Question 1

What test is used along with the mean cell volume (MCV) to morphologically classify anemias?

Accepted Answer

A)  Red blood count 
B)  Hemoglobin 
C)  Hematocrit 
D)  RDW 
A)  Red blood count 
B)  Hemoglobin 
C)  Hematocrit 
D)  RDW D

Question 2

What percentage of red cells is destroyed and replaced daily in a normal adult?

Accepted Answer

A)  1% 
B)  5% 
C)  10% 
D)  20% 
A)  1% 
B)  5% 
C)  10% 
D)  20% A

Question 3

Which of the following is typically a macrocytic anemia?

Accepted Answer

A)  Thalassemia 
B)  Iron deficiency 
C)  Folate deficiency 
D)  Aplastic 
A)  Thalassemia 
B)  Iron deficiency 
C)  Folate deficiency 
D)  Aplastic C

Question 4

Match the letter of the correct composition for the inclusion with the number for the inclusion.
Correct identification of inclusions in RBCs, when present, provides useful clinical information. They often help suggest the possible cause of an anemia, and thus further appropriate testing. The first list provides some red cell inclusions. The second list provides choices for composition.

-Basophilic stippling

Accepted Answer

A) Ferric nonheme iron 
B) Deoxyribonucleic acid (DN
A)  
C) Precipitated ribonucleic acid (RN
A)  
D) Denatured hemoglobin 
A) Ferric nonheme iron 
B) Deoxyribonucleic acid (DN
A)  
C) Precipitated ribonucleic acid (RN
A)  
D) Denatured hemoglobin

Question 5

The anemia found in liver disease is:

Accepted Answer

A)  Macrocytic nonmegaloblastic 
B)  Microcytic hypochromic 
C)  Macrocytic megaloblastic 
D)  Microcytic normochromic 
A)  Macrocytic nonmegaloblastic 
B)  Microcytic hypochromic 
C)  Macrocytic megaloblastic 
D)  Microcytic normochromic

Question 6

All of the following are physiologic adaptations the body makes when a slow drop in the number of red cells occurs except:

Accepted Answer

A)  Erythropoietin level increases. 
B)  Oxygen dissociation curve shifts to left. 
C)  Cardiac output increases. 
D)  Respiratory rate increases. 
A)  Erythropoietin level increases. 
B)  Oxygen dissociation curve shifts to left. 
C)  Cardiac output increases. 
D)  Respiratory rate increases.

Question 7

Which of the following is true of ineffective erythropoiesis?

Accepted Answer

A)  Lymphopenia and anemia are present. 
B)  RBC production in bone marrow is increased. 
C)  Release of RBCs to the peripheral blood is normal. 
D)  RBC survival in circulation is less than 40 days. 
A)  Lymphopenia and anemia are present. 
B)  RBC production in bone marrow is increased. 
C)  Release of RBCs to the peripheral blood is normal. 
D)  RBC survival in circulation is less than 40 days.

Question 8

An appropriately increased RPI greater than 3 is associated with:

Accepted Answer

A)  Iron deficiency anemia 
B)  Macrocytic megaloblastic anemia 
C)  Hemolytic anemia 
D)  Sideroblastic anemia 
A)  Iron deficiency anemia 
B)  Macrocytic megaloblastic anemia 
C)  Hemolytic anemia 
D)  Sideroblastic anemia

Question 9

Match the letter of the correct composition for the inclusion with the number for the inclusion.
Correct identification of inclusions in RBCs, when present, provides useful clinical information. They often help suggest the possible cause of an anemia, and thus further appropriate testing. The first list provides some red cell inclusions. The second list provides choices for composition.

-Heinz body

Accepted Answer

A) Ferric nonheme iron 
B) Deoxyribonucleic acid (DN
A)  
C) Precipitated ribonucleic acid (RN
A)  
D) Denatured hemoglobin 
A) Ferric nonheme iron 
B) Deoxyribonucleic acid (DN
A)  
C) Precipitated ribonucleic acid (RN
A)  
D) Denatured hemoglobin

Question 10

Which of the following is an example of a morphologic classification of anemia?

Accepted Answer

A)  Normocytic normochromic 
B)  Loss of blood 
C)  Increased destruction 
D)  Impaired production 
A)  Normocytic normochromic 
B)  Loss of blood 
C)  Increased destruction 
D)  Impaired production

Question 11

Which shape of red cell is described as a round, dense cell with no area of central pallor?

Accepted Answer

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

Question 12

Describe the morphologic appearance of the red cells given the following results. RBC: 1.89*1012/L
Hemoglobin: 7.5 g/dL
Hematocrit: 21.0%
RDW: 18.5

Accepted Answer

A)  Macrocytic with anisocytosis 
B)  Normocytic normochromic with anisocytosis 
C)  Microcytic hypochromic with little anisocytosis 
D)  Macrocytic with most cells the same size 
A)  Macrocytic with anisocytosis 
B)  Normocytic normochromic with anisocytosis 
C)  Microcytic hypochromic with little anisocytosis 
D)  Macrocytic with most cells the same size

Question 13

Which of the following conditions would warrant a bone marrow aspiration?

Accepted Answer

A)  Iron deficiency in a patient with colon cancer 
B)  Severe hereditary spherocytosis 
C)  Disseminated intravascular coagulation (DI
C)  with very low hemoglobin and marked red cell fragments 
D)  Not possible to determine obvious reason for anemia 
A)  Iron deficiency in a patient with colon cancer 
B)  Severe hereditary spherocytosis 
C)  Disseminated intravascular coagulation (DI
C)  with very low hemoglobin and marked red cell fragments 
D)  Not possible to determine obvious reason for anemia

Question 14

Two different patients both have hemoglobins in the 5.0 to 6.0 g/dL range. One has pallor, fatigue, and headaches, whereas the other is experiencing life-threatening shock. Which of the following is probably the major difference between the two patients?

