Question 1

Which of the following conditions is NOT characterized by the presence of schistocytes?

Accepted Answer

A) HUS 
B) TTP 
C) Malaria 
D) HELLP syndrome 
A) HUS 
B) TTP 
C) Malaria 
D) HELLP syndrome C

Question 2

What is identified as an initiator of exercise-induced hemoglobinuria associated with running?

Accepted Answer

A) Prosthetic heart valves 
B) Extensive thermal burns 
C) Erythrocyte membrane disorder 
D) Exercise-induced oxidative stress and erythrocyte age 
A) Prosthetic heart valves 
B) Extensive thermal burns 
C) Erythrocyte membrane disorder 
D) Exercise-induced oxidative stress and erythrocyte age D

Question 3

Damage to the endothelial lining of the small vessels results in deposits of fibrin with the vessels in what type of hemolytic anemia?

Accepted Answer

A) Exercise-induced hemoglobinuria 
B) That associated with infectious agents 
C) That associated with animal venoms 
D) Microangiopathic hemolytic anemia 
A) Exercise-induced hemoglobinuria 
B) That associated with infectious agents 
C) That associated with animal venoms 
D) Microangiopathic hemolytic anemia D

Question 4

The destruction of erythrocytes in MAHA is primarily due to what mechanism?

Accepted Answer

A) Extravascular hemolysis 
B) Loss of membrane proteins 
C) Complement-mediated hemolysis 
D) DIC 
A) Extravascular hemolysis 
B) Loss of membrane proteins 
C) Complement-mediated hemolysis 
D) DIC

Question 5

What are typical findings on the blood smear in DIC?

Accepted Answer

A) Spherocytes and leukopenia 
B) Target cells and leukocytosis 
C) Schistocytes and thrombocytopenia 
D) Helmet cells and thrombocytosis 
A) Spherocytes and leukopenia 
B) Target cells and leukocytosis 
C) Schistocytes and thrombocytopenia 
D) Helmet cells and thrombocytosis

Question 6

A mother brings her 3-year-old daughter to the Emergency Department because she is having trouble urinating.The child is not feverish.She has otherwise been healthy except for a bout of diarrhea about 10 days ago.Laboratory test results are as follows: $\begin{array}{|l|l|}
\hline\text { TEST } & \text { RESULT } \
\hline \text { RBC } & 4.30 \times 10^{12} / \mathrm{L} \text { (moderate schistocytes }\
&\text { present on peripheral blood smear) }\
\hline \text { WBC } & 5.00 \times 10^{9} / \mathrm{L} \
\hline \text { PLT } & 28 \times 10^{9} / \mathrm{L} \
\hline \text { HGB } & 13.0 \mathrm{~g} / \mathrm{dL} \
\hline \text { HCT } & 39 \% \
\hline \text { MCV } & 89 \mathrm{fl} \
\hline \text { MCH } & 28 \mathrm{pg} \
\hline \text { MCHC } & 33 \% \
\hline \text { BUN } & 85 \mathrm{mg} / \mathrm{dL}(\mathrm{RR}: 8-24 \mathrm{mg} / \mathrm{dL}) \
\hline \text { CREAT } & 3.3 \mathrm{mg} / \mathrm{dL}(\mathrm{RR}: 0.2-1.3 \mathrm{mg} / \mathrm{dL})\
\hline
\end{array}$
Based on the history and the laboratory results, what is the most likely diagnosis?

Accepted Answer

A) DIC 
B) Bartonella sp.infection 
C) HUS 
D) Previous Clostridium sp.infection 
A) DIC 
B) Bartonella sp.infection 
C) HUS 
D) Previous Clostridium sp.infection

Question 7

Describe the mechanism that causes the production of schistocytes in microangiopathic hemolytic anemia.

Accepted Answer

Damage to erythrocyte is usually the res

Question 8

A patient presented with fever, mild anemia, and thrombocytopenia.The peripheral blood smear showed the presence of intracellular organisms that were present as singles, doubles, and tetrads.What is the most likely identification of the organism?

