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Blood Module - 3rd year > 2015 module exam > Flashcards

2015 module exam Flashcards

1
Q

Which mutation is found in HbSS?
A) glu6val
B) glu26val
C) glu6lys

A

A) glu6val

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2
Q

How many alpha mutations are in HbH hemoglobin?
A) 2
B) 3
C) 4

A

B) 3

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3
Q 
Hb Bart's Hydrops fetalis syndrome results from deletions of how many and what type of globin?
A) 4, gamma globin 
B) 4, alpha globin 
C) 4, beta globin
D) 2, gamma globin
A

B) 4, alpha globin

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4
Q 
In HPFH, the switch from what to what is impaired?
A) gamma to beta
B) alpha to beta
C) epsilon to gamma 
D) alpha to gamma
A

A) gamma to beta

HPFH= Hereditary Persistence of Fetal Hemoglobin

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5
Q 
A patient underwent hypoxia while having an already-existing renal disease. Which hematopoietic cell decreases in this condition?
A) Neutrophils
B) Lymphocytes
C) Monocytes 
D) Proerythroblasts
A

D) Proerythroblasts

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6
Q 
what drug is used to prevent myelosuppression and mucositis during treatment with antimetabolites?
A) MTX
B) cytosine arabinoside
C) leucovorin
D) 6 – mp
A

C) leucovorin

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7
Q

Which of the following molecules is associated with lipid rafts?
A) Sphingomyelin
B) AE1 transporters
C) Glut1

A

A) Sphingomyelin

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8
Q 
Which of the following molecules activates FXII? 
A) Kallikrein
B) HMW kininogen 
D) Pre-kallikrein
E) Hagemanfactor
A

A) Kallikrein

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9
Q

Which of the following is responsible for T cell death upon its presentation to a self- antigen?
A) Positive selection
B) Negative selection
C) ADCC

A

B) Negative selection

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10
Q 
Which of the following immunoglobulins results in hemorrhagic disease of the newborn?
A) IgM  
B) IgA 
C) IgG
D) IgE
A

C) IgG

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11
Q 
In a man with Hereditary spherocytosis, which of the following is expected? 
A) high conjugated bilirubin
B) gallstone
C) low reticulocytes
D) hypocellular BM
A

B) gallstone

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12
Q

What blood type combination would cause hemolytic disease of the newborn?
A) Rh+ dad Rh- mom
B) Rh+ dad and Rh+ mom
C) Rh- dad Rh+ mom

A

A) Rh+ dad Rh- mom

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13
Q

A patient just came in from road traffic accident, what will you give him?
A) Packed RBC when 2 liters of blood is lost
B) FFP as a volume expander of blood
C) Packed RBC when 10% of his blood is lost

A

A) Packed RBC when 2 liters of blood is lost

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14
Q

What happens if you give IgA to an IgA deficient recipient?
A) Bacterial contamination
B) Graft vs host disease
C) Anaphylactic reaction
D) delayed hemolytic transfusion reaction

A

C) Anaphylactic reaction

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15
Q 
What is reduced with gamma irradiation? 
A) Graft vs host disease
B) Bacterial contamination
C) Viral infections
D) Acute hemolytic transfusion reaction
A

A) Graft vs host disease

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16
Q

What would be the strongest evidence to suggest iron-deficiency anemia?
A) Low transferrin saturation
B) Low hemosiderin
C) Low serum iron

A

A) Low transferrin saturation

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17
Q 
A patient came with severe blood loss and there was no time to type his blood type. What blood group can be used immediately in this emergency?
A) A + 
B) O- 
C) O+ 
D) AB+
A

B) O-

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18
Q

How do you store platelets?
A) 20C, 5 days
B) 20C, 30 days
C) -20 C, 5 days

A

A) 20C, 5 days

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19
Q 
If a person has a blood group A then which antibodies are present in that person's blood?
A) anti-A antibodies 
B) anti-B antibodies 
C) anti-O antibodies 
D) anti-H antibodies
A

B) anti-B antibodies

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20
Q 
There are few different markers that we use in the clinic to assist our differential to microcytic anemia. Which of the following types would have a reduced ferritin level?
A) Myelodysplasia
B) Anemia of chronic disease 
C) Sideroblastic anemia
D) Thalassemia
E) Iron deficiency anemia
A

E) Iron deficiency anemia

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21
Q

Which of the following fusion protein would result in the development of chronic myeloid leukemia?
A) P190
B) P210
C) P230

A

B) P210

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22
Q 
In hypersensitivity type II, which of these mechanisms results in RBCs destruction? 
A) ADCC
B) Major cationic proteins 
C) Perforin
D) Phagocytosis
A

A) ADCC

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23
Q 
What is the factor used to initiate the intrinsic pathway if we want to make the reaction in a tube (in vitro)?
A) prothrombin
B) factor Xa
C) factor XIIIa 
D) factor V
E) factor XIIa 
F) factor VII
A

E) factor XIIa

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24
Q

Which of the following is an oral anticoagulant with rapid action but short half-life?
A) Heparin
B) Otamixaban

A

B) Otamixaban

Otamixaban is administered by IV, so this is probably wrong.

