Question 1

Which of the following best correlates with an increased reticulocyte count?&#10;A)An increased bilirubin&#10;B)The presence of schistocytes in the peripheral blood smear&#10;C)Increased polychromasia on the peripheral blood smear&#10;D)Anisocytosis and poikilocytosis

Accepted Answer

Increased polychromasia on the peripheral blood smear is the best correlate with an increased reticulocyte count, as reticulocytes are immature red blood cells that are still able to synthesize hemoglobin and appear bluish-purple, giving them a polychromatic appearance on the peripheral blood smear. An increased bilirubin, the presence of schistocytes in the peripheral blood smear, and anisocytosis and poikilocytosis may indicate hemolysis or other causes of anemia, but do not necessarily correlate directly with an increased reticulocyte count.

Question 2

All of the following proteins interact with spectrin in the RBC membrane except:&#10;A)Glycophorin A&#10;B)Ankyrin&#10;C)Protein 4.1&#10;D)Actin

Accepted Answer

Glycophorin A is a transmembrane protein that does not directly interact with spectrin. Spectrin interacts with ankyrin, protein 4.1, and actin to maintain the structural integrity of the red blood cell membrane.

Question 3

What analyte can help to differentiate between intravascular and extravascular hemolysis?&#10;A)Hemoglobin&#10;B)Bilirubin&#10;C)Haptoglobin&#10;D)Reticulocytes

Accepted Answer

Haptoglobin is a protein that binds to free hemoglobin released from the breakdown of red blood cells. In intravascular hemolysis, there is a large amount of free hemoglobin in the plasma, leading to a decrease in haptoglobin levels. In extravascular hemolysis, the red blood cells are broken down by macrophages in the spleen and liver, and the hemoglobin is not released into the plasma. Therefore, haptoglobin levels remain normal in extravascular hemolysis. Hemoglobin, bilirubin, and reticulocytes may also be altered in hemolysis, but they are not specific enough to differentiate between intravascular and extravascular hemolysis.

Question 4

Polychromatophilic red blood cells are commonly called what cell type?&#10;A)Normoblast&#10;B)Prorubricyte&#10;C)Reticulocyte&#10;D)Metarubricyte

Accepted Answer

Polychromatophilic red blood cells are immature red blood cells that have not yet shed their RNA and still contain some ribosomes. They are therefore called reticulocytes.

Question 5

Red blood cell production begins with what cell?&#10;A)Progenitor&#10;B)Hematopoietic stem cell&#10;C)CFU&#10;D)BFU

Accepted Answer

Red blood cell production begins with a hematopoietic stem cell, which has the potential to differentiate into all blood cell types.

Question 6

The abnormal increased influx of sodium and water in stomatocytes results from a defect in:&#10;A)Peripheral proteins&#10;B)Integral proteins&#10;C)Actin&#10;D)Spectrin

Accepted Answer

Integral proteins are responsible for the transport of ions and molecules across the cell membrane. In stomatocytes, the defect in integral proteins causes increased influx of sodium and water, leading to the abnormal shape of the cell. Peripheral proteins, actin, and spectrin are not directly involved in ion transport across the cell membrane.

Question 7

Where does normal extravascular hemolysis take place?&#10;A)Blood vessels and bone marrow&#10;B)Lymph nodes and spleen&#10;C)Spleen and liver&#10;D)Bone marrow and liver

Accepted Answer

Extravascular hemolysis typically takes place in the spleen and liver, where old or damaged red blood cells are removed and broken down by macrophages.

Question 8

What is the primary mechanism by which erythropoietin affects RBC production?&#10;A)It expedites the maturation time of RBCs.&#10;B)It prevents premature apoptosis of RBCs.&#10;C)It stimulates facilitated incorporation of hemoglobin into RBCs.&#10;D)It stimulates expulsion of nuclei from nucleated erythrocyte precursors at a quicker rate.

