Question 1

Patients with renal disease are at risk for developing megaloblastic anemia due to:

Accepted Answer

A) Decreased EPO production and utilization. 
B) Increased NADPH production. 
C) Folate deficiency. 
D) Acute blood loss. 
A) Decreased EPO production and utilization. 
B) Increased NADPH production. 
C) Folate deficiency. 
D) Acute blood loss.

Question 2

The nuclear cytoplasmic asynchronous morphology in megaloblastosis is best characterized by:

Accepted Answer

A) Nuclear immaturity with cytoplasmic maturity. 
B) Nuclear maturity with cytoplasmic immaturity. 
C) Nuclear maturity with abundant cytoplasm. 
D) Normal nuclear and cytoplasmic maturity. 
A) Nuclear immaturity with cytoplasmic maturity. 
B) Nuclear maturity with cytoplasmic immaturity. 
C) Nuclear maturity with abundant cytoplasm. 
D) Normal nuclear and cytoplasmic maturity.

Question 3

Patients with blind loop syndrome can have vitamin B₁₂ deficiency complications due to:

Accepted Answer

A) Inadequate diet. 
B) Increased minimum daily requirements. 
C) Malabsorption. 
D) Biologic competition. 
A) Inadequate diet. 
B) Increased minimum daily requirements. 
C) Malabsorption. 
D) Biologic competition.

Question 4

Hypoproliferative anemia is defined as:

Accepted Answer

A) Decreased hematopoiesis in the bone marrow. 
B) Decreased hematopoiesis in the liver. 
C) Decreased erythropoiesis in the bone marrow. 
D) Ineffective erythropoiesis in the bone marrow. 
A) Decreased hematopoiesis in the bone marrow. 
B) Decreased hematopoiesis in the liver. 
C) Decreased erythropoiesis in the bone marrow. 
D) Ineffective erythropoiesis in the bone marrow.

Question 5

Name three causes of folate deficiency.How would they differ in results in regards to serum and RBC folate levels?

Accepted Answer

1.Decreased dietary intake 
2.

Question 6

Predict the levels of MMA and homocysteine in patients with Vitamin B₁₂ deficiency.

Accepted Answer

A) Both will be normal. 
B) Both will be decreased. 
C) Both will be increased. 
D) MMA will be increased and homocysteine will be normal. 
A) Both will be normal. 
B) Both will be decreased. 
C) Both will be increased. 
D) MMA will be increased and homocysteine will be normal.

Question 7

The reason that lack of vitamin B₁₂ causes megaloblastic changes is because vitamin B₁₂:

Accepted Answer

A) Is needed for the formation of nucleotide bases. 
B) Is needed for the conversion of methionine to SAM. 
C) Initiates mitosis. 
D) Is needed for synthesis of intrinsic factor. 
A) Is needed for the formation of nucleotide bases. 
B) Is needed for the conversion of methionine to SAM. 
C) Initiates mitosis. 
D) Is needed for synthesis of intrinsic factor.

Question 8

Which of the following treatments offers the best prognosis for aplastic anemia?

Accepted Answer

A) Synthetic cytokines 
B) Bone marrow transplant 
C) Immunosuppressive therapy 
D) Stem cell transplant 
A) Synthetic cytokines 
B) Bone marrow transplant 
C) Immunosuppressive therapy 
D) Stem cell transplant

Question 9

The presence of what poikilocyte would lead to a suspicion of myelophthisic anemia rather than pure red cell aplasia?

Accepted Answer

A) Dacryocyte 
B) Drepanocyte 
C) Schistocyte 
D) Stomatocyte 
A) Dacryocyte 
B) Drepanocyte 
C) Schistocyte 
D) Stomatocyte

Question 10

Which test is a better indicator of folate status in the body over the last month?

Accepted Answer

A) Folate level 
B) RBC folate level 
C) Vitamin B₁₂ level 
D) MMA 
A) Folate level 
B) RBC folate level 
C) Vitamin B₁₂ level 
D) MMA

Question 11

Explain how vitamin B₁₂ deficiency can cause folate deficiency.

Accepted Answer

Vitamin B₁₂ is needed to conve

Question 12

All of the following are considered diagnostic criteria for aplastic anemia except:

Accepted Answer

A) Granulocyte count 0.3 x 109/L. 
B) Platelet count 5 x 109/L. 
C) Anemia with absolute reticulocyte count of 22 x 109/L. 
D) BM cellularity of 32%. 
A) Granulocyte count 0.3 x 109/L. 
B) Platelet count 5 x 109/L. 
C) Anemia with absolute reticulocyte count of 22 x 109/L. 
D) BM cellularity of 32%.

