Hematologic Physiology And Disorders Practice Test

A 22-year-old African American man with a history of sickle cell disease presents to the emergency department with severe pain in his back and legs. He reports the pain began suddenly this morning. His temperature is 37.5°C (99.5°F), pulse is 110/min, and blood pressure is 130/80 mm Hg. Physical examination reveals tenderness to palpation over the lumbar spine and bilateral tibias. Laboratory studies show a hemoglobin of 8.2 g/dL. This patient's underlying disease is caused by a point mutation in the β-globin gene.

A 72-year-old man with a history of pernicious anemia presents with a 6-month history of progressive numbness and tingling in his feet, along with difficulty with balance. He has been non-adherent with his intramuscular vitamin B12 injections. Laboratory studies show a hemoglobin of 10.5 g/dL and an MCV of 115 fL. Neurologic examination reveals decreased vibratory and position sense in the lower extremities.