Deck 14: Hypoproliferative Anemia: Anemia Associated With Systemic Diseases

Question 1

The presence of both immature white and red cells on a peripheral smear is referred to as:

A) Leukoerythrocytopenia
B) Leukoerythroblastosis
C) Leukoerythrocytosis
D) Myelophthisic
E) Leukopenia

Answer 1

Leukoerythroblastosis

Question 2

Which of the following lists of laboratory findings would be most characteristic of the anemia of chronic disease?

A) Normocytic, hypochromic anemia; high serum iron level; increased TIBC; decreased ferritin levels
B) Normocytic, normochromic anemia; low serum iron level; decreased TIBC; increased ferritin levels
C) Microcytic, hypochromic anemia; normal serum iron level; decreased TIBC; normal ferritin levels
D) Macrocytic, normochromic anemia; low serum iron level; decreased TIBC; decreased ferritin levels

Answer 2

Normocytic, normochromic anemia; low serum iron level; decreased TIBC; increased ferritin levels

Question 3

In the anemia of inflammation, one of the ways the body attempts to compensate for the anemia is:

A) An increase in EPO (erythropoietin) production by kidneys
B) A decrease in EPO (erythropoietin) production by kidneys
C) An increase in iron stores
D) An increase in hemoglobin synthesis
E) An increase in transferrin synthesis

Answer 3

An increase in EPO (erythropoietin) production by kidneys

Question 4

Chronic blood loss in a patient with malignancy results in __________ anemia.

A) Hyperchromic
B) Hypochromic
C) Normochromic
D) Infection-associated
E) None of the above

Question 5

Macrocytosis in liver disease is caused by all of the following except:

A) Abnormal lipid metabolism
B) Direct effects of alcohol
C) Iron deficiency
D) Vitamin B₁₂ and folate deficiency
E) B and D are correct

Question 6

The term that best describes bone marrow infiltration by malignant tumors is:

A) Myelofibrosis
B) Myelodysplasia
C) Myelophthisic
D) Myeloproliferative
E) Hyperproliferative

Question 7

The anemia of inflammation can be differentiated from iron-deficiency anemia by which of the following?

A) Serum iron level
B) Bone marrow iron stores
C) FEP
D) % sideroblasts
E) Hematocrit

Question 8

The hematologic picture seen in HIV-positive patients reveals:

A) Reticulocytopenia
B) Increased bone marrow reticulin
C) Progressive aplasia
D) Normocytic hypoproliferative anemia
E) All of the above

Question 9

In the anemia of inflammation it is suggested that one of the reasons for a decreased transferrin saturation may be:

A) Inadequate diet
B) Iron is blocked in the fixed macrophages in the bone marrow
C) Accumulation of porphyrin precursors in the liver
D) Dietary iron is not adsorbed from GI tract
E) Transferrin deficiency

Question 10

Which of the following RBC morphologies can be seen on the peripheral smear of a patient with liver disease?

A) Macrocytes
B) Acanthocytes
C) Target cells
D) All of the above
E) None of the above

Question 11

Which of the following is characteristic of anemia of inflammation?

A) Decreased red blood cell life span
B) Impaired iron metabolism
C) Decreased erythropoiesis levels
D) Suppression of erythropoiesis
E) All of the above

Question 12

The presence of __________ on a peripheral blood smear often indicates marrow infiltration by a tumor.

A) Leukoerythroblastosis and sickle cells
B) Leukoerythroblastosis and teardrop red blood cells (RBCs)
C) Leukoerythroblastosis and target cells
D) Leukopenia and teardrop red blood cells (RBCs)
E) Leukopenia and target cells

Question 13

Which cytokines are thought of as key pathogenetic factors in AOI (anemia of inflammation)?

A) IL-1
B) Erythropoietin
C) Ferritin
D) Ferrous iron
E) Thrombopoietin

Question 14

Shortened red cell survival in anemia of inflammation may be due to:

A) Autoantibodies directed against red cell antigen
B) Decreased protoporphyrin synthesis
C) Red cell membrane defect
D) Extracorpuscular effects of activated macrophage-monocytes of the reticuloendothelial system (RES)
E) Intravascular hemolysis

Question 15

What recombinant cytokine has proven effective in counteracting the suppressing effects of IL-1 in AOI (anemia of inflammation)?

