14

Question 1

1. Most operational iron in human beings is found in
   A. the bone marrow
   B. the liver
   C. heme portion of hemoglobin and myoglobin
   D. the free hemoglobin in the circulation

Answer 1

C. heme portion of hemoglobin and myoglobin

Question 2

2. The etiology of IDA is
   A. nutritional deficiency
   B. faulty iron absorption
   C. excessive loss of iron
   D. all of the above

Answer 2

D. all of the above

Question 3

ron deficiency is still common in
A. toddlers
B. adolescent girls
C. women of childbearing age
D. all of the above

Answer 3

D. all of the above

Question 4

4. Decreased iron intake can result from
   A. sprue
   B. colon cancer
   C. adolescent growth spurt
   D. red meat–deficient diet

Answer 4

D. red meat–deficient diet

Question 5

5. Faulty iron absorption can result from
   A. celiac disease
   B. colon cancer
   C. adolescent growth spurt
   D. menstruation

Answer 5

A. celiac disease

Question 6

6. Pathological iron loss can be caused by
   A. sprue
   B. colon cancer
   C. adolescent growth spurt
   D. menstruation

Answer 6

B. colon cancer

Question 7

7. Physiological iron loss can be caused by
   A. sprue
   B. GI bleeding
   C. adolescent growth spurt
   D. heavy menstruation

Answer 7

D. heavy menstruation

Question 8

8. Increased iron utilization can be the result of
   A. sprue
   B. colon cancer
   C. adolescent growth spurt
   D. menstruation

Answer 8

C. adolescent growth spurt

Question 9

9. The average adult has _____ g of total iron.
   A. 0.2 to 1.4
   B. 1.5 to 3.4
   C. 3.5 to 5.0
   D. 5.1 to 10.0

Answer 9

C. 3.5 to 5.0

Question 10

10. 10 and 11. Approximately (10) _____% of iron from food is in the form of (11) _____ iron.
    A. 25
    B. 50
    C. 70
    D. 90

Answer 10

D. 90

Question 11

A. non heme
B. Heme

Answer 11

A. non heme

Question 12

12. The cytochemical stain that can demonstrate iron, hemosiderin, and ferritin is:
    A. New Methylene blue
    B. Romanowsky
    C. Prussian Blue
    D. Wright-Giemsa

Answer 12

C. Prussian Blue

Question 13

13. Most ingested iron is readily absorbed into the body in the
    A. stomach and duodenum
    B. duodenum and upper jejunum
    C. ileum and duodenum
    D. upper jejunum and ileum

Answer 13

B. duodenum and upper jejunum

Question 14

14. Transferrin represents a
    A. storage form of iron
    B. beta globulin that moves iron
    C. glycoprotein that moves iron
    D. both B and C

Answer 14

D. both B and C

Question 15

15. In stage 3 IDA, the erythrocytic indices are typically
    A. MCV increased, MCH decreased, and MCHC decreased
    B. MCV decreased, MCH decreased, and MCHC decreased
    C. MCV decreased, MCH increased, and MCHC decreased
    D. MCV decreased, MCH decreased, and MCHC normal

Answer 15

B. MCV decreased, MCH decreased, and MCHC decreased

Question 16

16. The peripheral blood smear demonstrates _____ red blood cells in IDA.
    A. microcytic, hypochromic
    B. macrocytic, hypochromic
    C. macrocytic and spherocytic
    D. either a or b

Answer 16

A. microcytic, hypochromic

Question 17

In ACD, the serum iron is decreased, transferrin saturation is decreased, TIBC is normal or decreased

A. serum iron is severely decreased, and the TIBC is increased
B. serum iron is decreased, and the TIBC is normal/decreased
C. serum iron is normal, and the TIBC is normal
D. serum iron is increased, and the TIBC is normal

Answer 17

B. serum iron is decreased, and the TIBC is normal/decreased

Question 18

The bone marrow of a patient, previously diagnosed with anemia, was examined because of the lack of a response to vitamin therapy for her fatigue. Prussian Blue staining was performed on a bone marrow smear, but the results were negative. It is likely that this patient is suffering from
A. hemochromatosis
B. iron deficiency anemia
C. chronic blood loss
D. acute blood loss

Answer 18

B. iron deficiency anemia

Question 19

21. Anemias of inflammation/chronic diseases can be caused by
    A. inflammation
    B. increased hepcidin production
    C. malignancy
    D. all of the above

