Pediatric and Geriatric Hematology and Hemostasis

Question 1

1. The CBC results for children (aged 3 to 12 years) differ from
   those of adults chiefly in what respect?
   a. NRBCs are present.
   b. Notable polychromasia is seen, indicating increased
   reticulocytosis.
   c. Platelet count is lower.
   d. The percentage of lymphocytes is higher

Answer 1

d. The percentage of lymphocytes is higher

Question 2

2. Physiologic anemia of infancy results from:
   a. Iron deficiency caused by a milk-only diet during the
   early neonatal period
   b. Increased oxygenation of blood and decreased erythropoietin
   c. Replacement of active marrow with fat soon after birth
   d. Hb F and its diminished oxygen delivery to tissues

Answer 2

b. Increased oxygenation of blood and decreased erythropoietin

Question 3

3. The CBC report on a 3-day-old neonate who was born 6
   weeks prematurely shows a decrease in hemoglobin compared with the value obtained 2 days earlier. Which of the
   following should be considered as an explanation for this
   result when no apparent source of hemolysis or bleeding is
   evident?
   a. The sample was collected from a vein at the time that an
   intravenous line was inserted.
   b. The sample was collected by heel puncture rather than
   finger puncture because of the infant’s small size.
   c. The umbilical cord was clamped quickly to begin appropriate treatment for a preterm infant.
   d. The infant has become dehydrated.

Answer 3

a. The sample was collected from a vein at the time that an
intravenous line was inserted

Question 4

4. Morphologically, the hematogones in newborns are:
   a. Similar to those seen in megaloblastic anemia
   b. Easily confused with leukemic blasts
   c. Monocytoid in appearance
   d. Similar to adult lymphocytes

Answer 4

b. Easily confused with leukemic blasts

Question 5

5. The most frequent cause of anemia in childhood is:
   a. Vitamin B12 deficiency
   b. Drug-related hemolysis
   c. Iron deficiency
   d. Folate deficiency

Answer 5

c. Iron deficiency

Question 6

6. As age increases, the hemoglobin level of elderly adults:
   a. Remains unchanged from that of middle-aged adults
   b. Increases due to diminished respiration and poor tissue
   oxygenation
   c. Decreases for reasons that are unclear
   d. Becomes comparable to that of newborns

Answer 6

c. Decreases for reasons that are unclear

Question 7

7. Which of the following are the most common anemias in
   the elderly population?
   a. Megaloblastic anemia and iron deficiency anemia
   b. Sideroblastic anemia and megaloblastic anemia
   c. Myelophthisic anemia and anemia of chronic inflammation
   d. Iron deficiency anemia and anemia of chronic inflammation

Answer 7

d. Iron deficiency anemia and anemia of chronic inflammation

Question 8

8. When iron deficiency is recognized in an elderly individual,
   the cause is usually:
   a. An iron-deficient diet
   b. Gastrointestinal bleeding
   c. Diminished absorption
   d. Impaired incorporation of iron into heme as a result of
   telomere loss. When iron deficiency is recognized in an elderly individual,
   the cause is usually:
   a. An iron-deficient diet
   b. Gastrointestinal bleeding
   c. Diminished absorption
   d. Impaired incorporation of iron into heme as a result of
   telomere loss

Answer 8

b. Gastrointestinal bleeding

Question 9

9. Which of the following conditions is least likely in an
   elderly individual?
   a. Acute lymphoblastic leukemia
   b. Multiple myeloma
   c. Myelodysplasia
   d. Chronic lymphocytic leukemia

Answer 9

a. Acute lymphoblastic leukemia

Question 10

10. The multiple medications used by the elderly makes this
    population more prone to:
    a. Anemia of chronic inflammation
    b. Megaloblastic anemia
    c. Hemolytic anemia
    d. Iron deficiency anemia

Answer 10

c. Hemolytic anemia