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40 terms

ch 26 patho

STUDY
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The neurologic symptoms in vitamin B12 deficiency anemia are not reversed even with appropriate treatment.
T
Considering oral iron therapy, the ferric form is preferred to the ferrous form because ferric is more readily absorbed
F - ferrous form versus ferric form
In hemolytic anemia, the bone marrow is capable of increasing red cell production because of elevated levels of erythropoietin
T
Anemia of chronic disease (ACD) is initially a normochromic and normocytic anemia, but as the condition progresses, it becomes hypochromic and microcytic.
T
Anemia of chronic disease (ACD) is initially a normochromic and normocytic anemia, but as the condition progresses, it becomes hypochromic and microcytic.
T
1. In some anemias the erythrocytes are present in various sizes, which is referred to as:
a.
poikilocytosis.
b.
isocytosis.
c.
anisocytosis.
d.
microcytosis.
anisocytosis.
2. The major physiologic manifestation of anemia is:
a.
hypotension.
b.
hyperesthesia.
c.
hypoxia.
d.
ischemia
hypoxia
3. The paresthesia that occurs in vitamin B12
a. deficiency anemia is a result of a(n):
reduction in acetylcholine receptors in the postsynaptic nerves.
b.
myelin degeneration in the spinal cord.
c.
destruction of myelin in peripheral nerves.
d.
altered function of neurons in the parietal lobe.
myelin degeneration in the spinal cord.
c.
4. The body compensates for anemia by:
a.
increasing rate and depth of breathing.
b.
capillary vasoconstriction.
c.
hemoglobin holds on to oxygen more firmly.
d.
kidneys release more erythropoietin.
increasing rate and depth of breathing.
b.
5. Which of the following is classified as a macrocytic-normochromic anemia?
a.
Iron deficiency
b.
Pernicious
c.
Sideroblastic
d.
Hemolytic
Pernicious
6. Deficiencies in folate and vitamin B12
a. alter the synthesis of:
RNA.
b.
cell membrane.
c.
DNA.
d.
mitochondria
DNA
7. The underlying disorder of _____ anemia is defective secretion of intrinsic factor, which is essential for the absorption of vitamin B
a.
12.
microcytic
b.
pernicious
c.
hypochromic
d.
hemolytic
pernicious
8. After a person has a subtotal gastrectomy for chronic gastritis, what type of anemia would result?
a.
Iron deficiency
b.
Pernicious
c.
Folic acid
d.
Vitamin B
12
Pernicious
9. Atrophy of gastric mucosal cells results in pernicious anemia because of:
a.
erythrocyte destruction.
b.
folic acid malabsorption.
c.
vitamin B12
d. malabsorption.
poor nutritional intake
vitamin B12
d. malabsorption.
10. A woman complains of chronic gastritis, fatigue, weight loss, and tingling in her fingers. Laboratory findings show low hemoglobin and hematocrit levels, and a high mean corpuscular volume. These findings are consistent with _____ anemia.
a.
folate deficiency
b.
pernicious
c.
iron deficiency
d.
aplastic
pernicious
11. The Schilling test is described as the:
a.
administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B12
b. deficiency.
measurement of antigen-antibody immune complexes in the blood to test for hemolytic anemia.
c.
measurement of serum ferritin and total iron-binding capacity in the blood to test for iron deficiency anemia.
d.
administration of folate and measurement in 2 hours of its level in a blood sample to test for folic acid deficiency anemia
administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B12
12. Pernicious anemia is treated with:
a.
vitamin B12
b. by oral intake.
cyanocobalamin by intramuscular injection.
c.
ferrous fumarate by intramuscular injection, Z track.
d.
folate by oral intake.
cyanocobalamin by intramuscular injection
13. Untreated pernicious anemia is fatal, usually because of:
a.
brain hypoxia.
b.
liver hypoxia.
c.
heart failure.
d.
renal failure.
heart failure.
14. How is the effectiveness of vitamin B12
a. therapy measured?
Reticulocyte count
b.
Serum transferring
c.
Hemoglobin
d.
Serum vitamin B
12
Reticulocyte count
15. Which statement about folic acid is false?
a.
Folic acid absorption is dependent on the enzyme folacin.
b.
Folic acid is stored in the liver.
c.
Folic acid is essential for RNA and DNA synthesis within erythrocytes.
d.
Folic acid is absorbed in the upper small intestine
Folic acid absorption is dependent on the enzyme folacin.
b.
16. Which anemia produces small, pale erythrocytes?
a.
Folic acid
b.
Hemolytic
c.
Iron deficiency
d.
