Question 1

What is the morphological classification of megaloblastic anemia?

Accepted Answer

A)  Microcytic hypochromic 
B)  Macrocytic hypochromic 
C)  Macrocytic normochromic 
D)  Microcytic normochromic 
E)  Normocytic normochromic 
A)  Microcytic hypochromic 
B)  Macrocytic hypochromic 
C)  Macrocytic normochromic 
D)  Microcytic normochromic 
E)  Normocytic normochromic C

Question 2

What is most striking when viewing the peripheral smear of a severely anemic patient with megaloblastic anemia?

Accepted Answer

A)  Anisocytosis 
B)  Poikilocytosis 
C)  Macro-ovalocytes 
D)  Hypersegmented neutrophils 
E)  All of the above 
A)  Anisocytosis 
B)  Poikilocytosis 
C)  Macro-ovalocytes 
D)  Hypersegmented neutrophils 
E)  All of the above E

Question 3

What two dietary substances are essential for DNA synthesis?

Accepted Answer

A)  Folic acid/carotene 
B)  Vitamin B12/folic acid 
C)  Vitamin B12/cyanocobalamin 
D)  Iron/globin 
E)  Transferrin/vitamin B12 
A)  Folic acid/carotene 
B)  Vitamin B12/folic acid 
C)  Vitamin B12/cyanocobalamin 
D)  Iron/globin 
E)  Transferrin/vitamin B12 B

Question 4

In megaloblastic anemia, the absolute reticulocyte count is decreased as a result of:

Accepted Answer

A)  Effective erythropoiesis 
B)  Ineffective erythropoiesis 
C)  Medullary hematopoiesis 
D)  Extramedullary hematopoiesis 
E)  None of the above 
A)  Effective erythropoiesis 
B)  Ineffective erythropoiesis 
C)  Medullary hematopoiesis 
D)  Extramedullary hematopoiesis 
E)  None of the above

Question 5

In megaloblastic anemia, the band and metamyelocyte may exhibit:

Accepted Answer

A)  Toxic granulation 
B)  Auer rods 
C)  Giantism 
D)  Pelger-Huët anomaly 
E)  None of the above 
A)  Toxic granulation 
B)  Auer rods 
C)  Giantism 
D)  Pelger-Huët anomaly 
E)  None of the above

Question 6

The reversed myeloid-erythroid ratio in the bone marrow of a person with megaloblastic anemia is defined as:

Accepted Answer

A)  Myeloid hyperplasia 
B)  Erythroid hypoplasia 
C)  Erythroid hyperplasia 
D)  Hypocellularity 
E)  None of the above 
A)  Myeloid hyperplasia 
B)  Erythroid hypoplasia 
C)  Erythroid hyperplasia 
D)  Hypocellularity 
E)  None of the above

Question 7

Which cell lineage may also be affected by megaloblastic change?

Accepted Answer

A)  Megakaryocytic 
B)  Lymphocytic 
C)  Granulocytic 
D)  A and C 
E)  B and C 
A)  Megakaryocytic 
B)  Lymphocytic 
C)  Granulocytic 
D)  A and C 
E)  B and C

Question 8

What percentage of megaloblastic anemia is due to vitamin B12 or folic acid deficiency?

Accepted Answer

A)  50% 
B)  90% 
C)  40% 
D)  60% 
E)  20% 
A)  50% 
B)  90% 
C)  40% 
D)  60% 
E)  20%

Question 9

What is the most common red cell inclusion body seen in megaloblastic anemia?

Accepted Answer

A)  Cabot ring 
B)  Howell-Jolly body 
C)  Basophilic stippling 
D)  Hemoglobin H bodies 
E)  None of the above 
A)  Cabot ring 
B)  Howell-Jolly body 
C)  Basophilic stippling 
D)  Hemoglobin H bodies 
E)  None of the above

Question 10

Which hematologic condition is indicated with a macrocytosis and a reticulocyte count of >5%?

Accepted Answer

A)  Iron-deficiency anemia 
B)  Hemolytic anemia 
C)  Megaloblastic anemia 
D)  Thalassemia 
E)  None of the above 
A)  Iron-deficiency anemia 
B)  Hemolytic anemia 
C)  Megaloblastic anemia 
D)  Thalassemia 
E)  None of the above

Question 11

What findings distinguishes megaloblastic anemia due to vitamin B12 deficiency from that due to folate deficiency?

