Question 1

Which of the following is a common clinical finding associated with hemolytic anemia?&#10;A)Ovarian tumors&#10;B)Jaundice&#10;C)Sarcoidosis&#10;D)Amyloidosis

Accepted Answer

Hemolytic anemia is characterized by the destruction of red blood cells, which can lead to an accumulation of bilirubin and subsequent jaundice. Ovarian tumors, sarcoidosis, and amyloidosis are not commonly associated with hemolytic anemia.

Question 2

All of the following indicate proper bone marrow turnover in response to hemolysis except:&#10;A)RPI of 3.&#10;B)Polychromasia on the blood smear.&#10;C)nRBCs in peripheral circulation.&#10;D)Thrombocytosis.

Accepted Answer

Thrombocytosis is not indicative of proper bone marrow turnover in response to hemolysis. Rather, it is a response to increased platelet demand or decreased platelet destruction. RPI of 3, polychromasia on the blood smear, and nRBCs in peripheral circulation are all indicative of proper bone marrow turnover in response to hemolysis.

Question 3

This test result is helpful in assessing erythropoietic activity in the bone marrow in response to hemolysis in the peripheral blood.&#10;A)Myeloid-to-erythroid relation&#10;B)Plasma iron-to-erythroid iron index&#10;C)Reticulocyte production index&#10;D)MCV

Accepted Answer

The reticulocyte production index (RPI) is a calculation that relates the number of reticulocytes (immature red blood cells) in the peripheral blood to the degree of anemia. It is useful in determining the cause of anemia: if the RPI is high, it suggests that the bone marrow is responding appropriately to the anemia by producing new red blood cells (erythropoiesis). Therefore, it can be used to assess erythropoietic activity in response to hemolysis in the peripheral blood. A normal RPI is between 1 and 3, and values higher than this suggest a vigorous erythropoietic response.

Question 4

Which results will help to differentiate between intravascular and extravascular hemolysis.&#10;A)Low hemoglobin in extravascular; normal hemoglobin in intravascular&#10;B)Low unconjugated bilirubin in extravascular; high unconjugated bilirubin in intravascular&#10;C)Presence of splenomegaly in intravascular; absence of splenomegaly in extravascular&#10;D)Normal haptoglobin in extravascular; low haptoglobin in intravascular

Accepted Answer

The best choice to differentiate between intravascular and extravascular hemolysis is the level of haptoglobin. Haptoglobin is a protein that binds to hemoglobin released from red blood cells after they are destroyed. In extravascular hemolysis, haptoglobin levels are normal as the hemoglobin is mostly trapped by macrophages in the spleen and liver. In contrast, in intravascular hemolysis, the hemoglobin is released directly into the bloodstream, leading to low levels of haptoglobin. The other options are not reliable indicators for distinguishing between the two types of hemolysis.

Question 5

A laboratory professional is reviewing a differential slide from a 35-year-old female recently diagnosed with megaloblastic anemia.Routine blood work is pending on this patient.What would be the most appropriate test to monitor hemolysis?

A)PB smear
B)Haptoglobin
C)Hemoglobin
D)Iron

Accepted Answer

Haptoglobin is a protein that binds to free hemoglobin in the blood, thereby preventing hemolysis. Monitoring haptoglobin levels can therefore provide a useful indication of ongoing hemolysis in patients with anemia. PB smear, hemoglobin, and iron tests are less directly related to hemolysis monitoring. However, a PB smear may help to confirm the presence of red blood cell abnormalities associated with hemolysis, such as spherocytosis. Hemoglobin and iron tests may reveal anemia and iron deficiency, respectively, but do not provide direct evidence of hemolysis.

Question 6

Which significant laboratory finding in extravascular hemolysis can be associated with products of heme catabolism?&#10;A)Hemoglobinemia&#10;B)Hemoglobinuria&#10;C)Hemosiderinuria&#10;D)Increased bilirubin

Accepted Answer

In extravascular hemolysis, red blood cells are broken down outside the blood vessels, leading to increased bilirubin levels due to the breakdown of heme from hemoglobin.

Question 7

All of the following support the diagnosis of hemolytic anemia except:&#10;A)Low haptoglobin.&#10;B)Low hemoglobin.&#10;C)Reticulocyte count of 1%.&#10;D)Bilirubin above 2.5 mg/dL.

Accepted Answer

A reticulocyte count of 1% actually suggests that the bone marrow is responding appropriately to the hemolysis and increasing red blood cell production. Low haptoglobin, low hemoglobin, and elevated bilirubin are all consistent with hemolytic anemia.

