Hematology in Practice - Chapter 5
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| Transferrin receptors for iron uptake are located on the: | Pronormoblast
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| In addition to iron ingestion, over 90% of iron in adults that is used for erythropoiesis is obtained through: | Recycling of iron
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| All of the following are symptoms of iron deficiency anemia except: A. Pallor B. Pica C. Vertigo D. Numbness | D. Numbness
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| Ringed sideroblasts in the bone marrow are characteristics of which of the following disorders? | Sideroblastic Anemia
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| Which type of inclusion is likely to be seen in the above patient? | Pappenheimer bodies
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| The alpha thalassemic condition that is incompatible with life is: | Bart's hydrops fetalis
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| Failure to thrive, facial structure abnormalities, severe anemia, and splenomegaly are signs of what disorder? | Thalassemia major
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| What laboratory tests would be abnormal through each stage of iron deficiency? | Serum ferritin
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| What is true regarding iron absorption? | Ascorbic acid (vitamin C) enhances absorption
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| Heme is composed of iron and: | protoporphyrin IX
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| Good dietary sources of iron include all except: A. Meat B. Fruit C. Fortified flour D. Legumes | B. Fruit
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| What are the major storage sites for iron in a normal individual? | liver and spleen
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| A markedly decreased iron percent saturation is consistent with: | iron deficiency
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| A bone marrow Prussian blue stain shows blue granules inside of macrophages. What disorder can be ruled out? | Iron deficiency
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| What is true about iron absorption? | It must be in ferrous form for absorption.
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| Lack of accessible iron is the mechanism for iron deficiency and what? | Anemia of chronic inflammation
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| Where is most of the iron in the body found? | Attached to hemoglobin in the red blood cells
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| What results are typical in stage 3 iron deficiency anemia? | Low mean cell volume (MCV), mean cell hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC)
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| What is the mechanism for the anemia in chronic inflammation (ACI)? | Hepcidin, lactoferrin, and ferritin impair iron mobilization
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| How does lead exposure and the porphyrias cause anemia? | interfere with heme production
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| Why is too much iron dangerous? | Free radicals and superoxide formed from ferrous iron plus oxygen damage cell membranes
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| What is true of stage 3 iron deficiency? | Free erythrocyte protoporphyrin (FEP) is increased
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| What would point to iron deficiency anemia (IDA) as opposed to the anemia of chronic inflammation (ACI)? | High transferrin
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| What is the basic hemoglobin defect in the thalassemias? | A structurally normal globin chain is absent or produced at lower levels.
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| What is the primary mechanism for anemia in the thalassemias? | An imbalance in the rate of globin chain synthesis
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| What is expected findings in beta-thalassemia minor? | Basophilic stippling
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| Homozygous alpha-thalassemia (-/-) has what clinical outcome? | incompatible with life
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| In regards to the thalassemias, the deficit has nothing to do with iron. | True
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| The morphologic classification of anemias is based on the: | Red blood cell indices
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| What symptom is specific for IDA? | Koilonychia
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| What laboratory test would be abnormal through each stage of iron deficiency? | Serum ferritin
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| A patient presents with a microcytic, hypochromic anemia with ragged-looking red blood cells in the peripheral smear and a high reticulocyte count. A brilliant cresyl blue preparation reveals inclusions that look like pitted golf balls. What disease? | Hgb H disease
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| The most cost-effective therapy for a patient with hereditary hemochromatosis is: | therapeutic phlebotomy
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| List two sets of laboratory data that can distinguish IDA from beta thalassemia trait: | Serum iron and RBC
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| What is the majority hemoglobin in thalassemia major? | Hgb F
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| Of the four clinical states of alpha thalassemia, which is incompatible with life? | Bart's hydrops fetalis
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| What hemoglobin has the chemical confirmation B4? | Hgb H
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| Although there are many complications in individuals with thalassemia major, what is the leading cause of death? | Cardiac complications
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