Deck 19: Diseases of the Hematological System

Question 1

Which of the following body parts are involved in hematopoiesis?

A) lungs and heart
B) bone marrow and spleen
C) veins and arteries
D) liver and pancreas
E) lymph nodes and adrenal glands

Answer 1

B

Question 2

What is the most likely cause of anemia if it is microcytic and hypochromic?

A) vitamin E toxicity
B) iron deficiency
C) thiamin deficiency
D) selenium overdose
E) vitamin E deficiency

Answer 2

B

Question 3

What is the product of heme metabolism that is excreted with bile?

A) thrombopoietin
B) ferritin
C) uric acid
D) bilirubin
E) hepcidin

Answer 3

D

Question 4

What minerals are closely tied to normal hematopoiesis?

A) calcium, magnesium, iron
B) lead, zinc, aluminum
C) phosphorus, potassium, copper
D) iron, zinc, copper
E) calcium, potassium, magnesium

Question 5

Which vitamin enhances the absorption of iron?

A) vitamin B₁
B) vitamin B₁₂
C) vitamin C
D) vitamin D
E) vitamin E

Question 6

Which of the following glycoproteins stimulates the production of red blood cells and regulates blood components?

A) erythropoietin
B) mucin
C) transferrin
D) thrombopoietin
E) immunoglobulin

Question 7

What is the main vitamin and mineral involved with the clotting process?

A) vitamin K and magnesium
B) vitamin C and copper
C) vitamin K and calcium
D) vitamin A and copper
E) vitamin C and calcium

Question 8

What is arachidonic acid?

A) an amino acid
B) a polysaccharide
C) an omega-3 fatty acid
D) an omega-6 fatty acid
E) an omega-9 fatty acid

Question 9

Which of the following occurs when less oxygen is supplied to the kidneys?

A) Kidneys secrete the hormone erythropoietin into the blood.
B) Kidneys stimulate the production of aldosterone into the blood.
C) Kidneys secrete the hormone thrombopoietin into the blood.
D) Kidneys stimulate the production of leptin into the blood.
E) Kidneys secrete the hormone hepcidin into the blood.

Question 10

Which hormone regulates iron homeostasis?

A) thrombopoietin
B) ferritin
C) leptin
D) vasopressin
E) hepcidin

Question 11

Hemoglobin is present in what type of cells?

A) white blood cells
B) red blood cells
C) liver cells
D) pancreatic cells
E) nerve cells

Question 12

What is the group of inherited blood disorders involving abnormal globin subunits in the hemoglobin molecule called?

A) thalassemia
B) lupus
C) sickle cell anemia
D) hemophilia
E) chronic myeloproliferative disease

Question 13

What is the term used to describe eating nonnutritive substances such as lead paint chips or clay?

A) bulimia
B) metallothionein
C) pica
D) hypovitaminosis
E) hypochromic disorder

Question 14

Which of the following is the most bioavailable source of iron?

A) 2 eggs
B) 1 cup of fortified cereal
C) ½ tortilla
D) ½ cup of seaweed
E) 1 cup of clams

Question 15

What kind of anemia develops from a folate deficiency?

A) microcytic
B) macrocytic
C) hemolytic
D) hypochromic
E) microblastic

Question 16

What is the most common cause of nutritional anemia?

A) protein deficiency
B) vitamin E toxicity
C) lead toxicity
D) iron deficiency
E) thiamin deficiency

Question 17

What are the three major categories of nutritional anemias?

A) mild, moderate, severe
B) vitamin deficiency, mineral deficiency, genetic
C) acute, chronic, fatal
D) macrocytic, microcytic, hemolytic
E) megaloblastic, microblastic, hypochromic

Question 18

Which is the densest or heaviest component of the blood evidenced by centrifuging?

A) serum
B) plasma
C) erythrocytes
D) leukocytes
E) electrolytes

Question 19

What kind of anemia develops from lead toxicity?

A) microcytic
B) macrocytic
C) hemolytic
D) hypochromic
E) microblastic

Question 20

What are immature red blood cells called?

A) osteocytes
B) lymphocytes
C) reticulocytes
D) thrombocytes
E) leukocytes

Question 21

Sickle cell anemia is a structural defect in what type of cells?

A) platelets
B) thrombocytes
C) lymphocytes
D) leukocytes
E) erythrocytes

Question 22

Which of the following best describes a nutrition therapy for anemia in premature infants?

