Anemia classification — UPSC CMS MCQs (Medicine)

Question 1

Which one of the following is associated with low MCV of red blood cells?

Accepted Answer

A. Thalassemia

Answer

Vitamin B12 deficiency anaemia

Answer

Folate deficiency anaemia

Answer

Sickle cell anaemia

Question 2

A 30-year-old female presents with malaise, breathlessness off and on and paraesthesias. She is vegetarian by diet. Her investigation revealed Hb = 6.2 gm/dL, MCV = 128 fL, platelet count = 1,20,000/cumm, with blood smear showing macrocytosis and neutrophil hypersegmentation. What is the likely diagnosis?

Accepted Answer

C. Megaloblastic anemia

Answer

Iron deficiency anemia

Answer

Myelophthisic anemia

Answer

Aplastic anemia

Question 3

A 46 year old lady on vegan diet for a decade presents with chief complaints of tingling and numbness in lower limbs for two months and a history of swaying while walking through narrow corridors. Which one of the following blood tests is advisable for diagnosis in this patient?

Accepted Answer

D. Vitamin B12 levels

Answer

Serum protein electrophoresis

Answer

Anti-gliadin antibodies

Answer

Vitamin 25(OH) D level

Question 4

In which of the following is a high reticulocyte production index seen?
1. Sickle cell disease
2. Vitamin B-12 deficiency
3. Glucose-6-phosphate dehydrogenase deficiency
4. Blood loss
Select the correct answer using the code:

Accepted Answer

C. 1, 3 and 4

Answer

1, 2 and 3

Answer

1, 2 and 4

Answer

2, 3 and 4

Question 5

All the following are causes of reactive thrombocytosis, EXCEPT:

Accepted Answer

B. Megaloblastic anemia

Answer

Hemolytic anemia

Answer

Post splenectomy

Answer

Chronic inflammatory disorders

Question 6

Red cell protoporphyrin levels will be raised in which of the following conditions?
1. Absolute iron deficiency
2. Relative iron deficiency
3. Lead poisoning
Select the correct answer using the code:

Accepted Answer

D. 1, 2 and 3

Answer

1 and 3 only

Answer

1 and 2 only

Answer

2 and 3 only

Question 7

Negative Iron Balance is the first stage in the progression to Iron Deficiency Anemia. Which of the following laboratory investigations will be found deranged in this stage, thereby pointing to early iron-store depletion?
1. Bone Marrow Iron Stores
2. Percent transferrin saturation
3. Serum ferritin
4. Total Iron Binding Capacity
Select the correct answer using the code:

Accepted Answer

C. 1, 3 and 4

Answer

1, 2 and 3

Answer

1, 2 and 4

Answer

2, 3 and 4

Question 8

The single most sensitive tool for evaluating the iron status in an individual is:

Accepted Answer

C. serum ferritin value

Answer

haemoglobin concentration

Answer

serum iron concentration

Answer

serum transferrin saturation

Question 9

A typical case of Iron Deficiency Anemia (IDA) in pregnancy will show which of the following?
1. Hb less than 10 gm%
2. PCV less than 30%
3. MCHC more than 30%
4. Microcytic hypochromic picture on peripheral blood smear (PBS)
Select the correct answer using the code:

Accepted Answer

B. 1, 2 and 4

Answer

1, 2 and 3

Answer

1, 3 and 4

Answer

2, 3 and 4

Question 10

Which of the following are blood values of Iron Deficiency Anemia?
1. Serum iron is less than 30 µg/100 mL
2. Total iron binding capacity is less than 400 µg/dL
3. Percentage saturation is 10% or less
4. Serum ferritin is below 30 µg/L
Select the correct answer using the code:

Accepted Answer

B. 1, 3 and 4

Answer

1, 2 and 3

Answer

2, 3 and 4

Answer

1, 2 and 4

Question 11

In India, the most widely prevalent stage of iron deficiency is:

