Patho Chapter 17

1. What are typical early general signs/symptoms of anemia?

Chest pain, palpitations

Jaundice, stomatitis

Pallor, dyspnea, and fatigue

Bradycardia, heat intolerance

2. What causes numbness and tingling in the fingers of individuals with untreated pernicious anemia?

Persistent hyperbilirubinemia

Increasing acidosis affecting metabolism

Vitamin B12 deficit causing peripheral nerve demyelination

Multiple small vascular occlusions affecting peripheral nerves

3. What would be the result of a reduced number of erythrocytes

Increased hemoglobin in the blood

A decreased hematocrit

Increased risk of hemostasis

Decreased osmotic pressure of the blood

4. What is the primary treatment for the leukemias?

Radiation

Chemotherapy

Surgery

Immunotherapy

5. What is a deficit of all types of blood cells called?

Leukopenia

Neutropenia

Pancytopenia

Erythrocytosis

6. Following hemolysis, which part of the hemoglobin molecule produces bilirubin

Heme

Globin

Amino acids

Iron

7. Which anemia is considered to result from a malabsorption problem?

Aplastic anemia

Sickle cell anemia

Thalassemia major

Pernicious anemia

8. Non-Hodgkin’s lymphoma differs from Hodgkin’s lymphoma in that non-Hodgkin’s lymphoma usually presents as:

Enlarged painful glands in the neck

Tumors in the spleen, liver and intestines

Multiple, scattered, enlarged and painless lymph nodes

Multiple infections unresponsive to treatment

9. Iron-deficiency anemia frequently results from any of the following except:

Certain vegetarian diets

Excessive menstrual flow

Malabsorption syndromes

Diabetes mellitus

10. Why do vascular occlusions and infarcts occur frequently with sickle-cell anemia?

The damaged membranes of many red blood cells

Increased hemolysis of erythrocytes

The change in shape of erythrocytes when hypoxia occurs

The inability of HbS to transport oxygen

11. What is the cause of oral ulcerations and delayed healing occurring with any progressive anemia?

Lack of folic acid for DNA synthesis

Frequent microinfarcts in the tissues

Deficit of oxygen for epithelial cell mitosis

Elevated bilirubin levels in blood and body fluids

12. Vitamin K is required by the liver to synthesize:

Heparin

Prothrombin

Amino acids

Bilirubin

13. What describes the characteristic erythrocyte associated with pernicious anemia?

Hypochromic, microcytic

Normochromic, normocytic

Elongated, sickle-shaped

Megaloblastic or macrocytic nucleated cells

14. Leukemia is frequently linked to chromosome abnormalities as evidenced by:

Presence of Philadelphia chromosome translocation in cases of acute myelogenous leukemia (AML)

Very low incidence in persons with Down syndrome

Lack of familial incidence

Transmission as a recessive gene

15. Which of the following is typical of Hodgkin’s disease?

Onset in early childhood

Multiple tumors spreading randomly through the body

Initial tumor is single, painless, enlarged lymph node, often cervical

A very poor prognosis

16. Why is pernicious anemia treated with injections of vitamin B12?

An immune reaction in the stomach would destroy the vitamin

Digestive enzymes would destroy the vitamin

The vitamin irritates the gastric mucosa

The ingested vitamin would not be absorbed into the blood

17. Petechiae and purpura are common signs of:

Excessive hemolysis

Leukopenia

Increased bleeding tendencies

Hemoglobin deficit

18. The Reed-Sternberg cell is diagnostic for:

Chronic myeloblastic leukemia

Hodgkin’s lymphoma

Multiple myeloma

Non-Hodgkin’s lymphoma

19. What is the cause of sickle-cell anemia?

A defective gene inherited from both parents

A genetic defect affecting synthesis of hemoglobin chains

Bone marrow depression

An autoimmune reaction

20. What is the basic abnormality in thalassemia?

Several amino acids in the globin chains have been replaced by substitute amino acid

