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Lab Dx Anemias

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					                               Lab Dx; Anemias

1. The three most common causes of anemia include all but the following:
      a. IDA
      b. ACD
      c. Thalassemia
      d. Folate B12 deficiency

2. Which hemoglobin level would indicate anemia?
   a. Male 14g/dL
   b. Pregnant female 12g/dL
   c. Female 11g/dL
   d. Pregnant female 13g/dL

3. If you find a low hemoglobin level, you would want to evaluate this for sure:
       a. Coombs
       b. MCV
       c. Peripheral blood smear
       d. Both b and c

4. You do a blood smear on a patient with anemia and find Spherocytes. What test
   would you run after this?
      a. Coomb’s test
      b. Osmotic fragility
      c. Hemoglobin electrophoresis
      d. Bone marrow examination
      e. Two of the above

5. The patient above should have this included in your differentials:
      a. Thalassemia
      b. Sickle cell
      c. DIC
      d. AIHA

6. With a MCV of 112 you might suspect:
      a. High ferritin
      b. Low reticulocyte count
      c. B12 deficiency
      d. Normal functioning

7. Which of the following is not included in the minimum recommended laboratory
   tests for anemia?
       a. CBC & reticulocyte count
       b. Peripheral blood smear
       c. Stool occult blood
       d. Hemoglobin electrophoresis
       e. Urinanalysis

8. Which of the following does not cause microcytic hypochromic anemia?
     a. Sideroblastic anemia
     b. Chronic blood loss
     c. B6 deficiency
     d. All of the above can cause it

9. T / F Both aplastic anemia and hereditary spherocytosis are considered to be
   normocytic normochromic anemias.

10. Microcytic hypochromic anemias could not be caused by:
       a. Iron deficiency
       b. Acute blood loss
       c. Lead poisoning
       d. Sideroblastic anemia

11. Benzene exposure is classically associated with:
       a. Microcytic hypochromic anemia
       b. Anemia of Chronic Disease
       c. Aplastic anemia
       d. Myelodysplastic Syndromes

12. Basophilic stippling can be seen in:
       a. Lead poisoning
       b. Microcytic Hypochromic anemia
       c. Sideroblastic anemia
       d. All of the above

13. Iron is the main cause for anemia and most common cause for microcytic
    hypochromic anemia. It is absorbed in ________form inside the ___________.
        a. ferric, duodenum
        b. ferric, jejunum
        c. ferrous, duodenum
        d. ferrouns, ileum

14. The total body iron is about:
       a. 10-30 mg
       b. 3-4 g
       c. 1-2 mg
       d. 5-6 g

15. Most of the iron in the body is found in:
      a. hemoglobin
      b. ferritin
      c. hemosiderin
       d. haptoglobin

16. If you want to see if a patient has IDA, you would order:
        a. Hemosiderin level
        b. Serum iron level
        c. Ferritin levels
        d. B12 levels

17. Lead toxicity causes increased values of serum iron because:
       a. Lead replaces the iron in the porphoryn ring
       b. The spleen is breaking down RBCs and releasing the contents into the
           vasculature
       c. Iron is unable to be transported adequately and remains in the blood
           stream
       d. Lead toxicity often causes microinfarcts and chronic bleeds

18. TIBC is an indirect measurement of:
       a. Ferritin
       b. Transferrin
       c. Iron
       d. Reticulocytes

19. When a body is deficient of iron,
      a. The duodenum increases uptake of ferrous iron
      b. Transferrin saturation decreases
      c. TIBC increases up to 30%
      d. All of the above

20. This is diagnostic for iron deficiency anemia:
       a. MCV < 11g/dL
       b. Ferritin < 10-12 mg/dL


21. Ferritin is:
        a. An acute reactive phase protein
        b. Is stored in the cells as haptoglobin
        c. Low in the stages of depletion to full blown IDA
        d. All of the above

22. Before the change in size of the RBC as you approach IDA, you will have:
       a. Hypochromotosis
       b. Increased size
       c. Decrease in transferring
       d. Both a and b

23. FEP is:
          a.   Increased in thalassemia
          b.   Free erythrocyte protoporphyrin
          c.   Is measured by the Mentzner index
          d.   Causes basophillic stipling

   24. Which of the following is true of B thalassemia major?
         a. There are decreased ferritin
         b. It is a macrocytic hypochromic anemia
         c. Haptoglobin is reduces
         d. Reticulocyte count decreases

   25. Indicate low, normal or high levels for Thalassemia:
                             Iron                   Thalassemia
Serum ferritin
TIBC
Serum Iron
FEP

   26. T / F A 6 y.o. presents to you office with sudden neurological abnormalities.
       His CBC is normal, but you can’t rule out lead.

   27. A new patient presents to your office feeling very fatigued. You learn that she
       has epilepsy and has been on dilantin for the last 6 months. Her peripheral blood
       smear may show:
           a. Megaloblastic RBCs
           b. Hypersegmented neutrophils
           c. Howell Jolly bodies
           d. All of the above

   28. Which would you choose to measure in the patient above?
         a. Urine methylmalonic acid assay
         b. Serum ferritin
         c. RBC folate
         d. Both a and c

   29. A deficiency of _____ can result in irreversible brain damage.
          a. Folate
          b. Iron
          c. B6
          d. B12

   30. Circle all of the following that alcoholism may cause:
           a. Target cells
           b. Ovalocytes
           c. Non-megaloblastic anemia
           d. Myelofibrosis
31. In renal disease, the type of anemia caused is:
        a. Microcytic hypochromic
        b. Macrocytic hypochromic
        c. Normocytic hypochromic
        d. Normocytic normochromic

32. In aplastic anemia caused by benzene, reticulocyte count is:
        a. Increased
        b. Decreased
        c. Unaffected
        d. Zero

33. Oxidative stress is associated with:
       a. G6PD deficiency
       b. Hereditary spherocytosis
       c. Aplastic anemia
       d. Iron deficiency

34. You can have hyperchromic RBCs in:
       a. Folate deficiency
       b. Hereditary spherocytosis
       c. Iron overload
       d. You cannot have hyperchromic cells

35. A compliment induced reaction that leads to hemolysis of RBCs is called:
       a. Warm autoimmune hemolytic anemia
       b. Cold autoimmune hemolytic anemia
       c. Paroxysmal Nocturnal Hemoglobinuria
       d. Hereditary hemolytic antibody syndrome