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[OS 216] Hema E1 > 2011 Samplex > Flashcards

2011 Samplex Flashcards

1
Q

Iron Deficiency Anemia produces this type of anemia

a. hypochromic, macrocytic
b. normochromic, macrocytic
c. hypochromic, microcytic
d. normochromic, microcytic

A

C

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2
Q

Pregnant women should routinely be given iron because

a. the fetus needs iron
b. the mother has lost iron from her previous monthly menses
c. she will lose blood when she delivers
d. all of the above

A

A

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3
Q

The gold standard in the diagnosis of iron deficiency anemia is

a. serum iron
b. serum ferritin
c. total iron binding capacity
d. hemosiderin in the bone marrow

A

D

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4
Q

During the first week of treatment with oral iron, which laboratory parameter should be taken?

a. hemoglobin
b. hematocrit
c. reticulocyte count
d. red cell indices

A

C

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5
Q

The duration of treatment with iron is usually six (6) months because

a. the body’s iron stores have to be replenished
b. this will cover for the future occurrence of bleeding
c. this will facilitate more absorption of iron
d. all of the above

A

A

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6
Q

Which food is rich in iron?

a. Fruits
b. Vegetables
c. Red meat
d. Fish

A

C

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7
Q

Why does a patient develop iron deficiency anemia after gastroduodenal bypass surgery?

a. Because of poor iron absorption
b. Because of poor iron utilization
c. Because of poor iron intake
d. Because of decrease in the reticulo-endothelial system

A

A

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8
Q

Parenteral iron is given if

a. rapid increase in hemoglobin (HB) is desired
b. malabsorption syndrome exists
c. the patient requests for it
d. rapid utilization of iron by the body

A

B

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9
Q

Infants should be given iron supplements as early as 2 months of age because

a. they are easily prone to colic
b. human and cow’s milk are poor sources of iron
c. they bleed easily
d. they have poor iron absorption

A

B

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10
Q

The most common single cause of iron deficiency in women is

a. poor intake of iron
b. obesity
c. poor release of iron by the reticulo-endothelial system
d. menstrual blood loss

A

D

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11
Q

Chronic ingestion of non steroidal anti-inflammatory medication can cause iron deficiency anemia by

a. interfering with iron transport
b. reducing amount of total iron binding capacity
c. inducing occult GI bleeding
d. preventing iron incorporation in the red cells

A

C

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12
Q

A transfusion reaction that usually appears rapidly that may result in fever, shock, or death is which of the following?

a. Immediate Hemolytic Transfusion Reaction
b. Transfusion Associated Circulatory Overload
c. Allergic Transfusion Reaction
d. Febrile Non-Hemolytic Transfusion Reaction

A

A

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13
Q

A donor who has ingested aspirin on the day of donation is temporarily deferred because

a. he has fever
b. he is infected
c. aspirin alters the quality of platelets
d. aspirin causes a hypercoagulable state

A

C

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14
Q

This is a cause for permanent deferral of a blood donor

a. upper respiratory infection
b. hepatitis B
c. fever
d. ingestion of contraceptive pill

A

B

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15
Q

Why is type O considered a universal donor?

a. it does not contain agglutinogens A and B
b. it does not contain anti A and B antibodies
c. it is the most common blood type
d. it is easy to procure

A

A

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16
Q

What is the purpose of doing a crossmatch before transfusion?

a. to detect autoantibodies present in the recipient
b. to prevent alloimmunization
c. to detect alloantibodies in the recipient
d. to avoid sensitization of the recipient

A

C

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17
Q

Which of the following blood components should have a crossmatch donor done before transfusion?

a. PRBC
b. platelets
c. WBC
d. fresh frozen plasma

A

A

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18
Q

What is the reason why an Rh negative recipient should not receive an Rh positive blood?

a. Presence of incompatibility
b. Prevention of alloimmunization to D antigen
c. Prevention of immediate post transfusion reaction
d. Prevention of infection

A

B

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19
Q

The most frequent cause of a febrile non-hemolytic transfusion reaction is

a. IgG protein in the transfused blood
b. ABO incompatibility
c. Presence of WBC and cytokines in the transfused blood
d. Presence of malarial parasite in the transfused blood

A

A

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20
Q

The “window period” in the testing for HIV in donor represents

a. the time from the infection of the donor up to the time that the antibody is detected
b. the duration of the HIV laboratory test
c. the incubation period of the reagents
d. the time when HIV symptoms became manifest

