Exam 2: NR 283/NR 283 Pathophysiology Exam 2
A 52-year-old female with type 1 diabetes has had progressive renal failure over the past three years.
She is not on dialysis and her examination shows no abnormalities. Her hemoglobin level is 9 g/dL,
hematocrit is 29%, and mean corpuscular volume is 92 fL, and a blood smear shows normocytic,
normochromic cells. Which of the following is the most likely cause of the anemia?
A. Acute blood loss
B. Pernicious anemia
C. Sickle cell disease
D. Erythropoietin deficiency
E. Hemolytic anemia
F. Polycythemia vera - ANSWER:D. erythropoietin deficiency
Which of the following anemias has normocytic RBCs?
A. Hemolytic anemia
B. Vitamin B12 deficiency
C. Folate deficiency
D. Anemia of chronic disease - ANSWER:A. hemolytic anemia
A healthy 3-year-old girl is brought to the emergency department because of severe uncontrolled
nosebleed. She has a history of ear infections that have improved after treatment. Her temperature is
elevated. She has numerous small bruises on her arms and legs. Her laboratory studies show:
Hemoglobin 4.6 g/dL
Leukocyte count 3,000/mm3
Reticulocyte count 0.1%
Platelet count 12,000/mm3
Which of the following is the most likely explanation for these findings?
A. Anemia due to blood loss
B. Aplastic anemia
C. Sickle cell disease
,D. Mononucleosis - ANSWER:B. aplastic anemia
In the 5 month (middle trimester) fetus hematopoiesis is most active in the:
A. Yolk sac
B. Spleen
C. Liver
D. Bone marrow - ANSWER:C. liver
Following the donation of a unit of blood, how long before hematocrit begins to increase?
A. One hour
B. Two hours
C. 24 hours
D. Five days
E. Two weeks - ANSWER:DC (1-5 days)
How would a cell that has a diameter of 9 m and an MCV of 106 be classified?
A. Macrocyte
B. Microcyte
C. Normal
D. Either normal or slightly microcytic - ANSWER:A. macrocyte
What are the laboratory findings in polycythemia vera?
A. Decreased hemoglobin and/or hematocrit, increased RBCs and granulocytes, decreased platelets
B. Increased hemoglobin and/or hematocrit; increased RBCs, granulocytes, and platelets
C. Normal hemoglobin and hematocrit, normal RBCs, increased granulocytes and platelets
D. Increased hemoglobin and/or hematocrit, increased RBCs, decreased granulocytes and platelets -
ANSWER:D. increased hemoglobin and/or hematocrit, increased RBCs, decreased granulocytes and
platelets
Regarding erythropoietin, choose the correct answer:
A. Erythropoietin is mainly secreted by the liver
B. Injection of erythropoietin leads to a rapid increase in the number of circulating red blood cells within
the next 48 hours
,C. Excessive exposure to x-rays with destruction of the bone marrow leads to an increased erythropoietin
secretion
D. Erythropoietin also acts on the spleen by decreasing red blood cell destruction - ANSWER:C. excessive
exposure to x-rays with destruction of the bone marrow leads to an increased erythropoietin secretion
where is erythropoietin secreted? - ANSWER:kidneys
What is the safest and least expensive treatment for patients with polycythemia vera?
A. High altitude
B. Decrease of iron levels
C. Therapeutic phlebotomy
D. Decrease of erythropoietin levels - ANSWER:C. therapeutic phlebotomy
A mother of blood type A+ who has always been perfectly healthy just delivered her second child. The
father is of blood group O-. Knowing that the child is of blood group O- (O, Rh-), what would you expect
to find in this child?
A. The child will suffer from erythroblastosis fetalis due to rhesus incompatibility
B. The child will suffer from erythroblastosis fetalis due to ABO blood group incompatibility
C. The child will suffer from both A and B
D. The child has no chance of developing HDN - ANSWER:D. the child has no chance of developing HDN
Erythroblastosis fetalis due to Rhesus incompatibility can, in the newborn, lead to all of the following
conditions EXCEPT:
A. Severe anemia
B. Jaundice due to increased circulating levels of bilirubin
C. Mental retardation
D. Atrophy of the spleen and the liver - ANSWER:D. atrophy of the spleen and the liver
Which couple cannot be the biological parents of a child with blood group AB?
