Microcytic And Normocytic Anemia Quiz

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Microcytic And Normocytic Anemia Quiz - Quiz

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An anemic person lacks enough RBCs to carry oxygen. Play this informative quiz on microcytic and normocytic anemia to gauge how much you know about it. The quiz has an educative value and will help you many clear doubts and concepts related to Anemia. The quiz contains questions ranging from easy, moderate, and hard levels that are sure to test your knowledge and provide you with important value addition. The quiz is suitable for those with having medical background. If you like the quiz, share it with your friends and family. All the best!


Questions and Answers
  • 1. 

    Which of the following is NOT a cause of Microcytic Anemia?

    • A.

      Thalassemia

    • B.

      Anaemia of chronic disease

    • C.

      Iron Deficiency Anemia

    • D.

      Pancytopaenia

    • E.

      Lead Poisoning

    Correct Answer
    D. Pancytopaenia
    Explanation
    Pancytopenia is a condition characterized by a decrease in all three types of blood cells (red blood cells, white blood cells, and platelets). It is not specifically associated with microcytic anemia, which is a condition characterized by smaller than normal red blood cells. Microcytic anemia is commonly caused by thalassemia, iron deficiency anemia, and anemia of chronic disease. Lead poisoning can also lead to microcytic anemia. Therefore, pancytopenia is the correct answer as it is not directly related to microcytic anemia.

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  • 2. 

    The lab reports for a patient with low MCV show high serum ferritin and low TIBC.  What is the most likely cause for this patient's anemia?

    • A.

      Fe deficiency

    • B.

      Anemia secondary to inflammation

    • C.

      Thallassemia

    • D.

      Hemoglobinopathy

    Correct Answer
    B. Anemia secondary to inflammation
    Explanation
    The lab reports indicate low mean corpuscular volume (MCV), high serum ferritin, and low total iron-binding capacity (TIBC). These findings are consistent with anemia secondary to inflammation. Inflammation can lead to increased ferritin levels as a result of iron trapping within cells and decreased TIBC due to reduced iron availability for binding to transferrin. This type of anemia is commonly seen in chronic diseases such as infections, autoimmune disorders, and malignancies. Fe deficiency, thalassemia, and hemoglobinopathy are less likely causes based on the given information.

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  • 3. 

    Fe is absorbed in the:

    • A.

      Stomach

    • B.

      Duodenum

    • C.

      Jejunum

    • D.

      Ileum

    Correct Answer
    B. Duodenum
    Explanation
    The correct answer is duodenum. The duodenum is the first part of the small intestine where most of the iron absorption takes place. It is responsible for breaking down food and absorbing nutrients, including iron, into the bloodstream. Iron is an essential mineral for various bodily functions, such as oxygen transport and energy production. Therefore, the duodenum plays a crucial role in ensuring adequate iron absorption for the body's needs.

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  • 4. 

    Where is most non-heme iron found in the body?

    • A.

      Bound to IF

    • B.

      Bound to transferrin

    • C.

      Free in plasma

    • D.

      Stored in liver

    Correct Answer
    B. Bound to transferrin
    Explanation
    Most non-heme iron in the body is found bound to transferrin. Transferrin is a protein that helps transport iron in the blood. It binds to iron and carries it to various tissues and cells in the body, where it is needed for various functions. This binding of iron to transferrin helps to regulate iron levels and prevent iron toxicity.

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  • 5. 

    Select the following that enhances Fe absorption.

    • A.

      Citric acid

    • B.

      Polyphenols (tea)

    • C.

      Phylate (bran)

    • D.

      Calcium

    • E.

      Ascorbic acid

    Correct Answer(s)
    A. Citric acid
    E. Ascorbic acid
    Explanation
    Citric acid and ascorbic acid enhance Fe absorption. Citric acid is a weak organic acid that forms soluble complexes with iron, making it easier for the body to absorb. Ascorbic acid, also known as vitamin C, can reduce iron from its ferric form to the more easily absorbed ferrous form. Both citric acid and ascorbic acid can increase the bioavailability of iron in the diet, helping to prevent iron deficiency.

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  • 6. 

    What is the most important test for Fe stores?

    • A.

      Serum iron

    • B.

      TIBC

    • C.

      Serum ferritin

    • D.

      Widal test

    Correct Answer
    C. Serum ferritin
    Explanation
    serum ferritin increases in infection, inflammation, malignancy, liver disease, hyper TSH & hemochromatosis/Fe overload. Serum iron varies daily. TIBC is highly specific for decrease Fe, measures total amount of transferrin in blood. Saturation is serum Fe divided by TIBC - would be low in Fe deficiency.

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  • 7. 