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Question 9

A blood sample has an elevated bilirubin,low haptoglobin,and low hemopexin.What is the most likely reason for this?&#10;A)Increased extravascular hemolysis&#10;B)Hypersplenism&#10;C)Ineffective erythropoiesis&#10;D)Increased intravascular hemolysis

Accepted Answer

Elevated bilirubin, low haptoglobin, and low hemopexin are indicative of increased hemolysis, with the breakdown of hemoglobin resulting in elevated bilirubin levels. Low haptoglobin indicates that the liver is unable to keep up with scavenging free hemoglobin released during hemolysis, and low hemopexin indicates that the liver is unable to keep up with the clearance of heme from the plasma, contributing to increased hemolysis. Intravascular hemolysis is typically associated with lower haptoglobin and hemopexin levels, while extravascular hemolysis is associated with higher levels of both proteins. Therefore, the most likely reason for this is increased intravascular hemolysis.

Question 10

The life span of a normal erythrocyte is about:&#10;A)9-11 days&#10;B)5-7 days&#10;C)120 days&#10;D)6 hours

Accepted Answer

The normal life span of an erythrocyte, also known as a red blood cell, is about 120 days. This is because they do not have a nucleus or other organelles, making them more flexible and able to squeeze through narrow capillaries, but also limiting their ability to repair damage or reproduce.

Question 11

Choose the correct order of normoblastic maturation from least mature to most mature.&#10;A)Erythrocyte,reticulocyte,polychromatophilic normoblast,orthochromatic normoblast,basophilic normoblast,pronormoblast&#10;B)Pronormoblast,basophilic normoblast,polychromatophilic normoblast,orthochromatic normoblast,reticulocyte,erythrocyte&#10;C)Basophilic normoblast,pronormoblast,polychromatophilic normoblast,orthochromatic normoblast,erythrocyte&#10;D)Pronormoblast,polychromatophilic normoblast,orthochromatic normoblast,reticulocyte,erythrocyte

Accepted Answer

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Question 12

A reticulocyte count is 6%.This result is:&#10;A)Normal.&#10;B)Increased.&#10;C)Decreased.&#10;D)Erroneous.

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Question 13

The heme moiety produced during intravascular hemolysis is excreted by the body as:&#10;A)Biliverdin&#10;B)Urobilinogen&#10;C)Ferrochelatase&#10;D)Iron

Accepted Answer

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Question 14

The average RBC is what size?&#10;A)20-25 mcM&#10;B)2-3 ,mcM&#10;C)12-15 mcM&#10;D)7-8 mcM

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Question 15

Which part of the RBC membrane is essential for transporting proteins and anions across the membrane?&#10;A)Lipids&#10;B)Integral proteins&#10;C)Peripheral proteins&#10;D)Skeletal proteins

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Question 16

Energy metabolism of the erythrocyte is achieved primarily through which of the following?&#10;A)Aerobic glycolysis&#10;B)Anaerobic glycolysis&#10;C)Asexual replication&#10;D)Mitosis

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Question 17

The deformability of the RBC membrane is attributed to which of the following?&#10;A)Peripheral proteins&#10;B)Integral proteins&#10;C)Sodium potassium pump&#10;D)Glycophorins

Accepted Answer

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Question 18

Of the following,who would have the highest concentration of erythropoietin?&#10;A)A child&#10;B)A patient who has just donated a kidney&#10;C)An anemic patient&#10;D)A pregnant mother

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Question 19

Increased hemoglobin affinity for oxygen correlates to which of the following?&#10;A)An elevated 2,3-BPG&#10;B)A normal 2,3-BPG&#10;C)A decreased 2,3-BPG&#10;D)This cannot be determined.

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Question 20

In a nonanemic adult,what is the normal range for peripheral blood reticulocytes?&#10;A)0.5-1.0%&#10;B)0.1-1.0%&#10;C)2.0-4.0%&#10;D)0.5-2.0%

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Question 21

What growth factor influences the production of the erythrocyte?&#10;A)Transforming growth factor-&#946;&#10;B)Interferon-&#947;&#10;C)Erythropoietin&#10;D)CFU-E

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Question 22

Which of the following &#34;marks&#34; the RBC as senescent?&#10;A)A cluster of band 3 proteins on the RBC membrane&#10;B)An RBC with denatured hemoglobin on the RBC membrane&#10;C)An elongated RBC&#10;D)Hyperphosphorylation of integral proteins

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Question 23

Explain how the body catabolizes hemoglobin in both extravascular and intravascular hemolysis.

