Deck 5: The Microcytic Anemias

Question 1

In adults, which of the following is the most common cause of iron deficiency anemia?

A) Intestinal parasites
B) Malabsorptive disorders
C) Dietary content
D) Chronic blood loss

Answer 1

D

Question 2

Which type of inclusion is likely to be seen in the above patient?

A) Howell-Jolly bodies
B) Pappenheimer bodies
C) Hemoglobin H inclusion bodies
D) Cabot rings

Answer 2

B

Question 3

In addition to iron ingestion, over 90% of iron in adults that is used for erythropoiesis is obtained through:

A) Transfusion
B) Recycling of iron
C) Storage forms from spleen and the liver
D) Hemosiderin

Answer 3

B

Question 4

Which inclusion is associated with a "pitted," golf ball appearance?

A) Hgb H inclusion
B) Howell-Jolly body
C) Cabot rings
D) Pappenheimer bodies

Question 5

Which if the following is also known as Cooley's anemia?

A) Alpha thalassemia
B) Beta thalassemia major
C) Hereditary hemochromatosis
D) IDA

Question 6

The globin chains found in hemoglobin A2 are:

A) Alpha 2, Delta 2
B) Alpha 2, Gamma 2
C) Alpha 2, Beta 2
D) Alpha 2, Epsilon 2

Question 7

The majority of the hemoglobin made in individuals with thalassemia major is:

A) Hemoglobin H
B) Hemoglobin A
C) Hemoglobin F
D) Hemoglobin Barts

Question 8

Ringed sideroblasts in the bone marrow are characteristics of which of the following disorders?

A) Chronic disease
B) Infection
C) Sideroblastic anemia
D) Inflammation

Question 9

The alpha thalassemic condition that is incompatible with life is:

A) Hemoglobin H disease
B) Bart's hydrops fetalis
C) Alpha thalassemia trait
D) Silent carrier condition

Question 10

The first stage of iron deficiency anemia is termed:

A) Microcytic hypochromic anemia
B) Iron depletion
C) Iron deficiency
D) Iron overload

Question 11

Storage iron is usually determined by the:

A) Serum transferrin level
B) Hemoglobin value
C) Myoglobin value
D) Serum ferritin level

Question 12

What is the presumptive clinical condition?

A) Pernicious anemia
B) Autoimmune hemolytic anemia
C) Iron deficiency trait
D) Thalassemia trait

Question 13

The alpha thalassemias result from:

A) Gene deletion
B) Defective alpha genes
C) Iron overload
D) Excessive production of alpha chains

Question 14

A 15-year-old Lebanese boy was sent to the laboratory for an evaluation of anemia and had the following lab results:

A) WBC = 7.5  10⁹/L
B) RBC = 5.9  10¹²/L
C) Hgb = 11.6 g/dL
D) Hct = 36%

Question 15

All of the following are symptoms of iron deficiency anemia except:

A) Pallor
B) Pica
C) Vertigo
D) Numbness

Question 16

Transferrin receptors for iron uptake are located on the:

A) Basophilic normoblast
B) Pronormoblast
C) Reticulocyte
D) Orthochromic normoblast

Question 17

The presence of which hemoglobin will result in an inherited methemoglobinemia?

A) Hemoglobin D
B) Hemoglobin M
C) Hemoglobin H
D) Bart's hemoglobin

Question 18

Failure to thrive, facial structure abnormalities, severe anemia, and splenomegaly are signs of which of the following disorders?

A) Thalassemia minor
B) Alpha thalassemia trait
C) Thalassemia major
D) Thalassemia intermedia

Question 19

One of the gravest clinical problems for individuals with thalassemia major is:

A) Chronic anemia
B) Iron overload
C) Therapeutic phlebotomy
D) Collapsed veins

Question 20

Given the laboratory results of serum iron = 300 g/dL, transferrin = 312 mg/dL, transferrin saturation = 122%, and ferritin = 1,000 ng/mL, which of the following should be considered?

A) Hereditary hemochromatosis
B) Anemia of inflammation
C) Iron deficiency anemia
D) Lead poisoning

Question 21

Hemoglobin H disease is associated with:

A) Bart's hydrops fetalis
B) Alpha thalassemia disease
C) Thalassemia major
D) Hereditary hemochromatosis

Question 22

The primary storage forms of iron are:

A) Ferritin and hemosiderin
B) Ferritin and transferrin
C) Hemosiderin and ferrous iron
D) Heme and ferritin

Question 23

In patients with iron overload, Desferal may be administered to chelate the excess iron.The chelated iron is shed in:

A) The feces
B) The urine
C) Gastric secretions
D) None of the above

Question 24

In the United States, approximately of the anemias seen are due to IDA.

A) 25%
B) 40%
C) 50%
D) 75%

Question 25

In regards to the thalassemias, the deficit has nothing to do with iron.

Question 26

In iron deficiency anemia, the reticulocyte count will be:

A) Normal
B) Low
C) High
D) Extremely high