Accepted Answer

A)  The morphologic classification of the anemia 
B)  Whether other cell lines (platelets or white cells) are also involved 
C)  The patient's sex 
D)  How quickly the anemia developed 
A)  The morphologic classification of the anemia 
B)  Whether other cell lines (platelets or white cells) are also involved 
C)  The patient's sex 
D)  How quickly the anemia developed

Question 15

Compare results of various tests in effective versus ineffective erythropoiesis.

Accepted Answer

A)  Both have increased rate of erythropoiesis in the bone marrow. 
B)  Both have an elevated reticulocyte production index (RPI) greater than 3. 
C)  Both have normal release of RBCs from the bone marrow. 
D)  Both have significantly shortened red cell survival in circulation. 
A)  Both have increased rate of erythropoiesis in the bone marrow. 
B)  Both have an elevated reticulocyte production index (RPI) greater than 3. 
C)  Both have normal release of RBCs from the bone marrow. 
D)  Both have significantly shortened red cell survival in circulation.

Question 16

The red cell histogram is wider than normal. Which of the following is true?

Accepted Answer

A)  The red blood cell distribution width (RDW) is decreased. 
B)  Most cells are larger than normal. 
C)  The coefficient of variation was calculated incorrectly. 
D)  Anisocytosis is present. 
A)  The red blood cell distribution width (RDW) is decreased. 
B)  Most cells are larger than normal. 
C)  The coefficient of variation was calculated incorrectly. 
D)  Anisocytosis is present.

Question 17

What is the best definition of anemia?

Accepted Answer

A)  Red cell count 10% lower than the patient's baseline 
B)  Decreased hemoglobin, hematocrit, and red cell count compared with healthy people in the same demographic group 
C)  Hemoglobin below 12 g/dL 
D)  Any clinical condition resulting in shortness of breath, increased heart rate, pallor, and fatigue 
A)  Red cell count 10% lower than the patient's baseline 
B)  Decreased hemoglobin, hematocrit, and red cell count compared with healthy people in the same demographic group 
C)  Hemoglobin below 12 g/dL 
D)  Any clinical condition resulting in shortness of breath, increased heart rate, pallor, and fatigue

Question 18

Match the letter of the correct composition for the inclusion with the number for the inclusion.
Correct identification of inclusions in RBCs, when present, provides useful clinical information. They often help suggest the possible cause of an anemia, and thus further appropriate testing. The first list provides some red cell inclusions. The second list provides choices for composition.

-Howell-Jolly body

Accepted Answer

A) Ferric nonheme iron 
B) Deoxyribonucleic acid (DN
A)  
C) Precipitated ribonucleic acid (RN
A)  
D) Denatured hemoglobin 
A) Ferric nonheme iron 
B) Deoxyribonucleic acid (DN
A)  
C) Precipitated ribonucleic acid (RN
A)  
D) Denatured hemoglobin

Question 19

What is the approximate average life span of a normal RBC in circulation?

Accepted Answer

A)  10 Days 
B)  20 Days 
C)  80 Days 
D)  120 Days 
A)  10 Days 
B)  20 Days 
C)  80 Days 
D)  120 Days

Question 20

Which of the following red blood cell (RBC) findings are specific for a certain condition as opposed to being nonspecific and found in many conditions?

Accepted Answer

A)  Ovalocytes 
B)  Poikilocytosis 
C)  Sickle cells 
D)  Burr cells 
A)  Ovalocytes 
B)  Poikilocytosis 
C)  Sickle cells 
D)  Burr cells

Exam 18: Anemias: Red Blood Cell Morphology and Approach to Diagnosis

What test is used along with the mean cell volume (MCV) to morphologically classify anemias?

What percentage of red cells is destroyed and replaced daily in a normal adult?

Which of the following is typically a macrocytic anemia?

The anemia found in liver disease is:

All of the following are physiologic adaptations the body makes when a slow drop in the number of red cells occurs except:

Which of the following is true of ineffective erythropoiesis?

An appropriately increased RPI greater than 3 is associated with:

Which of the following is an example of a morphologic classification of anemia?

Which shape of red cell is described as a round, dense cell with no area of central pallor?

Describe the morphologic appearance of the red cells given the following results. RBC: 1.89*1012/L Hemoglobin: 7.5 g/dL Hematocrit: 21.0% RDW: 18.5

Which of the following conditions would warrant a bone marrow aspiration?

Two different patients both have hemoglobins in the 5.0 to 6.0 g/dL range. One has pallor, fatigue, and headaches, whereas the other is experiencing life-threatening shock. Which of the following is probably the major difference between the two patients?

Compare results of various tests in effective versus ineffective erythropoiesis.

The red cell histogram is wider than normal. Which of the following is true?

What is the best definition of anemia?

What is the approximate average life span of a normal RBC in circulation?

Which of the following red blood cell (RBC) findings are specific for a certain condition as opposed to being nonspecific and found in many conditions?

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

Disorders of Iron and Heme Metabolism

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

Describe the morphologic appearance of the red cells given the following results. RBC: 1.89*10¹²/L Hemoglobin: 7.5 g/dL Hematocrit: 21.0% RDW: 18.5