Accepted Answer

A)  Severe neurologic manifestation 
B)  Jaundice 
C)  Abnormal epithelial cells 
D)  High reticulocyte count 
E)  None of the above 
A)  Severe neurologic manifestation 
B)  Jaundice 
C)  Abnormal epithelial cells 
D)  High reticulocyte count 
E)  None of the above

Question 12

What is the etiology of ineffective hematopoiesis in megaloblastic anemia?

Accepted Answer

A)  Decreased mature cells in peripheral blood 
B)  Premature death of precursor cells in the bone marrow 
C)  Increased mature cells in peripheral blood 
D)  A and B 
E)  None of the above 
A)  Decreased mature cells in peripheral blood 
B)  Premature death of precursor cells in the bone marrow 
C)  Increased mature cells in peripheral blood 
D)  A and B 
E)  None of the above

Question 13

What statement is true regarding pancytopenia?

Accepted Answer

A)  Decreased RBC 
B)  Decreased white blood cells (WBCs) 
C)  Decreased platelets 
D)  All of the above 
E)  None of the above 
A)  Decreased RBC 
B)  Decreased white blood cells (WBCs) 
C)  Decreased platelets 
D)  All of the above 
E)  None of the above

Question 14

How is asynchrony defined?

Accepted Answer

A)  Normal nuclear and cytoplasm development of hematopoietic cells in bone marrow 
B)  Lack of normal nuclear and cytoplasm development of hematopoietic cells in the bone marrow 
C)  Lack of normal nuclear and cytoplasm development of hematopoietic cells in peripheral blood 
D)  Normal nuclear and cytoplasm development in hematopoietic cells in peripheral blood 
E)  None of the above 
A)  Normal nuclear and cytoplasm development of hematopoietic cells in bone marrow 
B)  Lack of normal nuclear and cytoplasm development of hematopoietic cells in the bone marrow 
C)  Lack of normal nuclear and cytoplasm development of hematopoietic cells in peripheral blood 
D)  Normal nuclear and cytoplasm development in hematopoietic cells in peripheral blood 
E)  None of the above

Question 15

The presence of polychromatophilic macrocytes in a treated megaloblastic anemia is due to:

Accepted Answer

A)  RBC degeneration 
B)  Reticulocytosis 
C)  Macrocytosis 
D)  Megaloblastoid dyspoiesis 
E)  None of the above 
A)  RBC degeneration 
B)  Reticulocytosis 
C)  Macrocytosis 
D)  Megaloblastoid dyspoiesis 
E)  None of the above

Question 16

Which of the following is a form of megaloblastic anemia?

Accepted Answer

A)  Pernicious anemia 
B)  Aplastic anemia 
C)  Sideroblastic anemia 
D)  Sickle cell anemia 
E)  None of the above 
A)  Pernicious anemia 
B)  Aplastic anemia 
C)  Sideroblastic anemia 
D)  Sickle cell anemia 
E)  None of the above

Question 17

All of the following are initial diagnostic tests performed simultaneously in determining the cause of macrocytosis except:

Accepted Answer

A)  Reticulocyte count 
B)  Serum and red cell folate 
C)  Schilling test 
D)  Serum vitamin B12 
E)  None of the above 
A)  Reticulocyte count 
B)  Serum and red cell folate 
C)  Schilling test 
D)  Serum vitamin B12 
E)  None of the above

Question 18

Where is vitamin B12 stored?

Accepted Answer

A)  Pancreas 
B)  Liver 
C)  Kidney 
D)  Bone marrow 
E)  None of the above 
A)  Pancreas 
B)  Liver 
C)  Kidney 
D)  Bone marrow 
E)  None of the above

Question 19

What is the primary cause of vitamin B12 deficiency?

Accepted Answer

A)  Fish tapeworm infection 
B)  Malabsorption 
C)  Poor diet 
D)  Transportation defect 
E)  None of the above 
A)  Fish tapeworm infection 
B)  Malabsorption 
C)  Poor diet 
D)  Transportation defect 
E)  None of the above

Question 20

What hematologic parameter on an automated instrument would be increased in megaloblastic anemia?

Accepted Answer

A)  MCH (mean corpuscular hemoglobin) 
B)  MCHC (mean corpuscular hemoglobin concentration) 
C)  MCV (mean corpuscular volume) 
D)  RBC count 
E)  None of the above 
A)  MCH (mean corpuscular hemoglobin) 
B)  MCHC (mean corpuscular hemoglobin concentration) 
C)  MCV (mean corpuscular volume) 
D)  RBC count 
E)  None of the above

Exam 7: Megaloblastic Anemias

What is the morphological classification of megaloblastic anemia?

