Deck 8: Introduction to Anemia

Question 1

An instrument printout indicates an MCV of 63 fl and an MCHC of 26 g/dl.How will the red cells appear under the microscope?

A)Normocytic, normochromic
B)Macrocytic, normochromic
C)Microcytic, hypochromic
D)Normocytic, hypochromic

Answer 1

Microcytic, hypochromic

Question 2

How does the mean cell volume value classify cells?

A)Normochromic, hypochromic, and hyperchromic
B)Normocytic, microcytic, macrocytic
C)Poikilocytosis
D)Polychromasia

Answer 2

Normocytic, microcytic, macrocytic

Question 3

Which RBC inclusion is characterized by diffusely staining RNA precipitate that can be seen when blood is stained with Wright's stain?

A)Heinz bodies
B)Pappenheimer bodies
C)Howell-Jolly bodies
D)Basophilic stippling

Answer 3

Basophilic stippling

Question 4

An instrument printout reveals an RDW of 33.Which of the following would best correlate with those results?

A)The presence of a dimorphic cell population on the PB smear
B)The presence of marked polychromasia on the PB smear
C)The presence of spherocytes on the PB smear
D)The presence of macro-ovalocytes on the PB smear

Question 5

Codocytes are associated with all of the following conditions except:

A)Iron-deficiency anemia.
B)Thalassemias.
C)Hemoglobinopathies.
D)Hemolytic anemia.

Question 6

A patient sample had a retic count of 5%.The patient's hematocrit was 25%.Normal hematocrit is 45%.What is the corrected reticulocyte count?

A)3.50%
B)2.78%
C)5%
D)10%

Question 7

Which of the following laboratory values would best correlate with moderate polychromasia on the peripheral blood smear?

A)A low RBC count
B)A retic count of 8%
C)Schistocytes on the PB smear
D)A low PLT count

Question 8

All of the following laboratory tests can be used for evaluation of hemolysis except:

A)Haptoglobin.
B)Hemopexin.
C)Total protein.
D)Bilirubin.

Question 9

How would you differentiate between an acanthocyte and an echinocyte?

A)The variety in length and distribution of the spikes
B)The number of spikes
C)The presence or absence of a fish-mouth central pallor
D)The size of the cell

Question 10

A peripheral blood smear has an even distribution of both normocytic normochromic cells and microcytic hypochromic cells.What is this phenomenon called?

A)Extramedullary hematopoiesis
B)Nuclear-cytoplasmic asynchrony
C)Dimorphic cell population
D)Monoclonal cell population

Question 11

Red blood cell survival is best measured by which of the following when hemoglobin levels are stable?

A)Conjugated bilirubin
B)Urine hemoglobin
C)Depending on the disorder, the most sensitive and specific test available
D)Reticulocyte count

Question 12

What is the RPI for this patient with a reticulocyte count of 5% and hematocrit of 25%.Normal hematocrit is 45%.

A)2.39
B)2.59
C)1.39
D)4.50

Question 13

What is one of the disease states associated with the presence of target cells?

A)Sickle cell anemia
B)Thalassemia
C)Uremia
D)Hemolytic anemia

Question 14

A patient has hemolytic anemia.An instrument printout reveals a reticulocyte count of 8%, marked polychromasia and moderate schistocytes, and an MCV of 88 fl.What can be concluded about the bone marrow response to this hemolytic anemia?

A)It is adequate.
B)It is not adequate for the degree of hemolysis.
C)The reticulocyte count indicates that the marrow is responding at its maximum rate.
D)There is not enough information to determine if bone marrow response is adequate.

Question 15

All of the following are classic signs of anemia except:

A)Fatigue.
B)Pallor.
C)Shortness of breath
D)Nosebleeds.

Question 16

A patient sample has an RBC count of 4.30 x 1012?This is a superscript ?
/L and a reticulocyte count of 4%.What is the absolute retic count?
This is a superscript

A)142 x 109/L
B)172 x 109/L
C)350 x 109/L
D)90 x 109/L

Question 17

Howell-Jolly bodies are red cell inclusions associated with what disease state?