Accepted Answer

B. fall in percentage saturation of transferrin

Answer

decreased iron stores without any other detectable abnormalities

Answer

overt iron deficiency with impaired haemoglobin synthesis

Answer

decrease in the concentration of circulating haemoglobin

Question 12

During pregnancy iron supplementation is needed for:

Accepted Answer

A. all pregnant mothers from 16 weeks onwards

Answer

only those pregnant mothers who have Hb < 10 gm%

Answer

only those pregnant mothers who are not eating green vegetables

Answer

all pregnant mothers since 6 weeks of pregnancy

Question 13

The amount of iron lost per 28 day cycle in menstruating women is:

Accepted Answer

C. 12.5 mg

Answer

5.5 mg

Answer

8.5 mg

Answer

15.5 mg

Question 14

The daily requirement of iron during the second half of pregnancy is:

Accepted Answer

B. 6 mg per day

Answer

2 mg per day

Answer

10 mg per day

Answer

20 mg per day

Question 15

A full-term baby born with a birth weight of 2000 g comes for a well-baby visit at two months of age. Which of the following nutritional supplements would you advise?

Accepted Answer

D. Iron orally 2 mg/kg/day up to 1 year of age

Answer

Vitamin D orally 200 IU/day up to 3 months of age

Answer

Vitamin D orally 200 IU/day up to 1 year of age

Answer

Iron orally 2 mg/kg/day up to 3 months of age

Question 16

Which of the following are correct regarding activities under the Weekly Iron and Folic Acid Supplementation (WIFS) program?
1. Administration of supervised weekly iron-folic acid supplements of 100 mg elemental iron and 500 µg folic acid
2. Administration of supervised weekly iron-folic acid supplements of 60 mg elemental iron and 0.5 mg folic acid
3. Biannual de-worming with albendazole
4. Annual de-worming with albendazole
Select the correct answer using the code:

Accepted Answer

D. 2 and 3

Answer

1 and 4

Answer

1 and 3

Answer

2 and 4

Question 17

Which of the following are decreased during pregnancy?
1. Iron stores
2. Vitamin B12 levels
3. Folate levels
4. Coagulation factors
Select the correct answer using the code:

Accepted Answer

A. 1, 2 and 3

Answer

1 and 2 only

Answer

1, 3 and 4

Answer

2, 3 and 4

Question 18

An 8 year old child has consumed a few tablets of a drug that were being taken by his mother on a regular basis. Following this the child develops gastric necrosis, acidosis, shock and hepatic necrosis. Which is the most likely drug?

Accepted Answer

D. Iron

Answer

Multivitamins

Answer

Calcium carbonate

Answer

Folic acid

Question 19

In a child with high anion gap metabolic acidosis, poisoning with which of the following may be suspected?

Accepted Answer

A. Iron

Answer

Digoxin

Answer

Rifampicin

Answer

Beta blockers

Question 20

Whole Bowel Irrigation (WBI) as a method of gastrointestinal decontamination is useful for poisoning with:

Accepted Answer

B. Iron

Answer

Alcohol

Answer

Kerosene

Answer

Organophosphorus

Question 21

A 35 year female presents with easy fatigability. Investigations show that Hb is 6 g%; Red cell morphology is normocytic normochromic; and reticulocyte production index is 5.5. Which one of the following conditions favours this abnormality?

Accepted Answer

D. Intravascular hemolysis

Answer

Iron deficiency anemia

Answer

Sideroblastic anemia

Answer

Folate deficiency

Question 22

Which of the following investigations indicate active hemolysis?
1. Increased reticulocyte count
2. Increased conjugated bilirubin
3. Increased urinary urobilinogen
4. Decreased haptoglobin
Select the correct answer using the code:

Accepted Answer

C. 1, 3 and 4

Answer

1, 2 and 3

Answer

1 and 4 only

Answer

2 and 3 only

Question 23

Which type of anemia can be caused by the drug Dapsone?

