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38 Cards in this Set

  • Front
  • Back

Worldwide, which of the following is the most common type of anemia?


A. pernicious anemia


B. folate-deficiency anemia


C. anemia of chronic disease


D. iron-deficiency anemia



D. iron-deficiency anemia


Most of the body's iron is obtained from:


A. animal-based food sources

B. recycled iron content from aged red blood cells (RBCs)

C. endoplasmic reticulum production

D. vegetable-based food sources

B. recycled iron content from aged red blood cells (RBCs)

Which of the following is most consistent with


iron-deficiency anemia?


A. low mean corpuscular volume (MCV), normal mean corpuscular hemoglobin (MCH)

B. low MCV, low MCH


C. low MCV, elevated MCH

D. normal MCV, normal MCH

B. low MCV, low MCH

One of the earliest laboratory markers in evolving macrocytic or microcytic anemia is:


A. an increase in RBC distribution width (RDW)

B. a reduction in measurable hemoglobin

C. a low MCH level

D. an increased platelet count

A. an increase in RBC distribution width (RDW)

Possible lab change with 5 days of iron therapy post endometrial ablation for excessive perimenopausal bleeding and a Hct of 25%?

A. a correction of mean cell volume

B. an 8% increase in Hct level

C. reticulocytosis

D. a correction in ferritin level

C. reticulocytosis

Advice to 34 yo healthy male wanting to take iron supplments:

A. this is a prudent measure to ensure health

B. iron-deficiency anemia is a common problem in men of his age

C. use of an iron supplement in the absence of a documented deficiency can lead to iatrogenic iron overload

D. excess iron is easily excreted

C. use of an iron supplement in the absence of a documented deficiency can lead to iatrogenic iron overload

Which of the following is the best advice on taking ferrous sulfate to enhance iron absorption?


A. Take with other medications

B. Take on a full stomach

C. Take on an empty stomach

D. Do not take with vitamin C

C. Take on an empty stomach

Advice on taking ciprofloxacin and ferrous sulfate together:

A. take the medications with a large glass of water

B. can form an inactive drug compound if taken together

C. take the medications together to enhance adherence to therapy.

D. the ferrous sulfate potentially slows gastrointestinal motility and results in enhanced ciprofloxacin absorption.

B. an inactive drug compound is potentially formed if the two medications are taken together

One month into therapy for pernicious anemia, you wish to check the efficacy of the intervention. The best laboratory test to order at this point is a:


A. Schilling test

B. hemoglobin measurement

C. reticulocyte count

D. serum cobalamin

B. hemoglobin measurement

A woman who is planning a pregnancy should increase her intake of which of the following to minimize the risk of neural tube defect in the fetus?

A. iron

B. niacin

C. folic acid

D. vitamin C

C. folic acid

Risk factors for folate-deficiency anemia include:


A. menorrhagia

B. chronic ingestion of overcooked foods

C. use of nonsteroidal antiinflammatory drugs

D. gastric atrophy

B. chronic ingestion of overcooked foods

Folate-deficiency anemia causes which of the following changes in the RBC indices?


A. microcytic, normochromic

B. normocytic, normochromic

C. microcytic, hypochromic

D. macrocytic, normochromic

D. macrocytic, normochromic

Pernicious anemia is usually caused by:


A. dietary deficiency of vitamin B12

B. lack of production of intrinsic factor by the gastric mucosa

C. RBC enzyme deficiency

D. a combination of micronutrient deficiencies caused by malabsorption

B. lack of production of intrinsic factor by the gastric mucosa

Pernicious anemia causes which of the following changes in the RBC indices?


A. microcytic, normochromic

B. normocytic, normochromic

C. microcytic, hypochromic

D. macrocytic, normochromic

D. macrocytic, normochromic

Common physical examination findings in patients with pernicious anemia include:


A. hypoactive bowel sounds

B. stocking-glove neuropathy

C. thin, spoon-shaped nails

D. retinal hemorrhages

B. stocking-glove neuropathy

47 male presents with difficulty initiating and maintaining sleep and chronic


pharyngeal erythema with the following results on hemogram:


Hemoglobin (Hgb) = 15 g


Hct = 45%


RBC = 4.2 million mm3

MCV = 108 fL


MCHC = 33.2 g/dL


These values are most consistent with:

A. pernicious anemia

B. alcohol abuse

C. thalassemia minor

D. Fanconi disease

B. alcohol abuse

22-year-old Asain woman presenting without complaints. Hemogram results


are as follows:


Hgb = 9.1 g (normal 12 to 14 g)


Hct = 28% (normal 36% to 42%)


RBC = 5 million mm 3 (normal 3.2 to 4.3 million mm3)

MCV = 68 fL (normal 80 to 96 fL)


MCHC = 33.2 g/dL (normal 32 to 36 g/dL)


RBC distribution width (RDW) = 13% (normal 15%).