A

A

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21
Q

What is the optimum temperature for storing packed RBC?

a. 0 oC
b. room temperature
c. 4-6 oC
d. -20 oC

A

C (not sure)

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22
Q

Which of the following is a ground for permanent donor deferment?

a. ingestion of antibiotics
b. ingestion of alcohol
c. fever
d. diabetes

A

D

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23
Q

Thawed fresh frozen plasma (FFP) cannot be refrozen because

a. it is potentially infected
b. it has lost the activity of most of the coagulation factors
c. the plastic bag is already brittle
d. cytokines are released in the process of thawing

A

B

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24
Q

The following screening tests are done in blood donors except

a. hemoglobin determination
b. Hepatitis A
c. Hepatitis B
d. Hepatitis C

A

B

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25
Q

In severe iron deficiency anemia with symptoms of high output failure, which is the best blood product for transfusion?

a. packed RBC
b. fresh whole blood
c. whole blood
d. heparinized whole blood

A

A

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26
Q

Elderly patients who develop deep vein thrombosis should be worked up for

a. vasculitis
b. malignancy
c. atherosclerosis
d. liver cirrhosis

A

B

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27
Q

The most serious complication of deep vein thrombosis is

a. myocardial infarction
b. cerebrovascular thrombosis
c. peripheral vascular disease
d. pulmonary embolism

A

D

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28
Q

Arterial thrombosis occurs when:

a. there is an increase in the circulatory coagulation factors
b. prolonged immobilization
c. damage to the endothelium of blood vessels
d. increased synthesis of prothrombin

A

C

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29
Q

The initiating event in the formation of arterial thrombus is

a. activation of Factor X
b. adherence of platelets to damaged blood vessels promoting aggregation
c. activation of anti-thrombin III
d. increased synthesis of prothrombin

A

B

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30
Q

Hyperviscosity of the blood can lead to thrombosis because

a. there is a slowing of blood flow in the circulation
b. there are more circulating coagulation factors
c. plasminogen activator is deficient
d. anti-thrombin III is deficient

A

A

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31
Q

Why is diabetes a risk factor for developing thrombosis?

a. high blood sugar causes slowing of blood flow
b. there is an acquired Protein C deficiency
c. homocysteine is proportionately increased if blood sugar is elevated
d. diabetes is associated with endothelial damage

A

D

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32
Q

The most common leukemia in children is

a. Pre T ALL
b. Pre B ALL
c. AML
d. JMML

A

B

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33
Q

Finding on cytogenetics examination of the bone marrow

a. enables further characterization of leukemias into those with good vs poor prognosis
b. the finding of t(9:22) is seen exclusively in patients with CML
c. the finding of t(9:22) in patients with LL is associated with good prognosis
d. does not impact on chemotherapy and survival

A

A

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34
Q

The single most significant prognostic factor in children with ALL is

a. the presence of CNS involvement
b. extent of hepatomegaly
c. age at diagnosis
d. initial WBC at diagnosis

A

D

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35
Q

Myelodysplastic syndrome is characterized by

a. hyperleukocytosis at diagnosis
b. signs and symptoms associated with pancytopenia
c. testicular involvement (for ALL, not MDS)
d. bone marrow aplasia

A

B

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36
Q

The Auer Rod

a. is pathognomonic for acute lymphoblastic leukemia
b. is seen in stacks with acute myelogenous leukemia without maturation
c. may be found in all forms of childhood leukemia
d. represents granules forming elongated needles seen in acute myelogenous leukemia

A

D

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37
Q

Important “sanctuary” sites for acute lymphoblastic leukemia are

a. liver and spleen
b. lymph nodes and CNS
c. testes and CNS
d. Lymph nodes and liver

A

C

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38
Q

Hematopoietic stem cell transplantation

a. is the only curative form of treatment for ALL
b. allows intensification of therapy and replacement of diseased marrow with normal precursors
c. utilizes hematopoeitic stem cells derived from fetal liver, bone marrow, and cord blood
d. is associated with less risk than conventional chemotherapy

A

B

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39
Q

The use of immunosuppressive agents in hematopoietic transplantation aims to

a. prevent graft rejection and graft versus host disease
b. prevent graft versus host disease only
c. directly destroy abnormal hematopoietic cells
d. prevent infections