Answer 19

D. all of the above

Question 20

22. The typical peripheral blood film of a patient with AOI typically reveals _____ erythrocytes.
    A. microcytic, hypochromic
    B. macrocytic, hypochromic
    C. normocytic, normochromic
    D. many spherocytes

Question 21

23. Leukoerythroblastosis can appear as _____ on a peripheral blood smear.
    A. immature leukocytes
    B. immature erythrocytes
    C. immature thrombocytes
    D. both A and B

Answer 21

D. both A and B

Question 22

24. What is the most appropriate treatment for anemia of inflammation (AOI)?
    A. Red blood cell transfusion
    B. Iron therapy
    C. Erythropoietin injections
    D. Treatment of the inflammatory condition

Answer 22

D. Treatment of the inflammatory condition

Question 23

25. Sideroblastic anemia can be caused by

A. congenital (chromosomal) defect
B. drugs (e.g., chloramphenicol)
C. association with malignant disorders
D. all of the above

Answer 23

D. all of the above

Question 24

26. A common feature of sideroblastic anemia is
    A. ringed sideroblasts
    B. decreased serum iron
    C. decreased serum ferritin
    D. macrocytic red blood cells

Answer 24

A. ringed sideroblasts

Question 25

27. The greatest portion of operational body iron is normally contained in what compound? A. Heme portion of hemoglobin B. Ferritin C. Cytochromes D. mitochondria

Answer 25

A. Heme portion of hemoglobin

Question 26

28. Storage iron in the human body is A. found in hepatocytes B. found in macrophages C. sequestered as ferritin D. all of the above

Answer 26

D. all of the above

Question 27

The most sensitive assay for the diagnosis of hereditary hemochromatosis (HH) is A. serum iron B. serum iron–binding capacity C. transferrin D. transferrin saturation

Answer 27

D. transferrin saturation

Question 28

Prussian Blue cytochemical staining identifies A. basophilic stippling B. Heinz bodies C. siderotic granules D. reticulocytes

Answer 28

C. siderotic granules

Question 29

The bone marrow of a patient, previously diagnosed with anemia, was examined because of the lack of a response to iron therapy. No other laboratory data were available. Examination of the bone marrow revealed an erythroid hyperplasia with an increase (shift to the left) in more mature erythroid precursors. Prussian Blue staining revealed a significantly elevated concentration of storage iron with occasional sideroblasts. It is likely that this patient is suffering from A. hemochromatosis B. iron deficiency anemia C. chronic blood loss D. acute blood loss

Answer 29

A. hemochromatosis

Question 30

An acquired disorder of heme synthesis is A. congenital erythropoietic porphyria B. lead poisoning C. hemolytic anemia D. hemoglobinopathy

Answer 30

B. lead poisoning

Question 31

When porphyrin synthesis is impaired, the _______ become encrusted with iron. A. lysosomes B. nucleoli C. mitochondria D. vacuoles

Answer 31

C. mitochondria

Question 32

The initial condensation reaction in the synthesis of porphyrin preceding heme formation takes place in the (34) _____ and requires (35) _____. A. liver B. spleen C. red bone marrow D. mitochondria (35) A. Iron B. vitamin B6 C. vitamin B12 D. vitamin D

Answer 32

34. D. mitochondria 35. B. vitamin B6

Question 33

The final steps in heme synthesis, including the formation of protoporphyrin, take place in A. a cell’s nucleus B. a cell’s cytoplasm C. the spleen D. the mitochondria

Answer 33

D. the mitochondria

Question 34

In reference to case 14.2, the dark staining granules in the red blood cells when a peripheral blood smear stained with Wright- Giemsa stain is examined represent a defect of A. membrane development B. heme synthesis C. globulin synthesis D. red blood cell aging

Answer 34

B. heme synthesis

Question 35

In reference to Case 14.2, the child’s medical history and the appearance of dense, dark-staining particles in some of the red blood cells on a peripheral blood smear suggests a diagnosis of A. iron deficiency anemia B. malaria C. ingestion of lead D. sickle cell disease

Answer 35

C. ingestion of lead

Question 36

If globin synthesis is insufficient in a patient, iron accumulates in the cell as _____ aggregates. A. transferrin B. ferritin C. albumin D. iron

Answer 36

B. ferritin