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MWU Patho > Hematology > Flashcards

Hematology Flashcards

1
Q

A 68-year-old man comes to the physician complaining of fatigue for the last several weeks. He has been feeling dizzy and SOB when climbing the stairs. He has not visited a physician in years b/c he has “always felt healthy.” He has no paresthesia, cognitive impairment, joint pains, or abnormal bleeding episodes. Temp is 37, P is 96, respirations 14, and BP 144/88. Physical examination shows conjunctival pallor. The neck is non-tender, and no mass is palpated. Oropharyngeal examination reveals an enlarged, erythematous tongue; no gingival pigmentation is noted. Labs show Hgb 9.9. A stool guaiac test is positive. which of the following is the likely pathophysiology of this patient’s condition?
Overproduction of cytokines
Impaired heme synthesis due to enzyme inhibition
Destruction of myeloid stem cells
Impaired heme synthesis due to decreased substrate availability
defective globin synthesis

A

Impaired heme synthesis due to decreased substrate availability

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2
Q

_____ anemia is the most common type of anemia.

A

Iron deficiency

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3
Q

Serum iron levels are (increased/decreased) in iron deficiency.

A

decreased

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4
Q

(Organ system losing iron) ___ is the most common cause of iron deficiency anemia in the elderly in the western world.

A

Gastrointestinal loss

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5
Q

Chronic iron deficiency leads to (microcytic/macrocytic/normocytic) anemia

A

microcytic

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6
Q

_____ is a manifestation of iron deficiency anemia described as spooning of the nails.

A

Koilonychia

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7
Q

Variation in red blood cell size seen in iron deficiency is known as _____.

A

anisocytosis

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8
Q

Variation in red blood cell shape seen in iron deficiency anemia is know as _____.

A

poikilocytosis

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9
Q

TIBC is (increased/decreased) in iron deficiency anemia.

A

increased

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10
Q

Serum ferritin levels are (increased/decreased) in iron deficiency anemia.

A

decreased

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11
Q

Iron deficiency anemia seen in men over the age of 50yrs in the US classically raises suspicion for ____ cancer.

A

colon

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12
Q

_____ is the most common cause of iron deficiency anemia worldwide.

A

Nutritional deficiency

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13
Q

Iron deficiency anemia presents with (increased/decrease/normal) RCW.

A

increased

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14
Q

_______ is the most common side effect of ferrous sulfate supplementation.

A

Constipation

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15
Q

_____ is a form of iron deficiency anemia that presents with a triad of iron deficiency anemia, esophageal webs and dysphagia.

A

Plummer-Vinson syndrome

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16
Q

Microcytosis and (hypochromia/hyperchromia) are common findings on a peripheral blood smear in iron deficiency anemia.

A

hypochromia

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17
Q

The lack of iron in iron deficiency anemia decreases the synthesis of (heme/globin), thereby decreasing hgb levels.

A

Heme

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18
Q

Plummer-Vinson syndrome, presenting as a triad of iron deficiency anemia, esophageal webs, and dysphagia could progress to _____ of the esophagus.

A

squamous cell carcinoma

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19
Q

_____ is a manifestation of iron deficiency anemia described as the consumption of non-food substances.

A

Pica

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20
Q

Hemophilia B follows a(n) _____ genetic inheritance pattern.

A

X-linked recessive

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21
Q

Hemophilia A follows a(n) _____ genetic inheritance pattern.

A

X-linked recessive

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22
Q

Hemophilia B is a blood clotting disorder that is due to a deficiency in a factor _____.

A

IX

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23
Q

The (intrinsic/extrinsic) coagulation pathway is defective in hemophilia A.

A

intrinsic

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24
Q

PTT (increases/decreases) _____in hemophilia B.

A

increases

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25
Q

PT (increases/decreases/doesn’t change) in hemophilia B.

A

doesn’t change

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26
Q

Prothrombin time (increases/decreases/doesn’t change) in hemophilia A.

A

doesn’t change

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27
Q

_____ is the treatment for hemophilia B.

A

Factor IX concentrate

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28
Q

Partial thromboplastin time (increases/decrease) in hemophilia A.

A

increases

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29
Q

_____ is a macrohemorrhage that occurs in hemophilia A or B and involves bleeding into joints.

A

Hemarthrosis

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29
Q

Hemophilia A is a coagulation disorder that involves a genetic deficiency of _____.

A

factor VIII

30
Q

The bleeding time is (increased/normal) in patients with vitamin K deficiency.

A

normal

31
Q

Warfarin (stimulates/inhibits) vitamin K epoxide reductase and causes vitamin K deficiency.

A

inhibits

32
Q

Partial thromboplastin time (increases/does not change) in vitamin K deficiency.

A

increases

33
Q

Vitamin K deficiency will lead to a decreased activity in factors II,II, IX, X and factors C and factor ___.

A

S

34
Q

Prothrombin time (increases/does not change) in vitamin K deficiency.

A

increases

35
Q

Vitamin K deficiency bleeding in the newborn is prevented by _____.

A

prophylactic vitamin K injection

36
Q

_____ is a condition characterized by bleeding in a newborn due to immature liver function.

A

Vitamin K deficiency bleeding (hemorrhagic disease of the newborn)

37
Q

Vitamin _____ deficiency can be caused by medications like warfarin, anticonvulsants like phenytoin, and antibiotics.

