Question 1

How does lead exposure and the porphyrias cause anemia?

Accepted Answer

A)  Cause destruction of red cells 
B)  Chelae iron from the body 
C)  Impair iron absorption 
D)  Interfere with heme production 
A)  Cause destruction of red cells 
B)  Chelae iron from the body 
C)  Impair iron absorption 
D)  Interfere with heme production D

Question 2

Ringed sideroblasts are seen in:

Accepted Answer

A)  Inherited sideroblastic anemia 
B)  Acquired hemochromatosis 
C)  Iron deficiency anemia 
D)  ACI 
A)  Inherited sideroblastic anemia 
B)  Acquired hemochromatosis 
C)  Iron deficiency anemia 
D)  ACI A

Question 3

What is the most common cause of iron deficiency in men and postmenopausal women?

Accepted Answer

A)  Poor diet 
B)  Increased need 
C)  Chronic blood loss 
D)  Paroxysmal nocturnal hemoglobinuria 
A)  Poor diet 
B)  Increased need 
C)  Chronic blood loss 
D)  Paroxysmal nocturnal hemoglobinuria C

Question 4

What is most likely if a 10-month-old child fed only cow's milk has the following results? 
$\bullet$  Serum iron decreased
$\bullet$  Total iron-binding capacity (TIBC) increased
$\bullet$  Ferritin decreased

Accepted Answer

A)  Lead poisoning 
B)  Chronic disease 
C)  Iron deficiency from increased need and inadequate diet 
D)  Iron deficiency from chronic blood loss 
A)  Lead poisoning 
B)  Chronic disease 
C)  Iron deficiency from increased need and inadequate diet 
D)  Iron deficiency from chronic blood loss

Question 5

The ferritin test is being used to screen for hereditary hemochromatosis. A healthy young woman has a low ferritin. Which of the following is most likely?

Accepted Answer

A)  Homozygous hemochromatosis 
B)  Heterozygous hemochromatosis 
C)  Stage 2 iron deficiency 
D)  ACI 
A)  Homozygous hemochromatosis 
B)  Heterozygous hemochromatosis 
C)  Stage 2 iron deficiency 
D)  ACI

Question 6

Lack of accessible iron is the mechanism for iron deficiency and which of the following?

Accepted Answer

A)  Hemochromatosis 
B)  Hemosiderosis 
C)  Lead poisoning 
D)  Anemia of chronic inflammation (ACI) 
A)  Hemochromatosis 
B)  Hemosiderosis 
C)  Lead poisoning 
D)  Anemia of chronic inflammation (ACI)

Question 7

Which of the following results is or are typical in stage 3 iron deficiency anemia?

Accepted Answer

A)  Elevated reticulocyte percentage 
B)  Thrombocytopenia 
C)  Macrocytic red cells 
D)  Low mean cell volume (MCV), MCH, and mean cell hemoglobin concentration (MCH
C)  
A)  Elevated reticulocyte percentage 
B)  Thrombocytopenia 
C)  Macrocytic red cells 
D)  Low mean cell volume (MCV), MCH, and mean cell hemoglobin concentration (MCH
C)

Question 8

Blood for iron studies:

Accepted Answer

A)  Should be drawn fasting in the morning 
B)  Should be drawn following a standard meal rich in iron 
C)  May be drawn at any time of the day 
D)  Should be drawn in the morning with no fasting necessary 
A)  Should be drawn fasting in the morning 
B)  Should be drawn following a standard meal rich in iron 
C)  May be drawn at any time of the day 
D)  Should be drawn in the morning with no fasting necessary

Question 9

Where is most of the iron in the body found?

Accepted Answer

A)  Attached to hemoglobin in the red blood cells (RBCs) 
B)  Stored in macrophages in the bone marrow 
C)  Attached to transferrin 
D)  Myoglobin 
A)  Attached to hemoglobin in the red blood cells (RBCs) 
B)  Stored in macrophages in the bone marrow 
C)  Attached to transferrin 
D)  Myoglobin

Question 10

Why is lead poisoning of particular concern in children?

Accepted Answer

A)  Severe anemia may develop. 
B)  Impaired mental development may occur. 
C)  Secondary iron deficiency may develop. 
D)  FEP may accumulate. 
A)  Severe anemia may develop. 
B)  Impaired mental development may occur. 
C)  Secondary iron deficiency may develop. 
D)  FEP may accumulate.

Question 11

What is the mechanism for ACI?

Accepted Answer

A)  Acute phase reactants impair iron mobilization. 
B)  Inflammation and infections slow heme development. 
C)  Cytokines prevent iron incorporation into protoporphyrin. 
D)  Bone marrow iron stores are depleted by acute phase reactants. 
A)  Acute phase reactants impair iron mobilization. 
B)  Inflammation and infections slow heme development. 
C)  Cytokines prevent iron incorporation into protoporphyrin. 
D)  Bone marrow iron stores are depleted by acute phase reactants.

Question 12

Which of the following promotes increased iron absorption?

