Question 1

What salivary protein is important for the transport of dietary vitamin B₁₂ to the small intestine?

Accepted Answer

A) trypsin 
B) IF 
C) haptocorrin 
D) transcobalamin II 
A) trypsin 
B) IF 
C) haptocorrin 
D) transcobalamin II C

Question 2

All of the following have increased need for folate except

Accepted Answer

A) patients on chemotherapy. 
B) pregnant women. 
C) infants and children. 
D) male adults. 
A) patients on chemotherapy. 
B) pregnant women. 
C) infants and children. 
D) male adults. D

Question 3

Which of the following would be an unusual finding in megaloblastic anemia?

Accepted Answer

A) marked polychromasia on the blood film 
B) hypersegmented neutrophils 
C) oval macrocytes 
D) pancytopenia 
A) marked polychromasia on the blood film 
B) hypersegmented neutrophils 
C) oval macrocytes 
D) pancytopenia A

Question 4

Why are the red cells larger than normal in megaloblastic anemia?

Accepted Answer

A) Concentration of erythropoietin is increased. 
B) Release of reticulocytes is increased. 
C) Cells are made larger because fewer of them exist. 
D) Cell division is impaired. 
A) Concentration of erythropoietin is increased. 
B) Release of reticulocytes is increased. 
C) Cells are made larger because fewer of them exist. 
D) Cell division is impaired.

Question 5

A patient with moderate anemia has an elevated MCV and hypersegmented neutrophils.Which of the following should be ordered first?

Accepted Answer

A) Schilling test 
B) gastric analysis 
C) antibodies to IF 
D) vitamin B12 and folate assays 
A) Schilling test 
B) gastric analysis 
C) antibodies to IF 
D) vitamin B12 and folate assays

Question 6

Which vitamins are required for the nuclear development of blood cells?

Accepted Answer

A) vitamin C and folate 
B) vitamin B6 and folate 
C) vitamin B12 and folate 
D) vitamin B12 and D 
A) vitamin C and folate 
B) vitamin B6 and folate 
C) vitamin B12 and folate 
D) vitamin B12 and D

Question 7

Which of the following bone marrow findings would be unexpected in megaloblastic anemia?

Accepted Answer

A) nuclear cytoplasmic asynchrony 
B) giant bands and metas 
C) hypercellularity 
D) myeloid-to-erythroid (M:
E)  ratio of 10:1 
A) nuclear cytoplasmic asynchrony 
B) giant bands and metas 
C) hypercellularity 
D) myeloid-to-erythroid (M:
E)  ratio of 10:1

Question 8

Methotrexate and some other chemotherapeutic drugs work by

Accepted Answer

A) killing cancer cells with immune complexes. 
B) competing with folate. 
C) enhancing folate. 
D) inhibiting vitamin B12 absorption. 
A) killing cancer cells with immune complexes. 
B) competing with folate. 
C) enhancing folate. 
D) inhibiting vitamin B12 absorption.

Question 9

Which of the following is not associated with macrocytic red cells?

Accepted Answer

A) liver disease 
B) iron deficiency anemia 
C) megaloblastic anemia 
D) myelodysplastic syndrome 
A) liver disease 
B) iron deficiency anemia 
C) megaloblastic anemia 
D) myelodysplastic syndrome

Question 10

Which of the following is decreased in megaloblastic anemia?

Accepted Answer

A) reticulocyte production index (RPI) 
B) MCV 
C) lactic dehydrogenase (L
D)  
D) bilirubin 
A) reticulocyte production index (RPI) 
B) MCV 
C) lactic dehydrogenase (L
D)  
D) bilirubin

Question 11

What is the most effective treatment for PA?

Accepted Answer

A) oral folate 
B) injections of vitamin B12 
C) oral vitamin B12 
D) alterations in diet 
A) oral folate 
B) injections of vitamin B12 
C) oral vitamin B12 
D) alterations in diet

Question 12

Decreased folate is often associated with all of the following except

Accepted Answer

A) neural tube defects. 
B) increased potassium. 
C) microcytic anemia. 
D) hyperhomocysteinemia. 
A) neural tube defects. 
B) increased potassium. 
C) microcytic anemia. 
D) hyperhomocysteinemia.

Question 13

Which of the following is elevated in megaloblastic anemia?

