Deck 29: Alterations of Erythrocytes, Platelets, and Hemostatic Function

Question 1

What term is used to describe the capacity of some erythrocytes to vary in size, especially in relationship to some anemias?

A)Poikilocytosis
B)Isocytosis
C)Anisocytosis
D)Microcytosis

Answer 1

Anisocytosis

Question 2

A healthcare professional in an urban clinic is seeing a patient who has iron deficiency anemia (IDA). What question by the professional is most appropriate to assess for the cause of IDA?

A)"How many times a week do you have iron-rich foods?"
B)"Have you ever noticed any blood in your stool?"
C)"Do you have a history of heart valve replacement?"
D)"Have you had any recent viral infections?"

Answer 2

"Have you ever noticed any blood in your stool?"

Question 3

A healthcare professional works with recent refugees. A mother brings in her children who have been diagnosed with iron deficiency anemia. What action by the professional is most appropriate?

A)Educate the mother on an iron-rich diet.
B)Arrange to test for parasitic infections.
C)Explain the weekly iron infusions.
D)Teach the mother to give iron supplements.

Answer 3

Arrange to test for parasitic infections.

Question 4

A healthcare professional is reviewing a patient's laboratory results and sees that the patient has a low reticulocyte count and a high iron level. Which type of anemia does the professional associate these findings with?

A)Folate deficiency anemia
B)Iron deficiency anemia
C)Hemolytic anemia
D)Anemia of chronic disease

Question 5

A student asks the professor what the most common pathophysiologic process is that triggers aplastic anemia (AA). What response by the professor is most accurate?

A)Autoimmune disease against hematopoiesis by activated cytotoxic T (Tc) 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

Question 6

An allogenic bone marrow transplantation remains the preferred method for treating which anemia?

A)Polycythemia vera
B)Aplastic
C)Sideroblastic
D)Anemia of chronic disease (ACD)

Question 7

Which anemia produces small, pale erythrocytes?

A)Folic acid
B)Hemolytic
C)Iron deficiency
D)Pernicious

Question 8

After a person has a subtotal gastrectomy for chronic gastritis, which type of anemia will result?

A)Iron deficiency
B)Aplastic
C)Folic acid
D)Pernicious

Question 9

Which of these describes how the body compensates for anemia?

A)Increasing rate and depth of breathing
B)Decreasing capillary vasoconstriction
C)Hemoglobin holding more firmly onto oxygen
D)Kidneys releasing more erythropoietin

Question 10

A healthcare professional has educated a student on folic acid. Which statement by the student indicates that more teaching is needed?

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.

Question 11

A patient has hepatomegaly, bronze-colored skin, and cardiac dysrhythmias. What condition does the healthcare professional prepare to teach the patient about?

A)Aplastic anemia
B)Pernicious anemia
C)Hereditary hemochromatosis
D)Immune thrombocytopenia purpura

Question 12

Which condition resulting from untreated pernicious anemia (PA) is fatal?

A)Brain hypoxia
B)Liver hypoxia
C)Heart failure
D)Renal failure

Question 13

The paresthesia that occurs in vitamin B₁₂ deficiency anemia is a result of which of these?

A)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

Question 14

How is the effectiveness of vitamin B₁₂ therapy measured?

A)Reticulocyte count
B)Serum transferring
C)Hemoglobin
D)Serum vitamin B₁₂

Question 15

The students learn that deficiencies in folate and vitamin B₁₂ alter the synthesis of which of these?

A)RNA
B)Cell membrane
C)DNA
D)Mitochondria

Question 16

What is the fundamental physiologic manifestation of anemia?

A)Hypotension
B)Hyperesthesia
C)Hypoxia
D)Ischemia

Question 17

In aplastic anemia (AA), pancytopenia develops as a result of what?

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

Question 18

A patient has defective secretion of the intrinsic factor leading to anemia. What treatment option does the healthcare professional discuss with the patient?

A)Increasing iron sources in the diet such as red meat.
B)Vitamin B₁₂ injections initially given once a week.
C)Having relatives tested for bone marrow donation.
D)Better control of the patient's underlying disorder.

