Clin Chem A Test 3 Practice Questions
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52 Terms
The characteristics erythrocyte found in pernicious anemia is :
Macrocytic cells
3 multiple choice options
Hemolysis in paroxysmal nocturnal hemoglobinuria ( PNH) is:
Caused by a red cell membrane defect
3 multiple choice options
The direct antiglobulin test is used to differentiate _______
Inherited from acquired spherocytosis
3 multiple choice options
Anemia chronic infection is characterized by:
Decreased serum iron levels
3 multiple choice options
Factors commonly involved in producing amenia in patients with chronic renal disease include:
Inadequate erythropoisis
3 multiple choice options
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 :
Aplastic crisis
3 multiple choice options
Which of the following characteristics are common to hereditary spherocytosis, hereditary elliptocytosis, hereditary stomatocytosis, and paroxysmal nocturnal hemoglobinuria ?
Red cell membrane defect
3 multiple choice options
Which of the following are crises associated with sickle cell anemia ?
All of the above
3 multiple choice options
Which of the following is a cause of methemoglobinemia ?
all the above
3 multiple choice options
Which finding would be most useful in establishing a diagnosis of HbSC disease ?
Hemoglobin electrophoresis at Alkaline pH
3 multiple choice options
What factors contribute to the sickling of RBCs ?
Decrease in pH and deoxygenation and dehydration
2 multiple choice options
What are therapeutic strategies or goals in the management of sickle cell anemia ?
All the above
3 multiple choice options
What is the most common glycolytic enzymes deficiency associated with the pentose phosphate pathway ( aerobic pathway)
G6PD deficiency
3 multiple choice options
What is the most common glycolytic enzyme deficiency associated with the Embden - Meyerhof pathway?
Pyruvate kinase (PK) deficiency
3 multiple choice options
Oxidative denaturation of hemoglobin results in formation of small particles that are visualized with supravital staining, What is the term for these particles :
Heinze bodies
3 multiple choice options
In evaluation of a patient for G6PD deficiency which of the following test results would indicate a deficiency of the enzyme
all of the above
3 multiple choice options
Which hemoglobin deficiency causes hemoglobin to be oxidized from ferrous( Fe2+) to the ferric ( Fe3+) state ?
NADH- methemoglobin reductase deficiency
3 multiple choice options
Which of the following tests is not used to determine increased red cell destruction ?
all of the above
3 multiple choice options
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) :
2
3 multiple choice options
What test are useful in the classification of the cause of anemia of red Cell hemolysis ?
Coombs test
3 multiple choice options
Which of the following red cell membrane protein deficiencies does not cause hereditary spherocytosis ?
Protein 4.1 (Elliptocytosis)
3 multiple choice options
Which of the following laboratory tests would not be typical of hereditary spherocytosis ?
Decreased MCHC
3 multiple choice options
What is the most common cause congenital disorder associated with aplastic anemia ?
Fanconi's anemia
3 multiple choice options
Which of the following represent the most complete list of etiologies causing aplastic anemia ?
Secondary, idiopathic, and congenital
3 multiple choice options
Which of the following has not been associated with an acquired type of aplastic anemias ?
Increased chromosomal breakage
3 multiple choice options
Which of the following drug is not associated with the development of aplastic anemia ?
Aspirin
3 multiple choice options
Ionizing radiation causes aplastic anemia by which of the following mechanisms?
all of the above
3 multiple choice options
Which of the following is not seen in the peripheral smear of blood of patient with aplastic anemias ?
Increased reticulocyte count
3 multiple choice options
What is the appearance of bone marrow in aplastic anemia ?
Hypocellular
3 multiple choice options
What is the treatment of choice for severe aplastic anemia in patient who are younger than age 50 ?
Bone marrow transplantation
3 multiple choice options
What is the definition of pure red cell aplasia?
Lack of erythroid precursors with normal white blood cells and megakaryocytic precursors
3 multiple choice options
Which statement best describes paroxysmal nocturnal hemoglobinuria ?
Acquired hemolytic anemia associated with cellular membrane abnormalities
2 multiple choice options
What are the causes of red cell defect in paroxysmal nocturnal hemoglobinuria ( PNH) ?
Lack of GPI - anchored protein on the erythrocyte membrane
3 multiple choice options
Which of the following is a correct description of the Sugar water test ( sucrose hemolysis test) ?
PNH cells are lysed by complement after exposure to low- ionic strength sugar water
3 multiple choice options
What is the correct description of the Ham's test ( acidified serum lysis test)?
Patient's serum is acidified to enhance complement binding and lysis of patient cell
3 multiple choice options
The basis of flow cytometric test for diagnosis of PNH is which of the following ?
An affected patient will show decreased levels of CD55 and CD59 binding in a subset of cells
3 multiple choice options
Which of these test is used to diagnose PNH ? select all the applies
All of the above
3 multiple choice options
What is the pathophysiology of megaloblastic anemia ?
Defective DNA synthesis and abnormal nuclear maturation
3 multiple choice options
Which of the following laboratory findings coincide with megaloblastic anemia
Increased serum iron and serum bilirubin
3 multiple choice options
Megaloblastic anemia is associated with:
Ineffective erythropoiesis and decreased reticulocytes
3 multiple choice options
Which of the following is NOT a cause of Vitamin B 12 deficiency ?
Chronic glossitis
3 multiple choice options
Macrocytosis associated with acute blood loss is characterized by :
Increase reticulocyte count
3 multiple choice options
Which of the following is associated with pernicious anemia and not macrocytic anemia due to liver disease ?
Hypersegmented neutrophils
3 multiple choice options
The glycoprotein necessary for the intestinal absorption of vitamin B12 is :
Intrinsic factor
3 multiple choice options
The protein that transfers cobalamin ( Vit B12 ) in blood to it designated tissue or organ ( liver) is :
Transcobalamin II
3 multiple choice options
Which of the following schilling test results corresponds to a diagnosis of pernicious anemia ?
Part I abnormal (decrease/ no excretion of labelled cobalamin urine), part II ( labelled cobalamin + intrinsic factor) corrected
3 multiple choice options
Which of these are clinical manifestation of both B12 and folate deficiency ?
Anemia and Jaundice
3 multiple choice options
According to the classification anemias, megaloblastic anemias is a :
Macrocytic, normochromic anemia
3 multiple choice options
Which of the following are not seen on the peripheral smear of a patient with megaloblstic anemias ?
Hyposegmented neutrophils
3 multiple choice options
Which of the following are characteristics findings of the bone marrow in a patient with megaloblastic anemia ?
Hypercellular with low M: E ratio
3 multiple choice options
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 ?
Vitamin B12 deficiency
3 multiple choice options
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 Antigliadin antibodies are present. What is this patient most likely diagnosis?
Folate deficiency
3 multiple choice options