Exam 3: Anemia & Hematopoetic GF

Question 0

What do the RBCs look like in IDA?

Answer 0

Microcytic and hypochromic

Question 1

Most common form of chronic anemia?

Answer 1

Iron def. anemia

Question 2

What are the 3 oral forms in iron therapy?

Answer 2

Ferrous:

• sulfate
• gluconate
• fumarate

Question 3

Iron cheating compound for iron excretion? Non oral form

Answer 3

Deferoxamine

Question 4

Iron cheating compound for iron excretion? oral form

Answer 4

Deferasirox

Question 5

How many tablets can cause lethal effects of acute iron toxicity in a child?

Answer 5

10 tablets

Question 6

Adverse effects of iron therapy?

Answer 6

Constipation
Black stools
Epigastric discomfort
Abdominal cramps
Nausea 
Diarrhea

Question 7

How do the RBCs present in chronic iron toxicity?

Answer 7

Hemochromatosis

Question 8

What are the 2 preparations for parenteral iron therapy?

Answer 8

Iron dextran

Iron sucrose

Question 9

Iron dextran can present with what hypersensitivity reaction?

Answer 9

Urticaria

Question 10

What is the disease where there is defective secretion of intrinsic factor?

Answer 10

Pernicious anemia

Question 11

About how much folic acid is absorbed?
A. 10-20 mcg
B. 50-200 mcg
C. 70-400 mcg

Answer 11

B

Question 12

Which IL is necessary for the lymphoid cell line?
A. IL- 11
B. IL- 7
C. IL-3

Answer 12

C

Question 13

Your patient is neutropenic due to receiving several bouts of chemotherapy. Which growth factor should you prescribe to reverse the neutropenia?

Answer 13

Give G-CSF to increase neutrophil

Question 14

How many new blood cells are made by the bone marrow each day?
A. 100 million
B. 200 million
C. 300 million

Answer 14

B

Question 15

Hematopoiesis requires a constant supply of which essential nutrients? Name them. There are 3

Answer 15

Iron
Vit. B 12
Folic acid

Question 16

Anemia results when:
A. Inadequate supply of essential nutrients
B. Deficient growth factors
C. Both

Answer 16

C

Question 17

Most common symptoms of anemia include all except: 
A. Pallor
B. Fatigue
C. Dizziness
D. Exertional dyspnea
E. Tachycardia
F.  Dec CO
G. Vasodilation

Answer 17

F. There is inc cardiac output

Question 18

When there is inadequate iron, small erythrocytes with insufficient hemoglobin, which type of anemia can prevail?

Answer 18

Microcytic hypochromic anemia

Question 19

Free inorganic iron is extremely toxic. T/F

Answer 19

True

Question 20

Nearly all the iron used to support hematopoiesis comes from:
A. Diet
B. Gut microbiotia
C. Reclaimed catalysis of hemoglobin in senescent RBCs

Answer 20

C

Question 21

Which population does not need iron supplementation?
A. Pregnant
B. Children
C. Menstruating women
D. Alcoholics

Answer 21

D

Question 22

How much iron is absorbed daily from diet?
A. 0.5-1 mg
B. 1-1.5 mg
C. 1.5-3 mg

Answer 22

A

Question 23

Most of the iron is absorbed in the 
A. Duodenum 
B. Duodenum and proximal jejunum 
C. Distal ilium 
D. Proximal jejunum

Answer 23

B

Question 24

Eat this food for the best absorption of iron A. Green leafy veggies B. Whole grains C. Red meat

Answer 24

C

Question 25

Transferrin is a beta-globulin used to transfer iron in the blood. How many iron molecules can it bind?