Accepted Answer

D. Hemolytic anemia

Answer

Iron deficiency anemia

Answer

Sideroblastic anemia

Answer

Spur cell anemia

Question 24

Which of the following statements regarding G6PD enzyme deficiency are correct?
1. It is an X-linked deficiency.
2. Geographical distribution parallels the malaria belt.
3. Consumption of fava beans is protective.
4. Transfusion support may be life-saving.
Select the correct answer using the code:

Accepted Answer

B. 1, 2 and 4

Answer

1 and 3 only

Answer

1 and 4 only

Answer

2, 3 and 4

Question 25

Which of the following drugs carry a definite risk of causing clinical hemolysis in persons suffering from Glucose-6-phosphate dehydrogenase deficiency?
1. Primaquine
2. Dapsone
3. Cotrimoxazole
4. Nitrofurantoin
Select the correct answer using the code:

Accepted Answer

D. 1, 2, 3 and 4

Answer

1, 3 and 4

Answer

1 and 2 only

Answer

2, 3 and 4 only

Question 26

Which one of the following conditions characteristically may present with a triad of haemolysis, pancytopenia and venous thrombosis?

Accepted Answer

D. Paroxysmal nocturnal hemoglobinuria

Answer

Glucose-6-phosphate dehydrogenase deficiency

Answer

Hereditary spherocytosis

Answer

Hemolytic uremic syndrome

Question 27

A 39-year-old female presents with severe autoimmune hemolytic anemia. Which of the following should be the initial step in its management?

Accepted Answer

A. Prednisolone

Answer

Rituximab

Answer

Emergency splenectomy

Answer

Plasmapheresis

Question 28

Pyruvate kinase deficiency results in deficiency of ATP production and a chronic hemolytic anemia. The disorder is inherited as an:

Accepted Answer

A. Autosomal recessive trait

Answer

X-linked recessive trait

Answer

Autosomal dominant trait

Answer

X-linked dominant trait

Question 29

Every individual carries four alpha gene alleles. Deletion of three alleles leads to development of:

Accepted Answer

B. Haemoglobin H disease

Answer

Haemoglobin X disease

Answer

Haemoglobin F disease

Answer

Hydrops fetalis

Question 30

Consider the following statements:
Statement I: Signs of thalassemia major usually develop after 6 months of age.
Statement II: This is the time when haemoglobin synthesis switches from haemoglobin F to haemoglobin A.
Which one of the following is correct in respect of the above statements?

Accepted Answer

A. Both Statement I and Statement II are correct and Statement II is the correct explanation of Statement I

Answer

Both Statement I and Statement II are correct but Statement II is not the correct explanation of Statement I

Answer

Statement I is correct but Statement II is incorrect

Answer

Statement I is incorrect but Statement II is correct

Question 31

Which of the following hematological findings are seen in pregnant women with thalassemia trait?

Accepted Answer

A. Raised HbA₂ and low MCV

Answer

Low MCHC

Answer

Low serum total iron binding capacity

Answer

Low HbA₂ and raised MCV

Question 32

Which of the following are the etiologies of haemochromatosis?
1. Thalassemia
2. Anemia of pyruvate kinase deficiency
3. Chronic cor pulmonale
4. Porphyria cutanea tarda
Select the correct answer using the code:

Accepted Answer

B. 1, 2 and 4

Answer

1, 2 and 3

Answer

1 and 4 only

Answer

2, 3 and 4

Question 33

Which of the following are secondary iron overload conditions?
I. Transfusion related iron load
II. Thalassemia
III. Hepatitis C associated liver disease
Select the correct answer using the code:

Accepted Answer

A. I and II only

Answer

II and III only

Answer

I, II and III

Answer

I and III only

Q1. Which one of the following is associated with low MCV of red blood cells?

Q3. A 46 year old lady on vegan diet for a decade presents with chief complaints of tingling and numbness in lower limbs for two months and a history of swaying while walking through narrow corridors. Which one of the following blood tests is advisable for diagnosis in this patient?