    Which of the following is not an etiology of Fe deficiency anemia?

    • A.

      Chronic blood loss

    • B.

      Increased requirement

    • C.

      Infection

    • D.

      Malabsorption

    • E.

      Decreased intake

    Correct Answer
    C. Infection
    Explanation
    Infection is not an etiology of Fe deficiency anemia. Fe deficiency anemia occurs when there is a lack of iron in the body, which is needed for the production of red blood cells. The main causes of Fe deficiency anemia are chronic blood loss, increased requirement (such as during pregnancy or rapid growth), malabsorption (when the body is unable to absorb iron from the diet), and decreased intake (not consuming enough iron-rich foods). Infection does not directly cause Fe deficiency anemia, although it can contribute to anemia indirectly by causing chronic inflammation or affecting the body's ability to absorb or utilize iron.

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  • 8. 

    TIBC increases in iron deficiency anemia because:

    • A.

      Inflammatory response to deficiency

    • B.

      Compensation by other factors

    • C.

      Ability to absorb increases

    • D.

      Increases WBCs

    Correct Answer
    C. Ability to absorb increases
    Explanation
    The correct answer is "ability to absorb increases". In iron deficiency anemia, the body tries to compensate for the lack of iron by increasing its ability to absorb iron from the diet. This is done through upregulation of iron transporters in the intestines, allowing for enhanced absorption of iron. As a result, the total iron-binding capacity (TIBC) increases as the body tries to capture and transport more iron for utilization. This increase in TIBC is a response to the iron deficiency and is a compensatory mechanism to maintain iron homeostasis in the body.

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  • 9. 

    TIBC stands for?

    Correct Answer
    total iron binding capacity
    Explanation
    TIBC stands for total iron binding capacity. This term refers to the maximum amount of iron that can be bound to transferrin, a protein that transports iron in the blood. TIBC is a laboratory test that measures the level of transferrin in the blood, providing information about the body's ability to transport and bind iron. It is often used to assess iron deficiency or iron overload conditions.

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  • 10. 

    TIBC stands for?

    • A.

      Total iron binding capacity

    • B.

      Total iodine binding capacity

    • C.

      Total calcium binding capacity

    • D.

      Total vitamin binding capacity

    Correct Answer
    A. Total iron binding capacity
    Explanation
    TIBC stands for Total Iron Binding Capacity. This term refers to the maximum amount of iron that can be bound to transferrin, a protein responsible for transporting iron in the blood. By measuring TIBC, healthcare professionals can assess the body's ability to transport and bind iron, which is crucial for diagnosing conditions such as iron deficiency anemia. The other options, total iodine binding capacity, total calcium binding capacity, and total vitamin binding capacity, do not accurately represent the meaning of TIBC.

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  • 11. 

    Pica, a clinical presentation for Fe deficiency anemia, is:

    • A.

      Itchiness

    • B.

      ED

    • C.

      Desire to eat weird things

    • D.

      A small woodland creature

    Correct Answer
    C. Desire to eat weird things
    Explanation
    Other clinical presentations of Fe deficiency anemia include fatigue, pallor and SOBOE (short of breath on exercise). More serious presentations include glossitis, cheilosis and spoon nails.

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  • 12. 

    Which lab investigations would you order if you suspect Fe deficiency anemia?

    • A.

      CBC

    • B.

      Blood smear

    • C.

      Serum iron

    • D.

      Serum ferritin

    • E.

      TIBC

    Correct Answer(s)
    A. CBC
    B. Blood smear
    C. Serum iron
    D. Serum ferritin
    E. TIBC
    Explanation
    ALL OF THEM! muahaha. Can also look at bone marrow stained with Prussian blue, which would show decreased macrophage iron and decreased or normal sideroblasts.

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  • 13. 

    Where is beta Thalassemia most common? 

    • A.

      West Africa

    • B.

      Mediterranean

    • C.

      Arabian peninsula

    • D.

      Southeast Asia

    • E.

      CANADA!

    Correct Answer(s)
    B. Mediterranean
    C. Arabian peninsula
    D. Southeast Asia
    Explanation
    Beta thalassemia is a genetic blood disorder that affects the production of hemoglobin, resulting in anemia. It is most commonly found in regions where malaria is or was prevalent, as the genetic mutation that causes beta thalassemia provides some protection against the disease. The Mediterranean region, Arabian peninsula, and southeast Asia are all areas where malaria has historically been present, hence the high prevalence of beta thalassemia in these regions.

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  • 14. 

    What is the difference between beta-thalassemia major and beta thalassemia minor?

    • A.

      Homozygote vs. heterozygote

    • B.

      Acute vs. chronic

    • C.

