Hematopoiesis PDF

HEMATOPOEISIS What is the first type of cell produced bythe developing embryo? The mechanism that relays information about tissue oxygen levels to erythropoietin-producing sites is located in the A. Erythrocyt...

HEMATOPOEISIS What is the first type of cell produced bythe developing embryo? The mechanism that relays information about tissue oxygen levels to erythropoietin-producing sites is located in the A. Erythrocyte A. Brain B. Granulocyte B. Kidney C. Lymphocyte C. Liver D. Thrombocyte D. Spleen What percentage of tissue located in the bone marrow cavities of adults is fat? Antigen-independent lymphopoiesis occurs in primary lymphoid tissue A. 10% located in the B. 25% A. Liver and kidney B. Spleen and lymph nodes C. 50% C. Peyer's patches and spleen D. 75% D. Thymus and bone marrow Which of the following is NOT characteristic of pluripotent hematopoietic stem cells? Programmed cell death is called A. Possess self-renewal ability A. Necrosis B. Produce progenitor cells committed to a single cell lineage B. Apoptosis C. Express the stem cell marker CD 13 C. Cellular senescence D. Are morphologically unrecognizable D. Terminal differentiation In an adult, what are the two best areas for obtaining active bone marrow by aspiration? In what area of the bone marrow does hematopoiesis take place? A. Vertebra, tibia A. Cords B. Sternum, vertebra B. Endosteum C. Anterior iliac crest, tibia C. Endothelium D. Posterior iliac crest, sternum D. Sinuses What is the normal ratio of myeloid to erythroid precursors in bone marrow (M:Eratio)? Bone marrow cellularity refers to the ratio of A. 1:1 A. Red cell precursors to white cell precursors B. 1:3 B. Hematopoietic tissue to adipose tissue C. 4:1 C. Granulocytic cells to erythrocytic cells D. 8:1 D. Extravascular tissue to intravascular tissue Which of the following does NOT accurately describe hematopoietic growth factors? Interleukins and colony stimulating factors are cytokines produced by A. Bind to target cell receptors to express activity A. B lymphocytes and erythrocytes B. Action of majority is lineage restricted B. Erythrocytes and thrombocytes C. May promote or suppress cell death C. Monocytes and T lymphocytes D. Can stimulate or inhibit cell proliferation D. Neutrophils and monocytes In the third month of gestation, what is the primary site of hematopoiesis? What is the approximate total blood volume in an adult? A. Liver A. 1L B. Marrow of long bones B. 2L C. Spleen C. 6L D. Yolk sac D. 12L The myeloid progenitor cell can produce cells committed to The Na+-K+ cation pump is an important mechanism in keeping the red blood cell intact. Its function is to maintain a high level of A. Granulocytic, erythrocytic, monocytic, or megakaryocytic lineages A. Intracellular Na+ B. Granulocytic, monocytic, lymphocytic, or megakaryocytic lineages B. Intracellular K+ C. Erythrocytic, granulocytic, monocytic, or lymphocytic lineages C. Plasma Na+ D. Erythrocytic, granulocytic, lymphocytic, or megakaryocytic lineages D. Plasma K+ The largest hematopoietic cells in normal bone marrow are Which of the following depicts the structure of the hemoglobin molecule? A. Osteoblasts A. Two heme groups, two globin chains B. Osteoclasts B. Four heme groups, two globin chains C. Megakaryocytes C. Two heme groups, four globin chains D. Plasma cells D. Four heme groups, four globin chains When evaluating a bone marrow aspirate smear, which finding is considered ABNORMAL? A. A predominance of granulocyte precursors as compared to nucleated red Which of the following describes the process known as culling? cells A. Release of red cells from the bone marrow B. Detection of stainable iron in macrophages and erythroid precursors with Prussian blue B. Binding of free hemoglobin by transport proteins C. An average of three megakaryocytes seen per low power (10X) field C. Incorporation of iron into protoporphyrin IX D. The presence of 10% myeloblasts on the cell differential count D. Removal of abnormal red cells by the spleen As most blood cell lines mature, which of the following is characteristic? Hemoglobin forms that are incapable of oxygen transport include A. Cell diameter increases A. Deoxyhemoglobin and oxyhemoglobin B. Nucleus to cytoplasm ratio (N:C) decreases B. Oxyhemoglobin and carboxyhemoglobin C. Nuclear chromatin becomes less condensed