Turgeon: CHAPTER 5 - Erythrocyte Maturation, Physiology, and Lifecycle

B. yolk sac—liver and spleen—red bone marrow

1. The progression of erythropoiesis from prenatal life to adulthood is

A. yolk sac—red bone marrow—liver and spleen

B. yolk sac—liver and spleen—red bone marrow

C. red bone marrow—liver and spleen—yolk sac

D. liver and spleen—yolk sac—red bone marrow

D. All of the above

2. Which of the following is (are) characteristic(s) of erythropoietin?

A. Glycoprotein

B. Secreted by the liver

C. Secreted by the kidneys

D. All of the above

A. Produced primarily in the liver of the unborn

3. Which of the following is a characteristic of erythropoietin?

A. Produced primarily in the liver of the unborn

B. Gene for erythropoietin is found on chromosome 11

C. Most erythropoietin is secreted by the liver in adults

D. Cannot cross the placental barrier

A. tissue hypoxia

4. Stimulation of erythropoietin is caused by

A. tissue hypoxia

B. hypervolemia

C. inflammation

D. infection

D. both B and C

5. The maturational sequences of an erythrocyte are

A. rubriblast—prorubricyte—metarubricyte— rubricyte-reticulocyte

B. rubriblast—prorubricyte—rubricyte—metarubricyte-reticulocyte

C. pronormoblast—basophilic normoblast—polychromatic normoblast—orthochromatic normoblast— reticulocyte

D. both B and C

D. Prorubricyte (basophilic normoblast)

6. What is the immature erythrocyte found in the bone marrow with the following characteristics: 12 to 17 mm in diameter, N:C of 4:1, nucleoli not usually apparent, and basophilic cytoplasm?

A. Rubriblast (pronormoblast)

B. Reticulocyte

C. Metarubricyte (orthochromatic normoblast)

D. Prorubricyte (basophilic normoblast)

C. metarubricyte (orthochromatic normoblast)

7. The nucleated erythrocyte with a reddish pink cytoplasm and condensed chromatin pattern is a

A. rubricyte (polychromatic normoblast)

B. basophilic normoblast (prorubricyte)

C. metarubricyte (orthochromatic normoblast)

D. either B or C

A. 1 day

8. With a normal diet, an erythrocyte remains in the reticulocyte stage in the circulating blood for

A. 1 day

B. 2.5 days

C. 3 days

D. 120 days

C. polychromatophilia

9. In a Wright-stained peripheral blood film, the reticulocyte will have a blue appearance. This is referred to as

A. megaloblastic maturation

B. bluemia

C. polychromatophilia

D. erythroblastosis

D. both B and C

10. In the reticulocyte stage of erythrocytic development,

A. nuclear chromatin becomes more condensed

B. RNA is catabolized and ribosomes disintegrate

C. full hemoglobinization of the cell occurs

D. both B and C

C. larger than normal reticulocytes

11. On a Wright-stained peripheral blood smear, stress or shift reticulocytes are

A. smaller than normal reticulocytes

B. about the same size as normal reticulocytes

C. larger than normal reticulocytes

D. noticeable because of a decreased blue tint

C. 0.5% to 2.0%

12. The normal range for reticulocytes in adults is

A. 0% to 0.5%

B. 0.5% to 1.0%

C. 0.5% to 2.0%

D. 1.5% to 2.5%

C. 5.0%

13. If a male patient has a reticulocyte count of 5.0% and a packed cell volume of 0.45 L/L, what is his corrected reticulocyte count?

