Anemia refers to a deficiency of:  

a. blood plasma

b. erythrocytes

c. platelets

d. hemoglobin

e. both a&d are correct

e. both erythrocytes and hemoglobin

Anemia:  reduction in the total number of circulating erythrocytes or a decrease in the quality and quantity of hemoglobin

Etiology classification of anemia is based on:

a. size

b. color

c. shape

d. decreased or defective erythrocytes 

d.  decreased or defective erythrocytes 

*whether there is decreased/defective production or destruction of erythrocytes, anemias are classified according to their etiologic basis.  

Fewer erythrocytes are caused by: altered hemoglobin synthesis, altered DNA synthesis, stem cell dysfunction, bone marrow infiltrations, or RBC aplasia.  

***Destruction of erythrocytes is due to BLOOD LOSS or hemolysis!!!  

If a reticuloycyte count were done on an individual with iron deficiency anemia because of chronic bleeding, it would be:

a. high

b. low

c. normal

d. meaningless 

A 40 year old white, pregnant woman with four children experienced weakness, loss of appetite, and pallor.  Her CBC:  RBCs 2.5 x10.⁶ 

H/H 8.7/32

she most likely has:

a. sickle cell anemia

b. folic acid anemia 

c. iron deficiency

d. pernicious anemia 

b. folic acid anemia 

*folic deficiency= characterized by reduced hemoglobin 

Macrocytic anemia

caused by excessive hypoxia. 

   pregos will present with : Pale skin, lips, and nails, Feeling tired or weak, Dizziness, Shortness of breath, Rapid heartbeat, Trouble concentrating

A cause of macrocytic-normochromic anemia is: 

a. iron deficiency 

b. deficiency of B₁₂ and folic acid

c. an enzyme deficiency 

d. inheritance of abnormal heoglobin structure

b.  deficiency of B₁₂ and folic acid

*remember mnemonic: 

pregnant vegan (b12) with low hemoglobin (most pregos low on hemoglobin and folate acid) 

Hemolytic anemia may result in: 

a. jaundice

b. loss o vibratory sense

c. acidosis 

d. petechiae

a. jaundice 

*hemolytic means RBC are breaking up! its usually autoimmune. so when they break down it releases bilirubin- increased bilirubin= jaundice.

mnemonic:  mommies get HA when their babies are jaundice!!!  

The end result of anemia is:

a. anorexia

b. hypoxia

c. infection

d. bleeding

e. hypoexemia

b. hypoxia 

*inadequate cellular oxygen causes the rate and depth of breathing to increase in an attempt to make more oxygen available to the remaining erythrocytes.  

individuals at risk for iron deficiency anemia include those: 

a. who have undergone gastrectomy

b. who are Italian

c. with neoplastic disease

d. with warm antibodies

e. with minor, chronic blood loss

e. with minor, chronic blood loss

An individual who has chronic gastitis and tingling of his toes and fingers requires which of the following for treatment:

a. oral vitamin b₁₂

b. vitamin B₁₂ by intramuscular injection

c. ferrous fumarate by intramuscular injection

d. transfusions 

b. vitamin B₁₂ by intramuscular injection

  PA= b12 deficiency with peripheral neuropathy 

B12 is not absorbed well orally. 

The symptoms of sideroblastic anemia may include: 

a. glossitis

b. hepatomegaly & splenomegaly

c. bleeding and recurrent infections

d. neuropathy 

e. jaundice 

b. hepatomegaly & splenomegaly

** symtoms (due to iron overload): enlarged liver and spleen, bronze tint to skin, and cardiac dysrhythmia 

BBC- Caudle:

*3 different types:

1. acquired:   idiopathic.  MOST common!

2. reversible:  secondary to alcoholism, drug reactions (TB drugs), copper deficiency or hypothermia.

3. hereditary:  RARE (x-linked auto recessive) occurs in males and it present at birth but shows up later in life- develop heart failure due to  iron overload.  

