Question 1

Which of the following is decreased in intravascular hemolysis?

Accepted Answer

A)  Haptoglobin 
B)  Urine hemoglobin 
C)  Serum hemoglobin 
D)  Urine urobilinogen 
A)  Haptoglobin 
B)  Urine hemoglobin 
C)  Serum hemoglobin 
D)  Urine urobilinogen A

Question 2

Which of the following is found normally in urine?

Accepted Answer

A)  Conjugated bilirubin 
B)  Urobilinogen 
C)  Stercobilin 
D)  Unconjugated bilirubin 
A)  Conjugated bilirubin 
B)  Urobilinogen 
C)  Stercobilin 
D)  Unconjugated bilirubin B

Question 3

Which of the following tests for hemolysis is easiest and safest for the patient?

Accepted Answer

A)  Reticulocyte count 
B)  Red cell survival with labeled chromium 
C)  Bone marrow biopsy 
D)  Cross-transfusion studies 
A)  Reticulocyte count 
B)  Red cell survival with labeled chromium 
C)  Bone marrow biopsy 
D)  Cross-transfusion studies A

Question 4

The presence of hemoglobinuria, hemosiderinuria, and hemoglobinemia indicate that hemolysis is:

Accepted Answer

A)  Severe 
B)  Acquired 
C)  Compensated 
D)  Intravascular 
A)  Severe 
B)  Acquired 
C)  Compensated 
D)  Intravascular

Question 5

Unconjugated or indirect bilirubin is normally found in:

Accepted Answer

A)  Plasma 
B)  Erythrocytes 
C)  Urine 
D)  Intestines 
A)  Plasma 
B)  Erythrocytes 
C)  Urine 
D)  Intestines

Question 6

Which of the following breakdown products of hemoglobin is removed from the body instead of being recycled?

Accepted Answer

A)  Globin 
B)  Amino acids 
C)  Protoporphyrin ring 
D)  Iron 
A)  Globin 
B)  Amino acids 
C)  Protoporphyrin ring 
D)  Iron

Question 7

What are the bone marrow findings in hemolytic anemia?

Accepted Answer

A)  Myeloid-to-erythroid (M:
E)  ratio of 1:1 
B)  M:E ratio of 5:1 
C)  Reduced cellularity and increased fat 
D)  Erythroid hypoplasia 
A)  Myeloid-to-erythroid (M:
E)  ratio of 1:1 
B)  M:E ratio of 5:1 
C)  Reduced cellularity and increased fat 
D)  Erythroid hypoplasia

Question 8

A urine sediment stains with Prussian blue. The patient probably has:

Accepted Answer

A)  Hemoglobinemia 
B)  A membrane defect 
C)  Compensated hemolysis 
D)  Extravascular hemolysis 
A)  Hemoglobinemia 
B)  A membrane defect 
C)  Compensated hemolysis 
D)  Extravascular hemolysis

Question 9

An elevated reticulocyte count rules out which of the following?

Accepted Answer

A)  Acute blood loss 
B)  Aplastic crisis 
C)  Acute hemolysis 
D)  Successful patient response to iron therapy 
A)  Acute blood loss 
B)  Aplastic crisis 
C)  Acute hemolysis 
D)  Successful patient response to iron therapy

Question 10

A plasma sample appears hemolyzed or red. Which of the following is true?

Accepted Answer

A)  The patient has extravascular hemolysis. 
B)  The patient has increased haptoglobin. 
C)  The patient has increased hemopexin. 
D)  The plasma hemoglobin is greater than 50 mg/dL. 
A)  The patient has extravascular hemolysis. 
B)  The patient has increased haptoglobin. 
C)  The patient has increased hemopexin. 
D)  The plasma hemoglobin is greater than 50 mg/dL.

Question 11

Which of the following is the most specific indicator of accelerated intravascular red cell destruction?

