Question 1

Name the molecule that is responsible for oxidizing ferrous iron to ferric iron to be combined with transferrin.

Accepted Answer

A)  DCytB 
B)  DMT1 
C)  Ferroportin 
D)  Hephaestin 
A)  DCytB 
B)  DMT1 
C)  Ferroportin 
D)  Hephaestin D

Question 2

Before treating a patient for IDA, it is important to rule out thalassemia. Explain why that is and using 3 parameters, differentiate between the two disease states.

Accepted Answer

Iron deficiency anemia is due to a defect in hemoglobin synthesis caused by abnormal iron metabolism that results in a deficiency of iron. Thalassemia is a defect in globin synthesis, either a mutation or deletion and results in increased iron stores. If improperly diagnosed as IDA, the patient will be treated with parental iron therapy which will produce iron overload in the thalassemic patient.
Tests used to differentiate IDA from thalassemia include:
IDA Thalassemia
Serum Fe ↓ N
% Saturation ↑ N
Ferritin ↑ N
RBC ↓ ↑
MCV N to ↑ ↓↓
ZPP ↑↑↑ N to ↑

Question 3

Which of the following is the correct progression of iron-deficiency anemia?

Accepted Answer

A)  Storage depletion, iron-poor hemoglobin production, transport depletion 
B)  Storage depletion, transport depletion, iron-poor hemoglobin production 
C)  Iron-poor hemoglobin production, transport depletion, storage depletion 
D)  Iron-poor hemoglobin production, storage depletion, transport depletion 
A)  Storage depletion, iron-poor hemoglobin production, transport depletion 
B)  Storage depletion, transport depletion, iron-poor hemoglobin production 
C)  Iron-poor hemoglobin production, transport depletion, storage depletion 
D)  Iron-poor hemoglobin production, storage depletion, transport depletion B

Question 4

Iron-deficiency anemia can occur from what three mechanisms?

Accepted Answer

A)  Impaired iron absorption, blood loss, inadequate iron intake 
B)  ALAS deficiency, blood loss, decreased transferrin 
C)  Mutation of HFE gene, decreased transferrin, increased hepcidin 
D)  Inadequate iron intake, impaired iron absorption, decreased hepcidin 
A)  Impaired iron absorption, blood loss, inadequate iron intake 
B)  ALAS deficiency, blood loss, decreased transferrin 
C)  Mutation of HFE gene, decreased transferrin, increased hepcidin 
D)  Inadequate iron intake, impaired iron absorption, decreased hepcidin

Question 5

The patient was found to have normal serum iron studies. What other reflex test(s) should be done?

Accepted Answer

A)  Blood lead level 
B)  Porphyrin studies 
C)  Reticulocyte count 
D)  Osmotic fragility 
A)  Blood lead level 
B)  Porphyrin studies 
C)  Reticulocyte count 
D)  Osmotic fragility

Question 6

What enzyme is responsible for reducing ferric iron to the ferrous state at the enterocyte brush border?

Accepted Answer

A)  Apoferritin 
B)  DcytB 
C)  Ferritin 
D)  Transferrin 
A)  Apoferritin 
B)  DcytB 
C)  Ferritin 
D)  Transferrin

Question 7

The first peripheral blood marker to show an abnormal result in iron deficiency anemia is:

Accepted Answer

A)  Retic absolute 
B)  CHr or Ret-He 
C)  Retic % 
D)  MCV 
A)  Retic absolute 
B)  CHr or Ret-He 
C)  Retic % 
D)  MCV

Question 8

Regulation of iron entering the body occurs mainly through which mechanism?

Accepted Answer

A)  Transfer of iron in the enterocyte into the blood 
B)  Absorption of dietary iron into the enterocyte 
C)  Excretion of excess iron from the intestine into the urine 
D)  Chelation of dietary iron in the intestine 
A)  Transfer of iron in the enterocyte into the blood 
B)  Absorption of dietary iron into the enterocyte 
C)  Excretion of excess iron from the intestine into the urine 
D)  Chelation of dietary iron in the intestine

Question 9

Erythropoietic porphyrias are associated with:

Accepted Answer

A)  Abnormal iron metabolism 
B)  Abnormal enzymes in the heme biosynthetic pathway 
C)  Abnormal globin synthesis 
D)  DMT1 mutations 
A)  Abnormal iron metabolism 
B)  Abnormal enzymes in the heme biosynthetic pathway 
C)  Abnormal globin synthesis 
D)  DMT1 mutations

Question 10

Accumulation of heterogeneous aggregates of iron is called:

Accepted Answer

A)  Hemosiderosis 
B)  Sideroblastosis 
C)  Ferritinemia 
D)  Transferrinuria 
A)  Hemosiderosis 
B)  Sideroblastosis 
C)  Ferritinemia 
D)  Transferrinuria

Question 11

Which of the following is not characteristic of iron deficiency anemia?

Accepted Answer

A)  Decreased ZPP 
B)  Decreased serum iron 
C)  Increased TIBC 
D)  Decreased serum ferritin 
A)  Decreased ZPP 
B)  Decreased serum iron 
C)  Increased TIBC 
D)  Decreased serum ferritin

Question 12

Which laboratory test measures the maximum amount of iron able to be bound to transferrin in the serum?