Primary (absolute) polycythemia exists when there is: 

a. an increase in circulating RBCs, WBCs, and platlets.

b. a decrease of circulating plasma.

c. a physiologic response to hypoxia 

d. chronic obstructive pulmonary disease in an individual. 

a. an increase in circulating RBCs, WBCs, and platlets.

BBC:  Caudle:

*increase in production of RBC

absolute= results from an abnormality of the bone marrow stem cells. 

most are acquired,

PV is primary nomalignant disorder

thick, sticky blood, ruddy red faces, feet and hands 

Vitamin B12 is:

a. macrocytic-normochromic

b. microcytic-hypochromic

c. normocytic-normochromic

a. macrocytic-normochromic

*MaN= b12 or folate deficiency 

Iron deficiency:

a. macrocytic-normochromic (MaN) 

b. microcytic-hypochromic (MiH) 

c. normocytic-normochromic

b. microcytic-hypochromic

**MiH are characterized by erythrocytes that are abnormally small and contain abnormally reduced about of hemoglobin. Hypochromia occurs! 

MiH results from: disorders of iron metabolism, disorders of porphyrin, and heme synthesis, or disorders of globin synthesis. 

 MiH disorders:  IDA, sideroblastic, thalassemia

Folic acid deficiency:

a. macrocytic-normochromic

b. microcytic-hypochromic

c. normocytic-normochromic

a. macrocytic-normochromic

**MaN= b12 or folate deficiency 

Bone marrow depression:

a. macrocytic-normochromic

b. microcytic-hypochromic

c. normocytic-normochromic

c. normocytic-normochromic

*normocytic-normochromic anemias are characterized by erythrocytes that are relatively normal in size and hemoglobin content but insufficient in number. 

** NNAs: aplastic, posthemorrhagic, hemolytic, sickle cell, and anemia from chronic inflammation. 

hemolysis:

a. macrocytic-normochromic

b. microcytic-hypochromic

c. normocytic-normochromic

c. normocytic-normochromic

*** NNAs: aplastic, posthemorrhagic, hemolytic, sickle cell, and anemia from chronic inflammation. 

Malignancy:  

 a. macrocytic-normochromic

b. microcytic-hypochromic

c. normocytic-normochromic

c. normocytic-normochromic

*** NNAs: aplastic, posthemorrhagic, hemolytic, sickle cell, and anemia from chronic inflammation. 

Posthemorrhagic:

a. macrocytic-normochromic

b. microcytic-hypochromic

c. normocytic-normochromic

c. normocytic-normochromic

*** NNAs: aplastic, posthemorrhagic, hemolytic, sickle cell, and anemia from chronic inflammation. 

Decreased heme synthesis:

 a. macrocytic-normochromic

b. microcytic-hypochromic

c. normocytic-normochromic

b. microcytic-hypochromic

**MiH are characterized by erythrocytes that are abnormally small and contain abnormally reduced about of hemoglobin. Hypochromia occurs! 

MiH results from: disorders of iron metabolism, disorders of porphyrin, and heme synthesis, or disorders of globin synthesis. 

 MiH disorders:  IDA, sideroblastic, thalassemia

Chloramphenicol therapy: 

a. macrocytic-normochromic

b. microcytic-hypochromic

c. normocytic-normochromic

 b. microcytic-hypochromic

**MiH are characterized by erythrocytes that are abnormally small and contain abnormally reduced about of hemoglobin. Hypochromia occurs! 

MiH results from: disorders of iron metabolism, disorders of porphyrin, and heme synthesis, or disorders of globin synthesis. 

 MiH disorders:  IDA, sideroblastic, thalassemia

Leukocytosis is found in all of the following except: 

a. inflammatory responses 

b. allergic responses

c. bacterial infections

d. bone marrow depression

d. bone marrow depression

leukocytosis exists when the leukocyte coun is HIGHER than normal

*leukocytosis is a normal protective response to invading microorganisms, strenuous exercise, emotional changes, temp changes, anesthesia, surgery, pregnancy, some drugs, hormones, and toxins. Malignancy & hemotologic disorders also cause leukocytosis! Increase in circulating WBCs occur. Elevation of WBC can also occur as a result of polycythemia vera which INCREASES STEM CELL PROLIFERATION in BONE MARROW! 

