Hematology & Coagulation
Registry study questions
- 1.
The light-colored zone adjacent to the nucleus in a plasmacyte is the:
- A.
Ribosome
- B.
Chromatin
- C.
Mitochondria
- D.
Golgi area
Correct Answer
D. Golgi areaExplanation
Morphological identifiable perinuclear haloRate this question:
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- 2.
The following are compounds formed in the synthesis of heme:
- coproporphyrinogen
- porphobilinogen
- uroporphyrinogen
- protoporphyrinogen
- A.
4,3,1,2
- B.
2,3,1,4
- C.
4,2,3,1
- D.
2,1,3,4
Correct Answer
B. 2,3,1,4Explanation
Correct order of heme synthesisRate this question:
- 3.
The majority of the iron in an adult is found as a constituent of:
- A.
Hemoglobin
- B.
Hemosiderin
- C.
Myoglobin
- D.
Transferrin
Correct Answer
A. HemoglobinExplanation
2/3 iron in the body is bound to HgbRate this question:
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- 4.
The main function of the hexose monophosphate shunt in the erythrocyte is to:
- A.
Regulate the level of 2,3-DPG
- B.
Provide reduced glutathione to prevent oxidation of hemoglobin
- C.
Prevent the reduction of heme iron
- D.
Provide energy for membrane maintenance
Correct Answer
B. Provide reduced glutathione to prevent oxidation of hemoglobinExplanation
Maintains in Fe++ form by way of reduced glutathioneRate this question:
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- 5.
Refer to the following illustration: Which curve represents the production of alpha polypeptide chains of hemoglobin
- A.
A
- B.
B
- C.
C
- D.
D
Correct Answer
B. B -
- 6.
Refer to the following illustration: Which curve represents the production of beta polypeptide chains of hemoglobin?
- A.
B
- B.
C
- C.
E
- D.
D
Correct Answer
D. D -
- 7.
Refer to the following illustration: Which curve represents the production of gamma polypeptide chains of hemoglobin?
- A.
A
- B.
B
- C.
C
- D.
D
Correct Answer
C. C -
- 8.
Refer to the following illustration: Which curve represents the production of delta polypeptide chains of hemoglobin?
- A.
B
- B.
C
- C.
D
- D.
E
Correct Answer
D. E -
- 9.
Refer to the following illustration: Which curve represents the production of epsilon polypeptide chains of hemoglobin?
- A.
A
- B.
B
- C.
C
- D.
D
Correct Answer
A. A -
- 10.
In order for hemoglobin to combine reversibly with oxygen, the iron must be:
- A.
Complexed with haptoglobin
- B.
Freely circulating in the cytoplasm
- C.
Attached to transferrin
- D.
In the ferrous state
Correct Answer
D. In the ferrous stateExplanation
Functional form of Fe (reduced)Rate this question:
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- 11.
In which of the following disease states are teardrop cells and abnormal platelets most characteristically seen?
- A.
Hemolytic anemia
- B.
Multiple myeloma
- C.
G-6-PD deficiency
- D.
Myeloid metaplasia
Correct Answer
D. Myeloid metaplasiaExplanation
RBC morphology; disease state identifiicationRate this question:
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- 12.
The characteristic erythrocyte found in pernicious anemia is:
- A.
Microcytic
- B.
Spherocytic
- C.
Hypochromic
- D.
Macrocytic
Correct Answer
D. MacrocyticExplanation
Impaired DNA synthesis = macrocytesRate this question:
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- 13.
In the normal adult, the spleen acts as a site for:
- A.
Storage of red blood cells
- B.
Production of red blood cells
- C.
Synthesis of erythropoietin
- D.
Removal of imperfect and aging cells
Correct Answer
D. Removal of imperfect and aging cellsExplanation
Major site of destruction of senescent red blood cellsRate this question:
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- 14.
After the removal of red blood cells from the circulation hemoglobin is broken down into:
- A.
Iron, porphyrin, and amino acids
- B.
Iron, protoporphyrin, and globin
- C.
Heme, protoporphyrin, and amino acids
- D.
Heme, hemosiderin, and globin
Correct Answer
B. Iron, protoporphyrin, and globinExplanation
Normal degradation products of red blood cellsRate this question:
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- 15.
Heinz bodies are:
- A.
Readily identified with polychrome stains
- B.
Rarely found in glucose-6-phosphate dehydrogenase deficient erythrocytes
- C.
Closely associated with spherocytes
- D.
