Clin Chem A Test 3

Which of the following tests is NOT used to determine increased red blood cells destruction (hemolysis)

a) Increase unconjugated (indirect) bilirubin

b) Decrease serum haptoglobin

c) Positive Schumm's test (detects methemalbumin; an indication for intravascular hemolysis)

d) Increase reticulocyte count

e) Serum transferrin levels

e) Serum transferrin levels

Folic acid is made up of 3 major compounds/component chemicals. Which of the compound(s) below in the answer choices is/are a component of folic acid?

a) Glutamic acid

b) Para-aminobenzoic acid

c) Pteridin

d) Ascorbic acid

a) Glutamic acid

b) Para-aminobenzoic acid

c) Pteridin

A 2-year-old child is presented to the clinic with complains of fatigue, anemia, and lethargy. The patient was diagnosed with congenital pernicious after laboratory test. What is the pathophysiology of congenital pernicious anemia?

a) Antibodies against C3b

b) Antibodies against parietal cell

c) Antibodies against intrinsic factor

d) Mutation of intrinsic factor or Transcobalmin II

d) Mutation of intrinsic factor or Transcobalmin II

A 55 year old male present to the clinic with fatigue, dyspnea and generalized joint pain. he has lost 10lbs in the last two months with no change in his diet or activities. The patient has a history of rheumatoid arthritis and on medication for this condition. He is compliant with his medication and treatment. The patient labs show increase ferritin, decrease serum iron, decrease hemoglobin, hematocrit, RBC, normal TIBC and transferrin. What is the diagnosis?

a) Sideroblastic anemia

b) Iron deficiency anemia

c) Lead poisoning

d) megaloblastic anemia

e) Anemia of chronic disease

e) Anemia of chronic disease

The characteristics erythrocyte found in pernicious anemia is:

a) Microcytic

b) Spherocytic

c) Hypochromic

d) Macrocytic

d) Macrocytic

Hemolysis in paroxysmal nocturnal hemoglobinuria ( PNH) is:

a) Temperature -dependent

b) Complement -independent

c) Antibody -mediated

d) Caused be a red cell membrane defect

d) Caused be a red cell membrane defect

The direct antiglobulin test is used to differentiate ____________ :

a) Inherited from acquired spherocytosis

b) Intravascular from extravascular

c) Heterozygous from homozygous thalassemia

d) Sickle trait from sickle disease

a) Inherited from acquired spherocytosis

Anemia chronic infection is characterized by:

a) Decrease iron stores in the reticuloendothelial system

b) Decreased serum iron level

c) Macrocytic erythrocytes

d) Increased serum Iron binding capacity

b) Decreased serum iron level

Factors commonly involved in producing anemia in patients with chronic renal disease include:

a) Marrow hypoplasia

b) Inadequate erythropoiesis

c) Vitamin B12 deficiency

d) Increased Erythropoietin production

b) Inadequate erythropoiesis

A 24 year-old female with sickle cell anemia whose usual hemoglobin concentration is 8 g/dL( 80/L )develops fever, increased weakness and malaise. The hemoglobin concentration is 4 g/ dL ( 40g/L) and the reticulocyte count is 0.1%. The most likely explanation for her clinical picture at this time is:

a) Increase hemolysis due hypersplenism

b) Aplastic crisis

c) Thrombotic crisis

d) Occult blood loss

b) Aplastic crisis

Which of the following characteristics are common to hereditary spherocytosis, hereditary elliptocytosis, hereditary stomatocytosis, and paroxysmal nocturnal hemoglobinuria?

a) Autosomal dominant inheritance

b) Red cell membrane defect

c) Positive direct antiglobulin test

d) Measured platelet count

b) Red cell membrane defect

Which of the following are crises associated with sickle cell anemia?

a) Aplastic crisis with low reticulocyte count and infection

b) Hemolytic crisis with splenic sequestration, decrease hemoglobin and hematocrit, increased reticulocyte count, jaundice

c) Vaso-occlusive or painful crises with severe pain, tissue damage and necrosis

d) All of the above

d) All of the above

Which of the following is a cause of methemoglobinemia?

a) HbM variant

b) NADH- diaphorase deficiency

c) Toxic substances

d) All above

d) All above

Which finding would be most useful in establishing a diagnosis of HbSC disease?

