Question

1.) The following lab test results -HGB=6.2 g/dl; Hct=18.7%, RBC=2.1 x10^6 cells/uL; MCV = 120 fL; MCHC = 33.2 g/dL; RDW = 23% - suggest that you include which of the following in your differential diagnosis? (Include all that apply)

a. Folate deficiency

b. B12 Deficiency

c. iron deficiency anemia

d. acute intrabdominal hemorrhage

e. none of the above

2). The presence of large numbers of nucleated RBC's and/or reticulocytes in the blood suggests that:

a. Your patient is producing erthrocytes at a greater than normal rate.

b. Your patient is producing erthrocytes at a slower than normal rate.

c. You patient's erythropoietic function is normal.

d. None of the above.

3). Patient's who are suffering from a chronic disease such as cancer, typically exhibit which type of anemia?

a. Normocytic

b. Microcytic

c. Macrocytic

4). Clinically evident neurological signs/symptoms are characteristic of:

a. Vitamin B12 deficiency

b. Folate deficiency

c. Normocytic anemia

d. Microcytic anemia

5). If you have an anemic patient who exhibits elevated methylmalonic acid and elevated homocysteine levels, you would expect the serum B12 level to be

a. Lower than normal

b. Normal

c. Higher than normal

6). If you have an anemic patient who exhibits normal methylmalonic acid and elevated homocysteine levels, you would expect the serum folate level to be

a. Lower than normal

b. Normal

c. Higher than normal

7). An hour after receiving a transfusion, your patient develops shortness of breath. Which of the following would you request? (Include all that apply)

a. Careful monitoring for development of a non-purpuric rash

b. A PA film of the chest

c. Close monoring of the patient's blood pressure

d. A repeat Hgb/Hct

e. Repeat measurement of patient's temperature

8). Cytokines and reactive oxygen species (free radicals) are responsible for the sign/symptoms of:

a. Transfusion-related Acute Lung Injury (TRALI)

b. Acute non-dyspneic transfusion reactions

c. Anaphylaxis

d. Transfusion-associated Circulatory Overload (TACO)

Answer 1

1. C) iron deficiency anemia.

The normal range for MCV is 80-96 fL. Increased MCV indicates macrocytic (large average RBC size) and it is seen in Vitamin B12 and/or folic acid deficiciency.

In iron deficiency anemia, the the MCV level will be low.MCV measure has no significance in assessing intraabdominal bleeding.

The given patient has MCV 120 fl which means he has no possibility of having iron deficiency anemia.hence the differential diagnosis is iron deficiency anemia.

2) A

3) B

4) A

5) A

6) A

7) B

8) A