Domande erasmus Flashcards

1
Q

Hematopoietic stem cells are characterized by:
ability to self-renew
ability of phagocytosis
ability to transport oxygen
the ability to differentiate into targeted hematopoietic stem cells
ability to differentiate into nonhematopoietic cells

A

ability to self-renew
the ability to differentiate into targeted hematopoietic stem cells
ability to differentiate into nonhematopoietic cells

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2
Q

In a healthy adult, erythrocytes are formed in:
red and yellow bone marrow
red bone marrow
yellow bone marrow
spleen
red bone marrow and lymphatic organs

A

red bone marrow

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3
Q

Erythroblasts are characterized by:
as it matures, the cell shrinks
they have no core
marked cytoplasmic basophilia occurs during maturation
basophilic granules are present in the cytoplasm
as it matures, the cell enlarges

A

as it matures, the cell shrinks
(a. as the cell matures, it becomes smaller)

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4
Q

Hemoglobin A consists of
2 alpha chains and 2 beta chains
2 alpha chains and 2 delta chains
2 alpha chains
2 alpha chains and 2 gamma chains
2 chain gamma

A

2 alpha chains and 2 beta chains

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5
Q

A multipotent myeloid stem cell matures into all of the following directed stem cells EXCEPT:
red species
neutrophil - monocyte species
lymphatic species
megakaryocyte species
eosinophilic and basophilic species

A

lymphatic species

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6
Q

Among the mature cells of the white species - leukocytes - are:
neutrophils
monocytes
megakaryocytes
lymphocytes
myeloblasts

A

neutrophils
monocytes
lymphocytes

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7
Q

The first cell of the granulocyte species that no longer divides is:
myeloblast
promyelocyte
myelocyte
metamyelocyte
rod-shaped granulocyte

A

metamyelocyte

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8
Q

Neutrophilic granulocyte is characterized by:
that the core has 2 to 5 segments
intense orange-red colored granulation
absence of granulations
a nucleus is visible in each segment of the nucleus
that it has no sails

A

that the core has 2 to 5 segments

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9
Q

Neutrophilic granulocytes are characterized by:
to be found only in peripheral blood
that they pass quickly from the blood into the tissues
to live in tissues for several months
to transform into macrophages in tissues
to remain in the bone marrow at all times

A

that they pass quickly from the blood into the tissues

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10
Q

Eosinophilic granulocytes:
they do not pass from the blood into the tissues
are not capable of phagocytosis
are important in an early hypersensitivity reaction
are an important site of antibody formation
are a precursor of plasma

A

are important in an early hypersensitivity reaction

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11
Q

Among the mature cells of the lymphocyte type are:
lymphocytes B
T lymphocytes - inhibitor cells
T lymphocytes - killer cells
T lymphocytes - helper cells
lymphoblasts

A

lymphocytes B
T lymphocytes - inhibitor cells
T lymphocytes - killer cells
T lymphocytes - helper cells

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12
Q

Plasmas (plasmacells) develop from :
helper T-cell lymphocytes
from lymphocytes B
from granulocytes
from non-hematopoietic cells
from monocytes

A

from lymphocytes B

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13
Q

Monocytes:
are formed from a stem cell of the lymphatic type T
are formed from a lymphatic type B stem cell
form immunoglobulins
are converted in tissues into macrophages - histiocytes
they are found exclusively in peripheral blood

A

are converted in tissues into macrophages - histiocytes

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14
Q

Macrophages participate in the immune response by
synthesise immunoglobulins
mediate antigen to T lymphocytes
mediate antigen to B lymphocytes
transmit antigen to plasma cells
mediate granulocyte antigen

A

mediate antigen to T lymphocytes

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15
Q

Adult spleen: (3)
is an important organ of hematopoiesis
is an important lymphatic organ
is important in removing aged / damaged blood cells
an important reserve of erythrocytes
an important platelet reservoir

A

is an important lymphatic organ
is important in removing aged / damaged blood cells
an important platelet reservoir

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16
Q

Platelets are characterized by: (3)
- they are formed by the decay of the marginal part of the cytoplasm of megakaryocytes
- they are formed by the decay of the megakaryocyte nucleus
- they contain alpha granules, dense granules, and lysosomes in the cytoplasm
- they have a three-layer membrane with a high content of phospholipids
- that they have only a few hours of life

