2016 module exam Flashcards
What is the characteristic of hematopoietic stem cells?
a- Infrequent in adult bone marrow
b- No mechanism of apoptosis
c- Symmetric division of these cells
a- Infrequent in adult bone marrow
Which cells express CD34+ on their surface?
a- T-cells
b- Multipotent stem cells
c- Pluripotent stem cells
c- Pluripotent stem cells
Patient has rheumatoid arthritis with lab tests of high serum ferritin, what is the diagnosis?
a- anemia of chronic disease
b- pernicious anemia
c- acute hemolytic anemia
a- anemia of chronic disease
5-year-old boy with sickle cell anemia presented with reticulocytopenia. Blood smear shows giant mononucleated erythrocytes. What is the causative agent?
a) HIV
b) EBV
c) CMV
d) Rubella
(no answer given; parvovirus attacks erythroid precursors and causes reticulocytopenia, so that’s probably the answer)
How does CO2 affect Hb? a- Methemoglobin is produced b- o2 binding site of heme is blocked c- affinity for binding o2 decreases d- hemoglobin tetramer dissociates
c- affinity for binding o2 decreases
Folate deficiency during pregnancy can cause:
a) Hemolytic anemia
b) Neural tube defect
c) Phocomelia
d) Duodenal atresia
e) Hemolytic disease of the new born
b) Neural tube defect
The first sign of iron deficiency anemia: A- increase TIBC B- decrease serum iron C- decrease serum ferritin D- decrease transferrin saturation E- microcytic hypo-chromic anemia
C- decrease serum ferritin
What is the most important thing for RBC to withstand mechanical shear force when moving through small blood vessels?
a- G6PD enzyme present in RBC
b- Integral membrane protein noncovalent attachment to cytoskeleton
c- hemoglobin distributed evenly across the cell
b- Integral membrane protein noncovalent attachment to cytoskeleton
What is the main cause of medication-induced acute hepatic porphyria?
a) it increases the demand of heme
b) inhibit ALA synthase
a) it increases the demand of heme
Which hematopoietic cells are likely to be decreased in a 35-year-old male presenting with hypoxia due to a kidney disease? A) Megakaryocytes B) Monocytes C) Myelocytes D) Proerythroblasts
D) Proerythroblasts
What membrane component helps bind red cell membrane to cytoskeleton? a- AE 1 b- nucleoside transporter c- glucose transporter d- glycophorin A
a- AE 1
35-year-old woman underwent gastric sleeve operation for morbid obesity one year ago. She was referred to you complaining of shortness of breath on exertion, easy fatiguability, and bleeding. What is the mechanism explanation of the complaints?
A) hemolysis
B) autoantibodies against gastric intrinsic factors
C) defect primary hemostasis
D) distributed iron body cycle
D) distributed iron body cycle
direct coombs test is used to detect antibody in which compartment of blood?
a. serum
b. surface RBCs
c. surface of platelet
d. inside WBCs
b. surface RBCs
What virus is associated with tropical spastic paresis? a-HTLV-1 b-HTLV-2 c-CMV d-Parvovirus e-EBV
a-HTLV-1
Which of the following is a characteristic component of “lipid raft” microdomain? A-AE1 B-Glut1 C-ankyrin D-spectrin E-Sphingomyelin F-Phosphatidylcholine
E-Sphingomyelin
Which of the following is an integral membrane protein that attaches the cytoskeleton to the RBC membrane? A-AE1 B-Glut1 C-ankyrin D-spectrin E-Sphingomyelin F-Phosphatidylcholine
A-AE1
Which has abundant cytoplasm and prominent Rough ER? A- T-lymphocytes B- Plasma cells C- T-cytotoxic cells D- T-helper cells E- Kupffer cells F- Antigen Presenting Cells
B- Plasma cells
Which preferentially decreases in HIV? A- T-lymphocytes B- Plasma cells C- T-cytotoxic cells D- T-helper cells E- Kupffer cells F- Antigen Presenting Cells
D- T-helper cells
Which of the above choices is orthochromatic? a- Basophils b- Eosinophils c- T lymphocytes d- B lymphocytes e- Neutrophils g- Normoblast
g- Normoblast
HPFH is characterized by impairment of perinatal switching of which globin chains? a- alpha to beta b- epsilon to beta c- gamma to beta d- zeta to beta
c- gamma to beta
If Someone is living on high altitudes on the mountains, which enzyme has to be activated to compensate his status? a- 2,3 Biphosphoglycerate phosphatase b- 3-Phosphoglycerate kinase c- 2,3 Biphosphoglycerate mutase d- Pyruvate kinase
c- 2,3 Biphosphoglycerate mutase
Fresh frozen plasma should not be transfused to patients with which of the following conditions: A- severe liver disease B- DIC C- massive transfusion D- hemophilia A E- isolated inherited factor deficiency
D- hemophilia A
How does methylene blue reduce methemoglobin?
