Blood Physio MCQ Flashcards
- Blood clotting in a test tube would not require:
a. Ca2+
b. Platelets
c. Vitamin K
d. Thrombin
e. Phospholipids
c. Vitamin K
- Which of the following about serum is false?
a. Proteins form the main composition of weight
b. Has little fibrinogen
c. Has few cells
d. Has sodium ions
e. Has calcium ions
a. Proteins form the main composition of weight
- A patient with moderate to severe anemia with Fe deficiency is expected to have increased
a. Vasodilation
b. Blood viscosity
c. RBC MCV
d. Arterial PO2
e. O2 binding to RBC
a. Vasodilation
- Hemolytic anemia
a. Is caused by excessive blood loss
b. Lead to raised bilirubin levels
c. Causes decreased reticulocytes
d. Causes large RBCs
b. Lead to raised bilirubin levels
- The following causes hematopoiesis EXCEPT:
a. Blood loss
b. Systemic infection
c. Administration of GCSF
d. Blood transfusion
e. Malignancy of bone marrow
d. Blood transfusion
- If the maximum amount of blood that can be safely donated is 10% of total blood volume, and the standard fixed amount of blood collected at each donation is 400ml, what is the minimum required weight of a donor? (Assume hematocrit = 0.5)
a. 38 kg
b. 40 kg
c. 42 kg
d. 44 kg
e. 46 kg
b. 40 kg
- Which of the following is not a potential cause of hypertonicity in the body?
a. Water deprivation
b. Massive sweating
c. Massive secretion of vasopressin
d. Diabetes insipidus
e. Severe diarrhea
c. Massive secretion of vasopressin
- A young boy presents with easy bruising and prolonged bleeding from cuts. His PTT is prolonged but his PT is normal. Adding fresh plasma to the PTT test normalized the PTT. Which of the following is mostly likely to be the cause of this observation?
a. Factor II
b. Factor V
c. Factor VII
d. Factor VIII
e. Factor X
d. Factor VIII
- The coagulation pathway can be amplified via
a. Thrombin activating factor V, VIII, XI
b. Va-Xa prothrombinase complex
c. VIIIa-IXa tenase complex
d. VII activation
e. XI activation
a. Thrombin activating factor V, VIII, XI
- A functional test of primary haemostasis can be measured by
a. Bleeding time
b. Activated partial thromboplastin time
c. Platelet count
d. Prothrombin time
e. Fibrinogen concentration
a. Bleeding time
- Which of the following substances enzymatically cause the polymerization of plasma fibrinogen?
a. Thromboplastin
b. Prothrombin
c. Prothrombin activator
d. Thrombin
e. Phospholipids
d. Thrombin
- A young male has a mild bleeding tendency. He undergoes an appendectomy and experiences wound dehiscence. Further evaluation is done, and he is found to have dysfibrinogenemia. His laboratory tests reflect several abnormalities. Which laboratory test is a measure of the conversion of fibrinogen to fibrin?
a. Activated partial thromboplastin time
b. Prothrombin time
c. Tourniquet test
d. Bleeding time
e. Thrombin time
e. Thrombin time
- A 21-year-old male is known to have haemophilia B. He has frequent bleeding into his large joints. Recently, he was hospitalized for a GI bleed. Which of the following laboratory test results would most likely be abnormal secondary to the underlying bleeding disorder?
a. Activated partial thromboplastin time
b. Prothrombin time
c. Tourniquet test
d. Bleeding time
e. Thrombin time
a. Activated partial thromboplastin time
A previously healthy 56-year-old female presents to the ER with a swollen cyanotic left foot and calf. Dopper ultrasound shows reduced flow in the left deep saphenous vein. The patient was started on intravenous heparin. The mechanism of the anticoagulant effect of heparin is
a. Destruction of coagulation factors
b. Forming a complex with antithrombin III
c. Inhibition of a vital enzyme in the coagulation factor activation
d. Inhibition of coagulation factors synthesis
e. Stimulating the production of anticoagulant proteins
b. Forming a complex with antithrombin III
A 7-year-old neonate (newborn baby) presented to the emergency room with bleeding from the umbilicus. The baby was delivered at home in a rural setting. A vitamin deficiency was suspected. The clotting factors affected by this vitamin are
a. Factor II
b. Factor II and VII
c. Factor II, VII, IX and X
d. Factor IX and X
c. Factor II, VII, IX and X
- A 46-year-old female patient underwent elective cholecystectomy. The attending nurse noted mild bleeding at the site of the IV line and incision site during dressing. The patient also complained of bleeding from the gums and nose. Coagulation profiles revealed prolongation of aPTT, PT and TT along with decreased fibrinogen level and increased levels of fibrinogen degradation product (FDP). Platelet count was also decreased. The patient was not suffering from any bleeding disorder prior to her hospitalization. What is the most likely cause of this patient’s bleeding tendency?
a. Deficiency of clotting factors of the intrinsic pathway
b. Deficiency of clotting factors of the extrinsic pathway
c. Platelet functional defect
d. Disseminated intravascular coagulation (DIC)
e. Cholestatic jaundice.
