2008 module exam Flashcards
What will be less in a long term renal failure patient?
Erythroblasts
What is a correct order?
a. Yolk sac, liver & spleen & secondary lymphoid tissue, bone marrow
b. Amnion, lymphoid tissue, spleen
c. Placenta, spleen, BM, lymphoid
a. Yolk sac, liver & spleen & secondary lymphoid tissue, bone marrow
If platelet deficiency, which lineage is affected?
a. Myeloblast
b. Monoblast
c. Megakaryoblast
d. lymphoblast
c. Megakaryoblast
Child with swollen lymph nodes, heterophile positive blood. what virus does he have?
EBV
A man with tropical spastic paraparesis, what virus does he have?
HTLV-1
A chinese baby with nasopharyngeal carcinoma, what virus does he have?
EBV
In porphyria cutanea trada, taking sulfonamide, an antibiotic, provokes the symptoms ..why?
a. It promotes immunoglobulin synthesis
b. It activates cytochrome 450 pathway
b. It activates cytochrome 450 pathway
What is the purpose of giving hemin as a treatment for porphyria?
It inhibits delta-ALA synthase
What’s the most important enzyme in porphyrin synthesis
Delta-ALA synthase
If there is an increase in heme production, what occurs as a form of regulation?
Increase synthesis of globin
What is the compound in which hemoglobin Fe has six bonds?
a. Oxyhemoglobin
b. Deoxyhemoglobin
c. Methemoglobin
d. Carboxyhemoglobin
e. Hemoglobin
a. Oxyhemoglobin
What molecule is a negative effector in O2 binding to hemoglobin?
a. Carbon dioxide
b. Carbon monoxide
a. Carbon dioxide (Bohr Effect)
What is produced by RBC to control hemoglobin affinity to oxygen?
2,3 bisphosphoglycerate
What enzyme deficiency induces RBC hemolysis?
Glucose 6 phosphate dehydrogenase
Describe the oxygen affinity curve of myoglobin versus hemoglobin. (picture question)
myoglobin= hyperbola hemoglobin= sigmoid
Where is folate absorbed?
a. Terminal ilium
b. Duodenum
c. Juejenum
d. Large intestine
e. Stomach
c. Juejenum
What will be highly excreted in a patient with ATP:cobalamine adenosyl transferase deficiency?
a. Melanoic acid
b. Hemocysteine
c. Methylmelanolic acid
c. Methylmelanolic acid
In patient with pancreatic insufficiency, which molecule will interfere with cobalamine absorption?
Haptocorrin
In which case is hepcidin inhibited?
Increased erythropoiesis
What do type 2 hypersensitivity reactions target?
Membrane bound antibiotic
the drug is adsorbed into plasma membrane
What immunoglobulin causes hemolytic anemia in fetus?
IgG
Which is true about blood grouping?
a. People with blood group B have anti-B Ab
b. People with blood group A don’t express anti A Ab
c. AB are universal donors
b. People with blood group A don’t express anti A Ab
Anemia in Patient with gastric bypass due to morbid obesity + (picture of hypersegmented neutrophil). What is the cause?
B12 deficiency
Patient with macrocytic anemia. Tests show Positive anti-intrinsic factor .Positive antibodies against parietal cells. What is the patient most likely to suffer from?
a. MDS
b. Thalassemia major
c. Pernicious anemia
c. Pernicious anemia
Patient who is known to have long standing anemia and is transfusion dependent .She developed spleenomagaly & bronze discoloration .What does she likely suffer from?
a. MDS
b. Thalassemia major
c. Pernicious anemia
b. Thalassemia major
Increased creatinine level is a side effect of which drug?
Deferasirox
Which drug requires weekly CBC for risk of agranulocytosis& neutropenia?
Deferiprone
Patient who requires repeated blood transfusion is given deferoxamine, why?
To excrete Fe
Why do RBCs produce NADH?
a. To produce ATP
b. To reduce methemoglobin
c. To reduce lactate
b. To reduce methemoglobin
How is phosphatidyl serine kept on the inner surface?
By action of flippase
Patient with hereditary spherocytosis. What is the pathogenesis?
cytoskeleton-protein interactions
Which is least likely associated with hereditary spherocytosis?
a. Spectrin
b. GLUT
c. Actin
d. Band 4.2
e. Band 4.2
f. Anion exchanger
g. Ankyrin
b. GLUT
not sure
In HbC disease, hemoglobin precipitates due to water loss. What is the cause of water loss?
a. Activation of K channels
b. Activation of Na channels
a. Activation of K channels
In HbS disease, why does it migrate slower in protein electrophoresis?
a. Less charge
b. Due to its sickle shape
a. Less charge
A woman developed anemia after eating 3 falafel sandwiches. CBC given .What is the pathogenesis of this condition?
Oxidative damage to RBC membrane
A woman developed anemia after eating 3 falafel sandwiches. What test would you do to confirm your diagnoisis?
Measure G6PD level
Cancer patient on chemotherapy has developed petechial rash. Coagulation profile is normal. What must you give him?
Platelets
An elderly man developed a chest infection secondary to liver disease. What type of blood transfusion does he require?
Fresh frozen plasma
What is released to activate FXII in the intrinsic pathway?
a. Acidic Phospholipids
b. Tissue factor
a. Acidic Phospholipids (not 100% sure)
What mediates fibrinogen to fibrin?