C. Carboxyhemoglobin and methemoglobin D. Basophilia of the cytoplasm increases D. Methemoglobin and deoxyhemoglobin Which of the following describes thrombopoietin (TPO)? The majority of iron found in an adult is a constituent of A. Renal hormone that regulates marrow red cell production A. Ferritin B. Marrow hormone secreted by developing megakaryoblasts B. Myoglobin C. Hormone produced by the liver that stimulates megakaryopoiesis C. Hemoglobin D. Pituitary hormone that controls platelet sequestration by the spleen D. Peroxidase When the hepatic phase of fetal life is reactivated in an adult, hematopoiesis A senescent red blood cell is one that has can be termed A. Been hemolyze A. Myeloid or medullary B. Lived its life span B. Myeloid metaplasia or extramedullary C. Become deformed C. Myelophthisis or myelodysplasia D. Lost its mitochondria D. Mesoblastic or mesenchymal Erythrocytes ERYTHROCYTES What red cell morphologic abnormality is described by the term What is the average life span of a normal red blood cell? "poikilocytosis"? A. 1 day A. Variations in size B. 10 days B. Deviations from normal shape C. 60 days C. Presence of inclusions D. 120 days D. Alterations in hemoglobin concentration Howell-Jolly bodies are composed of Which of the following statements does NOT characterize erythropoietin (EPO)? A. DNA A. Transforms the CFU-E into the earliest recognizable RBC precursor B. Iron B. Increases the rate of red blood cell production by the bone marrow C. Reticulum C. Shortens the maturation time of developing erythroid precursors D. RNA D. Decreases stimulation of erythropoiesis when cellular hypoxia increases When spherocytes are reported, what is observed on the peripheral blood smear? Which of the following factors will result in an immediate increase in oxygen delivery to the tissues? A. Red cells without a central pallor A. Increased pH B. Red cells with blunt projections B. High altitudes C. Red cells with sharp projections C. Increased hemoglobin binding of 2,3-BPG D. Red cells with intracellular rod-shaped crystals D. Increased renal release of erythropoietin Periods of intense erythropoietin activity cause premature release of marrow The red cells found in lead poisoning characteristically exhibit coarse reticulocytes into the blood. Which of the following is NOT TRUE of these granules composed of that are reported as. early reticulocytes? A. Precipitated hemoglobin; Pappenheimer bodies A. Loss of residual RNA occurs immediately upon marrow release B. Aggregated ribosomes; basophilic stippling B. Circulate longer than usual beforereaching maturity C. Nuclear fragments; Pappenheimer bodies C. May be termed shift or stressreticulocytes D. Excess iron deposits; basophilic stippling D. Show diffuse basophilia with Wright's stain Rouleaux of red blood cells when seen in the monolayer of a blood smear is Which of the following inclusions is ONLY visible with supravital staining? characteristic of A. Basophilic stippling A. Hypersplenism B. Cabot rings B. Hypogammaglobulinemia C. Heinz bodies C. Cold hemagglutinin disease D. Pappenheimer bodies D. Multiple myeloma Which of the following statements about iron absorption is TRUE ? The presence of schistocytes on the peripheral blood smear is commonly A. Absorption occurs in the ileum. A. Increased iron mobilization B. The mucosal cell always absorbs the correct amount of iron to meet needs. B. Increased red cell destruction C. Absorption increases when erythropoietic activity increases. C. Decreased erythropoietin activity D. Alkaline pH favors absoiption. D. Decreased red cell proliferation What term describes a mature red blood cell that contains iron granules or deposits? Which of the following may be a sign of accelerated bone marrow erythropoiesis? A. Siderosome A. Hypercellular marrow with a decreased number of RBC precursors B. Sideroblast B. Bone marrow M:E ratio of 6:1 C. Ringed sideroblast C. Nucleated red cells in the peripheral circulation D. Siderocyte D. Low erythrocyte, hemoglobin, and hematocrit levels Which of the following is associated with a "shift to the left" in the oxygen dissociation curve of hemoglobin? Microcytic, hypochromic red cells are most often associated with impaired A. Decreased pH and elevated temperature A. DNA synthesis B. Decreased oxygen affinity B. RNA metabolism C. Decreased oxygen release C. Hemoglobin