Deck 17: Blood and Lymphatic Disorders

Question 1

Which of the following applies to sickle-cell trait?

A) Most hemoglobin is in the form of Hgb S.
B) Sickling of erythrocytes occurs with severe hypoxia.
C) Painful sickling crises with multiple infarctions occur frequently.
D) A child's skeletal growth is delayed.

Answer 1

Sickling of erythrocytes occurs with severe hypoxia.

Question 2

Which of the following would result from a reduced number of erythrocytes in the blood?

A) increased hemoglobin in the blood
B) decreased hematocrit
C) increased risk of hemostasis
D) decreased osmotic pressure of the blood

Answer 2

decreased hematocrit

Question 3

What term is used to describe a deficit of all types of blood cells?

A) leucopenia
B) neutropenia
C) pancytopenia
D) erythrocytosis

Answer 3

pancytopenia

Question 4

Jaundice is likely to be a sign of ___________?

A) sickle cell anemia
B) aplastic anemia
C) iron-deficiency anemia
D) acute leukemia

Question 5

Which of the following is considered to be a compensation mechanism for individuals with anemia?

A) peripheral vasodilation
B) increased erythropoiesis
C) tachycardia
D) secondary polycythemia

Question 6

Why do abnormally low hemoglobin values develop with pernicious anemia?

A) decreased production of erythrocytes
B) shorter lifespan of erythrocytes
C) abnormal structure of hemoglobin chains
D) deficit of folic acid

Question 7

Chronic blood loss causes anemia because of the:

A) shortened life span of the erythrocytes
B) lower metabolic rate
C) loss of protein and electrolytes
D) smaller amount of recycled iron available

Question 8

What is the cause of oral ulcerations and delayed healing occurring with any severe anemia?

A) lack of folic acid for DNA synthesis
B) frequent microinfarcts in the tissues
C) deficit of oxygen for epithelial cell mitosis
D) elevated bilirubin levels in blood and body fluids

Question 9

Why do vascular occlusions and infarcts occur frequently with sickle-cell anemia?

A) The red blood cells are abnormally large.
B) Increased hemolysis of erythrocytes occurs.
C) Erythrocytes change shape of when hypoxia occurs.
D) HbS is unable to transport oxygen.

Question 10

Why is pernicious anemia treated with injections of vitamin B₁₂?

A) An immune reaction in the stomach would destroy the vitamin.
B) Digestive enzymes would destroy the vitamin.
C) The vitamin irritates the gastric mucosa.
D) The ingested vitamin would not be absorbed into the blood.

Question 11

What are the common early signs of aplastic anemia?

A) painful joints and skeletal deformity
B) abdominal discomfort and splenomegaly
C) excessive bleeding and recurrent infections
D) palpitations and chest pain

Question 12

Vitamin K is required by the liver to synthesize:

A) heparin
B) prothrombin
C) amino acids
D) bilirubin

Question 13

Which of the following is present with pernicious anemia?

A) pancytopenia
B) hypochlorhydria
C) leukocytosis
D) multiple infarcts

Question 14

Following hemolysis,which part of the hemoglobin molecule produces bilirubin?

A) heme
B) globin
C) a chain of amino acids
D) iron

Question 15

What is the cause of sickle-cell anemia?

A) a defective gene inherited from both parents
B) a genetic defect affecting synthesis of hemoglobin chains
C) bone marrow depression
D) an autoimmune reaction

Question 16

Choose the typical early general signs/symptoms of anemia.

A) chest pain,palpitations
B) jaundice,stomatitis
C) pallor,dyspnea,and fatigue
D) bradycardia,heat intolerance

Question 17

Individuals with type O blood are considered to be universal donors because their blood:

A) contains A and B antibodies
B) contains A and B antigens
C) lacks A and B antibodies
D) lacks A and B antigens

Question 18

What causes numbness and tingling in the fingers of individuals with untreated pernicious anemia?

A) persistent hyperbilirubinemia
B) increasing acidosis affecting metabolism
C) vitamin B₁₂ deficit causing peripheral nerve demyelination
D) multiple small vascular occlusions affecting peripheral nerves

Question 19

Which of the following best describes the characteristic erythrocyte associated with pernicious anemia?

A) hypochromic,microcytic
B) normochromic,normocytic
C) elongated,sickle-shaped
D) megaloblastic or macrocytic nucleated cells

Question 20

What is the basic abnormality in thalassemia?

A) Several amino acids in the globin chains have been replaced by substitute amino acids.
B) More than four globin chains are found in the erythrocytes.
C) The iron molecule is displaced in hemoglobin.
D) There is failure to synthesize either the alpha or beta chains in the hemoglobin molecule.

Question 21

In cases of polycythemia vera,blood pressure is elevated due to:

A) increased blood volume
B) frequent infarcts in the coronary circulation
C) congested spleen and bone marrow
D) increased renin and aldosterone secretions

Question 22

The Reed-Sternberg cell is diagnostic for:

A) chronic myeloblastic leukemia
B) Hodgkin's lymphoma
C) multiple myeloma
D) non-Hodgkin's lymphoma

Question 23

Petechiae and purpura are common signs of:

A) excessive hemolysis
B) leucopenia
C) increased bleeding tendencies
D) hemoglobin deficit

Question 24

Which of the following is typical of Hodgkin's disease?

