NURS 231/NURS231 Module 4 V1 |
Pathophysiology Q&A with Rationale |
Portage Learning
1. A patient presents with microcytic, hypochromic erythrocytes on a peripheral blood smear.
Which of the following conditions is most likely responsible for these findings?
A. Vitamin B12 Deficiency
B. Folic Acid Deficiency
C. Iron Deficiency Anemia
D. Aplastic Anemia
Correct Answer: C
Rationale: Iron deficiency anemia is characterized by a decrease in hemoglobin synthesis,
leading to small (microcytic) and pale (hypochromic) red blood cells. In contrast, Vitamin
B12 and folate deficiencies result in macrocytic cells due to impaired DNA synthesis. This
condition is frequently caused by chronic blood loss or inadequate dietary intake of iron.
2. Which clinical manifestation is uniquely associated with Vitamin B12 deficiency anemia but
not folate deficiency?
A. Paresthesia of the hands and feet
B. Fatigue and weakness
C. Atrophic glossitis
,D. Shortness of breath
Correct Answer: A
Rationale: Vitamin B12 is essential for myelin sheath maintenance, so its deficiency leads
to neurological symptoms like paresthesia and ataxia. Folate deficiency causes similar
hematologic changes but lacks the neurologic involvement seen in B12 deficiency. Patients
with pernicious anemia often lack the intrinsic factor required for B12 absorption in the
ileum.
3. A patient with chronic kidney disease (CKD) is diagnosed with anemia. What is the primary
pathophysiological mechanism for this condition?
A. Increased destruction of red blood cells in the spleen
B. Deficiency in the production of erythropoietin
C. Inadequate intake of dietary protein
D. Chronic occult gastrointestinal bleeding
Correct Answer: B
Rationale: Erythropoietin is a hormone produced by the peritubular cells of the kidney
that stimulates the bone marrow to produce RBCs. In CKD, the kidneys cannot produce
sufficient erythropoietin, leading to a normocytic, normochromic anemia. Management
often involves the administration of synthetic erythropoiesis-stimulating agents to
maintain hemoglobin levels.
, 4. What is the hallmark finding in the bone marrow of a patient diagnosed with Aplastic
Anemia?
A. Hypercellularity with increased blast cells
B. Excessive accumulation of iron stores
C. Hypocellularity with replacement by fat
D. Massive infiltration of plasma cells
Correct Answer: C
Rationale: Aplastic anemia involves a failure of the bone marrow to produce all three
blood cell types, resulting in pancytopenia. The bone marrow biopsy typically shows a ‘dry
tap’ or hypocellularity where functional tissue is replaced by adipose tissue. This can be
triggered by radiation, toxins, or certain viral infections like hepatitis.
5. Which type of anemia is characterized by a genetic defect in the synthesis of hemoglobin
globin chains?
A. Thalassemia
B. Sickle Cell Anemia
C. Sideroblastic Anemia
D. Hemolytic Anemia
Correct Answer: A
Pathophysiology Q&A with Rationale |
Portage Learning
1. A patient presents with microcytic, hypochromic erythrocytes on a peripheral blood smear.
Which of the following conditions is most likely responsible for these findings?
A. Vitamin B12 Deficiency
B. Folic Acid Deficiency
C. Iron Deficiency Anemia
D. Aplastic Anemia
Correct Answer: C
Rationale: Iron deficiency anemia is characterized by a decrease in hemoglobin synthesis,
leading to small (microcytic) and pale (hypochromic) red blood cells. In contrast, Vitamin
B12 and folate deficiencies result in macrocytic cells due to impaired DNA synthesis. This
condition is frequently caused by chronic blood loss or inadequate dietary intake of iron.
2. Which clinical manifestation is uniquely associated with Vitamin B12 deficiency anemia but
not folate deficiency?
A. Paresthesia of the hands and feet
B. Fatigue and weakness
C. Atrophic glossitis
,D. Shortness of breath
Correct Answer: A
Rationale: Vitamin B12 is essential for myelin sheath maintenance, so its deficiency leads
to neurological symptoms like paresthesia and ataxia. Folate deficiency causes similar
hematologic changes but lacks the neurologic involvement seen in B12 deficiency. Patients
with pernicious anemia often lack the intrinsic factor required for B12 absorption in the
ileum.
3. A patient with chronic kidney disease (CKD) is diagnosed with anemia. What is the primary
pathophysiological mechanism for this condition?
A. Increased destruction of red blood cells in the spleen
B. Deficiency in the production of erythropoietin
C. Inadequate intake of dietary protein
D. Chronic occult gastrointestinal bleeding
Correct Answer: B
Rationale: Erythropoietin is a hormone produced by the peritubular cells of the kidney
that stimulates the bone marrow to produce RBCs. In CKD, the kidneys cannot produce
sufficient erythropoietin, leading to a normocytic, normochromic anemia. Management
often involves the administration of synthetic erythropoiesis-stimulating agents to
maintain hemoglobin levels.
, 4. What is the hallmark finding in the bone marrow of a patient diagnosed with Aplastic
Anemia?
A. Hypercellularity with increased blast cells
B. Excessive accumulation of iron stores
C. Hypocellularity with replacement by fat
D. Massive infiltration of plasma cells
Correct Answer: C
Rationale: Aplastic anemia involves a failure of the bone marrow to produce all three
blood cell types, resulting in pancytopenia. The bone marrow biopsy typically shows a ‘dry
tap’ or hypocellularity where functional tissue is replaced by adipose tissue. This can be
triggered by radiation, toxins, or certain viral infections like hepatitis.
5. Which type of anemia is characterized by a genetic defect in the synthesis of hemoglobin
globin chains?
A. Thalassemia
B. Sickle Cell Anemia
C. Sideroblastic Anemia
D. Hemolytic Anemia
Correct Answer: A