synthesis D. Presence of 2,3-bisphosphoglycerate (2,3-BPG) D. Enzyme metabolism When acanthocytes are found on the blood smear, it is usually the result of Excessive extravascular red cell destruction is associated with A. Abnormal membrane permeability A. Hemoglobinemia B. Altered membrane lipids B. Bilirubinemia C. Mechanical trauma C. Hemoglobinuria D. Polymerization of hemoglobin molecules D. Hemosiderinuria Which erythrocyte metabolic pathway generates adenosine triphosphate Which protein is primarily responsible fo transport of hemoglobin dimers (ATP) via glycolysis? resulting from intravascular hemolysis? A. Embden-Meyerhof A. Hemopexin B. Hexose monophosphate B. Albumin C. Rapoport-Luebering C. Hemosiderin D. Methemoglobin reductase D. Haptoglobin Which of the following red blood cell precursors is the last stage to undergo The morphologic abnormality characteristically found in MITOSIS ? hemoglobinopathies A. Pronormoblast A. Elliptocytes B. Basophilic normoblast B. Dacryocytes C. Polychromatophilic normoblast C. Codocytes D. Orthochromic normoblast D. Discocytes The major adult hemoglobin requires the synthesis of alpha-globin chains Where do the early and late stages of heme synthesis occur and A. On ribosomes A. Beta-globin chains B. In mitochondria B. Delta-globin chains C. In cytoplasm C. Epsilon-globin chains D. In nucleoli D. Gamma-globin chains Spectrin is a protein that occupies a major role in Defective nuclear maturation commonly results in the production of red cells A. Red cell membrane structure A. Normocytic B. Reducing ferric iron B. Hypochromic C. Red cell transport and removal of CC>2 C. Macrocytic D. Iron recovery during hemoglobin degradation D. Microcytic 5 What is the function of reduced glutathione (GSH) in the red blood cell? The major storage form of iron is A. Promotes Kreb's cycle activity A. Ferritin B. Maintains anion balance during the "chloride shift" B. Transferrin C. Neutralizes intracellular oxidants that accumulate C. Hemosiderin D. Prevents oxygen uptake by hemoglobin D. Hemachromatin The red cells observed on a peripheral blood smear show extreme anisocytosis with an equal number of macrocytes and microcytes. Which of What does measuring the total ironbinding capacity (TIBC) represent? the following values correlate with this finding? A. Amount of free iron in serum A. MCV 108.0 fL, RDW 14.0% B. Circulating protein-bound iron B. MCV 90.0 fL, RDW 25.0% C. Amount of iron that transferrin can bind C. MCV 75.0 fL, RDW 16.0% D. Indirect measurement of iron stores Serum ferritin is a good indicator of the amount of A. Cytochrome iron Pica is most commonly associated with which of the following conditions? B. Storage iron A. Pyridoxine deficiency C. Hemoglobin iron B. Lack of erythrocyte folate D. Transferrin saturation C. Iron deficiency D. Porphyrias Fetal hemoglobin differs from adult hemoglobin in that hemoglobin F A. Has a lower oxygen affinity Of the following, the leading cause of Folate Deficiency is B. Resists elution from red cells with acid solutions A. Increased requirements C. Is no longer synthesized after birth in a normal individual B. Dietary insufficiency C. Drug inhibition D. Has four gamma-globin chains D. Malabsorption ERYTHROCYTE DISORDER Which of the following statements about sickle cell syndromes is FALSE ? Impaired DNA metabolism is characteristic of A. Asplenism may result from repeated sickling crises in the homozygous state. A. Hemoglobin C disease B. Heterozygous persons may be partly protected from infection by B. Iron-deficiency anemia falciparum malaria. C. Sideroblastic anemia C. Hemoglobin S is more soluble in dithionite than is normal hemoglobin. D. Megaloblastic anemia D. Trait conditions are generally asymptomatic with no sickle cell formation. Which of the following is associated with glucose-6-phosphate dehydrogenase (G6PD) deficiency? Can befound in patients with microangiopathic hemolytic anemia (MAHA). Which of the following conditions could NOT be responsible for this type of A. G6PD gene is located on the X chromosome. red cell destruction? B. Ongoing intravascular hemolysis occurs. A. Disseminated intravascular coagulation (DIG) C. All circulating red cells, including reticulocytes, lack enzyme activity. B. Hemolytic uremic syndrome (HUS) D. Splenectomy can relieve the rate of red cell destruction. C. Thrombotic