A

A

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40
Q

The use of high dose chemotherapy and / or radiotherapy as a preparative regimen for hematopoietic stem cell transplantation aims to.

a. eradicate primary disease
b. prevent graft rejection
c. directly destroy abnormal hematopoietic cells
d. prevent infections

A

A

41
Q

Immunophenotyping

a. involves characterization of blast cells by identifying cell surface antigens
b. is less sensitive and specific compared to immunochemical staining
c. need not be performed with blast morphology is definite
d. can be performed on bone marrow samples only

A

A

42
Q

Rouleaux formation is seen in

a. afibrinogenemia
b. paraproteinemia
c. sickle cell anemia
d. autoimmune hemolytic anemia

A

B

43
Q

Microcytosis is best defined as

a. high RDW
b. low MCV
c. high MCH
d. low MCHC

A

B

44
Q

On a peripheral blood smear, red cells will normally have a central pallor which occupies

a. 1/3 of its diameter
b. ½ of its diameter
c. 2/3 of its diameter
d. ¾ of its diameter

A

A

45
Q

A neoplasm of immunosecreting terminally differentiated B lymphocyes is

a. B-cell chronic lymphocytic leukemia
b. B-cell acute lymphocytic leukemia
c. multiple myeloma
d. Chronic myelogenous leukemia

A

A

46
Q

The definitive diagnosis of chronic myelogenous leukemia is based on the demonstration of

a. marrow hyperplasia
b. leukocytosis with immature cells
c. megakaryocytic proliferation
d. Philadelphia chromosome

A

D

47
Q

An example of a neoplasm involving more than one cell line is

a. aplastic anemia
b. multiple myelome
c. acute lymphoblastic leukemia
d. chronic myelogenous leukemia

A

D

48
Q

According to the WHO classification, the diagnosis of AML requires the presence of ___ blasts in the marrows

a. > 10%
b. > 20%
c. > 30%
d. > 40%

A

B

49
Q

The clinical manifestation that distinguishes aplastic anemia from leukemia

a. severity of pallor
b. severity of bleeding
c. CNS involvement
d. presence of hepatosplenomegaly

A

D

50
Q

Acquired aplastic anemia in contrast to inherited form of bone marrow failure appears to be caused largely by

a. immune mediated destruction of marrow cells
b. loss of hematopoietic stem cells due to DNA damage
c. low threshold for apoptosis
d. NOTA

A

A

51
Q

This disease condition can co-exist with aplastic anemia

a. myelodysplastic syndrome
b. paroxysmal nocturnal hemoglobinuria
c. acute leukemia
d. myelofibrosis

A

B

52
Q

The following are the most important variables in disease outcome in myelodysplastic syndrome except

a. number of blasts in peripheral blood
b. number of blasts in the bone marrow
c. cytogenetic abnormality
d. severity of cytopenia

A

A

53
Q

Anemia of chronic renal failure

a. usually microcytic normochromic
b. erythropoietin deficiency is usually seen when creatinine is > 2 mg/dL
c. supplemental iron should be avoided as much as possible
d. erythropoietin alpha dose of 50-75 U/kgbw per week is usually required.

A

B

54
Q

Anemia of chronic disease

a. reticulocyte count is usually normal or increased
b. iron level is normal
c. iron binding capacity is increased
d. ferritin value is elevated

A

D

55
Q

The proposed mechanisms for anemia of chronic inflammatory condition include

a. increased red cell survival
b. decreased responsiveness to erythropoietin
c. decreased levels of erythropoietin
d. all of the above

A

B

56
Q

The life span of platelets is

a. 12 to 24 hours
b. 7-10 days
c. 45-60 days
d. 100-120 days

A

B

57
Q

The key organ in the pathophysiology of chronic immune thrombocytopenic purpura is

a. bone marrow
b. liver
c. spleen
d. kidneys

A

C

58
Q

A chronic ITP patient failed to respond to splenectomy. The presence of an accessory spleen is suspected by the presence of this abnormal red cell in the peripheral blood smear

a. Howell-Jolly bodies
b. target cells
c. tear-drop cells
d. histiocytes

A

A

59
Q

This screening test reflects the function of the intrinsic pathway of coagulation

a. bleeding time
b. prothrombin time
c. partial thromboplastin time
d. thrombin time