What is a notable characteristic of infectious mononucleosis?

a. short incubation

b. affects preteens

c. presence of atypical lympocytes

d. widespread invasion of T-cells

c. presence of atypical lympocytes

**acute infection of B lymphocytes! 

30-50 day incubation

usually occurs between age 15-35 "kissing disease" 

transmitted by saliva 

Which of the following is not associated with leukemia?

a. radiation

b. hereditary abnormality

c. polycythemia

d. chloramphenicol

e. increased production of other hematopoietic cells

e. increased production of other hematopoietic cells

*excessive proliferation dysfunctional leukocytes crowd bone marrow and cause decreased production of other normal hematopoietic cells. increased incidence of leukemia associated with hereditary abnormalities such as Down syndrome. tendency to occur in families, all are bone marrow depressive. 

Thrombocytopenia may be caused by all of the following except:  

a. an IgG antibody

b. drug hypersensitivities

c. viruses that stimulate platelet production

d. bacterial infections that consume platelets

e. viruses that destroy circulating platelets

c. viruses that stimulate platelet production

**thrombocytopenia: exists when platelet count below 100,000. It results from decreased platelet production, increased consumption, or both.

*occurs secondary to: viral infections, drugs, nutritional deficencies, chronic renal failure, APLASTIC ANEMIA, radiation, or bone marrow infiltration by cancer. 

a thrombocytopenia with a platelet count of 40,000/mm³  likely will cause:

a. hemorrhage from minor trauma

b. spontaneous bleeding

c. death

d. polycythemia

a. hemorrhage from minor trauma

**hemorrage from minor trauma can occur with counts of 50,000 or less.

**spontaneous bleeding occurs with counts betwenn 15,000 and 10,000. 

severe bleeding with counts below 10,000

DIC is associated with: 

a. endothelial damage

b. the activation of factor X

c. the release of tissue factor

d. gram positive sepsis

e. a, b, and c are correct. 

e. a, b, & c  

d cannot be true because DIC=gram NEGATIVE

DIC= ABCDEFGHI

A:  Aquired disorder B: Bacteria= Septicemia

    Bleeding out (bleeding:iv sites, eyes, vagina, nose) C: clotting, cyanosis of fingers & toes 

D: death E: endothelium damage starts the cascade!

F: FDP increased G: gram negative

H: hypoperfusion of organs 

I: ischemia

   infarction

In DIC, plasmin is associated with: 

a. begins to degrade fibrin before a stable clot develops

b. complexes with factor VII

c. activates factor V

d. all of the above

a. begins to degrade fibrin before a stable clot develops

as fibrin is broken down by plasmin, fibrin degradation products (FDP) are released into circulation; these are potent anticoagulants. 

The manifestation of leukemia include:

a. petechial hemorrage 

b. hyperuricemia

c. weight loss

d. night sweats

e. all of the above 

Acute ITP is: 

a. more common in individuals older than 40 years of age.

b. usually preceded by a viral infection.

c.  often manifested by menorrhagia

d. more common in females

e. c&d are correct 

b. usually preceded by a viral infection.

*immune in nature!

antigens immune complexes bind to platelets and cause distruction to platelets (often in spleen) .

problem resolves when problem (antigen) is removed. 

most common in children and young adults. 

a deficiency of vitamin K is caused by:

a. lack of clotting factor VII

b. impaired platelet function.

c.  altered gut flora 

d. a & b are correct. 

c.  altered gut flora 

rarely is a deficiency caused by lack of dietary intake!  MOST common cause of vitamin K deficiency is broad-spectum antibiotics that destroy normal gut flora! 

impaired hemostasis= lack of vitamin K 

(hence that is why babies get vitamin K before circumcision!)