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HEMA 1 RATIO QUIZ

Total questions: 51

Worksheet time: 26mins

Name
Class
Date
1.

Anemia can be caused by:

a)

-

b)

BOTH

2.

A classification of anemia wherein the MCV is greater than 96ft. MCHC is normal

a)

Macrocytic Normochromic Anemia

b)

Microcytic Hypochromic Anemia

c)

Normocytic Normochromic Anemia

d)

All of these

3.

Impaired release of storage iron associated with increased HEPCIDIN levels is due to

a)

Iron Deficiency

b)

Anemia of Chronic Dse

c)

Sideroblastic Anemia

d)

Megaloblastic Anemia

e)

Myelophtisic

4.

Caused by blocks on the protoporphyrin pathway resulting in defective hemoglobin synthesis and iron overload:

a)

Aplastic Anemia

b)

Sideroblastic Anemia

c)

Lead Poisoning

d)

Porphyrias

5.

An anemia with normocytic/normochromic anemia with characteristic course basophilic slipping:

a)

Lead Poisoning

b)

ACD

c)

Thalassemia

d)

IDA

6.

A falsely elevated HCT is obtained. Which of the following calculated values will not be affected

a)

MCH

b)

MCV

c)

MCHC

d)

All of these

7.

Which of these types of anemia are under the category of impaired production

a)

All of these

b)

IDA

c)

ACD

d)

Thalassemia

e)

Megaloblastic Anemia

8.

SITUATION: RBC indices obtained on a patient are as follows: MCV 88um3 fL; MCH 30pg; MCHC 34% (340). The RBCs on the peripheral smear would appear

a)

Normocytic Normochromic

b)

Macrocytic normochromic

c)

Microcytic hypochromic

d)

NOTA

9.

In an uncomplicated case of severe iron deficiency anemia, which of the following sets represents the typical pattern of results

a)

A

b)

B

c)

C

d)

D

10.

What is the first type of cell produced by the developing embryo

a)

RBC

b)

Erythrocyte

c)

Granulocyte

d)

Monocyte

11.

As most blood cell lines mature, which of the following is characteristics?

a)

-

b)

B. NUCLEUS TO CYTOPLASM RATION (N:C) DECREASES

12.

The direct antiglobulin test is often positive in

a)

Acquired Hemolytic Anemia

b)

IDA

c)

Acute Posthemorrhagic Anemia

d)

Chronic Blood loss

13.

The anemia of chronic infection is characterized

a)

Increased Serum Iron levels

b)

Decreased Serum Iron levels

c)

WBC is increased

d)

Platelet count is decreased

14.

A patient is admitted with a history of chronic bleeding secondary to peptic ulcer. Hematology workup reveals a sever microcytic, hypochromic anemia. Iron studies were requested. Which of the following would be expected in this case?

a)

A

b)

B

c)

C

d)

D

15.

Which of the following sets of laboratory findings is consistent with hemolytic anemia

a)

INCREASE ERYTHROCYTE SURVIVAL; INCREASED CATABOLISM OF HEME

b)

DECREASE ERYTHROCYTE SURVIVAL; INCREASED CATABOLISM OF HEME

c)

DECREASE ERYTHROCYTE SURVIVAL; DECREASE CATABOLISM OF HEME

d)

INCREASE ERYTHROCYTE SURVIVAL; DECREASED CATABOLISM OF HEME

16.

Chronic blood loss can lead to:

a)

Iron Deficiency

b)

Vitamin B12 deficiency

c)

Anemia of Chronic Disease

d)

Aplastic Anemia

17.

Many micro-spherocytes, schistocytes and budding off of spherocytes can be seen on peripheral blood smear of patients with

a)

Extensive Burns

b)

-

18.

Abetalipoproteinemia is characterized by mild anemia and numerous____ on the peripheral blood smear

a)

Acanthocytes

b)

Poikilocytosis

c)

Stomatocytosis

d)

Elliptocytosis

e)

Ovalocytosis

19.

What is the most common cause of iron deficiency

a)

Mild Injury

b)

Bleeding

c)

ABO incompatibility

d)

Extensive Burn

20.

