Block 10 RBC MCQ's

22 Questions | Total Attempts: 763

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Block 10 RBC MCQ

Questions and Answers
  • 1. 
    An 18 year old Swedish girl presents with jaundice and anemia. Laboratory studies are significant for a decreased mean cell volume (MCV), an increased mean corpuscular hemoglobin concentration (MCHC), and an increase in osmotic fragility of the red blood cells. Red blood cells on peripheral blood smear (PBS) are most likely to be
    • A. 

      Schistocytes

    • B. 

      Polkiolocytes

    • C. 

      Spherocytes

    • D. 

      Hypochromic microcytic red blood cells

  • 2. 
    A 52-year-old woman suffers from an acute onset of normocytic, normochromic anemia, hemoglobinuria, hemosiderinuria, and jaundice accompanied by a decreased serum haptoglobin. What is the most likely cause of this patient's findings?
    • A. 

      Hemolysis

    • B. 

      Iron deficiency

    • C. 

      Inadequate production of red blood cells

    • D. 

      Hemorrhage.

  • 3. 
    A 17-year-old black male has a history of severe lifelong anemia requiring many blood transfusions. He has non-healing leg ulcers and recurrent episodes of abdominal and chest pain. These signs and symptoms are most likely associated with which one of the following laboratory abnormalities?
    • A. 

      Positive RBC sucrose hemolysis test

    • B. 

      Positive RBC osmotic fragility test

    • C. 

      Positive direct Coombs test

    • D. 

      Increased hemoglobin S on electrophoresis

  • 4. 
    A 33-year-old woman was admitted to the hospital for a hysterectomy to control excessive uterine bleeding. Her Hgb was 7.4 gmjdL, hematocrit was 23% and red blood cell count was 2 millionjmm3. The most likely cause of her anemia is
    • A. 

      Bone marrow failure

    • B. 

      Chronic blood loss and iron deficiency anemia

    • C. 

      Acute blood loss and iron deficiency

    • D. 

      Hemolysis and irc:m deficiency

  • 5. 
    In a 34-year-old patient with a hemoglobin of 5.2 gjdL, a smooth and sore tongue, and spooning of the fingernails, the most likely red blood cell ind ices would be
    • A. 

      Macrocytic indices

    • B. 

      Normocytic indices with reticulocytosis

    • C. 

      Microcytic and hypochromic indices

    • D. 

      Normocytic indices without reticulocytosis

  • 6. 
    A 30 year old man with Hodgkin's Lymphoma is hospitalized with a fever and infection . Physical exam reveals a pale thin man with lymphadenopathy and spenolmegaly. His laboratory data show a low serum iron, low serum iron binding capacity, low mean corpuscular hemoglobin concentration and low mean cell volume. What is the most likely diagnosis?
    • A. 

      Myelophthisic anemia

    • B. 

      Anemia of chronic disease

    • C. 

      Megaloblastic anemia

    • D. 

      Iron deficiency anemia

    • E. 

      Thalessemia

  • 7. 
    A 65-year-old man with vague symptoms, fatigue and weight loss has a Hb=8 and Hct=24. His PBS shows hypochromic microcytic RBCS. His reticulocyte count is low. Which of the following would be most helpful in establishing a diagnosis?
    • A. 

      Direct Coombs test

    • B. 

      Indirect Coombs test

    • C. 

      Hemoglobin electrophoresis

    • D. 

      Schilling test

    • E. 

      Digital rectal exam and stool guaiac test

  • 8. 
    A 54-year-old woman who was being treated for hypertension with alpha methyldopa presented with malaise and generalized weakness. Her Hb=8 and Hct=24. Her corrected reticulocyte count and RDW are both increased. Spherocytes is seen on peripheral smear. Which of the following is the best test to order to help confirm the diagnosis?
    • A. 

      Indirect Coombs test

    • B. 

      Direct Coomb's test

    • C. 

      Bone marrow examination

    • D. 

      Osmotic fragility

    • E. 

      Protein electrophoresis

  • 9. 
    A 24-year-old woman presents with epistaxis.' Her physical exam reveals moderate splenomegaly. Her platelet count is significantly decreased, but her red and white blood cells are within normal limits. What is the next best step that should be done in the evaluation of this patient?
    • A. 

      Bleeding time

    • B. 

      Bone marrow biopsy

    • C. 

      Complete blood count

    • D. 

      Ristocetin test

    • E. 

      Osmotic Fragility test

  • 10. 
    A coagulation consult is requested for an asymptomatic patient who has had a surgery six days previously and a prolonged hospital course requiring intravenous antibiotics. Her PT & PTT are both prolonged. Mixing studies with normal plasma show that both PT and PTT are completely corrected. Which of the following coagulation factors is most likely to be decreased?
    • A. 

      Factor VIII

    • B. 

      Factor X

    • C. 

      Factor VII

    • D. 

      Factor XI

    • E. 

      Factor IX

  • 11. 
    Which of the following conditions is associated with the most severe serum haptoglobin depletion?
    • A. 

      Intravascular hemolysis

    • B. 

      Chronic blood loss

    • C. 

      Extravascular hemolysis

    • D. 

      Acute blood loss

  • 12. 
    In a patient w ith normocytic normochromic anemia, which of the following is the earl iest laboratory sign indicating iron deficiency?
    • A. 

      Decreased serum iron and increased serum tranferrin

    • B. 

