Deck 6: The Macrocytic Anemias

Question 1

One of the most common pathophysiologies that contribute to folic acid deficiency is:

A)Tropical sprue
B)Intrinsic factor deficiency
C)IDA
D)Infection with Diphyllobothrium latum

Answer 1

A

Question 2

Which MCV range is indicative of pernicious anemia?

A)70 to 80 fL
B)85 to 95 fL
C)110 to 120 fL
D)90 to 98 fL

Answer 2

C

Question 3

Which of the following is a clinical symptom specific to megaloblastic anemia?

A)Fever
B)Numbness and trouble with balance
C)Pallor
D)Splenomegaly

Answer 3

B

Question 4

Which of the following describes ineffective erythropoiesis?

A)An increase in the M:E ratio
B)A synthetic defect in hemoglobin
C)Premature destruction of red blood cell precursors
D)A DNA maturation defect

Question 5

Evidence of ineffective erythropoiesis in the CBC of patients with megaloblastic anemia are:

A)Anemia, thrombocytopenia, leukopenia
B)Anemia, thrombocytosis, leukopenia
C)Anemia, thrombophilia, leukocytosis
D)Anemia, thrombocytosis, leukopenia

Question 6

The Schilling test continues to be a historic reference method for the determination of:

A)IDA
B)Pernicious anemia
C)Folic acid deficiency
D)Hereditary hemochromatosis

Question 7

Which of the following red blood cell morphologies is classic in the megaloblastic anemias?

A)Polychromasia
B)Macroovalocytes
C)Basophilic stippling
D)Hypochromia

Question 8

All of the following are possible causes of low levels of intrinsic factor (IF) except which statement?

A)Partial gastrectomy may lead to the lack of IF.
B)Fifty-six percent of patients with pernicious anemia have antibodies to IF.
C)Atrophic gastritis may lead to the lack of IF.
D)Kidney failure may lead to lack of IF.

Question 9

A macrocytosis that is not megaloblastic in origin can be seen in all of the following except:

A)Chemotherapy
B)Postsplenectomy
C)Hypoglycemic patients
D)Reticulocytosis

Question 10

Which of the following can distinguish treated versus untreated megaloblastic anemia?

A)Polychromasia
B)Hypochromia
C)Howell-Jolly bodies
D)Siderocytes

Question 11

Macrocytic red blood cells are routinely seen in all the following except:

A)Pernicious anemia
B)Liver disease
C)Response to anemic stress
D)Thalassemia

Question 12

A bone marrow aspiration/examination is not necessary for patients with megaloblastic anemia.

Question 13

Which of the following is a key substance required for the incorporation of vitamin B₁₂ in the nuclear synthesis of red blood cells?

A)EPO
B)Transferrin
C)Intrinsic factor
D)Cytokines

Question 14

Which of the following terms describes the appearance of the erythropoietic precursors in the megaloblastic process?

A)Ordered arrangement of chromatin
B)Asynchrony
C)Eccentric nucleus
D)Pale cytoplasm

Question 15

Intrinsic factor is secreted by the:

A)Parietal cells of the stomach
B)Ileum
C)Thyroid
D)Bone marrow

Question 16

What would be an appropriate M:E ratio in the case of megaloblastic anemia?

A)1:3
B)4:1
C)5:1
D)1:10