Denatured hemoglobin inclusions that are readily removed by the spleen
Correct Answer
D. Denatured hemoglobin inclusions that are readily removed by the spleenExplanation
Formed with oxidization of Fe and formation of methemoglobinRate this question:
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- 16.
Hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) is:
- A.
Temperature-dependent
- B.
Complement-independent
- C.
Antibody-mediated
- D.
Caused by a red cell membrane defect
Correct Answer
D. Caused by a red cell membrane defectExplanation
RBC membrane defect increases susceptibility to complement mediated lysisRate this question:
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- 17.
Cells for the transport of O2 and CO2 are:
- A.
Erythrocytes
- B.
Granulocytes
- C.
Lymphocytes
- D.
Thrombocytes
Correct Answer
A. ErythrocytesExplanation
Primary functions of red blood cellsRate this question:
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- 18.
Erythropoietin acts to:
- A.
Shorten the replication time of the granulocytes
- B.
Stimulate RNA syntheses of erythroid cells
- C.
Increase colony-stimulating factors produced by the B-lymphocytes
- D.
Decrease the release of marrow reticulocytes
Correct Answer
B. Stimulate RNA syntheses of erythroid cellsExplanation
Erythropoietin actionRate this question:
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- 19.
What cell shape is most commonly associated with an increased MCHC?
- A.
Teardrop cells
- B.
Target cells
- C.
Spherocytes
- D.
Sickle cells
Correct Answer
C. SpherocytesExplanation
May be referred to as hyperchromic because of decreased MCHCRate this question:
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- 20.
Which of the following is most closely associated with idiopathic hemochromatosis?
- A.
Iron overload in tissue
- B.
Target cells
- C.
Basophilic stippling
- D.
Ringed sideroblasts
Correct Answer
A. Iron overload in tissueExplanation
Hemochromatosis results in iron deposits in the tissues.Rate this question:
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- 21.
A patient with polycythemia vera who is treated by phlebotomy is most likely to develop a deficiency of:
- A.
Iron
- B.
Vitamin B12
- C.
Folic acid
- D.
Erythropoietin
Correct Answer
A. IronExplanation
Iron loss with loss of bloodRate this question:
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- 22.
The direct antiglobulin test is often positive in:
- A.
Congenital hemolytic spherocytosis
- B.
March hemoglobinuria
- C.
Acquired hemolytic anemia
- D.
Thalassemia major
Correct Answer
C. Acquired hemolytic anemiaExplanation
Positive DATRate this question:
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- 23.
The anemia of chronic infection is characterized by:
- A.
Decreased iron stores in the reticuloendothelial system
- B.
Decreased serum iron levels
- C.
Macrocytic erythrocytes
- D.
Increased serum iron binding capicity
Correct Answer
B. Decreased serum iron levelsExplanation
Serum Fe levels low due to sequesration in macrophages and hepatocytesRate this question:
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- 24.
Factors commonly involved in producing anemia in patients with chronic renal disease include:
- A.
Marrow hypoplasia
- B.
Inadequate erythropoiesis
- C.
Vitamin B12 deficiency
- D.
Increased erythropoietin production
Correct Answer
B. Inadequate erythropoiesisExplanation
Erythropoietin production questionable in chronic renal diseaseRate this question:
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- 25.
A 20-year-old woman with sickle cell anemia whose usual hemoglobin concentration is 8 g/dL develops fever, increased weakness and malaise. The hemoglobin concentration is 4 g/dL and the reticulocyte count is 0.1%. The most likely explanation for her clinical picture is:
- A.
Increased hemolysis due to hypersplenism
- B.
Aplastic crisis
- C.
Thrombotic crisis
- D.
Occult blood loss
Correct Answer
B. Aplastic crisisExplanation
Sickle cell disease, effect on lab resultsRate this question:
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- 26.
The hypoproliferative red cell population in the bone marrow of uremic patients is caused by:
- A.
Infiltration of bone marrow by toxic waste products
- B.
Decreased levels of circulating erythropoietin
- C.
Defective globin synthesis
- D.
Overcrowding of bone marrow space by increased myeloid precursors
Correct Answer
B. Decreased levels of circulating erythropoietin -
- 27.
Which of the following characteristics are common to hereditary spherocytosis, hereditary elliptocytosis, hereditary stomatocytosis, and paroxysmal nocturnal hemoglobinuria?
- A.
Autosomal dominant inheritance
- B.
Red cell membrane defects
- C.
Positive DAT
- D.
Measured platelet count
Correct Answer
B. Red cell membrane defects -
- 28.
