Hematology End Of Rotation, Hematology Success, BOC Hematology

What is the first type of cell produced by the developing embryo?

A. Erythrocyte

B. Granulocyte

C. Lymphocyte

D. Thrombocyte

A. Erythrocyte

What percentage of tissue located in the bone marrow cavities of adults is fat?

A. 10%

B. 25%

C. 50%

D. 75%

C. 50%

Which of the following is not characteristic of pluripotent hematopoietic stem cells?

A. Possess self-renewal ability

B. Produce progenitor cells committed to a single cell lineage

C. Express the stem cell marker CD 13

D. Are morphologically unrecognizable

C. Express the stem cell marker CD13

In an adult, what are the two best areas for obtaining active bone marrow by aspiration?

A. Vertebra,tibia

B. Sternum,vertebra

C. Anterior iliac crest, tibia

D. Posterior iliac crest, sternum

D. Posterior iliac crest, sternum

What is the normal ratio of myeloid to erythroid precursors in bone marrow (M:E ratio)?

A. 1:1

B. 1:3

C. 4:1

D. 8:1

C. 4:1

Which of the following does not accurately describe hematopoietic growth factors?

A. Bind to target cell receptors to express

activity

B. Action of majority is lineage restricted

C. May promote or suppress cell death

D. Can stimulate or inhibit cell

proliferation

B. Action of majority is lineage restricted

In the third month of gestation, what is the primary state of hematopoiesis?

A. Liver

B. Marrow of long bones C. Spleen

D. Yolksac

A. Liver

The mechanism that relays information about tissue oxygen levels to erythropoietin-producing sites is located in the

A. Brain

B. Kidney

C. Liver

D. Spleen

B. Kidney

Antigen-independent lymphopoiesis occurs in primary lymphoid tissue located in the

A. Liver and kidney

B. Spleen and lymphnodes

C. Peyer's patches and spleen

D. Thymus and bone marrow

D. Thymus and bone marrow

Programmed cell death is called

A. Necrosis

B. Apoptosis

C. Cellular senescence

D. Terminal differentiation

B. Apoptosis

In what area of the bone marrow does hematopoiesis take place?

A. Cords

B. Endosteum

C. Endothelium

D. Sinuses

A. Cords

Bone marrow cellularity refers to the ratio of

A. Red cell precursors to white cell precursors

B. Hematopoietic tissue to adipose tissue

C. Granulocytic cells to erythrocytic cells

D. Extravascular tissue to intravascular

tissue

B. Hematopoietic tissue to adipose tissue

Interleukins and colony stimulation factors are cytokines produced by

A. B lymphocytes and erythrocytes

B. Erythrocytes and thrombocytes

C. Monocytes and T lymphocytes D. Neutrophils and monocytes

C. Monocytes and T lymphocytes

What is the approximate total blood volume in an adult?

A. 1L

B. 2L

C. 6L

D. 12L

C. 6L

The myeloid progenitor cell can produce cells committed to

A. Granulocytic, erythrocytic, monocytic,

or megakaryocytic lineages

B. Granulocytic, monocytic, lympho-

cytic, or megakaryocytic lineages

C. Erythrocytic, granulocytic, monocytic,

or lymphocytic lineages

D. Erythrocytic, granulocytic, lympho-

cytic, or megakaryocytic lineages

A. Granulocytic, erythrocytic, monocytic,

or megakaryocytic lineages

The largest hematopoietic cells in normal bone marrow are

A. Osteoblasts

B. Osteoclasts

C. Megakaryocytes

D. Plasma cells

C. Megakaryocytes

When evaluating a bone marrow aspirate smear, which finding is considered abnormal?

A. A predominance of granulocyte

precursors as compared to nucleated

red cells

B. Detection of stainable iron in

macrophages and erythroid precursors

with Prussian blue

C. An average of three megakaryocytes

seen per low power (10X) field

D. The presence of 10% myeloblasts on the cell differential count

D. The presence of 10% myeloblasts on the cell differential count

As most blood cells lines mature, which of the following is characteristic?