thrombocytopenic purpura (TTP) D. Idiopathic thrombocytopenic purpura (ITP) Color Plate 3B shows the peripheral blood of a 16-year-old female with a sporadic history of dizzy spells, fainting, and jaundice. This patient also had a history of periodic abdominal pain related to gallstones. Upon physical Which of the following blood findings does NOT correlate with the presence of examination, she exhibited mild splenomegaly. Her hemoglobin was 107 g/L ringed sideroblasts in the bone marrow? (10.7 g/dL), hematocrit was 0.32 L/L (32%), red cell indices were normal, and the direct antiglobulin test was negative. Based on history and peripheral A. Pappenheimer bodies blood morphology, which of the following statements is most likely true ? B. Basophilic stippling A. Hemoglobin S will be revealed by electrophoresis. C. Increased total iron-binding capacity8 D. Increased percent transferrin saturation B. Tests to confirm iron deficiency should be ordered. C. An intrinsic hereditary defect of red cells should be suspected. Which of the following conditions is NOT usually associated with marked reticulocytosis? D. The anemia is secondary to spleen and gallbladder disorders. A. Four days after a major hemorrhage B. Drug-induced autoimmune hemolyticanemia The Wright's stained blood smear showed the findings seen. C. Sickle cell anemia Hemoglobin electrophoresis was ordered with results as follows: D. Pernicious anemia HgbA 0% HgbA2 3% Hereditary stomatocytosis is manifested physiologically by changes in HgbF 97% A. Hemoglobin oxygen affinity Which condition is most likely causing th hematologic abnormalities? B. Membrane cation permeability A. Alpha-thalassemia major C. Efficiency of hemoglobin reduction B. Cooley beta-thalas semia maj or D. Glycolytic ATP production C. Hemoglobin H disease In addition to an increase in red blood cells, which of the following is Idiopathic aplastic anemia is best defined as a form of anemia that characteristic of Polycythemia Vera? A. Has no identifiable cause A. Decreased platelets, decreased granulocytes, decreased erythropoietin B. Is caused by a physician's treatment level C. Follows exposure to ionizing radiation B. Decreased platelets, decreased granulocytes, increased erythropoietin level D. Develops after a viral infection C. Increased platelets, increased granulocytes, increased erythropoietin level D. Increased platelets, increased granulocytes, decreased erythropoietin level Which of the following is a TRUE red blood cell aplasia? A. Marrow replacement anemia Which of the following is NOT characteristic of aplastic anemia? B. Fanconi anemia A. Extramedullary hematopoiesis C. Diamond-Blackfan anemia B. Bone marrow hypoplasia D. Donath-Landsteiner anemia C. Absolute reticulocytopenia D. Blood findings of pancytopenia Which of the following is NOT a cause of absolute secondary erythrocytosis? A. Defective cardiac or pulmonary function What values would you expect to obtain on hemoglobin and hematocrit B. High-altitude adjustment determinations done immediately after major hemorrhage, if hemoglobin and hematocrit values were normal prior to the hemorrhage? C. Dehydration secondary to diuretic use A. Both normal D. Hemoglobins with increased oxygen affinity B. Both decreased C. Hemoglobin decreased, hematocrit normal A cellulose acetate hemoglobin electrophoresis (alkaline pH), performed on the blood of a stillborn infant, revealed a single band that migrated farther D. Hemoglobin normal, hematocrit decreased toward the anode than did the Hb A control. What is the most likely composition of the stillborn infant's hemoglobin? A. Four beta chains Results from a 1-day-old infant include a hemoglobin of 201 g/L (20.1 g/dL), hematocrit of 0.60 L/L (60.0%), MCV of 110.2 fL, and 4 nucleated red B. Four gamma chains cells/100 WBCs. How should these results be interpreted? C. Two alpha and two beta chains A. The elevated hemoglobin and hematocrit values indicate possible dehydration. D. Two alpha and two gamma chains B. The nucleated red cells suggest accelerated erythropoiesis due to a hemolytic process. The most likely cause of the stillborn infant's condition in question above is C. Testing should be done to identify the cause of the macrocytosis. A. Erythroblastosis fetalis D. No further testing is indicated. B. Rh hemolytic disease of the fetus C. Hydrops