Question 1

Which of the following provides a negative feedback for heme synthesis,thus helping to control,by decreasing,its synthesis?

Accepted Answer

A) concentration of heme in the developing RBC 
B) concentration of hemoglobin in blood 
C) concentration of globin chain in the developing RBC 
D) number of RBCs in circulation 
A) concentration of heme in the developing RBC 
B) concentration of hemoglobin in blood 
C) concentration of globin chain in the developing RBC 
D) number of RBCs in circulation A

Question 2

Why is heme located inside a globin chain pocket surrounded by hydrophobic amino acids?

Accepted Answer

A) protects iron from being oxidized to its ferric form 
B) necessary for oxygen release to tissues 
C) makes hemoglobin insoluble 
D) keeps heme from being dissolved 
A) protects iron from being oxidized to its ferric form 
B) necessary for oxygen release to tissues 
C) makes hemoglobin insoluble 
D) keeps heme from being dissolved A

Question 3

Which of the following is true of the oxygen dissociation curve?

Accepted Answer

A) The normal partial pressure of oxygen (PO2) at which hemoglobin is 50% saturated is 20 mm Hg. 
B) A shift to the right or left in response to blood pH is called the Bohr effect. 
C) A shift to the left results in lower oxygen affinity. 
D) A shift to the right results in less effective delivery of oxygen to tissue. 
A) The normal partial pressure of oxygen (PO2) at which hemoglobin is 50% saturated is 20 mm Hg. 
B) A shift to the right or left in response to blood pH is called the Bohr effect. 
C) A shift to the left results in lower oxygen affinity. 
D) A shift to the right results in less effective delivery of oxygen to tissue. B

Question 4

Which of the following is true of hemoglobin if the oxygen dissociation curve shifts to the left?

Accepted Answer

A) has a lower affinity for oxygen 
B) picks up less oxygen in the lungs but delivers more to tissues 
C) picks up more oxygen in the lungs but delivers less to tissues 
D) picks up and delivers more oxygen 
A) has a lower affinity for oxygen 
B) picks up less oxygen in the lungs but delivers more to tissues 
C) picks up more oxygen in the lungs but delivers less to tissues 
D) picks up and delivers more oxygen

Question 5

Which of the following is true regarding carboxyhemoglobin?

Accepted Answer

A) Smokers have increased levels. 
B) It has hydrogen sulfide added to hemoglobin. 
C) Normal people have none. 
D) Levels of 15% to 20 % cause coma and death. 
A) Smokers have increased levels. 
B) It has hydrogen sulfide added to hemoglobin. 
C) Normal people have none. 
D) Levels of 15% to 20 % cause coma and death.

Question 6

Which of the following causes a shift to the right on the oxygen dissociation curve?

Accepted Answer

A) severe anemia 
B) alkalosis 
C) high levels of Hb F 
D) decreased levels of 2,3-biphosphoglycerate (2,3-BPG) 
A) severe anemia 
B) alkalosis 
C) high levels of Hb F 
D) decreased levels of 2,3-biphosphoglycerate (2,3-BPG)

Question 7

In which of the following conditions would patients have an increased concentration of methemoglobin?

Accepted Answer

A) patient receiving drug containing sulfonamide 
B) patient exposed to reducing agents 
C) patient with hemoglobin S (Hb S) 
D) patient with methemoglobin reductase deficiency 
A) patient receiving drug containing sulfonamide 
B) patient exposed to reducing agents 
C) patient with hemoglobin S (Hb S) 
D) patient with methemoglobin reductase deficiency

Question 8

Which of the following is true for the relative affinity of hemoglobin for oxygen in the lungs and tissue with the oxygen dissociation curve in its normal position?
LungsTissue
$\begin{array}{ll}\text { A) high } & \text { Tissue } \ \text { B) low } & \text { low } \ \text { C) high } & \text { high } \ \text { D) low } & \text { low }\end{array} $

Accepted Answer

A
The affinity of hemoglobin f

Question 9

The reference range for hemoglobin concentration

Accepted Answer

A) is lower in a newborn than in a male adult. 
B) is lower in a newborn than in a female adult. 
C) is higher in a newborn than in a male adult. 
D) is higher in a woman than in a man. 
A) is lower in a newborn than in a male adult. 
B) is lower in a newborn than in a female adult. 
C) is higher in a newborn than in a male adult. 
D) is higher in a woman than in a man.

Question 10

The globin chains making up Hb A are
a. two $ \varepsilon $ and two $ \gamma $ chains.
b. two $ \zeta $ and two $ \varepsilon $ chains.
c. two $ \alpha $ and two $ \gamma $ chains.
d. two $ \alpha $ and two $ \beta $ chains.