A. Cell diameter increases

B. Nucleus to cytoplasm ratio (N:C) decreases

C. Nuclear chromatin becomes less condensed

D. Basophilia of the cytoplasm increase

B. Nucleus to cytoplasm ratio (N:C) decreases

Which of the following describes thrombopoietin (TPO)?

A. Renal hormone that regulates marrow

red cell production

B. Marrow hormone secreted by

developing megakaryoblasts

C. Hormone produced by the liver that

stimulates megakaryopoiesis

D. Pituitary hormone that controls

platelet sequestration by the spleen

C. Hormone produced by the liver that

stimulates megakaryopoiesis

When the hepatic phase of fetal life is reactivated in an adult, hematopoiesis can be termed

A. Myeloid ormedullary

B. Myeloid metaplasia or extramedullary

C. Myelophthisis or myelodysplasia D. Mesoblastic or mesenchymal

B. Myeloid metaplasia or extramedullary

What is the average life span of a normal red blood cell?

A. 1 day

B. 10days

C. 60 days

D. 120 days

D. 120 days

The Na+-K+ cation pump is an important mechanism in keeping the red blood cell intact. Its function is to maintain a high level of

A. Intracellular Na+

B. Intracellular K+

C. PlasmaNa+

D. Plasma K+

B. Intracellular K+

Which of the following depicts the structure of the hemoglobin molecule?

A. Two heme groups, two globin chains

B. Four heme groups, two globin chains

C. Two heme groups, four globin chains

D. Four heme groups, four globin chains

D. Four heme groups, four globin chains

Which of the following describes the process known as culling?

A. Release of red cells from the bone

marrow

B. Binding of free hemoglobin by

transport proteins

C. Incorporation of iron into proto-

porphyrin IX

D. Removal of abnormal red cells by the

spleen

D. Removal of abnormal red cells by the spleen

Hemoglobin forms that are incapable of oxygen transport include

A. Deoxyhemoglobin and oxyhemoglobin

B. Oxyhemoglobin and

carboxyhemoglobin

C. Carboxyhemoglobin and

methemoglobin

D. Methemoglobin and deoxyhemoglobin

C. Carboxyhemoglobin and

methemoglobin

The majority of iron found in an adult is a constituent of

A. Ferritin

B. Myoglobin

C. Hemoglobin

D. Peroxidase

C. Hemoglobin

A senescent red blood cell is one that has

A. Been hemolyzed

B. Lived its life span

C. Become deformed

D. Lost its mitochondria

B. Lived its life span

What red cell morphologic abnormality is described by the term "poikilocytosis"?

A. Variations in size

B. Deviations from normal shape

C. Presence of inclusions

D. Alterations in hemoglobin concentration

B. Deviations from normal shape

Howell-Jolly bodies are composed of

A. DNA

B. Iron

C. Reticulum

D. RNA

A. DNA

When spherocytes are reported, what is observed on the peripheral blood smear?

A. Red cells without a central pallor

B. Red cells with blunt projections

C. Red cells with sharp projections

D. Red cells with intracellular rod-shaped

crystals

A. Red cells without a central pallor

The red cells found in lead poisoning characteristically exhibit coarse granules composed of ____ that are reported as ______

A. Precipitated hemoglobin; Pappen- heimer bodies

B. Aggregated ribosomes; basophilic stippling

C. Nuclear fragments; Pappenheimer bodies

D. Excess iron deposits; basophilic stippling

B. B. Aggregated ribosomes; basophilic stippling

Rouleaux of red blood cells when seen in the monolayer of a blood smear is characteristic of

A. Hypersplenism

B. Hypogammaglobulinemia

C. Cold hemagglutinin disease

D. Multiple myeloma

D. Multiple myeloma

Which of the following is not frequently associated with the inclusion bodies seen in Color Plate 1?

