A pre-operative, 20-year-old female has a mild microcytic anemia, with target cells and stippled red cells observed on the blood smear. Her hemoglobin A2 level is quantified at 5%. What do these findings suggest?, Heterozygous beta-thalassemia, Heterozygous alpha-thalassemia, Hemoglobin S/beta-thalassemia, Iron-deficiency anemia, What causes the hemolytic process in glucose-6 phosphate dehydrogenase deficiency following oxidant exposure?, Complement attachment, Coating of red cells by antibody, Osmotic pressure changes, Precipitation of denatured hemoglobin, In clinically severe hereditary spherocytosis, which of the following findings would NOT be found post-splenectomy?, A. Increased number of Howell-Jolly bodies, B. Higher number of circulating reticulocytes, C. Rise in the red cell count and hemoglobin level, D. Transient elevation in the platelet count, 4. Which of the following laboratory results is NOT consistent with accelerated red cell destruction?, A. Increased serum lactate dehydrogenase (LD), B. Increased plasma hemoglobin, C. Increased serum bilirubin, D. Increased serum haptoglobin, 5. Acquired hemolytic anemias are usually due to, . Changes in hemoglobin stability, B. Intracellular factors, C. Defects within the bone marrow, D. Extracorpuscular factors, . The antibody associated with paroxysmal cold hemoglobinuria shows specificity for, A. ABO antigens, B. I antigens, C. Rh antigens, D. P antigens, . A 69-year-old male is admitted with pallor, mild tachycardia, and difficulty walking because of numbness in the extremities. His CBC reveals a hemoglobin of 78 g/L, a hematocrit of 0.25 L/L, and MCV of 118.5 fL. This patient's symptoms and the blood findings are most suggestive of anemia due to a lack of, Ascorbic acid, B. Vitamin B6, C. Folic acid, D. Vitamin B12, A clinical laboratory scientist examined a Wright's stained peripheral smear and saw small, dark-staining granules in the mature erythrocytes. A second smear was stained with Prussian blue and a positive result was obtained. Based on this information, which of the following would you expect to be abnormal?, Serum ferritin level, B. Hemoglobin electrophoresis, C. Test for parietal cell antibodies, D. Plasma hemoglobin level, Hemoglobinopathies are characterized by, . Inability to transport and release oxygen to the tissues, B. Inhibition of iron chelation needed for heme biosynthesis, C. Absent or reduced rate of globin-chain synthesis, D. Production of structurally abnormal hemoglobin variants, Which of the following statements about hereditary spherocytosis is true?, Abnormally shaped cells are produced in the bone marrow., B. Red cell osmotic fragility is decreased., C. Membrane loss and red cell trapping occur in the splenic microcirculation., D. Cells have a decreased mean cell hemoglobin concentration (MCHC)., Which of the following statements about hereditary elliptocytosis (HE) is true?, HE cells are abnormally permeable to calcium., B. Cellular defect involves the lipid composition of the membrane., C. Heterogeneous group of disorders linked to Rh-null individuals., D. Characteristic oval shape occurs in mature erythrocytes., Which of the following disorders is NOT commonly linked to the development of anemia of chronic disease?, . Chronic gastrointestinal blood loss, B. Malignancy, C. Persistent infections, D. Noninfectious inflammatory disorders, Which of the following statements about hemoglobin C disease is FALSE?, The disorder is less severe than sickle cell disease., B. Red cells may contain bar-shaped intracellular crystals., C. Electrophoresis shows approximately 60% hemoglobin A and 40% hemoglobin C., D. Target cells are frequently seen on peripheral smears., Which of the following is associated with sickle cells?, There is decreased mechanical fragility., B. There is increased deformability., C. Increased sickling occludes vessels., D. Increased oxygen tension promotes sickling., A bone marrow M:E ratio of 4:1 would be an expected finding for, Sickle cell anemia, B. Megaloblastic anemia, C. Aplastic anemia, D. Beta-thalassemia major, An elderly man with a 10-year history of chronic lymphocytic leukemia presented with jaundice and fatigue attributed to a recent 3-gram drop in his hemoglobin. Many spherocytes and polychromatophilic red cells were found on his Wright's stained blood smear. Which type of immune hemolytic anemia