D236 Pathophysiology Week 5 Study Guide: Hematologic and
Lymphatic Systems 2026 |WGU
1. A patient is diagnosed with pernicious anemia. Which of the following is the
underlying cause of this condition?
A. Lack of intrinsic factor leading to vitamin B12 malabsorption
B. Chronic blood loss leading to iron depletion
C. Genetic mutation in the hemoglobin beta chain
D. Bone marrow failure due to chemical exposure
Answer: A
Rationale: Pernicious anemia is specifically caused by a lack of intrinsic factor, which is
necessary for the absorption of Vitamin B12 in the terminal ileum.
2. Which clinical manifestation is a hallmark sign specific to iron deficiency
anemia?
A. Jaundice and dark urine
B. Neurological symptoms like paresthesia
C. Koilonychia (spoon-shaped nails)
D. Splenomegaly and hepatomegaly
Answer: C
Rationale: Koilonychia, or brittle spoon-shaped nails, along with glossitis and pica, are
classic physical signs associated with chronic iron deficiency.
,3. In the extrinsic pathway of the coagulation cascade, which factor is
responsible for initiating the process after tissue injury?
A. Factor XII (Hageman factor)
B. Factor VIII (Antihemophilic factor)
C. Tissue Factor (Factor III)
D. Factor IX (Christmas factor)
Answer: C
Rationale: The extrinsic pathway is activated when Tissue Factor (Factor III) is released
from damaged vascular endothelial cells.
4. What is the primary pathophysiology behind Disseminated Intravascular
Coagulation (DIC)?
A. An isolated deficiency in Factor VIII
B. Excessive production of red blood cells in the bone marrow
C. Widespread activation of the clotting cascade and simultaneous consumption of clotting factors
D. Autoimmune destruction of platelets in the spleen
Answer: C
Rationale: DIC involves systemic activation of coagulation, leading to microthrombi that
consume platelets and clotting factors, ultimately resulting in severe bleeding.
5. Reed-Sternberg cells are a diagnostic marker for which of the following
diseases?
A. Non-Hodgkin Lymphoma
B. Hodgkin Lymphoma
C. Chronic Myelogenous Leukemia (CML)
D. Multiple Myeloma
Answer: B
Rationale: The presence of Reed-Sternberg cells (large, multinucleated cells) in lymph
node biopsies is the definitive hallmark of Hodgkin Lymphoma.
, 6. A patient presents with a ‘Philadelphia chromosome’ mutation. This is most
strongly associated with which type of leukemia?
A. Acute Lymphocytic Leukemia (ALL)
B. Chronic Myelogenous Leukemia (CML)
C. Acute Myelogenous Leukemia (AML)
D. Chronic Lymphocytic Leukemia (CLL)
Answer: B
Rationale: The Philadelphia chromosome (a translocation between chromosomes 9 and
22) is found in 95% of patients with CML.
7. Which type of anemia is characterized by pancytopenia and a ‘dry tap’ during
bone marrow aspiration?
A. Sickle Cell Anemia
B. Hemolytic Anemia
C. Sideroblastic Anemia
D. Aplastic Anemia
Answer: D
Rationale: Aplastic anemia is characterized by the failure of bone marrow to produce all
three blood cell lines (RBCs, WBCs, and platelets), leading to pancytopenia.
8. Which condition is caused by a point mutation that results in the replacement
of glutamic acid with valine in the hemoglobin chain?
A. Sickle Cell Disease
B. Polycythemia Vera
C. Thalassemia
D. Pernicious Anemia
Answer: A
Rationale: Sickle Cell Disease is caused by a specific point mutation in the beta-globin gene
where valine replaces glutamic acid, leading to Hemoglobin S formation.
Lymphatic Systems 2026 |WGU
1. A patient is diagnosed with pernicious anemia. Which of the following is the
underlying cause of this condition?
A. Lack of intrinsic factor leading to vitamin B12 malabsorption
B. Chronic blood loss leading to iron depletion
C. Genetic mutation in the hemoglobin beta chain
D. Bone marrow failure due to chemical exposure
Answer: A
Rationale: Pernicious anemia is specifically caused by a lack of intrinsic factor, which is
necessary for the absorption of Vitamin B12 in the terminal ileum.
2. Which clinical manifestation is a hallmark sign specific to iron deficiency
anemia?
A. Jaundice and dark urine
B. Neurological symptoms like paresthesia
C. Koilonychia (spoon-shaped nails)
D. Splenomegaly and hepatomegaly
Answer: C
Rationale: Koilonychia, or brittle spoon-shaped nails, along with glossitis and pica, are
classic physical signs associated with chronic iron deficiency.
,3. In the extrinsic pathway of the coagulation cascade, which factor is
responsible for initiating the process after tissue injury?
A. Factor XII (Hageman factor)
B. Factor VIII (Antihemophilic factor)
C. Tissue Factor (Factor III)
D. Factor IX (Christmas factor)
Answer: C
Rationale: The extrinsic pathway is activated when Tissue Factor (Factor III) is released
from damaged vascular endothelial cells.
4. What is the primary pathophysiology behind Disseminated Intravascular
Coagulation (DIC)?
A. An isolated deficiency in Factor VIII
B. Excessive production of red blood cells in the bone marrow
C. Widespread activation of the clotting cascade and simultaneous consumption of clotting factors
D. Autoimmune destruction of platelets in the spleen
Answer: C
Rationale: DIC involves systemic activation of coagulation, leading to microthrombi that
consume platelets and clotting factors, ultimately resulting in severe bleeding.
5. Reed-Sternberg cells are a diagnostic marker for which of the following
diseases?
A. Non-Hodgkin Lymphoma
B. Hodgkin Lymphoma
C. Chronic Myelogenous Leukemia (CML)
D. Multiple Myeloma
Answer: B
Rationale: The presence of Reed-Sternberg cells (large, multinucleated cells) in lymph
node biopsies is the definitive hallmark of Hodgkin Lymphoma.
, 6. A patient presents with a ‘Philadelphia chromosome’ mutation. This is most
strongly associated with which type of leukemia?
A. Acute Lymphocytic Leukemia (ALL)
B. Chronic Myelogenous Leukemia (CML)
C. Acute Myelogenous Leukemia (AML)
D. Chronic Lymphocytic Leukemia (CLL)
Answer: B
Rationale: The Philadelphia chromosome (a translocation between chromosomes 9 and
22) is found in 95% of patients with CML.
7. Which type of anemia is characterized by pancytopenia and a ‘dry tap’ during
bone marrow aspiration?
A. Sickle Cell Anemia
B. Hemolytic Anemia
C. Sideroblastic Anemia
D. Aplastic Anemia
Answer: D
Rationale: Aplastic anemia is characterized by the failure of bone marrow to produce all
three blood cell lines (RBCs, WBCs, and platelets), leading to pancytopenia.
8. Which condition is caused by a point mutation that results in the replacement
of glutamic acid with valine in the hemoglobin chain?
A. Sickle Cell Disease
B. Polycythemia Vera
C. Thalassemia
D. Pernicious Anemia
Answer: A
Rationale: Sickle Cell Disease is caused by a specific point mutation in the beta-globin gene
where valine replaces glutamic acid, leading to Hemoglobin S formation.
