Deck 6: The Macrocytic Anemias

Question 1

The MCV in pernicious anemia will be in the range of:

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

Answer 1

C

Question 2

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

Answer 2

True

Question 3

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 3

A

Question 4

All of the following are true about intrinsic factor (IF) except:

A) Partial gastrectomy may lead to the lack of IF.
B) 56% 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 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

Which of the following morphological features is classic in the megaloblastic anemias?

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

Question 7

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 8

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

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

Question 9

A key substance required for the incorporation of vitamin B₁₂ in red cell nuclear synthesis is the presence of:

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

Question 10

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 11

The cell pictured above may be seen in which of the following conditions?

A) Iron deficiency anemia
B) Megaloblastic anemia
C) Thalassemia major
D) Hereditary hemochromatosis

Question 12

Intrinsic factor is secreted by the:

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

Question 13

An appropriate M:E ratio in the case of megaloblastic anemia would be:

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

Question 14

A differentiation of treated versus untreated megaloblastic anemia can be determined by the presence of:

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

Question 15

Ineffective erythropoiesis is defined as:

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

Question 16

The stage of development of the cell at the end of the pointer is:

A) Polychromatophilic normoblast
B) A reticulocyte
C) A rubricyte
D) An orthochromatic normoblast

Question 17

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