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25
Q

In a patient with septicemia, prolonged APTT and PT, low platelets and fibrinogen, what diagnostic test is performed next?
A) D dimer
B) Blood test

A

A) D dimer

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26
Q 
Patient with MI was given anticoagulants, what would be a reason for alarm?
A) purpura
B) high creatinine
C) body weight
D) history of jaundice 
E) rash
F) nausea
A

A) purpura

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27
Q

A woman came to the clinic with a mottled purple leg. She had a previous miscarriage and her APTT was high. What could her diagnosis be?
A) antiphospholipid syndrome
B) DIC
C) TTP

A

A) antiphospholipid syndrome

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28
Q 
Which of the following is a transfusion hazard associated with platelets transfusion?
A) TRALI
B) Bacterial contamination
C) Febrile non-hemolytic reaction 
D) Graft vs host hemolysis
E) Delayed reaction hemolysis
F) Anaphylactic reaction
A

B) Bacterial contamination

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29
Q

40 y/o male with spontaneous gum swelling and bleeding. CBC: low Hb, low Plt, Normal WBC
PBS: circulating immature cells
What is the most useful investigation to help in diagnosis?
A) Morphology of BM aspirate
B) immunophenotyping of PB lymphocytes
C) Reticulocyte counts

A

A) Morphology of BM aspirate

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30
Q

Which of the following is a tyrosine kinase inhibitor?

a. clopidogrel
b. imantinib

A

b. imantinib

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31
Q 
What component if exposed on the outer aspect of the RBC will lead to the removal of the RBC from the circulation?
A) Phosphatidylserine 
C) Ankyrin
D) Spectrin
E) Actin
F) Phosphatidylcholine 
G) Sphingomyelin
A

A) phosphatidylserine

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32
Q 
Which leukemia is more likely to present with an abnormal tyrosine kinase activity?
A) CLL 
B) ALL 
C) AML 
D) CML
A

D) CML

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33
Q

What is the mechanism of action of heparin?
A) direct inhibitor of factor 10A
B) increases activity of antithrombin III
C) direct inhibitor of thrombin

A

B) increases activity of antithrombin III

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34
Q

what is involved in suppressing trilineage hematopoiesis activity in tuberculosis?
A) colony-stimulating factors (CSFs)
B) IL (interleukins)
C) TNF (tumor necrosis factor)

A

C) TNF (tumor necrosis factor)

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35
Q 
Which molecule chemotactically attracts neutrophils to sites of inflammation?
A) Complement fragments 
B) Immunoglobulins
D) Fc receptors
E) Defensins
A

A) Complement fragments

36
Q 
A gain of function mutation in which gene causes APC resistance and thrombotic disorder?
A) antithrombin
B) protein C
C) FV
D) tissue plasminogen activator
37
Q

Which of the following irreversibly inhibits ADP-dependent pathway of platelet aggregation?

a. clopidogrel
b. imantinib
c. deferoxamine
d. deferasirox

A

a. clopidogrel

38
Q

Which one of the following is an iron-chelating factor given as long subcutaneous transfusions?

a. clopidogrel
b. imantinib
c. deferoxamine
d. methotrexate

A

c. deferoxamine

39
Q

Which one is an iron-chelating factor that is lipophilic and can enter the cell?

a. clopidogrel
b. imantinib
c. leucovorin
d. deferasirox
e. deferoxamine

A

d. deferasirox

40
Q 
Which TWO cause photosensitivity/light sensitivity?
A) Protoporphyrin ix
B) ALA Acid
C) PBG
D) Hydroxymethlbilane
A

A) Protoporphyrin ix
&
D) Hydroxymethlbilane

41
Q

What is the mechanism of action for alkylating agents?
A) Cell cycle specific
B) Does not cause secondary cancer
C) Does not cause bone marrow suppression
D) Cross link DNA

