Question 1

A patient develops an immunoglobulin G (IgG)antibody that causes red cells to be destroyed by the spleen.This is what type of hemolysis?

Accepted Answer

A) inherited, intrinsic, extravascular, immune 
B) acquired, extrinsic, extravascular, immune 
C) acquired, intrinsic, intravascular, immune 
D) acquired, extrinsic, intravascular, traumatic 
A) inherited, intrinsic, extravascular, immune 
B) acquired, extrinsic, extravascular, immune 
C) acquired, intrinsic, intravascular, immune 
D) acquired, extrinsic, intravascular, traumatic B

Question 2

Unconjugated or indirect bilirubin is normally found in

Accepted Answer

A) plasma 
B) erythrocytes 
C) urine 
D) intestines 
A) plasma 
B) erythrocytes 
C) urine 
D) intestines A

Question 3

A plasma sample appears hemolyzed or red.Which of the following is true?

Accepted Answer

A) The patient has extravascular hemolysis. 
B) The patient has increased haptoglobin. 
C) The patient has increased hemopexin. 
D) The plasma hemoglobin is greater than 50 mg/dL. 
A) The patient has extravascular hemolysis. 
B) The patient has increased haptoglobin. 
C) The patient has increased hemopexin. 
D) The plasma hemoglobin is greater than 50 mg/dL. D

Question 4

Laboratory tests indicate that an female adult has an increased rate of red cell destruction in the circulation.Her hematocrit is 39%.Which of the following describes her hemolytic disorder?

Accepted Answer

A) mild 
B) moderate 
C) acute 
D) compensated 
A) mild 
B) moderate 
C) acute 
D) compensated

Question 5

The presence of hemoglobinuria,hemosiderinuria,and hemoglobinemia indicate that hemolysis is

Accepted Answer

A) severe. 
B) acquired. 
C) compensated. 
D) intravascular. 
A) severe. 
B) acquired. 
C) compensated. 
D) intravascular.

Question 6

How are normal red cells removed when they lose the ability to deform?

Accepted Answer

A) After 120 days, most are phagocytized by splenic macrophages. 
B) After 10 to 14 days, most are phagocytized by splenic macrophages. 
C) After 10 to 14 days, most are destroyed by complement. 
D) After 120 days, most are destroyed inside the blood vessels. 
A) After 120 days, most are phagocytized by splenic macrophages. 
B) After 10 to 14 days, most are phagocytized by splenic macrophages. 
C) After 10 to 14 days, most are destroyed by complement. 
D) After 120 days, most are destroyed inside the blood vessels.

Question 7

A urine sediment stains with Prussian blue.The patient probably has

Accepted Answer

A) hemoglobinemia. 
B) a membrane defect. 
C) compensated hemolysis. 
D) extravascular hemolysis. 
A) hemoglobinemia. 
B) a membrane defect. 
C) compensated hemolysis. 
D) extravascular hemolysis.

Question 8

Which of the following is the most specific indicator of accelerated intravascular red cell destruction?

Accepted Answer

A) increased serum bilirubin 
B) increased haptoglobin 
C) decreased hematocrit 
D) decreased haptoglobin 
A) increased serum bilirubin 
B) increased haptoglobin 
C) decreased hematocrit 
D) decreased haptoglobin

Question 9

What characteristic red cell shape is associated with extravascular hemolysis?

Accepted Answer

A) spherocyte 
B) schistocyte 
C) target cell 
D) burr cell 
A) spherocyte 
B) schistocyte 
C) target cell 
D) burr cell

Question 10

Which of the following test results suggests red blood cell (RBC)survival is significantly decreased from the normal of 120 days?

Accepted Answer

A) decreased glycated hemoglobin 
B) a T1/2 Cr of 30 days 
C) normal haptoglobin 
D) decreased lactic dehydrogenase 
A) decreased glycated hemoglobin 
B) a T1/2 Cr of 30 days 
C) normal haptoglobin 
D) decreased lactic dehydrogenase

Question 11

Which of the following is found normally in urine?

Accepted Answer

A) conjugated bilirubin 
B) urobilinogen 
C) stercobilin 
D) unconjugated bilirubin 
A) conjugated bilirubin 
B) urobilinogen 
C) stercobilin 
D) unconjugated bilirubin

Question 12

Which of the following clinical findings specifically suggests,if it is present,extravascular hemolysis?

Accepted Answer

A) increased heart rate 
B) splenomegaly 
C) pallor 
D) fatigue 
A) increased heart rate 
B) splenomegaly 
C) pallor 
D) fatigue

Question 13

Which of the following is decreased in intravascular hemolysis?

Accepted Answer

A) haptoglobin 
B) urine hemoglobin 
C) serum hemoglobin 
D) urine urobilinogen 
A) haptoglobin 
B) urine hemoglobin 
C) serum hemoglobin 
D) urine urobilinogen

Question 14

All of the following are often seen in various types of hemolytic anemia except

Accepted Answer

A) schistocytes. 
B) spherocytes. 
C) polychromasia. 
D) hypochromasia. 
A) schistocytes. 
B) spherocytes. 
C) polychromasia. 
D) hypochromasia.

Question 15

Which of the following tests for hemolysis is easiest and safest for the patient?

Accepted Answer

A) reticulocyte count 
B) red cell survival with labeled chromium 
C) bone marrow biopsy 
D) cross-transfusion studies 
A) reticulocyte count 
B) red cell survival with labeled chromium 
C) bone marrow biopsy 
D) cross-transfusion studies

Question 16

Which of the following suggests ongoing hemolysis in a patient who has not had massive blood loss or been hemodiluted?