A. 2.5%

B. 4.5%

C. 5.0%

D. 10%

D. 6.0

14. If a male patient has a reticulocyte count of 6.0% and a packed cell volume of 45%, what is his RPI?

A. 1.5

B. 3.0

C. 4.5

D. 6.0

C. two alpha and two beta chains

15. Normal adult hemoglobin has

A. two alpha and two delta chains

B. three alpha and one beta chains

C. two alpha and two beta chains

D. two beta and two epsilon chains

D. 4

16. The number of heme groups in a hemoglobin molecule is

A. 1

B. 2

C. 3

D. 4

B. decreases

17. Increased amounts of 2,3-DPG _____ the oxygen affinity of the hemoglobin molecule.

A. increases

B. decreases

C. does not alter

A. expels 2,3-DPG

18. After a molecule of hemoglobin gains the first two oxygen molecules, the molecule

A. expels 2,3-DPG

B. has decreased oxygen affinity

C. becomes saturated with oxygen

D. adds a molecule of oxygen to an alpha chain

C. a greater

19. If normal adult (A1 ) and fetal hemoglobin F are compared, fetal hemoglobin has _____ affinity for oxygen.

A. less

B. the same

C. a greater

B. stronger acid

20. Oxyhemoglobin is a _____ than deoxyhemoglobin.

A. weaker acid

B. stronger acid

D. both A and B

21. Heme is synthesized predominantly in the

A. liver

B. red bone marrow

C. mature erythrocytes

D. both A and B

22. D

23. B

Questions 22 and 23: The initial condensation reaction in the synthesis of porphyrin preceding heme formation takes place in the (22) _____ and requires (23) _____.

22. _____

A. liver

B. spleen

C. red bone marrow

D. mitochondria

23. _____

A. iron

B. vitamin B6

C. vitamin B12

D. vitamin D

D. the mitochondria

24. The final steps in heme synthesis, including the formation of protoporphyrin, take place in

A. a cell's nucleus

B. a cell's cytoplasm

C. the spleen

D. the mitochondria

B. lead poisoning

25. An acquired disorder of heme synthesis is

A. congenital erythropoietic porphyria

B. lead poisoning

C. hemolytic anemia

D. hemoglobinopathy

B. transferrin

26. The protein responsible for the transport of iron in hemoglobin synthesis is

A. globin

B. transferrin

C. oxyhemoglobin

D. ferritin

27. B

28. B

Questions 27 and 28: If globin synthesis is insufficient in a person, iron accumulates in the cell's (27) _____ as (28) _____ aggregates.

27. _____

A. nucleus

B. cytoplasm

C. Golgi apparatus

D. mitochondria

28. _____

A. transferrin

B. ferritin

C. albumin

D. iron

D. all of the above

29. Increased erythropoietin production in secondary polycythemia can be caused by

A. chronic lung disease

B. smoking

C. renal neoplasms

D. all of the above

D. the plasma volume is decreased

30. Relative polycythemia exists when

A. increased erythropoietin is produced

B. the total blood volume is expanded

C. the plasma volume is increased

D. the plasma volume is decreased

B. Nuclear maturation lags behind cytoplasmic maturation

31. Which of the following is (are) characteristic(s) of megaloblastic maturation?

A. Cells of some leukocytic cell lines are smaller than normal

B. Nuclear maturation lags behind cytoplasmic maturation

C. Cytoplasmic maturation lags behind nuclear maturation

D. Erythrocytes are smaller than normal

32. C

33. C

Questions 32 and 33: When porphyrin synthesis is impaired, the (32) _____ become encrusted with (33) _____.

32. _____

A. lysosomes

B. nucleoli

C. mitochondria

D. vacuoles

33. _____

A. protoporphyrin

B. hemoglobin

C. iron

D. delta-aminolevulinic acid

A. A

34. Which of the following hemoglobin types is the major type present in a normal adult?

A. A

B. S

C. A2

D. Bart

B. F

35. The alkaline denaturation test detects the presence of hemoglobin

A. A1C

B. F

C. C

D. S

36. C

37. A

38. D

39.

