MCQ on Anemia Classification, Pathogenesis and Diagnosis: Pathology

Multiple Choice Question on Classification, Pathogenesis, and Diagnosis of Anemia

1) Anemia is a reduction of total circulating red cell mass below the normal limits. The classical symptoms include palpitation, dizziness, angina, pallor of skin and nails, weakness, etc. 

Which of the following laboratory parameter is used to classify anemia into microcytic, normocytic, or macrocytic?

a) Mean Corpuscular Volume

b) Mean Corpuscular Hemoglobin

c) Mean Corpuscular Hemoglobin Concentration 

d) Red Cell Distribution Width

2) Based on the size of the red blood cells, microcytic anemia is defined when the mean corpuscular volume (MCV) is ...................................

a) Less than 80 fL/cell

b) Less than 120 fL/cell

c) Less than 160 fL/cell

d) Less than 200 fL/cell

3) Which of the following condition is not associated with microcytic anemia?

a) Iron Deficiency Anemia 

b) Aplastic Anemia 

c) Sieroblastic Anemia 

d) Thalassemia 

4) Identify the pathological condition associated with normocytic anemia

a) Sickle Cell Anemia 

b) G6PD deficiency

c) Aplastic Anemia 

d) All of the above

e) None of the above

5) Identify the pathological condition associated with macrocytic anemia

a) Sideroblastic anemia  

b) Folic acid deficiency

c) Autoimmune hemolytic anemia 

d) Myelofibrosis

6) Identify the anemia caused by diminished erythropoiesis 

a) Megaloblastic anemia

b) Iron deficiency anemia 

c) Aplastic Anemia 

d) All of the above

e) None of the above

7) Identify the underlying cause of hemolytic anemia from the following choices

a) Sickle-cell Disease

b) G6PD deficiency

c) Thalassemia 

d) All of the above

e) None of the above

8) Which of the following iron testing panel represents the diagnosis of iron deficiency anemia?

a) Increased Iron, Increased TIBC, Decreased % Saturation & Decreased Serum Ferritin

b) Decreased Iron, Increased TIBC, Decreased % Saturation & Decreased Serum Ferritin

c) Decreased Iron, Decreased TIBC, Decreased % Saturation & Increased Serum Ferritin

d) Decreased Iron, Normal TIBC, Normal % Saturation, Decreased Serum Ferritin

9) Which of the following iron testing panel represents the diagnosis of anemia of chronic disease?

a) Increased Iron, Increased TIBC, Decreased % Saturation & Decreased Serum Ferritin

b) Decreased Iron, Increased TIBC, Decreased % Saturation & Decreased Serum Ferritin

c) Decreased Iron, Decreased TIBC, Decreased % Saturation & Increased Serum Ferritin

d) Decreased Iron, Normal TIBC, Normal % Saturation, Decreased Serum Ferritin

10) Hereditary spherocytosis (HS) is an autosomal dominant disorder caused by a defect involving ankyrin and spectrin in the erythrocyte membrane; this causes a decrease in the erythrocyte surface membrane. 

Which of the following statement is true regarding spherocytosis?

a) Decreased Osmotic Fragility

b) Mild Hemolytic Anemia 

c) Normal MCH

d) All of the above

e) None of the above

11) Paroxysmal nocturnal hemoglobinuria (PNH) is hemolytic anemia caused by an acquired somatic mutation of a gene (PIGA) that encodes an anchor for proteins (CD55 and CD59) in the cell membrane. Identify the correct statement regarding PNH

a) Mutation of PIGA gene causes complement-mediated lysis of red blood cells

b) May causes pancytopenia and venous thrombosis

c) Increases the antibodies against Rh antigen on erythrocytes 

d) All of the above

12) Identify the underlying cause of hemolytic anemia from the following?

a) Pyruvate kinase deficiency

b) Hereditary elliptocytosis

c) Hereditary spherocytosis

d) All of the above

e) None of the above

13) Hereditary elliptocytosis is caused by.........................................................

a) Mutation of gene encoding pyruvate dehydrogenase

b) Mutation of gene encoding spectrin

c) Mutation of gene encoding ankyrin

d) All of the above

e) None of the above 

14) Polycythemia refers to increased red cell mass. 

Polycythemia can occur from which of the following conditions?

a) Chronic obstructive pulmonary disease

b) Cyanotic congenital heart disease 

c) Renal cell carcinoma 

d) All of the above 

e) None of the above

15) Aplastic anemia refers to a syndrome of chronic primary hematopoietic failure and attendant pancytopenia. 

Which of the following is not the acquired etiology of aplastic anemia?

a) Alkylating agents

b) Chloramphenicol

c) Fanconi syndrome

d) Cytomegalovirus infection

 

MCQ Answers:

1-a) Mean Corpuscular Volume, the classification is based on Red Blood Cell Size also known as Mean corpuscular volume.

2-a) Less than 80 fL/cell. Anemia characterized by smaller than normal red blood cells. It is often associated with iron deficiency anemia and thalassemias.

3-a) Iron Deficiency Anemia, anemia characterized by smaller than normal red blood cells.

4-d) All of the above, anemia with red blood cells of normal size.

5-b) Folic acid deficiency, Anemia characterized by larger-than-normal red blood cells. It is often due to deficiencies in vitamin B12 or folate.

6-d) All of the above. Erythropoiesis is the process by which red blood cells (erythrocytes) are produced in the bone marrow. When the RBCs production is low or diminished  different types of anemia can occur.

7-d) All of the above. Hemolytic anemia is a type of anemia characterized by the accelerated destruction of red blood cells in the bloodstream or in the spleen, this can lead to a decreased red blood cell count and a reduced capacity to carry oxygen.  Sickle-cell Disease, G6PD deficiency and Thalassemia are the primary cause or factors that result in hemolytic anemia.

8-b) Decreased Iron, Increased T IBC, Decreased % Saturation & Decreased Serum Ferritin

9-c) Decreased Iron, Decreased TIBC, Decreased % Saturation & Increased Serum Ferritin

10-b) Mild Hemolytic Anemia 

11-d) All of the above

12-Option a & b

13-b) Mutation of gene encoding spectrin

14-d) All of the above. Polycythemia is an abnormal increase in the number of red blood cells in the bloodstream

15-c) Fanconi syndrome. It is a rare disorder that affects the kidneys' ability to reabsorb certain substances in the urine, leading to their excessive excretion.