Accepted Answer

D
Hb A is composed of two a an

Question 11

Identify the primary organelle of synthesis site for globin chain and heme in developing RBCs.
Globin chainsHeme
$ \begin{array}{ll}\text { A) ribosomes } & \text { ribosomes } \ \text { B) Golgi complex } & \text { mitochondria } \ \text { C) ribosomes } & \text { mitochondria } \ \text { D) mitochondria } & \text { Golgi complex }\end{array} $

Accepted Answer

C
Globin chains are synthesize

Question 12

Select the form of hemoglobin that contains iron in the ferric rather than the ferrous state.

Accepted Answer

A) myoglobin 
B) methemoglobin 
C) deoxyhemoglobin 
D) carboxyhemoglobin 
A) myoglobin 
B) methemoglobin 
C) deoxyhemoglobin 
D) carboxyhemoglobin

Question 13

Why does Hb F have a higher oxygen affinity than adult hemoglobin?

Accepted Answer

A) Fetal blood has a higher pH than adult blood. 
B) Fetal blood has a higher hematocrit than adult blood. 
C) Body temperature is lower in fetus. 
D) It is necessary to extract oxygen from the maternal blood supply. 
A) Fetal blood has a higher pH than adult blood. 
B) Fetal blood has a higher hematocrit than adult blood. 
C) Body temperature is lower in fetus. 
D) It is necessary to extract oxygen from the maternal blood supply.

Question 14

An increase in the concentration of 2,3-BPG

Accepted Answer

A) puts hemoglobin the relaxed conformation form. 
B) shifts the oxygen dissociation curve to the left. 
C) increases the affinity of hemoglobin for oxygen. 
D) is present in patients with severe anemia and decreased blood pH (acidosis). 
A) puts hemoglobin the relaxed conformation form. 
B) shifts the oxygen dissociation curve to the left. 
C) increases the affinity of hemoglobin for oxygen. 
D) is present in patients with severe anemia and decreased blood pH (acidosis).

Question 15

Why is it important that synthesis of globin chains and heme be balanced in the RBCs?

Accepted Answer

A) Excess concentration of protoporphyrin increases bilirubin in plasma. 
B) An excess of one of the components of hemoglobin decreases RBC survival. 
C) An excess of one of the components of hemoglobin increases RBC survival leading to an eventual elevated RBC count. 
D) An excess of globin chains significantly decreases the concentration of globin chain messenger ribonucleic acid (mRN
A)  in the developing RBCs. 
A) Excess concentration of protoporphyrin increases bilirubin in plasma. 
B) An excess of one of the components of hemoglobin decreases RBC survival. 
C) An excess of one of the components of hemoglobin increases RBC survival leading to an eventual elevated RBC count. 
D) An excess of globin chains significantly decreases the concentration of globin chain messenger ribonucleic acid (mRN
A)  in the developing RBCs.

Question 16

How many molecules of oxygen can one molecule of hemoglobin carry?

Accepted Answer

A) one 
B) two 
C) three 
D) four 
A) one 
B) two 
C) three 
D) four

Question 17

Where is heme produced?

Accepted Answer

A) liver 
B) macrophages in the bone marrow 
C) red blood cell (RB
C)  precursors in the bone marrow 
D) mature RBCs in peripheral circulation 
A) liver 
B) macrophages in the bone marrow 
C) red blood cell (RB
C)  precursors in the bone marrow 
D) mature RBCs in peripheral circulation

Question 18

What is the effect of an increased concentration of 2,3-BPG in the RBC?

Accepted Answer

A) puts hemoglobin in the relaxed conformation 
B) shifts the oxygen dissociation curve to the right 
C) increases the affinity of hemoglobin for oxygen 
D) decreases the synthesis of globin chains 
A) puts hemoglobin in the relaxed conformation 
B) shifts the oxygen dissociation curve to the right 
C) increases the affinity of hemoglobin for oxygen 
D) decreases the synthesis of globin chains

Question 19

Which of the following correctly describes the structure of normal hemoglobin A (Hb A)?

Accepted Answer

A) four identical polypeptide chains, each containing two heme groups 
B) two $\alpha$ and two $\beta$ polypeptide chains, each containing one heme group 
C) conjugated protein with 141 amino acids, containing two atoms of iron 
D) two $ \delta $ and two $ \gamma $ polypeptide chains, each containing a single heme group 
A) four identical polypeptide chains, each containing two heme groups 
B) two $\alpha$ and two $\beta$ polypeptide chains, each containing one heme group 
C) conjugated protein with 141 amino acids, containing two atoms of iron 
D) two $ \delta $ and two $ \gamma $ polypeptide chains, each containing a single heme group

Question 20

The A₁c-modified component of Hb A is increased in what condition?