Accepted Answer

A) Plasmodium sp. 
B) Babesia microti 
C) Bartonella bacilliformis 
D) Trypanosoma cruzi 
A) Plasmodium sp. 
B) Babesia microti 
C) Bartonella bacilliformis 
D) Trypanosoma cruzi

Question 9

What features are identified on the peripheral blood smear in TTP?

Accepted Answer

A) Increase in presence of reticulocytes, nucleated erythrocytes, abundance of schistocytes 
B) Leukocytosis with left shift, schistocytes present reticulocytopenia 
C) Abundance of schistocytes, thrombocytosis and leukopenia 
D) Nucleated erythrocytes, Howell-Jolly bodies and absence of schistocytes 
A) Increase in presence of reticulocytes, nucleated erythrocytes, abundance of schistocytes 
B) Leukocytosis with left shift, schistocytes present reticulocytopenia 
C) Abundance of schistocytes, thrombocytosis and leukopenia 
D) Nucleated erythrocytes, Howell-Jolly bodies and absence of schistocytes

Question 10

A patient who presents with DIC would most likely have which of the following sets of coagulation test results? $\begin{array}{llll}
&\text { PT } & \text { PTT } & \text { D-dimer } & \text { Fibrinogen } \
\hline a.&\text { Prolonged } & \text { prolonged } & \text { elevated } & \text { decreased } \
b.&\text { Normal } & \text { prolonged } & \text { normal } & \text { normal } \
c.&\text { Prolonged } & \text { prolonged } & \text { decreased } & \text { increased } \
d.&\text { Normal } & \text { prolonged } & \text { decreased } & \text { decreased }
\end{array}$

Accepted Answer

a. Prolonged PT (Prothrombin Time), pro

Question 11

All of the following can lead to the formation of schistocytes EXCEPT:

Accepted Answer

A) DIC. 
B) Malignant hypertension. 
C) Insertion of prosthetic heart valves. 
D) AIHA. 
A) DIC. 
B) Malignant hypertension. 
C) Insertion of prosthetic heart valves. 
D) AIHA.

Question 12

Which of the following organisms causes erythrocyte damage by releasing hemolytic toxins?

Accepted Answer

A) Plasmodium sp. 
B) Babesia sp. 
C) Clostridium sp. 
D) Bartonella sp. 
A) Plasmodium sp. 
B) Babesia sp. 
C) Clostridium sp. 
D) Bartonella sp.

Question 13

The primary difference between D+ and D- forms of HUS is related to the:

Accepted Answer

A) Extent of damage to the kidney. 
B) Length of the symptomatic period. 
C) Severity of thrombocytopenia. 
D) Presence of diarrhea. 
A) Extent of damage to the kidney. 
B) Length of the symptomatic period. 
C) Severity of thrombocytopenia. 
D) Presence of diarrhea.

Question 14

A child presents to the Emergency Department with clinical findings of bloody diarrhea and fever.Laboratory findings reveal an elevated neutrophil count, increased C-reactive protein, thrombocytopenia, and a decreased haptoglobin.These findings are associated with what diagnosis? ?

Accepted Answer

A) TTP 
B) HUS 
C) DIC 
D) HELLP syndrome 
A) TTP 
B) HUS 
C) DIC 
D) HELLP syndrome

Question 15

Hemolytic uremic syndrome and thrombotic thrombocytopenic purpura can present with similar initial clinical symptoms.Which of following distinguishes TTP?

Accepted Answer

A) It occurs in children younger than 5 years old. 
B) Acute renal failure is present. 
C) There are severe CNS symptoms. 
D) There is thrombocytopenia. 
A) It occurs in children younger than 5 years old. 
B) Acute renal failure is present. 
C) There are severe CNS symptoms. 
D) There is thrombocytopenia.

Question 16

Explain why infections with Clostridium perfringens will lead to hemolysis of the RBCs.

Accepted Answer

C.perfringens releases an endo

Question 17

Explain how the action of E.coli O157:H7 toxin is related to the development of HUS.

