Question 1

Define constitutional aplastic anemia, and give an example.

Accepted Answer

Anemias with a congenital predisposition.Examples include: Fanconi's syndrome, CDA, and DBA.

Question 2

What CBC parameter would help differentiate Fanconi's syndrome from Diamond Blackfan anemia?

Accepted Answer

A) MCV 
B) WBC and PLT counts 
C) RBC counts 
D) Differential 
A) MCV 
B) WBC and PLT counts 
C) RBC counts 
D) Differential B

Question 3

Recent evidence suggests that the pathophysiology of most cases of acquired aplastic anemia is most likely:

Accepted Answer

A) Drug exposure. 
B) Viral infections. 
C) Defective stem cells. 
D) Immunologic suppression of hematopoiesis. 
A) Drug exposure. 
B) Viral infections. 
C) Defective stem cells. 
D) Immunologic suppression of hematopoiesis. D

Question 4

Pernicious anemia is a malabsorption of vitamin B₁₂ due to what component deficiency?

Accepted Answer

A) Gastric juice 
B) Intrinsic factor 
C) Histamine 
D) Folate 
A) Gastric juice 
B) Intrinsic factor 
C) Histamine 
D) Folate

Question 5

Fanconi's syndrome is an example of:

Accepted Answer

A) Constitutional aplastic anemia. 
B) Acquired aplastic anemia. 
C) Constitutional anemia due to external stimuli. 
D) Acquired aplastic anemia due to external exposure. 
A) Constitutional aplastic anemia. 
B) Acquired aplastic anemia. 
C) Constitutional anemia due to external stimuli. 
D) Acquired aplastic anemia due to external exposure.

Question 6

What congenital defects are found in Fanconi's syndrome?

Accepted Answer

A) Hypergonadism 
B) Skin hypopigmentation 
C) Mental retardation 
D) Thrombocytopurpura 
A) Hypergonadism 
B) Skin hypopigmentation 
C) Mental retardation 
D) Thrombocytopurpura

Question 7

What conditions listed can result in macrocytic anemia without megaloblastosis?

Accepted Answer

A) Diabetes 
B) Liver disease 
C) Myelodysplastic syndrome 
D) Pernicious anemia 
A) Diabetes 
B) Liver disease 
C) Myelodysplastic syndrome 
D) Pernicious anemia

Question 8

Explain why peripheral neuropathy is a common finding in vitamin B₁₂ deficiency.

Accepted Answer

In vitamin B₁₂ deficiency, there is a de

Question 9

Chronic renal disease is a common cause of anemia.Which of following is one of the possible causes of anemia in chronic renal disease?

Accepted Answer

A) Increased erythropoietin production 
B) Increased erythrocyte survival 
C) Blood loss 
D) Iron production 
A) Increased erythropoietin production 
B) Increased erythrocyte survival 
C) Blood loss 
D) Iron production

Question 10

Explain how high alcohol intake can cause macrocytosis.

Accepted Answer

Causes of macrocytosis in alcohol abuse

Question 11

Megaloblastic anemia is characterized by:

Accepted Answer

A) Hypersegmentation of PMNs. 
B) Presence of Heinz bodies. 
C) Ve hypochromia. 
D) Microcytosis. 
A) Hypersegmentation of PMNs. 
B) Presence of Heinz bodies. 
C) Ve hypochromia. 
D) Microcytosis.

Question 12

Diamond-Backfan syndrome anemia is a rare congential progressive erythrocyte aplasia.What is the most probable defect causing this rare disorder?

Accepted Answer

A) Deficiency of erythropoietin 
B) Antibodies against erythropoietin 
C) Intrinsic defect of erythroid progenitor cells 
D) Increased reticulocytes 
A) Deficiency of erythropoietin 
B) Antibodies against erythropoietin 
C) Intrinsic defect of erythroid progenitor cells 
D) Increased reticulocytes

Question 13

All of the following disorders can lead to macrocytic anemia except:

Accepted Answer

A) Alcoholism. 
B) Liver disease. 
C) Hypothyroidism. 
D) Iron deficiency. 
A) Alcoholism. 
B) Liver disease. 
C) Hypothyroidism. 
D) Iron deficiency.

