUS
3. HELLP syndrome
4. Mechanical hemolysis (e.g., heart valve prosthesis)