A
  • they are formed by the decay of the marginal part of the cytoplasm of megakaryocytes
  • they contain alpha granules, dense granules, and lysosomes in the cytoplasm
  • they have a three-layer membrane with a high content of phospholipids
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17
Q

Which of the following is not a change in the size, shape and colour of erythrocytes?
schizocytes
poikilocytosis
centrocytes
anisocytosis
spherocytes

A

centrocytes

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18
Q

It is recommended that a peripheral blood smear be examined if :
the leukocyte count is> 15 x 10 9 / l (> as 30)
the platelet count is <100 x 10 9 /
the proportion of lymphocytes is > 0.50
the leukocyte count is 4-10 x 10 9 / l
the eosinophil ratio is <0.20

A

the platelet count is <100 x 10 9 /

the proportion of lymphocytes is> 0.50

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19
Q

The normal ratio of hematopoietic cells to fat in the bone marrow is :
1: 2
1: 1
2: 1
3: 1
4: 1

A

1: 1

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20
Q

The average amount of Hb in the erythrocyte (MCH) is calculated from:
blood Hb concentration (g / L) and erythrocyte count
blood Hb concentration (g / L) and mean erythrocyte volume
hematocrit
blood Hb concentrations (g / L) and hematocrit
blood Hb concentrations (g / L)

A

blood Hb concentration (g / L) and erythrocyte count

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21
Q

Chronic myeloid leukemia is characterized by chromosomal translocation :
T (8; 21)
T (12; 21)
I nv (16)
T (9; 22)
D el (13) (q14.3)

A

T (9; 22) (BCR-ABL1 gene)

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22
Q

Determination of chromosomal abnormalities in leukemias and lymphomas is important for:
a. Determination of immunophenotype
b. Definitive diagnosis
c. Prognosis
d. Monitoring treatment effectiveness
e. FAB classification of leukemias
A. The correct answers are: a,b,c
B. The correct answers are: b,c,d
C. The correct answers are: c,d,e
D. The correct answers are: a,c,e
E. The correct answers are: a, b, d

A

B. The correct answers are: b,c,d

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23
Q

In acute leukemia, the following changes are usually found in the blood picture:
a. Increased or decreased number of leukocytes
b. Always reduced leukocyte count
c. Anemia
d. Decreased platelet count
e. Increased number of platelets
A. The correct answers are: a,b,c
B. The correct answers are: b,c,d
C. The correct answers are: c,d,e
D. The correct answers are: a,c,d
E. The correct answers are : a, b, d

A

D. The correct answers are: a,c,d

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24
Q

A 72-year-old patient with rheumatoid arthritis is being treated with gold salts, among other things. She has weakened in recent weeks, breathing faster. She noticed small hemorrhages on her shins, bleeding from her nose a few times. For the last 3 days she was in pain when swallowing, body temp. has risen above 38.0 ° C. She was taking a penicillin antibiotic, with no improvement. Examination: febrile, pale, with occasional hemorrhages across the palate and tiny purpura on the shins. The throat is red, without lining. There are no enlarged lymph nodes, liver and spleen. Rheumatoid arthritis has characteristic deformities on the hands. Blood count is as follows: L 1.1 x 10 9 / L, in DKS 0.2 x 10 9 / L neutrophilic granulocytes, no immature cells, hemoglobin concentration 67 g / L, platelets 12 x 10 9 / L. Which of the following diagnoses would be most likely?
acute myeloblastic leukemia
pure aplastic anemia
hairy cell leukemia
aplastic anemia
agranulocytosis

