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Section 17: Hematologic Disorders

Classification of anemias is not based on:

A. Pathophysiology

B. Morphology

C. RBC indices

D. Etiology

The answer is C. Anemia classification can be done through various methods. However, red blood cell indices can do not always distinguish between different types of anemias. For example, in vitamin B12 deficiency and folic acid deficiency anemia the MCV can be elevated. These indices can give clues about types of anemias, but are not definitive.

Stimulation of erythropoiesis

A. Is due to a decrease in tissue oxygen levels

B. Results in decreased release of reticulocytes from the bone marrow

C. Is due to an increase in tissue oxygen levels

D. Is due to rising levels of erythropoietin from the liver

The answer is A. Erythropoiesis increases when there is a drop in tissue oxygen levels. When this happens, the kidney produces more erythropoietin that stimulates the bone marrow to release more reticulocytes.

Serum iron levels in iron deficiency anemia:

A. May remain within the normal range

B. May have a 20% to 30% diurnal variation

C. Reflect the concentration of iron bound to transferrin

D. All of the above

The answer is D. Initially serum iron levels may not drop below normal range, despite the patient having iron deficiency anemia, due to the iron stores in the body. There is variation in this level depending on the time of the day and this level also represents iron is bound to transferrin.

Iron is best absorbed:

A. From vegetables

B. With concurrent tea administration

C. In the ferrous form

D. In an alkaline environment

The answer is C. There are several things that decrease oral iron absorption. Heme iron is better absorbed and this type of iron comes more from meats and not vegetables. Tea and wine due to the tannins decrease absorption. An acidic environment in the stomach increases absorption. Medication that suppress acid and make it more alkaline decrease absorption.

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