Accepted Answer

A)  Ferritin 
B)  Percent transferrin saturation 
C)  Serum iron 
D)  TIBC 
A)  Ferritin 
B)  Percent transferrin saturation 
C)  Serum iron 
D)  TIBC

Question 13

What measurements are used in the percent saturation calculation?

Accepted Answer

A)  Transferrin and ferritin 
B)  Ferritin and bone marrow iron 
C)  Serum iron and TIBC 
D)  Serum iron and ferritin 
A)  Transferrin and ferritin 
B)  Ferritin and bone marrow iron 
C)  Serum iron and TIBC 
D)  Serum iron and ferritin

Question 14

The most common form of hereditary sideroblastic anemia is due to:

Accepted Answer

A)  Abnormal ALAS 
B)  Plumbism 
C)  Autosomal recessive transmission 
D)  Decreased folate 
A)  Abnormal ALAS 
B)  Plumbism 
C)  Autosomal recessive transmission 
D)  Decreased folate

Question 15

A bone marrow aspirate is performed on a patient with sideroblastic anemia. The smear is stained with Prussian blue iron. The expected findings in this patient would be that iron stores:

Accepted Answer

A)  Will be decreased as compared with the normal control 
B)  Will be the same as those in the normal control 
C)  Will be increased as compared with the normal control 
D)  Cannot be determined based on the diagnosis alone 
A)  Will be decreased as compared with the normal control 
B)  Will be the same as those in the normal control 
C)  Will be increased as compared with the normal control 
D)  Cannot be determined based on the diagnosis alone

Question 16

A term used to describe anemia characterized by deficient iron for hemoglobin synthesis is:

Accepted Answer

A)  Sideropenic 
B)  Sideroblastic 
C)  Sideroachrestic 
D)  Siderocyte 
A)  Sideropenic 
B)  Sideroblastic 
C)  Sideroachrestic 
D)  Siderocyte

Question 17

Explain the difference between the chemical composition of hemosiderin and that of ferritin.

Accepted Answer

Hemosiderin is an amalgam of i

Question 18

A 4-year-old boy who primarily eats grilled cheese sandwiches and tomato soup can suffer from iron-deficiency anemia because of:

Accepted Answer

A)  Increased need 
B)  Inadequate intake 
C)  Impaired utilization 
D)  Increased need and inadequate intake 
A)  Increased need 
B)  Inadequate intake 
C)  Impaired utilization 
D)  Increased need and inadequate intake

Question 19

Anemia of chronic disease is characterized by:

Accepted Answer

A)  A block in globin synthesis 
B)  An inadequate intake of iron 
C)  A block in insertion of iron into the porphyrin ring of heme 
D)  A block in iron release from macrophages 
A)  A block in globin synthesis 
B)  An inadequate intake of iron 
C)  A block in insertion of iron into the porphyrin ring of heme 
D)  A block in iron release from macrophages

Question 20

Hypochromic, microcytic anemia is found in which stage of iron deficiency?

Accepted Answer

A)  1 
B)  2 
C)  3 
A)  1 
B)  2 
C)  3

Exam 12: Anemias of Disordered Iron Metabolism and Heme Synthesis

Name the molecule that is responsible for oxidizing ferrous iron to ferric iron to be combined with transferrin.

Before treating a patient for IDA, it is important to rule out thalassemia. Explain why that is and using 3 parameters, differentiate between the two disease states.

Which of the following is the correct progression of iron-deficiency anemia?

Iron-deficiency anemia can occur from what three mechanisms?

The patient was found to have normal serum iron studies. What other reflex test(s) should be done?

What enzyme is responsible for reducing ferric iron to the ferrous state at the enterocyte brush border?

The first peripheral blood marker to show an abnormal result in iron deficiency anemia is:

Regulation of iron entering the body occurs mainly through which mechanism?

Erythropoietic porphyrias are associated with:

Accumulation of heterogeneous aggregates of iron is called:

Which of the following is not characteristic of iron deficiency anemia?

Which laboratory test measures the maximum amount of iron able to be bound to transferrin in the serum?

What measurements are used in the percent saturation calculation?

The most common form of hereditary sideroblastic anemia is due to:

A bone marrow aspirate is performed on a patient with sideroblastic anemia. The smear is stained with Prussian blue iron. The expected findings in this patient would be that iron stores:

A term used to describe anemia characterized by deficient iron for hemoglobin synthesis is:

Explain the difference between the chemical composition of hemosiderin and that of ferritin.

A 4-year-old boy who primarily eats grilled cheese sandwiches and tomato soup can suffer from iron-deficiency anemia because of:

Anemia of chronic disease is characterized by:

Hypochromic, microcytic anemia is found in which stage of iron deficiency?

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

Hemoglobinopathies: Qualitative Defects

Thalassemia

Megaloblastic and Nonmegaloblastic Macrocytic Anemias

Hypoproliferative Anemias

Hemolytic Anemia: Membrane Defects

Hemolytic Anemia: Enzyme Deficiencies

Hemolytic Anemia: Immune Anemias

Hemolytic Anemia: Nonimmune Defects

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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