Term
Which of the following is a description for the term anemia?
A. Increased white blood cell size
B. Increased erythrocyte number in circulating blood
C. Decreased erythrocytes in circulating blood
D. Decreased circulating platelets |
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Definition
C. Decreased erythrocytes in circulating blood.
Anemia is a reduction in the total number of erythrocytes in the circulating blood or a decrease in the quality or quantity of hemoglobin. |
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Term
Which of the following is NOT one of the common causes of anemia?
A. Impaired production
B. Blood transfusion
C. Increased red cell destruction
D. Severe bleeding |
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Definition
B. Blood transfusion
Anemia can be caused by impaired production of erythrocytes, blood loss, increased red cell destruction, or any combination of these. |
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Term
Which of the following is a TRUE statement regarding pernicious anemia?
A. Rare form of megaloblastic anemia
B. Assciated with end-stage type A chronic atrophic gastritis
C.It is of viral origin
D.Mean age of onset of 6 years |
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Definition
B. Associated with end-stage type A chronic atrophic gastritis
Pernicious anemia is due to the absence of intrinsic factor. It generally occurs in older adults with mean age of onset of 60 years. It is the most common form of megaloblastic anemia. It is autoimmune and is associated with end-stage type A chronic atrophic gastritis. |
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Term
Which of the following is a TRUE statement regarding folate?
A.Dietary intake is about 50 to 200 mcg/day.
B.Pregnant women require less folate.
C.Folate synthesis takes place in the stomach.
D.Absorption of folate takes place in the stomach. |
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Definition
A. Dietary intake is about 50-200mcg/day
Pregnant women require more folate. Folate synthesis takes place in the human intestine, and absorption occurs in the small intestine. |
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Term
Which of the following is NOT a cause of microcytic-hypochromic anemia?
A.Disorders of iron metabolism
B.Disorders of porphyrin synthesis
C.Disorders of globin synthesis
D.Disorders of vitamin B12 absorption |
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Definition
D. Disorders of Vit B12 absorption
Pernicious anemia is a macrocytic-normochromic anemia that results in an inability to absorb vitamin B12. The others are all causes of microcytic-hypochromic anemia. |
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Term
Which form of anemia is caused by a deviation in mitochondrial metabolism?
A.Iron deficiency
B.Microcytic-hypochromic
C.Sideroblastic
D.Megaloblastic |
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Definition
C. Sideroblastic
Sideroblastic anemias are a heterogeneous group of disorders characterized by anemia of varying severity due to a deviation in mitochondrial metabolism |
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Term
Which of the following is TRUE regarding posthemorrhagic anemia?
A. healthy person can tolerate a loss of 2000 ml of blood.
B. results in normocytic and normochromic anemia.
C.Hypertension may be present.
D.There is increased venous return. |
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Definition
| B. results in normocytic-normochromic anemia |
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Term
Which of the following is the appropriate term for the increase in red cell production?
A.Anemia
B.Hemolytic crisis
C.Polycythemia
D.Apoferritin |
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Definition
C. Polycythemia
Anemia is a decrease in the number of red blood cells. Hemolytic crisis is fulminate hemolytic anemia and can present with shock. Apoferritin is a protein implicated in altered iron metabolism |
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Term
Which of the following terms best describes a higher-than-normal white blood cell count?
A. Leukopenia
B. Leukocytosis
C. Granulocytosis
D. Neutrophilia |
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Definition
B. Leukocytosis
Leukocytosis is an increase in the number of leukocytes or white blood cells in the blood. The decrease in number of white blood cells is termed leukopenia. Granulocytosis is an increase in the number of granulocytes in the blood. The neutrophil is the most numerous of the granulocytes and the term granulocytosis is often used in place of neutrophilia |
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Term
Which of the following is NOT a cause of neutropenia?
A. Decreased production
B. Reduced survival
C. Abnormal distribution
D. Increased vitamin storage |
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Definition
The three main causes of neutropenia include decreased production, reduced survival, and abnormal distribution.
D. Increased Vitamin Storage
Decreased vitamin intake can cause decreased production due to the lack of appropriate building blocks. |
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Term
Which of the following is NOT a cause of eosinophilia?
A. Asthma
B. Prolonged infection
C. Atopic dermatitis
D. Eczema |
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Definition
B. Prolonged Infection
Prolonged infection may actually cause leukopenia. Asthma, hay fever, drug reactions, eczema, pemphigus, and atopic dermatitis may cause increased eosinophils. |
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Term
Which of the following is a TRUE statement regarding infectious mononucleosis?
A. It is characterized by granulocytosis.
B. It is commonly caused by Epstein-Barr virus.
C. It usually affects older adults.
D. It is caused by the poxvirus family. |
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Definition
B. It is commonly caused by EBV
Infectious mononucleosis is typically caused by the herpesvirus, EBV, which causes approximately 85% of cases. It usually affects young adults between 15 and 35 years of age. There is characteristically an increase in B lymphocytes. |
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Term
At which level of platelets can spontaneous bleeding occur?