d. Disseminated intravascular coagulation (DIC)
In the lymph nodes, B lymphocytes are localized in follicles, with T cells more diffusely distributed in surrounding paracortical areas, also referred to as T-cell zones. Some of the B cell follicles include germinal centres, where B cells are undergoing intense proliferation. Each germinal centre consists predominately of activated B cells, a few T helper cells, and a small number of specialised cells known as
a. Eosinophils
b. Mast cells
c. Dendritic cells
d. Basophils
e. Neutrophils
c. Dendritic cells
- Cytokines are similar to polypeptide hormones, since they facilitate communication between cells and do so at very low concentrations. Cytokines are short-lived and may act locally either on the same cell that secreted them or other cells. They may also act systemically like hormones. More than 25 cytokines have now been identified to exhibit some sort of hematopoietic activity. Several have been found to have stimulatory activity on platelet production. One of these is
a. EPO
b. G-CSF
c. M-CSF
d. TPO
e. RANTES
d. TPO
A 13-year-old junior high school student awakens with a pimple on the end of his nose. In school, he is cruelly mocked and teased by his classmates who name him “Uncool bumpy nose”. In the restroom, he squeezes the pimple. At lunch, he collapses in the cafeteria and is brought to your clinic with a fever of 106°F. Which of the following would you expect to find on his differential white blood cell count?
a. Increased number of granulocytes
b. Increased number of platelets
c. Increased number of megakaryocytes
d. Increased number of reticulocytes
e. Increased number of lymphocytes
a. Increased number of granulocytes
You order heparin to be administrated prophylactically to your 59-year-old female patient who has suffered myocardial infarction: 10,000 USP units, q 12 h SC. Which test will you use to monitor this heparin therapy?
a. Prothombin time
b. Partial thromboplastin time
c. Thrombin time
d. Specific factor assay
e. Platelet count
b. Partial thromboplastin time
A 29-year-old female patient presented to the attending doctor with a complaint of black, tarry stools. History revealed that she had undergone mitral valve replacement surgery two years ago due to severe rheumatic mitral stenosis. Since then she has been receiving oral anticoagulants such as warfarin. On examination, her blood pressure and pulse rate were normal. However, she has subconjunctival hemorrhage and bleeding gums. Examination also reveals bruises on arms and legs. The attending resident rightly diagnosed an inadvertent dose of warfarin. Immediate restoration of hemostatic competence can be obtained by administration of:
a. Vitamin K1
b. Fresh frozen plasma
c. Protamine sulphate
d. Tissue plasminogen activator
e. Vitamin C
f. Calcium
b. Fresh frozen plasma
- Many proteins in the cell must undergo post-translational modifications in order to become physiologically active. Several of the enzymes involved in the blood coagulation cascade undergo post-translational modifications. One particular modification of prothrombin requires the presence of
a. Dicoumarol
b. Vitamin K
c. Calcium phosphate
d. Vitamin C
e. Oestrogen
b. Vitamin K
A 20-year-old female presents with a history of easy bruising, menorrhagia, and frequent epitaxis. Physical examination is otherwise unremarkable. Her CBC and coagulation results are as follows;
RBC 5.0 x 106/ml (3.5 – 5.5) Haemoglobin 12.5 mg/dl (11.0 – 16.0) WBC 5.6 x 103/ml (4.0 – 10.0) Platelets 120 x 103/ml (150 – 400) Bleeding time 12 minutes (2 – 6) PT 15 seconds (10 – 13) PTT 60 seconds (20 – 34) TT 1 second longer than control Fibrinogen 250 mg/dl (200 – 400)
The prolonged PTT completely corrects to 35 seconds after mixing with normal plasma (1:1 mix). Morphologic review of the peripheral blood smear is unremarkable. The next test you need to order for the patient’s work up is:
a. Fibrin degradation products
b. Intrinsic coagulation pathway factor assays
c. Platelet aggregation studies
d. Von Willebrand’s factor antigen assay
e. Von Willebrand’s factor multimeric assay
b. Intrinsic coagulation pathway factor assays
Prothombin time is prolonged in which of the following conditions?
a. Deficiency of factor VII
b. Haemophilia
c. Christmas disease
d. Thrombotic thrombocytopenia purpura
e. Henoch-Scholein purpura
a. Deficiency of factor VII
A 35-year-old female underwent elective cholecystectomy for obstructive jaundice and was given heparin prophylaxis for postoperative thromboembolism. The patient has started to bleed at incision site, and her partial thromboplastin time (PTT) was prolonged. The possible cause of her bleeding is due to which of the following?
a. Vitamin K deficiency
b. Heparin therapy
c. Congenital deficiency of factor VII
d. Afibrinogenemia
e. Disseminated intravascular coagulation (DIC)
b. Heparin therapy
A 30-year-old female (G2, P1) presents to your office for her 30th week atenatal care visit. The woman’s blood group is O, Rh negative. Her husband’s blood type is B, Rh positive. The mother had a previous newborn with Rh immune hemolytic anemia born at 40 weeks gestation. The spectrophotometric analysis of the amniotic fluid sample showed increased absorbance of 0.36 at 450 nm. The fetus was delivered by caesarean section and a decision to start exchange blood transfusion was made. The best management of the fetus at this point is
a. Blood transfusion using A, Rh negative blood
b. Blood transfusion using A, Rh positive blood
c. Blood transfusion using B, Rh negative blood
d. Blood transfusion using B, Rh positive blood
e. Blood transfusion using O, Rh negative blood
e. Blood transfusion using O, Rh negative blood
- Which of the following cases would result in a fatal transfusion reaction?
a. Donor group A, host group A
b. Donor group AB negative, host group AB, Rh positive
c. Donor Rh negative, host Rh positive, medical history negative for prior transfusions
d. Donor group AB, host group O
e. Donor group O, host group AB
d. Donor group AB, host group O