A

aplastic anemia

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25
One of the following diseases is not manifested by pancytopenia in the peripheral blood : aplastic anemia megaloblastic anemia myelodysplastic syndromes pure aplastic anemia hypersplenism
pure aplastic anemia
26
In a 60-year-old patient with aplastic anemia, the most successful treatment is : with immunosuppressive drugs replacement therapy with blood products by autologous hematopoietic stem cell transplantation by allogeneic hematopoietic stem cell transplantation with erythropoietin
with immunosuppressive drugs
27
Fanconi's anemia : (3) is inherited aplastic anemia it is accompanied by other anomalies is synonymous with pure aplastic anemia often progresses to acute leukemia spontaneous remissions are common
is inherited aplastic anemia it is accompanied by other anomalies often progresses to acute leukemia
28
Clonal hematopoietic stem cell diseases do not include: acute leukemia chronic leukemia myelodysplastic syndromes paroxysmal nocturnal hemoglobinuria inherited hemolytic anemias
inherited hemolytic anemias
29
Long-term treatment of aplastic anemia with erythrocyte transfusions results in: haemosiderosis transition to acute leukemia transition to myelodysplastic syndrome has no side effects erythrocytosis
haemosiderosis
30
In severe aplastic anemia, we usually find in the blood: severe normocytic anemia with reticulocytosis pancytopenia with reticulocytosis pancytopenia with decreased reticulocyte count signs of dyseritropoiesis are present in the bone marrow hyposegmentation of neutrophils
pancytopenia with decreased reticulocyte count
31
The ater investigation is the most appropriate to assess the density of cells in the bone marrow in aplastic anemia? puncture and cytological examination of KM biopsy and histological examination of the KM Magnetic resonance Computed tomography In ltrazvok
biopsy and histological examination of the KM
32
In patients younger than 20 years with very severe aplastic anemia, we decide to: immunosuppressive treatment treatment with growth factors allogeneic hematopoietic stem cell transplantation autologous hematopoietic stem cell transplantation regular treatment with transfusions of concentrated erythrocytes
allogeneic hematopoietic stem cell transplantation
33
If the wrinkles on the palms are as pale as the skin around them, the blood Hb concentration is usually less than: 100 g / l 90 g / l 70 g / l 60g / L 50 g / l
70 g / l (severe anemia)
34
Conditions where the concentration of Hb in the blood does not reflect the actual changes in the total amount of Hb or erythrocytes in the body are: (3) acute hemolysis anemia immediately after acute bleeding dehydration hyperhydration anemia with chronic inflammation
anemia immediately after acute bleeding dehydration hyperhydration (hypervolemia)
35
Which element of the blood picture is used to distinguish between anemia due to deficient erythrocyte formation and anemia due to excessive erythrocyte breakdown (hemolytic anemia): degree of anisocytosis degree of poikilocytosis reticulocyte count average erythrocyte volume (PVE, MCV) volume of compressed erythrocytes (all, hematocrit)
reticulocyte count (<100x10 ^ 9 / l is deficient erythropoiesis in anemia)
36
Which of the following anemias can be accompanied by jaundice: (2) hemolytic anemia iron deficiency anemia megaloblastic anemia aplastic anemia anemia after acute bleeding
hemolytic anemia megaloblastic anemia
37
Which three blood counts are key to defining anemias (by degree and type): blood Hb concentration erythrocyte count in the blood the number of reticulocytes in the blood PHE (MCH) PVE (MCV)
blood Hb concentration the number of reticulocytes in the blood PVE (MCV)
38
Microcytic anaemia is seen in: a. essential thrombocythaemia b. iron deficiency c. haemochromatosis d. thalassaemia syndrome
b. iron deficiency d. thalassaemia syndrome
39
Which of the following anaemias are microcytic: a. Myeloftious anaemia b. Thalassaemia c. Autoimmune haemolytic anaemia d. Megaloblastic anaemia e. Fe deficiency anaemia
b. Thalassaemia e. Fe deficiency anaemia
40
Folate is mainly absorbed in: duodenum and upper jejunum lower part of the jejunum evenly throughout the ileum terminal ileum evenly throughout the small intestine
duodenum and upper jejunum
41
Megaloblastic anemia in its pure form is always: normocytic hypochromic microcytic macrocytic hypochromic and microcytic
macrocytic
42
Megaloblastic anaemia affects : a. especially younger people b. mainly older people c. mainly men d. mainly women e. children