A

D) Cross link DNA

42
Q 
Which of the following is a folate antagonist? 
A) Methotrexate
B) leucovorin
C) imantinib 
D) deferoxamine
A

A) Methotrexate

43
Q 
A person had a car accident and started bleeding. His hemoglobin was 50g/l, then 2 packs of packed RBCs were transfused. what is his hemoglobin following the transfusion?
A) 55 g/l
B) 70 g/l 
C) 100 g/l 
D) 60 g/l
44
Q 
A 6-month old girl slipped and fell. She started bleeding from her mouth. The mother couldn't stop the bleeding, so she took her to the emergency.
Tests showed:
Platelet: 236 x10^9
PT: 12 seconds
APTT: > 120 seconds
What is the diagnosis?
A) Hemophilia A
B) Von Willebrand disease
C) Factor VII deficiency
D) Vitamin K deficiency
A

no answer given

45
Q

What is diminished with leukoreduction?
A) Febrile non-hemolytic reaction
B) Graft vs host disease
C) Lung injury

A

A) Febrile non-hemolytic reaction

leukoreduction= Filtration of the blood

46
Q

Exposure of what triggers thrombin formation?
A) internal lamina
B) external lamina
C) connective tissue of subendothelium

A

C) connective tissue of subendothelium

47
Q

CLL is characterized by which of the following?
A) Monoclonal b cell lymphocytosis
B) monoclonal ig increase

A

A) Monoclonal b cell lymphocytosis

48
Q 
What is frequently asymptomatic? 
A) AML
B) CML
C) MGUS
D) Bacterial infection
49
Q 
What causes renal failure and lytic bone lesions? 
A) Multiple myeloma
B) MGUS
C) AML
D) CML
A

A) Multiple myeloma

50
Q 
Which translocation causes acute promyeloid leukemia? 
A) t (9:22)
B) t (15:17) 
C) t (9:17)
D) t (8:14)
A

B) t (15:17)

51
Q 
What is the mutation found in Burkitt’s lymphoma? 
A) t (8:14)
B) t (14:18)
C) t (9:17)
D) t (9:22)
A

A) t (8:14)

52
Q 
Where would you find cells expressing CD15 and CD 30?
A) Hodgkin’s lymphoma 
B) CML
C) AML
D) ALL
E) Follicular lymphoma
A

A) Hodgkin’s lymphoma

53
Q

Which of the following is an anti-bacterial material present in eosinophils?
A) major basic protein and cationic protein
B) lysozymes
C) defensins
D) granzymes
E) perforins

A

A) major basic protein and cationic protein

54
Q

Which of the following is present in neutrophilic granules?
A) major basic protein and cationic protein
B) lysozymes
C) defensins
D) granzymes
E) perforins

A

B) lysozymes

55
Q 
Where would you find large binucleated cells? 
A) Hodgkin’s lymphoma
B) CML
C) AML
D) ALL
E) Follicular lymphoma
A

A) Hodgkin’s lymphoma

56
Q 
Which of the following has the lowest frequency of Philadelphia chromosome? 
A) child ALL
B) adult ALL 
C) CML
D) AML
57
Q 
A patient comes with intracranial hemorrhage and is on warfarin for treatment of heart disease. What would be administered?
A) FFP
B) Platelet concentrates 
C) Packed RBC
D) cryopercipetate
E) filtered Packed RBC
58
Q

In a biopsy of AML, what would you see in BM?
A) BM hypoplasia
B) infiltration by blast cells

A

B) infiltration by blast cells

59
Q

A patient with acute leukemia presentation + bone pain, what cells will u see in BM?
A) B lymphoblasts
B) B lymphocytes
C) neutrophils

A

A) B lymphoblasts

60
Q

Nucleoid budding, hypolobulated megakaryocytes, and pancytopenia indicate which of the following?
A) AML
B) CML
C) MDS

61
Q 
What factor is affected in a gain of function mutation that stabilizes 3' UTR causing thrombophilia?
A) Prothrombin 
B) Factor V
C) Factor VII 
D) Factor Xa 
E) Factor
A

A) Prothrombin

62
Q

Patient with low platelet count and large platelets seen on PBS. What do u administer?
A) platelet concentrates
B) FFP
C) Immunoglobulins

A

C) Immunoglobulins

??