a) Target cells and sickle cells on peripheral blood smear

b) Severe anemia: increased reticulocyte count

c) Hemoglobin electrophoresis at Alkaline pH

d) RBC indices

c) Hemoglobin electrophoresis at Alkaline pH

What factors contribute to the sickling of RBCs?

a) Increase in PH and oxygenation

b) Decrease in pH and oxygenation and dehydration

c) Increase in pH and decrease in oxygenation

d) Decrease in dehydration and increase in pH and oxygenation

b) Decrease in pH and oxygenation and dehydration

What are therapeutic strategies or goals in the management of sickle cell anemia?

a) Decrease microvascular entrapment of sickled cells or change the volume or RBCs

b) Modify oxygenation affinity or solubility of sickle hemoglobin

c) Increase production of fetal hemoglobin

d) All of the above

d) All of the above

What is the most common glycolytic enzymes deficiency associated with the pentose phosphate pathway (aerobic pathway)?

a) Pyruvate Kinase (PK) deficiency

b) G6PD deficiency

c) Hexokinase deficiency

d) Glutathione reductase deficiency

b) G6PD deficiency

What is the most common glycolytic enzyme deficiency associated with the Embden - Meyerhof pathway?

a) Pyruvate Kinase (PK) deficiency

b) G6PD

c) Hexokinase Deficiency

d) Glucokinase deficiency

e) Glutathione reductase deficiency

a) Pyruvate Kinase (PK) deficiency

Oxidative denaturation of hemoglobin results in formation of small particles that are visualized with supravital staining. What is the term for these particles:

a) Basophilic stippling

b) Howell - Jolly bodies

c) Pappenheimer -bodies

d) Heinz bodies

d) Heinz bodies

In evaluation of a patient for G6PD deficiency which of the following test results would indicate a deficiency of the enzyme?

a) Increased formation of Heinz bodies

b) Lack of fluorescence in the fluorescent spot test

C) Failure to reduce methemoglobin in the presences of methylene blue

D) All of the above

D) All of the above

Which hemoglobin deficiency causes hemoglobin to be oxidized from ferrous to the ferric state?

a) G6PD

b) PK deficiency

c) NADH- methemoglobin reductase deficiency

d) Lactate dehydrogenase deficiency

c) NADH- methemoglobin reductase deficiency

Which of the following tests is used to determine increased red cell destruction?

a) Unconjugated (indirect) bilirubin

b) Serum haptoglobin

c) Schumm's test

d) Reticulocyte count

e) All of the above

e) All of the above

Anemic patient investigated for hemolytic state has the following laboratory findings : Hbg 8g/dL, Hct, 23%, reticulocyte count 8 %, polymorphs on peripheral smear. What is the reticulocyte production index ( RPI):

a) 8

b) 4

c) 2

d) 1

c) 2

What test are useful in the classification of the cause of anemia of red Cell hemolysis?

a) Coombs test

b) Hemoglobin level and electrophoresis

c) Reticulocyte count

d) Red cell enzyme studies and iron -binding capacity

a) Coombs test

Which of the following red cell membrane protein deficiencies does not cause hereditary spherocytosis?

a) Ankyrin

b) Protein 4.1 (elliptocytosis)

c) Protein 4.2

d) Band 3

b) Protein 4.1 (elliptocytosis)

Which of the following laboratory tests would not be typical of hereditary spherocytosis?

a) Increase osmotic fragility

b) Spherocytes on peripheral smear

c) Decreased MCHC

d) Increased RPI

c) Decreased MCHC

What is the most common cause congenital disorder associated with aplastic anemia ?

a) Fanconi's anemia

b) Thrombocytopenia - absent radius ( TAR) syndrome

c) Congenital dyserythropoitiec anemia type1

d) Diamond -blackfan anemia

a) Fanconi's anemia

Which of the following represent the most complete list of etiologies causing aplastic anemia?

a) Secondary and congenital

b) Idiopathic and congenital

c) Secondary and idiopathic

d) Secondary, idiopathic, and congenital

d) Secondary, idiopathic, and congenital

Which of the following has not been associated with an acquired type of aplastic anemias ?

a) Ionizing radiation

b) Increased chromosomal breakage

c) Chemical agents

d) Drugs

b) Increased chromosomal breakage

Which of the following drug is not associated with the development of aplastic anemia ?