A 89-year-old Caucasian female was transferred from a nursing facility for treatment of chronic urinary tract infection with proteinuria. WBC: 10.0x10^3 RBC: 3.1x10^6 Hgb: 7.2 g/dL Hct: 24% MCV: 78 um^3 MCHC: 31% Serum iron: 29 ug/dL TIBC: 160 ug/dL Serum ferritin: 100 ng/mL These data are most consistent with which of the following conditions?
- A.
Iron deficiency anemia
- B.
Anemia of chronic inflammation
- C.
Hemochromatosis
- D.
Acute blood loss
Correct Answer
B. Anemia of chronic inflammationExplanation
RBC membrane defects are common to PNH, HS, and HERate this question:
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- 29.
A patient was admitted with a history of chronic bleeding secondary to peptic ulcer. Hematology workup reveals a severe microcytic, hypochromic anemia. Iron studies were requested. Which of the following would be expected in this case? Result A = decreased iron, increased TIBC, increased iron stores Result B = increased iron, decreased TIBC, increased iron stores Result C = decreased iron, increased TIBC, decreased iron stores Result D = increased iron, normal TIBC, decreased iron stores
- A.
Result A
- B.
Result B
- C.
Result C
- D.
Result D
Correct Answer
C. Result CExplanation
Iron studies - lab resultsRate this question:
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- 30.
Which of the following is most closely associated with iron deficiency anemia?
- A.
Iron overload in tissue
- B.
Target cells
- C.
Basophilic stippling
- D.
Chronic blood loss
Correct Answer
D. Chronic blood loss -
- 31.
Which one of the following hypochromic anemias is usually associated with a normal free erythrocyte protoporphyrin level?
- A.
Anemia of chronic disease
- B.
Iron deficiency
- C.
Lead poisoning
- D.
Thalassemia minor
Correct Answer
D. Thalassemia minor -
- 32.
Evidence indicates that the genetic defect in thalassemia usually results in:
- A.
The production of abnormal globin chains
- B.
A quantitative deficiency in RNA resulting in decreased globin chain production
- C.
A structural change in the heme portion of the hemoglobin
- D.
An abnormality in the alpha or beta chain binding or affinity
Correct Answer
B. A quantitative deficiency in RNA resulting in decreased globin chain production -
- 33.
A 20-year-old African-American man has peripheral blood changes suggesting thalassemia minor. The quantitative hemoglobin A2 level is normal, but the hemoglobin F level is 5% (normal is <2% in adults). This is most consistent with:
- A.
Alpha thalassemia minor
- B.
Beta thalassemia minor
- C.
Delta-beta thalassemia minor
- D.
Hereditary persistence of fetal hemoglobin
Correct Answer
C. Delta-beta thalassemia minor -
- 34.
Anemia secondary to uremia characteristically is:
- A.
Microcytic, hypochromic
- B.
Hemolytic
- C.
Normocytic, normochromic
- D.
Macrocytic
Correct Answer
C. Normocytic, normochromic -
- 35.
Which of the following sets of laboratory finding is consistent with hemolytic anemia?
- A.
Normal or slightly increased erythrocyte survival; normal osmotic fragility
- B.
Decreased erythrocyte survival; increased catabolism of heme
- C.
Decreased serum lactate dehydrogenase activity; normal catabolish of heme
- D.
Normal concentration of haptoglobin; marked hemoglobinuria
Correct Answer
B. Decreased erythrocyte survival; increased catabolism of heme -
- 36.
An enzyme deficiency associated with a moderate to severe hemolytic anemia after the patient is exposed to certain drugs and characterized by red cell inclusions formed by denatured hemoglobin in:
- A.
Lactate dehydrogenase deficiency
- B.
G-6-PD deficiency
- C.
Pyruvate kinase deficiency
- D.
Hexokinase deficiency
Correct Answer
B. G-6-PD deficiency -
- 37.
Patients with A(-) type G-6-PD deficiency are least likely to have hemolytic episodes in which of the following situations?
- A.
Following the administration of oxidizing drugs
- B.
Following the ingestion of fava beans
- C.
During infections
- D.
Spontaneously
Correct Answer
D. Spontaneously -
- 38.
A patient has a congenital nonspherocytic hemolytic anemia. After exposure to anti-malarial drugs the patient experiences a severe hemolytic episode. This episode is characterized by red cell inclusions caused by hemoglobin denaturation. Which of the following conditions is most consistent with these findings?
- A.
G-6-PD deficiency
- B.
Thalassemia major
- C.
Pyruvate kinase deficiency
- D.
Paroxysmal nocturnal hemoglobinuria
Correct Answer
A. G-6-PD deficiency -
- 39.
