Deck 20: Alterations of Hematologic Function

Question 1

A 60-year-old female emphysema patient experiences a rapid and pounding heart, dizziness, and fatigue with exertion. How would the respiratory system compensate for the increased oxygen demand?

A) Bronchoconstriction
B) Increased rate and depth of breathing
C) Dyspnea
D) Activation of the renin-angiotensin response

Answer 1

Increased rate and depth of breathing

Question 2

A 58-year-old female presents in the clinic with complaints of fatigue, weight loss, and tingling in her fingers. Laboratory findings show a low hemoglobin and hematocrit, a high mean corpuscular volume, and normal plasma iron. These findings are consistent with which type of anemia?

A) Hemolytic anemia
B) Pernicious anemia
C) Iron deficiency anemia
D) Aplastic anemia

Answer 2

Pernicious anemia

Question 3

Which of the following individuals is at highest risk for developing a vitamin B₁₂ deficiency anemia?

A) 47-year-old male who had a gastrectomy procedure (removal of the stomach)
B) 64-year-old male with a history of duodenal ulcers and gastrointestinal bleeding
C) 26-year-old female in the second trimester of her first pregnancy
D) 3-year-old female who is a fussy eater

Answer 3

47-year-old male who had a gastrectomy procedure (removal of the stomach)

Question 4

What hemodynamic change occurs after initial compensation for a reduction in the number of circulating erythrocytes?

A) Increased viscosity of blood
B) Decreased cardiac output
C) Altered coagulation
D) Hyperdynamic blood flow

Question 5

A newborn is diagnosed with congenital intrinsic factor deficiency. From which of the following types of anemia does he suffer?

A) Iron deficiency anemia
B) Pernicious anemia
C) Sideroblastic anemia
D) Hemolytic anemia

Question 6

A 40-year-old male vegetarian is diagnosed with folate deficiency anemia. He reports that he is an alcoholic. Which of the following factors put him at greatest risk for developing his disease?

A) Being vegetarian
B) Being alcoholic
C) Age
D) Gender

Question 7

A 25-year-old female has a heavy menses during which she loses a profuse amount of blood. Which of the following adaptations could be expected?

A) Movement of fluid into the cell
B) Decreased cardiac output
C) Decreased oxygen release from hemoglobin
D) Blood vessel dilation

Question 8

A 67-year-old female has chronic gastrointestinal bleeding. The primary cause of her anemia is:

A) vitamin B₁₂ deficiency.
B) iron deficiency.
C) folate deficiency.
D) bone marrow failure.

Question 9

A 45-year-old male is diagnosed with pernicious anemia. The most likely cause of this condition is:

A) defective DNA synthesis.
B) abnormal synthesis of hemoglobin.
C) defective use of vitamin C.
D) blocked protein synthesis.

Question 10

A 50-year-old male experienced loss of appetite, weight loss, and beefy red tongue shortly before his death. Autopsy would most likely reveal:

A) brain hypoxia.
B) liver hypoxia.
C) heart failure.
D) kidney failure.

Question 11

A 34-year-old male presents in the emergency room with extreme fatigue and shortness of breath. His skin and sclera appear to have a yellowish discoloration. These findings are consistent with which type of anemia?

A) Posthemorrhagic anemia
B) Iron deficiency anemia
C) Aplastic anemia
D) Hemolytic anemia

Question 12

A 2-year-old malnourished child has vitamin B₁₂ and folate deficiencies. A blood smear would reveal _____ amounts of hemoglobin.

A) normal
B) sporadic
C) low
D) high

Question 13

In some anemias, the erythrocytes are present in various sizes; this is referred to as:

A) normocytosis.
B) isocytosis.
C) anisocytosis.
D) microcytosis.

Question 14

The Schilling test for pernicious anemia involves:

A) the administration of radioactive cobalamin and the measurement of its excretion in the urine.
B) the measurement of antigen-antibody immune complexes.
C) the measurement of serum ferritin and total iron-binding capacity.
D) the administration of folate and evaluation of folate content in a blood serum sample.