More than four globin chains are found in the erythrocytes

The iron molecule is displaced in hemoglobin

Failure to synthesize either the alpha or beta chains in the hemoglobin molecule

21. In cases of polycythemia vera, why is blood pressure elevated?

Increased numbers of circulating blood cells

Frequent infarcts in the coronary circulation

Congested spleen and bone marrow

Increased renin and aldosterone secretions

22. What is a common predisposing factors to leukemia?

Exposure to radiation

Certain fungal and protozoal infections

Familial tendency

Cigarette smoking

23. What are common early signs of aplastic anemia

Painful joints and skeletal deformity

Abdominal discomfort and splenomegaly

Excessive bleeding and recurrent infections

Palpitations and chest pain

24. In pernicious anemia, antibodies form to:

Vitamin B12

Intrinsic factor or parietal cells

Mucus-producing glands

Hydrochloric acid

25. What is a compensation mechanisms for individuals with anemias?

Peripheral vasodilation

Increased erythropoiesis

Tachycardia

Secondary polycythemia

26. Which of the following apply to sickle-cell trait?

Most hemoglobin is HbS

Sickling of erythrocytes occurs with severe hypoxia

Painful sickling crises with infarctions occur frequently

A child’s skeletal growth is affected

27. Chronic blood loss causes anemia because of the:

Shortened life span of the erythrocytes

Lower metabolic rate

Loss of protein and electrolytes

Smaller amount of recycled iron available

28. Individuals with type O blood are considered to be universal donors because their blood:

Contains A and B antibodies

Contains A and B antigens

Lacks A and B antibodies

Lacks A and B antigens

29. Why is excessive bleeding a common occurrence with acute leukemia?

The deficit of calcium ions

Impaired production of prothrombin and fibrinogen

Decreased platelets

Dysfunctional thrombocytes

30. What is jaundice likely to be a sign of?

Sickle cell anemia

Aplastic anemia

Iron-deficiency anemia

Acute leukemia

31. Which are substances classified as anticoagulants? 1. prothrombin 2. heparin 3. fibrinogen 4. streptokinase 5. vitamin K

1, 2

2, 4

3, 5

1, 3, 4

32. Thalassemia is caused by:

A defect in one or more genes for hemoglobin

An abnormal form of heme

Abnormal liver production of amino acids & iron

Overproduction of hypochromic, microcytic RBCs

33. All of the following apply to vitamin K except:

It is used as an antidote for warfarin (Coumadin)

The liver requires it to produce prothrombin

It is a fat-soluble vitamin

The bone marrow requires it to synthesize hemoglobin

34. With the acute leukemias, the increased number of malignant leukocytes leads to: 1. decreased hemoglobin 2. thrombocytopenia 3. constant bone pain 4. splenomegaly

1, 2

2, 3

1, 3, 4

1, 2, 3, 4

35. Why do multiple opportunistic infections develop with acute leukemia?

The decreased number of white blood cells

Many nonfunctional immature leukocytes

Severe anemia and bleeding

Decreased appetite and nutritional intake

36. Multiple myeloma is a malignant tumor involving:

Plasma cells

Granulocytes

Bone cells

Lymph nodes

37. Which of the following statements apply to hemochromocytosis?

It is caused by excessive iron intake in the diet

It results from excessive hemolysis of RBCs

A metabolic error leads to excess amounts of hemosiderin causing damage to organs

An inherited defect results in abnormal hemoglobin

38. Which of the following is present with pernicious anemia?

Pancytopenia

Hypochlorhydria

Leukocytosis

Multiple infarcts

39. Why do low hemoglobin values develop with pernicious anemia?

Decreased production of erythrocytes

Shorter lifespan of erythrocytes

Abnormal structure of hemoglobin chains

Deficit of folic acid

40. Which of the following occur when disseminated intravascular coagulation develops?

Increased thrombocytes and blood-clotting

Hemolysis with loss of blood cells

Massive sepsis and hemorrhage

Multiple thrombi and deficit of clotting factors

41. Secondary polycythemia may be associated with:

Frequent angina attacks

Certain types of anemia

Severe chronic bronchitis

Renal disease

42. Which statement applies to the disorder, hemophilia A?

It is transmitted as an X-linked dominant trait

There is usually a total lack of factor VIII in the blood

Males and females can be carriers

Hematomas and hemarthroses are common