fetalis D. ABO hemolytic disease of the newborn Redblood cells with a single elongated projection are known as and may be seen in A. Acanthocytes; liver disease Which of the following conditions show similar CBC and blood smear findings? B. Echinocytes; liver disease A. Beta-thalassemia major and minor C. Drepanocytes; myelofibrosis B. Folic acid and vitamin B12 deficiencies D. Dacryocytes; myelofibrosis C. Acute and chronic blood loss D. Sickle cell disease and trait A patient with normocytic, normochromic anemia secondary to small cell carcinoma may be exhibiting an anemia designated as Which of the following conditions is NOT associated with the presence of A. Hemolytic schistocytes and spherocytes? A. Clostridial septicemia B. Megaloblastic B. Prosthetic heart valves C. Myelophthisic C. Severe thermal burns D. Sideroblastic D. Aplastic anemia A 30-year-old woman who has been vomiting for 3 days has a hemoglobin Which of the following would NOT result in the dual population of red cells? value of 180 g/L (18.0 g/dL) and a hematocrit of 0.54 L/L (54.0%). Her results suggest the presence of A. Blood transfusion A. Absolute erythrocytosis B. Oral iron therapy B. Primary polycythemia C. Spleen removal D. Coexisting deficiencies C. Secondary polycythemia D. Relative polycythemia On what is the classification of sickle cell trait versus sickle cell disease based? An excessive accumulation of iron in body tissues is called A. Severity of the clinical symptoms A. Hemochromatosis B. Number of irreversibly sickled cells (ISCs) B. Erythroblastosis C. Level of compensatory hemoglobin F C. Megaloblastosis D. Percentage of hemoglobin S on electrophoresis D. Acrocyanosis Which of the following is the most appropriate treatment for sickle cell Abetalipoproteinemia is characterized by mild anemia and numerous on the anemia? peripheral blood smear. A. Hydroxyurea A. Acanthocytes B. Elliptocytes B. Supportive therapy C. Echinocytes C. Hyperbaric oxygen D. Stomatocytes D. Iron What is the most common cause of iron deficiency? Which of the following values can be used to indicate the presence of a Hemolytic anemia? A. Bleeding A. Hemoglobin level B. Gastrectomy B. Hematocrit level C. Inadequate diet C. Erythrocyte count D. Intestinal malabsorption D. Reticulocyte count Which of the following does NOT characterize beta-thalassemia major? A. Transfusion-dependent anemia 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 B. Decreased alpha chains result in excess beta chains. hemoglobin A2 level is quantified at 5%. What do these findings suggest? C. Iron chelation therapy is necessary. A. Iron-deficiency anemia D. Common in persons of Mediterranean ancestry B. Heterozygous alpha-thalassemia In the anemia of chronic disease, what are the usual serum iron and C. Heterozygous beta-thalassemia transferrin levels? D. Hemoglobin S/beta-thalassemia A. Serum iron decreased, transferrin decreased B. Serum iron decreased, transferrin increased What causes the hemolytic process in G6PD following oxidant exposure? C. Serum iron normal, transferrin normal A. Coating of red cells by antibody D. Serum iron increased, transferrin increased B. Osmotic pressure changes C. Complement attachment In children, the most important effect of lead poisoning is on the D. Precipitation of denatured hemoglobin A. Liver B. Kidney C. Neurologic system D. Development of erythrocytes In clinically severe hereditary spherocytosis, which of the following findings Hemoglobinopathies are characterized by would NOT be found post-splenectomy? A. Absent or reduced rate of globin-chain synthesis A. Rise in the red cell count and hemoglobin level B. Inability to transport and release oxygen to the tissues B. Higher number of circulating reticulocytes C. Inhibition of iron chelation needed for heme biosynthesis C. Increased number of Howell-Jolly bodies D. Production of structurally abnormal hemoglobin variants D. Transient elevation in the platelet count Which of the following statements about hereditary spherocytosis is TRUE? A. Abnormally shaped cells are produced in the bone marrow. Which of the following laboratory results is NOT consistent with accelerated red cell destruction? B. Cells have a decreased mean cell hemoglobin concentration (MCHC). A. Increased serum bilirubin C. Membrane loss and red cell trapping occur in the splenic