Question 1

A healthcare professional works with recent refugees. A mother brings in her children who have been diagnosed with iron deficiency anemia. What action by the professional is most appropriate?

Accepted Answer

A)  Educate the mother on an iron-rich diet.
B)  Arrange to test for parasitic infections.
C)  Explain the weekly iron infusions.
D)  Teach the mother to give iron supplements. B

Question 2

The students learn that deficiencies in folate and vitamin B₁₂ alter the synthesis of which of these?

Accepted Answer

A)  RNA
B)  Cell membrane
C)  DNA
D)  Mitochondria C

Question 3

What does the student learn about warm autoimmune hemolytic anemia?

Accepted Answer

A)  Warm autoimmune hemolytic anemia occurs primarily in children.
B)  It is self-limiting and rarely produces hemolysis.
C)  Erythrocytes are bound to macrophages and sequestered in the spleen.
D)  Immunoglobulin M coats erythrocytes and binds them to receptors on monocytes. C

Question 4

A patient has polycythemia vera and presents to the Emergency Department with plethora and neurological changes. The student asks the healthcare professional to explain the primary cause of these symptoms. What response by the professional is best?

Accepted Answer

A)  Decreased erythrocyte count
B)  Destruction of erythrocytes
C)  Increased blood viscosity
D)  Tissue destruction by macrophages

Question 5

The paresthesia that occurs in vitamin B₁₂ deficiency anemia is a result of which of these?

Accepted Answer

A)  Reduction in acetylcholine receptors in the postsynaptic nerves
B)  Myelin degeneration in the spinal cord
C)  Destruction of myelin in peripheral nerves
D)  Altered function of neurons in the parietal lobe

Question 6

What term is used to describe the capacity of some erythrocytes to vary in size, especially in relationship to some anemias?

Accepted Answer

A)  Poikilocytosis
B)  Isocytosis
C)  Anisocytosis
D)  Microcytosis

Question 7

A patient is 8 hours postoperative after a long orthopedic procedure. The student asks why this patient is at particular risk of developing a thromboembolism. What response by the healthcare professional is best?

Accepted Answer

A)  Patients tend to have venous stasis from orthopedic operations.
B)  Anesthetic agents often cause an immune response against clotting factors.
C)  Endothelial damage occurs and repair is slowed by postoperative pain.
D)  Atherosclerotic build up causes turbulent blood flow leading to clots.

Question 8

A healthcare professional in an urban clinic is seeing a patient who has iron deficiency anemia (IDA). What question by the professional is most appropriate to assess for the cause of IDA?

Accepted Answer

A)  "How many times a week do you have iron-rich foods?"
B)  "Have you ever noticed any blood in your stool?"
C)  "Do you have a history of heart valve replacement?"
D)  "Have you had any recent viral infections?"

Question 9

A student asks the professor what the most common pathophysiologic process is that triggers aplastic anemia (AA). What response by the professor is most accurate?

Accepted Answer

A)  Autoimmune disease against hematopoiesis by activated cytotoxic T (Tc)  cells
B)  Malignancy of the bone marrow in which unregulated proliferation of erythrocytes crowd out other blood cells
C)  Autoimmune disease against hematopoiesis by activated immunoglobulins
D)  Inherited genetic disorder with recessive X-linked transmission

Question 10

In aplastic anemia (AA), pancytopenia develops as a result of what?

Accepted Answer

A)  Suppression of erythropoietin to produce adequate amounts of erythrocytes
B)  Suppression of the bone marrow to produce adequate amounts of erythrocytes, leukocytes, and thrombocytes
C)  Lack of DNA to form sufficient quantities of erythrocytes, leukocytes, and thrombocytes
D)  Lack of stem cells to form sufficient quantities of leukocytes

Question 11

An allogenic bone marrow transplantation remains the preferred method for treating which anemia?

Accepted Answer

A)  Polycythemia vera
B)  Aplastic
C)  Sideroblastic
D)  Anemia of chronic disease (AC
D)

Question 12

Which condition resulting from untreated pernicious anemia (PA) is fatal?

Accepted Answer

A)  Brain hypoxia
B)  Liver hypoxia
C)  Heart failure
D)  Renal failure

Question 13

After a person has a subtotal gastrectomy for chronic gastritis, which type of anemia will result?

Accepted Answer

A)  Iron deficiency
B)  Aplastic
C)  Folic acid
D)  Pernicious

Question 14

Which of these classified as a megaloblastic anemia?

Accepted Answer

A)  Iron deficiency
B)  Pernicious
C)  Sideroblastic
D)  Hemolytic

Question 15

What is the fundamental physiologic manifestation of anemia?

Accepted Answer

A)  Hypotension
B)  Hyperesthesia
C)  Hypoxia
D)  Ischemia

Question 16

An adult patient has been hospitalized with thrombocytopenia with a platelet count of 8000/mm³. What action by the healthcare professional is most appropriate?

Accepted Answer

A)  Tell the patient not to get out of bed without assistance.
B)  Prepare the patient for transfusions of whole blood.
C)  Educate the patient on side effects of heparin.
D)  Nothing; this finding is normal in an adult.

Question 17

A patient in the hospital has been receiving heparin injections. The platelet count on admission was 222,000/mm³ and four days later is 113,000/mm³. What action by the healthcare professional is best?

Accepted Answer

A)  Prepare to transfuse the patient with platelets.
B)  Do nothing; this is an expected side effect.
C)  Switch the heparin to lepirudin
D)  Stop all the patient's medications.

Question 18

What does treatment for polycythemia vera involve?

Accepted Answer

A)  Therapeutic phlebotomy and radioactive phosphorus
B)  Restoration of blood volume by plasma expanders
C)  Administration of cyanocobalamin
D)  Blood transfusions

Question 19

A healthcare professional is caring for five patients. Which one would the professional assess for disseminated intravascular coagulation (DIC) as the priority? (Select all that apply.)

Accepted Answer

A)  Heat stroke
B)  Severe pancreatitis
C)  Term delivery
D)  HELLP syndrome
E)  Snake bite

Question 20

A patient has hepatomegaly, bronze-colored skin, and cardiac dysrhythmias. What condition does the healthcare professional prepare to teach the patient about?

Accepted Answer

A)  Aplastic anemia
B)  Pernicious anemia
C)  Hereditary hemochromatosis
D)  Immune thrombocytopenia purpura

Exam 29: Alterations of Erythrocytes, Platelets, and Hemostatic Function