Question 15

Which of the following statements explains why vitamin B₁₂ and folate deficiencies cause anemia?

A) Stem cells are unable to differentiate into erythrocytes.
B) Red blood cells have malformed hemoglobin molecules.
C) Red blood cells have decreased O₂-carrying capacity.
D) Red blood cells have a shorter life span.

Question 16

A 20-year-old female undergoes lab testing for anemia. Results show high iron, bilirubin, and transferrin and low hemoglobin and hematocrit. Which of the following is the most likely diagnosis?

A) Pernicious anemia
B) Folate deficiency anemia
C) Iron deficiency anemia
D) Sideroblastic anemia

Question 17

A 5-year-old male was diagnosed with normocytic-normochromic anemia. Which of the following anemias falls into this category?

A) Sideroblastic anemia
B) Hemolytic anemia
C) Pernicious anemia
D) Iron deficiency anemia

Question 18

A 35-year-old female is diagnosed with vitamin B₁₂ deficiency anemia. A decrease in which of the following is the most likely cause?

A) Ferritin
B) Gastric enzymes
C) Intrinsic factor
D) Erythropoietin

Question 19

Erythrocytes that are _____ contain an abnormally low concentration of hemoglobin.

A) hyperchromic
B) hypochromic
C) macrocytic
D) microcytic

Question 20

Which of the following tests directly measures iron stores?

A) Serum ferritin
B) Transferrin saturation
C) Bone marrow biopsy
D) Total iron-binding capacity

Question 21

A 35-year-old male with hyperthyroidism begins treatment to decrease thyroid activity. Which of the following could result secondary to the treatment?

A) Eosinophilia
B) Basophilia
C) Monocytosis
D) Lymphocytosis

Question 22

A 35-year-old male was diagnosed with hepatitis B. Further tests revealed neutropenia characterized by a neutrophil count less than _____ per milliliter.

A) 5000
B) 2000
C) 3000
D) 10,000

Question 23

A 21-year-old female was recently diagnosed with iron deficiency anemia. In addition to fatigue and weakness, which of the following clinical signs and symptoms would she most likely exhibit?

A) Hyperactivity
B) Red, sore tongue
C) Gait problems
D) Petechiae and purpura

Question 24

A 15-year-old male with infectious mononucleosis is being given instructions on how to prevent the spread of this infection to others. Which statement represents a correct instruction?

A) Wear a surgical mask when others are in the room.
B) Do not share drinking glasses or eating utensils.
C) Avoid all contact with other people.
D) No precautions are necessary.

Question 25

A 15-year-old female presents with splenomegaly, hepatomegaly, and lymph node enlargement. She is diagnosed with infectious mononucleosis. Further testing would indicate an acute infection of:

A) monocytes.
B) B lymphocytes.
C) T lymphocytes.
D) macrophages.

Question 26

A 45-year-old male is diagnosed with sideroblastic anemia. Which of the following is the most likely cause of this disease?

A) Ineffective iron uptake and hemoglobin production
B) Misshapen erythrocytes
C) Decreased levels of tissue iron
D) Premature erythrocyte destruction

Question 27

A 67-year-old male was diagnosed with polycythemia vera but refused treatment. His condition is at risk for converting to:

A) chronic lymphocytic leukemia.
B) Burkitt lymphoma.
C) multiple myeloma.
D) acute myeloid leukemia.

Question 28

Aplastic anemia is caused by:

A) iron deficiency.
B) excess levels of erythropoietin.
C) hemolysis.
D) stem cell deficiency.

Question 29

A 57-year-old male presents to his physician for red face, hands, feet, ears, and headache and drowsiness. A blood smear reveals an increased number of erythrocytes, indicating:

A) polycythemia vera.
B) leukemia.
C) sideroblastic anemia.
D) hemosiderosis.

Question 30

All of the following pathogenic mechanisms cause anemia in chronic inflammation except:

A) decreased erythrocyte lifespan.
B) failure of mechanisms of compensatory erythropoiesis.
C) disturbances of the iron cycle.
D) increased basal metabolic rate.