b. mainly older people
43
Folate requirements are higher than usual: (3) in vitamin A12 B12 deficiency during pregnancy in hemolytic anemia in a vegetarian diet in chronic alcoholism
during pregnancy in hemolytic anemia in chronic alcoholism
44
The most common cause of megaloblastic anemia in our country is: terminal ileum disease vitamin B12 deficiency due to blind twist syndrome pernicious anemia folate deficiency folate deficiency in chronic alcoholism
pernicious anemia
45
The body's folate stores are sufficient to: a few days 4-5 weeks 4-5 months 1 year 4-5 years
4-5 months
46
The body's vitamin B12 stores are sufficient to: a few days 3-6 weeks 3-6 months 3-6 years 9-10 years
3-6 years
47
What is the symptom or sign of megaloblastic anemia: koilonihijo Hunter's glossitis ragade in the corners of the mouth Plummer-Vinson syndrome The emergence of PIZZA
Hunter's glossitis
48
The likelihood of megaloblastic anemia is low if the following are not found in the blood smear : severe macrocytosis anisocytosis Hypersegmentation of neutrophils Basophilic punctures Howell-Jolly bodies
Hypersegmentation of neutrophils
49
For lack of vit. B12 is characterized by the following changes in serum concentrations of some metabolites: increased homocysteine ​​+ normal methylmalonic acid increased homocysteine ​​+ increased methylmalonic acid normal homocysteine ​​+ normal methylmalonic acid increased homocysteine ​​+ normal methylmalonic acid reduced homocysteine ​​+ normal methylmalonic acid
increased homocysteine ​​+ increased methylmalonic acid
50
Folate deficiency was characterized by the following changes in serum concentrations of some metabolites: increased homocysteine ​​+ normal methylmalonic acid increased homocysteine ​​+ increased methylmalonic acid normal homocysteine ​​+ normal methylmalonic acid increased homocysteine ​​+ normal methylmalonic acid reduced homocysteine ​​+ normal methylmalonic acid
increased homocysteine ​​+ normal methylmalonic acid
51
The suspicion of pernicious anemia is confirmed by finding: high serum lactate dehydrogenase (ldh) activity antibodies to intrinsic factor antibodies against parietal cells increased serum homocysteine ​​concentration increased amount of methylmalonic acid in urine or serum
antibodies to intrinsic factor
52
In severe megaloblastic anemia can be found in the blood picture: (3) MCV > 120 and megalocytes Hyposegmentation of neutrophils Pancytopenia Reticulocytosis Hypersegmentation of neutrophils
MCV > 120 and megalocytes Pancytopenia Hypersegmentation of neutrophils
53
Which of the following measures is incorrect in an asymptomatic patient with megaloblastic anemia if B12 and folate levels are not yet available: treatment with vit only. B12 treatment with vit. B12 in folate treatment with folate only waiting for vit concentration test. B12 and serum folate treatment of associated diseases
treatment with folate only
54
It is sufficient to correct anaemia due to B12 deficiency and replenish the body's stores: a. One hydroxycobalamin injection 2.5 mg (1 amp) im. b. Two injections of hydroxycobalamin 2.5 mg (2 amp) im. c. Four injections of hydroxycobalamin 2.5 mg (1 amp) im. 1-2 days apart d. Ten injections of hydroxycobalamin 2.5 mg (1amp) every other day e. Twenty injections of hydroxycobalamin 2.5 mg (1amp) every other day
Four injections of hydroxycobalamin 2.5 mg (1 amp) im. 1-2 days apart
55
The established maintenance treatment for pernicious anaemia in our country is: a. Hydroxycobalamin 2.5 mg (1 amp) intramuscularly once a month b. Hydroxycobalamin 2.5 mg (1 amp) im. once a month and folate 5 mg/day per os c. Hydroxycobalamin 2.5 mg (1 amp) intravenously every 2-3 months d. Hydroxycobalamin 2.5 mg (1 amp) intramuscularly every 2-3 months e. Hydroxycobalamin 2.5 mg per person every 2-3 months
d. Hydroxycobalamin 2.5 mg (1 amp) intramuscularly every 2-3 months
56
Which of the following anemias does not belong to the group of anemias that can be macrocytic: anemia in chronic liver disease anemia in hypothyroidism aplastic anemia anemia in chronic inflammation myelophthisical anemia
anemia in chronic inflammation
57
The 63-year-old woman came to the doctor because she has been getting tired of everyday tasks for the last three months. On clinical examination, the skin was pale yellowish, and a spindle-shaped systolic murmur was heard at the base of the heart. There were no other abnormalities. About d take her blood for testing. The results of the examinations showed: Hb 54 g / L, PVE (MCV) 132 fL, reticulocytes 14x10 9 / L, leukocytes 2,4x10 9 / L, neutrophils 1.4x10 9 / L with hypersegmentation of neutrophils, platelets 82x10 9 / L. Thus, the blood picture was accompanied by LDH 62.8 ukat / L, total bilirubin 22 umol / L, conjugated 7 umol / L. Which of the following diagnoses would be most correct: hemolytic anemia megaloblastic anemia aplastic anemia refractory anemia hypersplenism
