16. Red Cell Disorders

Question 1

A patient comes in with complaints of fatigue and headaches.Blood test are done showing normochromic large cells. What could possibly be the cause of this patients issues?

A. Folate Deficiency 
B. Chronic Disease 
C. Lead Poisoning 
D. Thalassemia 
E. Acute blood loss

RFA

Answer 1

Ans. A. Folate Deficiency- would present as normochromic Macrocytic anemia

B. Chronic Disease- would be Normochromic Normocytic or Microcytic Hypochromic

C. Lead Poisoning- Microcytic Hypochromic

D. Thalassemia- Microcytic Hypochromic

E.Acute blood loss- Normochromic Normocytic

Question 2

A patient has a genetic disease that resulted in defective Ankyrin and Band 3. The patient has recently gotten ill with an infection. Which infection could causes severe damage to this patient?

A. Bordetella 
B. Parvovirus 
C.  Coronavirus 
D. Toxoplasma 
E.  Klebsiella 

RFA

Answer 2

Ans. B. Parvovirus- the patient has hereditary spherocytosis causes by defects in critical membrane proteins such as ankyrin and band 3.Noted on diagnosis by spherocytes and Howell-Jolly bodies.

People with this defect that have Parvovirus B19 can induce aplastic or hemolytic crisis

Question 3

A 65 y/o female with a history of defective aortic valve presents with dizziness, fatigue, and pallor. She is found to be anemic. Which of the following would also be present on labs?

A. Absent haptoglobin
B. Negative hemogloburia
C. Positive hemosideriuria
D. Splenomegaly
E. Maximum iron recycling

SZ

Answer 3

Ans. A. Absent haptoglobin and C. Positive hemosideriuria

Defective arotic valve, along with complement fixation and parasitic infections are causes of intravascular anemia.

In intravascular anemia haptoglobin is absent, hemoglobiuria and hemosideriuria occurs with minimal iron recycling.

Question 4

A patient from northern Europe presents jaundice and splenomegaly. A peripheral blood smear shows normochromic normocytic anemia, spherocytes and Howell-Jolly bodies. Which of the following would also be present on labs?

A. Decreased MCHC
B. Increased MCHC
C. Decreased haptoglobin
D. Decreased LDH
E. Increased MCV

Sz

Answer 4

Ans. B. Increased MCHC

Hereditary spherocytosis is the only anemia with an increase in MCHC.

Question 5

A 33 year old female presents with splenomegaly and low haptoglobin. You suspect she has a hemolytic anemia. Which of the following could be a possible cause? (MG)

A. Malaria
B. Clostridia infection
C. Defective heart valve
D. Complement fixation of antibody-coated RBCs
E. Spherocytosis

Answer 5

E. Spherocytosis

A-D are all intravascular causes of hemolytic anemia.

The diagnosis is extravascular hemolytic anemia

Question 6

A 24 year old female presents with splenomegaly, pale skin, fatigue, and jaundice. Infection with what organism could induce an aplastic or hemolytic crisis in this patient? (MG)

A. Parvovirus B19
B. Adenovirus
C. Candida albicans
D. Haemophilus influenzae
E. HIV

Answer 6

A. Parvovirus B19

Dx is hedereditary spherocytosis