Accepted Answer

A)  Increased serum bilirubin 
B)  Increased haptoglobin 
C)  Decreased hematocrit 
D)  Decreased haptoglobin 
A)  Increased serum bilirubin 
B)  Increased haptoglobin 
C)  Decreased hematocrit 
D)  Decreased haptoglobin

Question 12

The presence of schistocytes in the peripheral blood indicates which of the following processes?

Accepted Answer

A)  Iron deficiency anemia 
B)  Intravascular hemolysis 
C)  Megaloblastic anemia 
D)  Extravascular hemolysis 
A)  Iron deficiency anemia 
B)  Intravascular hemolysis 
C)  Megaloblastic anemia 
D)  Extravascular hemolysis

Question 13

Which of the following test results suggests significant hemoglobinemia may be present in a sample?

Accepted Answer

A)  Elevated mean cell volume (MCV) 
B)  Reticulocytosis 
C)  Hemoglobin less than 10 g/dL 
D)  Unrealistically high mean cell hemoglobin concentration (MCH
C)  
A)  Elevated mean cell volume (MCV) 
B)  Reticulocytosis 
C)  Hemoglobin less than 10 g/dL 
D)  Unrealistically high mean cell hemoglobin concentration (MCH
C)

Question 14

Which of the following suggests ongoing hemolysis in a patient who has not had massive blood loss or been hemodiluted?

Accepted Answer

A)  Reticulocyte production index (RPI) of 1 
B)  Reticulocyte count of 1.3% 
C)  Drop in hemoglobin of 1.3 g/dL in 1 week 
D)  Hemoglobin falling 0.5 g/dL 
A)  Reticulocyte production index (RPI) of 1 
B)  Reticulocyte count of 1.3% 
C)  Drop in hemoglobin of 1.3 g/dL in 1 week 
D)  Hemoglobin falling 0.5 g/dL

Question 15

All of the following are often seen in various types of hemolytic anemia except:

Accepted Answer

A)  Schistocytes 
B)  Spherocytes 
C)  Polychromasia 
D)  Hypochromasia 
A)  Schistocytes 
B)  Spherocytes 
C)  Polychromasia 
D)  Hypochromasia

Question 16

Which of the following test results suggest red blood cell (RBC) survival is significantly decreased from the normal of 120 days?

Accepted Answer

A)  Decreased glycated hemoglobin 
B)  A T1/2 Cr of 30 days 
C)  Normal haptoglobin 
D)  Decreased lactic dehydrogenase 
A)  Decreased glycated hemoglobin 
B)  A T1/2 Cr of 30 days 
C)  Normal haptoglobin 
D)  Decreased lactic dehydrogenase

Question 17

How are normal red cells removed when they lose the ability to deform?

Accepted Answer

A)  After 120 days, most are phagocytized by splenic macrophages. 
B)  After 10 to 14 days, most are phagocytized by splenic macrophages. 
C)  After 10 to 14 days, most are destroyed by complement. 
D)  After 120 days, most are destroyed inside the blood vessels. 
A)  After 120 days, most are phagocytized by splenic macrophages. 
B)  After 10 to 14 days, most are phagocytized by splenic macrophages. 
C)  After 10 to 14 days, most are destroyed by complement. 
D)  After 120 days, most are destroyed inside the blood vessels.

Question 18

What characteristic red cell shape is associated with extravascular hemolysis?

Accepted Answer

A)  Spherocyte 
B)  Schistocyte 
C)  Target cell 
D)  Burr cell 
A)  Spherocyte 
B)  Schistocyte 
C)  Target cell 
D)  Burr cell

Question 19

A patient develops an immunoglobulin G (IgG) antibody that causes red cells to be destroyed by the spleen. This is what type of hemolysis?

Accepted Answer

A)  Inherited, intrinsic, extravascular, immune 
B)  Acquired, extrinsic, extravascular, immune 
C)  Acquired, intrinsic, intravascular, immune 
D)  Acquired, extrinsic, intravascular, traumatic 
A)  Inherited, intrinsic, extravascular, immune 
B)  Acquired, extrinsic, extravascular, immune 
C)  Acquired, intrinsic, intravascular, immune 
D)  Acquired, extrinsic, intravascular, traumatic

Question 20

Laboratory tests indicate that an female adult has an increased rate of red cell destruction in the circulation. Her hematocrit is 39%. Which of the following describes her hemolytic disorder?