a- by NADPH-dependent methemoglobin reductase
b- by Cytochrome B5 NADH dependent methemoglobin reductase
a- by NADPH-dependent methemoglobin reductase
What is a common finding in B- thalassemia major patient? A- raised serum conjugated bilirubin B- low reticulocytes C- gallstones D- autosplenectomy e- hypocellular BM
C- gallstones
Which of the following cause acute hemolytic reaction if given to the patient? a- O donor to A recipient b- O donor to Ab recipient c- A donor to O recipient d- rh+ve to rh-ve e- rh-ve to rh+ve
c- A donor to O recipient
When it’s advised for a patient who receives regular blood transfusion to take Deferosirox?
a- when kidney function is abnormal
b- if iron is constantly greater than 1000g/m
c- after doing hepatic tests
d- if the patient develops diabetes
b- if iron is constantly greater than 1000g/m
21-year-old woman with low grade fever, sore throat, difficulty swallowing, general malaise and atypical mononuclear cell. What is the causative agent?
a) Hemophilus influenza
b) Epstein Barr virus
c) Parvovirus B19
d) Adenovirus
b) Epstein Barr virus
Which of the following is responsible for hemolysis of RBCs in auto immune haemolytic anemia?
a) Cytotoxic T-cells
b) Neutrophils
c) TNF
d) Perforins
a) Cytotoxic T-cells
A 2-year-old child brought to the pediatric ward by his Mediterranean parents he was not feeding normally, he showed pallor and not growing normally. On examination, he showed pallor and splenomegaly and microcytic hypochromic anemia. Which hemoglobin was found?
A- HbF
B- HbA2
A- HbF
What is the best treatment option of hemophilia A? a- fresh blood b- fresh frozen plasma c- factor VIII concentrate a- cryoprecipitate
c- factor VIII concentrate
Patient has microcytic anemia and splenomegaly, what is the diagnosis?
a- Sickle cell anemia
b- Thalassemia major
b- Thalassemia major
Abnormal hemoglobin tetramer developed by polymerization of 4 gene subunits a-Hb Gower 1 b-Hb Bart c-Hb Portland d-HbH e-HbE f- HbS
b-Hb Bart
Predominant type of defective Hb found in patients with severe alpha thalassemia? a-Hb Gower 1 b-Hb Bart c-Hb Portland d-HbH e-HbE
d-HbH
what’s the Hb found in 50% B-thalassemia major? a- HbS b- HbE c- HbE/beta thalassemia d- HbS/beta thalassemia
c- HbE/beta thalassemia
A 23 year old Italian woman going to her routine checkup in her first trimester the findings were: 110hb, low MCV low MCH and high HbA2 4.4%
A) B thalassemia heterozygosity
B) alpha thalassemia
A) B thalassemia heterozygosity
Which of the following anticancer drugs could cause pulmonary fibrosis as a side effect?
a- busulfan
b- topotecan
c- vincristine
a- busulfan
Which of the following molecules is used by granulocytes to opsonize pathogens? A) Adhesion molecules B) Fc receptors C) complement D) Defensins
B) Fc receptors
Patient comes to you with complaints of mild sore throat, fever, productive cough, and tachycardia. Upon examining the peripheral blood smear, what would you see?
a- Eosinophilia
b- Neutrophilic left shift
b- Neutrophilic left shift
What is the function of ETO-AML1?
a) transcription factor
b) TNF
c) Tyrosine Kinase inhibitor
a) transcription factor
A 55-year-old man admitted to the hospital with DVT in his right leg. CBC shows normal WBCs high Hb and very high platelets count (1350 X10^9/L). What genetic defect did he have?
a- BCR-ABL gene
b- JAK-2 defect
b- JAK-2 defect
What is the function of retinoic acid as a form of treatment when administered to patients with PML? a- Enhances / activates PML-RARA b- Degrades PML-RARA c- Increases affinity of PML-RARA d- Activates the expression of PML-RARA
d- Activates the expression of PML-RARA
(Not sure, the question was canceled)
(another exam ‘14 with the same Q had the answer as B)
What is a general characteristic of alkylating antineoplastic drug?