Pernicious
Iron deficiency
17. A man has fatigue, weakness, and dyspnea. His conjunctiva and palms are pale. His nails appear brittle, thin, and concave, and he has sores at the corners of his mouth. Considering this information, the nurse suspects that this patient probably has _____ anemia.
a.
pernicious
b.
iron deficiency
c.
aplastic
d.
hemolytic
iron deficiency
18. The most common cause of iron deficiency anemia is:
a.
decreased dietary intake.
b.
chronic blood loss.
c.
vitamin deficiency.
d.
autoimmune disease
chronic blood loss
19. Pernicious anemia generally requires continued therapy lasting:
a.
6 to 8 weeks.
b.
8 to 12 months.
c.
until the iron level is normal.
d.
the rest of one's life.
the rest of one's life.
20. A man has cheilosis, stomatitis, and painful ulceration of the buccal mucosa and mouth. He complains of dysphagia and watery diarrhea. These clinical manifestations are indicative of:
a.
PA.
b.
folate deficiency anemia.
c.
anemia of chronic disease.
d.
IDA.
folate deficiency anemia.
21. If a man has inherited the gene for sideroblastic anemia, he received it from his:
a.
mother.
b.
father.
c.
grandfather.
d.
grandmother
mother.
22. Clinical manifestations of mild to moderate splenomegaly and hepatomegaly, bronze-colored skin, and cardiac dysrhythmias are indicative of which anemia?
a.
Iron deficiency
b.
Pernicious
c.
Sideroblastic
d.
Aplastic
Sideroblastic
v23. A person with sideroblastic anemia would be likely to have _____ plasma levels of iron.
a.
high
b.
low
c.
normal
d.
absent
high
24. In a plastic anemia, pancytopenia develops as a result of the:
a.
suppression of erythropoietin to produce adequate amounts of erythrocytes.
b.
suppression of the bone marrow to produce adequate amounts of erythrocytes, leukocytes, and thrombocytes.
c.
lack of DNA to form sufficient quantities of erythrocytes, leukocytes, and thrombocytes.
d.
lack of stem cells to form sufficient quantities of leukocytes.
suppression of the bone marrow to produce adequate amounts of erythrocytes, leukocytes, and thrombocytes.
c.
25. What is the pathophysiologic process of aplastic anemia?
a.
Autoimmune disease against hematopoiesis by activated cytotoxic T cells
b.
Malignancy of the bone marrow in which unregulated proliferation of erythrocytes crowd out other blood cells
c.
Autoimmune disease against hematopoiesis by activated immunoglobulins
d.
Inherited genetic disorder with recessive X-linked transmission
Autoimmune disease against hematopoiesis by activated cytotoxic T cells
26. An allogenic bone marrow transplantation remains the preferred and most successful method for treating which anemia?
a.
Polycythemia vera
b.
Aplastic anemia
c.
Sideroblastic anemia
d.
Anemia of chronic disease
Aplastic anemia
27. Which is a characteristic of warm antibody immunohemolytic anemia?
a.
It occurs primarily in men.
b.
It is self-limiting and rarely produces hemolysis.
c.
Erythrocytes are bound to macrophages and sequestered in the spleen.
d.
IgM coats erythrocytes and binds them to receptors on monocytes.
Erythrocytes are bound to macrophages and sequestered in the spleen.
d.
28. In hemolytic anemia, jaundice occurs only when:
a.
erythrocytes are destroyed in the spleen.
b.
heme destruction exceeds the liver's ability to conjugate and excrete bilirubin.
c.
the patient has elevations in aspartate transaminase (AST) and alanine transaminase (ALT).
d.
the erythrocytes are coated with an immunoglobulin.
heme destruction exceeds the liver's ability to conjugate and excrete bilirubin.
c.
29. Erythrocyte life span less than 120 days, ineffective bone marrow response to erythropoietin, and altered iron metabolism describe the pathophysiology of:
a.
aplastic anemia.
b.
sideroblastic anemia.
c.
anemia of chronic disease.
d.
IDA.
30.
anemia of chronic disease
30. Anemia of chronic disease is a mild to moderate anemia associated with chronic infections, chronic noninfectious inflammatory diseases, and malignancies. Chronic diseases commonly associated with this anemia include all of the following except:
a.
rheumatoid arthritis.
b.
AIDS.
c.
polycythemia vera.
d.
systemic lupus erythematosus
.
polycythemia vera.
31. Symptoms of polycythemia vera are mainly the result of:
a.
a decreased erythrocyte count.
b.
destruction of erythrocytes.
c.
increased blood viscosity.
d.
neurologic involvement
increased blood viscosity
32. Treatment for polycythemia vera involves:
a.
therapeutic phlebotomy and radioactive phosphorus.
b.
restoration of blood volume by plasma expanders.
c.
the administration of cyanocobalamin.
d.
blood transfusions
therapeutic phlebotomy and radioactive phosphorus.
b.
1. Pernicious anemia
c.
Macrocytic-normochromic anemia
2. Sideroblastic anemia
b.
Microcytic-hypochromic anemia
3. Aplastic anemia
a.
Normocytic-normochromic anemia