Accepted Answer

The Shiga-like toxin of E.Coli O157:H7 h

Question 18

Bone marrow response in MAHA is reflected in the peripheral blood smear by the presence of:

Accepted Answer

A) Spherocytes. 
B) Reticulocytes. 
C) Schistocytes. 
D) Keratorcytes. 
A) Spherocytes. 
B) Reticulocytes. 
C) Schistocytes. 
D) Keratorcytes.

Question 19

Laboratory testing in DIC helps distinguish this condition from others.Which of the following would be expected results in DIC?

Accepted Answer

A) PT normal; APTT prolonged ; normal D-dimer test; normal fibrinogen 
B) PT, APTT, and TT prolonged; elevated D-dimer test; decrease in fibrinogen 
C) Fibrinogen increased; FDP and D-dimer decreased; PT, APTT, and TT prolonged 
D) PT, APTT, and TT normal; fibrinogen decreased; FDP and D-dimer increased 
A) PT normal; APTT prolonged ; normal D-dimer test; normal fibrinogen 
B) PT, APTT, and TT prolonged; elevated D-dimer test; decrease in fibrinogen 
C) Fibrinogen increased; FDP and D-dimer decreased; PT, APTT, and TT prolonged 
D) PT, APTT, and TT normal; fibrinogen decreased; FDP and D-dimer increased

Question 20

Plasmodium falciparum infection is accompanied by a severe form of anemia due to what factor?

Accepted Answer

A) Toxins produced by P.falciparum 
B) High levels of parasitemia 
C) Lack of spleen removal of the infected cells 
D) Production of exotoxins that affect host cell membranes 
A) Toxins produced by P.falciparum 
B) High levels of parasitemia 
C) Lack of spleen removal of the infected cells 
D) Production of exotoxins that affect host cell membranes

Exam 17: Hemolytic Anemia: Nonimmune Defects

Which of the following conditions is NOT characterized by the presence of schistocytes?

What is identified as an initiator of exercise-induced hemoglobinuria associated with running?

Damage to the endothelial lining of the small vessels results in deposits of fibrin with the vessels in what type of hemolytic anemia?

The destruction of erythrocytes in MAHA is primarily due to what mechanism?

What are typical findings on the blood smear in DIC?

Describe the mechanism that causes the production of schistocytes in microangiopathic hemolytic anemia.

A patient presented with fever, mild anemia, and thrombocytopenia.The peripheral blood smear showed the presence of intracellular organisms that were present as singles, doubles, and tetrads.What is the most likely identification of the organism?

What features are identified on the peripheral blood smear in TTP?

A patient who presents with DIC would most likely have which of the following sets of coagulation test results? PT PTT D-dimer Fibrinogen a. Prolonged prolonged elevated decreased b. Normal prolonged normal normal c. Prolonged prolonged decreased increased d. Normal prolonged decreased decreased

All of the following can lead to the formation of schistocytes EXCEPT:

Which of the following organisms causes erythrocyte damage by releasing hemolytic toxins?

The primary difference between D+ and D- forms of HUS is related to the:

A child presents to the Emergency Department with clinical findings of bloody diarrhea and fever.Laboratory findings reveal an elevated neutrophil count, increased C-reactive protein, thrombocytopenia, and a decreased haptoglobin.These findings are associated with what diagnosis? ?

Hemolytic uremic syndrome and thrombotic thrombocytopenic purpura can present with similar initial clinical symptoms.Which of following distinguishes TTP?

Explain why infections with Clostridium perfringens will lead to hemolysis of the RBCs.

Explain how the action of E.coli O157:H7 toxin is related to the development of HUS.

Bone marrow response in MAHA is reflected in the peripheral blood smear by the presence of:

Laboratory testing in DIC helps distinguish this condition from others.Which of the following would be expected results in DIC?

Plasmodium falciparum infection is accompanied by a severe form of anemia due to what factor?

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

Megaloblastic and Nonmegaloblastic Macrocytic Anemias

Introduction to Hemolytic Anemia

Hemolytic Anemia: Membrane Defects

Hemolytic Anemia: Enzyme Deficiencies

Hemolytic Anemia: Immune Anemias

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

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