The Quizzes about Hematology diseases – Part 2 (20 test)

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The Quizzes about Hematology diseases – Part 2 (20 test)
5 (100%) 2 votes

Select the ONE answer that is BEST in each case.

A 4-month-old infant is anemic with a hemoglobin level of 9.5 g/dL and MCV 77 fL. The baby looks well, the height and weight growth parameters are normal, and she is breastfeeding well. Which of the following is the most likely cause for her anemia?

Iron deficiency is the most common cause of anemia in infancy. Sixty percent of body iron concentration at birth is contained in circulating Hb. Milk is a poor source of iron, so the most common cause of iron deficiency in infancy is prolonged breast or bottle feeding. Cereals are high in iron content.

 

See all quizzes of  the Hematology diseases at here:

Part 1Part 2 | Part 3 |

 

26. A 4-month-old infant is anemic with a hemoglobin level of 9.5 g/dL and MCV 77 fL. The baby looks well, the height and weight growth parameters are normal, and she is breastfeeding well. Which of the following is the most likely cause for her anemia?

(A) inadequate dietary iron

(B) hemolysis

(C) late clamping of cord

(D) iron malabsorption

(E) folate deficiency

27. Which of the following is the most likely effect of increased levels of red blood cell 2,3 diphosphoglycerate (2,3-DPG)?

(A) hemolytic anemia due to sulfa drugs

(B) increased oxygen affinity

(C) decreased oxygen affinity

(D) loss of red cell energy

(E) multiple congenital abnormalities

28. A 63-year-old man is involved in a motor vehicle accident and is brought to the hospital. On examination, his blood pressure is 90/60 mm Hg, pulse 110/min, and his abdomen is distended and rigid. He has internal injuries and bleeding on an abdominal CT scan, and requires emergent blood transfusion on his way to the operating room. His blood group is AB. Which of the following statements is not correct?

(A) he is a universal recipient

(B) he has anti-A and anti-B in his serum

(C) if a cross-match is not available; group O RBCs are universal

(D) if insufficient AB blood is available, type A can be used

(E) if insufficient AB blood is available, type B can be used

29. A 60-year-old man notices right-sided chest pain after sneezing. The pain is made worse with breathing, but he reports no fever, sputum, or cough. Recently, he has been experiencing back discomfort and easy fatigue on exertion. On examination, the heart sounds are normal and lungs are clear. The left 6th rib is tender on palpation. X-rays of his chest are shown in Fig. 5–3 a and b. Which of the following is the most likely diagnosis?

(A) aneurysmal bone cyst

(B) multiple myeloma

(C) lymphosarcoma

(D) prostatic metastases

(E) hyperparathyroidism

30. A 36-year-old woman with sickle cell disease presents with increasing pain in her right hip. She has no fever, chills, back or other bone pain, and there is no history of any trauma. On examination, her temperature is 37.3C, range of motion in the right hip is reduced, she walks with a limp, and the right leg is shorter than the left. Movements of the hip and walking on it are painful. X-rays of the hip are shown in Fig. 5–4. Which of the following is the most likely diagnosis?

(A) avascular necrosis (AVN) of the femoral head

(B) osteomyelitis

(C) hip fracture

(D) septic arthritis

(E) multiple myeloma

31. A 30-year-old woman presents with increasing fatigue, but no other symptoms. On examination the conjunctivae are pale, her sclera are icteric, blood pressure 110/70 mm Hg, pulse 110/min, lungs clear, and heart sounds normal. Castell’s sign is negative and no spleen is palpable. Her hemoglobin is 6 g/dL, and the rest of the laboratory workup is shown in Table 5–1. Which of the following is the most likely diagnosis?

(A) iron deficiency

(B) congenital spherocytosis

(C) liver failure and hemolysis

(D) splenomegaly and hemolysis

(E) autoimmune hemolytic anemia

32. Inhibits platelet activation induced by ADP (SELECT ONE)

(A) aspirin

(B) naproxen

(C) tirofiban

(D) trimethoprim-sulfamethoxazole

(E) clopidogrel

(F) fish oils

(G) systemic lupus

(H) uremia

33. Depletes platelet arachidonic acid (SELECT ONE)

(A) aspirin

(B) naproxen

(C) tirofiban

(D) trimethoprim-sulfamethoxazole

(E) clopidogrel

(F) fish oils

(G) systemic lupus

(H) uremia

34. A 23-year-old man has recurrent episodes of mild back and chest pain, whenever he is ill. His physical examination is normal. The hemoglobin level is 9 g/dL, MCV 85 fL, and platelets 250,000/mL. His blood film shows characteristic red cell morphologic changes that have hemoglobin units polymerizing in long chains under hypoxic stress as the underlying mechanism. (SELECT ONE)

(A) beta-thalassemia major

(B) HbH disease

(C) sickle cell disease

(D) HbC disease

(E) HbM disease

35. A 32-year-old man has a mild anemia diagnosed on routine testing. He has no symptoms and feels fine. His clinical examination is normal, and a blood film reveals some target cells with some red cells having intraerythrocytic crystals. (SELECT ONE)