      Decreased serum transferrin and increased transferrin saturation

    • C. 

      Increased serum transferrin and decreased transferrin saturation

    • D. 

      Decreased serum ferritin and depletion of bone marrow iron store

  • 13. 
    In patients with heparin-induced thrombocytopenia, which of the following is the most dangerous complication?
    • A. 

      Gastrointestinal bleeding and bleeding after tooth extraction

    • B. 

      Cerebral hemorrhage and hemarthrosis

    • C. 

      Bleeding from a postoperative wound and multiple bruises

    • D. 

      Pulmonary thromboembolism and cerebral sinus thrombosis

  • 14. 
    Which microorganism is associated with development of cold immunohemolytic anemia?
    • A. 

      Strepococcus pleumoniae and Salmonella typhi

    • B. 

      Ebstein-Barr virus and Mycoplasma pneumoniae

    • C. 

      E.coli 0157: H7 and Shigella dysenteriae

    • D. 

      Chlamydiae trachomatis and parvovirus B19

  • 15. 
    Which of the following best describes the iron panel seen in patients with anemia of chronic diseases?
    • A. 

      Increased ferritin, decreased serum iron, decreased TIBC, decreased % saturation

    • B. 

      Decreased ferritin, decreased serum iron, increased TIBC, decreased % saturation

    • C. 

      Increased ferritin, increased serum iron, decreased TIBC, increased % saturation

    • D. 

      Normal ferritin, normal serum iron, normal TIBC, normal % saturation

  • 16. 
    Which of the following are the diagnostic signs that distinguish between B12-and folate-deficiency megaloblastic anemia?
    • A. 

      Pallor and fatigue

    • B. 

      Paresthesias in hands and feet

    • C. 

      Cheilosis/cheilitis and atrophic glossitis

    • D. 

      Macroovalocytes and hypersegmented neutrophils in peripheral blood

  • 17. 
    A 32-year-old Swedish woman presents to her obstetrician for a prenatal examination in her 8th  month of gestation. She complains of severe fatigue. Physical examination reveals a pale woman with tachypnea and tachycardia. Her laboratory data is significant for a decreased red blood cell and corrected reticulocyte count and a decrease in MCV and MCHC. What is the most likely diagnosis?
    • A. 

      Acute blood loss

    • B. 

      Hereditary spherocytosis

    • C. 

      Iron deficiency

    • D. 

      Sickle cell anemia

    • E. 

      G6PD Deficiency

  • 18. 
    The bone marrow shown below was most likely taken from a patient with:
    • A. 

      Pancytopenia and low reticulocyte count

    • B. 

      Erythrocytopenia and low reticulocyte count

    • C. 

      Pancytopenia and high reticulocyte count

    • D. 

      Erythopenia and high reticulocyte count

  • 19. 
    A 21 year old Italian girl comes to your office with severe shortness of breath. Her past medical history is significant for frequent red blood cell transfusions. Physical examination reveals a jaundiced woman in respiratory distress with pallor of the conjunctiva and oral mucosa, tachypnea and tachycardia. Laboratory tests are significant for decreased hemoglobin, hematocrit, red blood cell count, MCV, and MCHC. What is the most likely diagnosis?
    • A. 

      B-Thalassemia Major (Cooley's Anemia)

    • B. 

      B-Thalassemia Minor

    • C. 

      A-Thalassemia Major

    • D. 

      A-Thalassemia Minor

  • 20. 
    The following picture was taken of a peripheral blood smea r from an automobile accident victim who was brought to the ER with a blood pressure of 60 mm Hg (palpable) and a weak but rapid pulse (115 bpm). Physical exam revealed a cool , diaphoretic young man with no visible signs of bleeding. Laboratory data would most likely show a/an:
    • A. 

      Decreased hemoglobin and hematocrit with a normal MCV and MCHC

    • B. 

      Decreased hemoglobin, hematocrit, MCV and MCHC

    • C. 

      Decreased hemoglobin and hematocrit with an increassed MCV and MCHC

    • D. 

      Increased hemoglobin and hematocrit with a normal MCV and MCHC

  • 21. 
    During your internal medicine rotation, you are asked to take an history and perform a physical examination on a 55-year-old man with AIDS. Your findings include a history of headaches, confusion, fever, bleeding from his nose and gums with petechiae and purpura found on his trunk and extremities. The patient's partner also reported that he has had some episodes of bizarre behavior. Wh ich of the following laboratory results would be most helpful in confirming your diagnosis?
    • A. 

      Normal PT & PTT, increased bleeding time, and decreased platelet count

    • B. 

      Increased PT, PTT, bleeding time, and platelet count

    • C. 

      Decreased PT, PTT, bleeding time and platelet count

    • D. 

      Normal PT, PTT, bleeding time and platelet count

  • 22. 
    You are asked to examine the peripheral blood smears (image) from a 2 year old Swedish girl. Her mother reports that her little girl does not seem her usual energetic self and has no appetite. She also noticed the whites of her daughter's eyes had turned yellow. Physical exam reveals a listless pale girl with icteric sclera and splenomegaly. Her complete blood count shows a decrease in red blood cells, hemoglobin, and hematocrit. Which of the following test would be most beneficial in confirming your diagnosis?
    • A. 

      Hemoglobin electrophoresis

    • B. 

      Osmotic fragility test

    • C. 

      Direct Coombs test

    • D. 

      Indirect Coombs test

    • E. 

      Total bilirubin

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