a) Chloramphenicol

b) Phenylbutazone

c) Aspirin

d) Chemotherapeutic agents

c) Aspirin

Ionizing radiation causes aplastic anemia by which of the following mechanisms?

a) Dose - dependent destruction of the bone marrow stem cells

b) An idiosyncratic delayed development of bone marrow aplasia

c) Disruption of chemical bonds to form free radicals that damage the bone marrow cells

d) All of the Above

d) All of the Above

Which of the following is not seen in the peripheral smear of blood of patient with aplastic anemias ?

a) Normochromic, normocytic, anemias

b) Increased reticulocyte count

c) Relative lymphocytosis

d) Decrease neutrophils

b) Increased reticulocyte count

What is the appearance of bone marrow in aplastic anemia ?

a) Hypocellular

b) Normocellular

c) Hypercellular

d) Fibrotic

a) Hypocellular

What is the treatment of choice for severe aplastic anemia in patient who are younger than age 50 ?

a) Multiple transfusion

b) Androgens

c) Bone marrow transplantation

d) Erythropoietin therapy

c) Bone marrow transplantation

What is the definition of pure red cell aplasia?

a) Lack of hematopoietic precursors in the bone marrow

b) Abnormal, giant normoblast in the bone marrow

c) Lack of erythroid precursors with normal white blood cells and megakaryocytic precursors

d) Dysplastic red cells precursors with normal white

c) Lack of erythroid precursors with normal white blood cells and megakaryocytic precursors

Which statement best describes paroxysmal nocturnal hemoglobinuria?

a) Acquired hemolytic anemia associated with cellular membrane abnormalities

b) Congenital hemolytic anemias associated with the inflammatory response

c) A premalignant condition that almost always results in development of acute leukemia

a) Acquired hemolytic anemia associated with cellular membrane abnormalities

What are the causes of red cell defect in paroxysmal nocturnal hemoglobinuria ( PNH)?

a) Lack of GPI - anchored protein on the erythrocyte membrane

b) Excessive amount of complement components

c) Excessive amounts of complement components C5 and C9

d) Glucose -6- phosphate dehydrogenase enzyme deficiency

a) Lack of GPI - anchored protein on the erythrocyte membrane

Which of the following is a correct description of the Sugar water test ( sucrose hemolysis test)?

a) PNH cells are lysed by complement after exposure to low- ionic strength sugar water

b) PNH cells are lysed by antibody and complement after heating to 56oC in sugar water solution ( 5%)

c) Patient's serum is acidified to enhance complement binding and lysis of patient cell

d) Patient's serum is heated -inactivated and treated with HCl; complement is added: patient cell lysis occurs

a) PNH cells are lysed by complement after exposure to low- ionic strength sugar water

What is the correct description of the Ham's test (acidified serum lysis test)?

a) PNH cells are lysed by complement after exposure to low- ionic strength sugar water

b) PNH cells are lysed by antibody and complement after heating to 56 oC in sugar water solution ( 5 %)

c) Patient's serum is acidified to enhance complement binding and lysis of patient cell

d) Patient's serum is heated -inactivated and treated with HCl; complement is added: patient cell lysis occurs

c) Patient's serum is acidified to enhance complement binding and lysis of patient cell

The basis of flow cytometric test for diagnosis of PNH is which of the following ?

a) PNH will have increased amount of complement detected on the cell surface

b) PNH Cells are easily lysed and will show decreased number when analyzed

c) An affected patient will show decreased levels of CD55 and CD59 binding in a subset of cells

d) All of the patient cells will show decreased levels of GPI - anchored proteins on the erythrocyte membrane

c) An affected patient will show decreased levels of CD55 and CD59 binding in a subset of cells

Which of these test is used to diagnose PNH? Select all the applies

a) Sugar water test

b) Ham's test

c) Flow cytometric analysis for CD55 and CD 59

d) Schilling test

a) Sugar water test

b) Ham's test

c) Flow cytometric analysis for CD55 and CD 59

what is the pathophysiology of megaloblastic anemia?

a) Defective RNA synthesis and abnormal Cytoplasm maturation

b) Defective DNA synthesis and abnormal nuclear maturation

c) Defective RNA synthesis and abnormal nuclear maturation

d) Defective DNA synthesis and abnormal cytoplasm maturation

b) Defective DNA synthesis and abnormal nuclear maturation

Which of the following laboratory findings coincide with megaloblastic anemia?