microcirculation. B. Increased plasma hemoglobin D. Red cell osmotic fragility is decreased. C. Increased serum lactate dehydrogenase (LD) Which of the following statements about hereditary elliptocytosis (HE) is D. Increased serum haptoglobin TRUE? A. Characteristic oval shape occurs in mature erythrocytes. Acquired hemolytic anemias are usually due to B. Heterogeneous group of disorders linked to Rh-null individuals. A. Extracorpuscular factors C. Cellular defect involves the lipid composition of the membrane. B. Defects within the bone marrow D. HE cells are abnormally permeable to calcium C. Intracellular factors D. Changes in hemoglobin stability Which of the following disorders is NOT commonly linked to the development of anemia of chronic disease? The antibody associated with paroxysma cold hemoglobinuria shows A. Persistent infections specificity for B. Noninfectious inflammatory disorders A. ABO antigens C. Chronic gastrointestinal blood loss B. I antigens D. Malignancy C. P antigens D. Rh antigens Which of the following statements about hemoglobin C disease is FALSE ? A. Electrophoresis shows approximately 60% hemoglobin A and 40% hemoglobin C. A 69-year-old male is admitted with pallor, mild tachycardia, and difficulty walking because of numbness in the extremities. His CBC reveals a B. Target cells are frequently seen on peripheral smears. hemoglobin of 78 g/L (7.8 g/dL), a hematocrit of 0.25 L/L (25.0%), and MCV of 118.5 fL. Are most suggestive of anemia due to a lack of C. Red cells may contain bar-shaped intracellular crystals. A. Folic acid D. The disorder is less severe than sickle cell disease. B. Vitamin B12 C. Vitamin B6 Which of the following is associated with sickle cells? D. Ascorbic acid A. Increased oxygen tension promotes sickling. B. There is decreased mechanical fragility. A clinical laboratory scientist examined a Wright's stained peripheral smear C. There is increased deformability. and saw what appeared to be small, dark-staining granules in the mature D. Increased sickling occludes vessels. erythrocytes. A second smear was stained with Prussian blue and a positive result was obtained. which of the following would you expect to be abnormal? A. Plasma hemoglobin level A bone marrow M:E ratio of 4:1 would be an expected finding for B. Serum ferritin level A. Sickle cell anemia C. Hemoglobin electrophoresis B. Aplastic anemia D. Test for parietal cell antibodies C. Beta-thalassemia major D. Megaloblastic anemia An elderly man with a 10-year history of chronic lymphocytic leukemia Which of the following statements about the relative anemia of pregnancy is presented with jaundice and fatigue that was attributed to a recent 3-gram FALSE ? drop in his hemoglobin. Many spherocytes and polychromatophilic red cells were found on his Wright's stained blood smear. Which type of immune A. It is due to a reduction in the number of erythrocytes. hemolytic anemia is most likely? B. It is normocytic and normochromic. A. Idiopathic warm autoimmune hemolytic anemia C. It does not produce an oxygen deficit for the fetus. B. Secondary warm autoimmune hemolytic anemia D. It is associated with an increase in plasma volume. C. Primary cold hemagglutinin disease D. Paroxysmal cold hemoglobinuria The anemia found in chronic renal failure is most likely caused by A. Loss of erythropoietin synthesis B. Lack of cellular oxygen demand A moderately anemic patient with suspected pernicious anemia (PA) shows intrinsic factor antibodies and a low cobalamin level. Which of the C. Defective iron absorption following would NOT support the diagnosis of PA? D. Destruction of red cells by uremic metabolites A. Gastric atrophy and achlorhydria Which of the following phrases about aplastic anemia is false? B. Oval macrocytes and Howell-Jolly bodies A. Stem cell disorder C. Bone marrow erythroid precursors exhibit normoblastic maturation. B. Risk of life-threatening infection D. Elevated serum lactate dehydrogenase (LD) and bilirubin levels C. Frequent bleeding complications D. Reduced red cell survival A cellulose acetate electrophoresis revealed a large band of hemoglobin in the hemoglobin S position. This band quantified at 95%. The peripheral smear revealed 70% target cells, and the solubility test was negative. Based The fish tapeworm Diphyllobothrium latum is associated with the on this information, what is