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anaemia colloquium

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hematology Quiz on anaemia colloquium , created by nisha gurung on 27/05/2020.
nisha gurung
Quiz by nisha gurung, updated more than 1 year ago
nisha gurung
Created by nisha gurung almost 4 years ago
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Question 1

Question
Which of the following is NOT true for the erythrocytes:
Answer
  • 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

Question 2

Question
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
Answer
  • thrombophillia
  • sickle cell anemia
  • megaloblastic anemia
  • enzimopenic hemolytic anemia
  • thallasaemia

Question 3

Question
G6PD is an intraerytocytic enzyme necessary for production of what:
Answer
  • succinyl Co-A
  • methylmalonil Co A
  • pyruvate
  • NADPH
  • NAD

Question 4

Question
Which of the following are proteins from the membrane cytoskeleton of the RBCs?
Answer
  • ankirin and spectrin
  • vicin and convicin
  • vincristin and vinblastinn
  • NAD+ and NADPH
  • alpha and beta globine

Question 5

Question
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?
Answer
  • iron deficiency anemia
  • megaloblastic anemia
  • mircospherocytosis
  • thallasaemia major
  • aplastic anemia

Question 6

Question
What type of anemia is assosiciated with quantitative defects in hemoglobin production:
Answer
  • membranopathic hemolytic
  • enzymopathic hemolytic
  • hemoglionpathies
  • immune hemolytic
  • thallassemia

Question 7

Question
Damage to the duodenum. preventing nutrient absorption would cause which of the following forms of anemia:
Answer
  • iron deficiency anemia
  • vit B12 deficiency anemia
  • PK deficiency anemia
  • G6PD deficiency anemia
  • folic acid deficiency anemia

Question 8

Question
Damage to the ileum, preventing nutrient absorption would cause which of the following forms of anemia:
Answer
  • iron deficiency anemia
  • vit B12 deficiency anemia
  • PK deficiency anemia
  • G6PD deficiency anemia
  • folic acid deficiency anemia

Question 9

Question
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:
Answer
  • spleen
  • liver
  • bone marrow
  • small vessels

Question 10

Question
A patient presents with jaundice. Lab tests show anemia, decreased haptoglobin hemoglobinemia, hemoglobinuria.. Which of the following is most likely:
Answer
  • intravascular hemolysis
  • extravascular hemolysis
  • mircospherocytosis
  • acute hepatitis
  • acute cholecystitis

Question 11

Question
After an acute blood loss which of the following will be seen :
Answer
  • thrombocytopenia
  • leucopenia
  • reticulcytosis
  • thrombocytosis
  • leukocytosis

Question 12

Question
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:
Answer
  • G6PD deficiency anemia
  • sickle cell anemia
  • thallaseamia
  • autoimmune haemolytic anemia
  • microsperocytosis

Question 13

Question
What change is seen in 6 position of the beta globine chain in sickle cell anemia:
Answer
  • glycine for valine
  • valine for glycine
  • valine for glutamatic acid
  • gluamatic acid for valine
  • none of the above

Question 14

Question
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:
Answer
  • autoimmune haemolytic anemia with warm autoantibiodies
  • autoimmune haemolytic anemia with cold autoantibodies
  • CMV liver infection
  • paraoxysmal cold hemoglobinuria
  • march hemoglobinuria

Question 15

Question
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:
Answer
  • haemolytic anemia with cold autoantibodies
  • haemolytic anemia with warm autoantibodies
  • microphserocytosis
  • sickle cell anemia
  • malaria

Question 16

Question
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?
Answer
  • HA with warm antibodies
  • HA with cold antibodies
  • hereditary speherocytosis
  • drug induced haemolytic anemia (penicillin type)
  • drug induced HA (hapten type)

Question 17

Question
Which of the following is used to diagnose autoimmune hemolytic anemia by detecting autoantibodies and /or complement bound to the RBC:
Answer
  • DAT (direct coombs test)
  • PTT
  • APTT
  • D-dimers
  • IAT (indirect coombs test)

Question 18

Question
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:
Answer
  • vit K def
  • vit C def
  • folic acid def
  • vit B12 def
  • iron def

