Module 10 Exam

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Vaso-occlusive crisis in sickle cell disease manifests with which of the following symptoms?
A) Pain
B) Pancytopenia
C) Splenomegaly
D) Hypotension

A) Pain

The reticulocyte count in iron deficiency, vitamin B12, and folate deficiency is:
A) increased.
B) decreased.
C) absent.
D) impossible to measure.

B) decreased

Clinical manifestations unique to vitamin B12 anemia (i.e., usually absent in other types of anemia) include:
A) fatigue, dyspnea on exertion, and pale skin.
B) palpitations, chest pain, and signs of heart failure.
C) dizziness, headaches, and nausea.
D) paresthesias, muscle weakness, and ataxia.

D) paresthesias, muscle weakness, and ataxia.`

All of the following are reasons why chronic infections (HIV disease, hepatitis), rheumatological diseases, and malignancies result in anemia of chronic inflammation (anemia of chronic disease), except:

A) decreased erythropoiesis.
B) disordered iron utilization by developing erythrocytes.
C) decreased erythrocyte survival.
D) all of the above.

D) all of the above.

In evaluating for iron deficiency, which of the following lab tests provides the most accurate assessment of iron stores in the tissues?

A) Hemoglobin
B) Serum iron
C) MCV
D) Serum ferritin

D) Serum ferritin

Which of the following problems is not a known cause of iron deficiency?

A) Blood loss
B) Inadequate dietary iron
C) Severe diarrhea
D) Disorders of iron metabolism

C) Severe diarrhea

In anemia, which of the following is a physiologic response to hypoxia?

A) Low blood pressure
B) Splenomegaly
C) Increased respiratory rate
D) Clot formation

C) Increased respiratory rate

Pernicious anemia is caused by:

A) iron deficiency.
B) bone marrow failure.
C) folate deficiency.
D) vitamin B12 deficiency.

D) vitamin B12 deficiency.

The most common cause of acquired hemolytic anemia is:

A) viral infection of erythrocytes.
B) autoimmune destruction of erythrocytes.
C) severe nutritional deficiencies.
D) alcoholism.

B) autoimmune destruction of erythrocytes.

Immediate, life-threatening consequences of a massive hemorrhage are primarily related to:

A) loss of platelets.
B) low blood pressure.
C) activation of the immune response.
D) loss of hemoglobin.

B) low blood pressure.

Why is gastric bypass surgery for morbid obesity a risk factor for the development of pernicious (vitamin B12 deficiency) anemia?

A) Vitamin B12 is absorbed in the stomach.
B) Intrinsic factor production by the gastric epithelium is reduced.
C) Postoperative antibodies to vitamin B12 are produced.
D) Vitamin B12 stores are in the adipose tissue.

B) Intrinsic factor production by the gastric epithelium is reduced.

General causes of the decreased number of erythrocytes in anemia include all of the following except:
A) hemorrhage.
B) hemolysis.
C) dehydration.
D) decreased erythropoiesis.

C) dehydration.

Iron-deficiency anemia among adult populations in the United States is most commonly caused by:

A) chronic inflammatory and autoimmune diseases.
B) inadequate dietary iron.
C) chronic gastrointestinal bleeding.
D) renal disease.

C) chronic gastrointestinal bleeding.

Which of the following blood tests measures the percentage of erythrocytes in a given volume of blood?

A) Hemoglobin
B) Hematocrit
C) Mean cell volume (MCV)
D) Red blood cell count

B) Hematocrit

In addition to a low serum hemoglobin and hematocrit, which of the following problems also manifest with aplastic anemia?

A) Elevated bilirubin levels
B) Formation of deep vein thromboses
C) Increased risk of acquiring serious infections
D) All of the above

C) Increased risk of acquiring serious infections

Toxic causes of aplastic anemia include which of the following?

A) Drugs
B) Industrial toxins
C) Radiation exposure
D) All of the above

D) All of the above

What is the general cause of aplastic anemia?

A) Hemolysis in the spleen
B) Severe nutritional deficiencies
C) Autoimmune destruction of mature red blood cells
D) Bone marrow failure

D) Bone marrow failure

What is the pattern of inheritance of the gene for sickle cell disease?

A) Autosomal dominant
B) Nondisjunction
C) X-linked recessive
D) Autosomal recessive

D) Autosomal recessive

An increase in which of the following laboratory values would indicate the presence of a hemorrhagic or hemolytic anemia?

A) Hematocrit
B) MCV
C) Reticulocyte count
D) All of the above

C) Reticulocyte count

A unique manifestation of hemolytic anemia (i.e., generally absent in other forms) is:
A) jaundice.
B) paralysis.
C) cerebral edema.
D) cyanosis.

A) jaundice.

Which of the following statements provides the best general definition of anemia?

A) Decreased amount of circulating plasma volume
B) Decreased oxygen-carrying capacity of the blood cells
C) Presence of tissue hypoxia
D) Bone marrow failure

B) Decreased oxygen-carrying capacity of the blood cells

In anemia, what factor stimulates the production of erythropoietin?

A) Low blood viscosity
B) Tissue hypoxia
C) Inflammation
D) Release of stress hormones

B) Tissue hypoxia

Which of the following descriptions is characteristic of sickle cell disease?
A) Malformed, sickle-shaped platelets lead to thrombocytopenia and bleeding.

B) Hemoglobin reacts to deoxygenation or dehydration by sickling the erythrocytes.
C) Sickled erythroblasts are unable to form adequate amounts of hemoglobin.
D) Production of antibodies that attach to erythrocytes, causing sickling.

B) Hemoglobin reacts to deoxygenation or dehydration by sickling the erythrocytes.

Iron deficiency anemia usually exhibits a red blood cell morphology that is:

A) microcytic and hypochromic.
B) macrocytic and normochromic.
C) normocytic and normochromic.
D) macrocytic and hypochromic.

A) microcytic and hypochromic.

Vitamin B12 or folate deficiency anemia usually exhibits a red blood cell morphology that is:

A) microcytic and hypochromic.
B) macrocytic and normochromic.
C) normocytic and normochromic.
D) macrocytic and hypochromic.

B) macrocytic and normochromic.

A 28-year-old woman with a history of rheumatoid arthritis is seen in a prenatal clinic for the first time late in her second trimester of pregnancy. She reports severe fatigue and experiences shortness of breath when going up stairs. Laboratory evaluation reveals low hematocrit and hemoglobin levels. Which of the following is a (are) potential cause(s) of her anemia?

A) Anemia of chronic inflammation
B) Iron deficiency
C) Folate deficiency
D) All of the above

D) All of the above

Clinical manifestations of iron deficiency include all of the following except:

A) diarrhea.
B) fatigue and weakness.
C) brittle, concave nails.
D) a red, sore tongue.

A) diarrhea.

Anemia from recent blood loss (acute blood loss) usually exhibits a red blood cell morphology that is:

A) macrocytic and normochromic.
B) microcytic and hypochromic.
C) macrocytic and hypochromic.
D) normocytic and normochromic

D) normocytic and normochromic

In the United States, sickle cell disease is most common among _________ populations.

A) Hispanic/Latino
B) Asian
C) Black
D) Caucasian

C) Black

Which of the following population groups are at the highest risk for developing a folate deficiency anemia?

A) Children born with a congenital intrinsic factor deficiency
B) Alcoholics
C) Menstruating women
D) Vegetarians

B) Alcoholics

Which of the following blood tests allows the clinician to visualize structural changes in the erythrocytes such as sickle cells or schistocytes?

A) Blood smear
B) MCV
C) Mean corpuscular hemoglobin (MCH)
D) Hematocrit

A) Blood smear

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