A. Iron overload state

B. Post-transfusion

C. Post-splenectomy

D. Iron-deficient state

C. Post-splenectomy

Which of the following statements about iron absorption is true?

A. Absorption occurs in the ileum.

B. The mucosal cell always absorbs the

correct amount of iron to meet needs.

C. Absorption increases when erythropoietic activity increases.

D. Alkaline pH favors absorption.

C. Absorption increases when erythropoietic activity increases.

What term describes a mature red blood cell that contains iron granules or deposits?

A. Siderosome

B. Sideroblast

C. Ringed sideroblast

D. Siderocyte

D. Siderocyte

Which of the following is associated with a "shift to the left" in the oxygen dissociation curve of hemoglobin?

A. Decreased pH and elevated temperature

B. Decreased oxygen affinity

C. Decreased oxygen release

D. Presence of 2,3-bisphosphoglycerate

(2,3-BPG)

C. Decreased oxygen release

Which of the following statements does not characterize erythropoietin (EPO)?

A. Transforms the CFU-E into the earliest

recognizable RBC precursor

B. Increases the rate of red blood cell

production by the bone marrow

C. Shortens the maturation time of

developing erythroid precursors

D. Decreases stimulation of erythropoiesis when cellular hypoxia increases

D. Decreases stimulation of erythropoiesis when cellular hypoxia increases

Which of the following factors will result in am immediate increase in oxygen delivery to the tissues?

A. Increased pH

B. High altitudes

C. Increased hemoglobin binding of 2,3-BPG

D. Increased renal release of erythropoietin

C. Increased hemoglobin binding of 2,3-BPG

Periods of intents erythropoietin activity cause premature cause permanent release of marrow reticulocytes into the blood. Which of the following is not true of these early reticulocytes?

A. Loss of residual RNA occurs immediately upon marrow release

B. Circulate longer than usual before reaching maturity

C. May be termed shift or stress reticulocytes

D. Show diffuse basophilia with Wright's stain

A. Loss of residual RNA occurs immediately upon marrow release

Which of the following inclusions is only visible with supravital staining?

A. Basophilic stippling

B. Cabot rings

C. Heinz bodies

D. Pappenheimer bodies

C. Heinz bodies

The presence of shistocytes on the peripheral blood smear is commonly associated with

A. Increased iron mobilization

B. Increased red cell destruction

C. Decreased erythropoietin activity

D. Decreased red cell proliferation

B. Increased red cell destruction

Which of the following may be a sign of accelerated bone marrow erythropoiesis?

A. Hypercellular marrow with a

decreased number of RBC precursors

B. Bone marrow M:E ratio of 6:1

C. Nucleated red cells in the peripheral

circulation

D. Low erythrocyte, hemoglobin, and

hematocrit levels

C. Nucleated red cells in the peripheral

circulation

Microcytic, hypochromic red cells are most often associated with impaired

A. DNA synthesis

B. RNA metabolism

C. Hemoglobin synthesis

D. Enzyme metabolism

C. Hemoglobin synthesis

When in bone marrow, the nucleated red cells present in color plate 2, would be staged as

A. Basophilic normoblasts

B. Polychromatophilic normoblasts C. Orthochromic normoblasts

D. Pronormoblasts

C. Orthochromic normoblasts

When acanthocytes are found on the blood smear, it is usually the result of

A. Abnormal membrane permeability

B. Altered membrane lipids

C. Mechanical trauma

D. Polymerization of hemoglobin

molecules

B. Altered membrane lipids

Which erythrocyte metabolic pathway generates adenosine triphosphate (ATP) via glycolysis?

A. Embden-Meyerhof

B. Hexose monophosphate

C. Rapoport-Luebering

D. Methemoglobin reductase

A. Embden-Meyerhof

Which of the following red blood cell precursors is the last stage to undergo mitosis?