Answer 25

2

Question 26

Once the transferrin-iron complex enters via endocytosis, ferric iron is reduced to ferrous and enters the cytoplasm via

Answer 26

DMT1

Question 27

Storage form of iron

Answer 27

Ferritin

Question 28

``` Iron is stored in these places except: A. Alveolar macrophages B. Intestinal mucosal cells C. Macrophages and Parenchymal cells in the liver D. Spleen E. Bone ```

Answer 28

A

Question 29

If your serum hepcidin is elevated, A. Iron release is inhibited B. Iron is release

Answer 29

A

Question 30

``` Which marker do you look at to estimate total body iron stores? A. Transferrin B. Hepcidin C. Ferritin D. DMT1 ```

Answer 30

C

Question 31

What is the efficient mechanism for iron excretion? A. Lost in feces by exfoliation of intestinal mucosal cells B. Excreted in bile, urine and sweat C. None of the above

Answer 31

C. Excretion of iron is so limited. The factors listen above collaboratively only excrete 1 mg of iron per day

Question 32

What is the only clinical indication for the use of iron preparations?

Answer 32

IDA

Question 33

``` Menstruating women lose about _____ mg of iron each menses? A. 10 B. 20 C. 200 D. 30 ```

Answer 33

D

Question 34

If you have folic acid deficiency, what do the RBCs look like?

Answer 34

Macrocytic and normochromic

Question 35

If you have a deficiency of cobalamin, you can get which type of anemia?

Answer 35

Megaloblastic anemia

Question 36

What is the preferred type of Vit. B12? And why? A. Hydroxocobalamin B. Cyanocobalamin

Answer 36

A. Because it is more protein bound and therefore remains longer in circulation 100-1000 mcg

Question 37

What is the ultimate source of Vit. B12? A. Diet B. Microbial synthesis

Answer 37

B

Question 38

How much Vit. B12 do you absorb everyday?

Answer 38

1-5 mcg

Question 39

Vit. B12 is bound to which glycoprotein and stored in liver?

Answer 39

Transcobalamin 1, 2 and 3. But mainly 2

Question 40

Which vitamin is needed to convert N5- methyltetrahydrofolate to tetrahydrofolate ? A. B6 B. B9 C. B12

Answer 40

C

Question 41

B12 is needed for all of the following except for : A. Turning methyl-malonyl CoA into succinyl CoA B. THF Production C. Transfer of 2 carbon units D. Sufficient supplies of dTMP

Answer 41

C

Question 42

Which properly describes the methylfolate trap? A. Accumulation of THF and a depletion of N5methyltetrahydrofolate B. Accumulation of N5methyltetrahydrofolate and a depletion of THF

Answer 42

B

Question 43

An increase in which serum level can diagnose Vit. B12 deficiency? A. Methionine B. Homocysteine C. Thymidine

Answer 43

B

Question 44

Schilling test is a diagnostic test to determine which anemia?

Answer 44

Pernicious

Question 45

``` Folic acid is composed of: choose 2 A. Homocysteine B. Glutamic acid C. P-aminobenzoic acid D. Iron ```

Answer 45

B and C

Question 46

Long term use of phenytoin can cause folate deficiency due to the inhibition of which enzyme? A. Folate reductase B. Intestinal conjugase C. Thymidylate synthase

Answer 46

B

Question 47

``` Known hemtopoetic growth factors include all of the following: A. EPO B. G-CSF C. GM-CSF D. IL-11 E. All of the above ```

Answer 47

E

Question 48

``` First human hematopoietic growth factor to be isolated: A. EPO B. G-CSF C. GM-CSF D. IL-11 ```

Answer 48

A

Question 49

Modified form of EPO that has a 2x-3x longer half life that epoetin alfa: A. Darbepoetin Alfa B. Methoxy polyethylene glycol-epoetin beta C. No such drug exists

Answer 49

A

Question 50

``` Which hematopoietic GF can stimulate increased levels of megakaryocytes? A. EPO B. G-CSF C. GM-CSF D. IL-11 ```

Answer 50

C

Question 51

Endogenous regulators of platelet production

Answer 51

IL-11 and thrombopoietin