3: Hematology / Leukocytes: Physiology

Erythrocytes: Physiology

1. The light-colored zone adjacent to the nucleus in a plasmacyte is the:

a. Ribosome
b. Chromatin
c. Mitochondria
d. Golgi area
2. The following are compounds formed in the synthesis of heme:
1. Coproporphyinogen
2. Porphobilinogen
3. Uroporphyrinigen
4. Protoporphyrinogen

Which of the following iron in n adult is found as a constituent of:

a. 4,3,1,2
b. 2,3,1,4
c. 4,2,3,1
d. 2,1,3,4

3. The majority of the iron in an adult is found as a constituent of:

a. Hemoglobin
b. Hemosiderin
c. Myoglobin
d. Transferrin

4. The main function of the hexose monophosphate shunt in the erythrocyte is to:
a. Regulate the level of 2,3-DPG
b. Provide reduced glutathione to prevent oxidation of the hemoglobin
c. Prevent the reduction of heme iron
d. Provide energy for membrane maintenance

5. Refer to the following illustration:

Which curve represents the production of alpha polypeptide chains of hemoglobin?

a. A
b. B
c. C
d. D

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 6. Refer to the following illustration:

Which curve represents the production of beta polypeptide chains of hemoglobin?

a. B
b. C
c. E
d. D

7. Refer to the following illustration:

Which curve represents the production of gamma polypeptide chains of hemoglobin?

a. A
b. B
c. C
d. D

8. Refer to the following illustration:

Which curve represents the production of delta polypeptide chains of hemoglobin?

a. B
b. C
c. D
d. E
 9. Refer to the following illustration:

Which curve represents the production of epsilon polypeptide chains of hemoglobin?

a. A
b. B
c. C
d. D

10. In order to hemoglobin to combine reversibly with oxygen, the iron must be:
a. Complexed with haptoglobin
b. Freely circulating in the cytoplasm
c. Attached to transferrin
d. In the ferrous state

11. In which of the following disease states are teardrop cells and abnormal platelets most
characteristically seen?
a. Hemolytic anemia
b. Multiple myeloma
c. G-6-PD deficiency
d. Myeloid metaplasia

12. The characteristic erythrocyte found in pernicious anemia is:

a. Microcytic
b. Spherocytic
c. Hypochromic
d. Macrocytic

13. In the normal adult, the spleen acts as a site for:

a. Storage of red blood cells
b. Production of red blood cells
c. Synthesis of erythropoietin
d. Removal of imperfect and aging cells
14. After the removal of red blood cells from the circulation hemoglobin is broken down into:
a. Iron, porphyrin and amino acids
b. Iron, protoporphyrin and globin
c. Heme, protoporphyrin and amino acid
d. Heme, hemosiderin and globin
15. Heinz bodies are:
a. Readily identified with polychrome stains
b. Rarely found in glucose-6-phosphate dehydrogenase deficient erythrocytes
c. Closely associated with spherocytes
d. Denatured hemoglobin inclusions that are readily removed by the spleen
16. Hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) is:
a. Temperature-dependent
b. Compliment-independent
c. Antibody-mediated
d. Caused by a red cell membrane defect
17. Cells for the transport of O2 and CO2 are:
a. Erythrocytes
b. Granulocytes
c. Lymphocytes
d. Thrombocytes
18. Erythropoietin acts to:
a. Shorten the replication time of the granulocytes
b. Stimulate RNA synthesis of erythroid cells
c. Increase colony-stimulating factors produced by the B-lymphocytes
d. Decrease the release of marrow reticulocytes
19. What cell shape is meat commonly associated with an increased MCHC?
a. Teardrop cells
b. Target cells
c. Spherocytes
d. Sickle cells
20. Which of the following is most closely associated with idiopathic hemochromatosis?
a. Iron overload in tissue
b. Target cells
c. Basophilic stippling
d. Ringed sideroblasts
21. A patient with polycythemia vera who is treated by phlebotomy is most likely to develop a
deficient of:
a. Iron
b. Vitamin B12
c. Folic acid
d. Erythropoietin
22. The direct antiglobulin test is often positive in:
a. Congenital hemolytic spherocytosis
b. March hemoglobinuria
c. Acquired hemolytic anemia
d. Thalassemia major
23. The anemia of chronic infection is characterized by:
a. Decreased iron stores in the reticuloendothelial system
b. Decreased serum iron levels
c. Macrocytic erythrocytes
d. Increased serum iron binding capacity
24. Factors commonly involved in producing anemia in patients with chronic renal disease include:
a. Marrow hypoplasia
b. Inadequate erythropoiesis
c. Vitamin B12 deficiency
d. Increased erythropoietin production
25. A 20-year old woman with sickle cell anemia whose usual hemoglobin concentration is 8g/dL
(80g/L) develops fever, increased weakness and malaise. The hemoglobin concentration is 4
g/dL (40g/L) and the reticulocyte count is 0.1%. the most likely explanation for her clinical
picture is:
a. Increased hemolysis due to hypersplenism
b. aplastic crisis
c. thrombotic crisis
d. occult blood loss