A) EPO (erythropoietin)
B) Interferon gamma
C) TNF (tumor necrosis factor)
D) GM-CSF (granulocyte-macrophage colony-stimulating factor)
E) G-CSF (granulocyte colony-stimulating factor)

Question 16

What is a major adverse effect associated with the drug AZT used in the treatment of AIDS?

A) Leukocytosis
B) Anemia
C) Cardiac failure
D) Thrombocytosis
E) Erythrocytosis

Question 17

In the anemia of inflammation, there is an increase in the erythrocyte sedimentation rate (ESR) due to:

A) Increased fibrinogen
B) Decreased fibrinogen
C) Decreased globulin
D) Decreased albumin
E) Decreased transferrin

Question 18

Most HIV-infected patients develop __________.

A) Reticulocytosis
B) Leukocytosis
C) Pancytopenia
D) Macrocytosis
E) Erythrocytosis

Question 19

A Delta check of hemoglobin values for a patient helps with:

A) Anemia of infancy
B) Anemia of endocrine disorders
C) Anemia due to improperly collected laboratory samples
D) Anemia due to liver disease/alcoholism

Question 20

What are the typical hematologic findings associated with anemia from endocrine dysfunction?

A) Mild normocytic, normochromic anemia
B) Anemia, abnormal platelets, and coagulopathy
C) Target cells, macrocytes, and acanthocytes
D) Marked anisocytosis and poikilocytosis, and dysfunctional leukocytes

Question 21

Which of the following RBC morphologies is usually seen on the peripheral smear of a patient with renal disease?

A) Spherocytes
B) Target cells
C) Burr cells
D) Drepanocytes
E) B and C

Question 22

One of the most common forms of liver disease is due to chronic __________.

A) Hyperthyroidism
B) Malnutrition
C) Alcoholism
D) Malignancy
E) Drug abuse

Question 23

Hemolytic anemia seen in alcoholics occurs as a result of hemolysis in the __________.

A) Kidney
B) Liver
C) Pancreas
D) Spleen
E) Lungs

Question 24

In anemia associated with renal disease, the anemia that develops is the result of inadequate quantity of circulating:

A) Erythropoietin (EPO)
B) Thrombopoietin
C) Interleukin (IL-1)
D) G-CSF
E) GM-CSF

Question 25

Electrolyte disturbances in patients with renal failure can lead to the formation of these cells on the peripheral blood smear:

A) Burr cells
B) Nucleated red blood cells
C) Macrocytes
D) Target cells
E) Spherocytes

Question 26

Leukoerythroblastosis with teardrop-shaped red blood cells is indicative of:

A) Bone marrow fibrosis
B) Bone marrow stress
C) Abnormal lipid metabolism
D) Renal disease

Question 27

Iron deficiency in patients with chronic liver disease is due to:

A) Blood loss
B) Poor dietary habits
C) Dysfunctional porphyria
D) Dysfunctional hemoglobin
E) None of the above

Question 28

__________ is very common in chronic alcoholics and is not accompanied by hypersegmented neutrophils.

A) Spherocytosis
B) Macrocytosis
C) Microcytosis
D) Reticulocytosis
E) Megaloblastosis

Question 29

In the anemia of alcoholism, treatment of the underlying __________ disease is essential to the reversal of anemia.

A) Kidney
B) Liver
C) Thyroid
D) Renal
E) Lymph node

Question 30

In chronic liver disease, the hematologic picture may demonstrate the presence of:

A) Acanthocytes
B) Target cells
C) Macrocytes
D) All of the above
E) None of the above

Question 31

Macrocytosis in patients with cirrhosis and obstructive jaundice can be differentiated from the macrocytes seen in megaloblastic anemia because of:

A) An increase in mean corpuscular volume (MCV)
B) Absence of hypersegmented neutrophils
C) Megaloblastic anemia
D) Macro-ovalocytosis
E) Leukocytosis

Question 32

Folate deficiency in patients with liver disease is usually due to:

A) Blood loss
B) Poor dietary habits
C) Antibodies to intrinsic factor
D) Dysfunctional hemoglobin
E) Dysfunctional iron metabolism