megaloblastic anemia
58
Factors in the development of chronic inflammatory anemia:(3) iron metabolism disorder shortened erythrocyte lifespan inadequate renal erythropoietin release insufficient stocks of stored iron bleeding
iron metabolism disorder shortened erythrocyte lifespan inadequate renal erythropoietin release
59
Anemia of chronic inflammation can be found in: (3) osteomyelitis osteoporosis rheumatoid arthritis Hodgkin's lymphoma Hypothyroidism
osteomyelitis rheumatoid arthritis Hodgkin's lymphoma
60
In anemia due to chronic inflammation, we can find: (3) increased or normal serum ferritin concentration decreased serum ferritin concentration decreased serum iron concentration increased serum iron concentration decreased serum transferrin concentration increased serum transferrin concentration
increased or normal serum ferritin concentration decreased serum iron concentration decreased serum transferrin concentration
61
The most appropriate treatment for chronic inflammatory anemia is: with erythropoietin with glucocorticoids with iron preparations treatment of the underlying inflammatory disease erythrocyte transfusions
treatment of the underlying inflammatory disease
62
The most important factor in the development of anemia in renal failure is: inhibition of erythropoiesis due to uremic toxins iron deficiency folate loss due to hemodialysis shortened erythrocyte lifespan deficient erythropoietin production in the kidneys
deficient erythropoietin production in the kidneys
63
The characteristics of anemia in renal failure are: (3) anemia is normocytic anemia is microcytic anemia is macrocytic the number of reticulocytes in the blood is increased the number of reticulocytes in the blood is reduced serum erythropoietin concentration is reduced
anemia is normocytic the number of reticulocytes in the blood is reduced serum erythropoietin concentration is reduced
64
How to treat anemia in renal failure if Hb is 96 g / L and PVE (MCV) 85 fl: with erythrocyte transfusions with glucocorticoids with erythropoietin with folate with iron preparations
with erythropoietin
65
Which of the following statements is true for anaemia in chronic liver disease: (2) a. Anaemia is normocytic or mild macrocytic b. Anaemia is usually microcytic c. Schizocytes are detected in the blood smear d. Spherocytes can be found in the blood smear e. In a blood smear, nucleocytes (=particulate erythrocytes) can be detected
a. Anaemia is normocytic or mild macrocytic e. In a blood smear, nucleocytes (condocytes) (=particulate erythrocytes) can be detected
66
What diseases of the endocrine glands can be accompanied by anemia: (3) hypothyroidism hyperthyroidism Addison's disease Cushing's syndrome panhypopituitarism acromegaly
hypothyroidism Addison's disease panhypopituitarism
67
During pregnancy it is recommended to give preventive preparations: (2) iron vitamin B12 vitamin B6 vitamin C folate
iron folate
68
Myelophthisical anemia may be due to: bone marrow infiltration by cancer cells myelofibrosis miliary tuberculosis lipidosis all of the above
all of the above
69
Think of myelophthic anemia if: anisocytosis and poikilocytosis of erythrocytes leukoerythroblast blood count codocytes in the blood smear schizocytes in a blood smear acanthocytes in the blood smear
leukoerythroblast blood count
70
A 60-year-old patient came to the doctor due to the appearance of malaise, increased fatigue and dyspnoea with exertion. The patient underwent surgery (lobectomy) for bronchial carcinoma 2 years ago. In the blood picture, the concentration of Hb 90 g / L, MCV (PVE) 85 fL, reticulocytes 100x10 9 / L, leukocytes 5x10 9 / L, platelets 280x10 9 / L, shift to the left in the differential white blood picture (promyelocytes 1%) were found. , myelocytes 5%, rod neutrophils 5% segmented neutrophils 65%). There were also 1% erythroblasts in the blood and anisocytosis and poikilocytosis of erythrocytes. Which of the following diagnoses would be most correct: hemolytic anemia myelophthisical anemia anemia of chronic inflammation megaloblastic anemia refractory anemia (MDS)
myelophthisical anemia
71
The characteristics of the blood picture in iron deficiency anemia are: (3) reduced PVE (MCV) increased PVE increased no. reticulocytes reduced or normal no. reticulocytes hypochromia