All of the findings listed below may be seen in acquired hemolytic anemias of the autoimmune variety. The one considered to be the most characteristic is:
- A.
Increased osmotic fragility
- B.
Leukopenia and thrombocytopenia
- C.
Peripheral spherocytosis
- D.
Positive direct antiglobulin test
Correct Answer
D. Positive direct antiglobulin test -
- 40.
Peripheral blood smears from patients with untreated pernicious anemia are characterized by:
- A.
Pancytopenia and macrocytosis
- B.
Leukocytosis and elliptocytosis
- C.
Leukocytosis and ovalocytosis
- D.
Pancytopenia and microcytosis
Correct Answer
A. Pancytopenia and macrocytosis -
- 41.
Laboratory tests performed on a patient indicate macrocytosis, anemia, leukopenia and thrombocytopenia. Which of the following disorders is the patient most likely to have?
- A.
Anemia of chronic disorder
- B.
Vitamin B12 deficiency
- C.
Iron deficiency
- D.
Acute hemorrhage
Correct Answer
B. Vitamin B12 deficiency -
- 42.
A patient has the following lab data: RBC: 2.35x10^6/uL WBC: 3.0x10^3/uL Plt: 95.0x10^3 Hgb: 9.5 g/dL Hct: 27% MCV: 115 um^3 MCHC: 35% MCH: 40 pg Which of the following tests would contribute toward the diagnosis?
- A.
Reticulocyte count
- B.
Platelet factor 3
- C.
Serum B12 and folate
- D.
Leukocyte alkaline phosphatase
Correct Answer
C. Serum B12 and folate -
- 43.
The characteristic morphologic feature in folic acid deficiency is:
- A.
Macrocytosis
- B.
Target cells
- C.
Basophilis stippling
- D.
Rouleaux formation
Correct Answer
A. Macrocytosis -
- 44.
A 50-year-old patient was found to have the following lab results: Hgb: 7.0 g/dL Hct: 20% RBC: 2.0x10^6/uL It was determinded that the patient was suffering from pernicious anemia. Which of the following sets of results most likely was obtained from the same patient? result A WBC 17,500, Platelet count 350,000, Retic count 5.2% result B WBC 7,500, Platelet count 80,000, Retic count 4,1% result C WBC 5,000, Platelet count 425,000, Retic count 2.9% result D WBC 3,500, Platelet count 80,000, Retic count 0.8%
- A.
Result A
- B.
Result B
- C.
Result C
- D.
Result D
Correct Answer
D. Result D -
- 45.
The most likely cause of the macrocytosis that often accompanies anemia of myelofibrosis is:
- A.
Folic acid deficiency
- B.
Increased reticulocyte count
- C.
Inadequate B12 absorption
- D.
Pyridoxine deficiency
Correct Answer
A. Folic acid deficiency -
- 46.
Megaloblastic asynchronous development in the bone marrow indicates which one of the following?
- A.
Proliferation of erythrocyte precursors
- B.
Impaired synthesis of DNA
- C.
Inadequate production of erythropoietin
- D.
Deficiency of G-6-PD
Correct Answer
B. Impaired synthesis of DNA -
- 47.
Which of the following are found in association with megaloblastic anemia?
- A.
Neutropenia and thrombocytopenia
- B.
Decreased LD activity
- C.
Increased erythrocyte folate levels
- D.
Decreased plasma bilirubin levels
Correct Answer
A. Neutropenia and thrombocytopenia -
- 48.
Which of the following represents characteristic features of iron metabolism in patients with anemia of chronic disorder? result A Iron level normal, Transferrin normal, TIBC normal result B Iron level increased, Transferrin increased, TIBC normal or slightly increased result C Iron level normal, Transferrin markedly increased, TIBC normal result D Iron level decreased, Transferrin decreased, TIBC normal or decreased
- A.
Result A
- B.
Result B
- C.
Result C
- D.
Result D
Correct Answer
D. Result D -
- 49.
A characteristic morphologic feature in hemoglobin C disease is:
- A.
Macrocytosis
- B.
Spherocytosis
- C.
Rouleaux formation
- D.
Target cells
Correct Answer
D. Target cells -
- 50.
Thalassemias are characterized by:
- A.
Structural abnormalities in the hemoglobin molecule
- B.
Absence of iron in hemoglobin
- C.
Decreased rate of heme synthesis
- D.
Decreased rate of globin synthesis
Correct Answer
D. Decreased rate of globin synthesis -
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Mar 20, 2022Quiz Edited by
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