Question 31

A 70-year-old male is brought to the emergency room, where he dies shortly thereafter. Autopsy reveals polycythemia vera. His death was most likely the result of:

A) acute renal failure.
B) cerebral thrombosis.
C) infection and sepsis.
D) acute leukemia.

Question 32

Posthemorrhagic anemia can result in death when blood loss is in excess of:

A) 20% to 30%.
B) 30% to 40%.
C) 40% to 50%.
D) 50% to 60%.

Question 33

A 67-year-old female is admitted to the emergency room with a diagnosis of polycythemia vera. Treatment for her condition might involve:

A) therapeutic phlebotomy.
B) restoration of blood volume by plasma expanders.
C) the administration of packed red blood cells.
D) iron replacement therapy.

Question 34

A 21-year-old woman was recently diagnosed with iron deficiency anemia. Her hematocrit is 32%. Which of the following treatments would you expect to be prescribed for her?

A) Iron replacement and change of diet
B) Splenectomy and steroid therapy
C) A bone marrow transplant
D) No treatment is necessary

Question 35

A 15-year-old male is diagnosed with infectious mononucleosis. The most likely cause is:

A) adenovirus.
B) Epstein-Barr virus (EBV).
C) cytomegalovirus (CMV).
D) Toxoplasma gondii.

Question 36

Leukocytosis can be defined as:

A) a normal leukocyte count.
B) a high leukocyte count.
C) a low leukocyte count.
D) another term for leukopenia.

Question 37

A 67-year-old female is admitted to the emergency room with a diagnosis of polycythemia vera. She will most likely complain of:

A) hyperactivity.
B) decreased blood pressure.
C) chest pain.
D) a pale skin color.

Question 38

A 68-year-old female is admitted to the emergency room with a diagnosis of polycythemia vera. Her symptoms are mainly the result of:

A) a decreased erythrocyte count.
B) rapid blood flow to the major organs.
C) increased blood viscosity.
D) neurologic injury.

Question 39

A 20-year-old female has an increase in eosinophils. Which of the following is the most likely cause?

A) Parasitic invasion and allergic reactions
B) Viral and bacterial infections
C) Stress and anxiety reactions
D) Fungal infections and delayed hypersensitivity

Question 40

A 50-year-old female was diagnosed with sideroblastic anemia. Which of the following would most likely occur?

A) Pale skin
B) Iron overload
C) Normochromic erythrocytes
D) Aplastic bone marrow

Question 41

Multiple myeloma can be defined as a neoplasm of:

A) T cells.
B) B cells.
C) immature plasma cells.
D) mature red blood cells.

Question 42

Thrombocytopenia is described as a platelet count below _____ platelets per cubic millimeter.

A) 1,000,000
B) 150,000
C) 10,000
D) 1000

Question 43

The sequence of events in disseminated intravascular coagulation (DIC) is initiated by the release of:

A) histamine.
B) fibrin.
C) tissue factor.
D) plasmin.

Question 44

A 50-year-old female is diagnosed with primary thrombocythemia. A blood smear reveals _____ platelets.

A) defective
B) fragmented
C) consumed
D) overproduced

Question 45

Known causes of acute leukemia include:

A) cytomegalovirus (CMV) infection.
B) eating genetically modified food.
C) chemotherapy treatment for other cancers.
D) excessive ultraviolet radiation exposure.

Question 46

A 62-year-old female tells her health care provider she has been experiencing regular night sweats that cause her to wake up drenched. She also remarks that she has been unintentionally losing weight. Physical exam reveals enlarged lymph nodes on her neck that do not appear to be painful. She should be screened for which of the following cancers?

A) Non-Hodgkin lymphoma
B) Hodgkin lymphoma
C) Acute leukemia
D) Burkitt lymphoma

Question 47

A 5-year-old female is diagnosed with acute leukemia. She will most likely be treated with:

A) bone marrow transplant.
B) immunotherapy.
C) chemotherapy.
D) localized radiation therapy.