A. Pronormoblast

B. Basophilic normoblast

C. Polychromatophilic normoblast D. Orthochromic normoblast

C. Polychromatophilic normoblast

The major adult hemoglobin requires the synthesis of the alpha-globin chains and

A. Beta-globin chains

B. Delta-globin chains

C. Epsilon-globin chains

D. Gamma-globin chains

A. Beta-globin chains

Defective nuclear maturation commonly results in the production of red cells that are

A. Normocytic

B. Hypochromic

C. Macrocytic

D. Microcytic

C. Macrocytic

The major storage form of iron is

A. Ferritin

B. Transferrin

C. Hemosiderin

D. Hemachromatin

A. Ferritin

The red cells observed on a peripheral blood smear show extreme anisocytosis with an equal number of macrocytes and microcytes. Which of the following values correlate with this finding?

A. MCV 108.0 fL, RDW 14.0%

B. MCV 90.0 fL, RDW 25.0%

C. MCV 75.0 fL, RDW 16.0%

D. MCV 88.0 fL, RDW 12.0%

B. MCV 90.0 fL, RDW 25.0%

Excessive extravascular red cell destruction is associated with

A. Hemoglobinemia

B. Bilirubinemia

C. Hemoglobinuria

D. Hemosiderinuria

B. Bilirubinemia

Which protein is primarily responsible for transport of hemoglobin dimers resulting from intravascular hemolysis?

A. Hemopexin

B. Albumin

C. Hemosiderin

D. Haptoglobin

D. Haptoglobin

The morphologic abnormality characteristic found in hemoglobinopathies is

A. Elliptocytes

B. Dacryocytes

C. Codocytes

D. Discocytes

C. Codocytes

Where do the early and late stages of heme synthesis occur?

A. On ribosomes

B. In mitochondria

C. Incytoplasm

D. In nucleoli

B. In mitochondria

Spectrin is a protein that occupies a major role in

A. Red cell membrane structure

B. Reducing ferric iron

C. Red cell transport and removal of CC>2

D. Iron recovery during hemoglobin

degradation

A. Red cell membrane structure

What is the function of reduced glutathione (GSH) in the red blood cell?

A. Promotes Kreb's cycle activity

B. Maintains anion balance during the

"chloride shift"

C. Neutralizes intracellular oxidants that

accumulate

D. Prevents oxygen uptake by hemoglobin

C. Neutralizes intracellular oxidants that accumulate

What does measuring the total binding capacity (TIBC) represent?

A. Amount of free iron in serum

B. Circulating protein-bound iron

C. Amount of iron that transferrin can bind

D. Indirect measurement of iron stores

C. Amount of iron that transferrin can bind

Serum ferritin is a good indicator of the amount of

A. Cytochromeiron

B. Storage iron

C. Hemoglobin iron

D. Transferrinsaturation

B. Storage iron

Fetal hemoglobin differs from adult hemoglobin in the hemoglobin F

A. Cytochromeiron

B. Storage iron

C. Hemoglobin iron

D. Transferrinsaturation

B. Storage iron

Impaired DNA metabolism is characteristic of

A. Hemoglobin C disease

B. Iron-deficiencyanemia

C. Sideroblastic anemia

D. Megaloblastic anemia

D. Megaloblastic anemia

Which of the following is associated with glucose-6-phosphate dehydrogenase (G6PD) deficiency?

A. G6PD gene is located on the X chromosome

B. On going intravascular hemolysis

occurs.

C. All circulating red cells, including

reticulocytes, lack enzyme activity.

D. Splenectomy can relieve the rate of red

cell destruction.

A. G6PD gene is located on the X chromosome

In regard to the variant hemoglobin E, (alpha 2, beta 26 Glu -->Lys), which of the following statements is false?

A. There are two normal alpha chains.

B. Glutamic acid replaces lysine on

position 26 of the beta chains.

C. Hemoglobin E is the second most

common hemoglobin variant known.

D. Glutamic acid is normally found at

position 26 of the beta chain.

B. Glutamic acid replaces lysine on

position 26 of the beta chains.

