UAMS HEMATOLOGY ACTUAL FINAL PAPER QUESTIONS
AND ANSWERS GRADED A+
✔✔What are some abnormalities seen in the bone marrow of someone with
megaloblastic anemia? - ✔✔RBC hyperplasia (M:E ratio 1:1)
Asynchrony
Karyorrhexis (degenerating/pyknotic cells)
Moth-eaten nuclei
Giant bands and metamyelocytes
✔✔True or False: LDH, bilirubin, MMA, and homocysteine are all increased in B12
deficiency anemia. - ✔✔True
✔✔What is the name of the test that can be done to differentiate pernicious anemia
from the other deficiencies of vitamin B12? - ✔✔Schilling Test
-evaluates body's ability to absorb B12
-oral dose of labeled vitamin is given to patient
-if Intrinsic Factor (IF) is present, the labeled B12 will be detected in the urine. If not, a
new does of labeled vitamin will be given with IF
-if absorption occurs with IF added, diagnosis is PA
✔✔What are some causes macrocytic cells that are not due to a megaloblastic
condition? - ✔✔Liver disease
Alcoholism
Reticulocytosis
Artifact (cold agglutinin, high glucose causing cells to swell, very high WBC count since
WBCs are included in RBC count)
✔✔Most microcytic anemias are due to an inadequate production of
________________. - ✔✔hemoglobin
✔✔Where does most of the iron in our bodies come from? - ✔✔Recycling
✔✔What is the MCV in microcytic anemias? - ✔✔Decreased, <80 fL
✔✔What is the MCH, MCHC, and RDW in microcytic anemias? - ✔✔MCH and MCHC -
decreased
RDW - increased
✔✔What is the name of the protein that transports iron in the body? - ✔✔Transferrin
✔✔Which form of iron is the dietary form - ferric or ferrous? - ✔✔Ferric
, ✔✔How is iron deficiency anemia usually acquired? - ✔✔Increased blood loss (GI bleed
or menstruation)
✔✔True or False: IDA can be acquired from lack of iron in the diet in a matter of weeks.
- ✔✔False. It takes years to develop IDA due to diet since our iron stores should have
enough for years.
✔✔Who is most likely to have IDA? - ✔✔Women and children
✔✔True or False: In order for IDA to develop, the first thing that happens is the iron
stores are depleted. - ✔✔True. 1st ferritin is decreased, then transferrin is decreased,
then functional iron is decreased.
✔✔What is a unique symptom of IDA? - ✔✔Pica, the urge to eat things that are not food
✔✔How is IDA treated? - ✔✔Treat the underlying cause (control chronic bleed)
Oral iron supplements or transfuse if severe
Iron injections if there is an absorption problem
✔✔What is hemosiderosis? - ✔✔Iron overload (increased iron in reticuloendothelial
cells)
✔✔What can cause hemosiderosis? - ✔✔Hemolytic anemia with massive transfusions
Erythropoiesis disorders where iron can't be used and is building up, such as
thalassemia
✔✔What is hemochromatosis? - ✔✔A more severe form of hemosiderosis where the
excess iron starts causing damage to the liver, pancreas, and heart
✔✔What causes hemochromatosis? - ✔✔Can be inherited
Acquired due to long term transfusions
Acquired due to long term cirrhosis
✔✔How is hemosiderosis treated? - ✔✔Therapeutic phlebotomy (draw and discard 1
unit of blood)
Iron chelation (treat w/ iron binding drug to excrete excess iron in the urine)
✔✔What is thalassemia? - ✔✔An inherited disorder in which globin chains are not
adequately produced
✔✔What RBC morphology is abundant in thalassemia? - ✔✔Codocytes/target cells
✔✔What is the most common anemia among hospitalized patients? - ✔✔Anemia of
Chronic Disease
AND ANSWERS GRADED A+
✔✔What are some abnormalities seen in the bone marrow of someone with
megaloblastic anemia? - ✔✔RBC hyperplasia (M:E ratio 1:1)
Asynchrony
Karyorrhexis (degenerating/pyknotic cells)
Moth-eaten nuclei
Giant bands and metamyelocytes
✔✔True or False: LDH, bilirubin, MMA, and homocysteine are all increased in B12
deficiency anemia. - ✔✔True
✔✔What is the name of the test that can be done to differentiate pernicious anemia
from the other deficiencies of vitamin B12? - ✔✔Schilling Test
-evaluates body's ability to absorb B12
-oral dose of labeled vitamin is given to patient
-if Intrinsic Factor (IF) is present, the labeled B12 will be detected in the urine. If not, a
new does of labeled vitamin will be given with IF
-if absorption occurs with IF added, diagnosis is PA
✔✔What are some causes macrocytic cells that are not due to a megaloblastic
condition? - ✔✔Liver disease
Alcoholism
Reticulocytosis
Artifact (cold agglutinin, high glucose causing cells to swell, very high WBC count since
WBCs are included in RBC count)
✔✔Most microcytic anemias are due to an inadequate production of
________________. - ✔✔hemoglobin
✔✔Where does most of the iron in our bodies come from? - ✔✔Recycling
✔✔What is the MCV in microcytic anemias? - ✔✔Decreased, <80 fL
✔✔What is the MCH, MCHC, and RDW in microcytic anemias? - ✔✔MCH and MCHC -
decreased
RDW - increased
✔✔What is the name of the protein that transports iron in the body? - ✔✔Transferrin
✔✔Which form of iron is the dietary form - ferric or ferrous? - ✔✔Ferric
, ✔✔How is iron deficiency anemia usually acquired? - ✔✔Increased blood loss (GI bleed
or menstruation)
✔✔True or False: IDA can be acquired from lack of iron in the diet in a matter of weeks.
- ✔✔False. It takes years to develop IDA due to diet since our iron stores should have
enough for years.
✔✔Who is most likely to have IDA? - ✔✔Women and children
✔✔True or False: In order for IDA to develop, the first thing that happens is the iron
stores are depleted. - ✔✔True. 1st ferritin is decreased, then transferrin is decreased,
then functional iron is decreased.
✔✔What is a unique symptom of IDA? - ✔✔Pica, the urge to eat things that are not food
✔✔How is IDA treated? - ✔✔Treat the underlying cause (control chronic bleed)
Oral iron supplements or transfuse if severe
Iron injections if there is an absorption problem
✔✔What is hemosiderosis? - ✔✔Iron overload (increased iron in reticuloendothelial
cells)
✔✔What can cause hemosiderosis? - ✔✔Hemolytic anemia with massive transfusions
Erythropoiesis disorders where iron can't be used and is building up, such as
thalassemia
✔✔What is hemochromatosis? - ✔✔A more severe form of hemosiderosis where the
excess iron starts causing damage to the liver, pancreas, and heart
✔✔What causes hemochromatosis? - ✔✔Can be inherited
Acquired due to long term transfusions
Acquired due to long term cirrhosis
✔✔How is hemosiderosis treated? - ✔✔Therapeutic phlebotomy (draw and discard 1
unit of blood)
Iron chelation (treat w/ iron binding drug to excrete excess iron in the urine)
✔✔What is thalassemia? - ✔✔An inherited disorder in which globin chains are not
adequately produced
✔✔What RBC morphology is abundant in thalassemia? - ✔✔Codocytes/target cells
✔✔What is the most common anemia among hospitalized patients? - ✔✔Anemia of
Chronic Disease