A) onset usually in early childhood
B) multiple tumors spreading randomly through the body
C) initial tumor is single,painless,enlarged lymph node,often cervical
D) currently a very poor prognosis

Question 25

Multiple opportunistic infections develop with acute leukemia primarily because:

A) the number of white blood cells is decreased
B) many circulating leukocytes are immature
C) severe anemia interferes with the immune response
D) decreased appetite and nutritional intake reduce natural defenses

Question 26

Which of the following substances is classified as an anticoagulant?

A) prothrombin
B) heparin
C) fibrinogen
D) vitamin K

Question 27

Thalassemia is caused by:

A) a defect in one or more genes for hemoglobin
B) an abnormal form of heme
C) abnormal liver production of amino acids and iron
D) overproduction of hypochromic,microcytic RBCs

Question 28

In individuals with pernicious anemia,antibodies form to:

A) vitamin B₁₂
B) intrinsic factor or parietal cells
C) mucus-producing glands
D) hydrochloric acid

Question 29

Which of the following statements apply to hemochromocytosis? It is:

A) caused by excessive iron intake in the diet
B) results from excessive hemolysis of RBCs
C) a metabolic error leads to excess amounts of hemosiderin,causing damage to organs
D) an inherited defect results in abnormal hemoglobin

Question 30

Why is excessive bleeding a common occurrence with acute leukemia?

A) the deficit of calcium ions
B) impaired production of prothrombin and fibrinogen
C) decreased platelets
D) dysfunctional thrombocytes

Question 31

Predisposing factors to leukemia commonly include:

A) exposure to radiation
B) certain fungal and protozoal infections
C) familial tendency
D) cigarette smoking

Question 32

Non-Hodgkin's lymphoma differs from Hodgkin's lymphoma in that non-Hodgkin's lymphoma usually presents as:

A) enlarged painful glands in the neck
B) tumors in the spleen,liver,and intestines
C) multiple,scattered,enlarged and painless lymph nodes
D) multiple infections unresponsive to treatment

Question 33

Which statement applies to the disorder hemophilia A?

A) It is transmitted as an X-linked dominant trait.
B) There is usually a total lack of factor VIII in the blood.
C) Males and females can be carriers.
D) Hematomas and hemarthroses are common.

Question 34

Multiple myeloma is a malignant tumor involving:

A) plasma cells
B) granulocytes
C) bone cells
D) lymph nodes

Question 35

Which of the following occur when disseminated intravascular coagulation develops?

A) increased thrombocytes and blood-clotting
B) hemolysis with loss of blood cells
C) massive sepsis and hemorrhage
D) multiple thrombi and deficit of clotting factors

Question 36

Leukemia is sometimes linked to chromosome abnormalities,as evidenced by:

A) the presence of Philadelphia chromosome translocation in cases of acute myelogenous leukemia (AML)
B) very low incidence in persons with Down syndrome
C) little evidence of familial incidence
D) transmission as a recessive gene

Question 37

What is the primary treatment for the leukemias?

A) radiation
B) chemotherapy
C) surgery
D) immunotherapy

Question 38

Secondary polycythemia may be associated with:

A) frequent angina attacks
B) certain types of anemia
C) severe chronic bronchitis
D) renal disease

Question 39

Which of the following is considered to result from a malabsorption problem?

A) aplastic anemia
B) sickle cell anemia
C) thalassemia major
D) pernicious anemia

Question 40

All of the following apply to vitamin K EXCEPT:

A) it is used as an antidote for warfarin (Coumadin)
B) the liver requires it to produce prothrombin
C) it is a fat-soluble vitamin
D) the bone marrow requires it to synthesize hemoglobin

Question 41

Which of the following applies to the condition disseminated intravascular coagulation (DIC)?

A) It is usually a secondary complication.
B) It is always initiated by excessive bleeding.
C) Thrombi form in the large arteries and veins.
D) It is not life threatening.

Question 42

Iron-deficiency anemia frequently results from any of the following EXCEPT:

A) certain vegetarian diets
B) excessive menstrual flow
C) malabsorption syndromes
D) diabetes mellitus

Question 43

A high percentage of blast cells in the leukocyte population indicates a poor prognosis for an individual with:

A) Hodgkin's lymphoma
B) acute myelogenous leukemia
C) myelodysplastic syndrome
D) multiple myeloma

Question 44

Which of the following diagnostic tests would be within the normal range for an individual with hemophilia A?

A) bleeding time
B) coagulation time
C) PTT time
D) prothrombin time

Question 45

Which of the following applies to erythropoietin?

A) It is produced by the liver.
B) It increases iron absorption for heme production.
C) It stimulates production of red blood cells.
D) Hypoxia stimulates the red bone marrow to produce erythropoietin.

Question 46

Which stage of Hodgkin's lymphoma would be identified when several malignant lymph nodes are found in two regions on the same side of the diaphragm?

A) Stage I
B) Stage II
C) Stage III
D) Stage IV

Question 47

In which blood dyscrasia does pancytopenia develop?

A) pernicious anemia
B) aplastic anemia
C) iron-deficiency anemia
D) sickle-cell anemia

Question 48

Which of the following applies to the leukemias?

A) Chronic leukemias are more common in older people.
B) AML is the most common childhood leukemia.
C) Exposure to chemicals is not considered a predisposing factor.
D) Lymphoid tissue produces abnormal leukocytes.

Question 49

Which of the following applies to the etiology of aplastic anemia? It is:

A) idiopathic in many cases
B) a genetic disorder
C) predisposed by exposure to myelotoxins
D) a,b
E) a,c