Quiz on Approach to Normocytic Anemia • The Blood Project

Which of the following best defines a hypoproliferative anemia?

a

Anemia due to increased red cell destruction

b

Anemia due to blood loss

c

Anemia due to decreased red cell production

Hypoproliferative anemia reflects inadequate marrow response, often with low reticulocyte count.

d

Anemia with increased reticulocyte count

Match each component of the ABC spine with its conceptual domain:

A

C

B

Organ-related

Nutritional / Deficiency states

Inflammation

Correct! Sorry, Incorrect.

Note: The ABC spine is a conceptual scaffold for reasoning — not a hierarchy or fixed sequence. The letters themselves are arbitrary placeholders without intrinsic meaning. Their purpose is to provide a consistent mental map for approaching normocytic, hypoproliferative anemia — a way to structure diagnostic thinking into three broad conceptual clusters.

68-year-old woman presents with fatigue. Labs:

Hb 9.5 g/dL
MCV 88 fL
Ferritin 35 ng/mL
CRP 3.0 mg/L
Reticulocyte count 0.6 %

Which ABC category fits best?

a

Nutritional

b

Inflammatory

c

Organ/marrow

d

Mixed A + B

Ferritin borderline-low with elevated CRP → combined nutritional and inflammatory elements.

Which laboratory parameter best distinguishes an A-type anemia from a B-type anemia?

a

Hemoglobin

b

Ferritin

c

Soluble transferrin receptor

sTfR rises in true deficiency (A) but remains normal in inflammation (B).

d

Mean corpuscular volume

Sort each example into its ABC category:

Anemia of inflammation

Copper deficiency

Hypothyroidism

Vitamin B deficiency

Myelodysplastic syndrome

Folate deficiency

Iron deficiency

Chronic kidney disease

A

B

C

How does unexplained anemia of the elderly fit into the ABC framework?

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Often a blend of B (inflammatory) and C (organ/marrow) elements — low-grade inflammation, endocrine decline, and early clonal hematopoiesis.

Which statement is true?

a

ICUS shows clonal mutations but no cytopenia.

b

CCUS shows cytopenia + clonal mutation(s) without overt MDS.

c

Both ICUS and CCUS always progress to MDS.

d

Neither involves cytopenia.

A 58-year-old woman has normocytic anemia, ferritin normal, TSH low, and normal CRP. Which ABC category fits best?

a

Nutritional

b

Inflammatory

c

Organ/endocrine

Which of the following findings most directly links a C-type anemia to its pathophysiology?

a

Elevated hepcidin concentration

b

Reduced erythropoietin production

c

Low soluble transferrin receptor

d

Increased marrow iron stores

A patient with stable CKD develops worsening anemia after an episode of sepsis. Which statement best reflects the ABC logic?

a

Pure C-type process

b

Transition from C to B dominance

c

Superimposed A-type process

d

Framework no longer applicable

Which of the following best describes the purpose of the ABC framework?

a

To memorize causes of anemia

b

To provide a fixed classification of diseases

c

To structure reasoning across mechanistic clusters

d

To replace bone-marrow examination

Match each concept to its corresponding level of insight or application:

ICUS–CCUS Spectrum

Anemia of the Elderly

ABC Spine

Molecular insight into the marrow (C4) compartment

Practical bedside diagnostic reasoning

Recognition of the high prevalence of unexplained anemia

Correct! Sorry, Incorrect.

Note: Each framework captures a different dimension of understanding — how we reason at the bedside, how we recognize patterns in populations, and how we explore disease at a molecular level.