Hematology Exam 1 (chapter 5)

The earliest recognizable erythroid precursor on a Wright-stained smear of the bone marrow is:

A. pronormoblast

B. basophilic normoblast

C. CFU-E

D. BFU-E

A. pronormoblast

This renal hormone stimulates erythropoiesis in the bone marrow:

A. IL-1

B. erythropoietin

C. granulopoietin

D. thrombopoietin

B. erythropoietin

An increase in 2,3-BPG occurs at high altitude in an effort to:

A. increase oxygen affinity of hemoglobin

B. decrease oxygen affinity of hemoglobin

C. decrease the concentration of methemoglobin

D. protect the cell from oxidant damage

B. decrease oxygen affinity of hemoglobin

The erythrocyte life span is most directly determined by:

A. spleen size

B. serum haptoglobin level

C. membrane deformability

D. cell size and shape

C. membrane deformability

Which of the following depicts the normal sequence of erythroid maturation?

A. pronormoblast-> basophilic normoblast-> polychromatic normoblast-> orthochromic normoblast-> reticulocyte

A. pronormoblast-> basophilic normoblast-> polychromatic normoblast-> orthochromic normoblast-> reticulocyte

The primary effector (cause) of increased erythrocyte production, or erythropoiesis, is:

A. supply of iron

B. rate of bilirubin production

C. tissue hypoxia

D. rate of EPO secretion

C. tissue hypoxia

An increase in the reticulocyte count should be accompanied by:

A. a shift to the left in the Hb-O2 dissociation curve

B. abnormal maturation of normoblasts in the bone marrow

C. an increase in total and direct serum bilirubin

D. polychromasia on the Wright's-stained blood smear

D. polychromasia on the Wright's-stained blood smear

What property of the normal erythrocyte membrane allows the 7-mcM cell to squeeze through 3-mcM fenestrations in the spleen?

A. fluidity

B. elasticity

C. permeability

D. deformability

D. deformability

An increase of erythrocyte membrane rigidity would be predicted to have what effect?

A. increase in erythropoietin production

B. increase in cell volume

C. decrease in cell life span

D. decrease in reticulocytosis

C. decrease in cell life span

Extravascular erythrocyte destruction occurs in:

A. the bloodstream

B. macrophages in the spleen

C. the lymph nodes

D. bone marrow sinuses

B. macrophages in the spleen

Results of a CBC revealed a MCHC of 40 g/dL. What characteristic of the RBC will this affect?

A. oxygen affinity

B. cell metabolism

C. membrane permeability

D. cell deformability

D. cell deformability

If the erythrocyte cation pump fails because of inadequate generation of ATP, the result is:

A. decreased osmotic fragility due to formation of target cell

B. formation of echinocytes due to influx of potassium

C. cell crenation due to efflux of water and sodium

D. cell swelling due to influx of water and cations

D. cell swelling due to influx of water and cations

As a person ascends to high altitudes, the increased activity of the Rapoport-Leubering pathway:

A. causes precipitation

B. has no effect on oxygen delivery to tissues

C. causes increased release of oxygen to tissues

D. causes decreased release of oxygen to tissues

C. causes increased release of oxygen to tissues

A newborn has a hemoglobin level of 16.0 g/dL at birth. Two months later, a CBC indicates a hemoglobin concentration of 11.0 g/dL. The difference in hemoglobin concentration is most likely due to:

A. chronic blood loss

B. inherited anemia

C. increased intravascular hemolysis

D. physiologic anemia of the newborn

D. physiologic anemia of the newborn

A 50-year-old patient has a splenectomy after a car accident that damaged her spleen. She had a CBC performed at her 6-week postsurgical checkup. Many target cells were identified on the blood smear. This finding is most likely:

A. an indication of liver disease

B. a loss of RBC membrane peripheral proteins

C. an abnormal protein to phospholipid ratio to the RBC membrane

D. an accumulation of cholesterol and phospholipid in the RBC membrane

D. an accumulation of cholesterol and phospholipid in the RBC membrane

Which of the following is necessary to maintain reduced levels of methemoglobin in the erythrocyte?