Question 14

The defect in DNA synthesis associated with megaloblastic anemia affects which cells?

Accepted Answer

A) Only erythrocytes 
B) Only gastric cells and WBCs 
C) Only neurological cells 
D) All dividing cells 
A) Only erythrocytes 
B) Only gastric cells and WBCs 
C) Only neurological cells 
D) All dividing cells

Question 15

Autoantibodies against parietal cells and intrinsic factor are associated with:

Accepted Answer

A) Grave's disease. 
B) Hashimoto's thyroiditis. 
C) Addison's disease. 
D) Pernicious anemia. 
A) Grave's disease. 
B) Hashimoto's thyroiditis. 
C) Addison's disease. 
D) Pernicious anemia.

Question 16

Explain how exposure to the following can lead to aplastic anemia.
A)Chloramphenicol
B)Benzene
C)Gamma radiation
D)Starvation

Accepted Answer

a.Chloramphenicol: bone marrow

Question 17

Which of the following are key features found in nonmegaloblastic macrocytosis?

Accepted Answer

A) Oval red blood cells 
B) Hypersegmented neutrophils 
C) Jaundice, glossitis, and neuropathy 
D) Round macrocytes 
A) Oval red blood cells 
B) Hypersegmented neutrophils 
C) Jaundice, glossitis, and neuropathy 
D) Round macrocytes

Question 18

It is much easier to become folate-deficient than B₁₂-deficient because:

Accepted Answer

A) The body utilizes folate quicker than it does vitamin B₁₂. 
B) The body has larger vitamin B₁₂ stores than it does folate stores. 
C) The body has a greater need for folate than for vitamin B₁₂. 
D) It has not been determined why folate is needed by the body more so than vitamin B₁₂. 
A) The body utilizes folate quicker than it does vitamin B₁₂. 
B) The body has larger vitamin B₁₂ stores than it does folate stores. 
C) The body has a greater need for folate than for vitamin B₁₂. 
D) It has not been determined why folate is needed by the body more so than vitamin B₁₂.

Question 19

What diagnosis is suggested if part II of the Schilling test is more than 7.5% when part I was 1%?

Accepted Answer

A) Sprue 
B) Pernicious anemia 
C) Renal disease 
D) Celiac disease 
A) Sprue 
B) Pernicious anemia 
C) Renal disease 
D) Celiac disease

Question 20

Use this case to answer the following questions. A 55-year-old male consulted his physician because of weakness, lightheadedness, vertigo, and angina. The patient also complained of sores on his tongue. The physical examination revealed jaundice. The pulse rate was increased, and the spleen and liver were slightly enlarged. The tongue appeared smooth and bright red in color. Family history revealed no clues. Neurological exam revealed quickening of reflex responses. Patient history indicated a total gastrectomy five years ago for stomach cancer and intermittent heart problems that had not required surgery. The physician ordered the following tests:
 $\begin{array}{ll}
\text { TEST } & \text { RESULTS } \
\text { WBC } & 3.1 \times 10^{9} / \mathrm{L} \
\text { RBC } & 2.45 \times 10^{12} / \mathrm{L} \
\text { HGB } & 10.5 \mathrm{gm} / \mathrm{dL} \
\text { HCT } & 29.0 \% \
\text { MCV } & 118 \mathrm{fl} \
\text { MCH } & 42.8 \mathrm{pg} \
\text { MCHC } & 36.2 \mathrm{gm} / \mathrm{dL} \
\text { RDW } & 15.7 \
\text { PLT } & 83 \times 10^{9} / \mathrm{L}\
\text { Differential: }\
\text { Polys } & 49 \% \
\text { Stabs } & 6 \% \
\text { Lymphs } & 30 \% \
\text { Mono } & 8 \% \
\text { Eos } & 5 \% \
\text { Basos } & 2 \%
\end{array}$ 
Peripheral blood: macro-ovalocytes, no hypersegmentation noted.
-What would be the results of vitamin B?? and/or folate levels in a diagnosis of pernicious anemia?

