Deck 19: Diseases of the Hematological System

Question 1

What is the most bioavailable source of iron?

A) ​milk
B) ​spinach
C) ​kidney beans
D) ​seaweed 
E) ​clams

Answer 1

E

Question 2

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

Answer 2

C

Question 3

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

Answer 3

D

Question 4

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 5

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 6

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

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

Question 7

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

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

Question 8

What kind of anemia develops from a folate deficiency?

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

Question 9

What 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

Question 10

What is the hormone that regulates iron homeostasis?

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

Question 11

What part of long bones contain the red marrow?

A) ​spongy bone
B) ​compact bone
C) ​medullary cavity
D) ​diaphysis
E) ​endosteum

Question 12

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

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

Question 13

What are immature red blood cells called?

A) ​platelets
B) ​lymphocytes
C) ​reticulocytes
D) ​thrombocytes
E) ​leukocytes

Question 14

What vitamin enhances the absorption of iron?

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

Question 15

What kind of anemia develops from lead toxicity?

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

Question 16

What percent of total blood volume do white blood cells comprise?

A) ​1%
B) ​5%
C) ​8%
D) ​12%
E) ​18%

Question 17

What minerals are closely tied to normal hematopoiesis?

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

Question 18

What is the most common cause of a nutritional anemia?

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

Question 19

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

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

Question 20

Hemoglobin binds to what type of cell?

A) ​white blood cells
B) ​red blood cells
C) ​iron
D) ​oxygen
E) ​platelets

Question 21

What plasma protein factor is deficient in hemophilia B?

A) ​XI
B) ​X
C) ​IX
D) ​VIII
E) ​VII

Question 22

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

A) ​45
B) ​30
C) ​20
D) ​10
E) ​3

Question 23

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 24

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 B12 intake
D) ​ lack of dietary iron intake
E) ​GI malabsorption

Question 25

What percent of people with hemochromatosis develop cardiomyopathy?

A) ​10%
B) ​30%
C) ​50%
D) ​70%
E) ​90%

Question 26

What plasma protein factor is deficient in hemophilia A?

A) ​VIII
B) ​X
C) ​VI
D) ​V
E) ​IV

Question 27

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 28

What is the iron rich compound found in breast milk?​

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

Question 29

What vitamin deficiency causes pernicious anemia?

A) ​B2
B) ​B5
C) ​B12
D) ​B7
E) ​B3

Question 30

When does Erythroblastosis fetalis occur?

A) ​when Rh- infants are born to Rh+ mothers
B) ​when Rh+ infants are born to Rh- 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 31

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 32

What compound, released by stomach parietal cells, is needed to properly absorb vitamin B12?

A) ​hydrochloric acid
B) ​phytase
C) ​ferrous fumarate
D) ​pepsin
E) ​intrinsic factor

Question 33

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 B12 absorption due to inadequate intrinsic factor

Question 34

Sickle cell anemia is a structural defect in what cells?

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

Question 35

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 36

What causes primary hemochromatosis?

A) ​genetics
B) i​nadequate diet
C) ​iron supplements
D) ​severe blood loss
E) ​repeated blood transfusions

Question 37

If the MD were to prescribe folate for PS which of the following is a potential concern? 

A) ​folate could mask a B12 deficiency
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 growth of H. pylori

Question 38

What is the treatment for hemochromatosis?

A) ​megadosing of vitamin C
B) ​phlebotomy
C) ​use of proton pump inhibitors
D) ​use of H2 blockers
E) ​bone marrow transplant

Question 39

Which of the following is the richest source of folate?

A) ​strawberries
B) ​blueberries
C) ​flour tortillas
D) ​corn tortillas
E) ​asparagus

Question 40

What mineral deficiency is linked to restless leg syndrome?

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

Question 41

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

Question 42

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

Question 43

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

Question 44

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

Question 45

Disorders of porphyrin metabolism include the porphyria syndromes, where one or more of the intermediates for _______________ synthesis are abnormal or the enzymes for the steps are inactive.

Question 46

Antiretroviral therapy for HIV and AIDS patients causes abnormal clotting by decreasing the red bone marrow's ability to produce _______________.

Question 47

Folate and B12 deficiencies result in specific forms of anemia, where the red blood cells are megaloblastic and macrocytic.

Question 48

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

Question 49

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

Question 50

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

Question 51

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

Question 52

Erythropoiesis involves the incorporation of hemoglobin into a RBC.

Question 53

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

Question 54

Hemochromatosis is a condition in which a number of regulatory mechanisms for vitamin B12 are inoperative.

Question 55

The five major classes of hemoglobinopathy are: structural, thalassemias, thalassemic hemoglobin variants, hereditary persistence of fetal hemoglobin, and acquired hemoglobinopathy.

Question 56

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

Question 57

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

Question 58

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

Question 59

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

Question 60

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

Question 61

Discuss how aspirin impacts hemostasis.

Question 62

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

Question 63

Describe the main purpose of nutritional therapy for hemochromatosis.

Question 64

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

Question 65

Explain how hepcidin controls the level of plasma iron.

Question 66

List the plasma protein factors that are linked to hemophilia.

Question 67

Vitamin B12 is recycled and/or stored in the _______________.

Question 68

_______________ levels are thought to be the best markers of vitamin B12 status.

Question 69

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

Question 70

Vitamin B12 supplements are best taken _______________ or via injection.

Question 71

Chronic toxicity from iron overload leads to functional _______________, hepatomegaly, and eventually cirrhosis.

Question 72

Vitamin B12 or Folate deficiencies increases risk for elevated _______________ in children as well as in adults.

Question 73

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

Question 74

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

Question 75

Describe side roblastic anemia.

Question 76

List the subunits of the hemoglobin molecule.

Question 77

Describe the dietary factors that regulate hemostasis.

Question 78

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

Question 79

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

Question 80

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