A

C

60
Q

Which factor is not a vitamin K dependent coagulation factor

a. factor I
b. factor II
c. factor VII
d. factor IX
e. factor X

A

A

61
Q

Vitamin K deficiency causes abnormality of this screening test

a. bleeding time
b. platelet count
c. prothrombin time
d. partial thromboplastin time

A

C

62
Q

One of the following statements regarding treatment of DIC is not correct

a. correct any reversible cause
b. fresh frozen plasma and platelet concentrates are given for actively bleeding patients
c. heparin is used for patients with acrocyanosis and incipient gangrene
d. warfarin is effective for chronic DIC

A

D

63
Q

Abnormal red cell morphology seen in DIC due to a microangiopathic hemolytic anemia

a. spherocytes
b. target cells
c. dacrocytes
d. schistocytes

A

D

64
Q

This is true regarding bleeding disorder secondary to aspirin

a. aspirin impairs platelet release reaction
b. a severe bleeding disorder
c. aspirin causes reversible inhibition of cyclooxygenase enzyme
d. impaired hemostasis reverses in 24 hours

A

A

65
Q

A 20 year old male had laboratory tests done because of prolonged bleeding following dental extraction. Results were as follows: normal platelet count, bleeding time and prothrombin time, but prolonged PTT which was corrected by mixing test. The most likely diagnosis is:

a. von willebrand’s disease
b. hemophilia
c. chronic ITP
d. Glanzmann’s thrombasthenia

A

B

66
Q

A 30 year old male is suspected of having aplastic anemia. The expected bone marrow finding is

a. hypocellular marrow with 20% myeloblasts
b. hypocellular marrow with increased lymphocytes and plasma cells
c. granulocytic hyperplasia with all stages of myeloid maturation seen
d. megakaryocytic hyperplasia

A

B

67
Q

A 30 year old male diagnosed to have aplastic anemia 5 years ago gradually developed jaundice, pallor, reddish urine especially in the morning. Urinalysis was negative for red blood cells. The most helpful diagnostic test would be.

a. bone marrow aspiration and biopsy
b. leukemia immunophenotying
c. urine hemosiderin determination
d. flow cytometry for CD55, CD59

A

D

68
Q

The underlying pathophysiology for paroxysmal nocturnal hemoglobinuria is

a. hereditary
b. lack of glycosyl phosphatidyl inositol-linked cell surface membrane proteins
c. tumor necrosis factor and gamma interferon elaborated by cytotoxic T cells
d. presence of red cell antibodies

A

B

69
Q

Apheresis can be used to collect all of the following except

a. leukocytes
b. macrophages
c. hematopoietic progenitor cells
d. platelets

A

B

70
Q

Patients at greatest risk of developing transfusion associated circulatory overload may include:

a. children
b. elderly people
c. patients with chronic normo-volemic anemia
d. all of the above

A

D

71
Q

Fatal transfusion reactions are most frequently caused by

a. clerical errors
b. improper refrigeration
c. overheated blood
d. mechanical trauma

A

A

72
Q

When a suspected hemolytic reaction occurs, the first thing to do is

a. slow the transfusion rate and call the physician
b. administer medication to stop the reaction
c. stop the transfusion but keep the intravenous line open with saline
d. first inform the laboratory to begin an investigation

A

C

73
Q

Pre transfusion irradiation of all blood products in certain patients is done to prevent which of the following

a. cytomegalovirus
b. transfusion associated graft vs. host disease
c. febrile non hemolytic transfusion reaction
d. hemolytic transfusion reaction

A

B (Feedback answer: C)

74
Q

What describes the clonal cell in multiple myeloma?

a. bilobed nucleus with prominent eosinophilic nucleoli
b. large mononuclear cell, fine chromatin material with minimal cytoplasm
c. round cell with round indented nucleus and perinuclear clearing
d. small round cell with clumped chromatin material and minimal to moderate cytoplasm.

