Question 1

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 C

Question 2

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 B

Question 3

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 4

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 5

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 6

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 7

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 8

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

Accepted Answer

A)  Increased concentration of erythropoietin 
B)  Increased release of reticulocytes 
C)  Cells are made larger because fewer of them exist 
D)  Cell division is impaired 
A)  Increased concentration of erythropoietin 
B)  Increased release of reticulocytes 
C)  Cells are made larger because fewer of them exist 
D)  Cell division is impaired

Question 9

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 10

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 11

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 12

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 13

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 14

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

Question 15

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 16

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

Question 17

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 18

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

Question 19

Which of the following is normal in patients with pernicious anemia (PA)?

Accepted Answer

A)  Trypsin levels 
B)  Intrinsic factor (IF) 
C)  Stomach acid 
D)  Absorption of vitamin B12 
A)  Trypsin levels 
B)  Intrinsic factor (IF) 
C)  Stomach acid 
D)  Absorption of vitamin B12

Question 20

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

Exam 20: Anemias Caused by Defects of Dna Metabolism

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

What is the most effective treatment for PA?

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

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

Which of the following is decreased in megaloblastic anemia?

Methotrexate and some other chemotherapeutic drugs work by:

Which of the following is elevated in megaloblastic anemia?

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

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

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

PA can be distinguished from folate deficiency by the:

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?

Megaloblastic anemias are caused by a defect in the synthesis of:

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

Which of the following is true regarding hypersegmented neutrophils?

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

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

All of the following have increased need for folate except:

Which of the following is normal in patients with pernicious anemia (PA)?

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

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

Bone Marrow Failure

Introduction to Increased Destruction of Erythrocytes

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

Filters

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

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

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: