Question 1

Identify the primary organelle of synthesis site for globin chain and heme in developing RBCs. Globin chains Heme

Accepted Answer

A)  Ribosomes Ribosomes 
B)  Golgi complex Mitochondria 
C)  Ribosomes Mitochondria 
D)  Mitochondria Golgi complex 
A)  Ribosomes Ribosomes 
B)  Golgi complex Mitochondria 
C)  Ribosomes Mitochondria 
D)  Mitochondria Golgi complex C

Question 2

Which of the following provides a negative feedback for heme synthesis, thus helping to control, by decreasing, its synthesis?

Accepted Answer

A)  Concentration of heme in the developing RBC 
B)  Concentration of hemoglobin in blood 
C)  Concentration of globin chain in the developing RBC 
D)  Number of RBCs in circulation 
A)  Concentration of heme in the developing RBC 
B)  Concentration of hemoglobin in blood 
C)  Concentration of globin chain in the developing RBC 
D)  Number of RBCs in circulation A

Question 3

What is the effect of an increased concentration of 2,3-BPG in the RBC?

Accepted Answer

A)  Puts hemoglobin in the relaxed conformation 
B)  Shifts the oxygen dissociation curve to the left 
C)  Increases the affinity of hemoglobin for oxygen 
D)  Decreases the synthesis of globin chains 
A)  Puts hemoglobin in the relaxed conformation 
B)  Shifts the oxygen dissociation curve to the left 
C)  Increases the affinity of hemoglobin for oxygen 
D)  Decreases the synthesis of globin chains B

Question 4

Where is heme produced?

Accepted Answer

A)  Liver 
B)  Macrophages in the bone marrow 
C)  Red blood cell (RB
C)  precursors in the bone marrow 
D)  Mature RBCs in peripheral circulation 
A)  Liver 
B)  Macrophages in the bone marrow 
C)  Red blood cell (RB
C)  precursors in the bone marrow 
D)  Mature RBCs in peripheral circulation

Question 5

Why does Hb F have a higher oxygen affinity than adult hemoglobin?

Accepted Answer

A)  Fetal blood has a higher pH than adult blood. 
B)  Fetal blood has a higher hematocrit than adult blood. 
C)  Body temperature is lower in fetus. 
D)  It is necessary to extract oxygen from the maternal blood supply. 
A)  Fetal blood has a higher pH than adult blood. 
B)  Fetal blood has a higher hematocrit than adult blood. 
C)  Body temperature is lower in fetus. 
D)  It is necessary to extract oxygen from the maternal blood supply.

Question 6

Which of the following is true of the oxygen dissociation curve?

Accepted Answer

A)  The normal partial pressure of oxygen (PO2) at which hemoglobin is 50% saturated is 20 mm Hg. 
B)  A shift to the right or left in response to blood pH is called the Bohr effect. 
C)  A shift to the left results in lower oxygen affinity. 
D)  A shift to the right results in less effective delivery of oxygen to tissue. 
A)  The normal partial pressure of oxygen (PO2) at which hemoglobin is 50% saturated is 20 mm Hg. 
B)  A shift to the right or left in response to blood pH is called the Bohr effect. 
C)  A shift to the left results in lower oxygen affinity. 
D)  A shift to the right results in less effective delivery of oxygen to tissue.

Question 7

An increase in the concentration of 2,3-BPG:

Accepted Answer

A)  Puts hemoglobin the relaxed conformation form 
B)  Shifts the oxygen dissociation curve to the left 
C)  Increases the affinity of hemoglobin for oxygen 
D)  Is present in patients with severe anemia and decreased blood pH (acidosis) 
A)  Puts hemoglobin the relaxed conformation form 
B)  Shifts the oxygen dissociation curve to the left 
C)  Increases the affinity of hemoglobin for oxygen 
D)  Is present in patients with severe anemia and decreased blood pH (acidosis)

Question 8

The globin chains making up Hb A are:

Accepted Answer

A)  Two $\varepsilon$ and two $\gamma$ chains 
B)  Two   and two $\varepsilon$ chains 
C)  Two $\alpha$ and two $\gamma$ chains 
D)  Two $\alpha$ and two $\beta$ chains 
A)  Two $\varepsilon$ and two $\gamma$ chains 
B)  Two   and two $\varepsilon$ chains 
C)  Two $\alpha$ and two $\gamma$ chains 
D)  Two $\alpha$ and two $\beta$ chains

Question 9

Which of the following correctly describes the structure of normal hemoglobin A (Hb A)?