A. Greater than 100,000/mm3
B. Between 50,000 and 75,000/mm3
C. Between 20,000 and 50,000/mm3
D. Between 10,000 and 15,000/mm3 |
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Definition
D. Between 10,000 and 15,000
Spontaneous bleeding can occur with a platelet count between 10,000 and 15,000/mm3. With a platelet count of less than 10,000, severe bleeding may result. |
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Term
Which of the following is the most common cause of drug-induced thrombocytopenia?
A. Heparin
B. Thiazides
C. Estrogens
D. Ethanol |
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Definition
A Heparin
Heparin is the most common cause of drug-induced thrombocytopenia. The other choices do cause thrombocytopenia |
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Term
Which of the following is TRUE regarding immune thrombocytopenic purpura (ITP)?
A. It is an immune process involving autoantibodies.
B. The chronic form has a higher incidence in adolescence.
C. It starts with massive bleeding from the nose and mouth.
D. Intracranial bleeding is common. |
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Definition
A. It is an immune process involving autoantibodies
It is an immune process that involves autoantibodies. It usually starts with minor problems such as petechiae that progress to major hemorrhage from mucosal sites. Rarely will an individual present with intracranial or internal bleeding. |
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Term
Which of the following is NOT a true statement regarding acquired idiopathic thrombotic thrombocytopenic purpura (TTP)?
A. It is caused by platelet aggregates.
B. It is more common in females.
C. The most common age group is infants.
D. Its incidence is increasing. |
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Definition
C. The most common age group is infants
Acquired TTP occurs mostly in females in their 30s and is rarely observed in infants or older adults. Familial TTP is more rare and is usually chronic, relapsing, and seen in children. |
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Term
Which of the following factors is not regulated by vitamin K?
A. Protein C
B. VII
C. VIII
D. X |
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Definition
C. VIII
Prothrombin, procoagulant factors
VII, IX, and X, and anticoagulant regulators (proteins C and S) within the liver are regulated by vitamin K. |
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Term
Which of the following is NOT associated with disseminated intravascular coagulation?
A. Procoagulant inhibition
B. Fibrinolytic activity
C. Consumption of platelets and clotting factors.
D. End organ damage |
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Definition
A. Procoagulent Inhibition
Procoagulant activity, fibrinolytic activity, consumption of platelets and clotting factors, and end organ damage are all evidence for DIC. |
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Term
Which of the following is NOT one of the three characteristics of the triad of Virchow?
A. Injury to endothelium
B. Abnormalities of blood flow
C. Hypercoagulability of the blood
D. Decreased clotting factors |
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Definition
D. Decreased clotting factors
The triad of Virchow includes the factors that predispose to thrombus formation and include injury to the endothelium, abnormalities of blood flow, and hypercoagulability of the blood. |
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Term
Which of the following is TRUE regarding fetal and adult hemoglobin?
A. Fetal hemoglobin is composed of two α- and two γ-chains.
B. Adult hemoglobin is composed of two α- and one γ-chain.
C. Adult hemoglobin is HbF and HbA.
D. Three of the embryonic hemoglobins are Gower 1, 2, and 3. |
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Definition
The adult hemoglobins are HbA and HbA2, and they are composed of two α- and two β-chains. Fetal hemoglobin is
A. Fetal HgB is composed of two alpha and two gamma chains
HbF and is composed of two α- and two γ-chains. The embryonic hemoglobins are Gower 1, 2, 3. |
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Term
Which of the following is TRUE regarding anemia in children?
A. The most common cause is sickle cell disease.
B. Anemia is the most common blood disorder in children.
C. There is only one cause of hemolytic anemia.
D. Children rarely present with iron deficiency anemia. |
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Definition
B. Anemia is the most common blood disorder in children
Anemia is the most common blood disorder in children, and the most common cause is iron deficiency. There are two large categories for hemolytic anemia, including increased destruction and disorders related to damaging extraerythrocytic factors. |
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Term
Which of the following statements is TRUE regarding iron deficiency anemia?
A. Whites are more commonly affected.
B. Incidence is most common in those children older than 2 years.
C. It is common in children due to their extremely high need for iron for normal growth.
D. There is decreased risk in children of homeless women. |
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Definition
C.It is common in children due to their extremely high need for iron for normal growth
Iron deficiency anemia is common in children due to their extremely high need for iron for growth. Incidence is not related to race but is related to socioeconomic factors, including increased prevalence in the children of homeless women. It is most commonly found between the ages of 6 months and 2 years. |
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Term
Which of the following is TRUE regarding iron deficiency?
A. Splenomegaly is present in 90% of those affected.
B. Hemoglobin of less than 5 g/dl may be accompanied by pallor.
C. Hemoglobin of 10 g/dl is generally accompanied by tachycardia.
D. Widening of sutures is an early sign of iron deficiency. |
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Definition
Splenomegaly is evident in 10% to 15% of children with iron deficiency anemia. If the condition is long-standing, the sutures of the skull may widen. Mild to moderate iron deficiency (hemoglobin 6 to 10 g/dl) may show some cellular changes.