Thrombin
What mediates formation of primary hemostatic plug
a. Platelets
b. Thromboxane
c. vWF
a. Platelets
what promotes aggregation of platelets? Or what attracts platelets to the site of clot?
Thromboxane & ADP
What is the role of vWF?
Binds & stabilizes F VIII
What requires vitamin K?
Gla proteins
What’s the role of bradykinin
Stimulates the release of t-PA from endothelial cells
What constitutes the pale region of thrombus?
a. Fibrin & platelets
b. Fibrin & RBC
a. Fibrin & platelets
What does thrombomodulin activates?
Protein C
Prolonged APTT that is not corrected by normal plasma. Whats the diagnosis?
Lupus anticoagulant
Which of the following supports that the cause of bleeding is due to platelets rather than coagulation problem?
a. Hemarthrosis
b. Immediate and profuse bleeding after tooth extraction
c. Mucocutanous bleeding
c. Mucocutanous bleeding
Patient with chest infection .Prolonged PT & APTT .High level of D dimer .Low level of platelets. What is the diagnosis?
DIC
Ahmad was treated with anticoagulant, but developed bleeding which was controlled by protamine sulphate. What anticoagulant was he given?
a. Heparin
b. Warfarin
a. Heparin
Why does streptokinase cause systemic fibrinolysis while t-PA doesn’t?
a. Streptokinase is endogenous
b. Because it binds plasminogen
c. Streptokinase is more potentiative than t-PA
d. streptokinase binds fibrin-bound as well as free plasminogen, while tPA only binds fibrin-bound plasminogen
d. streptokinase binds fibrin-bound as well as free plasminogen, while tPA only binds fibrin-bound plasminogen
A girl with an infection was given amoxicillin, 8 days later, she later developed erythematous rash. What will you find?
a. Neutropilia
b. Esinophilia
c. Basophilia
b. Esinophilia
how do esinophils kill?
a. Cytotoxicity
b. phagocytosis
a. Cytotoxicity
What is used to mobilize stem cells from the bone marrow of the donor in stem cell transplant?
CSF
What cause trilineage suppression in TB?
TNF
What is homing is mediated by?
Adhesion molecules
What is involved in respiratory burst?
Oxygen reactive mediators
A woman with petechial rash & menorrhagia .high WBC, low RBC & platelets, petechial rash. PBS shows immature cells .What is likely the diagnosis?
a. Megaloblastic anemia
b. Immune mediated reaction
c. BM infiltration
d. Acute leukemia
d. Acute leukemia
How will you confirm the diagnosis of Acute leukemia?
a. Biopsy of skin with petechial rash
b. VB12 level
c. Restocitin
d. Coagulation profile
e. BM examination
e. BM examination
A child with joint pain and bleeding, whats the diagnosis?
F VIII defeciency
A patient with high RBC. High hematocrit. High WBC, high platelets. What’s the diagnosis?
PV
Whats the abnormality in PV?
JAK kinase gain of function
What is characterized by philadelphia chromosome?
CML
What causes CML to develop into its blast crisis?
a. Chromosomal trisomies
b. P 53 mutation
c. Chr 16 inversion
a. Chromosomal trisomies
Which conditionis associated with intracytoplasmic rods?
AML
Abnormality associated with AML
a. RARA transcription factor activation
b. P53 gene deletion
c. 2 philadelphia chromosomes
d. Chromosome 16 inversion
d. Chromosome 16 inversion
Where do thymocytes mature?
Thymus
What is the difference between Th1 & Th2?
Th1 activate cell mediated immunity while Th2 doesn’t
What produces cytokines to activate production of antibodies?
a. Th1
b. Th2
Tb. Th2
What suppresses T cell function activation?
T reg
Patient with lymphadenopathy, light chain restriction, spherocytes, anemia .What is the pathogenesis of anemia?
Immune mediated destruction
Patient with lymphadenopathy. Biopsy shows binucleated cells. What’s the diagnosis?
Hodgkin lymphoma
A patient with lymphadenopathy – follicular pattern. What is the most important diagnostic test?
a. Cytochemistry
b. Cytogenic analysis
b. Cytogenic analysis
What is multiple myeloma?
a. Bence Jones proteins in urine
b. Low calcium level
c. Polyclonal indication in gel electrophoresis
a. Bence Jones proteins in urine
A febrile patient with atypical lymphocytes. What is the cause?
Viral infection
A woman with neutrophilia, fever, & cough. What is the cause?
Bacterial infection
A patient with metastatic prostate cancer. Normal MCV, low Hb, normal platelets, low WBC. What is mechanism of disease?
a. Chronic blood loss
b. Ineffective erythropoiesis
c. Suppressed erythropiotic activity
d. Chronic blood loss
c. Suppressed erythropiotic activity
A man with microcytic hypochromic anemia .What might be the cause?
Chronic blood loss
What is true about Mercaptopurine?
Inhibits DNA synthesis
Premature baby with bleeding, what’s the cause?
vit k deficiency
Which immunoglobulin is most commonly associated with multiple myeloma?
IgG
If you suspect suppressed erythropiotic activity, what test must you use to confirm your diagnosis?
a. Erythropoietin level
b. Ferritin level
c. BM examination
c. BM examination