Color Plate 3 shows the peripheral blood of a 16-year-old female with a sporadic history of dizzy spells, fainting, and jaundice. This patient also had a history of periodic abdominal pain related to gallstones. Upon physical examination, she exhibited mild splenomegaly. Her hemoglobin was 107 g/L (10.7 g/dL), hematocrit was 0.32 L/L (32%), red cell indices were normal, and the direct antiglobulin test was negative. Based on history and peripheral blood morphology, which of the following statements is most likely true?

A. Hemoglobin S will be revealed by electrophoresis.

B. Tests to confirm iron deficiency should be ordered.

C. An intrinsic hereditary defect of red cells should be suspected.

D. The anemia is secondary to spleen and gallbladder disorders.

C. An intrinsic hereditary defect of red cells should be suspected.

A 9 month old male was seen int he ER with a femur fracture that had occurred from a fall down the stairs. Upon physical examination the physician noted hepatosplenomegaly, extreme pallor, and a slight arrhythmia. A complete blood count revealed the following:

WBC: 12.2

RBC: 3.05

Hgb: 61

Hct: .20

MCV: 65.5

MCH: 20

MCHC: 30.5

RDW 25%

The wrights stain blood smear showed the findings seen in the color plate 4. Hemoglobin electrophoresis was ordered with results as follows:

Hgb A : 0%

Hgb A2: 3%

Hgb F: 97%

Which conditions is most likely causing the hematologic abnormalities?

A. Alpha-thalassemia major

B. Cooley beta-thalassemia major C. Hemoglobin H disease

D. Hereditary persistence of

hemoglobin F

B. Cooley beta-thalassemia major

A 14 year old african male was seen in the clinic for abdominal pain. A compelte blood count revealed the following

WBC: 7.0

RBC: 2.90

Hgb: 85

Hct: .25

MCV: 86.2

MCH: 29.3

MCHC: 340 g//L

RDW: 21%

The peripheral smear showed the red blood cell morphology seen in the Color Plate 5. What condition is suggested by these findings?

A. Hemoglobin E disease

B. Hemoglobin S disease

C. Hemoglobin SC disease

D. Hemoglobin C disease

C. Hemoglobin SC disease

Pica is most commonly associated with which of the following conditions?

A. Pyridoxine deficiency

B. Lack of erythrocyte folate

C. Iron deficiency

D. Porphyrias

C. Iron deficiency

Of the following, the leading cause of folate deficiency is

A. Increased requirements

B. Dietary insufficiency

C. Drug inhibition

D. Malabsorption

B. Dietary insufficiency

Which of the following statements abut sickle cell syndromes is false?

A. Asplenism may result from repeated

sickling crises in the homozygous

state.

B. Heterozygous persons may be partly

protected from infection by falciparum

malaria.

C. Hemoglobin S is more soluble in

dithionite than is normal hemoglobin.

D. Trait conditions are generally

asymptomatic with no sickle cell formation.

C. Hemoglobin S is more soluble in

dithionite than is normal hemoglobin.

The findings seen in color plate 6 can be found in patients with microangiopathic hemolytic anemia (MAHA). Which of the following conditions could not be responsible for this type of red cell destruction?

A. Disseminatedintravascular coagulation (DIG)

B. Hemolytic uremic syndrome (HUS)

C. Thrombotic thrombocytopenic

purpura (TTP)

D. Idiopathic thrombocytopenic purpura

(ITP)

D. Idiopathic thrombocytopenic purpura

(ITP)$

Which of the following blood findings does not correlate with the presence of ringed sideroblasts in the bone marrow?

A. Pappenheimer bodies

B. Basophilic stippling

C. Increased total iron-binding capacity

D. Increased percent transferrin

saturation

C. Increased total iron-binding capacity

Which of the following conditions is not usually associated with marked reticulocytosis?

A. Four days after a major hemorrhage

B. Drug-inducedautoimmunehemolytic

anemia

C. Sickle cell anemia

D. Pernicious anemia

D. Pernicious anemia

Hereditary stomatocytosis is manifested physiologically by changes in

A. Hemoglobin oxygen affinity

B. Membrane cation permeability

C. Efficiency of hemoglobin reduction

D. Glycolytic ATP production

B. Membrane cation permeability

In addition to an increase in red blood cells, which of the following is characteristic of polycythemia vera?