Question 13

A 5-year-old boy with malformed thumbs and microcephaly has been suffering from prolonged bleeding episodes, extreme fatigue, and persistent repetitive infections.Cytogenetic analysis shows increased chromosome breakage with the addition of diepoxybutane.Based on these findings, what is the patient most likely suffering from?

Accepted Answer

A) CDA II 
B) Pure red cell aplasia 
C) Diamond Blackfan anemia 
D) Fanconi's syndrome 
A) CDA II 
B) Pure red cell aplasia 
C) Diamond Blackfan anemia 
D) Fanconi's syndrome

Question 14

A blood specimen is analyzed.The MCV is increased, the hemoglobin level is decreased, and the reticulocyte count is normal or low.What test could give more information on the cause of the anemia without drawing another blood specimen?

Accepted Answer

A) Serum iron 
B) Vitamin B₁₂ assay 
C) Blood smear morphological exam 
D) Serum alcohol 
A) Serum iron 
B) Vitamin B₁₂ assay 
C) Blood smear morphological exam 
D) Serum alcohol

Question 15

Vitamin B₁₂ is a cofactor used in the conversion of _______ to _______.

Accepted Answer

A) Hydrocobalamin; thymidine 
B) 5-methyltetrahydrofolate; tetrahydrofolate 
C) Folate; methionine 
D) Succinyl CoA; methylmalonic acid 
A) Hydrocobalamin; thymidine 
B) 5-methyltetrahydrofolate; tetrahydrofolate 
C) Folate; methionine 
D) Succinyl CoA; methylmalonic acid

Question 16

Explain why patients undergoing gastric bypass surgery are prone to developing pernicious anemia.

Accepted Answer

Gastric bypass involves resection of the

Question 17

The majority of PA patients have antibodies against what component necessary for vitamin B₁₂ absorption?

Accepted Answer

A) Parietal cells 
B) Vitamin B₁₂ 
C) Intrinsic factor 
D) Blocking antibody 
A) Parietal cells 
B) Vitamin B₁₂ 
C) Intrinsic factor 
D) Blocking antibody

Question 18

Which clinical manifestation is common in vitamin B₁₂ deficiency but not in folate deficiency?

Accepted Answer

A) Glossitis 
B) Pallor 
C) Fatigue 
D) Peripheral neuropathy 
A) Glossitis 
B) Pallor 
C) Fatigue 
D) Peripheral neuropathy

Question 19

Which of the following is a contributor to the production of a hypocellular bone marrow?

Accepted Answer

A) Damage to the stem or progenitor cells in the bone marrow 
B) Iron storage disease 
C) Gene mutations 
D) Hemoglobinopathy 
A) Damage to the stem or progenitor cells in the bone marrow 
B) Iron storage disease 
C) Gene mutations 
D) Hemoglobinopathy

Question 20

Aplastic anemia is most often caused by:

Accepted Answer

A) Drugs. 
B) Radiation. 
C) Unknown causes. 
D) Infectious agents. 
A) Drugs. 
B) Radiation. 
C) Unknown causes. 
D) Infectious agents.

Exam 12: Megaloblastic and Nonmegaloblastic Macrocytic Anemias

Patients with renal disease are at risk for developing megaloblastic anemia due to:

The nuclear cytoplasmic asynchronous morphology in megaloblastosis is best characterized by:

Patients with blind loop syndrome can have vitamin B₁₂ deficiency complications due to:

Hypoproliferative anemia is defined as:

Name three causes of folate deficiency.How would they differ in results in regards to serum and RBC folate levels?

Predict the levels of MMA and homocysteine in patients with Vitamin B₁₂ deficiency.

The reason that lack of vitamin B₁₂ causes megaloblastic changes is because vitamin B₁₂:

Which of the following treatments offers the best prognosis for aplastic anemia?

The presence of what poikilocyte would lead to a suspicion of myelophthisic anemia rather than pure red cell aplasia?

Which test is a better indicator of folate status in the body over the last month?

Explain how vitamin B₁₂ deficiency can cause folate deficiency.

All of the following are considered diagnostic criteria for aplastic anemia except:

A blood specimen is analyzed.The MCV is increased, the hemoglobin level is decreased, and the reticulocyte count is normal or low.What test could give more information on the cause of the anemia without drawing another blood specimen?

Vitamin B₁₂ is a cofactor used in the conversion of _______ to _______.

Explain why patients undergoing gastric bypass surgery are prone to developing pernicious anemia.

The majority of PA patients have antibodies against what component necessary for vitamin B₁₂ absorption?

Which clinical manifestation is common in vitamin B₁₂ deficiency but not in folate deficiency?

Which of the following is a contributor to the production of a hypocellular bone marrow?

Aplastic anemia is most often caused by:

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

Vitamin B₁₂ is a cofactor used in the conversion of _ to _.