is most likely?, Primary cold hemagglutinin disease, B. Paroxysmal cold hemoglobinuria, C. Secondary warm autoimmune hemolytic anemia, D. Idiopathic warm autoimmune hemolytic anemia, A moderately anemic patient with suspected pernicious anemia (PA) shows intrinsic factor antibodies and a low cobalamin level. Which of the following would NOT support the diagnosis of PA?, . Gastric atrophy and achlorhydria, B. Oval macrocytes and Howell-Jolly bodies, C. Elevated serum lactate dehydrogenase (LD) and bilirubin levels, D. Bone marrow erythroid precursors exhibit normoblastic maturation, A cellulose acetate electrophoresis revealed a large band of hemoglobin in the hemoglobin S position (quantified at 95%). The peripheral smear revealed 70% target cells, and the solubility test was negative. What is the hemoglobin?, A. Hemoglobin S, B. Hemoglobin E, C. Hemoglobin C, D. Hemoglobin D, A previously healthy man experiences weakness and hemoglobinuria after taking the antimalarial agent primaquine. This hemolytic attack most likely occurred because of a deficiency of, . Methemoglobin reductase, B. Pyruvate kinase, C. Glucose-6-phosphate dehydrogenase, D. 2,3-Bisphosphoglycerate, Which of the following is an acquired red cell membrane defect that results in increased sensitivity to complement binding?, March hemoglobinuria, B. Methemoglobinemia, C. Paroxysmal nocturnal hemoglobinuria, D. Paroxysmal cold hemoglobinuria, Which of the following is NOT associated with acquired reversible sideroblastic anemias?, . Lead intoxication, B. Methotrexate therapy, C. Acute alcohol ingestion, D. Isoniazid treatment for tuberculosis, Which of the following statements about the relative anemia of pregnancy is FALSE?, . It is due to a reduction in the number of erythrocytes., B. It does not produce an oxygen deficit for the fetus., C. It is normocytic and normochromic., D. It is associated with an increase in plasma volume., The anemia found in chronic renal failure is most likely caused by, . Destruction of red cells by uremic metabolites, B. Lack of cellular oxygen demand, C. Loss of erythropoietin synthesis, D. Defective iron absorption, Which of the following phrases about aplastic anemia is FALSE?, Frequent bleeding complications, B. Stem cell disorder, C. Reduced red cell survival, D. Risk of life-threatening infection, The fish tapeworm Diphyllobothrium latum is associated with the development of, Microcytic anemia, B. Hemolytic anemia, C. Hypoproliferative anemia, D. Macrocytic anemia, An increase in erythropoietin is NOT a normal compensating mechanism in which of the following conditions?, .Renal tumors, B. Heavy smoking, C. Pulmonary disease, D. Cardiovascular disease, Thalassemias are the result of a, Qualitative defect in globin-chain structure, B. Quantitative defect in globin-chain synthesis, C. Change in hemoglobin solubility properties, D. Structural defect in the heme portion of hemoglobin, Which of the following characterizes iron-deficiency anemia?, A. Increased serum transferrin, decreased transferrin saturation, decreased ferritin, B. Increased serum transferrin, increased transferrin saturation, decreased serum iron, C. Decreased serum iron, decreased transferrin saturation, normal ferritin, D. Decreased serum transferrin, decreased transferrin saturation, decreased ferritin, Clinical manifestations of a homozygous mutation involving the beta-globin gene will most likely appear, . In the neonate at birth, B. By 6 months of age, C. No later than 3 weeks after birth, D. During embryonic development, The hemolysis associated with infection by malaria organisms is due to the, Host's immunologic response to infected erythrocytes, B. Invasion of erythrocytes by merozoites, C. Toxins produced by the malarial organism, D. Release of merozoites from erythrocytes, A clinical laboratory scientist received a 5 mL EDTA tube that contained 0.5 mL of anticoagulated blood. A smear was prepared and stained with Wright's stain. The majority of cells appeared to have many evenly distributed, blunt spicules on the surface. How should this cellular appearance be interpreted?, A. Crenated cells caused by incorrect blood to anticoagulant ratio, B. Spur cells caused by using incorrect technique during slide preparation, C. An anemic condition requiring further testing, D. Artifact caused by a dirty spreader slide, . A failure to generate sufficient