Question 1

Aplastic anemia is most often caused by:

Accepted Answer

A)  Drugs 
B)  Radiation 
C)  Unknown causes 
D)  Infectious agents 
A)  Drugs 
B)  Radiation 
C)  Unknown causes 
D)  Infectious agents C

Question 2

A 55-year-old male is undergoing dialysis to treat his renal failure. Routine blood examination shows a low RBC count, low H&H, and a normal MCV. What is the most important factor contributing to this anemia?

Accepted Answer

A)  Ineffective erythropoiesis 
B)  Hemolysis 
C)  Decreased erythropoietin production 
D)  Presence of cytotoxic antibodies to erythropoietin-sensitive cells 
A)  Ineffective erythropoiesis 
B)  Hemolysis 
C)  Decreased erythropoietin production 
D)  Presence of cytotoxic antibodies to erythropoietin-sensitive cells C

Question 3

How can infection with the Epstein-Barr virus (EBV) lead to aplastic anemia?

Accepted Answer

A)  EBV causes defects in precursor cells. 
B)  EBV infects stem cells, and an immune response to destroy the stem cells is initiated. 
C)  EBV creates immune complexes on the surface of the stem cell that damages it. 
D)  Infection with the virus shuts down cytokine production by macrophages. 
A)  EBV causes defects in precursor cells. 
B)  EBV infects stem cells, and an immune response to destroy the stem cells is initiated. 
C)  EBV creates immune complexes on the surface of the stem cell that damages it. 
D)  Infection with the virus shuts down cytokine production by macrophages. B

Question 4

A 5-year-old boy with malformed thumbs and microcephaly has been suffering from prolonged bleeding episodes, extreme fatigue, and persistent repetitive infections. Cytogenetic analysis shows increased chromosome breakage with the addition of diepoxybutane. Based on these findings, what is the patient most likely suffering from?

Accepted Answer

A)  CDA II 
B)  Pure red cell aplasia 
C)  Diamond-Blackfan anemia 
D)  Fanconi's syndrome 
A)  CDA II 
B)  Pure red cell aplasia 
C)  Diamond-Blackfan anemia 
D)  Fanconi's syndrome

Question 5

Recent evidence suggests that the pathophysiology of most cases of acquired aplastic anemia is most likely:

Accepted Answer

A)  Drug exposure 
B)  Viral infections 
C)  Defective stem cells 
D)  Immunologic suppression of hematopoiesis 
A)  Drug exposure 
B)  Viral infections 
C)  Defective stem cells 
D)  Immunologic suppression of hematopoiesis

Question 6

Anemia in hypersplenism differs from anemia found in true hypoproliferative anemias because in hypersplenism, there is:

Accepted Answer

A)  Reticulocytosis 
B)  Ineffective hematopoiesis 
C)  Dyshematopoiesis 
D)  Hypoplastic bone marrow 
A)  Reticulocytosis 
B)  Ineffective hematopoiesis 
C)  Dyshematopoiesis 
D)  Hypoplastic bone marrow

Question 7

The presence of what poikilocyte would lead to a suspicion of myelophthisic anemia rather than pure red cell aplasia?

Accepted Answer

A)  Dacrocyte 
B)  Drepanocyte 
C)  Schistocyte 
D)  Stomatocyte 
A)  Dacrocyte 
B)  Drepanocyte 
C)  Schistocyte 
D)  Stomatocyte

Question 8

Which of the following describes the bone marrow in a patient with Fanconi's syndrome?

Accepted Answer

A)  Hypercellular with erythroid hyperplasia 
B)  Hypocellular with normal M:E ratio 
C)  Normocellular with decreased M:E ratio 
D)  Hypocellular with elevated M:E ratio 
A)  Hypercellular with erythroid hyperplasia 
B)  Hypocellular with normal M:E ratio 
C)  Normocellular with decreased M:E ratio 
D)  Hypocellular with elevated M:E ratio

Question 9

The cytopenias associated with MDS are caused by:

Accepted Answer

A)  Dyshematopoiesis 
B)  Bone marrow replacement 
C)  Hypoplasia of the bone marrow 
D)  Decreased cytokine production 
A)  Dyshematopoiesis 
B)  Bone marrow replacement 
C)  Hypoplasia of the bone marrow 
D)  Decreased cytokine production

Question 10

Acquired chronic pure red cell aplasia is a rare disorder encountered in association with several autoimmune disorders. What does the mechanism appear to be?

