Deck 4: Anemia: Diagnosis and Clinical Considerations

Question 1

How many cells are usually counted in the manual reticulocyte count?

A) 100
B) 1000
C) 200
D) 500
E) 50

Answer 1

1000

Question 2

Calculate the MCH based on the following parameters: hemoglobin = 12 g/dL, RBC count = 4.4 $\times$ 10¹²/ L:

A) 30 pg
B) 24 pg
C) 27 pg
D) 32 pg
E) None of the above

Answer 2

27 pg

Question 3

What cellular remnants in a reticulocyte are visible when stained with new methylene blue?

A) DNA
B) Hemosiderin
C) RNA
D) Denatured hemoglobin
E) None of the above

Answer 3

RNA

Question 4

The adult hemoglobin reference range for men and women, respectively, is:

A) 16.0 ± 2 g/dL to 14.0 ± 2 g/dL
B) 17.0 ± 2 g/dL to 12.0 ± 2 g/dL
C) 14.0 ± 2 g/dL to 11.0 ± 2 g/dL
D) 15.0 ± 2 g/dL to 16.0 ± 2 g/dL
E) None of the above

Question 5

Which physical symptoms may relate to moderate anemia?

A) Fatigue
B) Dyspnea on exertion
C) Muscle weakness
D) Increased heart rate
E) All of the above

Question 6

What percentage of senescent circulating RBCs is lost daily in a healthy ambulatory individual?

A) 5%
B) 3%
C) 1%
D) 7%
E) None of the above

Question 7

Polychromasia on the peripheral smear represents an increase in what cell and is a measure of the bone marrow's ability to replace red cells which have been destroyed?

A) Pronormoblast
B) Reticulocyte
C) Basophilic normoblast
D) Orthochromic normoblast
E) None of the above

Question 8

What hemoglobin range will suggest a newborn patient?

A) 16 ± 4 g/dL
B) 18 ± 4 g/dL
C) 20 ± 2 g/dL
D) 14 ± 2 g/dL
E) None of the above

Question 9

From the standpoint of hematologic studies, the usual diagnostic criteria for the evaluation of anemias would be:

A) Decreased hematocrit
B) Decreased hemoglobin
C) Decreased red blood cell (RBC) count
D) All of the above
E) None of the above

Question 10

A person living in a high-altitude environment reaching elevations as high as 10,000 feet will have a hemoglobin value that is:

A) Decreased
B) Increased
C) Within normal limits
D) Fluctuates randomly
E) None of the above

Question 11

What is the hematocrit reference range for adult women?

A) 34 ± 5%
B) 45 ± 5%
C) 42 ± 5%
D) 47 ± 5%
E) None of the above

Question 12

What is the normal range for hemoglobin in a newborn?

A) 12-14 g/dL
B) 10-12 g/dL
C) 14-22 g/dL
D) 8-10 g/dL
E) 22-26 g/dL

Question 13

In the presence of 2,3-diphosphoglycerate (2,3-DPG), hemoglobin can more readily release the oxygen it is carrying to peripheral tissues. In the state of chronic anemia, this compound is usually:

A) Unchanged
B) Increased
C) Decreased
D) Change is regulated by pH
E) None of the above

Question 14

What is the mean corpuscular hemoglobin (MCH) used to measure?

A) Packed cell volume
B) Average size of RBC
C) Iron content
D) Hemoglobin content
E) None of the above

Question 15

What hemoglobin value would support the diagnosis of severe anemia?

A) 7-10 g/dL
B) 12-14 g/dL
C) <7 g/dL
D) 14-16 g/dL
E) None of the above

Question 16

What would be the classification of anemia when the MCV is equal to 70 fL?

A) Macrocytic
B) Microcytic
C) Normocytic
D) Hypochromic
E) None of the above

Question 17

What is the mean corpuscular volume (MCV) used for?

A) Estimating the average size of RBCs
B) Estimating the hemoglobin content
C) Estimating the packed cell volume
D) All of the above
E) None of the above

Question 18

A patient's hemoglobin is 12 g/dL. What would you expect the hematocrit to be?

A) 36%
B) 33%
C) 42%
D) 39%
E) None of the above

Question 19

A patient whose RBC indices are MCV = 80 fL, MCH = 28 pg, and mean corpuscular hemoglobin concentration (MCHC) = 34% would be classified as:

A) Normocytic/normochromic
B) Normocytic/hyperchromic
C) Microcytic/hypochromic
D) Normocytic/hypochromic
E) None of the above

Question 20

Calculate the MCV, given the following parameters: hematocrit = 36%, RBC count = 4.0 $\times$ 10¹²/L

A) 70 fL
B) 80 fL
C) 85 fL
D) 90 fL
E) None of the above

Question 21

Which method for hemoglobin determination results in the formation of hemoglobin cyanide?

A) Carboxyhemoglobin
B) Oxyhemoglobin
C) Sulfhemoglobin
D) Cyanmethemoglobin
E) None of the above

Question 22

Heinz bodies may be seen in what hematologic disease?

A) Glucose 6-phosphate dehydrogenase (G6PD) deficiency
B) Alpha thalassemia
C) Unstable hemoglobinopathies
D) All of the above
E) None of the above

Question 23

A patient with microcytic anemia might have which of the following diseases?

A) Iron-deficiency anemia
B) Sideroblastic anemia
C) Lead poisoning
D) Thalassemia
E) All of the above

Question 24

A patient diagnosis with hereditary spherocytosis would have the following indices:

A) Decreased MCHC
B) Increased MCHC
C) Increased MCV
D) Decreased MCH
E) None of the above

Question 25

Which of the following can cause anemia?

A) Blood loss
B) Iron or vitamin B₁₂ deficiency
C) Cancer
D) Infection
E) All of the above

Question 26

What is the normal range for MCHC?

A) 25-30%
B) 32-36%
C) 36-38%
D) 40-42%
E) 25-30 pg

Question 27

What is the normal range for MCH?

A) 27-31 pg
B) 20-25 pg
C) 27-32%
D) 32-36%
E) 32-36 pg

Question 28

What is the normal range for MCV?

A) 60-80 fL
B) 40-60 fL
C) 80-100 fL
D) 100-120 fL
E) 27-32 pg

Question 29

The reference range for a reticulocyte count in a normal adult is:

A) 2.5-3.0%
B) 0.5-2.0%
C) 3.0-4.5%
D) 1.0-3.0%
E) None of the above

Question 30

A patient with a vitamin B₁₂ deficiency might have an anemia classified as:

A) Macrocytic/normochromic
B) Microcytic/normochromic
C) Normocytic/normochromic
D) Macrocytic/hypochromic
E) None of the above

Question 31

Calculate the MCHC given the following: Hb = 9.0 g/dL, Hct = 27.4%:

A) 36%
B) 33%
C) 40%
D) 31%
E) 27%

Question 32

What disease state can be assessed by hemoglobin electrophoresis?

A) RBC enzyme deficiency
B) Anemia of chronic disorders
C) Chronic leukemias
D) Hemoglobinopathies
E) None of the above

Question 33

What is the normal range for hematocrit in an adult male?

A) 37-45%
B) 52-60%
C) 30-35%
D) 42-52%
E) 60-70%