Question 19

Question
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:
Answer
  • vit K def
  • Vit C def
  • folic acid def
  • Vit B12 def
  • iron def

Question 20

Question
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:
Answer
  • vit K def
  • vit c def
  • folic acid def
  • Vit B12 def
  • iron def

Question 21

Question
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:
Answer
  • Diphilobotrum latum parasitosis
  • lime disease
  • malaria
  • HCV infection
  • EBV infection

Question 22

Question
Which of the following is associated with anemia, thrombocytopenia, leukopenia and reduction of all cellular elements of the blood?
Answer
  • hereditary HA
  • iron def anemia
  • aplastic anemia
  • thallasemia
  • autoimmune anemia

Question 23

Question
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?
Answer
  • serum ferritin concentration
  • serum transferin concentration
  • serum iron concentration
  • urine homocystein
  • serum hepcidin concentration

Question 24

Question
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?
Answer
  • serum ferritin concentration
  • serum transferin concentration
  • serum iron concentration
  • urine homocystein
  • serum folate concentration

Question 25

Question
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?
Answer
  • spinach and broccoli
  • black tea
  • chicken, fish and beef
  • fresh citrus fruits
  • iron fortified cereals

Question 26

Question
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?
Answer
  • haemolytic anemia
  • aplastic anemia
  • vit B12 def anemia
  • iron def anemia following acute blood loss

Question 27

Question
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?
Answer
  • haemolytic anemia
  • aplastic anemia
  • vit B12 def anemia
  • iron def anemia following acute blood loss

Question 28

Question
Which is usually the first sign of folate deficiency?
Answer
  • low RBC concentration
  • low hemoglobin concentration
  • hypersegmented neutrophils
  • low folate concentration
  • high MCV

Question 29

Question
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?
Answer
  • heme
  • haemoglobin
  • DNA
  • methylmalonic acid
  • alfa - globine chain

Question 30

Question
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?
Answer
  • iron and vit B12
  • folate
  • vit B12
  • folate and vit B12
  • folate and iron

Question 31

Question
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 :
Answer
  • lactoferin
  • transcobalamin
  • ghrelin
  • intrinsic factor
  • Rh factor

Question 32

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

Question 33

Question
What 'test. is performed in the initial evaluation of anemia after patient's history and physical exam?
Answer
  • PTT - prothrombin time
  • CBC - complete blood count
  • DBC - differential blood count
  • bleeding time
  • PTT - partial thromboplastin time

Question 34

Question
Which of the followings in not included in the differential diagnosis for mycrocytic hypochromic anemia:
Answer
  • thallasemia
  • iron def anemia
  • anemia in malignancy
  • anemia of chronic disease
  • megaloblastic anemia

Question 35

Question
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?
Answer
  • vit A def
  • folate def
  • vit B12 def
  • vit C def
  • vit K def

Question 36

Question
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?
Answer
  • vit A def
  • folate def
  • vit B12 def
  • vit C def
  • vit K def

Question 37

Question
What test is performed to exclude hemolysis in the evaluation of normocytic normochronic anemia?
Answer
  • reticulocyte count
  • serum ferritin
  • serum transferrin
  • complete blood count
  • serum transferin receptor

Question 38

Question
What lab differences show iron deficiency anemia from anemia of chronic disease?
Answer
  • reticulocyte count
  • serum ferritin
  • serum iron
  • serum bilrubin
  • serum haptoglobin

Question 39

Question
Which organ is responsible for producing 99% of body erythropoietin?
Answer
  • spleen
  • liver
  • kidneys
  • bone marrow
  • adrenal glands

Question 40

Question
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?
Answer
  • autoimmune haemolytic anemia
  • aplastic anemia
  • thallasemia
  • sickle cell disease
  • pernitious anemia

Question 41

Question
What is the most common cause for aplastic anemia?
Answer
  • drugs containing gold
  • chloramphenicol
  • benzene
  • radiation
  • idiopathic

