Question 1

The destruction of erythrocytes in MAHA is primarily the result of what mechanism?

Accepted Answer

A)  Extravascular hemolysis 
B)  Loss of membrane proteins 
C)  Complement-mediated hemolysis 
D)  DIC 
A)  Extravascular hemolysis 
B)  Loss of membrane proteins 
C)  Complement-mediated hemolysis 
D)  DIC A

Question 2

In what type of hemolytic anemia does damage to the endothelial lining of the small vessels result in deposits of fibrin with the vessels?

Accepted Answer

A)  Exercise-induced hemoglobinuria 
B)  The type associated with infectious agents 
C)  The type associated with animal venoms 
D)  Microangiopathic hemolytic anemia 
A)  Exercise-induced hemoglobinuria 
B)  The type associated with infectious agents 
C)  The type associated with animal venoms 
D)  Microangiopathic hemolytic anemia D

Question 3

Which of the following analytes is decreased in HUS?

Accepted Answer

A)  Bilirubin 
B)  Lactate dehydrogenase 
C)  Haptoglobin 
D)  BUN 
A)  Bilirubin 
B)  Lactate dehydrogenase 
C)  Haptoglobin 
D)  BUN C

Question 4

The primary difference between D+ and D- forms of HUS is related to the:

Accepted Answer

A)  Extent of damage to the kidney 
B)  Length of the symptomatic period 
C)  Severity of thrombocytopenia 
D)  Presence of diarrhea 
A)  Extent of damage to the kidney 
B)  Length of the symptomatic period 
C)  Severity of thrombocytopenia 
D)  Presence of diarrhea

Question 5

The underlying cause of TTP is:

Accepted Answer

A)  An unregulated coagulation cascade 
B)  Deficiency in VWF multimers 
C)  Deficiency of ADAMTS-13 protease 
D)  Overproduction of cryoprecipitate 
A)  An unregulated coagulation cascade 
B)  Deficiency in VWF multimers 
C)  Deficiency of ADAMTS-13 protease 
D)  Overproduction of cryoprecipitate

Question 6

What are typical findings on the blood smear in DIC?

Accepted Answer

A)  Spherocytes and leukopenia 
B)  Target cells and leukocytosis 
C)  Schistocytes and thrombocytopenia 
D)  Helmet cells and thrombocytosis 
A)  Spherocytes and leukopenia 
B)  Target cells and leukocytosis 
C)  Schistocytes and thrombocytopenia 
D)  Helmet cells and thrombocytosis

Question 7

A child presents to the hospital emergency department with clinical findings of bloody diarrhea and fever. Laboratory findings reveal an elevated neutrophil count, increased C-reactive protein, thrombocytopenia, and a decreased haptoglobin. With what diagnosis are these findings associated?

Accepted Answer

A)  TTP 
B)  HUS 
C)  DIC 
D)  HELLP syndrome 
A)  TTP 
B)  HUS 
C)  DIC 
D)  HELLP syndrome

Question 8

Bone marrow response in MAHA is reflected in the peripheral blood smear by the presence of:

Accepted Answer

A)  Spherocytes 
B)  Reticulocytes 
C)  Schistocytes 
D)  Keratocytes 
A)  Spherocytes 
B)  Reticulocytes 
C)  Schistocytes 
D)  Keratocytes

Question 9

Which of the following conditions is not characterized by the presence of schistocytes?

Accepted Answer

A)  HUS 
B)  TTP 
C)  Malaria 
D)  HELLP syndrome 
A)  HUS 
B)  TTP 
C)  Malaria 
D)  HELLP syndrome

Question 10

Hemolytic uremic syndrome and thrombotic thrombocytopenic purpura can present with similar initial clinical symptoms. Which of following distinguishes TTP?

Accepted Answer

A)  It occurs in children younger than 5 years old. 
B)  Acute renal failure is present. 
C)  There are severe CNS symptoms. 
D)  There is thrombocytopenia. 
A)  It occurs in children younger than 5 years old. 
B)  Acute renal failure is present. 
C)  There are severe CNS symptoms. 
D)  There is thrombocytopenia.

Question 11

Which of the following organisms causes erythrocyte damage by releasing hemolytic toxins?