A. Mother AB, father AB
B. Mother AB, father OO
C. Mother OB, father AA
, D. Mother AA, father BB
E. Mother OA, father OB - ANSWER:B. Mother AB, father OO
Which of the following transfusions will result in an immediate transfusion reaction?
A. O Rh- blood to an AB Rh+ patient
B. B Rh+ blood to a A Rh+ patient
C. AB Rh- blood to an AB Rh+ patient
D. B Rh- blood to an B Rh- patient - ANSWER:B. B Rh+ blood to a A Rh+ patient
Which of the following is true concerning erythroblastosis fetalis?
A. There is a decrease in vitamin B12 in the fetus
B. There are increased numbers of granulocytes in the mother
C. The erythropoietin level of the fetus is decreased
D. The free hemoglobin level in the fetus is elevated - ANSWER:D. the free hemoglobin level in the fetus
is elevated
Which of the following is a true statement?
A. In a transfusion reaction there is agglutination of the donor blood
B. Shutdown of the kidneys following a transfusion reaction takes several weeks
C. Blood transfusion of Rh+ blood into any Rh- recipient will always result in an transfusion reaction
D. A person with type O blood is considered a universal donor - ANSWER:A. In a transfusion reaction
there is agglutination of the donor blood
A pregnant woman comes in for a visit. She is AB Rh+ and her husband is A Rh-. This is her second child.
What should be done at this time?
A. Nothing
B. Administer anti-D immunoglobulin to the mother at this time
C. Administer anti-D immunoglobulin to the child after delivery
D. Administer anti-D immunoglobulin to the child if the child is Rh+ - ANSWER:A. nothing
A previously healthy, blood type O+, 22-year-old woman is admitted to the hospital because of
gastrointestinal bleeding. She has a hematocrit of 25%. She receives three units of blood. During
A 52-year-old female with type 1 diabetes has had progressive renal failure over the past three years.
She is not on dialysis and her examination shows no abnormalities. Her hemoglobin level is 9 g/dL,
hematocrit is 29%, and mean corpuscular volume is 92 fL, and a blood smear shows normocytic,
normochromic cells. Which of the following is the most likely cause of the anemia?
A. Acute blood loss
B. Pernicious anemia
C. Sickle cell disease
D. Erythropoietin deficiency
E. Hemolytic anemia
F. Polycythemia vera - ANSWER:D. erythropoietin deficiency
Which of the following anemias has normocytic RBCs?
A. Hemolytic anemia
B. Vitamin B12 deficiency
C. Folate deficiency
D. Anemia of chronic disease - ANSWER:A. hemolytic anemia
A healthy 3-year-old girl is brought to the emergency department because of severe uncontrolled
nosebleed. She has a history of ear infections that have improved after treatment. Her temperature is
elevated. She has numerous small bruises on her arms and legs. Her laboratory studies show:
Hemoglobin 4.6 g/dL
Leukocyte count 3,000/mm3
Reticulocyte count 0.1%
Platelet count 12,000/mm3
Which of the following is the most likely explanation for these findings?
A. Anemia due to blood loss
B. Aplastic anemia
C. Sickle cell disease
,D. Mononucleosis - ANSWER:B. aplastic anemia
In the 5 month (middle trimester) fetus hematopoiesis is most active in the:
A. Yolk sac
B. Spleen
C. Liver
D. Bone marrow - ANSWER:C. liver
Following the donation of a unit of blood, how long before hematocrit begins to increase?
A. One hour
B. Two hours
C. 24 hours
D. Five days
E. Two weeks - ANSWER:DC (1-5 days)
How would a cell that has a diameter of 9 m and an MCV of 106 be classified?
A. Macrocyte
B. Microcyte
C. Normal
D. Either normal or slightly microcytic - ANSWER:A. macrocyte
What are the laboratory findings in polycythemia vera?
