heme externship - heme 1.3-1.4

Question 1

the osmotic fragility test results in patient with that major would show
A. increased hemolysis
B. decreased hemolysis
C. normal resistance to hemolysis
D. decreased hemolysis after incubation at 37

Answer 1

B. decreased hemolysis
- increased amount of target cells

Question 2

all of the folliwng ar characteristic findings in a patient with IDA except
A. microcytic hypochromic RBC
B. decreased serum iron and ferritin levels
C. decreased TIBC
D. increased RBC protoporphyrin

Answer 2

C. decreased TIBC

Question 3

IDA may be distinguished from anemia of chronic infection by
A. serum iron level
B. RBC morphology
C. RBC indices
D. TIBC

Answer 3

D. TIBC
- increased in IDA, decreased in ACI

Question 4

which anemia has RBC morphology similar to that in IDA
A. sickle cell
B. thal syndrome
C. pernicious anemia
D. HS

Answer 4

B. thal synrome

Question 5

IDA is characterized by
A. decreased: plasma iron, % sat & increased TIBC
B. decreased: plasma iron, plasma ferritin, nromal RBC porphyrin
C. decreased: plasma iron, % sat, TIBC
D. decreased: plasma iron, TIBC & increased % sat

Answer 5

A.

Question 6

storage iron is usually best determined by
A. serum transferrin levels
B. hgb values
C myoglobin values
D. serum ferritin levels

Answer 6

D. serum ferritin levels
- serum ferritin is proportional to storage iron

Question 7

all of the following are associated with sideroblastic anemia except
A. increased serum iron
B. ringed sideroblasts
C. hypochromic anemia
D. decreased serum ferritin

Answer 7

D. decreased serum ferritin

Question 8

what is the basic hematologigal defect seen in patients with thalassemia major
A. DNA synthetic defect
B. Hgb structure
C. beta chain synthesis
D. hgb phosphorylation

Answer 8

C. beta chain synthesis
- thal major = little to no production of beta chains of hgb

Question 9

which of the following is the primary hgb in patients with that major
A. hgb D
B. hgb A
C. hgb C
D. hgb F

Answer 9

D. hgb F

Question 10

a patient has a hct of 30% an hgb of 8 g/dL, RBC of 4.0*10^12. what is the morphological classification of this anemia
(hint: use math)

Answer 10

microcytic hypochromic
- need to calculate MCV and MCHC
- MCV = 75
- MCHC = 26%

Question 11

in which of the following conditions is hgb A2 elevated
A. hgb H
B. hgb SC disease
C. beta that minor
D. hgb S trait

Answer 11

C. beta thal minor

Question 12

which of the following parameters may be similar for the anemia of inflammation and IDA
A. normocytic indices
B. decreased serum iron concentration
C. ringed sideroblasts
D. pappenheimer bodies

Answer 12

B. decreased serum iron concentration
- in ACI serum iron is low but ferritin is high
- in IDA serum iron is low and ferritin is low

Question 13

which morphological classificaiton is cahracteristic of megaloblastic anemia
A. normocytic normochromic
B. microcytic normochromic
C. macrocytic hypochromic
D. macrocytic normochromic

Answer 13

D. macrocytic normochromic
- megaloblastic anemias are a asynchronous development of nuclear maturation

Question 14

which anemia is characterized by lack of IF that prevents b12 absorption
A. tropical sprue
B. transcobalamin deficiency
C. blind loop syndrome
D. pernicious anemia

Answer 14

D. pernicious
- either antibodies against IF or against IF producing cells

Question 15

all of the following are characteristics of megaloblastic anemia except
A. pancytopenia
B. elevated retic
C. hypersegmented PMNs
D. macrocytic indices

Answer 15

B. elevated retic

Question 16

a patient with B12 anemia is prescribed a high dosage of folate. which of the following is expected as a result of this treatment
A. an improvement of neurological problems
B. an improvement of hematological abnormalities
C. no expected improvement
D. toxicity of liver and kidneys

Answer 16

B.
- will improve hematological problems but not neurological, confirms B12 anemiaw

Question 17

which of the followig disorders is associaed with ineffective erythropoiesis
A. G6PD deficiency
B. liver disease
C. hgb C disease
D. megaloblastic anemia

Answer 17

D. megaloblastic anemia

Question 18

a 50 yr old is suffering from pernicious anemia. which of the following lab data is most likely for this patient (generally I don’t want to type it all)
A. low RBC, high WBC, normal PLT
B. normal RBC, normal WBC, normal PLT
C. low RBC, normal WBC, high PLT
D. low RBC, low WBC, low PLT

Answer 18

D. pernicious anemia leads to pancytopenia with low RBC, WBC and PLT due to DNA maturation defect impacting all line

Question 19

which of the following may be seen in the PS from a patient with obstructive liver disease
A. schistocytes
B. macrocytes
C. HJ bodies
D. microcyte

Answer 19

B. macrocytes
- in true megaloblastic conditions they will be oval, in liver issue (not megaloblastic) will be round

Question 20

the macrocytes typically seen in megaloblastic processes are:
A. crescent shaped
B. teardrop shaped
C. oval shaped
D. pencil shaped

Answer 20

C. oval

Question 21

which of the following are most characteristic of the RBC indices associated with megaloblastic anemias
A. MCV: 99, MCH 28, MCHC 31%
B. MCV 62, MCH 27, MCHC 30%
C. MCV: 125, MCH 36, MCHC 34%
D. MCV 76, MCH: 23, MCHC: 30%

Answer 21

C. macrocytic normochromic

Question 22

a patient has 80 nRBCs per 100 leukocytes. in addition to increased polychromasia on the PS what other finding may be present on the CBC
A. increased PLTs
B. increased MCV
C. increased HCT
D. increased RBC count

Answer 22

B. increased MCV