Reticulocytes = 1.5%


This is most consistent with the laboratory assessment of:

A. iron-deficiency anemia

B. Cooley anemia

C. alpha-thalassemia minor

D. hemoglobin Barts

C. alpha-thalassemia minor

68-year-old healthy male presents with


new onset of “huffing and puffing” with exercise for the past 3 weeks. Physical examination reveals conjunctiva pallor and a hemic murmur. Hemogram results are as


follows:


Hgb = 7.6 g


Hct = 20.5%


RBC = 2.1 million mm3

MCV = 76 fL


MCHC = 28 g/dL


RDW = 18.4%


Reticulocytes = 1.8%


The most likely cause of these finding is:

A. poor nutrition

B. occult blood loss

C. malabsorption

D. chronic inflammation

B. occult blood loss

57-year-old woman with rheumatoid arthritis on disease-modifying antirheumatic disease but continues to have poor disease control and find the following results :


Hgb = 10.5 g


Hct = 33%


RBC = 3.1 million mm3

MCV = 88 fL


MCHC = 32.8 g/dL


RDW = 12.2%


Reticulocytes = 0.8%


The laboratory findings are most consistent with:

A. pernicious anemia


B. anemia of chronic disease


C. beta-thalassemia minor


D. folate-deficiency anemia

C. beta-thalassemia minor

You examine a 27-year-old woman with menorrhagia who is otherwise well and note the following results on hemogram:


Hgb = 10.1 g


Hct = 32%


RBC = 2.9 million mm 3

MCV = 72 fL


MCHC = 28.2 g/dL


RDW = 18.9%


Physical examination is likely to include:

A. conjunctiva pallor

B. hemic murmur

C. tachycardia

D. no specific anemia-related findings

D. no specific anemia-related findings

Results of hemogram in a person with anemia of chronic disease include:

A. microcytosis

B. anisocytosis

C. reticulocytopenia

D. macrocytosis

C. reticulocytopenia

When prescribing erythropoietin supplementation, the NP considers that:

A. the adrenal glands are its endogenous source

B. the addition of micronutrient supplementation needed for erythropoiesis is advisable

C. its use is as an adjunct in treating thrombocytopenia

D. with its use, the RBC life span is prolonged

B. the addition of micronutrient supplementation needed for erythropoiesis is advisable

In the first weeks of anemia therapy with parenteral vitamin B12 in a 68-year-old woman with hypertension who is taking a thiazide diuretic, the patient should be


carefully monitored for:

A. hypernatremia

B. dehydration

C. hypokalemia

D. acidemia

C. hypokalemia

Which of the following conditions is unlikely to result in anemia of chronic disease?


A. rheumatoid arthritis

B. peripheral vascular disease

C. chronic renal insufficiency

D. osteomyelitis

B. peripheral vascular disease

In health, the ratio of hemoglobin to hematocrit is usually:


A. 1:1

B. 1:2

C. 1:3

D. 1:4

C. 1:3

An increase in the normal variation of RBC size is known as:

A. poikilocytosis

B. granulation

C. anisocytosis

D. basophilic stippling

C. anisocytosis

Erythropoietin is a glycoprotein that influences a stem cell to become a:


A. lymphocyte

B. platelet

C. neutrophil

D. red blood cell

D. red blood cell

Intervention in anemia of chronic disease most often includes:


A. oral vitamin B12

B. treatment of the underlying cause

C. transfusion

D. parenteral iron

B. treatment of the underlying cause

Poikilocytosis refers to alterations in a red blood cells:

A. thickness.

B. color

C. shape

D. size

C. shape

Which of the following is not consistent with anemia of chronic disease (ACD)?

A. NL RDW

B. NL MCHC

C. Hct less than 24%

D. NL to slightly elevated serum ferritin

C. Hct less than 24%

In children younger than age 6 years, accidental overdose of iron-containing products is:

A. easily treated

B. a source of significant GI upset

C. worrisome but rarely causes significant harm

D. a leading cause of fatal poisoning in the age group

D. a leading cause of fatal poisoning in the age group

When counseling a patient about the neurological alterations often associated with vitamin B12 deficiency, the NP advises that:

A. these usually resolve within days with appropriate therapy

B. if present for longer than 6 months, these changes are occasionally permanent

C. the use of parenteral vitamin B12 therapy is needed to ensure symptom resolution

D. cognitive changes associated with vitamin B12 deficiency are seldom reversible even with appropriate therapy

B. if present for longer than 6 months, these changes are occasionally permanent

When the cause of a macrocytic anemia is uncertain, the most commonly recommended additional testing includes which of the following?

A. haptoglobin and reticulocyte count

B. Schilling test and gastric biopsy

C. methylmalonic acid and homocysteine

D. transferrin and prealbumin

C. methylmalonic acid and homocysteine


True or False?


Anemia in children is potentially associated with


poorer school performance.

True

Ture or False?


During pregnancy, folic acid requirements increase two fold to four fold.

True

True or False?


The red blood cell content is approximately 90%


hemoglobin.

True

True or False?


Approximately 90% of the body's erythropoietin


is produced by the kidney.

True

Ture or False?


The body's normative response to anemia is


reticulocytopenia.

False