Accepted Answer

A)  Mild 
B)  Moderate 
C)  Acute 
D)  Compensated 
A)  Mild 
B)  Moderate 
C)  Acute 
D)  Compensated

Exam 22: Introduction to Increased Destruction of Erythrocytes

Which of the following is decreased in intravascular hemolysis?

Which of the following is found normally in urine?

Which of the following tests for hemolysis is easiest and safest for the patient?

The presence of hemoglobinuria, hemosiderinuria, and hemoglobinemia indicate that hemolysis is:

Unconjugated or indirect bilirubin is normally found in:

Which of the following breakdown products of hemoglobin is removed from the body instead of being recycled?

What are the bone marrow findings in hemolytic anemia?

A urine sediment stains with Prussian blue. The patient probably has:

An elevated reticulocyte count rules out which of the following?

A plasma sample appears hemolyzed or red. Which of the following is true?

Which of the following is the most specific indicator of accelerated intravascular red cell destruction?

The presence of schistocytes in the peripheral blood indicates which of the following processes?

Which of the following test results suggests significant hemoglobinemia may be present in a sample?

Which of the following suggests ongoing hemolysis in a patient who has not had massive blood loss or been hemodiluted?

All of the following are often seen in various types of hemolytic anemia except:

Which of the following test results suggest red blood cell (RBC) survival is significantly decreased from the normal of 120 days?

How are normal red cells removed when they lose the ability to deform?

What characteristic red cell shape is associated with extravascular hemolysis?

A patient develops an immunoglobulin G (IgG) antibody that causes red cells to be destroyed by the spleen. This is what type of hemolysis?

Laboratory tests indicate that an female adult has an increased rate of red cell destruction in the circulation. Her hematocrit is 39%. Which of the following describes her hemolytic disorder?

An Overview of Clinical Laboratory Hematology

Safety in the Hematology Laboratory

Specimen Collection

Care and Use of the Microscope

Quality Assurance in Hematology and Hemostasis Testing

Cellular Structure and Function

Hematopoiesis

Erythrocyte Production and Destruction

Energy Metabolism and Membrane Physiology of the Erythrocyte

Hemoglobin Metabolism

Iron Metabolism

Leukocyte Development, Kinetics, and Functions

Platelet Production, Structure, and Function

Routine and Point-Of-Care Testing in Hematology: Manual and Semiautomated Methods

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

Bone Marrow Examination

Body Fluids in the Hematology Laboratory

Anemias: Red Blood Cell Morphology and Approach to Diagnosis

Disorders of Iron and Heme Metabolism

Anemias Caused by Defects of Dna Metabolism

Bone Marrow Failure

Intrinsic Defects Leading to Increased Erythrocyte Destruction

Extrinsic Defects Leading to Increased Erythrocytedestructionnonimmune Causes

Extrinsic Defects Leading to Increased Erythrocytedestructionimmune Causes

Hemoglobinopathies Structural Defects in Hemoglobin

Thalassemias

Nonmalignant Leukocyte Disorders

Introduction to Leukocyte Neoplasms

Cytochemistry

Cytogenetics

Molecular Diagnostics in the Clinical Laboratory

Flow Cytometric Analysis in Hematologic Disorders

Myeloproliferative Neoplasms

Myelodysplastic Syndromes

Acute Leukemias

Mature Lymphoid Neoplasms

Pediatric and Geriatric Hematology

Automated Cell-Counting Instrumentation

Normal Hemostasis and Coagulation

Hemorrhagic Coagulation Disorders

Thrombosis Risk Testing

Thrombocytopenia and Thrombocytosis

Qualitative Disorders of Platelets and Vasculature

Laboratory Evaluation of Hemostasis

Monitoring Antithrombotic Therapies

Coagulation Instrumentation

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