Anemias, coagulation disorders, leukemias and lymphomas, and classic tumor markers tested on USMLE Step 1.
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- What is the MCV classification (microcytic, normocytic, or macrocytic) of iron deficiency anemia?
- Microcytic
- In iron deficiency anemia, how do serum ferritin and TIBC change?
- Ferritin decreases; TIBC (total iron binding capacity) increases
- What red blood cell finding on peripheral smear is characteristic of thalassemia?
- Target cells
- What bone marrow finding defines sideroblastic anemia?
- Ringed sideroblasts (erythroblasts with iron laden mitochondria encircling the nucleus)
- What peripheral smear finding is classically seen in lead poisoning?
- Basophilic stippling of red blood cells
- In megaloblastic anemia, neutrophils show ____ (nuclei with 6 or more lobes).
- hypersegmentation
- What is the mechanism of pernicious anemia?
- Autoantibodies against intrinsic factor or gastric parietal cells impair vitamin B12 absorption
- Unlike vitamin B12 deficiency, folate deficiency does not cause ____.
- neurologic symptoms
- What happens to serum haptoglobin during hemolysis?
- It decreases, since it is consumed binding free hemoglobin
- What single amino acid substitution causes sickle cell disease?
- Glutamic acid is replaced by valine at position 6 of the beta-globin chain
- What red cell membrane protein defect underlies hereditary spherocytosis?
- Deficiency of spectrin or ankyrin
- What peripheral smear findings are seen in G6PD deficiency during an oxidative stress episode?
- Heinz bodies and bite cells
- What test detects antibodies bound to a patient's own red blood cells in autoimmune hemolytic anemia?
- Direct Coombs test (direct antiglobulin test)
- What clotting factor is deficient in Hemophilia A?
- Factor VIII
- In hemophilia, what happens to PT and PTT?
- PTT is prolonged; PT is normal