3: Hematology | Erythrocytes: Physiology Questions 8 Refer to the following illustration present lypeptide chains Which curve represents the production of delta polypeptide chains of hemoglobin? aB bc «D ade 9 Refer to the following illustration: 6 -3 birth 3 6 (Months) S 50 ¥B 6 _ 40 85 30} Be 20] Qo 10- So & x Which curve represents the production of epsilon polypeptide chains of hemoglobin? 10 In order for hemoglobin to combine reversibly with oxygen, the iron must be a complexed with haptoglobin b freely circulating in the cytoplasm € attached to transferrin in the ferrous state 11 _Inwhich of the following disease states are teardrop cells and abnormal platelets most characteristically seen? a hemolytic anemia b multiple myeloma © G-6-PD deficiency d_ myeloid metaplasia ‘The characteristic erythrocyte found in pernicious anemia is: microcytic spherocytic hypochromic macrocytic aooe Clinical Laboratory Certification Examinations 147Hematology | Erythrocytes: Physiology Questions In the normal adult, the spleen acts as a site for: storage of red blood cells b production of red blood cells synthesis of erythropoietin d_ removal of imperfect and aging cells After the removal of red blood cells from the circulation hemoglobin is broken down into: iron, porphyrin, and amino acids b iron, protoporphyrin, and globin € heme, protoporphyrin, and amino acids heme, hemosiderin, and globin Heinz bodies are: readily identified with polychrome stains rarely found in glucose-6-phosphate dehydrogenase deficient erythrocytes closely associated with spherocytes denatured hemoglobin inclusions that are readily removed by the spleen ane Hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) is: a temperature-dependent b complement-independent ¢ antibody-mediated caused by a red cell membrane defect Cells for the transport of O7 and CO> are: a erythrocytes b granulocytes € lymphocytes 4 thrombocytes Erythropoietin acts to: a shorten the replication time of the granulocytes b stimulate RNA synthesis of erythroid cells € increase colony-stimulating factors produced by the B-lymphocytes d decrease the release of marrow reticulocytes What cell shape is most commonly associated with an increased MCHC? a teardrop cells b target cells ‘© spherocytes sickle cells Which of the following is most closely associated with idiopathic hemochromatosis? iron overload in tissue b target cells € basophilic stippling ringed sideroblasts 148 The Board of Certification Study Guide3: Hematology | Erythrocytes: Disease States Questions Erythrocytes: Disease States 21 22 23 24 tas ny 25 26 us oxy 27 A patient with polycythemia vera who is treated by phlebotomy is most likely to develop a deficiency of: a iron b vitamin By» © folic acid 4 erythropoietin ‘The direct antiglobulin test is often positive in: congenital hemolytic spherocytosis march hemoglobinuria acquired hemolytic anemia thalassemia major ange ‘The anemia of chronic infection is characterized by: decreased iron stores in the reticuloendothelial system decreased serum iron levels macrocytic erythrocytes increased serum iron binding capacity nage Factors commonly involved in producing anemia in patients with chronic renal disease include. a marrow hypoplasia b inadequate erythropoiesis ¢ vitamin By) deficiency 4 increased erythropoietin production A.20-year-old woman with sickle cell anemia whose usual hemoglobin concentration is 8 g/dL (80 g/L) develops fever, increased weakness and malaise. The hemoglobin concentration is 4 g/dL. (40 g/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 ¢ thrombotic crisis occult blood loss ‘The hypoproliferative red cell population in the bone marrow of uremic patients is caused by: infiltration of bone marrow by toxic waste products decreased levels of circulating erythropoietin defective globin synthesis overcrowding of bone marrow space by increased myeloid precursors anos Which of the following characteristics are common to hereditary spherocytosis, hereditary elliptocytosis, hereditary stomatocytosis, and paroxysmal nocturnal hemoglobinuria? autosomal dominant inheritance red cell membrane defects positive direct antiglobulin test measured platelet count poo Clinical Laboratory Certification Examinations 149