Question 1

What can falsely elevate the serum folate level?

Accepted Answer

A) Hemolysis of the serum sample 
B) Recent low dietary intake 
C) Vitamin B₁₂ deficiency 
D) Recent alcohol consumption 
A) Hemolysis of the serum sample 
B) Recent low dietary intake 
C) Vitamin B₁₂ deficiency 
D) Recent alcohol consumption

Question 2

Megaloblastic anemia is characterized by:

Accepted Answer

A) Hypersegmentation of PMNs 
B) Presence of Heinz bodies 
C) hypochromia 
D) Microcytosis 
A) Hypersegmentation of PMNs 
B) Presence of Heinz bodies 
C) hypochromia 
D) Microcytosis

Question 3

All of the following disorders can lead to macrocytic anemia except:

Accepted Answer

A) Alcoholism 
B) Liver disease 
C) Hypothyroidism 
D) Iron deficiency 
A) Alcoholism 
B) Liver disease 
C) Hypothyroidism 
D) Iron deficiency

Question 4

Megaloblastic anemia is most often caused by deficiencies of what two components?

Accepted Answer

A) Iron and transferrin 
B) Ferritin and hemoglobin 
C) Vitamin B₁₂ and folate 
D) Iron and liver disease 
A) Iron and transferrin 
B) Ferritin and hemoglobin 
C) Vitamin B₁₂ and folate 
D) Iron and liver disease

Question 5

An analyzed blood specimen reveals the following: the MCV is increased,the hemoglobin level is decreased,and the reticulocyte count is normal or low.What test could give more information on the cause of the anemia without drawing another blood specimen?

Accepted Answer

A) Serum iron 
B) Vitamin B₁₂ assay 
C) Blood smear morphological exam 
D) Serum alcohol 
A) Serum iron 
B) Vitamin B₁₂ assay 
C) Blood smear morphological exam 
D) Serum alcohol

Question 6

Explain how high alcohol intake can cause macrocytosis.

Accepted Answer

Causes of macrocytosis in alcohol abuse

Question 7

The nuclear cytoplasmic asynchronous morphology in megaloblastosis is best characterized by:

Accepted Answer

A) Nuclear immaturity with cytoplasmic maturity 
B) Nuclear maturity with cytoplasmic immaturity 
C) Nuclear maturity with abundant cytoplasm 
D) Normal nuclear and cytoplasmic maturity 
A) Nuclear immaturity with cytoplasmic maturity 
B) Nuclear maturity with cytoplasmic immaturity 
C) Nuclear maturity with abundant cytoplasm 
D) Normal nuclear and cytoplasmic maturity

Question 8

Explain how vitamin B₁₂ deficiency can cause folate deficiency.

Accepted Answer

Vitamin B₁₂ is needed to conve

Question 9

It is much easier to become folate-deficient than B₁₂ -deficient because:

Accepted Answer

A) The body utilizes folate more quickly than it does vitamin B₁₂ . 
B) The body has larger vitamin B₁₂ stores than folate stores. 
C) The body has a greater need for folate than for vitamin B₁₂ . 
D) It has not been determined why the body needs folate more than vitamin B₁₂ . 
A) The body utilizes folate more quickly than it does vitamin B₁₂ . 
B) The body has larger vitamin B₁₂ stores than folate stores. 
C) The body has a greater need for folate than for vitamin B₁₂ . 
D) It has not been determined why the body needs folate more than vitamin B₁₂ .

Question 10

The defect in DNA synthesis associated with megaloblastic anemia affects which cells?

Accepted Answer

A) Only erythrocytes 
B) Only gastric cells and WBCs 
C) Only neurological cells 
D) All dividing cells 
A) Only erythrocytes 
B) Only gastric cells and WBCs 
C) Only neurological cells 
D) All dividing cells

Question 11

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

Accepted Answer

A) Macrocytic erythrocytes 
B) Howell-Jolly bodies 
C) Heinz bodies 
D) Hypochromia 
A) Macrocytic erythrocytes 
B) Howell-Jolly bodies 
C) Heinz bodies 
D) Hypochromia

Question 12

The majority of PA patients have antibodies against what component necessary for vitamin B₁₂ absorption?

Accepted Answer

A) Parietal cells 
B) Vitamin B₁₂ 
C) Intrinsic factor 
D) Blocking antibody 
A) Parietal cells 
B) Vitamin B₁₂ 
C) Intrinsic factor 
D) Blocking antibody

Question 13

Patients with blind loop syndrome can have vitamin B₁₂ deficiency complications resulting from:

Accepted Answer

A) Inadequate diet 
B) Increased minimum daily requirements 
C) Malabsorption 
D) Biologic competition 
A) Inadequate diet 
B) Increased minimum daily requirements 
C) Malabsorption 
D) Biologic competition

Question 14

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:  
-All of the following are expected laboratory findings of PA except:

Accepted Answer

A) Decreased vitamin B₁₂ levels 
B) Increased MMA in the urine 
C) Part I of Schilling test = 5%;part II of Schilling test = 10% 
D) Part I of Schilling test = 2.5%;part II of Schilling test = 2.5% 
A) Decreased vitamin B₁₂ levels 
B) Increased MMA in the urine 
C) Part I of Schilling test = 5%;part II of Schilling test = 10% 
D) Part I of Schilling test = 2.5%;part II of Schilling test = 2.5%

Exam 15: Megaloblastic and Nonmegaloblastic Macrocytic Anemias

What can falsely elevate the serum folate level?

Megaloblastic anemia is characterized by:

All of the following disorders can lead to macrocytic anemia except:

Megaloblastic anemia is most often caused by deficiencies of what two components?

An analyzed blood specimen reveals the following: the MCV is increased,the hemoglobin level is decreased,and the reticulocyte count is normal or low.What test could give more information on the cause of the anemia without drawing another blood specimen?

Explain how high alcohol intake can cause macrocytosis.

The nuclear cytoplasmic asynchronous morphology in megaloblastosis is best characterized by:

Explain how vitamin B₁₂ deficiency can cause folate deficiency.

It is much easier to become folate-deficient than B₁₂ -deficient because:

The defect in DNA synthesis associated with megaloblastic anemia affects which cells?

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

The majority of PA patients have antibodies against what component necessary for vitamin B₁₂ absorption?

Patients with blind loop syndrome can have vitamin B₁₂ deficiency complications resulting from:

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

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