A. Decreased hemoglobin and/or hematocrit, increased RBCs and granulocytes, decreased platelets
B. Increased hemoglobin and/or hematocrit; increased RBCs, granulocytes, and platelets
C. Normal hemoglobin and hematocrit, normal RBCs, increased granulocytes and platelets
D. Increased hemoglobin and/or hematocrit, increased RBCs, decreased granulocytes and platelets -
ANSWER:D. increased hemoglobin and/or hematocrit, increased RBCs, decreased granulocytes and
platelets
Regarding erythropoietin, choose the correct answer:
A. Erythropoietin is mainly secreted by the liver
B. Injection of erythropoietin leads to a rapid increase in the number of circulating red blood cells within
the next 48 hours
,C. Excessive exposure to x-rays with destruction of the bone marrow leads to an increased erythropoietin
secretion
D. Erythropoietin also acts on the spleen by decreasing red blood cell destruction - ANSWER:C. excessive
exposure to x-rays with destruction of the bone marrow leads to an increased erythropoietin secretion
where is erythropoietin secreted? - ANSWER:kidneys
What is the safest and least expensive treatment for patients with polycythemia vera?
A. High altitude
B. Decrease of iron levels
C. Therapeutic phlebotomy
D. Decrease of erythropoietin levels - ANSWER:C. therapeutic phlebotomy
A mother of blood type A+ who has always been perfectly healthy just delivered her second child. The
father is of blood group O-. Knowing that the child is of blood group O- (O, Rh-), what would you expect
to find in this child?
A. The child will suffer from erythroblastosis fetalis due to rhesus incompatibility
B. The child will suffer from erythroblastosis fetalis due to ABO blood group incompatibility
C. The child will suffer from both A and B
D. The child has no chance of developing HDN - ANSWER:D. the child has no chance of developing HDN
Erythroblastosis fetalis due to Rhesus incompatibility can, in the newborn, lead to all of the following
conditions EXCEPT:
A. Severe anemia
B. Jaundice due to increased circulating levels of bilirubin
C. Mental retardation
D. Atrophy of the spleen and the liver - ANSWER:D. atrophy of the spleen and the liver
Which couple cannot be the biological parents of a child with blood group AB?
A. Mother AB, father AB
B. Mother AB, father OO
C. Mother OB, father AA
, D. Mother AA, father BB
E. Mother OA, father OB - ANSWER:B. Mother AB, father OO
Which of the following transfusions will result in an immediate transfusion reaction?
A. O Rh- blood to an AB Rh+ patient
B. B Rh+ blood to a A Rh+ patient
C. AB Rh- blood to an AB Rh+ patient
D. B Rh- blood to an B Rh- patient - ANSWER:B. B Rh+ blood to a A Rh+ patient
Which of the following is true concerning erythroblastosis fetalis?
A. There is a decrease in vitamin B12 in the fetus
B. There are increased numbers of granulocytes in the mother
C. The erythropoietin level of the fetus is decreased
D. The free hemoglobin level in the fetus is elevated - ANSWER:D. the free hemoglobin level in the fetus
is elevated
Which of the following is a true statement?
A. In a transfusion reaction there is agglutination of the donor blood
B. Shutdown of the kidneys following a transfusion reaction takes several weeks
C. Blood transfusion of Rh+ blood into any Rh- recipient will always result in an transfusion reaction
D. A person with type O blood is considered a universal donor - ANSWER:A. In a transfusion reaction
there is agglutination of the donor blood
A pregnant woman comes in for a visit. She is AB Rh+ and her husband is A Rh-. This is her second child.
What should be done at this time?
A. Nothing
B. Administer anti-D immunoglobulin to the mother at this time
C. Administer anti-D immunoglobulin to the child after delivery
D. Administer anti-D immunoglobulin to the child if the child is Rh+ - ANSWER:A. nothing
A previously healthy, blood type O+, 22-year-old woman is admitted to the hospital because of
gastrointestinal bleeding. She has a hematocrit of 25%. She receives three units of blood. During
