Question 1

In adults, which of the following is the most common cause of iron deficiency anemia?&#10;A) Intestinal parasites&#10;B) Malabsorptive disorders&#10;C) Dietary content&#10;D) Chronic blood loss

Accepted Answer

Chronic blood loss, typically from gastrointestinal or genitourinary sources, is the most common cause of iron deficiency anemia in adults. Other causes such as malabsorptive disorders and dietary content may contribute to iron deficiency anemia, but are less common. Intestinal parasites can also lead to iron deficiency anemia, but are more commonly found in developing countries.

Question 2

Which type of inclusion is likely to be seen in the above patient?&#10;A) Howell-Jolly bodies&#10;B) Pappenheimer bodies&#10;C) Hemoglobin H inclusion bodies&#10;D) Cabot rings

Accepted Answer

B

Question 3

In addition to iron ingestion, over 90% of iron in adults that is used for erythropoiesis is obtained through:&#10;A) Transfusion&#10;B) Recycling of iron&#10;C) Storage forms from spleen and the liver&#10;D) Hemosiderin

Accepted Answer

The majority of iron used for erythropoiesis is obtained through recycling. This involves the breakdown of old erythrocytes and the reuse of their iron-containing heme molecules. The iron is then transported back to the bone marrow for use in new erythrocyte production. Only a small amount of iron is obtained through dietary intake and absorption from the small intestine. Transfusion may be used in cases of severe anemia, but it is not a regular source of iron for erythropoiesis. Storage forms such as ferritin and hemosiderin are used to store excess iron, but they are not a direct source of iron for erythropoiesis.

Question 4

Which inclusion is associated with a &#34;pitted,&#34; golf ball appearance?&#10;A) Hgb H inclusion&#10;B) Howell-Jolly body&#10;C) Cabot rings&#10;D) Pappenheimer bodies

Accepted Answer

Hgb H inclusions are associated with a "pitted," golf ball appearance in red blood cells, typically seen in cases of alpha-thalassemia.

Question 5

Which if the following is also known as Cooley's anemia?&#10;A) Alpha thalassemia&#10;B) Beta thalassemia major&#10;C) Hereditary hemochromatosis&#10;D) IDA

Accepted Answer

Beta thalassemia major is also known as Cooley's anemia.

Question 6

The globin chains found in hemoglobin A2 are:&#10;A) Alpha 2, Delta 2&#10;B) Alpha 2, Gamma 2&#10;C) Alpha 2, Beta 2&#10;D) Alpha 2, Epsilon 2

Accepted Answer

Hemoglobin A2 is composed of two alpha chains and two delta chains, hence the correct answer is Alpha 2, Delta 2.

Question 7

The majority of the hemoglobin made in individuals with thalassemia major is:&#10;A) Hemoglobin H&#10;B) Hemoglobin A&#10;C) Hemoglobin F&#10;D) Hemoglobin Barts

Accepted Answer

In individuals with thalassemia major, the majority of hemoglobin made is Hemoglobin F (fetal hemoglobin). This is because the mutations affecting the alpha or beta globin genes in thalassemia interfere with the production of adult hemoglobin (Hemoglobin A), leading to a compensatory increase in fetal hemoglobin production.

Question 8

Ringed sideroblasts in the bone marrow are characteristics of which of the following disorders?&#10;A) Chronic disease&#10;B) Infection&#10;C) Sideroblastic anemia&#10;D) Inflammation

Accepted Answer

Ringed sideroblasts in the bone marrow are a hallmark feature of sideroblastic anemia. This condition is characterized by defective heme synthesis in the bone marrow, resulting in the presence of iron-laden, ring-shaped precursors of red blood cells called sideroblasts. Chronic disease, infection, and inflammation may cause anemia, but they do not specifically lead to the formation of ringed sideroblasts.

Question 9

The alpha thalassemic condition that is incompatible with life is:&#10;A) Hemoglobin H disease&#10;B) Bart's hydrops fetalis&#10;C) Alpha thalassemia trait&#10;D) Silent carrier condition

Accepted Answer

Bart's hydrops fetalis is a severe form of alpha thalassemia that occurs when there is a complete absence of alpha globin chains, leading to a buildup of gamma globin chains, and resulting in severe anemia and heart failure. This condition is incompatible with life, and affected fetuses usually die before birth or shortly after. Hemoglobin H disease is a milder form of alpha thalassemia, and alpha thalassemia trait and silent carrier condition are asymptomatic carrier states.

Question 10

The first stage of iron deficiency anemia is termed:&#10;A) Microcytic hypochromic anemia&#10;B) Iron depletion&#10;C) Iron deficiency&#10;D) Iron overload

Accepted Answer

Iron depletion is the initial stage of iron deficiency anemia, where there is a decrease in stored iron in the body. This is followed by iron-deficient erythropoiesis and eventually microcytic hypochromic anemia. Iron overload (choice D) is not a stage of iron deficiency anemia, but rather a condition where there is an excess of iron in the body.

