Barkley Hematology PRACTICE
QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP
GRADED A+*INSTANT DOWNLOAD PDF
1.
A 24-year-old woman presents with fatigue and heavy menstrual
bleeding. CBC shows hemoglobin 8.9 g/dL, MCV 68 fL, and elevated
RDW. Which diagnosis is most likely?
A. Vitamin B12 deficiency
B. Anemia of chronic disease
C. Iron-deficiency anemia
D. Hereditary spherocytosis
Iron deficiency typically produces a microcytic, hypochromic anemia
with increased RDW. Chronic blood loss from menstruation is a
common cause in reproductive-age women.
2.
Which laboratory finding is most consistent with iron-deficiency
anemia?
A. Increased ferritin
B. Decreased TIBC
C. Increased transferrin saturation
D. Decreased ferritin
Serum ferritin reflects iron stores and is typically decreased in iron
deficiency. Ferritin can be falsely elevated during inflammation.
,3.
A patient with iron-deficiency anemia asks about dietary sources of
heme iron. Which food is the best source?
A. Spinach
B. Fortified cereal
C. Lentils
D. Beef
Heme iron from animal products is generally absorbed more
efficiently than nonheme iron from plant sources.
4.
Which finding is characteristic of vitamin B12 deficiency?
A. Microcytosis
B. Low MCV
C. Macrocytosis with neurologic manifestations
D. Isolated thrombocytopenia
Vitamin B12 deficiency causes megaloblastic macrocytic anemia and
may produce paresthesias, gait abnormalities, and cognitive
changes.
5.
Which medication is associated with folate deficiency?
A. Acetaminophen
B. Methotrexate
C. Omeprazole for one week
D. Amoxicillin
Methotrexate inhibits dihydrofolate reductase and can interfere with
folate metabolism.
6.
,A patient has hemoglobin 7.8 g/dL, MCV 112 fL, hypersegmented
neutrophils, and paresthesias. Which deficiency is most likely?
A. Iron
B. Folate
C. Vitamin B12
D. Vitamin C
Macrocytosis, hypersegmented neutrophils, and neurologic
symptoms strongly suggest vitamin B12 deficiency.
7.
Which test is particularly useful for confirming vitamin B12 deficiency
when the serum B12 level is borderline?
A. Ferritin
B. Haptoglobin
C. Methylmalonic acid
D. Fibrinogen
Methylmalonic acid rises in vitamin B12 deficiency and is usually
normal in isolated folate deficiency.
8.
Which neurologic complication is associated with prolonged vitamin
B12 deficiency?
A. Peripheral edema
B. Subacute combined degeneration of the spinal cord
C. Myasthenia gravis
D. Cerebral aneurysm
Vitamin B12 deficiency can damage the posterior and lateral columns
of the spinal cord, producing subacute combined degeneration.
9.
, Which laboratory pattern is most consistent with anemia of chronic
disease?
A. Low ferritin and high TIBC
B. Low serum iron, low TIBC, and normal or increased ferritin
C. High serum iron and high TIBC
D. High transferrin saturation
Inflammation increases hepcidin, limiting iron availability. Ferritin is
often normal or elevated because it is also an acute-phase reactant.
10.
The primary regulatory hormone responsible for stimulating
erythropoiesis is:
A. Thrombopoietin
B. Hepcidin
C. Erythropoietin
D. Renin
Erythropoietin is primarily produced by the kidneys in response to
tissue hypoxia and stimulates erythroid precursor production.
11.
A patient with chronic kidney disease develops normocytic anemia.
Which mechanism is most likely?
A. Excessive folate production
B. Increased hemolysis
C. Reduced erythropoietin production
D. Increased iron absorption
Diseased kidneys may produce inadequate erythropoietin, resulting in
reduced red blood cell production.
12.
QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP
GRADED A+*INSTANT DOWNLOAD PDF
1.
A 24-year-old woman presents with fatigue and heavy menstrual
bleeding. CBC shows hemoglobin 8.9 g/dL, MCV 68 fL, and elevated
RDW. Which diagnosis is most likely?
A. Vitamin B12 deficiency
B. Anemia of chronic disease
C. Iron-deficiency anemia
D. Hereditary spherocytosis
Iron deficiency typically produces a microcytic, hypochromic anemia
with increased RDW. Chronic blood loss from menstruation is a
common cause in reproductive-age women.
2.
Which laboratory finding is most consistent with iron-deficiency
anemia?
A. Increased ferritin
B. Decreased TIBC
C. Increased transferrin saturation
D. Decreased ferritin
Serum ferritin reflects iron stores and is typically decreased in iron
deficiency. Ferritin can be falsely elevated during inflammation.
,3.
A patient with iron-deficiency anemia asks about dietary sources of
heme iron. Which food is the best source?
A. Spinach
B. Fortified cereal
C. Lentils
D. Beef
Heme iron from animal products is generally absorbed more
efficiently than nonheme iron from plant sources.
4.
Which finding is characteristic of vitamin B12 deficiency?
A. Microcytosis
B. Low MCV
C. Macrocytosis with neurologic manifestations
D. Isolated thrombocytopenia
Vitamin B12 deficiency causes megaloblastic macrocytic anemia and
may produce paresthesias, gait abnormalities, and cognitive
changes.
5.
Which medication is associated with folate deficiency?
A. Acetaminophen
B. Methotrexate
C. Omeprazole for one week
D. Amoxicillin
Methotrexate inhibits dihydrofolate reductase and can interfere with
folate metabolism.
6.
,A patient has hemoglobin 7.8 g/dL, MCV 112 fL, hypersegmented
neutrophils, and paresthesias. Which deficiency is most likely?
A. Iron
B. Folate
C. Vitamin B12
D. Vitamin C
Macrocytosis, hypersegmented neutrophils, and neurologic
symptoms strongly suggest vitamin B12 deficiency.
7.
Which test is particularly useful for confirming vitamin B12 deficiency
when the serum B12 level is borderline?
A. Ferritin
B. Haptoglobin
C. Methylmalonic acid
D. Fibrinogen
Methylmalonic acid rises in vitamin B12 deficiency and is usually
normal in isolated folate deficiency.
8.
Which neurologic complication is associated with prolonged vitamin
B12 deficiency?
A. Peripheral edema
B. Subacute combined degeneration of the spinal cord
C. Myasthenia gravis
D. Cerebral aneurysm
Vitamin B12 deficiency can damage the posterior and lateral columns
of the spinal cord, producing subacute combined degeneration.
9.
, Which laboratory pattern is most consistent with anemia of chronic
disease?
A. Low ferritin and high TIBC
B. Low serum iron, low TIBC, and normal or increased ferritin
C. High serum iron and high TIBC
D. High transferrin saturation
Inflammation increases hepcidin, limiting iron availability. Ferritin is
often normal or elevated because it is also an acute-phase reactant.
10.
The primary regulatory hormone responsible for stimulating
erythropoiesis is:
A. Thrombopoietin
B. Hepcidin
C. Erythropoietin
D. Renin
Erythropoietin is primarily produced by the kidneys in response to
tissue hypoxia and stimulates erythroid precursor production.
11.
A patient with chronic kidney disease develops normocytic anemia.
Which mechanism is most likely?
A. Excessive folate production
B. Increased hemolysis
C. Reduced erythropoietin production
D. Increased iron absorption
Diseased kidneys may produce inadequate erythropoietin, resulting in
reduced red blood cell production.
12.
