Q: Which of the following equations correctly represents the calculation of Mean Corpuscular Volume (MCV)?

$$MCV = \frac{Hematocrit (\%)}{RBC (\text{millions}/\mu L)} \times 10$$

Question 1

Which plasma protein is primarily responsible for maintaining oncotic pressure in the blood, and what is its clinical significance?

Accepted Answer

Albumin; it helps retain fluid within the vasculature, preventing edema.

Question 2

A 32-year-old woman presents with fatigue, pallor, and spoon-shaped nails. Laboratory results show low hemoglobin, low ferritin, and microcytic, hypochromic RBCs. Which is the most likely underlying cause?

Accepted Answer

Iron deficiency anemia due to chronic blood loss.

Question 3

Which of the following best describes the role of hepcidin in iron metabolism?

Accepted Answer

Hepcidin inhibits iron absorption and release from stores by downregulating ferroportin.

Question 4

A patient with chronic kidney disease develops anemia. Laboratory findings show normal iron stores but low transferrin saturation. What is the most likely mechanism?

Accepted Answer

Functional iron deficiency due to increased hepcidin levels.

Question 5

Which laboratory value is most useful for distinguishing between iron deficiency anemia and anemia of chronic disease?

Accepted Answer

Serum ferritin

Question 6

A 45-year-old male with a history of peptic ulcer disease presents with fatigue and low hemoglobin. Which medication is most likely to impair his iron absorption?

Accepted Answer

Omeprazole

Question 7

Which of the following best explains why vitamin B12 deficiency leads to neurologic symptoms, while folate deficiency does not?

Accepted Answer

Vitamin B12 is required for myelin synthesis in the nervous system.

Question 8

A patient with sickle cell disease is at increased risk for which of the following complications due to the pathophysiology of the disease?

Accepted Answer

Vaso-occlusive crises leading to organ infarction

Question 9

Which of the following best describes the difference between absolute and functional iron deficiency?

Accepted Answer

Absolute iron deficiency is due to depleted iron stores, while functional iron deficiency is due to impaired iron utilization despite adequate stores.

Question 10

A 60-year-old woman presents with macrocytic anemia, glossitis, and paresthesias. Laboratory studies reveal low vitamin B12. Which of the following is the most likely cause?

Accepted Answer

Autoimmune destruction of gastric parietal cells leading to loss of intrinsic factor

Question 11

Which of the following equations correctly represents the calculation of Mean Corpuscular Volume (MCV)?

Accepted Answer

$$MCV = \frac{Hematocrit (\%)}{RBC (	ext{millions}/\mu L)} 	imes 10$$

Question 12

A patient with thalassemia major is at risk for which of the following complications due to repeated blood transfusions?

Accepted Answer

Iron overload (secondary hemochromatosis)

Question 13

Which of the following best explains why reticulocyte count increases in hemolytic anemia?

Accepted Answer

Bone marrow compensates for increased RBC destruction by increasing erythropoiesis.

Question 14

A 25-year-old man develops acute hemolytic anemia after taking sulfa drugs. Which enzyme deficiency is most likely responsible?

Accepted Answer

Glucose-6-phosphate dehydrogenase (G6PD) deficiency

Question 15

Which of the following is a common clinical feature of megaloblastic anemia due to folate deficiency?

Accepted Answer

Macrocytic, oval-shaped RBCs on peripheral smear

Question 16

A patient presents with increased RBC mass, elevated hemoglobin, and hematocrit. Which of the following is the most likely diagnosis?

Accepted Answer

Polycythemia vera

Question 17

Which of the following best describes the function of transferrin in iron metabolism?

Accepted Answer

Transferrin transports iron in the plasma to various tissues.

Question 18

A patient with anemia has the following lab values: low hemoglobin, low MCV, low ferritin, and high RDW. Which type of anemia is most likely?

Accepted Answer

Iron deficiency anemia

Question 19

Which of the following is a typical time frame for the development of vitamin B12 deficiency after cessation of intake?

Accepted Answer

Several years due to substantial body stores

Question 20

A patient with anemia is found to have low hemoglobin, normal ferritin, low transferrin saturation, and high hepcidin. Which condition is most likely?

Accepted Answer

Anemia of chronic disease

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