MLT GlobeHematology: RBC indices & anemias
138 Hematology MCQs on RBC indices & anemias with answers and explanations.
A CBC shows reduced red cells, white cells and platelets at the same time. What term describes this?
Pancytopenia means all three blood lineages are decreased, as seen in marrow failure or infiltration. Thrombocytopenia and leukopenia each refer to a single lineage.
Which range is typical for the red cell count of a healthy adult woman?
Adult female RBC counts are usually around 4.0–5.2 × 10^12/L, slightly lower than men. Laboratories should use locally validated intervals.
Which range is typical for the red cell count of a healthy adult man?
Adult men usually have RBC counts of about 4.5–5.9 × 10^12/L, higher than women because testosterone stimulates erythropoietin. Use locally validated intervals.
Which protein holds the readily mobilized storage iron of the body and is measured in serum to assess iron stores?
Ferritin is the soluble, readily available iron store and its serum level mirrors body stores. Hemosiderin is an insoluble, slowly released form; transferrin transports iron.
Which red cell index expresses average cell size, with a typical adult range of about 80–100 fL?
Mean cell volume in femtolitres classifies anemias as micro-, normo- or macrocytic. MCH is picograms per cell; RDW shows variation in size.
Which red cell index reports average hemoglobin mass per cell, typically about 27–33 pg?
Mean cell hemoglobin is Hb divided by RBC count, expressed in picograms. MCHC is a concentration (g/dL) and MCV is volume (fL).
Which red cell index gives the average hemoglobin concentration within red cells, normally about 32–36 g/dL?
MCHC is Hb divided by hematocrit. A raised MCHC suggests spherocytes or interference such as cold agglutinins; low values accompany hypochromia.
What is a typical reference interval for reticulocytes in a healthy adult?
Normal marrow output gives about 0.5–2.5% reticulocytes (roughly 25–100 × 10^9/L). Higher values indicate a response to hemolysis or bleeding.
Rouleaux formation in a blood sample mainly affects which test result?
Stacked red cells sediment faster because of their greater mass-to-surface ratio, raising the ESR. Raised fibrinogen and globulins promote rouleaux.
A patient with a poor diet and high alcohol intake develops macrocytic anemia with megaloblasts in the marrow. Which deficiency is most likely?
Folate is needed for thymidine synthesis; its lack causes megaloblastic anemia. Poor diet and alcohol commonly cause folate deficiency. Iron deficiency causes microcytosis.
Which of these is the most common cause of iron deficiency anemia in adults?
Chronic loss, such as heavy menstruation or gastrointestinal bleeding, depletes iron stores. In men and postmenopausal women, a GI source must be looked for.
Vitamin B12 is also known by which name?
B12 contains cobalt and is called cobalamin. Thiamine is B1, riboflavin B2 and niacin B3.
Fanconi anemia is best described as which kind of anemia?
Fanconi anemia is an inherited DNA repair disorder causing marrow failure, often with skeletal anomalies. Chromosome breakage testing confirms it.
Which anemia is typically normocytic and normochromic?
Marrow failure reduces cell numbers without altering hemoglobin synthesis, giving normocytic indices (sometimes mildly macrocytic). Iron deficiency and thalassemia are microcytic; B12 deficiency is macrocytic.
Two parents both have sickle cell trait (HbAS). What is the chance that each child will have sickle cell anemia (HbSS)?
Sickle cell disease is autosomal recessive. Each carrier parent passes the HbS allele half the time, so each child has a 1 in 4 chance of HbSS.
Red cells with an enlarged area of central pallor, making them look pale, are described as what?
Hypochromia means reduced hemoglobin content, seen as central pallor over one third of the cell diameter, as in iron deficiency and thalassemia.
An 18-year-old woman has Hb 9.8 g/dL, RBC 3.6 × 10^12/L, MCV 70 fL and MCH 21.8 pg. What is expected on her blood film?
Low MCV and MCH indicate small, pale red cells, as in iron deficiency or thalassemia. Macrocytes suggest B12 or folate deficiency.
A microcytic hypochromic blood picture with normal ferritin suggests which condition?
Thalassemias reduce globin synthesis, giving small pale cells despite normal iron stores. The other conditions are usually normocytic.
In which condition are megaloblasts found in the bone marrow?
Folate or B12 deficiency slows DNA synthesis, so nuclei lag behind cytoplasm, producing large megaloblasts. Aplastic marrow is hypocellular.
A raised reticulocyte count is expected in which condition?
Healthy marrow responds to hemolysis by releasing more reticulocytes. Marrow failure, megaloblastic anemia and low erythropoietin all blunt this response.