Lead poisoning causes anemia because it does which of the following?

A) binds to hemoglobin with high affinity

B) causes increased iron absorption from gut, disrupting heme synthesis

C) disrupts DNA synthesis, causing megaloblastic changes in RBC

D) inhibits ferrochelatase, disrupting heme synthesis

E) increases the action of aminolevulinate dehydratase, disrupting heme synthesis

A 60 year old woman presents to her physician with decreased proprioception in her lower extremities and gait instability secondary to cobalamin deficiency. Blood tests show normal hematocrit and near normal MCV. The physician orders more tests, which of the following support a diagnosis of cobalamin deficiency?

A) decreased LDH

B) elevated MMA

C) elevated WBC count

D) increased cobalamin level

E) microcytosis

F) Negative anti-intrinsic factor antibody

G) negative Schilling test

A type of lymphoma is characterized by onset of middle age and by neoplastic cells that resemble normal germinal center B lymphocytes. Additionally it is the most common type of non-Hodgkin's lymphoma in the US. What is the characteristic chromosomal translocation and protein produced by the translocation?

A) t(8;14), c-myc

B) t(9;22), bcr-abl

C) t(11;22), EWS-FL-1

D) t(14:18), bcl-2

E) t(15;17), PML-RAR-alpha

A 20 year old African-American woman develops anemia after being treated for urinary tract infection. A peripheral blood smear shows RBC lysis and precipitates of hemoglobin within the RBCs. Which of the following drug classes caused her hemolytic anemia?

A) aminoglycosides

B) fluoroquinolones

C) macrolides

D) sulfonamides

E) tetracyclines

A 35-year-old man comes to the emergency department with meningeal symptoms. He says he was taken to a trauma center in rural Ecuador 2 years ago after experiencing blunt abdominal trauma. He does not remember exactly what was done, but he believes they took drastic measures to control intra-abdominal bleeding. Before leaving the trauma center, he was counseled about a new seusceptibility to encapsulated organism. Lab tests show elevated platelet count. Which of the following findings would be seen in a peripheral blood of this patient?

A) Heinz bodies, target cells, more platelets

B) Megaloblastic anemia

C) Schistocytes

D) Sickle cells

E) Spherocytes

An 8-year old boy has a chronic history of severe anemia, hepatosplenomegaly and maxillary overgrowth. Hemoglobin electrophoresis shows elevation of HbF and increased HbA2 and absence of HBA1. Assuming he has not had a recent blood transfusion, which of the following diagnoses is most consistant with the patients electrophoresis?

a) alpha thalassemia minor

b) beta thalassemia major

c) beta thalassemia minor

d) G6PD deficiency

e) HbH

f) RBCs containing hemoglobin Barts

A 45 year old woman arrives in the emergency department complaining of intense pain in her upper abdomen for the past 4 hours. She had a similar episode in the past, but it went away in an hour. Her history is significant for recent flulike symptoms and prolonged feelings of lethargy. Physical findings reveal icteric sclera, abnormally pigmented palate, yellow hue skin. Ultrasound shows radiopaque gallstones. A Coombs' test is negative. A peripheral blood cells show microcytic RBCs, some of which have no central pallor. What is most likely causing the patient's condition?

A) mutation in the gene encoding ankyrin

B) G6PD gene mutation

C) circulating antibodies targeted against erythrocytes

D) iron deficiency anemia

E) RBC hemolysis because of mechanical heart valve