Accepted Answer

A)  Four identical polypeptide chains, each containing two heme groups 
B)  Two $\alpha$ and two $\beta$ polypeptide chains, each containing one heme group 
C)  Conjugated protein with 141 amino acids, containing two atoms of iron 
D)  Two $\delta$ and two $\gamma$ polypeptide chains, each containing a single heme group 
A)  Four identical polypeptide chains, each containing two heme groups 
B)  Two $\alpha$ and two $\beta$ polypeptide chains, each containing one heme group 
C)  Conjugated protein with 141 amino acids, containing two atoms of iron 
D)  Two $\delta$ and two $\gamma$ polypeptide chains, each containing a single heme group

Question 10

Why is heme located inside a globin chain pocket surrounded by hydrophobic amino acids?

Accepted Answer

A)  Protects iron from being oxidized to its ferric form 
B)  Necessary for oxygen release to tissues 
C)  Makes hemoglobin insoluble 
D)  Keeps heme from being dissolved 
A)  Protects iron from being oxidized to its ferric form 
B)  Necessary for oxygen release to tissues 
C)  Makes hemoglobin insoluble 
D)  Keeps heme from being dissolved

Question 11

All of the following hemoglobins are found in a normal human adult except:

Accepted Answer

A)  Hb A 
B)  Hemoglobin Gower-2 
C)  Fetal hemoglobin (Hb F) 
D)  Hb A2 
A)  Hb A 
B)  Hemoglobin Gower-2 
C)  Fetal hemoglobin (Hb F) 
D)  Hb A2

Question 12

Which of the following is true of hemoglobin if the oxygen dissociation curve shifts to the left?

Accepted Answer

A)  Has a lower affinity for oxygen 
B)  Picks up less oxygen in the lungs but delivers more to tissues 
C)  Picks up more oxygen in the lungs but delivers less to tissues 
D)  Picks up and delivers more oxygen 
A)  Has a lower affinity for oxygen 
B)  Picks up less oxygen in the lungs but delivers more to tissues 
C)  Picks up more oxygen in the lungs but delivers less to tissues 
D)  Picks up and delivers more oxygen

Question 13

Which of the following is true for the relative affinity of hemoglobin for oxygen in the lungs and tissue with the oxygen dissociation curve in its normal position? Lungs Tissue

Accepted Answer

A)  High Low 
B)  Low Low 
C)  High High 
D)  low low 
A)  High Low 
B)  Low Low 
C)  High High 
D)  low low

Question 14

Select the form of hemoglobin that contains iron in the ferric rather than the ferrous state.

Accepted Answer

A)  Myoglobin 
B)  Methemoglobin 
C)  Deoxyhemoglobin 
D)  Carboxyhemoglobin 
A)  Myoglobin 
B)  Methemoglobin 
C)  Deoxyhemoglobin 
D)  Carboxyhemoglobin

Question 15

Which of the following is true regarding carboxyhemoglobin?

Accepted Answer

A)  Smokers have increased levels. 
B)  It has hydrogen sulfide added to hemoglobin. 
C)  Normal people have none. 
D)  Levels of 15% to 20 % cause coma and death. 
A)  Smokers have increased levels. 
B)  It has hydrogen sulfide added to hemoglobin. 
C)  Normal people have none. 
D)  Levels of 15% to 20 % cause coma and death.

Question 16

Which of the following causes a shift to the right on the oxygen dissociation curve?