63
Q 
what binds to Vitamin B12 in the duodenum? 
A) haptorcorrin
B) gastric intrinsic factor 
C) hepcidin
D) food protein
A

B) gastric intrinsic factor

64
Q

What glycoprotein helps thrombin bind to activated protein C?
A) Thrombomodulin
B) Prothrombin
C) Factor 8

A

A) Thrombomodulin

65
Q

Myoglobin and hemoglobin curve, why is it shaped the way it is?
A) Myoglobin has Fe3+ iron but Hb doesn’t
B) Myoglobin binds CO2 Hb doesn’t
C) Myoglobin has no cooperativity

A

C) Myoglobin has no cooperativity

66
Q 
A man was traveling and had a car accident, which resulted in bleeding and severe anemia. He needed a blood transfusion. His blood group is (O positive) and received group (A positive) blood transfusion. What will happen?
A) agglutination of donor’s blood
B) Agglutination of recipient’s blood 
C) Both will agglutinate.
D) No agglutination occurs.
A

A) agglutination of donor’s blood

67
Q

What is true about O2 binding to hemoglobin?

a. Cooperativity is present, due to iron moving relative to the plane of heme
b. No cooperativity present

A

a. Cooperativity is present, due to iron moving relative to the plane of heme

68
Q

Suppression of which hormone will help in the treatment of microcytic anemia in patients with rheumatoid arthritis?
A) Hepicidin
B) Erythropoietin
C) TSH

A

B) Erythropoietin

69
Q

Why is G-CSF given to stem cell donors?

A

mobilize stem cell to peripheral blood of donor

70
Q

During treatment for malignancy, suppression of myeloid lineage occurred. What do you give the patient?
A) G –CSF
B) TNF

A

A) G –CSF

71
Q

Mutation in which part of the vWF gene will lead to thrombocytopenia?
A) Gp1B
B) heparin
C) ADAMTS13

A

A) Gp1B
&
C) ADAMTS13

72
Q

What induces hypersensitivity cytotoxicity towards RBCs?

A

drugs adsorbed to RBCs

73
Q

Which of the following is an anti-bacterial material present in eosinophils?
A) granzymes
B) lysozymes
C) defensins
D) major basic protein and cationic protein
E) perforins

A

D) major basic protein and cationic protein

74
Q 
Which of the following is present in neutrophilic granules? A) major basic protein and cationic protein
B) lysozymes
C) defensins
D) granzymes 
E) perforins
A

B) lysozymes

75
Q 
Which of the following has the lowest frequency of Philadelphia chromosome? 
A) child ALL
B) adult ALL 
C) CML
D) AML
76
Q

How do you store platelets?
A) 20C, 5days
B) 20C, 30days
C) -20 C, 5 days

A

A) 20C, 5days

77
Q 
A patient comes with intracranial hemorrhage and is on warfarin for treatment of heart disease. What would be administered?
A) Platelet concentrates
B) FFP
C) Packed RBC
D) cryoprecipitate
E) filtered Packed RBC
78
Q

Patient with burning sensation in hands. CBC showed high hemoglobin, WBCs, and platelets. What would the investigation of the BM reveal?

A

Panmyelosis

why not ET?

79
Q

How does methylene blue reduce methemoglobin?
a- by NADPH-dependent methemoglobin reductase
b- by Cytochrome B5 NADH dependent methemoglobin reductase

A

a- by NADPH-dependent methemoglobin reductase

80
Q 
What protects vitamin B12 from denaturation in the stomach? 
A) haptocorrin
B) gastric intrinsic factor 
D) hepcidin
E) food protein
A

A) haptocorrin

81
Q

What is the most important thing for the RBCs to help withstand the mechanical sheer force of moving through small blood vessels?
A) covalent linking between membrane lipids to integral proteins
B) covalent linking of rafts to spectrin
C) binding of cytoskeleton to hemoglobin
D) binding of integral membrane proteins to cytoskeleton

A

D) binding of integral membrane proteins to cytoskeleton

82
Q

A 66-year-old female presented with dizziness & spontaneous bleeding. Her CBC findings show anemia & thrombocytopenia, her BM aspiration shows mononuclear megakaryocytes & erythroid cells with nuclear budding. What could be the issue?

A

myelodysplastic syndrome

83
Q

Characteristic of B cell diffuse lymphoma
A) Indolent lymphoma
B) Malignant cell expressCD20
C) t (14,18)

A

B) Malignant cell expressCD20

84
Q

Factor V Leiden mutation leads to thrombotic diseases. Which molecule controls normal factor V function?

85
Q

What do eosinophils secrete during respiratory burst?

A

reactive oxidative intermediates

Blood Module - 3rd year (16 decks)

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