A. Decreased platelets, decreased

granulocytes, decreased erythropoietin

level

B. Decreased platelets, decreased

granulocytes, increased erythropoietin

level

C. Increased platelets, increased

granulocytes, increased erythropoietin

level

D. Increased platelets, increased

granulocytes, decreased erythropoietin level

D. Increased platelets, increased

granulocytes, decreased erythropoietin level

Which of the following is not characteristic of aplastic anemia?

A. Extramedullary hematopoiesis

B. Bone marrow hypoplasia

C. Absolute reticulocytopenia

D. Blood findings of pancytopenia

A. Extramedullary hematopoiesis

What values would you expect to obtain on hemoglobin and hematocrit determinations done immediately after a major hemorrhage, if hemoglobin and hematocrit values were normal prior to the hemorrhage?

A. Both normal

B. Both decreased

C. Hemoglobin decreased, hematocrit

normal

D. Hemoglobin normal, hematocrit

decreased

A. Both normal

Results from a 1-day-old infant include a hemoglobin of 201 g/L (20.1 g/dL), hematocrit of 0.60 L/L (60.0%), MCV of 110.2 fL, and 4 nucleated red cells/100 WBCs. How should these results be interpreted?

A. The elevated hemoglobin and hematocrit values indicate possible dehydration.

B. The nucleated red cells suggest accelerated erythropoiesis due to a hemolytic process.

C. Testing should be done to identify the cause of the macrocytosis.

D. No further testing is indicated.

D. No further testing is indicated.

When viewing Color Plate 7 1m, the red blood cells with a single elongated projection are known as and may be seen in

A. Acanthocytes; liver disease

B. Echinocytes; liver disease

C. Drepanocytes; myelofibrosis

D. Dacryocytes; myelofibrosis

D. Dacryocytes; myelofibrosis

A patient with normocytic, normochromic anemia secondary to small cell carcinoma may be exhibiting an anemia designated as

A. Hemolytic

B. Megaloblastic

C. Myelophthisic

D. Sideroblastic

C. Myelophthisic

Idiopathic aplastic anemia is best defined as a form of anemia that

A. Has no identifiable cause

B. Is caused by a physician's treatment

C. Follows exposure to ionizing radiation

D. Develops after a viral infection

A. Has no identifiable cause

Which of the following is a true red blood cell aplasia?

A. Marrow replacement anemia

B. Fanconi anemia

C. Diamond-Blackfananemia

D. Donath-Landsteiner anemia

C. Diamond-Blackfan anemia

Which of the following is not a cause of absolute secondary erythrocytosis?

A. Defective cardiac or pulmonary

function

B. High-altitude adjustment

C. Dehydration secondary to diuretic use

D. Hemoglobins with increased oxygen

affinity

C. Dehydration secondary to diuretic use

A cellulose acetate hemoglobin electrophoresis (alkaline pH), performed on the blood of a stillborn infant, revealed a single band that migrated farther toward the anode than did the Hb A control. What is the most likely composition of the stillborn infant's hemoglobin?

A. Four beta chains

B. Four gamma chains

C. Two alpha and two beta chains

D. Two alpha and two gamma chains

B. Four gamma chains

The most likely cause of the stillborn infant's condition in question 83 is

A. Erythroblastosis fetalis

B. Rh hemolytic disease of the fetus

C. Hydrops fetalis

D. ABO hemolytic disease of the newborn

C. Hydrops fetalis

Which of the following conditions show similar CBC and blood smear findings?

A. Beta-thalassemia major and minor

B. Folic acid and vitamin B12 deficiencies

C. Acute and chronic blood loss

D. Sickle cell disease and trait

B. Folic acid and vitamin B12 deficiencies

Which of the following would be useful in identifying the cause of the blood profile seen in Color Plate 8«?

