nisha gurung
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hematology Quiz on anaemia colloquium , created by nisha gurung on 27/05/2020.

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anaemia colloquium

Question 1 of 60

1

Which of the following is NOT true for the erythrocytes:

Select one or more of the following:

  • RBC are most numerous in blood

  • Mature RBC contain no organelles, particularly no mitochondria

  • RBCs contain no protein, but can synthesize proteins necessary for their survival

  • RBC cytoplasm has heme and enzymes to prevent and repair the oxidative damage

  • RBC produce 2,3 DPG which helps with 02 unloading in tissue

Explanation

Question 2 of 60

1

The pentose phosphate pathway in RBC metabolizes about 5-10% of the glucose entering the cell and produces NADPH. G6PD deficiency stops this pathway and thus would cause which of the following

Select one or more of the following:

  • thrombophillia

  • sickle cell anemia

  • megaloblastic anemia

  • enzimopenic hemolytic anemia

  • thallasaemia

Explanation

Question 3 of 60

1

G6PD is an intraerytocytic enzyme necessary for production of what:

Select one or more of the following:

  • succinyl Co-A

  • methylmalonil Co A

  • pyruvate

  • NADPH

  • NAD

Explanation

Question 4 of 60

1

Which of the following are proteins from the membrane cytoskeleton of the RBCs?

Select one or more of the following:

  • ankirin and spectrin

  • vicin and convicin

  • vincristin and vinblastinn

  • NAD+ and NADPH

  • alpha and beta globine

Explanation

Question 5 of 60

1

Splenomegaly is found on routine physical examination. Blood tests show mild hemolytic anemia. Osmotic fragility test is positive. The patient is consulted on spl enectomy. Which of following, is most likely?

Select one or more of the following:

  • iron deficiency anemia

  • megaloblastic anemia

  • mircospherocytosis

  • thallasaemia major

  • aplastic anemia

Explanation

Question 6 of 60

1

What type of anemia is assosiciated with quantitative defects in hemoglobin production:

Select one or more of the following:

  • membranopathic hemolytic

  • enzymopathic hemolytic

  • hemoglionpathies

  • immune hemolytic

  • thallassemia

Explanation

Question 7 of 60

1

Damage to the duodenum. preventing nutrient absorption would cause which of the following forms of anemia:

Select one or more of the following:

  • iron deficiency anemia

  • vit B12 deficiency anemia

  • PK deficiency anemia

  • G6PD deficiency anemia

  • folic acid deficiency anemia

Explanation

Question 8 of 60

1

Damage to the ileum, preventing nutrient absorption would cause which of the following forms of anemia:

Select one or more of the following:

  • iron deficiency anemia

  • vit B12 deficiency anemia

  • PK deficiency anemia

  • G6PD deficiency anemia

  • folic acid deficiency anemia

Explanation

Question 9 of 60

1

A patient presents with jaundice. Testing reveals anemia, decreased haptoglobin, no signs of hemoglobinemia and hemoglobiuria. If extravasal hemolysis is suspected what is the major organ involved:

Select one or more of the following:

  • spleen

  • liver

  • bone marrow

  • small vessels

Explanation

Question 10 of 60

1

A patient presents with jaundice. Lab tests show anemia, decreased haptoglobin hemoglobinemia, hemoglobinuria.. Which of the following is most likely:

Select one or more of the following:

  • intravascular hemolysis

  • extravascular hemolysis

  • mircospherocytosis

  • acute hepatitis

  • acute cholecystitis

Explanation

Question 11 of 60

1

After an acute blood loss which of the following will be seen :

Select one or more of the following:

  • thrombocytopenia

  • leucopenia

  • reticulcytosis

  • thrombocytosis

  • leukocytosis

Explanation

Question 12 of 60

1

An African American is recently successfully recovered from malaria after a mission trip in Central Africa. He presents with haemolytic anemia. He said he ate many broad beans . Blood tests show Heinz bodies. Which of the following is most likely:

Select one or more of the following:

  • G6PD deficiency anemia

  • sickle cell anemia

  • thallaseamia

  • autoimmune haemolytic anemia

  • microsperocytosis

Explanation

Question 13 of 60

1

What change is seen in 6 position of the beta globine chain in sickle cell anemia:

Select one or more of the following:

  • glycine for valine

  • valine for glycine

  • valine for glutamatic acid

  • gluamatic acid for valine

  • none of the above

Explanation

Question 14 of 60

1

A child feels unwell after a day at the ski slopes — fever, paleness, jaundice, dark urine, abdominal pains. Tests show haemolytic anemia with biphase autoantibodies (Donath — Landsteiner) What is the correct diagnosis:

Select one or more of the following:

