Quiz 10

Question 1

Howell Jolly bodies and hypersegmented PMNs

Answer 1

Macrocytic anemia

Question 2

Low Iron, low ferritin, high TIBC

Answer 2

Iron deficiency anemia

Question 3

Sx of iron deficiency anemia

Answer 3

Sx: HA, irritability, loss of stamina, increased pallor, difficult concentration
Severe deficiencies – pica, glossitis, cheilosis, concave nails, increased heart rate, dyspnea, restless leg syndrome, glossal pain, reduced salivary flow leading to dry mouth,

Question 4

Labs for Iron Deficiency Anemia

Answer 4

CBC/smear
Stool blood
Iron Absorption
Iron, TIBC, ferritin

Question 5

Labs for Sideroblastic Anemia

Answer 5

CBC/smear
Iron Ferritin
BM biopsy
Lead screen

Question 6

Labs for Anemia of Chronic Dz

Answer 6

CBC/smear
Iron, Ferritin, Transferrin
ESR, CRP
EPO Epogen

Question 7

Target cells, stippling, polychromatophilic, erythroid hyperplasia in BM.
High iron, ferritin, transferrin

Answer 7

Sideroblastic anemia

Question 8

Microcytic, hypochromic

Bone marrow responsiveness to erythropoietin is mediated by inflammatory cytokines

Answer 8

Anemia of chronic dz

Question 9

Causes of anemia of chronic dz

Answer 9

• Causes: infectious, inflammatory, neoplastic disease, severe trauma, heart failure, diabetes mellitus, anemia of the elderly, and acute or chronic immune activation

Question 10

Labs for Hypoproliferative Anemia

Answer 10

CBC/smear
Creatinine clearance
TSH
BM biopsy

Question 11

Low marrow activity due to lack of EPO or inability of marrow to respond to it

Answer 11

Hypoproliferative Anemia

Question 12

Pancytopenia of all cell lines

Answer 12

Aplastic/Hypoplastic anemia

Question 13

Thrombocytopenia: ecchymosis, petechiae, bleeding from gums, ocular fundi

Answer 13

Aplastic/Hypoplastic anemia

Question 14

Causes: Chemical exposure: drugs, pesticides, industrial chemicals, benzenes, anti-cancer agents (unknown mechanisms). Infections such as Parvo-B19, HIV

Answer 14

Aplastic/Hypoplastic anemia

Question 15

Labs for Aplastic Anemia

Answer 15

CBC/smear
Iron
RET
BM aspiration (Acellular bone marrow)

Question 16

Marrow is replaced by a tumor, granuloma, lipid storage diseases, or fibrosis

Answer 16

Myelophthisic anemia

Question 17

Labs for Myelophthisic anemia

Answer 17

CBC/smear

BM biopsy

Question 18

Anisocytosis, poikilocytosis, nucleated RBCs, immature myeloid cells

Answer 18

Myelophthisic anemia

Question 19

Neurological signs, glossitis, diarrhea, muscle wasting

Answer 19

Macrocytic anemia

Question 20

MCV > 95-100, aniso, poikilo, high RDW

Answer 20

Macrocytic anemia

Question 21

Labs for Macrocytic anemia

Answer 21

CBC/smear

B12/folate

Question 22

Autoimmune Hemolytic anemia: warm is assocated with RBC breakdown in ______ cold is associated with breakdown in ______

Answer 22

Warm - spleen

Cold - liver

Question 23

Labs for Autoimmune Hemolytic anemia

Answer 23

Coombs test

Question 24

MCV low/norm, MCHC high, aniso, high LDH and bilirubin, low haptoglobin

Answer 24

Hereditary Spherocytosis, Elliptocytosis

Question 25

High RET, Heinz bodies and bite cells

Answer 25

G6PD anemia

Question 26

Labs for G6PD anemia

Answer 26

G6PD assay

Question 27

Norm MCV, Norm/High WBC, nucleated RBC, high plasma Hgb, high haptoglobin

Answer 27

Sickle Cell anemia

Question 28

SX of Sickle Cell anemia

Answer 28

Abd pain/vomit, bone pain, leg ulcers, myalgia, hematuria

Question 29

Labs for Sickle Cell anemia

Answer 29

Hgb electrophoresis

Question 30

Norm MCH, 30-100% target cells and spherocytes

Answer 30

Hgb C Disease

Question 31

Low MCV, low MCH, marked aniso and poiklilocytosis, target cells, stippling, nucleated RBC, norm/high iron

Answer 31

Thalassemia

Question 32

Labs for Thalassemia

Answer 32

Hgb electrophoresis

Question 33

leg ulcers, gallstones

Answer 33

Thalassemia

Question 34

Labs for Neutropenia

Answer 34

CBC, bact & fung blood cultures, skin lesion biopsy, UA, CXR, Radiography of sinuses, BM biopsy

Question 35

Low PMNs, granulocytes

Answer 35

Neutropenia

Question 36

Low lymphocytes

Answer 36

Lymphocytopenia

Question 37

Diminished tonsils/lymph nodes, LAD

Answer 37

Lymphocytopenia

Question 38

List the categories of severity of Neutropenia and give the severity

Answer 38

1000-1500/mm3 mild risk infx 500-1000/mm3 mod risk infx <200/mm3 – rapidly fatal infx

Question 39

Sx of severe Neutropenia

Answer 39

Cellulitis, liver abscesses, furunculosis, pneumonia, and septicemia

Question 40

What levels of lymphocytes define Lymphocytopenia?

Answer 40

< 3000/mm3 in children <2 yo