Question 1

Which of the following is true of aplastic anemia?&#10;A) It is most common in children.&#10;B) It is caused by a deficiency of intrinsic factor.&#10;C) It is the most common enzymopathy of humans.&#10;D) It occurs when hematopoietic stem cells are unable to proliferate, differentiate, or give rise to mature blood cells.

Accepted Answer

Aplastic anemia occurs when the bone marrow is unable to produce adequate numbers of RBCs,white blood cells,and platelets.The hematopoietic stem cells are unable to proliferate,differentiate,or give rise to mature blood cells.Aplastic anemia is most common in young adults and in persons older than 60 years of age.Pernicious anemia is caused by a deficiency of intrinsic factor.G-6-PD is the most common enzymopathy in humAnswer.

Question 2

Which of the following dental local anesthetics should be avoided in a patient with sickle cell anemia?&#10;A) lidocaine&#10;B) mepivacaine&#10;C) prilocaine&#10;D) articaine

Accepted Answer

Prilocaine should be avoided for the patient with sickle cell anemia.The use of a local anesthetic with epinephrine 1:100,000 to attain hemostasis and profound anesthesia is warranted.Stronger concentrations of epinephrine must be avoided.If required,nitrous oxide-oxygen (N₂O-O₂)should be used for short periods,with at least 50% oxygen concentration provided.

Question 3

Which of the following types of anemia is associated with a &#34;hair on end&#34; appearance in the cortical regions of a skull film?&#10;A) aplastic anemia&#10;B) sickle cell anemia&#10;C) thalassemia&#10;D) hemolytic anemia

Accepted Answer

Dental radiographs of patients with sickle cell anemia may show enlarged bone marrow (medullary)spaces associated with bone marrow hyperplasia,increased widening and decreased numbers of trabeculations,and generalized osteoporosis (thinning of the inferior border of the mandible).The trabeculae between teeth may appear as horizontal rows or in a "stepladder" configuration.This can also manifest as frontal bossing or "hair on end" appearance in the cortical regions of a skull film.

Question 4

What is the most common therapy for aplastic anemia?&#10;A) long-term use of erythropoietin&#10;B) cyanocobalamin injections&#10;C) immunosuppression with antithymocyte globulin (ATG) alone or with cyclosporine&#10;D) iron supplements

Accepted Answer

Immunosuppression with antithymocyte globulin (ATG)alone or with cyclosporine is the most common therapy for aplastic anemia.About 60% to 80% of patients respond to immunosuppression therapy,with about 20% to 30% having a complete recovery.The other 50% to 70% achieve a partial response and become trAnswerfusion independent.The patients who do not respond to immunosuppression can benefit from a second course of immunosuppression (about 75% of these patients respond to the second treatment).

Question 5

The medical management of sickle cell anemia in children primarily relies on the use of ________.&#10;A) steroids&#10;B) antibiotics&#10;C) acetaminophen&#10;D) blood transfusions

Accepted Answer

Management of sickle cell anemia is based on routine prophylactic penicillin for infants and the early use of antibiotics to prevent severe infection.Because folic acid deficiency may play a role in the causes of crises,folic acid dietary supplements are given daily to most patients with sickle cell anemia.In addition,penicillin prophylaxis is used for at least the first 5 years of life.

Question 6

Which of the following types of food contain folate?&#10;A) red meat&#10;B) grains&#10;C) leafy vegetables&#10;D) a and b&#10;E) b and c

Accepted Answer

Folate is found in fruits and leafy vegetables.It is not stored in the body in large amounts,so a continual dietary supply is needed.Its absorption and metabolism are interfered with by alcohol consumption and certain drugs.Risk factors for folate deficiency include poor diet,alcoholism,history of malabsorption disorders,and pregnancy.

Question 7

Pernicious anemia is caused by a deficiency of ________.&#10;A) iron&#10;B) intrinsic factor&#10;C) the enzyme G-6-PD&#10;D) erythropoietin

Accepted Answer

Pernicious anemia is caused by a deficiency of intrinsic factor,a substance secreted by stomach parietal cells that is necessary for absorption of vitamin B₁₂ (cobalamin).Because vitamin B₁₂ may be stored for several years,this form of nutritional deficiency is rare and usually does not develop until late adulthood.Most patients with pernicious anemia have chronic atrophic gastritis with decreased intrinsic factor and hydrochloric acid secretion.Antibodies against parietal cells and intrinsic factor also are present in the sera of most patients.

Question 8

Which of the following serves as the primary sensor in the body for determining oxygenation of the blood?&#10;A) gastrointestinal tract&#10;B) lungs&#10;C) kidney&#10;D) liver

Accepted Answer

The kidney serves as the primary sensor for determining the level of oxygenation.If the level is low,the kidney releases erythropoietin,a hormone that stimulates the bone marrow to release RBCs.About 95% of erythropoietin is produced by cortical cells in the kidney.The other 5% is produced by the liver.

Question 9

Which of the following is the most common type of anemia among persons in the United States?&#10;A) hemolytic anemia&#10;B) iron deficiency anemia&#10;C) folate deficiency anemia&#10;D) sickle cell anemia

Accepted Answer

Iron deficiency anemia is the most common type of anemia in the United States.It is a microcytic anemia that can be caused by excessive blood loss,poor iron intake,poor iron absorption,or increased demand for iron.

Deck 22: Disorders of Red Blood Cells