A) supplementation of arachidonic acid along with folate
B) vitamin C supplementation during thrombopoietin treatment
C) vitamin E supplementation during erythropoietin treatment
D) supplementation of ascorbic acid during deferoxamine treatment
E) supplementation of vitamin B₁₂along with folate

Question 23

Which plasma protein factor is deficient in hemophilia B?

A) XI
B) X
C) IX
D) VIII
E) VII

Question 24

PS is an 87-year-old male admitted to a hospital for stomach pain. He has mild breathing problems and complains of fatigue and chronic stomach upset, for which he takes a daily antacid. While hospitalized, a physician has determined that PS has megaloblastic anemia. Which of the following is least likely to cause PS's anemia?

A) reduced intrinsic factor production
B) lack of dietary folate intake
C) lack of dietary B₁₂intake
D) lack of dietary iron intake
E) GI malabsorption

Question 25

Which of the following is the richest source of folate?

A) 2 cups of strawberries
B) 4 cups of blueberries
C) ¼ cup of seaweed
D) ½ cup of broccoli
E) 1 cup of asparagus

Question 26

PS is an 87-year-old male admitted to a hospital for stomach pain. He has mild breathing problems and complains of fatigue and chronic stomach upset, for which he takes a daily antacid. While hospitalized, a physician has determined that PS has megaloblastic anemia. If the MD were to prescribe folate for PS, which of the following is a potential concern?

A) Folate could mask a B₁₂deficiency.
B) Folate is very expensive and hard to find.
C) Folate is a blood thinner.
D) Folate negatively interacts with his iron supplement.
E) Folate could promote the growth of H. pylori .

Question 27

Which of the following is the iron-rich compound found in breast milk?

A) lactoferrin
B) ferrous glycinate
C) ferric glycinate
D) phytase
E) ferrous fumarate

Question 28

Which compound is needed for the absorption of vitamin B₁₂and is produced by the parietal cells in the stomach?

A) amylase
B) phytase
C) ferrous fumarate
D) lipase
E) intrinsic factor

Question 29

PS is an 87-year-old male admitted to a hospital for stomach pain. He has mild breathing problems and complains of fatigue and chronic stomach upset, for which he takes a daily antacid. While hospitalized, a physician has determined that PS has megaloblastic anemia. What lab values would be altered given the likely cause of PS's problem?

A) low folate
B) low creatinine
C) low cyanocobalamin
D) high serum ferritin
E) high leukocytes

Question 30

Vitamin K is a fat-soluble compound that can be stored in the adult liver for approximately how many days?

A) 454
B) 30
C) 20
D) 10
E) 3

Question 31

What is the treatment for hemochromatosis?

A) megadosing of vitamin C
B) phlebotomy
C) use of proton pump inhibitors
D) use of H₂blockers
E) bone marrow transplant

Question 32

What is the upper intake level of iron established for the United States?

A) 15 mg/day
B) 25 mg/day
C) 35 mg/day
D) 45 mg/day
E) 55 mg/day

Question 33

Deficiency of which vitamin causes pernicious anemia?

A) vitamin C
B) vitamin B₅
C) vitamin B₁₂
D) vitamin B₇
E) vitamin K

Question 34

What is the normal range of hemoglobin levels in females?

A) 12-15 g/dL
B) 7.5-9.5 g/dL
C) 15-18 g/dL
D) 3.5-7.5 g/dL
E) 20-23 g/dL

Question 35

What is a result of impaired globin synthesis?

A) reduced erythrocyte production
B) increased leukocyte production
C) increased iron absorption
D) decreased hemoglobin synthesis
E) increased mineral absorption

Question 36

Which mineral deficiency is linked to restless leg syndrome?

A) calcium
B) iron
C) copper
D) lithium
E) boron

Question 37

When does erythroblastosis fetalis occur?

A) when Rh-negative infants are born to Rh-positive mothers
B) when Rh-positive infants are born to Rh-negative mothers
C) when infants are born to folate-deficient mothers
D) when infants are born to iron-deficient mothers
E) when a fetus experiences lead poisoning in the womb

Question 38

PS is an 87-year-old male admitted to a hospital for stomach pain. He has mild breathing problems and complains of fatigue and chronic stomach upset, for which he takes a daily antacid. While hospitalized, a physician has determined that PS has megaloblastic anemia. What should PS consider adding to his diet to potentially help with his condition?