Questions 36 through 39: Match the following hemoglobin types. 36. _____ A

37. _____ A2

38. _____ F

39. _____ Embryonic

A. Two alpha and two delta chains

B. Zeta chains and either epsilon or gamma chains

C. Two alpha and two beta chains

D. Two alpha and two gamma chains

C. several months after birth

40. Fetal hemoglobin (hemoglobin F) persists until

A. a few days after birth

B. a few weeks after birth

C. several months after birth

D. adulthood

D. both A and C

41. Cellulose acetate at pH 8.6 separates the hemoglobin fractions

A. S

B. H

C. A

D. both A and C

D. C

A2CE

SGDLepore

F

A

42. If an alkaline (pH 8.6) electrophoresis is performed, hemoglobin E has the same mobility as hemoglobin

A. S

B. F

C. A

D. C

C. no mitochondria for oxidative metabolism

43. The limited metabolic ability of erythrocytes is owing to

A. the absence of RNA

B. the absence of ribosomes

C. no mitochondria for oxidative metabolism

D. the absence of DNA

D. Both A and C

44. Which of the following statements is (are) true of the erythrocytic cytoplasmic contents?

A. High in potassium ion

B. High in sodium ion

C. Contain glucose and enzymes necessary for glycolysis

D. Both A and C

D. 90

45. The Embden-Meyerhof glycolytic pathway uses _____ % of the erythrocyte's total glucose.

A. 10

B. 20

C. 50

D. 90

D. all of the above

46. The Embden-Meyerhof pathway net gain of ATP provides high energy phosphates to

A. maintain membrane lipids

B. power the cation pump needed for the sodium potassium concentration pump and calcium flux

C. preserve the shape and flexibility of the cellular membrane

D. all of the above

B. lactate

47. The end product of the Embden-Meyerhof pathway of glucose metabolism in the erythrocyte is

A. pyruvate

B. lactate

C. glucose-6-phosphate

D. the trioses

B. 2

48. The net gain in ATPs in the Embden-Meyerhof glycolytic pathway is

A. 1

B. 2

C. 4

D. 6

B. pyruvate kinase

49. The most common erythrocytic enzyme deficiency involving the Embden-Meyerhof glycolytic pathway is a deficiency of A. ATPase

B. pyruvate kinase

C. glucose-6-phosphate dehydrogenase

D. lactic dehydrogenase

D. All of the above

50. If a defect in the oxidative pathway (hexose monophosphate shunt) occurs, what will result?

A. Insufficient amounts of reduced glutathione

B. Denaturation of globin

C. Precipitation of Heinz bodies

D. All of the above

A. prevent oxidation of heme iron

51. The function of the methemoglobin reductase pathway is to

A. prevent oxidation of heme iron

B. produce methemoglobinemia

C. provide cellular energy

D. control the rate of glycolysis

A. permits the accumulation of 2,3-DPG

52. The Luebering-Rapoport pathway

A. permits the accumulation of 2,3-DPG

B. promotes glycolysis

C. produces cellular energy

D. produces acidosis

D. all of the above

53. In conditions of acidosis,

A. erythrocytic glycolysis is reduced

B. available oxygen is increased

C. DPG levels fall to a level sufficient to normalize oxygen tension

D. all of the above

D. all of the above

54. As the erythrocyte ages,

A. the membrane becomes less flexible with loss of cell membrane

B. cellular hemoglobin increases

C. enzyme activity, particularly glycolysis, decreases

D. all of the above

D. all of the above

55. Erythrocytic catabolism produces the disassembling of hemoglobin followed by

A. iron transported in the plasma by transferrin

B. globin catabolized in the liver to amino acids and then entering the amino acid pool

C. bilirubin formed from opened porphyrin ring and carried by plasma albumin to the liver, conjugated, and excreted in bile

D. all of the above

D. All of the above

56. Which of the following statements are true of the intra vascular destruction of erythrocytes?

A. It accounts for less than 10% of normal erythrocyte breakdown.

B. Hemoglobin is released directly into blood.

C. Alpha and beta dimers are bound to haptoglobin.

D. All of the above.

D. 14 to 18.0 g/dL

57. The upper limit of the reference range of hemoglobin in an adult male is

A. 10.5 to 12.0 g/dL

B. 12.5 to 14.0 g/dL

C. 13.5 to 15.0 g/dL

D. 14 to 18.0 g/dL

58. A

59. C

60. B

Questions 58 through 60: Match the specific erythrocytic indices with the appropriate formula.

58. _____ MCV

59. _____ MCH

60. _____ MCHC

A. Packed cell volume or hematocrit (in L/L)/ erythrocyte count (×1012 /L) =fL

B. Hemoglobin (in g/dL)/packed cell volume or hematocrit (in L/L) = g/dL

C. Hemoglobin (×10 g/dL)/erythrocyte count (×1012/L) = pg

61. C

62. B

63. A

Questions 61 through 63: Match the erythrocytic indices with the appropriate normal value.

61. _____ MCV

62. _____ MCH

63. _____ MCHC

A. 32 to 36 g/dL

B. 27 to 32 pg

C. 80 to 96 fL

D. 4

16. The number of heme groups in a hemoglobin molecule is

A. 1

B. 2

C. 3

D. 4