Deck 23: Introduction to Increased Destruction of Erythrocytes

Question 1

What are the bone marrow findings in hemolytic anemia?

A)myeloid-to-erythroid (M:E) ratio of 1:1
B)M:E ratio of 5:1
C)reduced cellularity and increased fat
D)erythroid hypoplasia

Answer 1

myeloid-to-erythroid (M:E) ratio of 1:1

Question 2

What characteristic red cell shape is associated with extravascular hemolysis?

A)spherocyte
B)schistocyte
C)target cell
D)burr cell

Answer 2

spherocyte

Question 3

Which of the following are typical findings in extravascular hemolysis?

A)increased serum and urine conjugated bilirubin
B)increased serum and urine unconjugated bilirubin
C)increased serum unconjugated bilirubin and increased urine urobilinogen
D)decreased urine and stool conjugated bilirubin

Answer 3

increased serum unconjugated bilirubin and increased urine urobilinogen

Question 4

Unconjugated or indirect bilirubin is normally found in

A)plasma
B)erythrocytes
C)urine
D)intestines

Question 5

Which of the following clinical findings specifically suggests,if it is present,extravascular hemolysis?

A)increased heart rate
B)splenomegaly
C)pallor
D)fatigue

Question 6

A plasma sample appears hemolyzed or red.Which of the following is true?

A)The patient has extravascular hemolysis.
B)The patient has increased haptoglobin.
C)The patient has increased hemopexin.
D)The plasma hemoglobin is greater than 50 mg/dL.

Question 7

Which of the following test results suggests red blood cell (RBC)survival is significantly decreased from the normal of 120 days?

A)decreased glycated hemoglobin
B)a T1/2 Cr of 30 days
C)normal haptoglobin
D)decreased lactic dehydrogenase

Question 8

Which of the following suggests ongoing hemolysis in a patient who has not had massive blood loss or been hemodiluted?

A)reticulocyte production index (RPI) of 1
B)reticulocyte count of 1.3%
C)drop in hemoglobin of 1.3 g/dL in 1 week
D)hemoglobin falling 0.5 g/dL

Question 9

Which of the following is the most specific indicator of accelerated intravascular red cell destruction?

A)increased serum bilirubin
B)increased haptoglobin
C)decreased hematocrit
D)decreased haptoglobin

Question 10

Laboratory tests indicate that an female adult has an increased rate of red cell destruction in the circulation.Her hematocrit is 39%.Which of the following describes her hemolytic disorder?

A)mild
B)moderate
C)acute
D)compensated

Question 11

All of the following are often seen in various types of hemolytic anemia except

A)schistocytes.
B)spherocytes.
C)polychromasia.
D)hypochromasia.

Question 12

A patient develops an immunoglobulin G (IgG)antibody that causes red cells to be destroyed by the spleen.This is what type of hemolysis?

A)inherited, intrinsic, extravascular, immune
B)acquired, extrinsic, extravascular, immune
C)acquired, intrinsic, intravascular, immune
D)acquired, extrinsic, intravascular, traumatic

Question 13

An elevated reticulocyte count rules out which of the following?

A)acute blood loss
B)aplastic crisis
C)acute hemolysis
D)successful patient response to iron therapy

Question 14

Which of the following is decreased in intravascular hemolysis?

A)haptoglobin
B)urine hemoglobin
C)serum hemoglobin
D)urine urobilinogen

Question 15

Which of the following tests for hemolysis is easiest and safest for the patient?

A)reticulocyte count
B)red cell survival with labeled chromium
C)bone marrow biopsy
D)cross-transfusion studies

Question 16

Which of the following breakdown products of hemoglobin is removed from the body instead of being recycled?

A)globin
B)amino acids
C)protoporphyrin ring
D)iron

Question 17

The presence of hemoglobinuria,hemosiderinuria,and hemoglobinemia indicate that hemolysis is

A)severe.
B)acquired.
C)compensated.
D)intravascular.

Question 18

How are normal red cells removed when they lose the ability to deform?

A)After 120 days, most are phagocytized by splenic macrophages.
B)After 10 to 14 days, most are phagocytized by splenic macrophages.
C)After 10 to 14 days, most are destroyed by complement.
D)After 120 days, most are destroyed inside the blood vessels.

Question 19

Which of the following is found normally in urine?

A)conjugated bilirubin
B)urobilinogen
C)stercobilin
D)unconjugated bilirubin

Question 20

A urine sediment stains with Prussian blue.The patient probably has

A)hemoglobinemia.
B)a membrane defect.
C)compensated hemolysis.
D)extravascular hemolysis.

Question 21

The presence of schistocytes in the peripheral blood indicates which of the following processes?

A)iron deficiency anemia
B)intravascular hemolysis
C)megaloblastic anemia
D)extravascular hemolysis