A. vitamin B6

B. NADH

C. 2,3-BPG

D. lactate

B. NADH

A patient lost about 1500 mL of blood during surgery but was not given blood transfusions. His hemoglobin before surgery was in the reference range. The most likely finding 3 days later would be:

A. increase in total bilirubin

B. increase in indirect bilirubin

C. increase in erythropoietin

D. increased haptoglobin

C. increase in erythropoietin

A patient with kidney disease has a hemoglobin of 8 g/dL. This is the most likely associated with:

A. decreased EPO production

B. increased intravascular hemolysis

C. abnormal RBC membrane permeability

D. RBC fragility due to accumulation of intracellular calcium

A. decreased EPO production

A laboratory professional finds evidence of Heinz bodies in the erythrocytes of a 30-year-old male. This is evidence of:

A. increased oxidant concentration in the cell

B. decreased hemoglobin-oxygen affinity

C. decreased production of ATP

D. decreased stability of the cell membrane

A. increased oxidant concentration in the cell

A 65-year-old female presents with an anemia of 3 weeks' duration. In addition to a decrease in her hemoglobin and hematocrit, she has a reticulocyte count of 6% and 3+ polychromasia on her blood smear. Based on these preliminary findings, what serum erythropoietin result is expected?

A. decreased

B. normal

C. increased

D. no correlation

C. increased

A blood sample has an elevated bilirubin, low haptoglobin, and low hemopexin. What is the most likely reason for this?

A. Increased extravascular hemolysis

B. Hypersplenism

C. Ineffective erythropoiesis

D. Increased intravascular hemolysis

D. Increased intravascular hemolysis

Polychromatophilic red blood cells are commonly called what cell type?

A. Normoblast

B. Prorubricyte

C. Reticulocyte

D. Metarubricyte

C. Reticulocyte

What effect would a deficiency in G6PD have on RBC survival?

A. It would increase the survival of the RBCs.

B. It would decrease the survival of the RBCs.

C. It would have no effect on the survival of the RBCs.

D. This cannot be determined.

B. It would decrease the survival of the RBCs.

The deformability of the RBC membrane is attributed to which of the following?

A. Peripheral proteins

B. Integral proteins

C. Sodium potassium pump

D. Glycophorins

A. Peripheral proteins

In a non anemic adult, what is the normal range for peripheral blood reticulocytes?

A. 0.5−1.0%

B. 0.1−1.0%

C. 2.0−4.0%

D. 0.5−2.0%

D. 0.5−2.0%

Which pathway produces the energy required for proper RBC function from ~90% of the consumed glucose:

A. Methemoglobin reductase

B. Hexose monophosphate shunt

C. Glycolytic

D. Rapoport-Leubering shunt

C. Glycolytic

Red blood cell production begins with what cell?

A. Progenitor

B. Hematopoietic stem cell

C. CFU

D. BFU

B. Hematopoietic stem cell

The life span of a normal erythrocyte is about:

A. 9−11 days

B. 5−7 days

C. 120 days

D. 6 hours

C. 120 days

Which of the following best correlates with an increased reticulocyte count?

A. An increased bilirubin

B. The presence of schistocytes in the peripheral blood smear

C. Increased polychromasia on the peripheral blood smear

D. Anisocytosis and poikilocytosis

C. Increased polychromasia on the peripheral blood smear

Identify the cells at the end of the pointers.

A. Reticulocyte

B. Spherocyte

C. Sickle cell

D. Target cell

D. Target cell

The red cell protein that is responsible for deformability and flexibility of the red cell is:

A. Spectrin

B. Glycophorin

C. Glycine

D. EPO

A. Spectrin

When hemolysis is produced by the intravascular fragmentation of red cells, which red cell morphology will be produced?

A. Spherocytes

B. Macrocytes

C. Acanthocytes

D. Schistocytes

D. Schistocytes

Which of the following RBC pathways is responsible for providing 90% of the cellular ATP for red cell metabolism?

A. Embden-Meyerhof pathway

B. Methemoglobin reductase pathway

C. Rapoport-Luebering pathway

D. Hexose monophosphate shunt

A. Embden-Meyerhof pathway

The last nucleated stage of erythrocytic maturation is the:

A. Pronormoblast

B. Orthochromic normoblast

C. Polychromatophilic normoblast

D. Basophilic normoblast

B. Orthochromic normoblast

What is the primary mechanism by which erythropoietin affects RBC production?

A. It expedites the maturation time of RBCs.

B. It prevents premature apoptosis of RBCs.

C. It stimulates facilitated incorporation of hemoglobin into RBCs.

D. It stimulates expulsion of nuclei from nucleated erythrocyte precursors at a quicker rate.

A. It expedites the maturation time of RBCs.

A reticulocyte count is 6%. This result is:

A. Normal.

B. Increased.

C. Decreased.

D. Erroneous.

B. Increased.

What growth factor influences the production of the erythrocyte?

A. Transforming growth factor- β

B. Interferon-γ

C. Erythropoietin

D. CFU-E

C. Erythropoietin

The average RBC is what size?

A. 20-25 mcM

B. 2-3 ,mcM

C. 12-15 mcM

D. 7-8 mcM

D. 7-8 mcM