Normocytic and normochromic anemias

Question 1

Hypersplenism is characterized by:
A. Polycythemia
B. Pancytosis
C. Leukopenia
D. Myelodysplasia

Answer 1

C

Question 1

Hypersplenism is characterized by:
A. Polycythemia
B. Pancytosis
C. Leukopenia
D. Myelodysplasia

Question 2

Which of the following organs is responsible for
the “pitting process” for RBCs?
A. Liver
B. Spleen
C. Kidney
D. Lymph nodes

Answer 2

B

Question 3

Spherocytes differ from normal red cells in all of
the following except:
A. Decreased surface to volume
B. No central pallor
C. Decreased resistance to hypotonic saline
D. Increased deformability

Answer 3

D

Question 4

Which of the following is not associated with
hereditary spherocytosis?
A. Increased osmotic fragility
B. An MCHC greater than 36%
C. Intravascular hemolysis
D. Extravascular hemolysis

Answer 4

C

Question 5

Which of the following disorders has an increase
in osmotic fragility?
A. Iron deficiency anemia
B. Hereditary elliptocytosis
C. Hereditary stomatocytosis
D. Hereditary spherocytosis

Answer 5

D

Question 6

6. The anemia seen in sickle cell disease is usually:
   A. Microcytic, normochromic
   B. Microcytic, hypochromic
   C. Normocytic, normochromic
   D. Normocytic, hypochromic

Answer 6

C

Question 7

Which is the major Hgb found in the RBCs of
patients with sickle cell trait?
A. Hgb S
B. Hgb F
C. Hgb A2
D. Hgb A

Answer 7

D

Question 8

Select the amino acid substitution that is
responsible for sickle cell anemia.
A. Lysine is substituted for glutamic acid at the
sixth position of the α-chain
B. Valine is substituted for glutamic acid at the
sixth position of the β-chain
C. Valine is substituted for glutamic acid at
the sixth position of the α-chain
D. Glutamine is substituted for glutamic acid at
the sixth position of the β-chain

Answer 8

B

Question 9

All of the following are usually found in Hgb C
disease except:
A. Hgb C crystals
B. Target cells
C. Lysine substituted for glutamic acid at the sixth
position of the β–chain
D. Fast mobility of Hgb C at pH 8.6

Answer 9

D

Question 10

Which of the following hemoglobins migrates to
the same position as Hgb A2 at pH 8.6?
A. Hgb H
B. Hgb F
C. Hgb C
D. Hgb S

Answer 10

C

Question 11

Which of the following electrophoretic results is
consistent with a diagnosis of sickle cell trait?
A. Hgb A: 40% Hgb S: 35% Hgb F: 5%
B. Hgb A: 60% Hgb S: 40% Hgb A2: 2%
C. Hgb A: 0% Hgb A2: 5% Hgb F: 95%
D. Hgb A: 80% Hgb S: 10% Hgb A2: 10%

Answer 11

B Electrophoresis at alkaline pH usually shows 50%–70% Hgb A, 20%–40% Hgb S, and normal levels of Hgb A2 in a patient with the sickle cell trait

Question 12

In which of the following conditions will
autosplenectomy most likely occur?
A. Thalassemia major
B. Hgb C disease
C. Hgb SC disease
D. Sickle cell disease

Answer 12

D

Question 13

Which of the following is most true of paroxysmal
nocturnal hemoglobinuria (PNH)?
A. It is a rare acquired stem cell disorder that results
in hemolysis
B. It is inherited as a sex-linked trait
C. It is inherited as an autosomal dominant trait
D. It is inherited as an autosomal recessive trait

Answer 13

A

Question 14

Hemolytic uremic syndrome (HUS) is
characterized by all of the following except:
A. Hemorrhage
B. Thrombocytopenia
C. Hemoglobinuria
D. Reticulocytopenia

Answer 14

D

Question 15

An autohemolysis test is positive in all the
following conditions except:
A. Glucose-6-phosphate dehydrogenase (G6PD)
deficiency
B. Hereditary spherocytosis (HS)
C. Pyruvate kinase (PK) deficiency
D. Paroxysmal nocturnal hemoglobinuria (PNH)

