Deck 31: Alterations of Hematologic Function in Children

Question 1

What is the most common cause of insufficient erythropoiesis in children?

A)Folic acid deficiency
B)Iron deficiency
C)Hemoglobin abnormality
D)Erythrocyte abnormality

Answer 1

Iron deficiency

Question 2

A child has iron deficiency anemia. In addition to iron supplements, what else does the healthcare professional educate the parents on giving the child?

A)Vitamin A
B)Magnesium
C)Vitamin C
D)Zinc

Answer 2

Vitamin C

Question 3

Why does fetal hemoglobin have a greater affinity for oxygen than adult hemoglobin?

A)The fetus does not have its own oxygen supply and must rely on oxygen from the maternal vascular system.
B)The fetus has two g-chains on the hemoglobin, rather than two b-chains as in the adult.
C)Fetal hemoglobin interacts less readily with diphosphoglycerate (DPG), which inhibits hemoglobin-oxygen binding.
D)Fetal hemoglobin production occurs in the vessels and liver rather than in the bone marrow as in the adult.

Answer 3

Fetal hemoglobin interacts less readily with diphosphoglycerate (DPG), which inhibits hemoglobin-oxygen binding.

Question 4

What is the cause of polycythemia in the fetus?

A)Fetal hemoglobin has a greater affinity for oxygen as a result of diphosphoglycerate (DPG).
B)The fetus has a different hemoglobin structure of two a- and two g-chains rather than two a-and two b-chains.
C)Increased erythropoiesis occurs in response to the hypoxic intrauterine environment.
D)The lungs of the fetus are undeveloped and unable to diffuse oxygen adequately to the pulmonary capillaries.

Question 5

Which blood cell type is elevated at birth and through the preschool years, but decreases to adult levels afterward?

A)Monocytes
B)Platelets
C)Neutrophils
D)Lymphocytes

Question 6

Which mother does the healthcare professional prepare to administer Rh immune globulin (Rho-GAM) to?

A)Is Rh-positive and the fetus is Rh-negative
B)Is Rh-negative and the fetus is Rh-positive
C)Has type A blood and the fetus has type O
D)Has type AB blood and the fetus has type B

Question 7

The healthcare professional is caring for a woman whose baby died of hydrops fetalis. How does the professional explain this condition to a student?

A)Inherited condition where the RBC skeletal membrane is abnormal
B)Hyperbilirubinemia that occurs shortly after birth and can affect the brain
C)Hemolytic disease of the fetus and newborn
D)Severe intrauterine anemia that leads to edema of the entire body

Question 8

Which manifestations of vasoocclusive crisis are associated with sickle cell disease (SCD) in children?

A)Atelectasis and pneumonia
B)Edema of the hands and feet
C)Stasis ulcers of the hands, ankles, and feet
D)Splenomegaly and hepatomegaly

Question 9

Hemoglobin S (HbS) is formed in sickle cell disease as a result of which process?

A)Deficiency in glucose 6-phosphate dehydrogenase (G6PD) that changes hemoglobin A (HbA) to HbS.
B)Genetic mutation in which two amino acids (histidine and leucine) are missing.
C)Genetic mutation in which one amino acid (glutamate) is replaced by another (valine).
D)Autoimmune response in which one amino acid (proline) is detected as an antigen by abnormal immunoglobulin G (IgG).

Question 10

When diagnosed with hemolytic disease of the fetus and newborn (HDFN), why does the newborn develop hyperbilirubinemia after birth but not in utero?

A)Excretion of unconjugated bilirubin through the placenta into the mother's circulation is no longer possible.
B)Hemoglobin does not breakdown into bilirubin in the intrauterine environment.
C)The liver of the fetus is too immature to conjugate bilirubin from a lipid-soluble to water-soluble form.
D)The destruction of erythrocytes producing bilirubin is greater after birth.

Question 11

A healthcare professional is teaching a community group about inherited disorders. What pattern of inheritance does the professional describe for sickle cell disease?

A)Inherited X-linked recessive disorder
B)Inherited autosomal recessive disorder
C)Disorder initiated by hypoxemia and acidosis
D)Disorder that is diagnosed equally in men and women

Question 12

An infant was born with hemolytic disease of the fetus and newborn (HDFN). What treatment does the healthcare professional anticipate for this baby?

A)Administration of intravenous fluids to dilute the blood
B)Replacement transfusion of Rh-positive blood not contaminated with anti-Rh antibodies
C)Performance of a splenectomy to prevent the destruction of abnormal erythrocytes
D)Replacement transfusion of Rh-negative erythrocytes

Question 13

A newborn displays pallor, tachycardia, and has a systolic murmur. What hemoglobin value does the healthcare professional correlate with these manifestations?

A)11 g/dL
B)9 g/dL
C)7 g/dL
D)5 g/dL

Question 14

A child has sickle cell disease (SCD). What treatment or therapy does the healthcare professional discuss with the parents and child?