A) Cross link DNA
B) Does not cause secondary cancer
C) Does not cause bone marrow suppression
D) Cell cycle specific
A) Cross link DNA
30-year-old woman experiences weakness and fatigue. Her CBC showed low hemoglobin, low platelet, low WBC, and low reticulocytes. Patient did not show hepatosplenomegaly nor lymphadenopathy. Peripheral blood smear examination showed macrocytic RBCs with hyper segmented neutrophils. What is the diagnosis? a- aplastic anemia b-hyperthyroidism c-megaloblastic anemia d-MDS e-liver disease
c-megaloblastic anemia
MDS= Myelodysplastic syndrome
What is the structural unit of bone marrow?
a. haversian system
b. capillary-venous sinus
b. capillary-venous sinus
Which drug is a tyrosine kinase inhibitor? a- Imatinib b- Cyclophosphamide c- Doxorubicin d- Mercaptopurine e- Methotrexate f- Fluorouracil
a- Imatinib
Which drug causes neurotoxicity? a- Imatinib b- Cyclophosphamide c- Doxorubicin d- Mercaptopurine e- Methotrexate f- Fluorouracil
e- Methotrexate
Patient is a 66-years old woman. CBC shows anemia and thrombocytopenia. BM aspirate shows mononuclear megakaryocytes and erythroid cells with nuclear budding. What’s the most likely diagnosis?
a- MDS
b- AML
a- MDS
What is treated by tyrosine kinase inhibitor?
a- megaloblastic leukemia
b- acute myeloid leukemia
c- chronic myeloid leukemia
c- chronic myeloid leukemia
A 35-year-old man presented with a painful burning sensation of the hands. CBC shows normal Hb, normal WBC and the platelet is 1000*10^9gm/l. What's the most likely diagnosis? a- Acute Lymphoid Leukemia b- Acute Myeloid Leukemia c- Polycythemia Vera d- Essential thrombocytopenia
d- Essential thrombocytopenia
Which is an azurophilic cell that is involved in allergic reactions? a- Basophils b- Eosinophils c- Neutrophils d- Macrophages e- T lymphocytes
b- Eosinophils
Which is an antibacterial factor found in neutrophilic granules? A- Cationic protein B- IFN gamma C-TNF alfa D-granzymes E- lysozyme G-Perforin
E- lysozyme
Which is an anti-bacterial factor present in eosinophilic granules? A- Cationic protein B- IFN gamma C-TNF alfa D-granzymes E- lysozyme G-Perforin
A- Cationic protein
which condition is associated with mutations in nucleophosmin1? a-CLL b-CML c-AML d-MDS e-ALL
c-AML
Retinoic acid is a treatment option for which of the following? a-CLL b-CML c-AML d-MDS e-ALL
c-AML
APL= more accurate
Which of the following produce cytokines? a-Eosinophils and neutrophils b- Basophils and neutrophils c- Megakaryocytes and B cells d- Macrophages and T cells
d- Macrophages and T cells
How do cytotoxic T cells identify viral antigens? a- With MHC class 1 molecules b- With MHC class 2 molecules c- CD8 d- CD4
c- CD8
T-cells that recognize self-antigen presented on MHC are eliminated by a process called:
a) negative selection
b) positive selection
c) T Cell activation
d) T cell suppression
e) T cell differentiation
a) negative selection
Which of the following is true regarding primary amyloidosis?