Accepted Answer

A)  Plasmodium sp. 
B)  Babesia sp. 
C)  Clostridium sp. 
D)  Bartonella sp. 
A)  Plasmodium sp. 
B)  Babesia sp. 
C)  Clostridium sp. 
D)  Bartonella sp.

Question 12

A patient who presents with DIC would most likely have which of the following sets of coagulation test results? PT aPTT D-dimer Fibrinogen

Accepted Answer

A)  Prolonged Prolonged Elevated Decreased 
B)  Normal Prolonged Normal Normal 
C)  Prolonged Prolonged Decreased Increased 
D)  Normal Prolonged Decreased Decreased 
A)  Prolonged Prolonged Elevated Decreased 
B)  Normal Prolonged Normal Normal 
C)  Prolonged Prolonged Decreased Increased 
D)  Normal Prolonged Decreased Decreased

Question 13

Plasmodium falciparum infection is accompanied by a severe form of anemia from what factor?

Accepted Answer

A)  Toxins produced by P. falciparum 
B)  High levels of parasitemia 
C)  Lack of spleen removal of the infected cells (red blood cells) 
D)  Production of exotoxins that affect host cell membranes 
A)  Toxins produced by P. falciparum 
B)  High levels of parasitemia 
C)  Lack of spleen removal of the infected cells (red blood cells) 
D)  Production of exotoxins that affect host cell membranes

Question 14

Which of the following results are typically found in HUS? PT aPTT

Accepted Answer

A)  Prolonged Prolonged 
B)  Normal Prolonged 
C)  Prolonged Normal 
D)  Normal Normal 
A)  Prolonged Prolonged 
B)  Normal Prolonged 
C)  Prolonged Normal 
D)  Normal Normal

Question 15

Explain how the action of E. coli O157:H7 toxin is related to the development of HUS.

Accepted Answer

The Shigalike toxin of E. Coli O157:H7 h

Question 16

A woman visits her obstetrician for a routine prenatal visit at 24 weeks. Her blood pressure is 180/100 and her urinalysis shows 3+ proteins. The peripheral blood smear demonstrated the presence of schistocytes. What other elevated test results might be found?

Accepted Answer

A)  Liver enzymes 
B)  BUN and creatinine 
C)  PT and APTT 
D)  Haptoglobin 
A)  Liver enzymes 
B)  BUN and creatinine 
C)  PT and APTT 
D)  Haptoglobin

Question 17

A 20-year-old disoriented female is brought to the hospital with a fever of 102°F. Results of the CBC demonstrate a platelet count of 68 × 109/L, a hemoglobin of 9.0 gm/dl, WBC count of 22 × 109/L, and the presence of polychromasia and schistocytes on the peripheral blood smear. Her husband indicated she had no recent episodes of diarrhea but had been taking penicillin for an ongoing infection. The most likely diagnosis for the patient is:

Accepted Answer

A)  TTP 
B)  D-HUS 
C)  DIC 
D)  HELLP syndrome 
A)  TTP 
B)  D-HUS 
C)  DIC 
D)  HELLP syndrome

Question 18

A patient presented with fever, mild anemia, and thrombocytopenia. The peripheral blood smear showed the presence of intracellular organisms that were present as singles, doubles, and tetrads. What is the most likely identification of the organism?

Accepted Answer

A)  Plasmodium falciparum 
B)  Babesia microti 
C)  Bartonella bacilliformis 
D)  Trypanosoma cruzi 
A)  Plasmodium falciparum 
B)  Babesia microti 
C)  Bartonella bacilliformis 
D)  Trypanosoma cruzi

Question 19

Which of the following laboratory findings occur in both HUS and TTP?

Accepted Answer

A)  Increased reticulocytes; thrombocytopenia; decrease in haptoglobin 
B)  Decreased reticulocytes; decrease in haptoglobin and thrombocytopenia 
C)  Increased total and unconjugated serum bilirubin; increase in haptoglobin 
D)  Decreased total and unconjugated serum bilirubin; decreased haptoglobin 
A)  Increased reticulocytes; thrombocytopenia; decrease in haptoglobin 
B)  Decreased reticulocytes; decrease in haptoglobin and thrombocytopenia 
C)  Increased total and unconjugated serum bilirubin; increase in haptoglobin 
D)  Decreased total and unconjugated serum bilirubin; decreased haptoglobin

Question 20

Which of following is identified as an initiator of exercise-induced hemoglobinuria associated with running?