Answer 15

D

Question 16

Which antibody is associated with paroxysmal cold
hemoglobinuria (PCH)?
A. Anti-I
B. Anti-i
C. Anti-M
D. Anti-P

Answer 16

D

Question 17

All of the following are associated with
intravascular hemolysis except:
A. Methemoglobinemia
B. Hemoglobinuria
C. Hemoglobinemia
D. Decreased haptoglobin

Answer 17

A

Question 18

Autoimmune hemolytic anemia is best
characterized by which of the following?
A. Increased levels of plasma C3
B. Spherocytic red cells
C. Decreased osmotic fragility
D. Decreased unconjugated bilirubin

Answer 18

B

Question 19

“Bite cells” are usually seen in patients with:
A. Rh null trait
B. Chronic granulomatous disease
C. G6PD deficiency
D. PK deficiency

Answer 19

C

Question 20

The morphological classification of anemias is
based on which of the following?
A. M:E (myeloid:erythroid) ratio
B. Prussian blue stain
C. RBC indices
D. Reticulocyte count

Answer 20

C

Question 21

Which of the following is a common finding in
aplastic anemia?
A. A monoclonal disorder
B. Tumor infiltration
C. Peripheral blood pancytopenia
D. Defective DNA synthesis

Answer 21

C

Question 22

Congenital dyserythropoietic anemias (CDAs) are
characterized by:
A. Bizarre multinucleated erythroblasts
B. Cytogenetic disorders
C. Megaloblastic erythropoiesis
D. An elevated M:E ratio

Answer 22

A

Question 23

Microangiopathic hemolytic anemia is
characterized by:
A. Target cells and Cabot rings
B. Toxic granulation and Döhle bodies
C. Pappenheimer bodies and basophilic stippling
D. Schistocytes and nucleated RBCs

Answer 23

D

Question 24

Microangiopathic hemolytic anemia is characterized by: A. Target cells and Cabot rings B. Toxic granulation and Döhle bodies C. Pappenheimer bodies and basophilic stippling D. Schistocytes and nucleated RBCs

Answer 24

D

Question 25

Which antibiotic(s) is (are) most often implicated in the development of aplastic anemia? A. Sulfonamides B. Penicillin C. Tetracycline D. Chloramphenicol

Answer 25

D

Question 25

Which antibiotic(s) is (are) most often implicated in the development of aplastic anemia? A. Sulfonamides B. Penicillin C. Tetracycline D. Chloramphenicol

Answer 25

D

Question 26

Sickle cell disorders are: A. Hereditary, intracorpuscular RBC defects B. Hereditary, extracorpuscular RBC defects C. Acquired, intracorpuscular RBC defects D. Acquired, extracorpuscular RBC defects

Answer 26

A

Question 27

Which of the following conditions may produce spherocytes in a peripheral smear? A. Pelger–Huët anomaly B. Pernicious anemia C. Autoimmune hemolytic anemia D. Sideroblastic anemia

Answer 27

C

Question 28

A patient’s peripheral smear reveals numerous NRBCs, marked variation of red cell morphology, and pronounced polychromasia. In addition to a decreased Hgb and decreased Hct values, what other CBC parameters may be anticipated? A. Reduced platelets B. Increased MCHC C. Increased MCV D. Decreased red-cell distribution width (RDW)

Answer 28

C

Question 29

What red cell inclusion may be seen in the peripheral blood smear of a patient postsplenectomy? A. Toxic granulation B. Howell–Jolly bodies C. Malarial parasites D. Siderotic granules

Answer 29

B

Question 30

Reticulocytosis usually indicates: A. Response to inflammation B. Neoplastic process C. Aplastic anemia D. Red cell regeneration

Answer 30

D

Question 30

Reticulocytosis usually indicates: A. Response to inflammation B. Neoplastic process C. Aplastic anemia D. Red cell regeneration

Answer 30

D

Question 30

Reticulocytosis usually indicates: A. Response to inflammation B. Neoplastic process C. Aplastic anemia D. Red cell regeneration

Answer 30

D

Question 31

Hereditary pyropoikilocytosis (HP) is a red cell membrane defect characterized by: A. Increased pencil-shaped cells B. Increased oval macrocytes C. Misshapen budding fragmented cells D. Bite cells

Answer 31

C