a) Increased serum iron and serum bilirubin

b) Decreased serum iron and serum bilirubin

c) Decreased serum muramidase

d) Increased haptoglobin

a) Increased serum iron and serum bilirubin

Megaloblastic anemia is associated with:

a) Ineffective erythropoiesis and increased reticulocytes

b) Ineffective erythropoiesis and decreased reticulocytes

c) Ineffective erythropoiesis and decreased and decreased LDH

d) Ineffective erythropoiesis and decreased erythropoietin

b) Ineffective erythropoiesis and decreased reticulocytes

Which of the following is not a cause of Vitamin B 12 deficiency?

a) Atrophic gastritis

b) Total gastrectomy

c) Blind loop syndrome

d) Chronic glossitis

d) Chronic glossitis

Macrocytosis associated with acute blood loss is characterized by:

a) Decrease reticulocyte count

b) Increase reticulocyte count

c) Pancytopenia

d) Macro-ovalocytes

b) Increase reticulocyte count

Which of the following is associated with pernicious anemia and not macrocytic anemia due to liver disease?

a) Increase LDH

b) Increase bilirubin

c) Increase MCV

d) Hypersegmented neutrophils

d) Hypersegmented neutrophils

The glycoprotein necessary for the intestinal absorption of vitamin B12 is:

a) Albumin

b) Transcobalamin II

c) Haptoglobulin

d) Intrinsic factor

d) Intrinsic factor

The protein that transfers cobalamin ( Vit B12 ) in blood to it designated tissue or organ ( liver) is:

a) Albumin

b. Transcobalamin II

c. Haptoglobulin

d. Intrinsic factor

b. Transcobalamin II

Which of the following schilling test results corresponds to a diagnosis of pernicious anemia?

a) Part I abnormal (decrease/ no excretion labelled cobalamin urine) , part II( cobalamin + intrinsic factor) not corrected

b) Part I abnormal (decrease/ no excretion of labelled cobalamin urine), part II ( labelled cobalamin + intrinsic factor) corrected

c) Part I abnormal (decrease/ no excretion of labelled cobalamin urine) , part II (labelled cobalamin + intrinsic factor) abnormal

d) Part I normal (decrease/ no excretion of labelled cobalamin urine) , part II ( Labelled cobalamin + intrinsic factor) corrected

b) Part I abnormal (decrease/ no excretion of labelled cobalamin urine), part II ( labelled cobalamin + intrinsic factor) corrected

Which of these are clinical manifestation of both B12 and folate deficiency?

a) Anemia and Jaundice

b) Thrombocytosis

c) Hemoglobinemia

d) Hemoglobinuria

a) Anemia and Jaundice

According to the classification anemias, megaloblastic anemias is a:

a) Macrocytic , hypochromic anemia

b) Macrocytic, hyperchromic anemia

c) Macrocytic, normochromic anemia

d) Normocytic, normochromic anemias

c) Macrocytic, normochromic anemia

Which of the following are not seen on the peripheral smear of a patient with megaloblastic anemias?

a. Macro-ovalocytes

b. Hypersegmented neutrophils

c. Hyposegmented neutrophils

d. Howell -jolly bodies

c. Hyposegmented neutrophils

Which of the following are characteristics findings of the bone marrow in a patient with megaloblastic anemia?

a) Hypocellular with low M:E ratio

b) Hypercellular with high M:E ratio

c) Hypocellular with high M:E ratio

d) Hypercellular with low M: E ratio

d) Hypercellular with low M: E ratio

A 65 years old female complains of fatigue and chronic diarrhea. Physical examination reveals a beefy red tongue with fissuring along the lateral edges. Vibratory sensation is absent in both lower extremities and there is loss of balance when standing up with her eyes closed that is corrected when the eyes are open . A CBC shows pancytopenia and MCV of 125 um3 . Peripheral smear shows hypersegmented neutrophils What is the most likely diagnosis of this patient?

a) Folate deficiency

b) Anemia of chronic disease

c) Aplastic anemia

d) Vitamin B12 deficiency

e) G6PD deficiency

d) Vitamin B12 deficiency

A 30 years female complains of fatigue and chronic diarrhea with greasy stools. Physical examination reveals pale conjunctivae, glossitis and normal neurologic examination. A CBC shows macrocytic anemia with neutropenia and thrombocytopenia. The peripheral smear reveals macro-ovalocytes and few hypersegmented neutrophils. A stool for occult blood is negative. Serum Anti Gliadin antibodies are present. What is this patient most likely diagnosis?