  • autoimmune haemolytic anemia with warm autoantibiodies

  • autoimmune haemolytic anemia with cold autoantibodies

  • CMV liver infection

  • paraoxysmal cold hemoglobinuria

  • march hemoglobinuria

Explanation

Question 15 of 60

1

A patients presents with Rayno- phenomena after therapy for mycoplasma pneumoniae infection. Lab tests show anemia, spherocytes, erythrocytes clumping. Which type of anemia do you suspect:

Select one or more of the following:

  • haemolytic anemia with cold autoantibodies

  • haemolytic anemia with warm autoantibodies

  • microphserocytosis

  • sickle cell anemia

  • malaria

Explanation

Question 16 of 60

1

A pateint being treated for syphilis presents with tiredness. Lab tests show haemolytic anemia ( HA) and positive direct DAT with IgG bound to the RBC membranes. Which diagnosis is most likely?

Select one or more of the following:

  • HA with warm antibodies

  • HA with cold antibodies

  • hereditary speherocytosis

  • drug induced haemolytic anemia (penicillin type)

  • drug induced HA (hapten type)

Explanation

Question 17 of 60

1

Which of the following is used to diagnose autoimmune hemolytic anemia by detecting autoantibodies and /or complement bound to the RBC:

Select one or more of the following:

  • DAT (direct coombs test)

  • PTT

  • APTT

  • D-dimers

  • IAT (indirect coombs test)

Explanation

Question 18 of 60

1

An alcoholic presents with diarrhoea and weight loss. He states he drinks alcoholol and eats only fast food. Lab tests show anemia with MCV 130fl. Which of the following is most likely:

Select one or more of the following:

  • vit K def

  • vit C def

  • folic acid def

  • vit B12 def

  • iron def

Explanation

Question 19 of 60

1

A child from a developing country presents with exhaustion. Blood tests show microcyric, hypochromic anemia, low iron in serum, low ferritin and high transferin in serum. The chlid complaints of burning tongue and Plummer Vilson syndrome. Which of the following is most likely:

Select one or more of the following:

  • vit K def

  • Vit C def

  • folic acid def

  • Vit B12 def

  • iron def

Explanation

Question 20 of 60

1

An elderly patient with terminal ileitis ( Krohn disease) and vitilgo complaints from fatigue. Lab tests show anemia with MCV 127fl. Which of the following is most likely:

Select one or more of the following:

  • vit K def

  • vit c def

  • folic acid def

  • Vit B12 def

  • iron def

Explanation

Question 21 of 60

1

An elderly man, living in Finland goes fishing in his free time. He complaints of fatigue and blood tests show megaloblastic anemia. Which of the following can be suspected:

Select one or more of the following:

  • Diphilobotrum latum parasitosis

  • lime disease

  • malaria

  • HCV infection

  • EBV infection

Explanation

Question 22 of 60

1

Which of the following is associated with anemia, thrombocytopenia, leukopenia and reduction of all cellular elements of the blood?

Select one or more of the following:

  • hereditary HA

  • iron def anemia

  • aplastic anemia

  • thallasemia

  • autoimmune anemia

Explanation

Question 23 of 60

1

A 19 year-old female comes to you for a pre-athletic physical examination . She looks pale. You ask her about her diet and find out that she rarely eats meat but drinks milk and tea, eats lo is of fruits and vegetables. Blood tests show Hb MT,/ , MCV 76f1. Which test do you order next?

Select one or more of the following:

  • serum ferritin concentration

  • serum transferin concentration

  • serum iron concentration

  • urine homocystein

  • serum hepcidin concentration

Explanation

Question 24 of 60

1

A 19 year-old female comes to you for a pre-athletic physical examination . She looks pale. You ask her for her diet and find out that she rarely eats meat but drinks milk and tea, eats lots of fruits and vegetables. Blood tests show Hb 72,/1 , MCV 76fl. Which of the serum proteins do you expect to be elevated?

Select one or more of the following:

  • serum ferritin concentration

  • serum transferin concentration

  • serum iron concentration

  • urine homocystein

  • serum folate concentration

Explanation

Question 25 of 60

1

A 76 year- old lady comes to your practice with mild iron deficiency anemia. Which foods would you recommend as a best source of iron with best absorption rate?

Select one or more of the following:

  • spinach and broccoli

  • black tea

  • chicken, fish and beef

  • fresh citrus fruits

  • iron fortified cereals

Explanation

Question 26 of 60

1

Mrs Smith, a 48 year old woman had a car accident and sustained the following injuries: broken ribs, punctured lung, a ruptured spleen, injuries to her small intestine and. Her spleen, a part of her small intestine including the lower third were removed. What type of anemia do you expect her to develop in the next 7-10 days?