Accepted Answer

A)  Repeated phlebotomy 
B)  Eating iron-rich foods along with those high in ascorbic acid 
C)  Desferrioxamine 
D)  Vegetarian diet 
A)  Repeated phlebotomy 
B)  Eating iron-rich foods along with those high in ascorbic acid 
C)  Desferrioxamine 
D)  Vegetarian diet

Question 13

Which of the following red cell inclusions is or are often found in lead poisoning?

Accepted Answer

A)  Howell-Jolly bodies 
B)  Basophilic stippling 
C)  Heinz bodies 
D)  Cabot rings 
A)  Howell-Jolly bodies 
B)  Basophilic stippling 
C)  Heinz bodies 
D)  Cabot rings

Question 14

Which test will rise first after successful treatment for iron deficiency?

Accepted Answer

A)  Reticulocyte count 
B)  Ferritin 
C)  MCV 
D)  Hemoglobin 
A)  Reticulocyte count 
B)  Ferritin 
C)  MCV 
D)  Hemoglobin

Question 15

Which of the following would point to iron deficiency anemia as opposed to the ACI?

Accepted Answer

A)  Anemia 
B)  High transferrin 
C)  Low serum iron 
D)  Elevated FEP 
A)  Anemia 
B)  High transferrin 
C)  Low serum iron 
D)  Elevated FEP

Question 16

Which of the following groups is least likely to develop iron deficiency?

Accepted Answer

A)  Infants 
B)  Young men 
C)  Teenage girls 
D)  Adult premenopausal women 
A)  Infants 
B)  Young men 
C)  Teenage girls 
D)  Adult premenopausal women

Question 17

Which of the following is the best test to distinguish iron deficiency anemia from ACI?

Accepted Answer

A)  Serum iron 
B)  Hemoglobin 
C)  Free erythrocyte protoporphyrin (FEP) 
D)  Ferritin 
A)  Serum iron 
B)  Hemoglobin 
C)  Free erythrocyte protoporphyrin (FEP) 
D)  Ferritin

Question 18

All of the following are true about hepcidin except that:

Accepted Answer

A)  It is an acute phase protein. 
B)  It is a hormone. 
C)  It decreases in response to increased ferritin. 
D)  It increases in response to increased iron stores. 
A)  It is an acute phase protein. 
B)  It is a hormone. 
C)  It decreases in response to increased ferritin. 
D)  It increases in response to increased iron stores.

Question 19

Which of following are typical laboratory results for ACI?

Accepted Answer

A)  Decreased ferritin and decreased bone marrow Prussian blue staining 
B)  Low serum iron and high TIBC 
C)  Low serum iron and low TIBC 
D)  Increased transferrin saturation and decreased FEP 
A)  Decreased ferritin and decreased bone marrow Prussian blue staining 
B)  Low serum iron and high TIBC 
C)  Low serum iron and low TIBC 
D)  Increased transferrin saturation and decreased FEP

Question 20

Transfusion-related hemochromatosis is seen in patients who:

Accepted Answer

A)  Had an adverse reaction to a blood transfusion 
B)  Received the wrong type of blood 
C)  Had life-long repeated red cell transfusions 
D)  Received a transfusion from a relative 
A)  Had an adverse reaction to a blood transfusion 
B)  Received the wrong type of blood 
C)  Had life-long repeated red cell transfusions 
D)  Received a transfusion from a relative

Exam 19: Disorders of Iron and Heme Metabolism

How does lead exposure and the porphyrias cause anemia?

Ringed sideroblasts are seen in:

What is the most common cause of iron deficiency in men and postmenopausal women?

What is most likely if a 10-month-old child fed only cow's milk has the following results? ∙\bullet∙ Serum iron decreased ∙\bullet∙ Total iron-binding capacity (TIBC) increased ∙\bullet∙ Ferritin decreased

The ferritin test is being used to screen for hereditary hemochromatosis. A healthy young woman has a low ferritin. Which of the following is most likely?

Lack of accessible iron is the mechanism for iron deficiency and which of the following?

Which of the following results is or are typical in stage 3 iron deficiency anemia?

Blood for iron studies:

Where is most of the iron in the body found?

Why is lead poisoning of particular concern in children?

What is the mechanism for ACI?

Which of the following promotes increased iron absorption?

Which of the following red cell inclusions is or are often found in lead poisoning?

Which test will rise first after successful treatment for iron deficiency?

Which of the following would point to iron deficiency anemia as opposed to the ACI?

Which of the following groups is least likely to develop iron deficiency?

Which of the following is the best test to distinguish iron deficiency anemia from ACI?

All of the following are true about hepcidin except that:

Which of following are typical laboratory results for ACI?

Transfusion-related hemochromatosis is seen in patients who:

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

Anemias Caused by Defects of Dna 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

What is most likely if a 10-month-old child fed only cow's milk has the following results? $\bullet$ Serum iron decreased $\bullet$ Total iron-binding capacity (TIBC) increased $\bullet$ Ferritin decreased