Q4. In which of the following is a high reticulocyte production index seen? 1. Sickle cell disease 2. Vitamin B-12 deficiency 3. Glucose-6-phosphate dehydrogenase deficiency 4. Blood loss Select the correct answer using the code:

Q5. All the following are causes of reactive thrombocytosis, EXCEPT:

Q6. Red cell protoporphyrin levels will be raised in which of the following conditions? 1. Absolute iron deficiency 2. Relative iron deficiency 3. Lead poisoning Select the correct answer using the code:

Q8. The single most sensitive tool for evaluating the iron status in an individual is:

Q9. A typical case of Iron Deficiency Anemia (IDA) in pregnancy will show which of the following? 1. Hb less than 10 gm% 2. PCV less than 30% 3. MCHC more than 30% 4. Microcytic hypochromic picture on peripheral blood smear (PBS) Select the correct answer using the code:

Q10. Which of the following are blood values of Iron Deficiency Anemia? 1. Serum iron is less than 30 µg/100 mL 2. Total iron binding capacity is less than 400 µg/dL 3. Percentage saturation is 10% or less 4. Serum ferritin is below 30 µg/L Select the correct answer using the code:

Q11. In India, the most widely prevalent stage of iron deficiency is:

Q12. During pregnancy iron supplementation is needed for:

Q13. The amount of iron lost per 28 day cycle in menstruating women is:

Q14. The daily requirement of iron during the second half of pregnancy is:

Q15. A full-term baby born with a birth weight of 2000 g comes for a well-baby visit at two months of age. Which of the following nutritional supplements would you advise?

Q17. Which of the following are decreased during pregnancy? 1. Iron stores 2. Vitamin B12 levels 3. Folate levels 4. Coagulation factors Select the correct answer using the code:

Q18. An 8 year old child has consumed a few tablets of a drug that were being taken by his mother on a regular basis. Following this the child develops gastric necrosis, acidosis, shock and hepatic necrosis. Which is the most likely drug?

Q19. In a child with high anion gap metabolic acidosis, poisoning with which of the following may be suspected?

Q20. Whole Bowel Irrigation (WBI) as a method of gastrointestinal decontamination is useful for poisoning with:

Q21. A 35 year female presents with easy fatigability. Investigations show that Hb is 6 g%; Red cell morphology is normocytic normochromic; and reticulocyte production index is 5.5. Which one of the following conditions favours this abnormality?

Q22. Which of the following investigations indicate active hemolysis? 1. Increased reticulocyte count 2. Increased conjugated bilirubin 3. Increased urinary urobilinogen 4. Decreased haptoglobin Select the correct answer using the code:

Q23. Which type of anemia can be caused by the drug Dapsone?

Q25. Which of the following drugs carry a definite risk of causing clinical hemolysis in persons suffering from Glucose-6-phosphate dehydrogenase deficiency? 1. Primaquine 2. Dapsone 3. Cotrimoxazole 4. Nitrofurantoin Select the correct answer using the code:

Q26. Which one of the following conditions characteristically may present with a triad of haemolysis, pancytopenia and venous thrombosis?

Q27. A 39-year-old female presents with severe autoimmune hemolytic anemia. Which of the following should be the initial step in its management?

Q28. Pyruvate kinase deficiency results in deficiency of ATP production and a chronic hemolytic anemia. The disorder is inherited as an:

Q29. Every individual carries four alpha gene alleles. Deletion of three alleles leads to development of:

Q30. Consider the following statements: Statement I: Signs of thalassemia major usually develop after 6 months of age. Statement II: This is the time when haemoglobin synthesis switches from haemoglobin F to haemoglobin A. Which one of the following is correct in respect of the above statements?

Q31. Which of the following hematological findings are seen in pregnant women with thalassemia trait?

Q32. Which of the following are the etiologies of haemochromatosis? 1. Thalassemia 2. Anemia of pyruvate kinase deficiency 3. Chronic cor pulmonale 4. Porphyria cutanea tarda Select the correct answer using the code:

Q33. Which of the following are secondary iron overload conditions? I. Transfusion related iron load II. Thalassemia III. Hepatitis C associated liver disease Select the correct answer using the code: