Quiz 28: Alterations of Erythrocyte Function
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1. What term is used to describe the capacity of some erythrocytes to vary in size, especially in relationship to some anemias?
a. Poikilocytosis c. Anisocytosis
b. Isocytosis d. Microcytosis
2. What is the fundamental physiologic manifestation of anemia?
a. Hypotension c. Hypoxia
b. Hyperesthesia d. Ischemia
3. The paresthesia that occurs in vitamin B12 deficiency anemia is a result of which of the following?
a. Reduction in acetylcholine receptors in the postsynaptic nerves
b. Myelin degeneration in the spinal cord
c. Destruction of myelin in peripheral nerves
d. Altered function of neurons in the parietal lobe
4. Which of the following describes how the body compensates for anemia?
a. Increasing rate and depth of breathing
b. Decreasing capillary vasoconstriction
c. Hemoglobin holding more firmly onto oxygen
d. Kidneys releasing more erythropoietin
5. Which of the following is classified as a megaloblastic anemia?
a. Iron deficiency c. Sideroblastic
b. Pernicious d. Hemolytic
6. Deficiencies in folate and vitamin B12 alter the synthesis of which of the following?
a. RNA c. DNA
b. Cell membrane d. Mitochondria
7. The underlying disorder of which anemia is a result of the defective secretion of the intrinsic factor, which is essential for the absorption of vitamin B12?
a. Microcytic c. Hypochromic
b. Pernicious d. Hemolytic
8. After a person has a subtotal gastrectomy for chronic gastritis, which type of anemia will result?
a. Iron deficiency c. Folic acid
b. Aplastic d. Pernicious
9. What causes the atrophy of gastric mucosal cells that result in pernicious anemia?
a. Erythrocyte destruction c. Vitamin B12 malabsorption
b. Folic acid malabsorption d. Poor nutritional intake
10. Which statement best describes a Schilling test?
a. Administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B12 deficiency
b. Measurement of antigen-antibody immune complexes in the blood to test for hemolytic anemia
c. Measurement of serum ferritin and total iron-binding capacity in the blood to test for iron deficiency anemia
d. Administration of folate and measurement in 2 hours of its level in a blood sample to test for folic acid deficiency anemia.
11. What is the treatment of choice for pernicious anemia (PA)?
a. Cyanocobalamin by oral intake
b. Vitamin B12 by injection
c. Ferrous fumarate by Z-track injection
d. Folate by oral intake
12. Which condition resulting from untreated pernicious anemia (PA) is fatal?
a. Brain hypoxia c. Heart failure
b. Liver hypoxia d. Renal failure
13. How is the effectiveness of vitamin B12 therapy measured?
a. Reticulocyte count c. Hemoglobin
b. Serum transferring d. Serum vitamin B12
14. Which statement about folic acid is false?
a. Folic acid absorption is dependent on the enzyme folacin.
b. Folic acid is stored in the liver.
c. Folic acid is essential for RNA and DNA synthesis within erythrocytes.
d. Folic acid is absorbed in the upper small intestine.
15. Which anemia produces small, pale erythrocytes?
a. Folic acid c. Iron deficiency
b. Hemolytic d. Pernicious
16. Which type of anemia is characterized by fatigue, weakness, and dyspnea, as well as conjunctiva of the eyes and brittle, concave nails?
a. Pernicious c. Aplastic
b. Iron deficiency d. Hemolytic
17. What is the most common cause of iron deficiency anemia (IDA)?
a. Decreased dietary intake c. Vitamin deficiency
b. Chronic blood loss d. Autoimmune disease
18. Continued therapy of pernicious anemia (PA) generally lasts how long?
a. 6 to 8 weeks c. Until the iron level is normal
b. 8 to 12 months d. The rest of one’s life
19. Sideroblastic anemia can occasionally result from an autosomal recessive transmission inherited from which relative?
a. Mother c. Grandfather
b. Father d. Grandmother
20. Clinical manifestations of mild-to-moderate splenomegaly and hepatomegaly, bronze-colored skin, and cardiac dysrhythmias are indicative of which anemia?
a. Iron deficiency c. Sideroblastic
b. Pernicious d. Aplastic
21. Considering sideroblastic anemia, what would be the expected effect on the plasma iron levels?
a. Plasma iron levels would be high.
b. Levels would be low.
c. Levels would be normal.
d. Levels would be only minimally affected.
22. In aplastic anemia (AA), pancytopenia develops as a result of which of the following?
a. Suppression of erythropoietin to produce adequate amounts of erythrocytes
b. Suppression of the bone marrow to produce adequate amounts of erythrocytes, leukocytes, and thrombocytes
c. Lack of DNA to form sufficient quantities of erythrocytes, leukocytes, and thrombocytes
d. Lack of stem cells to form sufficient quantities of leukocytes
23. What is the most common pathophysiologic process that triggers aplastic anemia (AA)?
a. Autoimmune disease against hematopoiesis by activated cytotoxic T (Tc) cells
b. Malignancy of the bone marrow in which unregulated proliferation of erythrocytes crowd out other blood cells
c. Autoimmune disease against hematopoiesis by activated immunoglobulins
d. Inherited genetic disorder with recessive X-linked transmission
24. An allogenic bone marrow transplantation remains the preferred method for treating which anemia?
a. Polycythemia vera c. Sideroblastic
b. Aplastic d. Anemia of chronic disease (ACD)
25. Which statement is true regarding warm autoimmune hemolytic anemia?
a. Warm autoimmune hemolytic anemia occurs primarily in men.
b. It is self-limiting and rarely produces hemolysis.
c. Erythrocytes are bound to macrophages and sequestered in the spleen.
d. Immunoglobulin M coats erythrocytes and binds them to receptors on monocytes.
26. When considering hemolytic anemia, which statement is true regarding the occurrence of jaundice?
a. Erythrocytes are destroyed in the spleen.
b. Heme destruction exceeds the liver’s ability to conjugate and excrete bilirubin.
c. The patient has elevations in aspartate transaminase (AST) and alanine transaminase (ALT).
d. The erythrocytes are coated with an immunoglobulin.
27. Erythrocyte life span of less than 120 days, ineffective bone marrow response to erythropoietin, and altered iron metabolism describe the pathophysiologic characteristics of which type of anemia?
a. Aplastic c. Anemia of chronic disease
b. Sideroblastic d. Iron deficiency
28. What is the primary cause of the symptoms of polycythemia vera?
a. Decreased erythrocyte count c. Increased blood viscosity
b. Destruction of erythrocytes d. Neurologic involvement
29. Treatment for polycythemia vera involves which of the following?
a. Therapeutic phlebotomy and radioactive phosphorus
b. Restoration of blood volume by plasma expanders
c. Administration of cyanocobalamin
d. Blood transfusions
30. Considering iron replacement therapy prescribed for iron deficiency anemia, who is likely to require long-term daily maintenance dosage?
a. A woman who has not yet experienced menopause
b. A teenager who is involved in strenuous athletics
c. A middle-aged man who smokes two packs of cigarettes a day
d. An older person demonstrating signs of dementia
31. Which statement is true regarding the physical manifestations of vitamin B12 deficiency anemia?
a. Vitamin B12 deficiency anemia seldom results in neurologic symptoms.
b. The chances of a cure are good with appropriate treatment.
c. The condition is reversible in 75% of the cases.
d. Symptoms are a result of demyelination.
32. A 2000 ml blood loss will produce which assessment finding? (Select all that apply.)
a. Air hunger
b. Normal blood pressure in the supine position
c. Rapid thready pulse
d. Cold clammy skin
e. lactic acidosis
33. Which medications are associated with an intermediate increase in a person’s risk for developing aplastic anemia? (Select all that apply.)
b. Chloramphenicol (Chloromycetin)
c. Phenytoin (Dilantin)
d. Trimethoprim-sulfamethoxazole (Bactrim)
34. Which conditions are generally included in the symptoms of pernicious anemia (PA)? (Select all that apply.)
b. Weight gain
c. Low hemoglobin
e. Low hematocrit
35. What are the clinical manifestations of folate deficiency anemia? (Select all that apply.)
36. Which diseases are commonly associated with anemia of chronic disease? (Select all that apply.)
a. Rheumatoid arthritis
b. Acquired immunodeficiency syndrome (AIDS)
c. Polycythemia vera
d. Systemic lupus erythematosus
e. Chronic hepatitis
Match the phrases with the corresponding terms. Options may be used more than once.
______ A. Normocytic-normochromic anemia
______ B. Microcytic-hypochromic anemia
______ C. Macrocytic-normochromic anemia
37. Pernicious anemia
38. Sideroblastic anemia
39. Aplastic anemia