Question 1

Which of the following are key features found in nonmegaloblastic macrocytosis?

Accepted Answer

A) Oval red blood cells 
B) Hypersegmented neutrophils 
C) Jaundice,glossitis,and neuropathy 
D) Round macrocytes 
A) Oval red blood cells 
B) Hypersegmented neutrophils 
C) Jaundice,glossitis,and neuropathy 
D) Round macrocytes D

Question 2

Predict the levels of MMA and homocysteine in patients with Vitamin B₁₂ deficiency.

Accepted Answer

A) Both will be normal. 
B) Both will be decreased. 
C) Both will be increased. 
D) MMA will be increased and homocysteine will be normal. 
A) Both will be normal. 
B) Both will be decreased. 
C) Both will be increased. 
D) MMA will be increased and homocysteine will be normal. C

Question 3

The reason that lack of vitamin B₁₂ causes megaloblastic changes is that vitamin B₁₂ :

Accepted Answer

A) Is needed for the formation of nucleotide bases 
B) Is needed for the conversion of methionine to SAM 
C) Initiates mitosis 
D) Is needed for synthesis of intrinsic factor 
A) Is needed for the formation of nucleotide bases 
B) Is needed for the conversion of methionine to SAM 
C) Initiates mitosis 
D) Is needed for synthesis of intrinsic factor A

Question 4

What conditions listed can result in macrocytic anemia without megaloblastosis?

Accepted Answer

A) Diabetes 
B) Liver disease 
C) Myelodysplastic syndrome 
D) Pernicious anemia 
A) Diabetes 
B) Liver disease 
C) Myelodysplastic syndrome 
D) Pernicious anemia

Question 5

Neurological symptoms are prevalent in Vitamin B₁₂ deficiency because of:

Accepted Answer

A) Antibodies to intrinsic factor 
B) Decreased secretion of intrinsic factor 
C) Improper fatty acid metabolism 
D) Improper metabolism of methionine 
A) Antibodies to intrinsic factor 
B) Decreased secretion of intrinsic factor 
C) Improper fatty acid metabolism 
D) Improper metabolism of methionine

Question 6

Which of the following is found in megaloblastic macrocytosis but not in nonmegaloblastic macrocytosis?

Accepted Answer

A) Decreased WBC count and vitamin B₁₂ levels 
B) Decreased hemoglobin and hematocrit 
C) Normal-to-decreased reticulocyte count 
D) Increased serum bilirubin 
A) Decreased WBC count and vitamin B₁₂ levels 
B) Decreased hemoglobin and hematocrit 
C) Normal-to-decreased reticulocyte count 
D) Increased serum bilirubin

Question 7

Deficiencies in folic acid lead to which of the following?

Accepted Answer

A) Nuclear cytoplasmic asynchrony 
B) Absence of nuclear division 
C) Excessive proliferation of myeloid precursors 
D) Decreased proliferation of erythroid precursors 
A) Nuclear cytoplasmic asynchrony 
B) Absence of nuclear division 
C) Excessive proliferation of myeloid precursors 
D) Decreased proliferation of erythroid precursors

Question 8

Which test is a better indicator of folate status in the body over the past month?

Accepted Answer

A) Folate level 
B) RBC folate level 
C) Vitamin B₁₂ level 
D) MMA 
A) Folate level 
B) RBC folate level 
C) Vitamin B₁₂ level 
D) MMA

Question 9

Explain why patients undergoing gastric bypass surgery are prone to developing pernicious anemia.

Accepted Answer

Gastric bypass involves resection of the

Question 10

Explain why peripheral neuropathy is a common finding in vitamin B₁₂ deficiency.

Accepted Answer

In vitamin B₁₂ deficiency,there is a def

Question 11

Autoantibodies against parietal cells and intrinsic factor are associated with:

Accepted Answer

A) Grave's disease 
B) Hashimoto's thyroiditis 
C) Addison's disease 
D) Pernicious anemia 
A) Grave's disease 
B) Hashimoto's thyroiditis 
C) Addison's disease 
D) Pernicious anemia

Question 12

5-7.Use this case to answer the following questions.A 55-year-old male consulted his physician because of weakness,lightheadedness,vertigo,and angina.The patient also complained of sores on his tongue.The physical examination revealed jaundice.The pulse rate was increased,and the spleen and liver were slightly enlarged.The tongue appeared smooth and bright red in color.Family history revealed no clues.Neurological exam revealed quickening of reflex responses.Patient history indicated a total gastrectomy five years earlier for stomach cancer and intermittent heart problems that had not required surgery.The physician ordered the following tests:  
-What is (are)the most appropriate reflex test(s)?

Accepted Answer

A) Iron studies 
B) Bilirubin 
C) Vitamin B₁₂ and folate levels 
D) Hemoglobin electrophoresis 
A) Iron studies 
B) Bilirubin 
C) Vitamin B₁₂ and folate levels 
D) Hemoglobin electrophoresis

Question 13

Name four causes of folate deficiency.How would they differ in results in regard to serum and RBC folate levels?

