The Microcytic Anemias Exam Prep Chapter 5

Chapter 5. The Microcytic Anemias

Multiple Choice

1. Transferrin receptors for iron uptake are located on the:

A. Basophilic normoblast

B. Pronormoblast

C. Reticulocyte

D. Orthochromic normoblast

L.O. 5.3

2. Which of the following lab analyses determines iron stores?

A. Serum transferrin level

B. Hemoglobin value

C. Myoglobin value

D. Serum ferritin level

L.O. 5.7

3. In addition to iron ingestion, over 90% of iron in adults used for erythropoiesis is obtained through:

A. Transfusion

B. Recycling of iron

C. Storage forms from spleen and the liver

D. Hemosiderin

L.O. 5.3

4. The first stage of iron deficiency anemia is termed:

A. Microcytic hypochromic anemia

B. Iron depletion

C. Iron deficiency

D. Iron overload

L.O. 5.4

5. All of the following are symptoms of iron deficiency anemia except:

A. Pallor

B. Pica

C. Vertigo

D. Numbness

L.O. 5.5

6. In adults, which of the following is the most common cause of iron-deficiency anemia?

A. Intestinal parasites

B. Malabsorptive disorders

C. Dietary content

D. Chronic blood loss

L.O. 5.6

7. Ringed sideroblasts in the bone marrow are indicative of which of the following disorders?

A. Chronic disease

B. Infection

C. Sideroblastic anemia

D. Inflammation

L.O. 5.8

8. Given the laboratory results of serum iron = 300 μg/dL, transferrin = 312 mg/dL, transferrin saturation = 122%, and ferritin = 1,000 ng/mL, and physical symptoms of hair loss and cardiac arrhythmia, which of the following should be considered?

A. Hereditary hemochromatosis

B. Anemia of inflammation

C. Iron-deficiency anemia

D. Lead poisoning

L.O. 5.9 and 5.11

9. Which type of inclusion is likely to be seen in a patient with hereditary hemochromatosis?

A. Howell-Jolly bodies

B. Pappenheimer bodies

C. Hemoglobin H inclusion bodies

D. Cabot rings

L.O. 5.11

10. A 15-year-old Lebanese boy was sent to the laboratory for an evaluation of anemia and had the following lab results:

A. WBC = 7.5 × 10⁹/L

B. RBC = 5.9 × 10¹²/L

C. Hgb = 11.6 g/dL

D. Hct = 36%

What is the presumptive clinical condition?

A. Pernicious anemia

B. Autoimmune hemolytic anemia

C. Iron deficiency trait

D. Thalassemia trait

L.O. 5.15

12. Which of the following alpha thalassemic conditions are incompatible with life?

A. Hemoglobin H disease

B. Bart’s hydrops fetalis

C. Alpha thalassemia trait

D. Silent carrier condition

L.O. 5.13

13. Which inclusion is associated with a “pitted” golf ball appearance and seen in one of the thalassemic conditions?

A. Hgb H inclusion

B. Howell-Jolly bodies

C. Cabot rings

D. Pappenheimer bodies

L.O. 5.13 and 5.16

14. Failure to thrive, facial structure abnormalities, severe anemia, and splenomegaly are signs of which of the following disorders?

A. Thalassemia minor

B. Alpha thalassemia trait

C. Thalassemia major

D. Thalassemia intermedia

L.O. 5.15

15. One of the gravest clinical problems for individuals with thalassemia major is:

A. Chronic anemia

B. Iron overload

C. Therapeutic phlebotomy

D. Collapsed veins

L.O. 5.15

16. The majority of the hemoglobin made in individuals with thalassemia major is:

A. Hemoglobin H

B. Hemoglobin A

C. Hemoglobin F

D. Hemoglobin Barts

L.O. 5.17

17. Which of the following is also known as Cooley’s anemia?

A. Alpha thalassemia

B. Beta thalassemia major

C. Hereditary hemochromatosis

D. IDA

L.O. 5.15 and 5.14

18. The alpha thalassemias result from which of the following?

A. Gene deletion

B. Defective alpha genes

C. Iron overload

D. Excessive production of alpha chains

L.O. 5.13

19. Which of the following red blood cell indices combinations is accurate for microcytic, hypochromic anemia?

A. Low MCV, low MCH, low MCHC

B. Normal MCV, low MCH, low MCHC

C. High MCV, normal MCH, low MCHC

D. Low MCV, normal MCH, high MCHC

L.O. 5.1

20. When a pregnant patient is seen to have a microcytic, hypochromic anemia, which condition should seriously be investigated?

A. Alpha thalassemia

B. Iron-deficiency anemia

C. Hereditary hemochromatosis

D. Sideroblastic anemia

L.O. 5.2

21. Hemoglobin H disease is associated with:

A. Bart’s hydrops fetalis

B. Alpha thalassemia disease

C. Thalassemia major

D. Hereditary hemochromatosis

L.O. 5.13

22. The primary storage forms of iron are:

A. Ferritin and hemosiderin

B. Ferritin and transferrin

C. Hemosiderin and ferrous iron

D. Heme and ferritin

L.O. 5.3

23. In the United States, approximately ____ of the anemias seen are due to IDA.

A. 25%

B. 40%

C. 50%

D. 75%

L.O. 5.6

24. In iron-deficiency anemia, the reticulocyte count will be:

A. Normal

B. Low

C. High

D. Extremely high

L.O. 5.7

25. In patients with iron overload, Desferal may be administered to chelate the excess iron. The chelated iron is shed in:

A. Feces

B. Urine

C. Gastric secretions

D. None of the above

L.O. 5.10

True/False

26. In the thalassemias, the deficit has nothing to do with iron.

L.O. 5.12

Short Answer

27. Describe the transfusion protocols for patients with thalassemia major, including contraindications.

L.O. 5.18