Question 1

Which laboratory test provides early and sensitive indication for the diagnosis of a hemolytic disease?

Accepted Answer

A)   MCV
B)   Bilirubin
C)   Serum lactate dehydrogenase
D)   Haptoglobin C

Question 2

Which of the following represents an example of an intrinsic erythrocyte defect?

Accepted Answer

A)   Hb S
B)   Antibody-coated RBCs
C)   Snake venom
D)   Disseminated intravascular coagulation A

Question 3

All of the following laboratory tests can be used for evaluation of hemolysis except:

Accepted Answer

A)   Haptoglobin
B)   Hemopexin
C)   Total protein
D)   Bilirubin C

Question 4

A bone marrow examination was ordered on a patient with a 6.8 g/dL hemoglobin. The examination revealed an increase in fibrous tissue. This is an indication that the anemia is likely the result of a:

Accepted Answer

A)   Proliferation defect
B)   Nuclear maturation defect
C)   Survival defect
D)   Cytoplasmic maturation defect

Question 5

A patient with a bleeding problem is complaining to her physician about excessive fatigue. Physical examination reveals a thin, pale woman with pale mucosal membranes. Significant CBC findings include an MCV of 70 fl. Based on these findings, follow-up testing should be ordered for:

Accepted Answer

A)   Iron studies
B)   Vitamin B12 and folate assays
C)   Coagulation screening tests
D)   A bone marrow aspirate

Question 6

Which of the following defines an intrinsic erythrocyte defect?

Accepted Answer

A)   Erythrocytes that are damaged by chemical, mechanical, or physical agents
B)   The agglutination of erythrocytes by antigen/antibody interactions
C)   Inherited abnormalities of an erythrocyte
D)   Destruction of red cells within the vasculature

Question 7

A blood sample has moderate spherocytes, schistocytes, and polychromasia on the smear. What would you expect the results of the following to be?
a. Bilirubin
b. LDH
c. Hemoglobin
d. Retic count
e. Haptoglobin

Accepted Answer

The answer of A blood sample has moderate spherocytes, schistocytes,...

Question 8

CBC results on a pregnant patient indicate an MCV of 112 fl. What would be the most appropriate reflex test?

Accepted Answer

A)   Iron studies
B)   Bilirubin
C)   LDH
D)   Folate assay

Question 9

A patient sample had a retic count of 5% and hematocrit of 25%. Normal hematocrit is 45%. How would a bone marrow evaluation help you determine whether the bone marrow is responding to the pancytopenia?

Accepted Answer

The answer of A patient sample had a retic count...

Question 10

The peripheral blood smear of a patient with anemia reveals normocytic, normochromic RBCs and the RPI is <2. Which of the following is likely to be the cause of the anemia?

Accepted Answer

A)   Thalassemia
B)   Chronic inflammation
C)   Sickle cell anemia
D)   Porphyrias

Question 11

Which of the following clinical findings is associated with anemia?

Accepted Answer

A)   Jaundice
B)   Hepatomegaly
C)   Splenomegaly
D)   All of the above

Question 12

An instrument printout indicates that a patient has an RPI of 1.3, hemoglobin of 7 g/dL, and MCV of 112 fl. What can be concluded from this?

Accepted Answer

A)   There is acute hemolysis present.
B)   This is the result of iron deficiency.
C)   The anemia is associated with renal disease.
D)   There could be a nuclear maturation defect.

Question 13

Which of the following defines hemolysis?

Accepted Answer

A)   The destruction of red cells resulting in the release of hemoglobin
B)   The disorder characterized by a decrease in the normal concentration of hemoglobin or erythrocytes
C)   The breakdown product of the heme portion of the hemoglobin molecule
D)   The loss of a large amount of blood either internally or externally

Question 14

Which of the following laboratory values would best correlate with moderate polychromasia on the peripheral blood smear?

Accepted Answer

A)   Decreased bilirubin
B)   Increased RPI
C)   Schistocytes on the PB smear
D)   Low PLT count

Question 15

A patient presents with an RPI of >2 and macrocytic morphology of the red blood cells. Which survival defect does this most likely represent?

Accepted Answer

A)   B12 deficiency
B)   Folate deficiency
C)   Hemorrhage or hemolysis
D)   Myelodysplasia

Question 16

The finding of a positive direct antiglobulin test (DAT) for a patient is likely to result in which of the following pathologies:

Accepted Answer

A)   Increased bone marrow production of erythrocytes
B)   Increased erythrocyte destruction
C)   Decreased bone marrow production of erythrocytes
D)   Liver disease

Question 17

Which of the following poikilocytes would be associated with a hemolytic anemia?

Accepted Answer

A)   Oval macrocytes
B)   Echinocytes
C)   Dacryocytes
D)   Spherocytes

Question 18

A patient sample had a retic count of 5%. The patient's hematocrit was 25%. Normal hematocrit is 45%. What is the corrected reticulocyte count?

Accepted Answer

A)   3.50%
B)   2.78%
C)   5%
D)   10%

Question 19

Which of the following pathologic conditions would produce an anemia with anisocytosis?

Accepted Answer

A)   Aplastic anemia
B)   Acute hemorrhage
C)   Chronic leukemia
D)   Immune hemolytic anemia

Question 20

What test is the most sensitive and specific for detecting iron-deficiency anemia?

Accepted Answer

A)   Vitamin B12 assay
B)   Ferritin
C)   RDW
D)   Transferrin saturation

Exam 11: Introduction to Anemia