      Legal drinking age

    Correct Answer
    A. Homozygote vs. heterozygote
    Explanation
    with beta Thalassemia minor, there is decreased synthesis of the beta-globulin chain. In beta Thalassemia major, there is a total absence of synthesis for the beta-globulin chain.

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  • 15. 

    Heinz bodies are made of:

    • A.

      Excess gamma chains

    • B.

      Excess alpha chains

    • C.

      Excess beta chains

    • D.

      Excess ketchup

    Correct Answer
    B. Excess alpha chains
    Explanation
    Heinz bodies are abnormal structures that form within red blood cells. They are composed of excess alpha chains of hemoglobin. Normally, hemoglobin consists of two alpha chains and two beta chains. However, in certain conditions such as thalassemia or unstable hemoglobinopathies, there can be an imbalance in the production of alpha and beta chains. The excess alpha chains can precipitate and form Heinz bodies, leading to red blood cell damage and potential hemolysis.

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  • 16. 

    Beta Thalassemia, unlike alpha thalassemia, presents at approximately 6 months of age.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Fetus blood uses HbA and HbF - as HbF converts to adult type in infancy, the beta thalassemia defect is revealed.

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  • 17. 

    Which would you expect to see on a blood smear for beta Thalassemia? 

    • A.

      Heinz bodies

    • B.

      Multinucleated neutrophils

    • C.

      Target cells

    • D.

      Hypochromic microcytic cells

    • E.

      Hyperchromic microcytic cells

    Correct Answer(s)
    A. Heinz bodies
    C. Target cells
    D. Hypochromic microcytic cells
    Explanation
    Beta thalassemia is a genetic disorder that affects the production of hemoglobin, leading to abnormal red blood cells. Heinz bodies are denatured hemoglobin that forms within the red blood cells, and their presence indicates oxidative damage. Target cells are red blood cells with a bullseye-like appearance, which can be seen in beta thalassemia due to abnormal cell membrane structure. Hypochromic microcytic cells are red blood cells that are pale and smaller than normal, which is a characteristic finding in beta thalassemia. Therefore, the presence of Heinz bodies, target cells, and hypochromic microcytic cells on a blood smear would be expected in beta thalassemia.

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  • 18. 

    What test would you do, besides history, CBC, and blood smear, to confirm Thalassemia?

    • A.

      Electrophoresis

    • B.

      Widal

    • C.

      RTPCR

    • D.

      Electrolysis

    Correct Answer
    A. Electrophoresis
    Explanation
    Electrophoresis is a laboratory test that can be used to confirm the diagnosis of Thalassemia. Thalassemia is a genetic blood disorder that affects the production of hemoglobin, leading to abnormal red blood cells. Electrophoresis is a technique that separates molecules based on their size and charge, allowing for the identification of abnormal hemoglobin variants present in Thalassemia. This test can help differentiate between different types of Thalassemia and provide valuable information for the diagnosis and management of the condition.

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  • 19. 

    What is the treatment for beta-thalassemia minor?

    • A.

      Blood transfusions

    • B.

      Iron chelation

    • C.

      Bone marrow transplant

    • D.

      None of the above

    Correct Answer
    D. None of the above
    Explanation
    beta thalassemia minor (heterozygote) is usually asymptomatic.

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  • 20. 

    Alpha-Thalassemia is a gene deletion related to the production of the alpha-Hb protein.  What happens when one is missing all 4 genes for alpha-Th?

    • A.

      Hydrops fetalis

    • B.

      Hb Barts

    • C.

      Death

    Correct Answer
    A. Hydrops fetalis
    Explanation
    When someone is missing all 4 genes for alpha-Thalassemia, it leads to a condition called hydrops fetalis. Hydrops fetalis is a severe form of anemia that occurs in fetuses and newborns. It is characterized by abnormal fluid buildup in the body, causing swelling and potentially leading to heart failure. This condition is often fatal, resulting in stillbirth or death shortly after birth. Additionally, the absence of these genes prevents the production of the alpha-Hb protein, which is essential for normal red blood cell function.

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  • 21. 

    Decreased or stopped production of alpha-globin chains result in HbH (4 gamma chains together) and Hb Barts (4 beta chains together)

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    HbH: 4 BETA chains
    Hb Barts: 4 GAMMA chains

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  • 22. 

    On a CBC for alpha-Thalassemia, you would see anemia and reticulocytosis.  You would see Heinz bodies, hypochromic microcytic cells, and occasional target cells on the blood smear.  

    • A.

      LDH

    • B.

      Unconjugated bilirubin

    • C.

      Conjugated bilirubin

    • D.

      Urine urobilinogen

    • E.

