HEMA BOC REVIEWER QUESTIONS AND ANSWERS A+
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Compounds formed in the synthesis of heme
Which of the following responses lists there compounds in the order in which
they are formed?
Porphobilinogen
Uroporphyrinogen
Coproporphyrinogen
Protoporphyrinogen
Majority of the iron in an adult is found as a constituent of
Hemoglobin
The main function of the hexose monophosphate shunt in the rbc is to
provide reduced glutathione to prevent oxidation of hemoglobin
In order for hemoglobin to combine reversibly with oxygen, the iron must be
in the ferrous state
In which of the ff. disease states are teardrop cells and abnormal platelets most
characteristically seen?
Myeloid metaplasia
The characteristic erythrocyte found in pernicious anemia is
Macrocytic
In the normal adult, the spleen acts as a site for
removal of imperfect and aging cells
After the removal of rbc from the circulation hemoglobin is broken down into
Iron, protoporphyrin, and globin
Heinz bodies are
denatured hemoglobin inclusions that are readily removed by the spleen
Hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) is
caused by a red cell membrane defect
Cells for the transport of O2 and CO2 are
erythrocytes
Erythropoietin acts as
stimulates RNA synthesis of erythroid cells
What cell shape is MOST commonly associated with an increased MCHC
spherocytes
Which of the following is most closely associated with idiopathic
hemochromatosis?
iron overload in tissue
A patient with polycythemia vera who is treated by phlebotomy is most likely to
develop a deficiency of
iron
,A 20 year old african-american man has peripheral blood changes suggesting
thalassemia minor. The quantitative hemoglobin A2 level is normal, but the
hemoglobin F level is 5% (normal <2%) This is most consistent with
delta-beta thalassemia minor
Anemia secondary to uremia characteristically is
normocytic, normochromic
Which of the following sets of laboratory findings is consistent with hemolytic
anemia?
decreased erythrocyte survival, increased catabolism of heme
An enzyme deficiency associated with a moderate to severe hemolytic anemia
after the patient is exposed to certain drugs and characterized by red cell
inclusions formed by denatured hemoglobin is:
G6PD deficiency
Patients with A (-) type G6PD deficiency are least likely to have hemolytic
episodes in which of the following situations?
spontaneously
A patient has a congenital nonspherocytic hemolytic anemia. After exposure to
anti-malarial drugs the patient experiences a severe hemolytic episode. This
episode is characterized by red cell inclusions caused by hemoglobin
denaturation. Which of the ff. conditions is most consistent with these findings?
G6PD deficiency
All of the findings listed below may be seen in acquired hemolytic anemias of the
autoimmune variety. The one considered to be the most characteristic is:
A. increased osmotic fragility
B. leukopenia and thrombocytopenia
C. peripheral spherocytosis
D. positive direct antiglobulin test
D. positive direct antiglobulin test
Peripheral blood smears from patients with untreated pernicious anemia are
characterized by
pancytopenia and macrocytosis
Laboratory test performed on a patient indicate macrocytosis, anemia,
leukopenia, and thrombocytopenia. Which of the ff. disorders is the patient most
likely to have?
Vitamin B12 deficiency
The characteristic morphologic feature in folic acid deficiency is
macrocytosis
Megaloblastic asynchronous development in the bone marrow indicates which
one of the ff.?
impaired synthesis of DNA
Which of the ff. are found in association with megaloblastic anemia?
neutropenia and thrombocytopenia
A characteristic morphologic feature in hemoglobin C disease is
target cells
Thalassemia are characterized by
decreased rate of globin synthesis
, Laboratory findings in hereditary spherocytosis do not include
decreased osmotic fragility
Which of the ff. types of polycythemia is a severely burned patient most likely to
have?
relative polycythemia associated with dehydration
Which of the ff. is most likely to be seen in lead poisoning?
basophilic stippling
Giant, vacuolated, multinucleated erythroid precursors are present in which of
the following
erythroleukemia
Which of the ff. is a significant feature of erythroleukemia/acute erythroid
leukemia (Di Guglielmo syndrome)?
megaloblastoid erythropoiesis
The M:E ratio in erythroleukemia is usually
low
The characteristic morphologic feature in lead poisoning is
basophilic stippling
Which of the ff. is increased in erythrocytosis secondary to a congenital heart
defect?
erythropoietin
Which of the ff. is characteristic of polycythemia vera?
decreased or absent bone marrow iron stores
Which of the ff. technical factors will cause a decreased erythrocyte
sedimentation rate?
small fibrin clots in the sample
Which of the RBC indices is a measure of the amount of hemoglobin in individual
red blood cells?
MCH
The RDW-CV and RDW-SD performed by automated cells counters are
calculations that provide:
an index of the distribution of rbc volumes
The ESR can be falsely elevated by
tilting the tube
Which of the ff. is the formula for absolute cell count?
% of cells counted x total count
The mean value of a reticulocyte count on specimens of cord blood from healthy,
full-term newborns is approximately
5.0%
A rbc about 5um in diameter that stains bright red and shows no central pallor is
a
spherocyte
The presence of excessive rouleaux formation on a blood smear is often
accompanied by an increased
sedimentation rate
The characteristic peripheral blood morphologic feature in multiple myeloma is
rouleaux formation
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Compounds formed in the synthesis of heme
Which of the following responses lists there compounds in the order in which
they are formed?