reduced PVE (MCV) reduced or normal no. reticulocytes hypochromia
72
The most common cause of iron deficiency in women of childbearing age is: occult gastrointestinal bleeding microhematuria increased blood loss with monthly laundry inadequate nutrition hormonal contraception
increased blood loss with monthly laundry
73
The body's iron stores are usually estimated from: serum iron concentrations serum ferritin concentrations serum hemoglobin concentrations protoporphyrin concentrations in erythrocytes bone marrow staining on iron
serum ferritin concentrations
74
The main criteria for evaluating the success of Fe treatment are: a. Increase in serum Fe concentration b. Increase in serum ferritin concentration c. > 20 g/L increase in haemoglobin concentration during the first 3 weeks of treatment d. absence of symptoms of Fe deficiency e. PVE growth (MCV)
c. > 20 g/L increase in haemoglobin concentration during the first 3 weeks
75
Iron deficiency anemia is : the most common anemia very rare anemia it is common in adult men it is rare in women of childbearing age it occurs only in children
the most common anemia
76
It applies to iron in the human body (3): is a component of the cell participates in many chemical reactions in tissues, iron is found as a free cation it is stored in the form of ferritin and hemosiderin heme iron is less well absorbed than ionic iron
is a component of the cell participates in many chemical reactions it is stored in the form of ferritin and hemosiderin
77
What is considered iron deficiency anaemia? a. anaemia occurs gradually b. stored iron is used first c. iron requirements are reduced in pregnancy d. in women of childbearing age, the most common cause of anaemia is heavy menstrual periods e. despite gastric resection, iron resorption from food is normal
a. anaemia occurs gradually b. stored iron is used first d. in women of childbearing age, the most common cause of anaemia is heavy menstrual periods
78
The absorption of iron in the gastrointestinal tract is (3) a. iron in the form of heme is better absorbed than ionic iron b. in a healthy person, 10% of all iron is absorbed from food c. iron is absorbed mainly in the duodenum and jejunum d. iron absorption is better if the gastric juice is less acidic e. iron deficiency reduces the proportion of iron absorbed from food
a. iron in the form of heme is better absorbed than ionic iron b. in a healthy person, 10% of all iron is absorbed from food c. iron is absorbed mainly in the duodenum and jejunum
79
What applies to iron deficiency anemia: (3) anemia develops rapidly the stored iron is consumed first serum ferritin concentration is reduced chronic bleeding is the most common cause of iron deficiency in an age of rapid growth, children need less iron
the stored iron is consumed first serum ferritin concentration is reduced chronic bleeding is the most common cause of iron deficiency
80
In iron deficiency anemia , in addition to the general signs of anemia, we can also find: (3) ragade in the corners of the mouth changes in the nails of the hands (koilonihija) Hunter's glossitis subicterus swallowing disorders (Plummer Vinson syndrome)
ragade in the corners of the mouth changes on the nails of the hands (koilonychia) swallowing disorders (Plummer Vinson syndrome)
81
We admitted the 45-year-old patient for 14 days of malaise, headache and pain in the hips while walking. 2 days before admission, she felt severe burning pain behind her chest while walking up the stairs. For the past six months, she has had heavy menstrual bleeding that has lasted as long as 12 days. A gynecologist discovered uterine fibroids. Clinical examination revealed pallor of the skin and mucous membranes, ragades of the corners of the mouth and nails flattened in the shape of a watch glass. Laboratory : conc. hemoglobin 70 g / l, MCV (PVE) 66 fl, platelet count, leukocyte count and white differential blood count were within normal limits. Serum iron and ferritin concentrations were decreased, TIBC increased, and transferrin saturation decreased. Values ​​of urea, creatinine, bilirubin, electrolytes, transaminase activity were within normal limits, as well as urine results. Which of the following diagnoses is the most correct? A. idiopathic megaloblastic anemia B. hemolytic anemia C. iron deficiency anemia D. sideroblastic anemia E. thalassemia syndrome
C. iron deficiency anemia
82
Extracorpuscular hemolytic anemias are: congenital obtained congenital and acquired
obtained
83
Corpuscular hemolytic anemias are: congenital obtained congenital and acquired