Accepted Answer

A) Increased folate 
B) Increased vitamin B?? 
C) Decreased vitamin B?? 
D) Decreased folate and vitamin B?? 
A) Increased folate 
B) Increased vitamin B?? 
C) Decreased vitamin B?? 
D) Decreased folate and vitamin B??

Exam 12: Megaloblastic and Nonmegaloblastic Macrocytic Anemias

Define constitutional aplastic anemia, and give an example.

What CBC parameter would help differentiate Fanconi's syndrome from Diamond Blackfan anemia?

Recent evidence suggests that the pathophysiology of most cases of acquired aplastic anemia is most likely:

Pernicious anemia is a malabsorption of vitamin B₁₂ due to what component deficiency?

Fanconi's syndrome is an example of:

What congenital defects are found in Fanconi's syndrome?

What conditions listed can result in macrocytic anemia without megaloblastosis?

Explain why peripheral neuropathy is a common finding in vitamin B₁₂ deficiency.

Chronic renal disease is a common cause of anemia.Which of following is one of the possible causes of anemia in chronic renal disease?

Explain how high alcohol intake can cause macrocytosis.

Megaloblastic anemia is characterized by:

Diamond-Backfan syndrome anemia is a rare congential progressive erythrocyte aplasia.What is the most probable defect causing this rare disorder?

All of the following disorders can lead to macrocytic anemia except:

The defect in DNA synthesis associated with megaloblastic anemia affects which cells?

Autoantibodies against parietal cells and intrinsic factor are associated with:

Explain how exposure to the following can lead to aplastic anemia. A)Chloramphenicol B)Benzene C)Gamma radiation D)Starvation

Which of the following are key features found in nonmegaloblastic macrocytosis?

It is much easier to become folate-deficient than B₁₂-deficient because:

What diagnosis is suggested if part II of the Schilling test is more than 7.5% when part I was 1%?

Introduction

Cellular Homeostasis

Hematopoiesis

Structure and Function of Hematopoietic Organs

The Erythrocyte

Hemoglobin

The Leukocyte

Introduction to Anemia

Anemias of Disordered Iron Metabolism and Heme Synthesis

Hemoglobinopaties: Qualitative Defects

Thalassemia

Introduction to Hemolytic Anemia

Hemolytic Anemia: Membrane Defects

Hemolytic Anemia: Enzyme Deficiencies

Hemolytic Anemia: Immune Anemias

Hemolytic Anemia: Nonimmune Defects

Nonmalignant Granulocyte and Monocyte Disorders

Nonmalignant Lymphocyte Disorders

Introduction to Hematopoietic Neoplasms

Myeloproliferative Disorders

Myelodysplastic Syndromes

Acute Myeloid Leukemias

Acute Lymphoblastic Leukemias

Lymphoid Malignancies: Chronic Lymphoid Leukemias, Lymphomas, and Plasma Cell Neoplasms

Hematopoietic Stem Cell Transplantation

Morphologic Analysis of Body Fluids in the Hematology Laboratory

Primary Hemostasis

Secondary Hemostasis and Fibrinolysis

Disorders of Primary Hemostasis

Disorders of Secondary Hemostasis

Thrombophilia

Hematology Procedures and Hemostasis

Bone Marrow Examination

Automation in Hematology and Hemostasis

Flow Cytometry

Chromosome Analysis of Hematopoietic and Lymphoid Disorders

Molecular Analysis of Hematologic Diseases

Laboratory Testing in Coagulation

Quality Assessment in the Hematology Laboratory

Filters