What is most striking when viewing the peripheral smear of a severely anemic patient with megaloblastic anemia?

What two dietary substances are essential for DNA synthesis?

In megaloblastic anemia, the absolute reticulocyte count is decreased as a result of:

In megaloblastic anemia, the band and metamyelocyte may exhibit:

The reversed myeloid-erythroid ratio in the bone marrow of a person with megaloblastic anemia is defined as:

Which cell lineage may also be affected by megaloblastic change?

What percentage of megaloblastic anemia is due to vitamin B12 or folic acid deficiency?

What is the most common red cell inclusion body seen in megaloblastic anemia?

Which hematologic condition is indicated with a macrocytosis and a reticulocyte count of >5%?

What findings distinguishes megaloblastic anemia due to vitamin B12 deficiency from that due to folate deficiency?

What is the etiology of ineffective hematopoiesis in megaloblastic anemia?

What statement is true regarding pancytopenia?

How is asynchrony defined?

The presence of polychromatophilic macrocytes in a treated megaloblastic anemia is due to:

Which of the following is a form of megaloblastic anemia?

All of the following are initial diagnostic tests performed simultaneously in determining the cause of macrocytosis except:

Where is vitamin B12 stored?

What is the primary cause of vitamin B12 deficiency?

What hematologic parameter on an automated instrument would be increased in megaloblastic anemia?

Morphology of Human Blood and Marrow Cells: Hematopoiesis

Bone Marrow

The Red Blood Cell: Structure and Function

Anemia: Diagnosis and Clinical Considerations

Evaluation of Red Blood Cell Morphology and Introduction to Platelet and White Blood Cell Morphology

Iron Metabolism and Hypochromic Anemias

Aplastic Anemia Including Pure Red Cell Aplasia and Congenital Dyserythropoietic Anemia and Paroxysmal Nocturnal Hemoglobinuria

Introduction to Hemolytic Anemias: Intracorpuscular Defects: I Hereditary Defects of the Red Cell Membrane

Hemolytic Anemias: Intracorpuscular Defects: II Hereditary Enzyme Deficiencies

Hemolytic Anemias: Intracorpuscular Defects: III the Hemoglobinopathies

Hemolytic Anemias: Intracorpuscular Defects: Iv Thalassemia

Hemolytic Anemias: Extracorpuscular Defects

Hypoproliferative Anemia: Anemia Associated With Systemic Diseases

Cell Biology, Disorders of Neutrophils, Infectious Mononucleosis, and Reactive Lymphocytosis

Introduction to Leukemia and the Acute Leukemias

Chronic Myeloproliferative Disorders I: Chronic Myelogenous Leukemia

Chronic Myeloproliferative Disorders Ii: Polycythemia Vera, Essential Thrombocythemia, and Idiopathic Myelofibrosis

Myelodysplastic Syndromes

Chronic Lymphocytic Leukemia and Related Lymphoproliferative Disorders

The Lymphomas

Multiple Myeloma and Related Plasma Cell Disorders

Lipid Lysosomal Storage Diseases and Histiocytosis

Introduction to Hemostasis

Disorders of Primary Hemostasis: Quantitative and Qualitative Platelet Disorders and Vascular Disorders

Disorders of Plasma Clotting Factors

Interaction of the Fibrinolytic, Coagulation, and Kinin Systems; Disseminated Intravascular Coagulation; and Related Pathology

Introduction to Thrombosis and Anticoagulant Therapy

Quality Control in the Hematology Laboratory

Body Fluid Examination: the Qualitative, Quantitative, and Morphologic Analysis of Serous, Cerebrospinal, and Synovial Fluids

Hematology Methods

Principles of Automated Differential Analysis

Coagulation Procedures

Applications of Flow Cytometry to Hematology and Hemostasis

Molecular Diagnostic Techniques in Hematopathology

Special Stainscytochemistry

Filters

What percentage of megaloblastic anemia is due to vitamin B₁₂or folic acid deficiency?

What findings distinguishes megaloblastic anemia due to vitamin B₁₂deficiency from that due to folate deficiency?

Where is vitamin B₁₂stored?

What is the primary cause of vitamin B₁₂deficiency?