ATP is characteristic of red blood cells with, . Pyruvate kinase deficiency, B. Hexokinase deficiency, C. Lipoprotein deficiency, D. Glucose-6-phosphate dehydrogenase deficiency, When iron use exceeds absorption, which of the following occurs first?, . Hemoglobin level decreases., B. Iron stores are depleted., C. Transferrin synthesis increases., D. Excretion of iron decreases., The major mechanism responsible for the anemia of chronic disease is, . Impaired release of storage iron because of increased hepcidin levels, B. Damaged bone marrow stem cells, C. Immune destruction caused by red cell autoantibodies, D. Increased erythropoietin response by committed red cell progenitor cells, Which of the following is NOT a characteristic of the idiopathic type of sideroblastic anemia?, Blocks in heme synthesis are unknown, B. Refractory to treatment, C. Subtype of myelodysplastic syndromes, D. Reversible with intramuscular vitamin B12 injections, Thinning of bones and deformation of facial bone structure seen in homozygous beta-thalassemia is a, Result of increased fibroclast activity, B. Secondary disorder due to immunologic response, C. Result of hyperplastic marrow activity, D. Consequence of disturbances in calcium metabolism, Which of the following does NOT accurately describe cold autoimmune hemolytic anemia?, . It may occur secondary to Mycoplasma pneumonia., B. Hemolysis is complement-mediated or via removal of coated cells., C. The autoantibody is usually an IgG type directed against Rh antigens., D. Red cell agglutination in extremities induces Raynaud's phenomenon, Which of the following represents an anemia that would have a high red cell distribution width (RDW)?, A. Sickle cell disease during crisis, B. Anemia of chronic disorders, C. Thalassemia minor, D. Aplastic anemia, In which of the following disorders would splenomegaly NOT be a common finding?, A. Hemoglobin SC disease, B. Folic acid deficiency, C. Hereditary spherocytosis, D. Homozygous beta-thalassemia, Functionally, white blood cells are divided into, Granulocytes, nongranulocytes, B. Polymorphonuclears, mononuclears, C. Granulocytes, lymphocytes, D. Phagocytes, immunocytes, What is the largest white blood cell normally found in the peripheral blood?, Lymphocyte, B. Neutrophil, C. Monocyte, D. Eosinophil, What is the approximate amount of time a granulocyte spends in the circulation before migrating into the tissues?, A. About 3 days, B. More than 10 days, C. Less than 1 day, D. Up to 5 days, What percentage of neutrophils in the peripheral blood constitutes the circulating pool?, . 100%, B. 80%, C. 50%, D. 30%, What is the major phagocytic cell involved in the initial defense against bacterial pathogens?, . Basophil, B. Neutrophil, C. Monocyte, D. Eosinophil, What is the growth factor that is primarily responsible for regulating granulocyte and monocyte production?, Erythropoietin, B. Colony stimulating factor, C. Thrombopoietin, D. Interleukin, What does the granulocyte mitotic pool in the bone marrow contain?, The majority of marrow granulocytes, B. Myeloblasts and promyelocytes, C. Band and segmented forms, D. Myelocytes and metamyelocytes, . A 'shift to the left,' when used to describe a cell population, refers to, . A cell production 'hiatus' or gap, B. Increased cells in the blood due to a redistribution of blood pools, C. A higher percentage of lymphocytes than neutrophils, D. An increase in immature blood cells following release of bone marrow pools, . Which of the following is characteristic of agranulocytosis?, Immature granulocytes in the peripheral blood, B. Decreased numbers of granulocytes, C. Neutrophils without granules, D. Decreased numbers of granulocytes, red cells, and platelets, Which of the following is NOT a characteristic of T lymphocytes?, Comprise majority of cells in the blood lymphocyte pool, B. Secrete cytokines, C. Regulate the immune response, D. Synthesize antibody, An adult has a total WBC count of 4.0 x 10^9/L. Differential: PMNs 25%, bands 5%, lymphocytes 65%, monocytes 5%. The absolute value reference range for lymphocytes is 1.0-4.0 x 10^9/L. Which of the following is true?, . The percentage of lymphocytes is normal, B. There is both an absolute and a relative lymphocytosis., C. There is a relative lymphocytosis., D. There is an absolute lymphocytosis..

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