Select one or more of the following:

  • haemolytic anemia

  • aplastic anemia

  • vit B12 def anemia

  • iron def anemia following acute blood loss

Explanation

Question 27 of 60

1

Mrs Smith, a 48 year old woman had a car accident and sustained the following injuries: broken ribs, punctured lung, a ruptured spleen, injuries to her small intestine. Her spleen, part of her small intestine including the lower third were removed. What type of anemia do you expect her to develop in the next 3-4 years?

Select one or more of the following:

  • haemolytic anemia

  • aplastic anemia

  • vit B12 def anemia

  • iron def anemia following acute blood loss

Explanation

Question 28 of 60

1

Which is usually the first sign of folate deficiency?

Select one or more of the following:

  • low RBC concentration

  • low hemoglobin concentration

  • hypersegmented neutrophils

  • low folate concentration

  • high MCV

Explanation

Question 29 of 60

1

A 47 year old woman is found to have macrocytosis. Upon investigation folate deficiency is diagnosed. The macrocytosis is a result of impaired synthesis of which compound?

Select one or more of the following:

  • heme

  • haemoglobin

  • DNA

  • methylmalonic acid

  • alfa - globine chain

Explanation

Question 30 of 60

1

A 26 year old woman comes to you for a check —up. She has intestinal inflammatory disease ( Crohn's disease) which causies GI bleeding. She has recently had most of her ileum removed. Which nutritional deficiency or combination of deficiencies is most likely in her?

Select one or more of the following:

  • iron and vit B12

  • folate

  • vit B12

  • folate and vit B12

  • folate and iron

Explanation

Question 31 of 60

1

A 61 year old man has just had a surgical resection of his entire stomach because of cancer. This type of surgery puts him at high risk for nutritional anemia because lack of :

Select one or more of the following:

  • lactoferin

  • transcobalamin

  • ghrelin

  • intrinsic factor

  • Rh factor

Explanation

Question 32 of 60

1

What is the lower limit of normal Hb concentration in venous blood as defined by World Health Organization for males and females:

Select one or more of the following:

  • 12g/dl and 11g/dl

  • 11g/dl and 12g/dl

  • 13g/dl and 12g/dl

  • 12 g/dl and 13 g/dl

  • 14 g/dl and 13 g/dl

Explanation

Question 33 of 60

1

What 'test. is performed in the initial evaluation of anemia after patient's history and physical exam?

Select one or more of the following:

  • PTT - prothrombin time

  • CBC - complete blood count

  • DBC - differential blood count

  • bleeding time

  • PTT - partial thromboplastin time

Explanation

Question 34 of 60

1

Which of the followings in not included in the differential diagnosis for mycrocytic hypochromic anemia:

Select one or more of the following:

  • thallasemia

  • iron def anemia

  • anemia in malignancy

  • anemia of chronic disease

  • megaloblastic anemia

Explanation

Question 35 of 60

1

An alcoholic patient presents with diarrhoea and goit disturbancies. Ankle reflexes are absent. Position sense is impaired. Physical exam reveals a beefy, atrophic tongue. The blood smear slows macrocytosis. Which of the following is most likely?

Select one or more of the following:

  • vit A def

  • folate def

  • vit B12 def

  • vit C def

  • vit K def

Explanation

Question 36 of 60

1

An elderly patient presents with vitilgo and hypothyroidismus. Ankle reflexes are absent. Position sense is impaired. Physical exam reveals a beefy, atrophic tongue.The blood smear shows macrocytosis. Which of the following is most likely?

Select one or more of the following:

  • vit A def

  • folate def

  • vit B12 def

  • vit C def

  • vit K def

Explanation

Question 37 of 60

1

What test is performed to exclude hemolysis in the evaluation of normocytic normochronic anemia?

Select one or more of the following:

  • reticulocyte count

  • serum ferritin

  • serum transferrin

  • complete blood count

  • serum transferin receptor

Explanation

Question 38 of 60

1

What lab differences show iron deficiency anemia from anemia of chronic disease?

Select one or more of the following:

  • reticulocyte count

  • serum ferritin

  • serum iron

  • serum bilrubin

  • serum haptoglobin

Explanation

Question 39 of 60

1

Which organ is responsible for producing 99% of body erythropoietin?

Select one or more of the following:

  • spleen

  • liver

  • kidneys

  • bone marrow

  • adrenal glands

Explanation

Question 40 of 60

1

Which of the following is characterised by peripheral pancytopenia, bone marrow hypocellularity. absence of malignat myelo — or lymphoproliferation and is cured by all ogeneic stem cell transplantation?

Select one or more of the following:

  • autoimmune haemolytic anemia

  • aplastic anemia

  • thallasemia

  • sickle cell disease

  • pernitious anemia

Explanation

Question 41 of 60

1

What is the most common cause for aplastic anemia?

Select one or more of the following:

  • drugs containing gold

  • chloramphenicol

  • benzene

  • radiation

  • idiopathic

Explanation

Question 42 of 60

1

Which therapy is considered in patient with aplastic anemia younger than 40 years?