Corpuscular hemolytic anemias are hereditary, except for paroxysmal nocturnal hemoglobinuria
84
Corpuscular hemolytic anemias are hereditary with the exception of: sickle cell anemia thalassemia beta paroxysmal nocturnal hemoglobinuria thalassemia alpha G-6-PD deficiency
paroxysmal nocturnal hemoglobinuria
85
Laboratory signs of hemolysis are: (3) A. decreased serum haptoglobin concentration B. increased serum haptoglobin concentration C, increased concentration of unconjugated bilirubin D. increased concentration of conjugated bilirubin E. reticulocytosis
A. decreased serum haptoglobin concentration C. increased concentration of unconjugated bilirubin E. reticulocytosis
86
Laboratory signs of severe intravascular hemolysis are:(3) hemoglobinuria hemoglobinemia methemalbuminemia methaemoglobinaemia hemosiderinemia
hemoglobinuria hemoglobinemia methemalbuminemia
87
Signs of chronic or recurrent intravascular hemolysis are: hemoglobinuria hemosiderin in urinary sediment hemoglobinemia methemalbuminemia methaemoglobinaemia
hemosiderin in urinary sediment
88
What erythrocyte change is present in hemolytic anemia due to mechanical erythrocyte damage: codocytes schizocytes drepanocytes spherocytes Heinz's body
schizocytes
89
What erythrocyte change is present in autoimmune hemolytic anemia: codocytes schizocytes drepanocytes spherocytes Heinz's body
spherocytes
90
What erythrocyte change is characteristic of a HbS homozygote: codocytes schizocytes drepanocytes spherocytes Heinz's body
drepanocytes (= sickle erythrocytes, narrow sickle shape a; in HbS homozygotes )
91
Codocytes in a blood smear are present in: HbS g-6-pd deficiency thalassemia paroxysmal nocturnal hemoglobinuria all of the above
thalassemia (kodoci such as t ar d Asti erythrocytes; present in liver diseases)
92
Which test confirms autoimmune hemolytic anemia: by the indirect Coombs test by the direct Coombs test evidence of spherocytes in a blood smear erythrocyte osmotic resistance test immunofixation
by the direct Coombs test
93
Evidence of microangiopathic hemolytic anemia is characterized by all but: (Int. P. 1286 ) A. increase in LDH concentration B. the presence of schistocytes - fragmented erythrocytes C. increase in haptoglobin concentration D. increase in unconjugated bilirubin concentration E. negative direct Coombs test
C. increase in haptoglobin concentration
94
Approximately one-third of cases of symptomatic autoimmune hemolytic anemia occur in: viral infections lymphoproliferative diseases rheumatic diseases chronic inflammation nonhematological malignancies
lymphoproliferative diseases
95
Warm autoantibodies in autoimmune hemolytic anemia usually belong to immunoglobulins of the class: IgM IgA IgG IgE IgD
IgG
96
In autoimmune hemolytic anemia with warm antibodies, the following signs may be present EXCEPT: pale jaundice enlarged spleen enlarged liver cyanosis
cyanosis
97
Treatment of newly discovered autoimmune hemolytic anemia with warm antibodies begins with: cyclosporine A glucocorticoids cyclophosphamide azathioprine rituximab
glucocorticoids
98
A 45-year-old patient was accidentally diagnosed with mild macrocytic anemia with reticulocytosis. Clinical examination was normal except for subicterus. Results of laboratory tests: Hb 110 g / L, PVE 109 fL, reticulocytes 480x10 9 / L, leukocytes 9.6, neutrophils 8.2, platelets 259, there are individual spherocytes in the blood smear, direct Coombs is positive, total bilirubin 59 µmol / L, direct 8 µmol / L. Which of the following diagnoses would be most correct: A. megaloblastic anemia B. autoimmune hemolytic anemia C. myelophthisical anemia D. hereditary spherocytosis E. thalassemia
B. autoimmune hemolytic anemia
99
The characteristics of the disease due to cold agglutinins are all EXCEPT: acrocyanosis , which occurs in the cold high titer of cold agglutinins negative direct Coombs test with monospecific serum for IgG positive direct Coombs test with monospecific complement serum is always due to lymphatic neoplasms
is always due to lymphatic neoplasms
100
Autoantibodies in cold agglutinin disease belong to immunoglobulins of the class: IgA IgG IgE IgM IgD
IgM
101
Typical causes of mechanical erythrocyte damage are all listed EXCEPT: aortic valve defects thrombotic thrombocytopenic purpura in DIK syndrome during a long run on hard ground arterial vascular stents
arterial vascular stents
102
Characteristics of anemia due to mechanical damage of erythrocytes: (2) hemolysis is intravascular hemolysis is extravascular schizocytes are visible in the blood smear acanthocytes are visible in the blood smear in erythrocytes are Howell-Jolly bodies