A

K

38
Q

Vitamin K deficiency causes signs and symptoms of bleeding that is related to (platelet inhibition/coagulation pathway defect), such as easy bruising.

A

coagulation pathway defect

39
Q

Serum iron is (increased/decreased/unchanged) in anemia of chronic disease.

A

decreased

40
Q

Anemia of chronic disease is associated with autoimmune disorders such as _____.

A

systemic lupus erythematosus and rheumatoid arthritis

41
Q

Chronic inflammation, as see with anemia of chronic disease, increases the levels of _____, an acute phase reactant released by the liver that binds to ferroportin, thereby inhibiting iron transport.

A

hepcidin

42
Q

_____ is a type of anemia typically associated with chronic inflammation or cancer.

A

Anemia of chronic disease

43
Q

_____ is a nonhemolytic anemia due to chronic inflammation/disease that can become microcytic in its later stages.

A

Anemia of chronic disease

44
Q

_____ can be used to treat anemia of chronic disease associated with chronic renal failure.

A

Erythropoietin

45
Q

Ferritin levels are (increased/decreased/unchanged) in anemia of chronic disease.

A

increased

46
Q

TIBC is (increased/decreased/unchanged) in anemia of chronic disease.

A

decreased

47
Q

Individuals that have the sickle cell trait have a resistance to the mosquito borne infection _____.

A

malaria

48
Q

______ syndrome is a painful vaso-occlusive crisis seen in sickle-cell disease that involves severe chest pain and shortness of breath due to occlusion of the pulmonary microcirculation.

A

Acute chest

49
Q

Glutamic acid to valine (at position 6) is an amino acid substitution seen in the ____ chain in sickle cell disease.

A

beta-globin

50
Q

Autosplenectomy is a complication of sickle-cell disease tat leads to an increased risk of infection with encapsulated organisms and the formation of _______ in red blood cells.

A

Howell-Jolly bodies

51
Q

_____ is the most common cause of death in adults with sickle-cell disease.

A

Upper respiratory tract infection

52
Q

_____ is an anti-neoplastic drug used in myeloproliferative disorders that can treat the painful attacks of sickle-cell disease by increasing hemoglobin F expression.

A

Hydroxyurea

53
Q

Patients with ______ have hemoglobin with one normal and one malformed beta-globin chain.

A

sickle-cell trait

54
Q

Sickle cell disease is diagnosed by_____.

A

hemoglobin electrophoresis

55
Q

______ and Staphylococcus aureus are the bacteria commonly associated with osteomyelitis in patients with sickle cell disease.

A

Salmonella spp.

56
Q

_____ is a complication of sickle-cell disease that leads to an increased risk of infection with encapsulated organisms and the formation of Howell-jolly blood cells.

A

Autosplenectomy

57
Q

Sickle-cell disease typically follows an _____ genetic inheritance pattern.

A

autosomal recessive

58
Q

_____ disease is a hematological cause of focal segmental glomerulosclerosis due to poor oxygenation of the glomeruli and structural weakness of red blood cells.

A

Sickle-cell

59
Q

_______ is a possible complication of sickle cell anemia that presents as a severely painful penile erection that does not become flaccid.

A

Priapism

60
Q

Aplastic crisis is a possible complication of sickle cell disease that can be triggered by _____.

A

parvovirus B19

61
Q

_____ disease causes vaso-occlusive symptoms as a result of red blood cell sickling.

A

Sickle-cell

62
Q

Newborns that have sickle-cell disease are initially asymptomatic because _____ levels are high, while hemoglobin S levels are low.

A

hemoglobin F

63
Q

_____ is a painful vaso-occlusive crisis seen in sickle-cell disease that involves painful swelling of the hands.

A

Dactylitis

64
Q

Erythrocytes have an affinity for each of the following except
mitochondria
oxygen
carbon dioxide
glucose

A

mitochondria

65
Q

Common causes of anemia include each of the following except
severe bleeding
low erythropoietin level
hemolysis
polycythemia

A

polycythemia

66
Q

A patient has chronic anemia associated with chronic renal failure. What substance does the healthcare professional tell the patient is needed to treat this anemia?

A

Erythropoietin

67
Q

A patient has microcytic and hypochromic erythrocytes. What is the expected diagnosis?

A

Iron Deficiency Anemia

68
Q

A patient presents with paresthesia of hands and feel fatigue and pallor. The CBC reveals reduced number of erythrocytes, low hemoglobin and low hematocrit. The MCV is high. What is most likely causing the symptoms?

A

Pernicious Anemia

69
Q

Which of the following is most likely to trigger a sickle cell crisis?
snow skiing in the Rocky Mountains
Drinking 6-8 glasses of water each day
cruise ship vacation
Daily folic acid supplements

A

snow skiing in the Rocky Mountains

70
Q

What is needed to absorb B12?

A

Intrinsic Factor

71
Q

What is hemoglobin?

A

A protein composed of iron and globin capable of oxygen and carbon dioxide transport.

72
Q

For the patient with pernicious anemia, which of the following is least likely to be observed?
Stomatitis
Microcytic erythrocytes
Parathesis of extremities
History of gastric bypass bariatric surgery

A

Microcytic erythrocytes

MWU Patho (7 decks)

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