Question 8

Infections with Plasmodium cause __________ hemolysis.&#10;A)Intravascular&#10;B)Extravascular&#10;C)Both intravascular and extravascular&#10;D)It cannot be determined.

Accepted Answer

The answer of Infections with Plasmodium cause __________ hemolysis.&#10;A)Intravascular&#10;B)Extravascular&#10;C)Both intravascular...

Question 9

The presence of schistocytes in the peripheral blood smear indicate:&#10;A)Hemolysis due to extracorpuscular defects.&#10;B)Hemolysis due to intracorpuscular defects.&#10;C)Hemolysis due to both extracorpuscular and intracorpuscular defects.&#10;D)Hemolysis with prominent bone marrow response.

Accepted Answer

Schistocytes are fragmented red blood cells typically seen in conditions involving mechanical destruction of red blood cells, such as microangiopathic hemolytic anemia, which is an extracorpuscular defect.

Question 10

Intravascular hemolysis releases this component into the circulation.&#10;A)Haptoglobin&#10;B)Hemoglobin&#10;C)Bilirubin&#10;D)Hemopexin

Accepted Answer

Intravascular hemolysis involves the rupture of red blood cells (RBCs) within blood vessels, resulting in the release of the hemoglobin contained within them into the circulation. This can lead to increased levels of free hemoglobin in the blood, which can cause various downstream effects, including oxidative stress, inflammation, and organ damage. Therefore, option B (Hemoglobin) is the correct answer, as it is the component released into circulation during intravascular hemolysis. Options A, C, and D are all involved in the metabolism and/or transport of heme and/or hemoglobin but are not directly released into circulation during intravascular hemolysis.

Question 11

What limits the degree of increased erythropoiesis in the bone marrow in the presence of hemolytic anemia?&#10;A)Amount of B&#8321;&#8322; and folate stores&#10;B)Amount of iron that can be mobilized&#10;C)Quantity of stem cells in the BM&#10;D)Degree of extramedullary erythropoiesis

Accepted Answer

The answer of What limits the degree of increased erythropoiesis...

Question 12

Which of the following is associated with intravascular hemolysis and not extravascular hemolysis?&#10;A)Hemosiderinuria&#10;B)Increased bilirubin&#10;C)Reticulocytosis&#10;D)Polychromasia on the blood smear

Accepted Answer

The answer of Which of the following is associated with...

Question 13

The presence of blood in the urine indicates:&#10;A)Intravascular hemolysis.&#10;B)Extravascular hemolysis.&#10;C)Both intravascular and extravascular hemolysis.&#10;D)It cannot be determined.

Accepted Answer

The answer of The presence of blood in the urine...

Question 14

Hemolysis is defined as:&#10;A)Excessive bone marrow turnover.&#10;B)Excessive blood cell destruction.&#10;C)Premature blood cell destruction.&#10;D)Excessive bilirubin in serum.

Accepted Answer

The answer of Hemolysis is defined as:&#10;A)Excessive bone marrow turnover.&#10;B)Excessive...

Question 15

Prosthetic heart valves can lead to an ________ form of hemolysis in which the predominating cell seen is a __________.&#10;A)Inherited; schistocyte&#10;B)Acquired; schistocyte&#10;C)Inherited; spherocyte&#10;D)Acquired; polychromasia

Accepted Answer

The answer of Prosthetic heart valves can lead to an...

Question 16

Which of the following test results indicates that there is significant bone marrow turnover in response to hemolysis?&#10;A)Thrombocytosis&#10;B)Low RBC count&#10;C)High IRF&#10;D)Elevated bilirubin

Accepted Answer

The answer of Which of the following test results indicates...

Question 17

Which of the following test results may help differentiate between intravascular hemolysis and extravascular hemolysis in the body?&#10;A)Hemoglobin&#10;B)Unconjugated bilirubin&#10;C)Splenomegaly&#10;D)Haptoglobin

Accepted Answer

The answer of Which of the following test results may...

Question 18

A condition in which the rate of hemolysis equals the rate of bone marrow erythrocyte production is called:&#10;A)Intrinsic hemolytic anemia.&#10;B)Compensated hemolytic anemia.&#10;C)Extrinsic hemolytic anemia.&#10;D)Extravascular hemolysis.

Accepted Answer

The answer of A condition in which the rate of...