Ineffective erythropoiesis is/are due to the following, EXCEPT:

a)

Iron Deficiency

b)

Megaloblastic Anemia

c)

Sideroblastic Anemia

d)

Vitamin B12 Deficiency

e)

Thalassemia

21.

This red cell parameter is increased in iron deficiency anemia

a)

TIBC

b)

Ferritin

c)

Bone Marrow Iron

d)

Serum Iron

22.

When there is defective G6PD in red cells, then the cause of hemolysis is:

a)

Intrinsic

b)

Extrinsic

c)

Both

d)

NOTA

23.

In chronic post-hemorrhagic anemia, this is NOT TRUE.

a)

Reticulocyte is VERY LOW

b)

Platelet is VERY LOW

c)

WBC count is slightly increased

d)

platelet count is decreased

24.

Isoimmune hemolytic disease of the newborn maybe due to:

a)

ABO Incompatibility

b)

Bleeding

c)

Lead Poisoning

d)

Iron Deficiency

25.

In aplastic anemias, marrow cellularity is:

a)

Decreased

b)

Increased

c)

Normal

d)

NOTA

26.

Rh null disease person shows morphological changes in red cells. Persons with Rh-negative condition possesses the CDE antigen.

a)

1st statement is TRUE, 2nd statement is FALSE

b)

1st statement is TRUE, 2nd statement is TRUE

c)

Both are False

d)

Both are correct

27.

Acanthocytes and echinocytes can be differentiated based on which of the following:

a)

-

b)

ALL OF THESE

28.

The opposite of aplastic anemia is:

a)

Polycythemia

b)

Acanthocyte

c)

Post hemorrhagic Anemia

d)

All of these

29.

Extrinsic Hemolytic Anemia is caused by:

a)

Chemical

b)

Physical

c)

Vegetable and animal

d)

Infectious agents

e)

Presence of autoantibodies, isoantibodies

30.

Defect of red cell itself usually hereditary & grouped as membrane, metabolic or hemoglobin defects

a)

Extrinsic Hemolytic Anemia

b)

Intrinsic Hemolytic Anemia

31.

Anemia most commonly present with which one of the following set of symptoms

a)

Pallor

b)

Shortness of Breath and Fatigue

c)

Low blood pressure

d)

Slight fever

32.

Which one of the following conditions would be included in the differential diagnosis of an anemic adult patient with an MCV of 125fL and an RDW of 20% (reference interval: 11.5% to 14.5%)

a)

Vitamin B 12 Deficiency

b)

Aplastic Anemia

c)

Folate Deficiency

d)

Sickle cell anemia

33.

Schistocytes, ovalocytes, and acanthocytes are examples of abnormal changes in RBC:

a)

Volume

b)

Shape

c)

Inclusions

d)

Hemoglobin Concentrations

34.

Which of the following is detectable only by examination of a peripheral blood film?

a)

Microcytosis

b)

Anisocytosis

c)

Hypochromia

d)

Poikilocytosis

35.

Which of the following patients would be considered anemic with a hemoglobin value of 14.5g/dL?

a)

Adult man

b)

Adult woman

c)

A newborn boy

d)

10-year old girl

36.

What are the initial laboratory tests that are performed for the diagnosis of anemia

a)

CBC, iron studies, and reticulocyte count

b)

CBC, reticulocyte count, and peripheral blood film examination

c)

Reticulocyte count and serum iron, vitamin B12 and folate assays

d)

Bone marrow study, iron studies, and peripheral blood film examination

37.

An increased in which one of the following suggests a shorted life span of RBCs and hemolytic anemia?

a)

Reticulocyte count

b)

Red cell count

c)

Hematocrit count

d)

WBC count

38.

An autoimmune reaction destroys the hematopoietic stem cells in the bone marrow of a young adult patient, and the amount of active bone marrow, including erythroid precursors, is diminished. Erythroid precursor that are present are normal in appearance, but there are too few to meet the demand for circulating red blood cells, and anemia develops. The reticulocyte count is low. The mechanism of the anemia would be described as

a)

Effective erythropoiesis

b)

Ineffective erythropoiesis

c)

Insufficient erythropoiesis

39.