Accepted Answer

A)  Prosthetic heart valves 
B)  Extensive thermal burns 
C)  Erythrocyte membrane disorder 
D)  Exercise-induced oxidative stress and erythrocyte age 
A)  Prosthetic heart valves 
B)  Extensive thermal burns 
C)  Erythrocyte membrane disorder 
D)  Exercise-induced oxidative stress and erythrocyte age

Exam 20: Hemolytic Anemia: Nonimmune Defects

The destruction of erythrocytes in MAHA is primarily the result of what mechanism?

In what type of hemolytic anemia does damage to the endothelial lining of the small vessels result in deposits of fibrin with the vessels?

Which of the following analytes is decreased in HUS?

The primary difference between D+ and D- forms of HUS is related to the:

The underlying cause of TTP is:

What are typical findings on the blood smear in DIC?

A child presents to the hospital emergency department with clinical findings of bloody diarrhea and fever. Laboratory findings reveal an elevated neutrophil count, increased C-reactive protein, thrombocytopenia, and a decreased haptoglobin. With what diagnosis are these findings associated?

Bone marrow response in MAHA is reflected in the peripheral blood smear by the presence of:

Which of the following conditions is not characterized by the presence of schistocytes?

Hemolytic uremic syndrome and thrombotic thrombocytopenic purpura can present with similar initial clinical symptoms. Which of following distinguishes TTP?

Which of the following organisms causes erythrocyte damage by releasing hemolytic toxins?

A patient who presents with DIC would most likely have which of the following sets of coagulation test results? PT aPTT D-dimer Fibrinogen

Plasmodium falciparum infection is accompanied by a severe form of anemia from what factor?

Which of the following results are typically found in HUS? PT aPTT

Explain how the action of E. coli O157:H7 toxin is related to the development of HUS.

A woman visits her obstetrician for a routine prenatal visit at 24 weeks. Her blood pressure is 180/100 and her urinalysis shows 3+ proteins. The peripheral blood smear demonstrated the presence of schistocytes. What other elevated test results might be found?

A patient presented with fever, mild anemia, and thrombocytopenia. The peripheral blood smear showed the presence of intracellular organisms that were present as singles, doubles, and tetrads. What is the most likely identification of the organism?

Which of the following laboratory findings occur in both HUS and TTP?

Which of following is identified as an initiator of exercise-induced hemoglobinuria associated with running?

Introduction

Cellular Homeostasis

Structure and Function of Hematopoietic Organs

Hematopoiesis

The Erythrocyte

Hemoglobin

Granulocytes and Monocytes

Lymphocytes

The Platelet

The Complete Blood Count and Peripheral Blood Smear Evaluation

Introduction to Anemia

Anemias of Disordered Iron Metabolism and Heme Synthesis

Hemoglobinopathies: Qualitative Defects

Thalassemia

Megaloblastic and Nonmegaloblastic Macrocytic Anemias

Hypoproliferative Anemias

Hemolytic Anemia: Membrane Defects

Hemolytic Anemia: Enzyme Deficiencies

Hemolytic Anemia: Immune Anemias

Nonmalignant Disorders of Leukocytes: Granulocytes and Monocytes

Nonmalignant Lymphocyte Disorders

Introduction to Hematopoietic Neoplasms

Myeloproliferative Neoplasms

Myelodysplastic Syndromes

Acute Myeloid Leukemias

Precursor Lymphoid Neoplasms

Mature Lymphoid Neoplasms

Hematopoietic Stem Cell Transplantation

Morphologic Analysis of Body Fluids in the Hematology

Primary Hemostasis

Secondary Hemostasis and Fibrinolysis

Disorders of Primary Hemostasis

Disorders of Secondary Hemostasis

Thrombophilia

Hemostasis: Laboratory Testing and Instrumentation

Hematology Procedures

Bone Marrow Examination

Automation in Hematology

Flow Cytometry

Chromosome Analysis of Hematopoietic and Lymphoid Disorders

Molecular Analysis of Hematologic Diseases

Quality Assessment in the Hematology Laboratory

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