Porphobilinogen
Uroporphyrinogen
Coproporphyrinogen
Protoporphyrinogen
Majority of the iron in an adult is found as a constituent of
Hemoglobin
The main function of the hexose monophosphate shunt in the rbc is to
provide reduced glutathione to prevent oxidation of hemoglobin
In order for hemoglobin to combine reversibly with oxygen, the iron must be
in the ferrous state
In which of the ff. disease states are teardrop cells and abnormal platelets most
characteristically seen?
Myeloid metaplasia
The characteristic erythrocyte found in pernicious anemia is
Macrocytic
In the normal adult, the spleen acts as a site for
removal of imperfect and aging cells
After the removal of rbc from the circulation hemoglobin is broken down into
Iron, protoporphyrin, and globin
Heinz bodies are
denatured hemoglobin inclusions that are readily removed by the spleen
Hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) is
caused by a red cell membrane defect
Cells for the transport of O2 and CO2 are
erythrocytes
Erythropoietin acts as
stimulates RNA synthesis of erythroid cells
What cell shape is MOST commonly associated with an increased MCHC
spherocytes
Which of the following is most closely associated with idiopathic
hemochromatosis?
iron overload in tissue
A patient with polycythemia vera who is treated by phlebotomy is most likely to
develop a deficiency of
iron
,A 20 year old african-american man has peripheral blood changes suggesting
thalassemia minor. The quantitative hemoglobin A2 level is normal, but the
hemoglobin F level is 5% (normal <2%) This is most consistent with
delta-beta thalassemia minor
Anemia secondary to uremia characteristically is
normocytic, normochromic
Which of the following sets of laboratory findings is consistent with hemolytic
anemia?
decreased erythrocyte survival, increased catabolism of heme
An enzyme deficiency associated with a moderate to severe hemolytic anemia
after the patient is exposed to certain drugs and characterized by red cell
inclusions formed by denatured hemoglobin is:
G6PD deficiency
Patients with A (-) type G6PD deficiency are least likely to have hemolytic
episodes in which of the following situations?
spontaneously
A patient has a congenital nonspherocytic hemolytic anemia. After exposure to
anti-malarial drugs the patient experiences a severe hemolytic episode. This
episode is characterized by red cell inclusions caused by hemoglobin
denaturation. Which of the ff. conditions is most consistent with these findings?
G6PD deficiency
All of the findings listed below may be seen in acquired hemolytic anemias of the
autoimmune variety. The one considered to be the most characteristic is:
A. increased osmotic fragility
B. leukopenia and thrombocytopenia
C. peripheral spherocytosis
D. positive direct antiglobulin test
D. positive direct antiglobulin test
Peripheral blood smears from patients with untreated pernicious anemia are
characterized by
pancytopenia and macrocytosis
Laboratory test performed on a patient indicate macrocytosis, anemia,
leukopenia, and thrombocytopenia. Which of the ff. disorders is the patient most
likely to have?
Vitamin B12 deficiency
The characteristic morphologic feature in folic acid deficiency is
macrocytosis
Megaloblastic asynchronous development in the bone marrow indicates which
one of the ff.?
impaired synthesis of DNA
Which of the ff. are found in association with megaloblastic anemia?
neutropenia and thrombocytopenia
A characteristic morphologic feature in hemoglobin C disease is
target cells
Thalassemia are characterized by
decreased rate of globin synthesis
, Laboratory findings in hereditary spherocytosis do not include
decreased osmotic fragility
Which of the ff. types of polycythemia is a severely burned patient most likely to
have?
relative polycythemia associated with dehydration
Which of the ff. is most likely to be seen in lead poisoning?
basophilic stippling
Giant, vacuolated, multinucleated erythroid precursors are present in which of
the following
erythroleukemia
Which of the ff. is a significant feature of erythroleukemia/acute erythroid
leukemia (Di Guglielmo syndrome)?
megaloblastoid erythropoiesis
The M:E ratio in erythroleukemia is usually
low
The characteristic morphologic feature in lead poisoning is
basophilic stippling
Which of the ff. is increased in erythrocytosis secondary to a congenital heart
defect?
erythropoietin
Which of the ff. is characteristic of polycythemia vera?
decreased or absent bone marrow iron stores
Which of the ff. technical factors will cause a decreased erythrocyte
sedimentation rate?
small fibrin clots in the sample
Which of the RBC indices is a measure of the amount of hemoglobin in individual
red blood cells?
MCH
The RDW-CV and RDW-SD performed by automated cells counters are
calculations that provide:
an index of the distribution of rbc volumes
The ESR can be falsely elevated by
tilting the tube
Which of the ff. is the formula for absolute cell count?
% of cells counted x total count
The mean value of a reticulocyte count on specimens of cord blood from healthy,
full-term newborns is approximately
5.0%
A rbc about 5um in diameter that stains bright red and shows no central pallor is
a
spherocyte
The presence of excessive rouleaux formation on a blood smear is often
accompanied by an increased
sedimentation rate
The characteristic peripheral blood morphologic feature in multiple myeloma is
rouleaux formation