Accepted Answer

(a)Decreased dietary intake,(b

Question 14

Vitamin B₁₂ is a cofactor used in the conversion of _______ to _______.

Accepted Answer

A) Hydroxocobalamin;thymidine 
B) 5-methyltetrahydrofolate;tetrahydrofolate 
C) Folate;methionine 
D) Succinyl CoA;methylmalonic acid 
A) Hydroxocobalamin;thymidine 
B) 5-methyltetrahydrofolate;tetrahydrofolate 
C) Folate;methionine 
D) Succinyl CoA;methylmalonic acid

Question 15

Which clinical manifestation is common in vitamin B₁₂ deficiency but not in folate deficiency?

Accepted Answer

A) Glossitis 
B) Pallor 
C) Fatigue 
D) Peripheral neuropathy 
A) Glossitis 
B) Pallor 
C) Fatigue 
D) Peripheral neuropathy

Question 16

Macrocytes are often seen in hospitalized alcoholics because of:

Accepted Answer

A) Alcohol toxicity on erythroid precursors 
B) Stimulated erythropoiesis 
C) Reticulocytosis 
D) Iron deficiency 
A) Alcohol toxicity on erythroid precursors 
B) Stimulated erythropoiesis 
C) Reticulocytosis 
D) Iron deficiency

Question 17

Pernicious anemia is a disorder characterized by:

Accepted Answer

A) Antivitamin B₁₂ antibodies 
B) Lack of IF 
C) Improper dietary intake of vitamin B₁₂ 
D) Increased absorption of vitamin B₁₂ 
A) Antivitamin B₁₂ antibodies 
B) Lack of IF 
C) Improper dietary intake of vitamin B₁₂ 
D) Increased absorption of vitamin B₁₂

Question 18

5-7.Use this case to answer the following questions.A 55-year-old male consulted his physician because of weakness,lightheadedness,vertigo,and angina.The patient also complained of sores on his tongue.The physical examination revealed jaundice.The pulse rate was increased,and the spleen and liver were slightly enlarged.The tongue appeared smooth and bright red in color.Family history revealed no clues.Neurological exam revealed quickening of reflex responses.Patient history indicated a total gastrectomy five years earlier for stomach cancer and intermittent heart problems that had not required surgery.The physician ordered the following tests:  
-What would be the results of vitamin B₁₂ and/or folate levels in a diagnosis of pernicious anemia?

Accepted Answer

A) Increased folate 
B) Increased vitamin B₁₂ 
C) Decreased vitamin B₁₂ 
D) Decreased folate and vitamin B₁₂ 
A) Increased folate 
B) Increased vitamin B₁₂ 
C) Decreased vitamin B₁₂ 
D) Decreased folate and vitamin B₁₂

Question 19

Pernicious anemia is a malabsorption of vitamin B₁₂ from what component deficiency?

Accepted Answer

A) Gastric juice 
B) Intrinsic factor 
C) Histamine 
D) Folate 
A) Gastric juice 
B) Intrinsic factor 
C) Histamine 
D) Folate

Question 20

What diagnosis is suggested if part II of the Schilling test is more than 7.5% when part I was 1%?

Accepted Answer

A) Sprue 
B) Pernicious anemia 
C) Renal disease 
D) Celiac disease 
A) Sprue 
B) Pernicious anemia 
C) Renal disease 
D) Celiac disease

Exam 15: Megaloblastic and Nonmegaloblastic Macrocytic Anemias

Which of the following are key features found in nonmegaloblastic macrocytosis?

Predict the levels of MMA and homocysteine in patients with Vitamin B₁₂ deficiency.

The reason that lack of vitamin B₁₂ causes megaloblastic changes is that vitamin B₁₂ :

What conditions listed can result in macrocytic anemia without megaloblastosis?

Neurological symptoms are prevalent in Vitamin B₁₂ deficiency because of:

Which of the following is found in megaloblastic macrocytosis but not in nonmegaloblastic macrocytosis?

Deficiencies in folic acid lead to which of the following?

Which test is a better indicator of folate status in the body over the past month?

Explain why patients undergoing gastric bypass surgery are prone to developing pernicious anemia.

Explain why peripheral neuropathy is a common finding in vitamin B₁₂ deficiency.

Autoantibodies against parietal cells and intrinsic factor are associated with:

Name four causes of folate deficiency.How would they differ in results in regard to serum and RBC folate levels?

Vitamin B₁₂ is a cofactor used in the conversion of _______ to _______.

Which clinical manifestation is common in vitamin B₁₂ deficiency but not in folate deficiency?

Macrocytes are often seen in hospitalized alcoholics because of:

Pernicious anemia is a disorder characterized by:

Pernicious anemia is a malabsorption of vitamin B₁₂ from what component deficiency?

What diagnosis is suggested if part II of the Schilling test is more than 7.5% when part I was 1%?

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

Hypoproliferative 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 Laboratory

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

Filters

Vitamin B₁₂ is a cofactor used in the conversion of _ to _.