Accepted Answer

A)  B cell-mediated immunosuppression of neutrophils 
B)  T cell-mediated immunosuppression of erythropoiesis 
C)  Cytokine-mediated immunosuppression of erythropoiesis 
D)  Increased serum erythropoietin 
A)  B cell-mediated immunosuppression of neutrophils 
B)  T cell-mediated immunosuppression of erythropoiesis 
C)  Cytokine-mediated immunosuppression of erythropoiesis 
D)  Increased serum erythropoietin

Question 11

Which of the following treatments offers the best prognosis for aplastic anemia?

Accepted Answer

A)  Synthetic cytokines 
B)  Bone marrow transplant 
C)  Immunosuppressive therapy 
D)  Stem cell transplant 
A)  Synthetic cytokines 
B)  Bone marrow transplant 
C)  Immunosuppressive therapy 
D)  Stem cell transplant

Question 12

All of the following are considered diagnostic criteria for aplastic anemia except:

Accepted Answer

A)  Granulocyte count 0.3 × 109/L 
B)  Platelet count 5 × 109/L 
C)  Anemia with absolute reticulocyte count of 22 × 109/L 
D)  BM cellularity of 32% 
A)  Granulocyte count 0.3 × 109/L 
B)  Platelet count 5 × 109/L 
C)  Anemia with absolute reticulocyte count of 22 × 109/L 
D)  BM cellularity of 32%

Question 13

Laboratory findings include a blood urea nitrogen >30 mg/dL, serum ferritin levels higher than normal, and a normocytic, normochromic morphology. What cause can be attributed to the anemia?

Accepted Answer

A)  Chronic renal disease 
B)  Iron deficiency 
C)  Diamond-Blackfan anemia 
D)  Fanconi's syndrome 
A)  Chronic renal disease 
B)  Iron deficiency 
C)  Diamond-Blackfan anemia 
D)  Fanconi's syndrome

Question 14

Explain how exposure to the following can lead to aplastic anemia.
a. Chloramphenicol
b. Benzene
c. Gamma radiation
d. Starvation

Accepted Answer

a. Bone marrow toxicity
b. Toxicity to c

Question 15

Which of the following puts a patient with long term exposure to benzene at risk for developing aplastic anemia?

Accepted Answer

A)  Benzene promotes an immune response against stem cells. 
B)  Benzene is toxic to the proliferating precursor cells in the bone marrow. 
C)  Benzene toxicity results in stem cell resistance to essential cytokines. 
D)  Benzene causes decreased cytokine production. 
A)  Benzene promotes an immune response against stem cells. 
B)  Benzene is toxic to the proliferating precursor cells in the bone marrow. 
C)  Benzene toxicity results in stem cell resistance to essential cytokines. 
D)  Benzene causes decreased cytokine production.

Question 16

List two examples of a congenital aplastic anemia.

Accepted Answer

Examples include Fanconi's syn

Question 17

Which of the following tests would help differentiate TEC from DBA?

Accepted Answer

A)  RBC count and RBC indices 
B)  Bone marrow cellularity and M:E ratio 
C)  Fetal erythrocyte characteristics 
D)  Ham test 
A)  RBC count and RBC indices 
B)  Bone marrow cellularity and M:E ratio 
C)  Fetal erythrocyte characteristics 
D)  Ham test

Question 18

What congenital defects are found in Fanconi's syndrome?

Accepted Answer

A)  Hypergonadism 
B)  Skin hypopigmentation 
C)  Mental retardation 
D)  Thrombocytic purpura 
A)  Hypergonadism 
B)  Skin hypopigmentation 
C)  Mental retardation 
D)  Thrombocytic purpura

Question 19

Chronic renal disease is a common cause of anemia. Which of the following is one of the possible causes of anemia in chronic renal disease?