Question 11

Storage iron is usually determined by the:&#10;A) Serum transferrin level&#10;B) Hemoglobin value&#10;C) Myoglobin value&#10;D) Serum ferritin level

Accepted Answer

The answer of Storage iron is usually determined by the:&#10;A)...

Question 12

What is the presumptive clinical condition?&#10;A) Pernicious anemia&#10;B) Autoimmune hemolytic anemia&#10;C) Iron deficiency trait&#10;D) Thalassemia trait

Accepted Answer

The answer of What is the presumptive clinical condition?&#10;A) Pernicious...

Question 13

The alpha thalassemias result from:&#10;A) Gene deletion&#10;B) Defective alpha genes&#10;C) Iron overload&#10;D) Excessive production of alpha chains

Accepted Answer

The answer of The alpha thalassemias result from:&#10;A) Gene deletion&#10;B)...

Question 14

A 15-year-old Lebanese boy was sent to the laboratory for an evaluation of anemia and had the following lab results: A) WBC = 7.5 $\times$ 10⁹/L B) RBC = 5.9 $\times$ 10¹²/L C) Hgb = 11.6 g/dL D) Hct = 36%

Accepted Answer

The answer of A 15-year-old Lebanese boy was sent to...

Question 15

All of the following are symptoms of iron deficiency anemia except:&#10;A) Pallor&#10;B) Pica&#10;C) Vertigo&#10;D) Numbness

Accepted Answer

The answer of All of the following are symptoms of...

Question 16

Transferrin receptors for iron uptake are located on the:&#10;A) Basophilic normoblast&#10;B) Pronormoblast&#10;C) Reticulocyte&#10;D) Orthochromic normoblast

Accepted Answer

The answer of Transferrin receptors for iron uptake are located...

Question 17

The presence of which hemoglobin will result in an inherited methemoglobinemia?&#10;A) Hemoglobin D&#10;B) Hemoglobin M&#10;C) Hemoglobin H&#10;D) Bart's hemoglobin

Accepted Answer

The answer of The presence of which hemoglobin will result...

Question 18

Failure to thrive, facial structure abnormalities, severe anemia, and splenomegaly are signs of which of the following disorders?&#10;A) Thalassemia minor&#10;B) Alpha thalassemia trait&#10;C) Thalassemia major&#10;D) Thalassemia intermedia

Accepted Answer

The answer of Failure to thrive, facial structure abnormalities, severe...

Question 19

One of the gravest clinical problems for individuals with thalassemia major is:&#10;A) Chronic anemia&#10;B) Iron overload&#10;C) Therapeutic phlebotomy&#10;D) Collapsed veins

Accepted Answer

The answer of One of the gravest clinical problems for...

Question 20

Given the laboratory results of serum iron = 300 $\mu$g/dL, transferrin = 312 mg/dL, transferrin saturation = 122%, and ferritin = 1,000 ng/mL, which of the following should be considered?&#10;A) Hereditary hemochromatosis&#10;B) Anemia of inflammation&#10;C) Iron deficiency anemia&#10;D) Lead poisoning

Accepted Answer

The answer of Given the laboratory results of serum iron...

Question 21

Hemoglobin H disease is associated with:&#10;A) Bart's hydrops fetalis&#10;B) Alpha thalassemia disease&#10;C) Thalassemia major&#10;D) Hereditary hemochromatosis

Accepted Answer

The answer of Hemoglobin H disease is associated with:&#10;A) Bart's...

Question 22

The primary storage forms of iron are:&#10;A) Ferritin and hemosiderin&#10;B) Ferritin and transferrin&#10;C) Hemosiderin and ferrous iron&#10;D) Heme and ferritin

Accepted Answer

The answer of The primary storage forms of iron are:&#10;A)...

Question 23

In patients with iron overload, Desferal may be administered to chelate the excess iron.The chelated iron is shed in:&#10;A) The feces&#10;B) The urine&#10;C) Gastric secretions&#10;D) None of the above

Accepted Answer

The answer of In patients with iron overload, Desferal may...

Question 24

In the United States, approximately of the anemias seen are due to IDA.&#10;A) 25%&#10;B) 40%&#10;C) 50%&#10;D) 75%

Accepted Answer

The answer of In the United States, approximately of the...

Question 25

In regards to the thalassemias, the deficit has nothing to do with iron.

Accepted Answer

The answer of In regards to the thalassemias, the deficit...

Question 26

In iron deficiency anemia, the reticulocyte count will be:&#10;A) Normal&#10;B) Low&#10;C) High&#10;D) Extremely high

Accepted Answer

The answer of In iron deficiency anemia, the reticulocyte count...

Deck 5: The Microcytic Anemias