Anemia

Question 1

RDW Iron deficiency anemia =
RDW Thalassemia =

Answer 1

• High RDW
• Normal RDW

Question 2

Causes of microcytic anemia:
IRON LAST

Answer 2

• IRON deficiency
• Lead poisoning
• Anemia of chronic disease
• Sideroblastic anemia
• Thalassemia

Question 3

Asymptomatic or fatigued individual with microcytic anemia and normal iron studies:

Answer 3

Thalassemia

Question 4

How do the following laboratory values change in iron deficiency anemia?
- Serum iron:
- TIBC:
- RDW
- % Saturation Transferrin:
- Ferritin:

Answer 4

• decreased
• increased
• increased
• decreased
• decreased

Question 5

How do the following laboratory values change in chronic inflammation anemia?
- Serum iron:
- TIBC:
- RDW
- % Saturation Transferrin:
- Ferritin:

Answer 5

• decreased
• decreased
• normal
• normal
• increased

Question 6

How do the following laboratory values change in sideroblastic anemia?
- Serum iron:
- TIBC:
- RDW
- % Saturation Transferrin:
- Ferritin:

Answer 6

• Increased
• decreased
• normal
• increased
• increased

Question 7

In ________, peripheral blood shows presence of ringed sideroblasts and basophilic stippling of RBCs

Answer 7

Sideroblastic anemia

Question 8

Child with excessive consumption of cow’s milk (>24 ounces per day). What should you suspect?

Answer 8

Iron deficiency anemia

Question 9

What are the major causes of acute severe anemia in sickle cell disease?
- Aplastic crisis (Parvovirus B19):
- Splenic sequestration (Vaso-occlusion):

Answer 9

↓ reticulocyte count + no splenomegaly
- ↑ reticulocyte count + splenomegaly

Question 10

Parvovirus B19 commonly causes aplastic crisis in patients with:

Answer 10

Sickle cell, thalassemias, and hereditary spherocytosis

Question 11

What blood smear finding is consistent with autoimmune hemolytic anemia?

Answer 11

Spherocytes

Question 12

Spherocytes are seen in:

Answer 12

• Autoinmmune hemolysis
• Hereditary spherocytosis

Question 13

What test is used to diagnose autoimmune hemolytic anemia?

Answer 13

Direct antiglobulin test (Coombs)

Question 14

What pathologic RBC is seen with end-stage renal disease, pyruvate kinase deficiency, and liver disease?

Answer 14

Echinocyte (“burr cell”)

Question 15

Patient whose smear shows features of hemolysis with bite cells and Heinz bodies:

Answer 15

G6PD deficiency

Question 16

Most prevalent erythrocyte enzyme disorders:

Answer 16

• Glucose-6-phosphate dehydrogenase deficiency
• Pyruvate kinase deficiency

Question 17

G6PD deficiency presents with ______ and _____ hours after exposure to oxidative stress

Answer 17

hemoglobinuria and back pain

Question 18

What is the likely diagnosis in a well-appearing child that presents with a microcytic, hypochromic anemia with normal RBC count and RDW?

Answer 18

Thalassemia minor

Question 19

What is the likely diagnosis in an African-American patient that presents with dark urine that stains positive with Prussian blue after being treated for a urinary tract infection?

Answer 19

G6PD deficiency

Question 20

What is the likely diagnosis in a child with a family history of anemia that presents with increased MCHC, Coombs-negative hemolytic anemia, jaundice, and splenomegaly?

Answer 20

Hereditary spherocytosis

Question 21

What is the best confirmatory test for hereditary spherocytosis?

Answer 21

The eosin-5-maleimide (EMA) binding test

Question 22

Clinical features of paroxysmal nocturnal hemoglobinuria (PNH) can be remembered with the mnemonic:
PNH Thrombosis

Answer 22

• Pancytopenia
• Nocturnal build up of red/pink urineCoombs (-)
• Hemolytic anemia
• Venous Thrombosis

Question 22

Which form of autoimmune hemolytic anemia causes painful, blue fingers and toes with cold exposure?

Answer 22

IgM (cold agglutinin)

Question 23

Hereditary spherocytosis is characterized by a(n) ______ RDW

Answer 23

increased

Question 24

First line treatment of paroxysmal nocturnal hemoglobinuria

Answer 24

Eculizumab

Question 25

_______ is indicated in all infants > 9 months, children, and adolescents with sickle cell anemia regardless of symptom severity because it reduces the incidence of acute vasoocclusive episodes

Answer 25

Hydroxyurea

Question 26

Patients with Hereditary Spherocytosis who do not receive adequate treatment are at risk of:

Answer 26

Folic acid deficiency.

Question 27

Macroangiopathic hemolytic anemia may be seen with:

Answer 27

Prosthetic heart valves and aortic stenosis

Question 28

Rapid Diagnosis: Triphalangeal thumb, craniofacial abnormalities, macrocytic anemia, reticulocytopenia, normal platelets and WBC counts:

Answer 28

Diamond-Blackfan syndrome

Question 29

Levels of homocysteine and methylmalonic acid in folate and vitamin B 12 deficiency:

Answer 29

- Folate: increased homocysteine levels, and normal methylmalonic acid levels. - Vitamin B12: both homocysteine and methylmalonic acid would be increased

Question 30

Which protein synthesis inhibitor can cause dose-independent aplastic anemia?

Answer 30

Chloramphenicol

Question 31

_______deficiency is characterized by sideroblastic anemia and peripheral neuropathy

Answer 31

Vitamin B6

Question 32

Warm AIHA is treated with _____, recurrent episodes are treated with _____

Answer 32

- Steroids - Splenectomy

Question 32

What hepatobiliary complication is associated with hereditary spherocytosis?

Answer 32

Pigmented gallstones (± acute cholecystitis)

Question 33

Severe cold AIHA is treated with:

Answer 33

Rituximab

Question 34

What is the most common cause of IgG-mediated immune hemolytic anemia?

Answer 34

Systemic lupus erythematosus (SLE)

Question 35

Which form of immune hemolytic anemia may be caused by drugs?

Answer 35

Warm IgG hemolytic anemia