B. HgB of less than 5g/dl may be accompanied by pallor
Hemoglobin less than 5 g/dl will demonstrate pallor, tachycardia, and a systolic murmur. |
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Term
Which of the following is a TRUE statement regarding maternal antibodies?
A. Placental detachment does not result in fetal erythrocytes crossing the placenta.
B. The first Rh-incompatible pregnancy usually presents with severe complications.
C. Anti-Rh antibodies are formed only in the response to transfusion.
D. ABO incompatibility can cause hemolytic disease without erythrocytes escaping maternal circulation. |
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Definition
D. ABO incompatibility can cause hemolytic disease without erythrocytes escaping maternal circulation
ABO incompatibility can cause hemolytic disease of the newborn without erythrocytes escaping maternal circulation. Placental detachment results in a large number of fetal erythrocytes entering the mother’s bloodstream. The first Rh-incompatible pregnancy usually presents with no difficulties. Anti-Rh antibodies are formed in the response to the presence of incompatible (Rh-positive) erythrocytes in the blood of an Rh-negative mother. |
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Term
Which of the following is the appropriate term for an alloimmune disease in which maternal blood and fetal blood are antigenically incompatible?
A. Erythroblastosis fetalis
B. Hydrops fetalis
C. Icterus neonatorum
D. Icterus gravis neonatorum |
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Definition
A. Erythroblastosis fetalis
Hydrops fetalis is the term for fetuses that do not survive anemia in utero. They are stillborn with gross edema of the entire body. Icterus neonatorum is neonatal jaundice. Cerebral damage causes death, and this is caused by icterus gravis neonatorum. |
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Term
Which of the following is TRUE regarding the Coombs test?
A. Indirect Coombs confirms the diagnosis of antibody-mediated hemolytic disease.
B. Indirect Coombs measures antibodies to the mother’s circulation.
C. Direct Coombs indicates if the fetus is at risk for hemolytic disease.
D. Direct Coombs measures free antibodies. |
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Definition
B. Indirect Coombs mearsure antibodies to the mother's circulation
The indirect Coombs measures antibody in the mother’s circulation and indicates if the fetus is at risk for hemolytic disease. The direct Coombs test measures antibody already bound to the surfaces of fetal erythrocytes and is used primarily to confirm the diagnosis of antibody-mediated hemolytic disease |
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Term
Which of the following is TRUE regarding G6PD deficiency?
A. Most commonly found in females
B. Most common manifestation is polycythemia
C. Associated with icterus neonatorum
D. Associated with green bean ingestion |
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Definition
C. Associated with icterus neonatorum
G6PD is most commonly found in males. It is associated with icterus neonatorum in Asian and Mediterranean infants. It results in hemolysis. Fava beans and the ingestion of certain drugs can cause a reaction. |
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Term
Which of the following terms describes a person with Hb(s) and another type of abnormal Hgb?
A. Sickle cell anemia
B. Sickle cell thalassemia
C. Sickle cell trait
D. Hereditary spherocytosis |
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Definition
B. Sickle cell thalassemia
Sickle cell anemia has two Hb(s) genes. Sickle cell trait has one Hb(s) and one normal Hg(A). Hereditary spherocytosis often represents a new mutation. |
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Term
Which of the following is a TRUE statement regarding sickle cell disease?
A. Sickle cell trait is the homozygous form of the disease.
B. Sickle cell disease means a person has HbA genes.
C. It is most common in European descent.
D. It is an autosomal recessive disease |
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Definition
D. It is an autosomal recessive disease
Sickle cell disease is most common in central Africa, the Near East, the Mediterranean, and part of India. Sickle cell trait has one Hb(s) and one normal Hg(A). In sickle cell disease, a person has two Hb(s) genes, and this represents the homozygous form of this disease. It is an autosomal recessive disorder. |
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Term
Which of the following is the most common trigger for sickling?
A. Hypoxemia
B. Decreased hydrogen ions
C. Decreased plasma osmolality
D. High temperature |
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Definition
A. Hypoxemia
Hypoxemia is the most common cause of sickling. Sickling is an occasional, intermittent phenomenon that can be triggered or sustained by hypoxemia, increased hydrogen ion concentration in the blood (decreased pH), increased plasma osmolality, decreased plasma volume, and low temperature |
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Term
Which of the following is the appropriate term for a transient cessation in red blood cell production resulting in acute anemia?
A. Vaso-occlusive crisis
B. Aplastic crisis
C. Sequestration crisis
D. Hyperhemolytic crisis |
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Definition
B. Aplastic Crisis
Vaso-occlusive crisis may develop spontaneously or be precipitated by infection, cold temperatures, dehydration, or low pH. This is when the cells clump and occlude vessels. Sequestration crisis is when large amounts of the blood become pooled in the liver and spleen. Hyperhemolytic crisis is unusual and often occurs with G6PD. |
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Term
Which of the following hemophilias is autosomal recessive and is found equally in males and females?
A. Hemophilia A
B. Hemophilia B
C. Hemophilia C
D. von Willebrand disease |
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Definition
C. Hemophilia C
Hemophilia A and B are X-linked recessive and are found in men. Von Willebrand disease is autosomal dominant |
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