Question 42

Question
Which therapy is considered in patient with aplastic anemia younger than 40 years?
Answer
  • immunosupression
  • best supportive care
  • autologious stem cell transplantation
  • allogenic stem cell transplantation
  • splenectomy

Question 43

Question
Which therapy is considered in patient with aplastic anemia older than 40. years?
Answer
  • immunosupression
  • best supportive care
  • autologious stem cell transplantation
  • allogenic stem cell transplantation
  • splenectomy

Question 44

Question
Which of the following will be NOT increased in patient with haemolytic anemia?
Answer
  • ferritin
  • reticulocytes
  • serum iron
  • LDH
  • direct bilirubin

Question 45

Question
Which of the following is associatated with hyposplenism ( asplenia), possibly megaloblastic anemia and iscaemic crises?
Answer
  • acanthocytosis
  • G6PD def anemia
  • sickle cell disease
  • thallaseamia
  • pernitious anemia

Question 46

Question
What is the treatment of choice for autoimmune hemolytic anemia:
Answer
  • chloramphenicol
  • bone marrow transplantation
  • steroids
  • splenectomy
  • blood transfusion

Question 47

Question
Which of the following is a definitive test for G6PD deficiency
Answer
  • bite cells
  • Heinz bodies
  • electroforesis of hemoglobin
  • G6PD assay
  • target cells

Question 48

Question
Which of the following is a definitive test for thallasemia
Answer
  • bite cells
  • heinz bodies
  • electroforesis of hemoglobin
  • G6PD assay
  • target cells

Question 49

Question
In which of the following disease there is an excess of alfa — globin chains
Answer
  • beta-thallaseamia
  • alfa thallasemia minor
  • sickle cell anemia
  • alfa-thallasemia homozygous form
  • G6PD def anemia

Question 50

Question
Which of the following is NOT a symptom of sickle cell anemia
Answer
  • spleen infraction
  • priapism
  • ischeamic stroke
  • bone and joint infraction
  • brain haemorrhage

Question 51

Question
Which of the following is used in the management of sickle cell disease:
Answer
  • angiography
  • heparin
  • warfarin
  • aspirin
  • RBC transfusions

Question 52

Question
What is NOT a common reason for death in sickle cell anemia:
Answer
  • bleeding
  • acute chest syndrome
  • myocardial infraction
  • septicaemia
  • stroke

Question 53

Question
What is the most common reason for death in thallasemia major:
Answer
  • diabetes mellitus
  • osteoporosis
  • brain haemorrhage
  • cardiac insufficiency
  • cholelithiasis

Question 54

Question
Hemosiderosis because of iron overload is NOT a complication of:
Answer
  • sickle cell disease
  • thallasemia
  • megaloblastic anemia
  • autoimmune haemolytic anemia
  • microspherocytosis

Question 55

Question
Besides regular blood transfusions in the management of thallasemia are included:
Answer
  • steroids
  • immunopressors
  • cytostatics
  • iron helating agents
  • NSAID

Question 56

Question
Which of the following is NOT a therapeutic option in thallasemia major:
Answer
  • stem cell transplantation
  • blood transfusion
  • immunosuppressive therapy
  • splenectomy
  • iron helating agents

Question 57

Question
In which of the following splenectomy is the therapy of first choice:
Answer
  • autoimmune haemolytic anemia
  • microspherocytosis
  • G6PD def
  • aplastic anemia
  • sickle cell disease

Question 58

Question
How long is the duration of Vit B12 supplementation therapy in patients with pernitious anemia:
Answer
  • 3-4 years
  • only in haemolytic crises
  • till Hb level> 10g/dl
  • life-long
  • till the reticulocyte crisis

Question 59

Question
Allogeneic stem cell transplantation is a therapeutic option in ALL BUT ONE of the following:
Answer
  • aplastic anemia
  • beta-thallasemia major
  • sickle cell disease
  • automimmunoe hemolytic anemia
  • none of the above

Question 60

Question
Best donor for allogeneic stem cell transplantation is
Answer
  • HLA matched related donor
  • HLA matched unrelated donor
  • HLA mismatched donor in 1 allele
  • HLA mismatched donor
  • stem cell from cord blood
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