      Urine hemosiderin

    Correct Answer(s)
    A. LDH
    B. Unconjugated bilirubin
    D. Urine urobilinogen
    E. Urine hemosiderin
    Explanation
    To confirm, you can do electrophoresis for HbH and/or Hb Barts.

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  • 23. 

    The ABCDs of Normocytic anemia are: Acute blood loss Bone marrow failure Chronic disease and_______

    • A.

      Destruction

    • B.

      Haemophilia

    • C.

      Haemolysis

    • D.

      None of the above

    Correct Answer
    C. Haemolysis
    Explanation
    The correct answer is "haemolysis". Normocytic anemia can also be caused by the destruction of red blood cells, a condition known as haemolysis. This occurs when red blood cells are destroyed at a faster rate than they can be produced, leading to a decrease in overall red blood cell count and resulting in anemia. Other causes of normocytic anemia include acute blood loss, bone marrow failure, and chronic disease.

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  • 24. 

    Aplastic anemia can be acquired (more common) and inherited.  What are some of the ways it can be acquired?

    • A.

      Post viral infection

    • B.

      Pregnancy

    • C.

      Ionizing radiation

    • D.

      Drugs and chemicals

    • E.

      Who knows? (idiopathic)

    Correct Answer(s)
    A. Post viral infection
    B. Pregnancy
    C. Ionizing radiation
    D. Drugs and chemicals
    E. Who knows? (idiopathic)
    Explanation
    yes, all. Also: paroxysmal nocturnal haemoblocinuria (PNH). Chemotherapy drugs have a dose-response severity. The inherited disorder is called Fanconi's anemia.

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  • 25. 

    Aside from the gradual onset signs of anemia, what other clinical presentations would you see with aplastic anemia?

    • A.

      Koilonychias, "spoon nails"

    • B.

      Associated thrombocytopenia, e.g. history of bleeding from the gums

    • C.

      Neutropenia, e.g. repeat bacterial infections

    • D.

      Purpura

    • E.

      Pica

    Correct Answer(s)
    B. Associated thrombocytopenia, e.g. history of bleeding from the gums
    C. Neutropenia, e.g. repeat bacterial infections
    D. Purpura
    Explanation
    On the physical exam, you would not find splenomegaly or lymphadenopathy - unlike leukemia.

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  • 26. 

    How would you diagnose aplastic anemia?

    • A.

      Blood smear

    • B.

      Bone marrow biopsy

    • C.

      Spleen biopsy

    • D.

      CBC

    • E.

      Magic 8-ball consultation

    Correct Answer
    B. Bone marrow biopsy
    Explanation
    A bone marrow biopsy is the most reliable method to diagnose aplastic anemia. This procedure involves extracting a small sample of bone marrow from the hipbone or sternum and examining it under a microscope. It helps determine the number and quality of blood cells being produced in the bone marrow. Aplastic anemia is characterized by a decrease in all types of blood cells, and a bone marrow biopsy can confirm this by showing a reduction in cellularity and abnormal cell development. Other tests like blood smear and CBC can provide additional information, but a bone marrow biopsy is essential for an accurate diagnosis.

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  • 27. 

    Select treatment options for aplastic anemia.

    • A.

      IV equine ATG

    • B.

      Bone marrow transplant

    • C.

      Splenectomy

    • D.

      Immune suppresion

    Correct Answer(s)
    A. IV equine ATG
    B. Bone marrow transplant
    D. Immune suppresion
    Explanation
    The correct answer includes three treatment options for aplastic anemia: IV equine ATG, bone marrow transplant, and immune suppression. IV equine ATG refers to intravenous administration of antithymocyte globulin, which helps to suppress the immune system and prevent it from attacking the bone marrow. A bone marrow transplant involves replacing the damaged bone marrow with healthy cells from a donor. Immune suppression involves using medications to suppress the immune system and prevent it from attacking the bone marrow. These treatment options aim to improve the production of blood cells in individuals with aplastic anemia.

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  • 28. 

    G6PD hemolytic anemia is brought on by...

    • A.

      Infection

    • B.

      Oxidative stress

    • C.

      Reductive stress

    • D.

      None of the above

    Correct Answer
    B. Oxidative stress
    Explanation
    G6PD hemolytic anemia is caused by oxidative stress. G6PD (glucose-6-phosphate dehydrogenase) is an enzyme that helps protect red blood cells from damage caused by reactive oxygen species. When there is an imbalance between the production of reactive oxygen species and the ability of G6PD to neutralize them, oxidative stress occurs. This oxidative stress can lead to the destruction of red blood cells, resulting in hemolytic anemia. Infections and reductive stress are not directly associated with the development of G6PD hemolytic anemia.

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  • Aug 24, 2023
    Quiz Edited by
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