Question 1

One of the most common pathophysiologies that contribute to folic acid deficiency is:&#10;A)Tropical sprue&#10;B)Intrinsic factor deficiency&#10;C)IDA&#10;D)Infection with Diphyllobothrium latum

Accepted Answer

Tropical sprue is a condition that affects the absorption of nutrients, including folic acid, in the small intestine, leading to folic acid deficiency.

Question 2

Which MCV range is indicative of pernicious anemia?&#10;A)70 to 80 fL&#10;B)85 to 95 fL&#10;C)110 to 120 fL&#10;D)90 to 98 fL

Accepted Answer

Pernicious anemia is characterized by the presence of very large red blood cells, leading to a high mean corpuscular volume (MCV), typically in the range of 110 to 120 femtoliters (fL).

Question 3

Which of the following is a clinical symptom specific to megaloblastic anemia?&#10;A)Fever&#10;B)Numbness and trouble with balance&#10;C)Pallor&#10;D)Splenomegaly

Accepted Answer

Numbness and trouble with balance are specific to megaloblastic anemia due to the effects of vitamin B12 deficiency on the nervous system, which is not seen in other types of anemia.

Question 4

Which of the following describes ineffective erythropoiesis?&#10;A)An increase in the M:E ratio&#10;B)A synthetic defect in hemoglobin&#10;C)Premature destruction of red blood cell precursors&#10;D)A DNA maturation defect

Accepted Answer

Ineffective erythropoiesis refers to the premature destruction of red blood cell precursors before they can mature and enter the bloodstream. This process leads to anemia because the body cannot produce enough mature red blood cells to replace those that are lost or destroyed.

Question 5

Evidence of ineffective erythropoiesis in the CBC of patients with megaloblastic anemia are:&#10;A)Anemia, thrombocytopenia, leukopenia&#10;B)Anemia, thrombocytosis, leukopenia&#10;C)Anemia, thrombophilia, leukocytosis&#10;D)Anemia, thrombocytosis, leukopenia

Accepted Answer

In megaloblastic anemia, ineffective erythropoiesis often leads to a triad of anemia, thrombocytopenia, and leukopenia due to the impaired DNA synthesis affecting all bone marrow cell lines.

Question 6

The Schilling test continues to be a historic reference method for the determination of:&#10;A)IDA&#10;B)Pernicious anemia&#10;C)Folic acid deficiency&#10;D)Hereditary hemochromatosis

Accepted Answer

The Schilling test was historically used to diagnose vitamin B12 deficiency, specifically to determine the cause of pernicious anemia by assessing the body's ability to absorb vitamin B12.

Question 7

Which of the following red blood cell morphologies is classic in the megaloblastic anemias?&#10;A)Polychromasia&#10;B)Macroovalocytes&#10;C)Basophilic stippling&#10;D)Hypochromia

Accepted Answer

Macroovalocytes are characteristic of megaloblastic anemias, which are typically due to vitamin B12 or folate deficiencies, leading to ineffective erythropoiesis and the production of larger than normal, oval-shaped red blood cells.

Question 8

All of the following are possible causes of low levels of intrinsic factor (IF) except which statement?&#10;A)Partial gastrectomy may lead to the lack of IF.&#10;B)Fifty-six percent of patients with pernicious anemia have antibodies to IF.&#10;C)Atrophic gastritis may lead to the lack of IF.&#10;D)Kidney failure may lead to lack of IF.

Accepted Answer

Kidney failure does not directly affect the production of intrinsic factor (IF), as IF is produced by the parietal cells in the stomach, not the kidneys.

Question 9

A macrocytosis that is not megaloblastic in origin can be seen in all of the following except:&#10;A)Chemotherapy&#10;B)Postsplenectomy&#10;C)Hypoglycemic patients&#10;D)Reticulocytosis

Accepted Answer

Macrocytosis not related to megaloblastic processes can indeed be seen in patients undergoing chemotherapy, after splenectomy, and in conditions leading to reticulocytosis. However, hypoglycemic patients do not typically exhibit macrocytosis unless there is another underlying condition affecting red blood cell morphology.

Question 10

Which of the following can distinguish treated versus untreated megaloblastic anemia?&#10;A)Polychromasia&#10;B)Hypochromia&#10;C)Howell-Jolly bodies&#10;D)Siderocytes

Accepted Answer

The answer of Which of the following can distinguish treated...

Question 11

Macrocytic red blood cells are routinely seen in all the following except:&#10;A)Pernicious anemia&#10;B)Liver disease&#10;C)Response to anemic stress&#10;D)Thalassemia

Accepted Answer

The answer of Macrocytic red blood cells are routinely seen...

Question 12

A bone marrow aspiration/examination is not necessary for patients with megaloblastic anemia.

Accepted Answer

The answer of A bone marrow aspiration/examination is not necessary...

Question 13

Which of the following is a key substance required for the incorporation of vitamin B₁₂ in the nuclear synthesis of red blood cells? A)EPO B)Transferrin C)Intrinsic factor D)Cytokines

Accepted Answer

The answer of Which of the following is a key...

Question 14

Which of the following terms describes the appearance of the erythropoietic precursors in the megaloblastic process?&#10;A)Ordered arrangement of chromatin&#10;B)Asynchrony&#10;C)Eccentric nucleus&#10;D)Pale cytoplasm

Accepted Answer

The answer of Which of the following terms describes the...

Question 15

Intrinsic factor is secreted by the:&#10;A)Parietal cells of the stomach&#10;B)Ileum&#10;C)Thyroid&#10;D)Bone marrow

Accepted Answer

The answer of Intrinsic factor is secreted by the:&#10;A)Parietal cells...

Question 16

What would be an appropriate M:E ratio in the case of megaloblastic anemia?&#10;A)1:3&#10;B)4:1&#10;C)5:1&#10;D)1:10

Accepted Answer

The answer of What would be an appropriate M:E ratio...

Deck 6: The Macrocytic Anemias