Question 19

Which of these classified as a megaloblastic anemia?

A)Iron deficiency
B)Pernicious
C)Sideroblastic
D)Hemolytic

Question 20

A patient in the healthcare clinic reports fatigue, weakness, and dyspnea, as well as pale conjunctiva of the eyes and brittle, concave nails. What assessment by the healthcare professional is most appropriate for the suspected anemia?

A)Blood pressure and apical pulse
B)Oral mucus membranes and tongue
C)Ability to swallow foods and liquids
D)Skin and sclera for normal coloration

Question 21

A patient has been hospitalized for a large deep vein thrombosis and states he is the third person in his family to have this condition in the last 2 years. What response by the healthcare professional is most appropriate?

A)"This condition is not transmitted genetically."
B)"We can test your blood for factor V Leiden."
C)"Were they all men or both men and women?"
D)"Familial thromboses tend to be very severe."

Question 22

What does the student learn about warm autoimmune hemolytic anemia?

A)Warm autoimmune hemolytic anemia occurs primarily in children.
B)It is self-limiting and rarely produces hemolysis.
C)Erythrocytes are bound to macrophages and sequestered in the spleen.
D)Immunoglobulin M coats erythrocytes and binds them to receptors on monocytes.

Question 23

A student asks the professor to explain the jaundice that accompanies hemolytic anemia. Which statement is by the professor is most accurate?

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.

Question 24

What does treatment for polycythemia vera involve?

A)Therapeutic phlebotomy and radioactive phosphorus
B)Restoration of blood volume by plasma expanders
C)Administration of cyanocobalamin
D)Blood transfusions

Question 25

A patient has polycythemia vera and presents to the Emergency Department with plethora and neurological changes. The student asks the healthcare professional to explain the primary cause of these symptoms. What response by the professional is best?

A)Decreased erythrocyte count
B)Destruction of erythrocytes
C)Increased blood viscosity
D)Tissue destruction by macrophages

Question 26

Shortened erythrocyte life span, ineffective bone marrow response to erythropoietin, and altered iron metabolism describe the pathophysiologic characteristics of which type of anemia?

A)Aplastic
B)Sideroblastic
C)Anemia of chronic disease
D)Iron deficiency

Question 27

An adult patient has been hospitalized with thrombocytopenia with a platelet count of 8000/mm³. What action by the healthcare professional is most appropriate?

A)Tell the patient not to get out of bed without assistance.
B)Prepare the patient for transfusions of whole blood.
C)Educate the patient on side effects of heparin.
D)Nothing; this finding is normal in an adult.

Question 28

A healthcare professional is evaluating laboratory results for a patient who has disseminated intravascular coagulation (DIC). What results would the professional consider consistent with this condition? (Select all that apply.)

A)Elevated d-dimer
B)Elevated creatinine
C)Decreased protein C
D)Decreased lactate dehydrogenase
E)Increased pH

Question 29

A healthcare professional is caring for five patients. Which one would the professional assess for disseminated intravascular coagulation (DIC) as the priority? (Select all that apply.)

A)Heat stroke
B)Severe pancreatitis
C)Term delivery
D)HELLP syndrome
E)Snake bite

Question 30

A patient is 8 hours postoperative after a long orthopedic procedure. The student asks why this patient is at particular risk of developing a thromboembolism. What response by the healthcare professional is best?

A)Patients tend to have venous stasis from orthopedic operations.
B)Anesthetic agents often cause an immune response against clotting factors.
C)Endothelial damage occurs and repair is slowed by postoperative pain.
D)Atherosclerotic build up causes turbulent blood flow leading to clots.

Question 31

A patient in the hospital has been receiving heparin injections. The platelet count on admission was 222,000/mm³ and four days later is 113,000/mm³. What action by the healthcare professional is best?

A)Prepare to transfuse the patient with platelets.
B)Do nothing; this is an expected side effect.
C)Switch the heparin to lepirudin
D)Stop all the patient's medications.