the hemoglobin? development of A. Hemoglobin C A. Microcytic anemia B. Macrocytic anemia B. Hemoglobin D C. Hemolytic anemia C. Hemoglobin E D. Hemoglobin S D. Hypoproliferative anemia A previously healthy man experiences weakness and hemoglobinuria after An increase in erythropoietin is NOT a normal compensating mechanism taking the antimalarial agent primaquine. This hemolytic attack most likely in which of the following conditions? A. Pyruvate kinase A. Renal tumors B. Glucose-6-phosphate dehydrogenase B. Heavy smoking C. 2,3-Bisphosphoglycerate C. Cardiovascular disease D. Methemoglobin reductase D. Pulmonary disease Which of the following is an acquired red cell membrane defect that results in Thalassemias are the result of a increased sensitivity to complement binding? A. Structural defect in the heme portion of hemoglobin A. March hemoglobinuria B. Quantitative defect in globin-chain synthesis B. Paroxysmal nocturnal hemoglobinuria C. Qualitative defect in globin-chain structure C. Paroxysmal cold hemoglobinuria D. Change in hemoglobin solubility properties D. Methemoglobinemia Which of the following characterizes iron deficiency anemia? Which of the following is NOT associated with acquired reversible A. Decreased serum iron, decreased transferrin saturation, normal ferritin sideroblastic anemias? B. Decreased serum transferrin, decreased transferrin saturation, decreased A. Methotrexate therapy ferritin B. Lead intoxication C. Increased serum transferrin, decreased transferrin saturation, decreased C. Isoniazid treatment for tuberculosis ferritin D. Acute alcohol ingestion D. Increased serum transferrin, increased transferrin saturation, decreased serum iron Clinical manifestations of a homozygous mutation involving the beta-globin Thinning of bones and deformation of facial bone structure seen in gene will most likely appear homozygous beta-thalassemia is a A. During embryonic development A. Consequence of disturbances in calcium metabolism B. In the neonate at birth B. Result of hyperplastic marrow activity C. No later than 3 weeks after birth C. Secondary disorder due to immunologic response D. By 6 months of age D. Result of increased fibroclast activity The hemolysis associated with infection by malaria organisms is due to the Which of the following does not accurately describe cold autoimmune hemolytic anemia? A. Release of merozoites from erythrocytes A. Red cell agglutination in extremities induces Raynaud's phenomenon. B. Invasion of erythrocytes by merozoites B. It may occur secondary to Mycoplasma pneumonia. C. Host's immunologic response to infected erythrocytes C. Hemolysis is complement-mediated or via removal of coated cells. D. Toxins produced by the malarial organism D. The autoantibody is usually an IgG type directed against Rh antigens. 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. When examined microscopically, the majority of cells appeared Which of the following represents an anemia that would have a HIGH red cell distribution width (RDW)? to have many evenly distributed, blunt spicules on the surface. How should this cellular appearance be interpreted? A. Sickle cell disease during crisis A. An anemic condition requiring further testing B. Spur cells caused by using incorrect technique during slide preparation B. Thalassemia minor C. Artifact caused by a dirty spreader slide C. Aplastic anemia D. Crenated cells caused by incorrect blood to anticoagulant ratio D. Anemia of chronic disorders A failure to generate sufficient ATP is characteristic of red blood cells with A. Pyruvate kinase deficiency In which of the following disorders would splenomegaly NOT be a common finding? B. Glucose-6-phosphate dehydrogenase deficiency A. Homozygous beta-thalassemia C. Lipoprotein deficiency B. Hereditary spherocytosis D. Hexokinase deficiency C. Hemoglobin SC disease D. Folic acid deficiency When iron use exceeds absorption, which of the following occurs first? A. 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 A. 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 bybcommitted red cell progenitor cells Which of the following is NOT a characteristic of the idiopathic type of sideroblastic anemia? A. Refractory to treatment B. Blocks in heme synthesis are unknown C. Reversible with intramuscular vitamin B12 injections D. Subtype of myelodysplastic syndromes