a) Folate deficiency

b) Anemia of chronic disease

c) Aplastic anemia

d) Vitamin B12 deficiency

e) G6PD deficiency

a) Folate deficiency

A 22 year old male with chronic cholecystitis has a family history of anemia. Physical examination reveals splenomegaly . CBC shows a normocytic anemia with an increased corrected reticulocyte count . Peripheral blood shows acanthocytes/ thorny RBCs

What is the most likely diagnosis:

a) G6PD ( Glucose -6-phosphate dehydrogenase deficiency)

b) Pyruvate Kinase (PK) deficiency

c) PNH (Paroxysmal nocturnal hemoglobinuria)

d) Hereditary spherocytosis

b) Pyruvate Kinase (PK) deficiency

Which of the following are causes of vitamin B12 deficiency?

a) Achlorhydria

b) Anti-parietal cell antibodies

c) Anti-intrinsic factor

d) Bloom syndrome

e) Transcobalamin II protein mutation

a) Achlorhydria

b) Anti-parietal cell antibodies

c) Anti-intrinsic factor

e) Transcobalamin II protein mutation

Folate is absorbed in what part of the gastrointestinal tract?

a) Terminal ileum

b) Duodenum and jejunum

c) Fundus of the stomach

d) Sigmoid colon

b) Duodenum and jejunum

What is the function of pepsin in Vitamin B12 absorption?

a) Cleave off the R-binder (haptocorin)

b) Delivers Vitamin B12 to metabolically active cells for DNA synthesis

c) Protect vitamin B12 from acid destruction

d) Frees vitamin B12 from ingested food

d) Frees vitamin B12 from ingested food

Which of the following is a major red blood cell integral proteins. (PATA)

a) Band 3

b) Glycophorin

c) Ankyrin

d) Spectrin

a) Band 3

b) Glycophorin

Jane, 20-year-old female present to the clinic with dyspnea on exertion, fatigue, and mild mood disorder. The patient blood shows decrease reticulocyte, hematocrit, hemoglobin. The total white cell count, platelet are normal. The patient suffered a respiratory illness in the past two weeks that resolved spontaneously without treatment. What is the next best test after CBC.

a) Flow cytometry

b) Direct Coombs test

c) Parvo B19 serology test

d) Hemoglobin electrophoresis

e) Osmotic fragility test

c) Parvo B19 serology test

Which test is useful in the classification of hemolytic anemia with peripheral smear showing spherocytes?

a) Coombs test

b) Hemoglobin level and electrophoresis

c) Reticulocyte count

d) Red cell enzyme studied and iron-binding capacity

a) Coombs test

Megaloblastic anemia, a subgroup of macrocytic anemia is characterized by defective nuclear maturation caused by impaired deoxyribonucleic acid (DNA) Synthesis.

a. True

b. False

a. True

John 20-year-old male present to the clinic with fatigue, dyspnea on exertion, and mild jaundice. Patient CBC indicates normocytic anemia, and peripheral blood smear shows spherocytes. What is the next best test in diagnosing the cause of patient anemia?

a) Sugar water test

b) Iron studies

c) Hemoglobin electrophoresis

d) Acidified serum test

e) Direct antibody test (Direct Coombs test)

e) Direct antibody test (Direct Coombs test)

What type of globin chain and hemoglobin are characteristics of severe alpha-thalassemia?

a) Two a chains and two b-chains (HbA)

b) Two a-chains and two b-chains (HbA2)

c) Four b-chain (HbH) or four y-chains (Hb Bart's)

d) Two a-chains and two y-chains (HbF)

c) Four b-chain (HbH) or four y-chains (Hb Bart's)

Which metabolite is most sensitive for vitamin B12 deficiency?

a. Homocysteine

b. Bilirubin

c. Methylmalonic acid

d. Ferritin

c. Methylmalonic acid

Which deficiency is associated with neurologic symptoms such as paresthesias and loss of proprioception?

a. Iron deficiency

b. Folate deficiency

c. Vitamin B12 deficiency

d. Aplastic anemia

c. Vitamin B12 deficiency

Which of the following findings is NOT typically seen in folate deficiency?