Accepted Answer

A) sickle cell anemia 
B) thalassemia 
C) disorders of heme 
D) uncontrolled diabetes mellitus 
A) sickle cell anemia 
B) thalassemia 
C) disorders of heme 
D) uncontrolled diabetes mellitus

Exam 10: Hemoglobin Metabolism

Which of the following provides a negative feedback for heme synthesis,thus helping to control,by decreasing,its synthesis?

Why is heme located inside a globin chain pocket surrounded by hydrophobic amino acids?

Which of the following is true of the oxygen dissociation curve?

Which of the following is true of hemoglobin if the oxygen dissociation curve shifts to the left?

Which of the following is true regarding carboxyhemoglobin?

Which of the following causes a shift to the right on the oxygen dissociation curve?

In which of the following conditions would patients have an increased concentration of methemoglobin?

Which of the following is true for the relative affinity of hemoglobin for oxygen in the lungs and tissue with the oxygen dissociation curve in its normal position? LungsTissue A) high Tissue B) low low C) high high D) low low

The reference range for hemoglobin concentration

The globin chains making up Hb A are a. two ε \varepsilon ε and two γ \gamma γ chains. b. two ζ \zeta ζ and two ε \varepsilon ε chains. c. two α \alpha α and two γ \gamma γ chains. d. two α \alpha α and two β \beta β chains.

Identify the primary organelle of synthesis site for globin chain and heme in developing RBCs. Globin chainsHeme A) ribosomes ribosomes B) Golgi complex mitochondria C) ribosomes mitochondria D) mitochondria Golgi complex

Select the form of hemoglobin that contains iron in the ferric rather than the ferrous state.

Why does Hb F have a higher oxygen affinity than adult hemoglobin?

An increase in the concentration of 2,3-BPG

Why is it important that synthesis of globin chains and heme be balanced in the RBCs?

How many molecules of oxygen can one molecule of hemoglobin carry?

Where is heme produced?

What is the effect of an increased concentration of 2,3-BPG in the RBC?

Which of the following correctly describes the structure of normal hemoglobin A (Hb A)?

The A₁c-modified component of Hb A is increased in what condition?

An Overview of Clinical Laboratory Hematology

Safety in the Hematology Laboratory

Blood Specimen Collection

Care and Use of the Microscope

Quality Assurance in Hematology and Hemostasis Testing

Cellular Structure and Function

Hematopoiesis

Erythrocyte Production and Destruction

Erythrocyte Metabolism and Membrane Structure and Function

Iron Kinetics and Laboratory Assessment

Leukocyte Development, Kinetics, and Functions

Platelet Production, Structure, and Function

Manual, Semiautomated and Point-of-Care Testing in Hematology

Automated Blood Cell Analysis

Examination of the Peripheral Blood Film and Correlation with the Complete Blood Count

Bone Marrow Examination

Body Fluid Analysis in the Hematology Laboratory

Anemias: Red Blood Cell Morphology and Approach to Diagnosis

Disorders of Iron Kinetics and Heme Metabolism

Anemias Caused by Defects of DNA Metabolism

Bone Marrow Failure

Introduction to Increased Destruction of Erythrocytes

Intrinsic Defects Leading to Increased Erythrocyte Destruction

Extrinsic Defects Leading to Increased Erythrocyte Destruction Nonimmune Causes

Extrinsic Defects Leading to Increased Erythrocyte Destruction Immune Causes

Hemoglobinopathies (Structural Defects in Hemoglobin)

Thalassemias

Nonmalignant Leukocyte Disorders

Cytogenetics

Molecular Diagnostics in Hematopathology

Flow Cytometric Analysis in Hematologic Disorders

Myeloproliferative Neoplasms

Myelodysplastic Syndromes

Acute Leukemias

Mature Lymphoid Neoplasms

Normal Hemostasis and Coagulation

Hemorrhagic Disorders and Laboratory Assessment

Thrombotic Disorders and Laboratory Assessment

Thrombocytopenia and Thrombocytosis

Qualitative Disorders of Platelets and Vasculature

Laboratory Evaluation of Hemostasis

Antithrombotic Therapies and their Laboratory Assessment

Hemostasis and Coagulation Instrumentation

Pediatric and Geriatric Hematology and Hemostasis

Filters

The globin chains making up Hb A are a. two $\varepsilon$ and two $\gamma$ chains. b. two $\zeta$ and two $\varepsilon$ chains. c. two $\alpha$ and two $\gamma$ chains. d. two $\alpha$ and two $\beta$ chains.