Accepted Answer

A) white blood count 
B) mean cell hemoglobin (MCH) 
C) red blood count 
D) platelet count 
A) white blood count 
B) mean cell hemoglobin (MCH) 
C) red blood count 
D) platelet count

Question 14

A patient has a decreased vitamin B₁₂ assay.The Schilling test detects labeled vitamin B₁₂ in the urine when it is given with IF.What is the correct interpretation?

Accepted Answer

A) vitamin B12  assay probably incorrect 
B) PA 
C) vitamin B12 deficiency that is not PA 
D) gastric analysis should be performed 
A) vitamin B12  assay probably incorrect 
B) PA 
C) vitamin B12 deficiency that is not PA 
D) gastric analysis should be performed

Question 15

Patients with vitamin B₁₂ or folate deficiency commonly experience symptoms related to

Accepted Answer

A) gastrointestinal and neurologic systems. 
B) liver and lymph node enlargement. 
C) skeletal and muscle problems. 
D) kidney and bladder infections. 
A) gastrointestinal and neurologic systems. 
B) liver and lymph node enlargement. 
C) skeletal and muscle problems. 
D) kidney and bladder infections.

Question 16

Which of the following is the best source of dietary vitamin B₁₂?

Accepted Answer

A) fruit 
B) green vegetables 
C) meat 
D) legumes 
A) fruit 
B) green vegetables 
C) meat 
D) legumes

Question 17

PA can be distinguished from folate deficiency by the

Accepted Answer

A) presence of hypersegmented neutrophils. 
B) mean cell volume (MCV). 
C) bone marrow findings. 
D) presence of autoantibodies to IF. 
A) presence of hypersegmented neutrophils. 
B) mean cell volume (MCV). 
C) bone marrow findings. 
D) presence of autoantibodies to IF.

Question 18

Megaloblastic anemias are caused by a defect in the synthesis of

Accepted Answer

A) deoxyribonucleic acid (DN
A) . 
B) ribonucleic acid (RN
A) . 
C) erythropoietin. 
D) heme. 
A) deoxyribonucleic acid (DN
A) . 
B) ribonucleic acid (RN
A) . 
C) erythropoietin. 
D) heme.

Question 19

Which of the following is true regarding hypersegmented neutrophils?

Accepted Answer

A) found in so many conditions that they are not significant 
B) reported when neutrophils have four or more nuclear segments 
C) are an early, consistent, and specific finding in megaloblastic anemia 
D) usually accompany microcytic red cells 
A) found in so many conditions that they are not significant 
B) reported when neutrophils have four or more nuclear segments 
C) are an early, consistent, and specific finding in megaloblastic anemia 
D) usually accompany microcytic red cells

Question 20

Which of the following tests for PA would be easiest for the patient?

Accepted Answer

A) vitamin B12 assay 
B) bone marrow 
C) gastric analysis 
D) Schilling test 
A) vitamin B12 assay 
B) bone marrow 
C) gastric analysis 
D) Schilling test

Exam 21: Anemias Caused by Defects of DNA Metabolism

What salivary protein is important for the transport of dietary vitamin B₁₂ to the small intestine?

All of the following have increased need for folate except

Which of the following would be an unusual finding in megaloblastic anemia?

Why are the red cells larger than normal in megaloblastic anemia?

A patient with moderate anemia has an elevated MCV and hypersegmented neutrophils.Which of the following should be ordered first?

Which vitamins are required for the nuclear development of blood cells?

Which of the following bone marrow findings would be unexpected in megaloblastic anemia?

Methotrexate and some other chemotherapeutic drugs work by

Which of the following is not associated with macrocytic red cells?

Which of the following is decreased in megaloblastic anemia?

What is the most effective treatment for PA?

Decreased folate is often associated with all of the following except

Which of the following is elevated in megaloblastic anemia?

A patient has a decreased vitamin B₁₂ assay.The Schilling test detects labeled vitamin B₁₂ in the urine when it is given with IF.What is the correct interpretation?

Patients with vitamin B₁₂ or folate deficiency commonly experience symptoms related to

Which of the following is the best source of dietary vitamin B₁₂?

PA can be distinguished from folate deficiency by the

Megaloblastic anemias are caused by a defect in the synthesis of

Which of the following is true regarding hypersegmented neutrophils?

Which of the following tests for PA would be easiest for the patient?

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

Hemoglobin Metabolism

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

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

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