a- extracellular deposition of fibrin
b- extracellular deposition of proteins in an abnormal fibrillar form
b- extracellular deposition of proteins in an abnormal fibrillar form
An 8-year-old boy complaining of bone pain and limping. His CBC showed leukocytosis and thrombocytopenia. His peripheral blood smear showed small rare circulating mononuclear cells with high nuclear-cytoplasmic ratio, scanty cytoplasm and fine chromatin. What could be the cause? A) Acute viral infection B) Osteomyelitis C) Acute lymphocytic leukemia D) Chronic myeloid leukemia
C) Acute lymphocytic leukemia
A 30-year-old female shows normocytic anemia and spherocytosis on a peripheral blood smear examination. Her DAT is positive. What is the diagnosis? A) Acute viral infection B) Osteomyelitis C) Immune mediated hemolysis D) Spherocytosis
C) Immune mediated hemolysis
Peripheral blood smear from a 68-year-old man shows increased mature lymphocytes and smudge cells. Which of the following does he have? a- CLL b- Hodgkin’s lymphoma c- Follicular Lymphoma d- Diffused large B-cell lymphoma e- Multiple Myeloma f- Burkitt’s lymphoma
a- CLL
Chronic lymphocytic leukemia
Patient cytogenic analysis showed translocation t(14,18). Which of the following does he have? a- CLL b- Hodgkin’s lymphoma c- Follicular Lymphoma d- Diffused large B-cell lymphoma e- Multiple Myeloma f- Burkitt’s lymphoma
c- Follicular Lymphoma
Patient has CD15/30 in biopsy examination and showed binucleated cells. Which of the following does he have? a- CLL b- Hodgkin’s lymphoma c- Follicular Lymphoma d- Diffused large B-cell lymphoma e- Multiple Myeloma f- Burkitt’s lymphoma
b- Hodgkin’s lymphoma
What is expected in coagulation profile in thrombotic thrombocytopenia purpura (TTP)?
a- prolonged PT
b- prolonged APTT
c- normal PT and APTT
c- normal PT and APTT
a 76-year-old male with ischemic heart disease with symptoms of anemia, blood in the stool. PT, APTT, and platelet count is normal. What is the most likely diagnosis?
a- Platelet dysfunction
b- Aspirin therapy
b- Aspirin therapy
Why is Vitamin-K important?
Glutamate carboxylation
What is the mechanism underlying the abnormal coagulation test results in DIC?
A) consumptive coagulopathy
B) extravascular hemolysis
C) impaired synthesis of Coagulation factors
D) autoimmunity disorders
A) consumptive coagulopathy
A father with Hemophilia A, what is the probability of him passing it to his daughters? a- 25% b- 50% c- 75% d- 100%
d- 100%
Which substances promote platelet aggregation? A- serotonin and v factor B- Thromboxane a2 and ADP C- protein C and protein S D- Antithrombin and a2-antiplasmin E- vWF and growth factors
B- Thromboxane a2 and ADP
What is the consequence of rearrangement of factor 8 gene? A) gene inactivation, severe hemophilia B) gene duplication, mild hemophilia C) gene mutation, severe hemophilia D) gene deletion, mild hemophilia
A) gene inactivation, severe hemophilia
Which factor has the shortest half-life? a- V b- VII c- VIII d- Prothrombin e- XIII
d- Prothrombin (Not sure, the question was canceled)
Recurrent abortions are seen in: a-Factor XI deficiency b- Factor II deficiency c- Von Willebrand disease d-Factor VIII deficiency e- Antiphospholipid syndrome
e- Antiphospholipid syndrome
A mutation in what factor leads to activated resistance to Protein C & thrombotic disease?
A) Factor V
B) Factor protein C
C) Prothrombin
A) Factor V
Why is tPA is less likely to cause systemic adverse effects when given as a drug?
a- it has a short half life
b- it is an endogenous protease
c- preferentially activates fibrin bound plasminogen
d- selectively inhibits the conversion of fibrinogen to fibrin
e- it is less potent than urokinase and streptokinase
c- preferentially activates fibrin bound plasminogen
tPA=Tissue plasminogen activator
What is the role of bradykinin?
What reaction is induced by bradykinin in the dissociation of a clot?
a) Release of PAI
b) Stimulates the release of tPA from endothelial cells
c) Degradation of fibrin and fibrinogen
b) Stimulates the release of tPA from endothelial cells
Which inhibits ADP receptor?
a) Aspirin
b) Warfarin
c) Heparin
d) Enoxaparin
e) Ticlopidine
f) Alteplase
e) Ticlopidine
Mutation in vWF affects which factor? a- Prothrombin b- Plasmin c- Factor 13 d- Factor 12 e- Factor 3 f- Factor 8 g- Factor 5
f- Factor 8
Blood is clotted in a plain tube, what initiated the reaction? a- Prothrombin b- Plasmin c- Factor 13 d- Factor 12 e- Factor 3 f- Factor 8 g- Factor 5
d- Factor 12
Mutation in which factor can cause DVT? (thrombophilia) a- Prothrombin b- Plasmin c- Factor 13 d- Factor 12 e- Factor 3 f- Factor 8 g- Factor 5
g- Factor 5