Accepted Answer

A)  Severe anemia 
B)  Alkalosis 
C)  High levels of Hb F 
D)  Decreased levels of 2,3-biphosphoglycerate (2,3-BPG) 
A)  Severe anemia 
B)  Alkalosis 
C)  High levels of Hb F 
D)  Decreased levels of 2,3-biphosphoglycerate (2,3-BPG)

Question 17

The reference range for hemoglobin concentration:

Accepted Answer

A)  Is lower in a newborn than in a male adult 
B)  Is lower in a newborn than in a female adult 
C)  Is higher in a newborn than in a male adult 
D)  Is higher in a woman than in a man 
A)  Is lower in a newborn than in a male adult 
B)  Is lower in a newborn than in a female adult 
C)  Is higher in a newborn than in a male adult 
D)  Is higher in a woman than in a man

Question 18

How many molecules of oxygen can one molecule of hemoglobin carry?

Accepted Answer

A)  One 
B)  Two 
C)  Three 
D)  Four 
A)  One 
B)  Two 
C)  Three 
D)  Four

Question 19

Why is it important that synthesis of globin chains and heme be balanced in the RBCs?

Accepted Answer

A)  Excess concentration of protoporphyrin increases bilirubin in plasma. 
B)  An excess of one of the components of hemoglobin decreases RBC survival. 
C)  An excess of one of the components of hemoglobin increases RBC survival leading to an eventual elevated RBC count. 
D)  An excess of globin chains significantly decreases the concentration of globin chain messenger ribonucleic acid (mRN
A)  in the developing RBCs. 
A)  Excess concentration of protoporphyrin increases bilirubin in plasma. 
B)  An excess of one of the components of hemoglobin decreases RBC survival. 
C)  An excess of one of the components of hemoglobin increases RBC survival leading to an eventual elevated RBC count. 
D)  An excess of globin chains significantly decreases the concentration of globin chain messenger ribonucleic acid (mRN
A)  in the developing RBCs.

Question 20

Which of the following statements is true about Hb F?

Accepted Answer

A)  It is the major hemoglobin during fetal life. 
B)  It is increased in concentration in children up to 2 years old. 
C)  It is evenly distributed at low concentration in all RBCs of an adult. 
D)  It has a low oxygen affinity. 
A)  It is the major hemoglobin during fetal life. 
B)  It is increased in concentration in children up to 2 years old. 
C)  It is evenly distributed at low concentration in all RBCs of an adult. 
D)  It has a low oxygen affinity.

Exam 10: Hemoglobin Metabolism

Identify the primary organelle of synthesis site for globin chain and heme in developing RBCs. Globin chains Heme

Which of the following provides a negative feedback for heme synthesis, thus helping to control, by decreasing, its synthesis?

What is the effect of an increased concentration of 2,3-BPG in the RBC?

Where is heme produced?

Why does Hb F have a higher oxygen affinity than adult hemoglobin?

Which of the following is true of the oxygen dissociation curve?

An increase in the concentration of 2,3-BPG:

The globin chains making up Hb A are:

Which of the following correctly describes the structure of normal hemoglobin A (Hb A)?

Why is heme located inside a globin chain pocket surrounded by hydrophobic amino acids?

All of the following hemoglobins are found in a normal human adult except:

Which of the following is true of hemoglobin if the oxygen dissociation curve shifts to the left?

Which of the following is true for the relative affinity of hemoglobin for oxygen in the lungs and tissue with the oxygen dissociation curve in its normal position? Lungs Tissue

Select the form of hemoglobin that contains iron in the ferric rather than the ferrous state.

Which of the following is true regarding carboxyhemoglobin?

Which of the following causes a shift to the right on the oxygen dissociation curve?

The reference range for hemoglobin concentration:

How many molecules of oxygen can one molecule of hemoglobin carry?

Why is it important that synthesis of globin chains and heme be balanced in the RBCs?

Which of the following statements is true about Hb F?

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

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

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

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