Accepted Answer

A) reticulocyte production index (RPI) of 1 
B) reticulocyte count of 1.3% 
C) drop in hemoglobin of 1.3 g/dL in 1 week 
D) hemoglobin falling 0.5 g/dL 
A) reticulocyte production index (RPI) of 1 
B) reticulocyte count of 1.3% 
C) drop in hemoglobin of 1.3 g/dL in 1 week 
D) hemoglobin falling 0.5 g/dL

Question 17

What are the bone marrow findings in hemolytic anemia?

Accepted Answer

A) myeloid-to-erythroid (M:
E)  ratio of 1:1 
B) M:E ratio of 5:1 
C) reduced cellularity and increased fat 
D) erythroid hypoplasia 
A) myeloid-to-erythroid (M:
E)  ratio of 1:1 
B) M:E ratio of 5:1 
C) reduced cellularity and increased fat 
D) erythroid hypoplasia

Question 18

Which of the following are typical findings in extravascular hemolysis?

Accepted Answer

A) increased serum and urine conjugated bilirubin 
B) increased serum and urine unconjugated bilirubin 
C) increased serum unconjugated bilirubin and increased urine urobilinogen 
D) decreased urine and stool conjugated bilirubin 
A) increased serum and urine conjugated bilirubin 
B) increased serum and urine unconjugated bilirubin 
C) increased serum unconjugated bilirubin and increased urine urobilinogen 
D) decreased urine and stool conjugated bilirubin

Question 19

An elevated reticulocyte count rules out which of the following?

Accepted Answer

A) acute blood loss 
B) aplastic crisis 
C) acute hemolysis 
D) successful patient response to iron therapy 
A) acute blood loss 
B) aplastic crisis 
C) acute hemolysis 
D) successful patient response to iron therapy

Question 20

The presence of schistocytes in the peripheral blood indicates which of the following processes?

Accepted Answer

A) iron deficiency anemia 
B) intravascular hemolysis 
C) megaloblastic anemia 
D) extravascular hemolysis 
A) iron deficiency anemia 
B) intravascular hemolysis 
C) megaloblastic anemia 
D) extravascular hemolysis

Exam 23: Introduction to Increased Destruction of Erythrocytes

A patient develops an immunoglobulin G (IgG)antibody that causes red cells to be destroyed by the spleen.This is what type of hemolysis?

Unconjugated or indirect bilirubin is normally found in

A plasma sample appears hemolyzed or red.Which of the following is true?

Laboratory tests indicate that an female adult has an increased rate of red cell destruction in the circulation.Her hematocrit is 39%.Which of the following describes her hemolytic disorder?

The presence of hemoglobinuria,hemosiderinuria,and hemoglobinemia indicate that hemolysis is

How are normal red cells removed when they lose the ability to deform?

A urine sediment stains with Prussian blue.The patient probably has

Which of the following is the most specific indicator of accelerated intravascular red cell destruction?

What characteristic red cell shape is associated with extravascular hemolysis?

Which of the following test results suggests red blood cell (RBC)survival is significantly decreased from the normal of 120 days?

Which of the following is found normally in urine?

Which of the following clinical findings specifically suggests,if it is present,extravascular hemolysis?

Which of the following is decreased in intravascular hemolysis?

All of the following are often seen in various types of hemolytic anemia except

Which of the following tests for hemolysis is easiest and safest for the patient?

Which of the following suggests ongoing hemolysis in a patient who has not had massive blood loss or been hemodiluted?

What are the bone marrow findings in hemolytic anemia?

Which of the following are typical findings in extravascular hemolysis?

An elevated reticulocyte count rules out which of the following?

The presence of schistocytes in the peripheral blood indicates which of the following processes?

An Overview of Clinical Laboratory Hematology

Safety in the Hematology Laboratory

Blood Specimen Collection

Care and Use of the Microscope

Quality Assurance in Hematology and Hemostasis Testing

Cellular Structure and Function

Hematopoiesis

Erythrocyte Production and Destruction

Erythrocyte Metabolism and Membrane Structure and Function

Hemoglobin Metabolism

Iron Kinetics and Laboratory Assessment

Leukocyte Development, Kinetics, and Functions

Platelet Production, Structure, and Function

Manual, Semiautomated and Point-of-Care Testing in Hematology

Automated Blood Cell Analysis

Examination of the Peripheral Blood Film and Correlation with the Complete Blood Count

Bone Marrow Examination

Body Fluid Analysis in the Hematology Laboratory

Anemias: Red Blood Cell Morphology and Approach to Diagnosis

Disorders of Iron Kinetics and Heme Metabolism

Anemias Caused by Defects of DNA Metabolism

Bone Marrow Failure

Intrinsic Defects Leading to Increased Erythrocyte Destruction

Extrinsic Defects Leading to Increased Erythrocyte Destruction Nonimmune Causes

Extrinsic Defects Leading to Increased Erythrocyte Destruction Immune Causes

Hemoglobinopathies (Structural Defects in Hemoglobin)

Thalassemias

Nonmalignant Leukocyte Disorders

Cytogenetics

Molecular Diagnostics in Hematopathology

Flow Cytometric Analysis in Hematologic Disorders

Myeloproliferative Neoplasms

Myelodysplastic Syndromes

Acute Leukemias

Mature Lymphoid Neoplasms

Normal Hemostasis and Coagulation

Hemorrhagic Disorders and Laboratory Assessment

Thrombotic Disorders and Laboratory Assessment

Thrombocytopenia and Thrombocytosis

Qualitative Disorders of Platelets and Vasculature

Laboratory Evaluation of Hemostasis

Antithrombotic Therapies and their Laboratory Assessment

Hemostasis and Coagulation Instrumentation

Pediatric and Geriatric Hematology and Hemostasis

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