A)Hydroxyurea
B)Low-dose daily aspirin
C)Heparin injections
D)Genetic testing

Question 15

How does hemolytic disease of the fetus and newborn (HDFN) cause acquired congenital hemolytic anemia?

A)HDFN develops when hypoxia or dehydration causes the erythrocytes to change shapes, which are then recognized as foreign and removed from circulation.
B)HDFN is an alloimmune disease in which the mother's immune system produces antibodies against fetal erythrocytes, which are recognized as foreign and removed from circulation.
C)HDFN develops when the polycythemia present in fetal life continues after birth, causing the excessive number of erythrocytes to be removed from circulation.
D)HDFN is an autoimmune disease in which the fetus's immune system produces antibodies against fetal erythrocytes, which are recognized as foreign and removed from circulation.

Question 16

In a full-term infant, the normal erythrocyte life span is _____ days.

A)30 to 50
B)60 to 80
C)90 to 110
D)120 to 130

Question 17

The healthcare professional explains to a student that glucose 6-phosphate dehydrogenase (G6PD) deficiency is what type of inherited disorder?

A)X-linked dominant
B)X-linked recessive
C)Autosomal dominant
D)Autosomal recessive

Question 18

What is the name of the disorder in which levels of bilirubin remain excessively high in the newborn and are deposited in the brain?

A)Kernicterus
B)Icterus neonatorum
C)Jaundice
D)Icterus gravis neonatorum

Question 19

How is erythroblastosis fetalis defined?

A)Allergic disease in which maternal blood and fetal blood are antigenically incompatible
B)Alloimmune disease in which maternal blood and fetal blood are antigenically incompatible
C)Autoimmune disease in immature nucleated cells that are released into the bloodstream
D)Autosomal dominant hereditary disease

Question 20

A couple who both carry the sickle cell trait wish to have children. What does the healthcare professional tell them is the chance that each pregnancy will result in a child who has sickle cell disease (SCD)?

A)20%
B)25%
C)33%
D)50%

Question 21

A patient has thalassemia major. After receiving multiple blood transfusions over the last several months, what complication does the healthcare professional assess the patient for?

A)Hemochromatosis
B)Iron deficiency anemia
C)Vitamin C depletion
D)Rh autoimmunity

Question 22

Hemophilia B is caused by a deficiency of which clotting factor?

A)V
B)VIII
C)IX
D)X

Question 23

A patient has leukemia. The healthcare professional explains to a patient about the significance of hyperdiploidy. What statement by the professional is most accurate?

A)It indicates a good prognosis.
B)It indicates a poor prognosis.
C)It limits treatment options.
D)Hyperdiploidy demonstrates remission.

Question 24

A healthcare professional educates parents to monitor their child's dietary intake for sufficient iron during which period of time as the priority?

A)Between 2 months and 1 year
B)Between 6 months and 2 years
C)Between 12 months and 3 years
D)Between 18 months and 4 years

Question 25

A student asks the professor why hemophilia A is seen mostly in men. The professor explains that hemophilia A is considered to be what type of inherited disorder?

A)Autosomal dominant
B)Autosomal recessive
C)X-linked recessive
D)X-linked dominant

Question 26

Which disease is an autosomal dominant inherited hemorrhagic disease?

A)Hemophilia A
B)von Willebrand disease
C)Christmas disease
D)Hemophilia B

Question 27

When does fetal erythrocyte production shift from the liver to the bone marrow?

A)Fourth month of gestation
B)Fifth month of gestation
C)Eighth month of gestation
D)At birth

Question 28

A patient has microcytic, hypochromic anemia. Which type of treatment or procedure does the healthcare professional discuss as a potential cure with the patient?

A)Cord blood transplantation
B)Scheduled infusion of gamma globulins
C)Massive blood transfusions
D)Repeated injections of Rho-GAM

Question 29

What are the common triggers for sickle cell crisis? (Select all that apply.)

A)Fever
B)Infection
C)Dehydration
D)Alkalosis
E)Exposure to the cold

Question 30

A patient has primary immune thrombocytopenic purpura (ITP) and is hospitalized after a bleeding episode. What treatment does the healthcare provider anticipate being ordered for this patient?

A)Blood transfusions
B)Infusion of IVIG
C)Anticoagulants
D)Large doses of folic acid

Question 31

The alpha- and beta-thalassemias are considered what types of inherited disorder?

A)Autosomal recessive
B)Autosomal dominant
C)X-linked recessive
D)X-linked dominant

Question 32

A pediatric patient presents with pallor, fatigue, fever, petechiae, and purpura. What diagnostic testing does the healthcare professional help prepare the patient for? (Select all that apply.)

A)Complete blood count
B)Renal function studies
C)Bone marrow biopsy
D)Chest x-ray
E)Joint fluid sampling