Which of the following are important to consider in the patient’s history when investigating the cause of an anemia?

a)

Diet and medications

b)

Occupation, hobbies, and travel

c)

Bleeding episodes in the patient

d)

All of the above

40.

To determine which of the following condition would be included in the differential diagnosis of an anemic adult patient with an absolute reticulocyte count of 20 3 109 /L and an MVC of 65fL

a)

Aplastic Anemia

b)

Sickle cell anemia

c)

Iron deficiency

d)

Vitamin B12 deficiency

41.

Which one of the ff is reduced as an adaptation to long-standing anemia

a)

Heart rate

b)

Respiratory Rate

c)

Oxygen affinity of hemoglobin

d)

Volume of blood ejected from the heart w each contraction

42.

Which of the following findings is consistent with a

diagnosis of megaloblastic anemia?

a)

Hyposegmentation of neutrophils

b)

Decreased serum lactate dehydrogenase level

c)

Absolute increase in reticulocytes

d)

Increased MCV

43.

A patient has a clinical picture of megaloblastic anemia.

The serum folate level is decreased, and the serum vitamin

B12 level is 600 pg/mL (reference interval is 200 to 900

pg/mL). What is the expected value for the methylmalonic

acid assay?

a)

Increased

b)

Decreased

c)

Within the reference interval

44.

Which one of the following statements characterizes the

relationships among macrocytic anemia, megaloblastic

anemia, and pernicious anemia?

a)

Macrocytic anemias are megaloblastic.

b)

Macrocytic anemia is pernicious anemia.

c)

Megaloblastic anemia is macrocytic.

d)

Megaloblastic anemia is pernicious anemia.

45.

Which of the following CBC findings is most suggestive

of a megaloblastic anemia?

a)

MCV of 103 fL

b)

Hypersegmentation of neutrophils

c)

RDW of 16% d. Hemoglobin concentration of 9.1 g/dL

46.

In the following description of a bone marrow smear, find

the statement that is inconsistent with the expected picture

in megaloblastic anemia. “The marrow appears

hypercellular with a myeloid-to-erythroid ratio of 1:1 due to

prominent erythroid hyperplasia. Megakaryocytes appear

normal in number and appearance. WBC elements appear

larger than normal, with especially large metamyelocytes,

although they otherwise appear morphologically normal.

Erythroid precursors also appear large. There is

nuclear-cytoplasmic asynchrony, with the nucleus appearing more mature than expected for the color of the cytoplasm.”

a)

Erythroid nuclei that are more mature than cytoplasm

b)

Larger than normal WBC elements

c)

Larger than normal erythroid precursors

d)

Normal appearance of megakaryocytes

47.

Which one of the following findings would be inconsistent

with elevated titers of intrinsic factor blocking antibodies?

a)

a. Hypersegmentation of neutrophils

b)

b. Low levels of methylmalonic acid

c)

c. Macrocytic RBCs

d)

d. Low levels of vitamin B12

48.

Which of the following is the most metabolically active

form of absorbed vitamin B12?

a)

Transcobalamin

b)

Intrinsic factor-vitamin B12 complex

c)

Holotranscobalamin

d)

d. Haptocorrin-vitamin B12 complex

49.

8. Folate and vitamin B12 work together in the production of:

a)

Amino acids

b)

RNA

c)

Phospholipids

d)

DNA

50.

The macrocytosis associated with megaloblastic anemia

results from:

a)

Reduced numbers of cell divisions with normal

cytoplasmic development

b)

Activation of a gene that is typically active only in

megakaryocytes

c)

Reduced concentration of hemoglobin in the cells so that

larger cells are needed to provide the same oxygen-carrying

capacity

d)

Increased production of reticulocytes in an attempt to

compensate for the anemia

51.

Which one of the following groups has the highest risk

for pernicious anemia?

a)

Malnourished infants

b)

Children during growth periods

c)

Persons older than 60 years of ageChildren during growth periods

d)

Pregnant women