Accepted Answer

A)  Increased erythropoietin production 
B)  Increased erythrocyte survival 
C)  Blood loss 
D)  Iron production 
A)  Increased erythropoietin production 
B)  Increased erythrocyte survival 
C)  Blood loss 
D)  Iron production

Question 20

Aplastic anemia in the acquired form can result from drugs or chemical agent exposure. If the link cannot be made to any environmental factor, what form of anemia does the client have?

Accepted Answer

A)  Pure red cell aplasia 
B)  Anemia of chronic renal disease 
C)  Idiopathic 
D)  Chronic 
A)  Pure red cell aplasia 
B)  Anemia of chronic renal disease 
C)  Idiopathic 
D)  Chronic

Exam 16: Hypoproliferative Anemias

Aplastic anemia is most often caused by:

A 55-year-old male is undergoing dialysis to treat his renal failure. Routine blood examination shows a low RBC count, low H&H, and a normal MCV. What is the most important factor contributing to this anemia?

How can infection with the Epstein-Barr virus (EBV) lead to aplastic anemia?

Recent evidence suggests that the pathophysiology of most cases of acquired aplastic anemia is most likely:

Anemia in hypersplenism differs from anemia found in true hypoproliferative anemias because in hypersplenism, there is:

The presence of what poikilocyte would lead to a suspicion of myelophthisic anemia rather than pure red cell aplasia?

Which of the following describes the bone marrow in a patient with Fanconi's syndrome?

The cytopenias associated with MDS are caused by:

Acquired chronic pure red cell aplasia is a rare disorder encountered in association with several autoimmune disorders. What does the mechanism appear to be?

Which of the following treatments offers the best prognosis for aplastic anemia?

All of the following are considered diagnostic criteria for aplastic anemia except:

Laboratory findings include a blood urea nitrogen >30 mg/dL, serum ferritin levels higher than normal, and a normocytic, normochromic morphology. What cause can be attributed to the anemia?

Explain how exposure to the following can lead to aplastic anemia. a. Chloramphenicol b. Benzene c. Gamma radiation d. Starvation

Which of the following puts a patient with long term exposure to benzene at risk for developing aplastic anemia?

List two examples of a congenital aplastic anemia.

Which of the following tests would help differentiate TEC from DBA?

What congenital defects are found in Fanconi's syndrome?

Chronic renal disease is a common cause of anemia. Which of the following is one of the possible causes of anemia in chronic renal disease?

Aplastic anemia in the acquired form can result from drugs or chemical agent exposure. If the link cannot be made to any environmental factor, what form of anemia does the client have?

Introduction

Cellular Homeostasis

Structure and Function of Hematopoietic Organs

Hematopoiesis

The Erythrocyte

Hemoglobin

Granulocytes and Monocytes

Lymphocytes

The Platelet

The Complete Blood Count and Peripheral Blood Smear Evaluation

Introduction to Anemia

Anemias of Disordered Iron Metabolism and Heme Synthesis

Hemoglobinopathies: Qualitative Defects

Thalassemia

Megaloblastic and Nonmegaloblastic Macrocytic Anemias

Hemolytic Anemia: Membrane Defects

Hemolytic Anemia: Enzyme Deficiencies

Hemolytic Anemia: Immune Anemias

Hemolytic Anemia: Nonimmune Defects

Nonmalignant Disorders of Leukocytes: Granulocytes and Monocytes

Nonmalignant Lymphocyte Disorders

Introduction to Hematopoietic Neoplasms

Myeloproliferative Neoplasms

Myelodysplastic Syndromes

Acute Myeloid Leukemias

Precursor Lymphoid Neoplasms

Mature Lymphoid Neoplasms

Hematopoietic Stem Cell Transplantation

Morphologic Analysis of Body Fluids in the Hematology

Primary Hemostasis

Secondary Hemostasis and Fibrinolysis

Disorders of Primary Hemostasis

Disorders of Secondary Hemostasis

Thrombophilia

Hemostasis: Laboratory Testing and Instrumentation

Hematology Procedures

Bone Marrow Examination

Automation in Hematology

Flow Cytometry

Chromosome Analysis of Hematopoietic and Lymphoid Disorders

Molecular Analysis of Hematologic Diseases

Quality Assessment in the Hematology Laboratory

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