A. Osmotic fragility test

B. Reticulocytecount

C. Direct antiglobulin test

D. Urine urobilinogen level

C. Direct antiglobulin test

Which of the following conditions is not associated with the presence of schistocytes and spherocytes?

A. Clostridial septicemia

B. Prosthetic heart valves

C. Severe thermal burns

D. Aplastic anemia

D. Aplastic anemia

A 30-year-old woman who has been vomiting for 3 days has a hemoglobin value of 180 g/L (18.0 g/dL) and a hematocrit of 0.54 L/L (54.0%). Her results suggest the presence of

A. Absolute erythrocytosis

B. Primary polycythemia

C. Secondary polycythemia

D. Relative polycythemia

D. Relative polycythemia

An excessive accumulation of iron in body tissues is called

A. Hemochromatosis

B. Erythroblastosis

C. Megaloblastosis

D. Acrocyanosis

A. Hemochromatosis

Abetalipoproteinemia is characterized by mild anemia and numerous

on the peripheral

blood smear.

A. Acanthocytes

B. Elliptocytes

C. Echinocytes

D. Stomatocytes

A. Acanthocytes

What is the most common cause of iron deficiency?

A. Bleeding

B. Gastrectomy

C. Inadequate diet

D. Intestinal malabsorption

A. Bleeding

Which of the following does not characterize beta-thalassemia major?

A. Transfusion-dependent anemia

B. Decreased alpha chains result in

excess beta chains.

C. Iron chelation therapy is necessary.

D. Common in persons of Mediterranean

ancestry

B. Decreased alpha chains result in

excess beta chains.

In the anemia of chronic disease, what are the usual serum iron and transferrin levels?

A. Serum iron decreased, transferrin

decreased

B. Serum iron decreased, transferrin

increased

C. Serum iron normal, transferrin normal

D. Serum iron increased, transferrin

increased

A. Serum iron decreased, transferrin

decreased

In children, the most important effect of lead poisoning is on the

A. Liver

B. Kidney

C. Neurologic system

D. Development of erythrocytes

C. Neurologic system

Which of the following would not result in the dual population of red cells represented in Color Plate 9B?

A. Blood transfusion

B. Oral iron therapy

C. Spleen removal

D. Coexisting deficiencies

C. Spleen removal

What is the most likely genetic defect in the hemoglobin of cells seen in Color Plate 10B?

A. Substitution of valine for glutamic acid

in position 6 of the alpha-globin chain

B. Substitution of valine for glutamic acid

in position 6 of the beta-globin chain

C. Substitution of lysine for glutamic acid

in position 6 of the alpha-globin chain

D. Substitution of lysine for glutamic acid in position 6 of the beta-globin chain

B. Substitution of valine for glutamic acid

in position 6 of the beta-globin chain

On what is the classification of sickle cell trait versus sickle cell disease based?

A. Severity of the clinical symptoms

B. Number of irreversibly sickled cells

(ISCs)

C. Level of compensatory hemoglobin F

D. Percentage of hemoglobin S on

electrophoresis

D. Percentage of hemoglobin S on

electrophoresis

Which of the following is the most appropriate treatment for sickle cell anemia?

A. Hydroxyurea

B. Supportive therapy

C. Hyperbaric oxygen

D. Iron

B. Supportive therapy

Which of the following values can be used to indicate the presence of a hemolytic anemia?

A. Hemoglobin level

B. Hematocrit level

C. Erythrocyte count

D. Reticulocyte count

D. Reticulocyte count

A pre-operative, 20-year-old female has a mild microcytic anemia, with target cells and stippled red cells observed on the blood smear. Her hemoglobin A2 level is quantified at 5%. What do these findings suggest?

A. Iron-deficiency anemia

B. Heterozygous alpha-thalassemia

C. Heterozygous beta-thalassemia D. Hemoglobin S/beta-thalassemia

C. Heterozygous beta-thalassemia