A) asparagus
B) beef liver
C) kidney beans
D) citrus fruits
E) broccoli

Question 39

PS is an 87-year-old male admitted to a hospital for stomach pain. He has mild breathing problems and complains of fatigue and chronic stomach upset, for which he takes a daily antacid. While hospitalized, a physician has determined that PS has megaloblastic anemia. Given PS's age and symptoms, what is a likely cause of the megaloblastic anemia?

A) excessive loss of blood from stomach ulcer
B) lack of folate from poor dietary habits
C) liver disease
D) lead poisoning
E) reduced B₁₂absorption due to inadequate intrinsic factor

Question 40

Which plasma protein factor is deficient in hemophilia A?

A) VIII
B) X
C) VI
D) V
E) IV

Question 41

Supplemental iron should be given as ferrous _______________ or ferrous _______________, which are better absorbed and tolerated than other iron chelates.

Question 42

The coagulation proteins are vitamin _______________-dependent and are synthesized in the liver.

Question 43

The hematological system involves the bone marrow and _______________ for hematopoiesis.

Question 44

There are two sets of globin protein chains: delta and gamma.

Question 45

Megaloblastic anemia may result from an inadequate intake of vitamin _______________.

Question 46

Erythropoiesis involves the incorporation of hemoglobin into an RBC

Question 47

Hemolytic anemia may be due to deficiencies or excesses of vitamin D.

Question 48

Folate and B₁₂deficiencies result in specific forms of anemia, where the red blood cells are megaloblastic and macrocytic.

Question 49

The inflammatory signals act on red marrow to increase _______________, which regulates platelet production.

Question 50

Hematocrit is expressed as the percent of packed red blood cell volume of whole blood upon centrifugation.

Question 51

Both anemia and lead poisoning are associated with impaired _______________ function and neurological damage in children.

Question 52

Hemochromatosis is a condition in which a number of regulatory mechanisms for vitamin B₁₂are inoperative.

Question 53

The von Willebrand factor is a protein on the platelet membrane surface that causes platelets to become sticky and adhere to other platelets and blood constituents.

Question 54

Platelets or thrombocytes are short-lived cell fragments that comprise less than 1% of the total blood volume.

Question 55

Heme protein levels in red marrow and the spleen control _______________ synthesis.

Question 56

Hemophilia, an inherited disorder, results in insufficient factors for ferritin synthesis.

Question 57

Zinc deficiency results in decreased immunity and is tied to abnormal _______________ and iron uptake.

Question 58

Plant sources of iron are the most bioavailable because they do not contain compounds that bind iron and render it less absorbable.

Question 59

Hemoglobin is a four-subunit metalloprotein containing _______________ at the center of each subunit.

Question 60

All blood components are generated from the _______________ stem cells, which have the capability of differentiating into various cell types.

Question 61

True primary _______________ anemia is also known as Fanconi's anemia.

Question 62

Real _______________ is a result of dysregulated feedback and increased production of RBCs by marrow, usually detected by abnormal erythropoietin levels.

Question 63

What is the main purpose of nutritional therapy for hemochromatosis?

Question 64

Describe how iron-deficiency anemia and impaired thyroid function are related.

Question 65

Describe sideroblastic anemia.

Question 66

The _______________ are inherited disorders of abnormal alpha or beta globin synthesis.

Question 67

Cirrhosis leads to the decreased production of transferrin and _______________ for iron mobilization.

Question 68

_______________ levels are thought to be the best markers of vitamin B₁₂status.

Question 69

Vitamin B₁₂is recycled and/or stored in the _______________.

Question 70

Hemorrhagic disease of the newborn is characterized by clotting deficiencies due to insufficient amounts of _______________ available to the neonate.

Question 71

Describe the dietary factors that regulate hemostasis.

Question 72

Chronic toxicity from iron overload leads to functional _______________, hepatomegaly, cicatrix formation, and eventually cirrhosis, through oxidative damage to cellular membranes in nearby locations.

Question 73

Vitamin B₁₂or folate deficiencies increase risk for elevated _______________ in children as well as in adults.

Question 74

List the plasma protein factors that are linked to hemophilia.

Question 75

Discuss how aspirin impacts hemostasis.

Question 76

Secondary hemochromatosis is caused by other _______________ disorders or repeated blood transfusions.

Question 77

List the subunits of the hemoglobin molecule.

Question 78

Explain how hepcidin controls the level of plasma iron.

Question 79

Define sickle cell anemia and describe the role of nutrition therapy in sickle cell anemia.

Question 80

Discuss how the feedback mechanism for iron absorption is altered in iron-deficiency anemia.