A)Lead poisoning
B)G6PD deficiency
C)Megaloblastic anemia
D)Normal reticulocytes

Question 18

An instrument printout has an RPI of 1.3, a hemoglobin of 7 g/dL and an MCV of 112 fl.What can be concluded from this?

A)There is acute hemolysis present.
B)This is due to iron deficiency.
C)The anemia is associated with renal disease.
D)There may be a nuclear maturation defect.

Question 19

A patient with a bleeding problem is complaining to her physician about excessive fatigue.Physical examination reveals a thin, pale woman with pale mucosal membranes.Significant CBC findings include an MCV of 70 fl.Based on these findings follow-up testing should be ordered for:

A)Iron studies.
B)Vitamin B₁₂ and folate assays.
C)Coagulation screening tests.
D)A bone marrow aspirate.

Question 20

A patient presents with a RPI of greater than 2 and macrocytic morphology of the red blood cells.Which survival defect does this most likely represent?

A)B₁₂ deficiency
B)Folate deficiency
C)Hemorrhage or hemolysis
D)Myelodysphasia

Question 21

What staining method can be used to differentiate Pappenheimer bodies from reticulocytes?

A)New methylene blue
B)PAS
C)Perl's Prussian blue
D)Phase microscopy on wet prep

Question 22

Remnants of DNA inside an RBC produce which type of inclusion?

A)Howell-Jolly bodies
B)Basophilic stippling
C)Cabot rings
D)Pappenheimer bodies

Question 23

An apparent pancytopenia is noted in a patient's CBC results.A bone marrow aspirate is performed, and the M:E results are 2:1.Do these results make sense? Why or why not?

Question 24

Acanthocytes or spur cells have membranes with irregular distribution of spikes.What other significant feature does this cell possess?

A)Increased size
B)Presence of Pappenheimer bodies
C)Decreased life span
D)Lack of central pallor

Question 25

Blood flow adaptations to anemia are achieved by increasing the respiration rate and _________________

A)Increasing circulation rate.
B)Decreasing 2,3-BPG.
C)Decreasing cardiac output.
D)Increasing blood viscosity.

Question 26

CBC results on a pregnant patient indicate an MCV of 112 fl.What would be the most appropriate reflex test?

A)Iron studies
B)Bilirubin
C)LDH
D)Folate assay

Question 27

What test is the most sensitive and specific for detecting iron-deficiency anemia?

A)Vitamin B₁₂ assay
B)Ferritin
C)RDW
D)Transferrin saturation

Question 28

A bone marrow aspirate is hypercellular and has an M:E ratio of 1:4.What can be concluded from this? There is:

A)Myeloid hyperplasia.
B)Myeloid hypoplasia.
C)Erythroid hypoplasia.
D)Erythroid hyperplasia.

Question 29

Patient results indicate an RPI of 1.8 and an MCV of 109 fl.Do these results make sense? Why or why not?

Question 30

A blood sample has moderate spherocytes, schistocytes, and polychromasia on the smear.What would you expect the results of the following to be?

A)Bilirubin
B)LDH
C)Hemoglobin
D)Retic count
E)M:E ratio

Question 31

A patient sample had a retic count of 5%.The patient's hematocrit was 25%.Normal hematocrit is 45%.What other bone marrow test(s) could you perform to help determine if the bone marrow is responding to the pancytopenia?

Question 32

An increased red cell distribution width (RDW) usually indicates what abnormality?

A)Increase of average erythrocyte volume
B)Increase of average weight of hemoglobin
C)Decrease in ratio of hemoglobin mass to volume
D)Variation in erythrocyte size

Question 33

Why do we see Howell-Jolly bodies in patients who have had a splenectomy? Explain your answer.

Question 34

What RBC inclusions cannot be seen with Romanowsky stain but can be visualized with supravital stain?

A)Howell-Jolly bodies
B)Pappenheimer bodies
C)Cabot rings
D)Heinz bodies

Question 35

What disease state is associated with helmet cells?

A)Diabetes
B)Iron deficiency
C)Heart valve hemolysis
D)Thalassemia