ATI Hematologic System Quizlet

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NADPH is a product of the hexose monophosphate pathway (HMP) in the red blood cell. The NADPH is used for the

  • A. Synthesis of fatty acids
  • B. Reduction of glutathione
  • C. Formation of ATP
  • D. Removal of oxygen radicals
Correct Answer: B

Rationale: The correct answer is B: Reduction of glutathione. In the hexose monophosphate pathway (HMP), NADPH is generated, which serves as a reducing agent. This NADPH is crucial for reducing oxidized glutathione back to its reduced form, maintaining cellular antioxidant defense. This process helps to protect cells from oxidative damage and maintain redox balance.

Now, let's summarize why the other choices are incorrect:
A: Synthesis of fatty acids - NADPH is indeed involved in fatty acid synthesis, but in the context of red blood cells, the primary role of NADPH is in reducing glutathione.
C: Formation of ATP - NADPH is not directly involved in ATP synthesis. ATP is primarily produced through processes like glycolysis and oxidative phosphorylation.
D: Removal of oxygen radicals - While NADPH indirectly contributes to the removal of oxygen radicals through its role in reducing glutathione, it is not the primary function of NAD

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Splenectomy is contraindicated in:

  • A. pyruvate kinase def.
  • B. ITP
  • C. BM failure
  • D. angiogenic myeloid metaplasia
Correct Answer: C

Rationale: The correct answer is C: BM failure. Splenectomy is contraindicated in patients with bone marrow failure due to conditions such as aplastic anemia or myelodysplastic syndromes. The spleen plays a role in removing abnormal blood cells, and removing it can worsen cytopenias in these patients. Choices A, B, and D are not contraindications for splenectomy as they do not directly involve the bone marrow function. Pyruvate kinase deficiency (A) does not affect bone marrow function, ITP (B) is a platelet disorder, and angiogenic myeloid metaplasia (D) is a condition related to abnormal blood cell production, not bone marrow failure.

You are consulted on a 4-year-old girl who is newly diagnosed with standard-risk pre-B acute lymphoblastic leukemia. After reviewing her previous complete blood examinations, you note she has had a platelet count ranging from 80,000 to 100,000 cells/mcL over the past 2 years. Her father mentions that he has also been told he has mild thrombocytopenia. You suspect the child may have a cancer predisposition syndrome. Which sample should you send for analysis, and which gene is most likely implicated?

  • A. Skin fibroblasts to evaluate the RUNX1 gene
  • B. Skin fibroblasts to evaluate the ETV6 gene
  • C. Buccal swab to evaluate the RUNX1 gene
  • D. Buccal swab to evaluate the ETV6 gene
Correct Answer: B

Rationale: The correct answer is B: Skin fibroblasts to evaluate the ETV6 gene.
1. ETV6 gene mutations are associated with inherited thrombocytopenia, making it a likely candidate in this case.
2. Skin fibroblasts are needed for genetic analysis as they provide a reliable sample for detecting genetic mutations.
3. RUNX1 gene mutations are also linked to thrombocytopenia but are more commonly associated with familial platelet disorder with predisposition to acute myeloid leukemia.
4. Buccal swabs are not ideal for evaluating genetic mutations related to thrombocytopenia as they may not provide sufficient genetic material for accurate testing.

Outstanding feature of ITP:

  • A. fever
  • B. gum bleeding
  • C. moderate splenomegaly
  • D. stema tenderness
Correct Answer: B

Rationale: The correct answer is B: gum bleeding. In immune thrombocytopenic purpura (ITP), the hallmark feature is low platelet count leading to easy bruising and bleeding, including gum bleeding. Fever (choice A) is not a typical feature of ITP. Moderate splenomegaly (choice C) is less common in ITP. Stema tenderness (choice D) is not a recognized feature of ITP. Therefore, gum bleeding is the outstanding feature of ITP due to the primary underlying mechanism of platelet destruction.

A 72-year-old male with enlargement of superficial lymph nodes and mild hepatosplenomegaly is diagnosed as having chronic lymphatic leukemia (CLL). The most important criteria for diagnosis of this disease is the

  • A. Presence of hypogammaglobulinemia
  • B. Absolute lymphocytes
  • C. Male predominance
  • D. Presence of enlarged lymph nodes
Correct Answer: B

Rationale: The correct answer is B: Absolute lymphocytes. In CLL, the most important diagnostic criterion is an absolute lymphocyte count of more than 5,000 cells per microliter in the peripheral blood. This is a key feature of CLL and distinguishes it from other conditions. Hypogammaglobulinemia (choice A) may occur in CLL but is not as specific for diagnosis. Male predominance (choice C) is a general characteristic of CLL but is not a diagnostic criterion. Presence of enlarged lymph nodes (choice D) is a common manifestation of CLL but not the most important criteria for diagnosis.

In microcytic hypochromic anaemia

  • A. Red cells are larger with normal staining
  • B. Red blood cell count is increased
  • C. Haemtocrit and mean corpuscular haemoglobin are normal
  • D. Red cells are smaller with a pale large central pallor
Correct Answer: D

Rationale: In microcytic hypochromic anemia, red cells are smaller with decreased hemoglobin content, leading to pale appearance. Choice D is correct as it describes the typical characteristics of microcytic hypochromic anemia. Choice A is incorrect as red cells are smaller, not larger. Choice B is incorrect as red blood cell count is usually decreased. Choice C is incorrect as both hematocrit and mean corpuscular hemoglobin are decreased in microcytic hypochromic anemia.

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