Select one or more of the following:

  • immunosupression

  • best supportive care

  • autologious stem cell transplantation

  • allogenic stem cell transplantation

  • splenectomy

Explanation

Question 43 of 60

1

Which therapy is considered in patient with aplastic anemia older than 40. years?

Select one or more of the following:

  • immunosupression

  • best supportive care

  • autologious stem cell transplantation

  • allogenic stem cell transplantation

  • splenectomy

Explanation

Question 44 of 60

1

Which of the following will be NOT increased in patient with haemolytic anemia?

Select one or more of the following:

  • ferritin

  • reticulocytes

  • serum iron

  • LDH

  • direct bilirubin

Explanation

Question 45 of 60

1

Which of the following is associatated with hyposplenism ( asplenia), possibly megaloblastic anemia and iscaemic crises?

Select one or more of the following:

  • acanthocytosis

  • G6PD def anemia

  • sickle cell disease

  • thallaseamia

  • pernitious anemia

Explanation

Question 46 of 60

1

What is the treatment of choice for autoimmune hemolytic anemia:

Select one or more of the following:

  • chloramphenicol

  • bone marrow transplantation

  • steroids

  • splenectomy

  • blood transfusion

Explanation

Question 47 of 60

1

Which of the following is a definitive test for G6PD deficiency

Select one or more of the following:

  • bite cells

  • Heinz bodies

  • electroforesis of hemoglobin

  • G6PD assay

  • target cells

Explanation

Question 48 of 60

1

Which of the following is a definitive test for thallasemia

Select one or more of the following:

  • bite cells

  • heinz bodies

  • electroforesis of hemoglobin

  • G6PD assay

  • target cells

Explanation

Question 49 of 60

1

In which of the following disease there is an excess of alfa — globin chains

Select one or more of the following:

  • beta-thallaseamia

  • alfa thallasemia minor

  • sickle cell anemia

  • alfa-thallasemia homozygous form

  • G6PD def anemia

Explanation

Question 50 of 60

1

Which of the following is NOT a symptom of sickle cell anemia

Select one or more of the following:

  • spleen infraction

  • priapism

  • ischeamic stroke

  • bone and joint infraction

  • brain haemorrhage

Explanation

Question 51 of 60

1

Which of the following is used in the management of sickle cell disease:

Select one or more of the following:

  • angiography

  • heparin

  • warfarin

  • aspirin

  • RBC transfusions

Explanation

Question 52 of 60

1

What is NOT a common reason for death in sickle cell anemia:

Select one or more of the following:

  • bleeding

  • acute chest syndrome

  • myocardial infraction

  • septicaemia

  • stroke

Explanation

Question 53 of 60

1

What is the most common reason for death in thallasemia major:

Select one or more of the following:

  • diabetes mellitus

  • osteoporosis

  • brain haemorrhage

  • cardiac insufficiency

  • cholelithiasis

Explanation

Question 54 of 60

1

Hemosiderosis because of iron overload is NOT a complication of:

Select one or more of the following:

  • sickle cell disease

  • thallasemia

  • megaloblastic anemia

  • autoimmune haemolytic anemia

  • microspherocytosis

Explanation

Question 55 of 60

1

Besides regular blood transfusions in the management of thallasemia are included:

Select one or more of the following:

  • steroids

  • immunopressors

  • cytostatics

  • iron helating agents

  • NSAID

Explanation

Question 56 of 60

1

Which of the following is NOT a therapeutic option in thallasemia major:

Select one or more of the following:

  • stem cell transplantation

  • blood transfusion

  • immunosuppressive therapy

  • splenectomy

  • iron helating agents

Explanation

Question 57 of 60

1

In which of the following splenectomy is the therapy of first choice:

Select one or more of the following:

  • autoimmune haemolytic anemia

  • microspherocytosis

  • G6PD def

  • aplastic anemia

  • sickle cell disease

Explanation

Question 58 of 60

1

How long is the duration of Vit B12 supplementation therapy in patients with pernitious anemia:

Select one or more of the following:

  • 3-4 years

  • only in haemolytic crises

  • till Hb level> 10g/dl

  • life-long

  • till the reticulocyte crisis

Explanation

Question 59 of 60

1

Allogeneic stem cell transplantation is a therapeutic option in ALL BUT ONE of the following:

Select one or more of the following:

  • aplastic anemia

  • beta-thallasemia major

  • sickle cell disease

  • automimmunoe hemolytic anemia

  • none of the above

Explanation

Question 60 of 60

1

Best donor for allogeneic stem cell transplantation is

Select one or more of the following:

  • HLA matched related donor

  • HLA matched unrelated donor

  • HLA mismatched donor in 1 allele

  • HLA mismatched donor

  • stem cell from cord blood

Explanation

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