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Question 24

Which pathway produces the energy required for proper RBC function from ~90% of the consumed glucose:&#10;A)Methemoglobin reductase&#10;B)Hexose monophosphate shunt&#10;C)Glycolytic&#10;D)Rapoport-Leubering shunt

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Question 25

Which metabolic pathway protects hemoglobin from oxidation via NADH?&#10;A)Rapoport-Luebering shunt&#10;B)Embden Meyerhof pathway&#10;C)Hexose monophosphate shunt&#10;D)Methemoglobin reductase pathway

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Question 26

What protein is the major membrane attachment point of the latticework that laminates the inner lining of the RBC membrane?&#10;A)Tropomodulin&#10;B)Troponyosin&#10;C)Ankyrin&#10;D)Band 3

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Question 27

What element or property contributes to the normal shape of the RBC?&#10;A)Sodium&#10;B)Spectrin tetramer&#10;C)Calcium&#10;D)Magnesium

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Question 28

The production of 2,3-BPG occurs in which erythrocytic metabolic pathway?&#10;A)Embden-Meyerhof pathway&#10;B)Hexose monophosphate shunt&#10;C) Rapoport-Luebering shunt&#10;D)All of the above Correct

Accepted Answer

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Question 29

Describe the nuclear and cytoplasmic morphologic changes in erythrocytes during maturation.

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Question 30

Explain the effect of the following on RBC survival.&#10;a.An absence of G6PD&#10;b.An absence of PK&#10;c.A defect in spectrin&#10;d.A defect in ankyrin

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Question 31

Predict the results of erythropoietin in a patient with hypoxia.&#10;A)It will be increased.&#10;B)It will be normal.&#10;C)It will be decreased.&#10;D)This cannot be determined.

Accepted Answer

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Question 32

Explain how EPO regulates RBC production.

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Question 33

What contributes to the RBC cell's membrane integrity?&#10;A)Skeletal proteins&#10;B)Glycolytic pathway&#10;C)2,3-BPG&#10;D)Methemoglobin reductase

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Question 34

Which of the following molecules is a senescence signal when it is exposed on the outer leaflet of the erythrocyte?&#10;A)Band 3&#10;B)Ankyrin&#10;C)Phosphatidylethanolamine (PE)&#10;D)Phosphatidylserine (PS)

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Question 35

What effect would a deficiency in G6PD have on RBC survival?&#10;A)It would increase the survival of the RBCs.&#10;B)It would decrease the survival of the RBCs.&#10;C)It would have no effect on the survival of the RBCs.&#10;D)This cannot be determined.

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Question 36

Which major integral protein is used in the mechanism to transport the chloride-bicarbonate exchange?&#10;A)Glucose transporter&#10;B)Anion exchange protein&#10;C)Ankyrin&#10;D)Adducing

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Question 37

Match between columns&#10;                        Premises: Stage when the nucleus becomes pyknotic and is extruded&#10;Stage when the nucleus becomes pyknotic and is extruded&#10;Stage when the nucleus becomes pyknotic and is extruded&#10;Stage when the nucleus becomes pyknotic and is extruded&#10;Stage when the nucleus becomes pyknotic and is extruded&#10;Stage when the nucleus becomes pyknotic and is extruded&#10;First stage without ribosomes&#10;First stage without ribosomes&#10;First stage without ribosomes&#10;First stage without ribosomes&#10;First stage without ribosomes&#10;First stage without ribosomes&#10;First visible appearance of hemoglobin&#10;First visible appearance of hemoglobin&#10;First visible appearance of hemoglobin&#10;First visible appearance of hemoglobin&#10;First visible appearance of hemoglobin&#10;First visible appearance of hemoglobin&#10;Last stage capable of mitosis&#10;Last stage capable of mitosis&#10;Last stage capable of mitosis&#10;Last stage capable of mitosis&#10;Last stage capable of mitosis&#10;Last stage capable of mitosis&#10;Earliest morphologically recognizable erythrocytic cell&#10;Earliest morphologically recognizable erythrocytic cell&#10;Earliest morphologically recognizable erythrocytic cell&#10;Earliest morphologically recognizable erythrocytic cell&#10;Earliest morphologically recognizable erythrocytic cell&#10;Earliest morphologically recognizable erythrocytic cell&#10;First stage without a nucleus&#10;First stage without a nucleus&#10;First stage without a nucleus&#10;First stage without a nucleus&#10;First stage without a nucleus&#10;First stage without a nucleus

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Deck 5: The Erythrocyte