Question 48

A 35-year-old female is diagnosed with lymphadenopathy. The most likely finding leading to this diagnosis is:

A) small, hard lymph nodes.
B) disordered lymph nodes.
C) nonpalpable, nontender lymph nodes.
D) enlarged lymph nodes.

Question 49

A 52-year-old male IV drug user was diagnosed with hepatitis C 5 years ago. He is now experiencing impaired blood clotting. A decrease in which of the following could be the cause?

A) K
B) D
C) E
D) B₁₂

Question 50

A 10-year-old male presents with abdominal swelling, night sweats, fever, and weight loss. He is diagnosed with Burkitt lymphoma. Which of the following is the most likely cause?

A) Cytomegalovirus (CMV)
B) Adenovirus
C) Human papilloma virus (HPV)
D) Epstein-Barr virus (EBV)

Question 51

The country with the lowest rate of Hodgkin lymphoma is:

A) the United States.
B) Japan.
C) Denmark.
D) Great Britain.

Question 52

A 35-year-old male has enlarged lymph nodes in the neck and a mediastinal mass. He was diagnosed with Hodgkin lymphoma. Which of the following abnormal cells would be expected with this disease?

A) Merkel cell
B) Schwann cell
C) Reed-Sternberg cell
D) Kupffer cell

Question 53

A 10-year-old male is diagnosed with leukemia. Which of the following could be associated with his disease?

A) Down syndrome
B) hemophilia
C) hyperthyroidism
D) pheochromocytoma

Question 54

A 40-year-old female develops disseminated intravascular coagulation (DIC). The most likely cause of this condition is:

A) snake venom.
B) blood transfusion.
C) sepsis.
D) immune thrombocytopenic purpura (ITP).

Question 55

A 65-year-old male is diagnosed with multiple myeloma. He complains of severe pain. This pain can be attributed to:

A) neuropathic infiltrations.
B) destruction of bone tissue.
C) tissue hypoxia.
D) accumulation of toxic proteins.

Question 56

A 15-year-old male is diagnosed with infectious mononucleosis. He most likely presented with the classic triad of symptoms: fever, sore throat, and:

A) lymph node enlargement.
B) hepatitis.
C) rash on the trunk and extremities.
D) dyspnea.

Question 57

Thrombocytopenia may be:

A) transient or consistent.
B) normal or abnormal.
C) congenital or acquired.
D) active or inactive.

Question 58

Individuals with liver disease often suffer from coagulation disorders because:

A) the liver is often the site of platelet pooling.
B) clotting factors are produced in the liver.
C) high levels of bilirubin interfere with the clotting system.
D) treatment medications for liver failure cause fibrinolysis.

Question 59

A 30-year-old female presents with hematuria, menorrhagia, and bleeding gums. She is diagnosed with immune thrombocytic purpura (ITP). The most likely cause is:

A) allergy-induced platelet lysis.
B) an immune response to hypersplenism.
C) antibody destruction of platelets.
D) T cell injury to megakaryocytes.

Question 60

Under the conditions of hypersplenism, erythrocytes are:

A) proliferated.
B) activated.
C) sequestered.
D) infected.

Question 61

A 22-year-old female just delivered a healthy baby girl. She suffered from eclampsia during her pregnancy, and on the second postpartum day she complained of bleeding gums and bruising on her arms and legs. Hematology lab tests indicate that she had DIC. Further testing revealed an increase in:

A) platelets.
B) hematocrit.
C) fibrin degradation products (FDPs).
D) factor X.

Question 62

A common, life-threatening complication of a thrombus in a deep vein is:

A) disseminated intravascular coagulation.
B) lower extremity edema.
C) stroke.
D) pulmonary embolus.

Question 63

In DIC, active bleeding occurs after intravascular clotting because:

A) prothrombin is activated.
B) clotting factors are depleted.
C) inflammatory mediators are released.
D) tissue factor (TF) is inactivated.