(A) beta-thalassemia major

(B) HbH disease

(C) sickle cell disease

(D) HbC disease

(E) HbM disease

36. A 4-month-old baby has developed feeding problems and diarrhea. Laboratory evaluation reveals severe anemia with hemoglobin of 7 g/dL. The blood film shows hypochromic microcytic cells and target cells. In this disorder, decreased beta-chain production leads to excess alpha-chain production and destruction of red cell precursors. (SELECT ONE)

(A) beta-thalassemia major

(B) HbH disease

(C) sickle cell disease

(D) HbC disease

(E) HbM disease

37. A 4-year-old boy has a chronic microcytic anemia, but no other symptoms. His physical examination is normal except for splenomegaly. His condition is due to decreased alpha-chain production, which leads to four beta-chain tetramer formation (HbH). (SELECT ONE)

(A) beta-thalassemia major

(B) HbH disease

(C) sickle cell disease

(D) HbC disease

(E) HbM disease

38. A 27-year-old woman complains of constant back pain. She recently had an episode of severe chest and back pain that required narcotic medications, blood transfusions, and lots of fluids to treat. On examination, she is afebrile, with midthoracic tenderness on palpation. X-rays of the spine reveal periosteal reaction of the eighth thoracic vertebra She has a chronic blood disorder where bone infarction can occur that may be difficult to distinguish from osteomyelitis. (SELECT ONE)

(A) beta-thalassemia major

(B) HbH disease

(C) sickle cell disease

(D) HbC disease

(E) HbM disease

41. A 24-year-old pregnant woman is found to be anemic. (SELECT ONE)

(A) loss of Achillis tendon reflex

(B) increased perioperative morbidity

(C) renal concentration defect

(D) helmet cells and schistocytes are common

(E) occurs most commonly in the first trimester

(F) renal papillary necrosis

(G) cardiac arrhythmias

(H) increased HbH

(I) responds to folic acid

(J) paresthesias

42. A 32-year-old woman has had a previous child with beta-thalassemia. She has just been confirmed as being 6 weeks pregnant. She is worried that the current pregnancy may also be affected. Which of the following methods is most likely to establish an accurate prenatal diagnosis?

(A) fetal ultrasound at 12 weeks

(B) cord blood electrophoresis

(C) chorionic villus sampling

(D) buccal mucosal cytology of both parents

(E) electrophoresis of amniotic fluid

43. A 27-year-old female presents with easy fatigue and light-headedness. She also has a dry cough and fever for the past few days. On examination, she is pale, her lungs are clear, and the rest is normal. A chest x-ray (CXR) shows patchy bilateral infiltrates; the hemoglobin is 8.4 g/dL, reticulocyte count of 6%, and many spherocytes on the peripheral blood film. Which of the following is the most likely significance of the spherocytosis on the blood film?

(A) multiple long bone fracture

(B) hereditary elliptocytosis

(C) Coombs’-positive hemolytic anemia

(D) glucose-6-phosphate dehydrogenase (G6PD) deficiency

(E) leukemia

44. A 25-year-old woman is pregnant for the first time. At prenatal assessment, she is found to have blood group A and Rh(D)-negative. Her husband is tested and he is Rh(D)-positive. Which of the following is the most appropriate initial test to determine her risk for hemolytic disease of the newborn (erythroblastosis fetalis) due to Rh incompatibility?

(A) anti-Rh(D) antibody in maternal serum

(B) direct Coombs’ test of maternal serum

(C) anti-Rh

(D) antibody in baby’s serum

(D) ABO testing of the husband

(E) direct Coombs’ test of neonate serum after birth

45. A 63-year-old man presents with fatigue, shortness of breath on exertion, and easy bruising. He has no prior history of bleeding disorders, and is not taking any medications. On examination, his conjunctivae are pale, he has palpable spleen, and there are multiple bruises and petechiae on his legs. A CBC reveals a hemoglobin of 8.3 g/dL, WBC of 2300/mL, and platelets of 30,000/mL. A blood film also shows multiple lymphocytes with prominent cytoplasmic projections. A bone marrow biopsy also shows similar cells in the marrow and marrow fibrosis. Which of the following is the most likely diagnosis? (See Fig. 5–5.)

(A) lymphoma

(B) myeloma

(C) myelofibrosis and myeloid metaplasia

(D) hairy cell leukemia

(E) chronic myelogenous leukemia

46. A 22-year-old long-distance runner is found to be mildly anemic. He is asymptomatic; his stool is negative for occult blood, and the ferritin level is 200 ng/mL. Which intervention is most likely to result in return of the hemoglobin to normal?

(A) using more supportive footwear

(B) iron replacement

(C) folate replacement

(D) altering his exercise program

(E) investigating and treating gastrointestinal

(GI) pathology

47. A 49-year-old man presents with jaundice, nausea, and vomiting. He has a history of chronic alcoholism, and is currently drinking over one bottle of red wine a day. On physical examination, he is jaundiced and pale with a large tender liver. Laboratory data include hemoglobin of 9 g/dL, WBC of 4200/mL, and platelet count of 80,000/mL. His liver enzymes and bilirubin are also elevated. Ultrasound of the abdomen reveals liver enlargement with no bile duct obstruction, a normal size spleen, and no ascites. Which of the following is the most likely toxic effect of alcohol on the bone marrow?

(A) developing erythrocytes and myelocytes

(B) mature polymorphonuclear leukocytes

(C) mature red cells

(D) mature platelets

(E) eosinophils

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