A

C

75
Q

What is included in the “B symptoms” of lymphoma?

a. Pruritus
b. Jaundice
c. Weight Loss
d. Anorexia

A

C

76
Q

Which anemic patient with high creatinine likely has multiple myeloma?

a. Normal serum calcium and high uric acid
b. High serum calcium and lytic lesions on bone scan
c. > 30% plasma cell on bone marrow aspirate and lytic lesions on skeletal survey
d. 10% plasma cell on bone marrow aspirate and elevated serum Ig

A

C

77
Q

Prognosis is best correlated with that in Multiple Myeloma?

a. CRP and B microglobulin
b. LDH and serum creatinine
c. ESR and LDH
d. serum calcium and LDH

A

A

78
Q

Lymphoma and Multiple Myeloma are disorder of what lineage?

a. Myeloid
b. Lymphoid
c. Unknown
d. Stromal Cells

A

B

79
Q

The diagnostic test for the thalassemias is

a. Autohemolyis test
b. Coombs’ Test
c. Hemoglobin Electrophoresis
d. Osmotic Fragility Test

A

C

80
Q

The definitice diagnostic procedure for Hereditary Spherocytosis is

a. Hgb electrophoresis
b. Ham’s Test
c. Osmotic Fragility Test
d. Coomb’s Test

A

C

81
Q

Which treatment option offers a clinical cure for hereditary spherocytosis?

a. PRBC transfusion
b. Splenectomy
c. Folic Acid
d. Iron chelatation

A

B

82
Q

In Beta thalassemia major, this Hgb is markedly elevated

a. Hb A1
b. Hb A2
c. Hb H
d. Hb F

A

D

83
Q

The clinical triad of hemolytic anemia does not include:

a. Splenomegaly
b. Hepatomegaly
c. Jaundice
d. Pallor

A

B

84
Q

The objective of hypertransfusion and supertransfusion in thalassemia major is

a. to increase the patient’s Hgb level
b. to increase patient’s RBC in the blood
c. to increase the patients iron stores
d. to suppress erythropoiesis

A

D

85
Q

In tumor lysis syndrome, what is the metabolic imbalance encountered?

a. inc K, low PO4, low Ca, High uric acid
b. inc. K, High Po4, High Ca, High uric acid
c. inc. K, High Po4, low Ca, high Uric acid
d. dec. K, High Po4, low Ca, High Uric acid

A

C

86
Q

In chronic lymphocytic leukemia, the proliferating cells in the blood are:

a. large with round nuclei, prominent nucleoli and scant cytoplasm
b. large indented nuclei, prominent nucleoli and abundant cytoplasm
c. small irregular nuclei, inconspicuous nucleoli and vacuolated cytoplasm
d. small with round nuclei, inconspicuous nucleoli and scant cytoplasm

A

D

87
Q

Red cell hypochromasia is seen only in:

a. myelodysplastic syndrome
b. sickle cell disease
c. spherocytosis
d. polychythemia

A

A

88
Q

At birth fetal red cells contain 53 to 95%

a. Hb A1
b. Hb A2
c. Hb F
d. Hb H

A

C

89
Q

The only indication in fresh whole blood in neonates is:

a. hemodialysis
b. exchange transfusion
c. hypovolemic shock
d. uremia

A

B

90
Q

Choice of blood for exchange transfusion in ABO incompatibility:

a. Type O Rh positive PRBC
b. Type-specific Rh positive FWB
c. Type O Rh positive FWB
d. Type-specific Rh positive PRBC

A

C

91
Q

Hemophilia A and B are both inherited as:

a. Autosomal recessive
b. Autosomal dominant
c. x-linked recessive
d. x-linked dominant

A

C

92
Q

A hemophilic baby should be delivered by:

a. normal vaginal delivery
b. caesarian section
c. outlet forceps extraction
d. vacuum extraction

A

B

93
Q

Prevention of hemorrhagic disease of the newborn is achieved by:

a. cryosupernate transfusion at birth
b. fresh frozen plasma transfusion at birth
c. cow’s milk formula
d. routine Vit K prophlaxis at birth

A

D

94
Q

Treatment of bleeds in Von Willebrand’s Disease:

a. platelet concentrates
b. stored plasma
c. Cryoprecipitates
d. Cryosupernates

A

C

95
Q

The blood component of choice for Hemophilia B is:

a. Fresh Frozen plasma
b. Cryoprecipitates
c. Cryosupernates
d. Platelet concentrates
A

C

96
Q

(+) Anti A testing reagent
(-) Anti B testing reagent

Blood type?

A

Type A

97
Q

(-) Anti A testing reagent
(+) Anti B testing reagent

Blood type?

A

Type B

98
Q

(-) Anti A testing reagent
(-) Anti B testing reagent

Blood type?

A

Type O

99
Q

(+) Anti A testing reagent
(+) Anti B testing reagent

Blood type?

A

Type AB

[OS 216] Hema E1 (7 decks)

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