The acid elution test for hemoglobin F was performed on a patient ...

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The acid elution test for hemoglobin F was performed on a patient sample, and examination of the slide revealed an uneven distribution of hemoglobin F within the erythrocytes. Control slides were acceptable.
 
  Which of the following is associated with this observation?
 
  a. Iron deficiency anemia
  b. Sickle cell anemia
  c. Pernicious anemia
  d. Hereditary persistence of fetal hemoglobin

Question 2

The following are preliminary screening test results. Name the suspected disorder associated with each finding, and explain how you would confirm each.
 
  a. Positive sugar-water test
  b. Positive hemolysis after both incubation periods
  c. Normal sTFR levels
  d. Many spherocytes noted on PB smear
  e. Blasts noted on PB smear
 
  What will be an ideal response?

[Chou]

Answer to Question 1

Correct Answer: B

Answer to Question 2

Answer:
a. Suspected disorder: PNH; confirmation: flow cytometry for an absence of CD55 and CD59
b. Suspected disorder: PCH; confirmation: Donath-Landsteiner test. Further testing is not warranted.
c. Suspected disorder: anemia of chronic disease; confirmation: increased ferritin; low iron and TIBC
d. Suspected disorder: hereditary spherocytosis or hemolysis; confirmation: osmotic fragility
e. Suspected disorder: acute leukemia; confirmation: bone marrow aspirate and cytochemical stains and immunophenotyping