a. Macro-ovalocytes

b. Hypersegmented neutrophils

c. Glossitis

d. Neurologic deficits

d. Neurologic deficits

Intrinsic factor is produced by which cells?

a. Chief cells

b. Goblet cells

c. Enterocytes

d. Parietal cells

d. Parietal cells

What is the primary function of transcobalamin II (TCII)?

a. Transport vitamin B12 to tissues

b. Protect B12 from acid destruction

c. Cleave R-binders from B12

d. Produce intrinsic factor

a. Transport vitamin B12 to tissues

Which condition is most associated with anti-intrinsic factor antibodies?

a. Folate deficiency

b. Pernicious anemia

c. Iron deficiency anemia

d. G6PD deficiency

b. Pernicious anemia

What is the hallmark peripheral smear finding in megaloblastic anemia?

a. Spherocytes

b. Schistocytes

c. Target cells

d. Hypersegmented neutrophils

d. Hypersegmented neutrophils

Which of the following is a non-megaloblastic cause of macrocytosis?

a. Vitamin B12 deficiency

b. Folate deficiency

c. Alcoholism

d. Pernicious anemia

c. Alcoholism

Which type of hemolysis is most associated with increased unconjugated bilirubin and splenomegaly?

a. Intravascular hemolysis

b. Mechanical hemolysis

c. Complement-mediated hemolysis

d. Extravascular hemolysis

d. Extravascular hemolysis

A decrease in serum haptoglobin is most characteristic of:

a. Intravascular hemolysis

b. Iron deficiency anemia

c. Aplastic anemia

d. Folate deficiency

a. Intravascular hemolysis

Which of the following is the preferred diagnostic test for hereditary spherocytosis?

a. Ham test

b. Coombs test

c. EMA binding test

d. Schilling test

c. EMA binding test

Which red blood cell membrane protein defect is most common in hereditary spherocytosis?

a. Spectrin

b. Band 4.1

c. Band 3

d. Ankyrin

d. Ankyrin

What laboratory abnormality is commonly increased in hereditary spherocytosis?

a. Osmotic resistance

b. MCV

c. MCHC

d. Ferritin

c. MCHC

Which condition classically causes burr cells (echinocytes)?

a. Liver failure

b. Chronic renal failure

c. Iron deficiency anemia

d. Folate deficiency

b. Chronic renal failure

The most common cause of anemia in chronic renal failure is:

a. Iron deficiency

b. Hemolysis

c. Bone marrow fibrosis

d. Decreased erythropoietin production

d. Decreased erythropoietin production

What is the characteristic bone marrow finding in aplastic anemia?

a. Hypercellular marrow

b. Hypocellular marrow with fatty replacement

c. Increased megakaryocytes

d. Fibrosis

b. Hypocellular marrow with fatty replacement

Which of the following is commonly seen in aplastic anemia?

a. Reticulocytosis

b. Splenomegaly

c. Pancytopenia

d. Hypersegmented neutrophils

c. Pancytopenia

Pure red cell aplasia (PRCA) is characterized by:

a. Pancytopenia

b. Increased platelets

c. Absence of erythroid precursors with normal WBCs and platelets

d. Hypercellular marrow

c. Absence of erythroid precursors with normal WBCs and platelets

Parvovirus B19 most commonly infects which cells?

a. Megakaryocytes

b. Neutrophils

c. Erythroid precursor cells

d. Lymphocytes

c. Erythroid precursor cells

Which proteins are deficient in PNH?

a. Spectrin and ankyrin

b. Hemoglobin A and A2

c. CD55 and CD59

d. Glycophorin and band 3

c. CD55 and CD59

What is the screening test for PNH?

a. Sucrose hemolysis (sugar water) test

b. Coombs test

c. Schilling test

d. Osmotic fragility test

a. Sucrose hemolysis (sugar water) test

What is the confirmatory test for PNH?

a. EMA binding test

b. Direct Coombs test

c. Ham test (acidified serum test)

d. Heinz body prep

c. Ham test (acidified serum test)

Which deficiency protects against Plasmodium falciparum malaria?

a. Pyruvate kinase deficiency

b. Iron deficiency

c. G6PD deficiency

d. Hereditary spherocytosis

c. G6PD deficiency

Oxidative stress in G6PD deficiency leads to formation of:

a. Howell-Jolly bodies

b. Pappenheimer bodies

c. Basophilic stippling

d. Heinz bodies

d. Heinz bodies