NURS 611: Advanced Pathophysiology - Hematologic Disorders 2026
|Maryville
1. Which of the following describes the primary molecular defect in
Polycythemia Vera?
A. Inactivation of the erythropoietin receptor
B. Translocation between chromosomes 9 and 22
C. Overproduction of thrombopoietin by the liver
D. JAK2 V617F mutation causing constitutive tyrosine kinase activity
Answer: D
Rationale: Polycythemia Vera is characterized by a somatic mutation in the Janus kinase 2
(JAK2) gene, leading to erythropoietin-independent signaling and uncontrolled red cell
production.
2. In Iron Deficiency Anemia, which laboratory finding is most characteristic of
the late-stage progression?
A. Microcytic, hypochromic erythrocyte morphology
B. Decreased Total Iron Binding Capacity (TIBC)
C. Increased serum ferritin
D. Macrocytic, normochromic erythrocyte morphology
Answer: A
Rationale: As iron stores are depleted, the hemoglobin synthesis decreases, resulting in
cells that are smaller (microcytic) and contain less color (hypochromic).
,3. A patient with Pernicious Anemia lacks intrinsic factor. This deficiency
prevents the absorption of which nutrient?
A. Folic acid
B. Vitamin B12
C. Vitamin B6
D. Iron
Answer: B
Rationale: Intrinsic factor, secreted by gastric parietal cells, is essential for the ileal
absorption of Vitamin B12; its absence leads to megaloblastic anemia.
4. Which mediator is primarily responsible for the systemic inflammatory
response and induction of Hepcidin in Anemia of Chronic Disease?
A. Interleukin-10 (IL-10)
B. Interleukin-6 (IL-6)
C. Erythropoietin
D. Transferrin
Answer: B
Rationale: IL-6 is a key inflammatory cytokine that stimulates the liver to produce
hepcidin, which then sequesters iron in macrophages and reduces intestinal iron
absorption.
5. In Sickle Cell Disease, the substitution of valine for glutamic acid occurs on
which chain?
A. Alpha-globin chain
B. Delta-globin chain
C. Beta-globin chain
D. Gamma-globin chain
Answer: C
, Rationale: Sickle Cell Disease is caused by a point mutation in the beta-globin gene on
chromosome 11, substituting valine for glutamic acid at the sixth position.
6. Which mechanism is responsible for the ‘shift to the left’ observed in a white
blood cell differential?
A. Increased production of mature lymphocytes
B. Excessive apoptosis of myeloid progenitor cells
C. Sequestration of white blood cells in the spleen
D. Premature release of immature neutrophils (bands) from the bone marrow
Answer: D
Rationale: A ‘shift to the left’ refers to the presence of an increased proportion of
immature neutrophils, typically in response to acute infection or inflammation.
7. Disseminated Intravascular Coagulation (DIC) is characterized by which of the
following paradoxical states?
A. Excessive clotting and excessive bleeding occurring simultaneously
B. High platelet counts and low fibrinogen levels
C. Increased red blood cell production and low plasma volume
D. Isolated deficiency of Factor VIII
Answer: A
Rationale: DIC involves widespread activation of coagulation leading to microvascular
thrombi, which eventually consumes clotting factors and platelets, resulting in severe
hemorrhage.
|Maryville
1. Which of the following describes the primary molecular defect in
Polycythemia Vera?
A. Inactivation of the erythropoietin receptor
B. Translocation between chromosomes 9 and 22
C. Overproduction of thrombopoietin by the liver
D. JAK2 V617F mutation causing constitutive tyrosine kinase activity
Answer: D
Rationale: Polycythemia Vera is characterized by a somatic mutation in the Janus kinase 2
(JAK2) gene, leading to erythropoietin-independent signaling and uncontrolled red cell
production.
2. In Iron Deficiency Anemia, which laboratory finding is most characteristic of
the late-stage progression?
A. Microcytic, hypochromic erythrocyte morphology
B. Decreased Total Iron Binding Capacity (TIBC)
C. Increased serum ferritin
D. Macrocytic, normochromic erythrocyte morphology
Answer: A
Rationale: As iron stores are depleted, the hemoglobin synthesis decreases, resulting in
cells that are smaller (microcytic) and contain less color (hypochromic).
,3. A patient with Pernicious Anemia lacks intrinsic factor. This deficiency
prevents the absorption of which nutrient?
A. Folic acid
B. Vitamin B12
C. Vitamin B6
D. Iron
Answer: B
Rationale: Intrinsic factor, secreted by gastric parietal cells, is essential for the ileal
absorption of Vitamin B12; its absence leads to megaloblastic anemia.
4. Which mediator is primarily responsible for the systemic inflammatory
response and induction of Hepcidin in Anemia of Chronic Disease?
A. Interleukin-10 (IL-10)
B. Interleukin-6 (IL-6)
C. Erythropoietin
D. Transferrin
Answer: B
Rationale: IL-6 is a key inflammatory cytokine that stimulates the liver to produce
hepcidin, which then sequesters iron in macrophages and reduces intestinal iron
absorption.
5. In Sickle Cell Disease, the substitution of valine for glutamic acid occurs on
which chain?
A. Alpha-globin chain
B. Delta-globin chain
C. Beta-globin chain
D. Gamma-globin chain
Answer: C
, Rationale: Sickle Cell Disease is caused by a point mutation in the beta-globin gene on
chromosome 11, substituting valine for glutamic acid at the sixth position.
6. Which mechanism is responsible for the ‘shift to the left’ observed in a white
blood cell differential?
A. Increased production of mature lymphocytes
B. Excessive apoptosis of myeloid progenitor cells
C. Sequestration of white blood cells in the spleen
D. Premature release of immature neutrophils (bands) from the bone marrow
Answer: D
Rationale: A ‘shift to the left’ refers to the presence of an increased proportion of
immature neutrophils, typically in response to acute infection or inflammation.
7. Disseminated Intravascular Coagulation (DIC) is characterized by which of the
following paradoxical states?
A. Excessive clotting and excessive bleeding occurring simultaneously
B. High platelet counts and low fibrinogen levels
C. Increased red blood cell production and low plasma volume
D. Isolated deficiency of Factor VIII
Answer: A
Rationale: DIC involves widespread activation of coagulation leading to microvascular
thrombi, which eventually consumes clotting factors and platelets, resulting in severe
hemorrhage.