Question 19

What is one of the primary clinical findings associated with severe hemolytic anemia?&#10;A)Thickening of the cortical bone&#10;B)Rosy complexion&#10;C)Pain&#10;D)Jaundice

Accepted Answer

The answer of What is one of the primary clinical...

Question 20

In severe intravascular hemolysis, synthesis of this protein may not be sufficient to what is being used to transport hemoglobin to the liver.&#10;A)Bilirubin&#10;B)Haptoglobin&#10;C)Albumin&#10;D)Methemoglobin

Accepted Answer

The answer of In severe intravascular hemolysis, synthesis of this...

Question 21

A patient has numerous spherocytes noted on the blood smear.Which of the following will confirm a diagnosis of autoimmune hemolytic anemia.&#10;A)MCV of 70 fl&#10;B)Banding in the A1, A2, and F regions&#10;C)Positive direct antiglobulin test&#10;D)Normal unconjugated bilirubin

Accepted Answer

The answer of A patient has numerous spherocytes noted on...

Question 22

List three laboratory test results from peripheral blood that indicate increased erythropoietic activity in the bone marrow.

Accepted Answer

The answer of List three laboratory test results from peripheral...

Question 23

Splenic hypertrophy indicates which of the following?&#10;A)Acute hemolytic anemia&#10;B)Chronic hemolytic anemia&#10;C)Extravascular hemolysis&#10;D)Intravascular hemolysis

Accepted Answer

The answer of Splenic hypertrophy indicates which of the following?&#10;A)Acute...

Question 24

A laboratory professional is reviewing blood smears, and notices moderate spherocytes on one patient.What appropriate follow-up test would help determine the etiology of these cells?&#10;A)MCV&#10;B)Hemoglobin electrophoresis&#10;C)Direct antiglobulin test&#10;D)Unconjugated bilirubin

Accepted Answer

The answer of A laboratory professional is reviewing blood smears,...

Question 25

Free hemoglobin released in intravascular hemolysis is bound to this protein and transported to the liver.&#10;A)Methemalbumin&#10;B)Carbon monoxide&#10;C)Haptoglobin&#10;D)Hemosiderin

Accepted Answer

The answer of Free hemoglobin released in intravascular hemolysis is...

Question 26

A patient's laboratory tests show an increased LDH, a decreased haptoglobin, schistocytes, spherocytes, and polychromasia on the peripheral blood smear.Physical exam revealed splenomegaly.Excessive destruction of erythrocytes may be occurring in the:

A)Blood vessels.
B)Spleen.
C)Marrow.
D)Lymph nodes.

Accepted Answer

The answer of A patient's laboratory tests show an increased...

Question 27

Explain how the tests below differ for acute hemolytic anemia and compensated hemolytic anemia.&#10;A)PB smear&#10;B)Hemoglobin&#10;C)Bone changes&#10;

Accepted Answer

The answer of Explain how the tests below differ for...

Question 28

Extravascular hemolysis due to a high degree of ineffective erythropoiesis is associated with:&#10;A)Cytoplasmic maturation defects.&#10;B)Autoimmune hemolytic anemia.&#10;C)Physical trauma to the erythrocyte.&#10;D)Snake venoms.

Accepted Answer

The answer of Extravascular hemolysis due to a high degree...

Question 29

A clinical finding associated with a chronic hemolytic anemia includes:&#10;A)Gallstones.&#10;B)Increased bone marrow M:E ratio.&#10;C)Pica.&#10;D)Unstable gait.

Accepted Answer

The answer of A clinical finding associated with a chronic...

Question 30

In cases of mild hemolytic processes, what clinical study can provide helpful survival information regarding the red blood cell?&#10;A)Hemoglobin electrophoresis&#10;B)Erythrocyte survival studies&#10;C)Schilling test&#10;D)G6PD test

Accepted Answer

The answer of In cases of mild hemolytic processes, what...

Question 31

In immune mediated hemolytic anemia this test is helpful in identifying erythrocytes sensitized with antibodies and/or complement.&#10;A)DAT&#10;B)RPI&#10;C)IRF&#10;D)Erythrocyte survival studies?

Accepted Answer

The answer of In immune mediated hemolytic anemia this test...

Question 32

The presence of spherocytes in peripheral circulation indicates which of the following?&#10;A)An intracorpuscular membrane defect&#10;B)An intracorpuscular enzyme defect&#10;C)An extracorpuscular membrane defect&#10;D)An extracorpuscular enzyme defect

Accepted Answer

The answer of The presence of spherocytes in peripheral circulation...

Deck 13: Introduction to Hemolytic Anemia