hemolysis is intravascular schizocytes are visible in the blood smear
103
Paroxysmal nocturnal hemoglobinuria is: (3) acquired hemolytic anemia congenital hemolytic anemia corpuscular hemolytic anemia extracorpuscular hemolytic anemia hemolysis is extravascular hemolysis is intravascular
acquired hemolytic anemia corpuscular hemolytic anemia hemolysis is intravascular
104
Which of the following anemias is characterized by intravascular hemolysis: (3) cold agglutinin disease paroxysmal nocturnal hemoglobinuria hereditary spherocytosis anemia due to mechanical damage to erythrocytes paroxysmal hemoglobinuria due to cooling
paroxysmal nocturnal hemoglobinuria anemia due to mechanical damage to erythrocytes paroxysmal hemoglobinuria due to cooling
105
Paroxysmal nocturnal hemoglobinuria applies to all but the following: is a clonal disease a characteristic defect in the blood cell membrane is present cytopenias of varying degrees may be present the risk of venous thrombosis is increased the number of reticulocytes is reduced, so the anemia is microcytic
the number of reticulocytes is reduced, so the anemia is microcytic
106
The characteristics of hereditary spherocytosis are: (2) gender-related inheritance enlarged spleen transient rapid exacerbations of anemia hemolysis is intravascular belongs to extracorpuscular hemolytic anemias
enlarged spleen transient rapid exacerbations of anemia (crisis)
107
Inherited spherocytosis is treated with: glucocorticoids splenectomy erythrocyte transfusions immunoglobulins with cyclosporine A
splenectomy
108
A 26-year-old patient sought help for years of jaundice. This has become more pronounced in recent months. Father and uncle also had jaundice and had their spleen removed. On examination, it is pale, the skin and whites are straw yellow, the spleen is palpable 4 cm below the costal arch. Laboratory: Hb 87 g / L, PVE 85 fL, reticulocytes 142x10 9 / L, there are spherocytes in the blood smear, the concentration of total bilirubin is 102 µmol / L, indirect 6.8 µmol / L. Which of the following diagnoses would be most correct: A. autoimmune hemolytic anemia B. megaloblastic anemia C. myelophthisical anemia D. hereditary spherocytosis E. thalassemia
D. hereditary spherocytosis
109
Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency: (3) is the most common enzymopathy worldwide; the gene for G-6-PD is located on the Y chromosome; the G-6-PD gene is located on the X chromosome; acute hemolysis may be triggered by infection or certain medications; we find drepanocytes in the blood;
is the most common enzymopathy worldwide the G-6-PD gene is located on the X chromosome acute hemolysis may be triggered by infection or certain medications
110
The characteristics of thalassemia beta minor are: (3) reduced PVE (MCV) decreased serum iron and ferritin increased serum iron and ferritin concentrations increased proportion of Hb A2 in erythrocytes decreased proportion of Hb A2 in erythrocytes
reduced PVE (MCV) increased serum iron and ferritin concentrations increased proportion of Hb A2 in erythrocytes
111
The characteristics of sickle cell anemia are: (2) pain crises koilonihija ragade in the corners of the mouth Hunter's glossitis signs of hemolytic anemia are present
signs of hemolytic anemia are present pain crises
112
What is leukoerythroblast blood count: A.there are increased numbers of eosinophils and platelets in the blood B.there is an increased number of immature granulocytes and normoblasts in the blood C.there is an increased number of normoblasts and reticulocytes in the blood D.there is an increased number of lymphocytes and reticulocytes in the blood E.there is an increased number of eosinophilic granulocytes and reticulocytes in the blood
B.there is an increased number of immature granulocytes and normoblasts in the blood Leukoerythroblastic reaction. In addition to immature granulocytes, polychromatic and orthochromatic normoblasts can be found in the blood
113
The characteristics of agranulocytosis are: (3) A. the number of granulocytes in the blood is less than 0.2 x 10 9 / L B. necrotizing angina with sepsis C. the number of granulocytes in the blood is less than 1.0 x 10 9 / L D. occurs after taking certain medications E. it always occurs after vaccination
A. the number of granulocytes in the blood is less than 0.2 x 10 9 / L B. necrotizing angina with sepsis D. occurs after taking certain medications
114
The characteristics of idiopathic leukocytosis in smokers are: the number of leukocytes in the blood up to 29 x 10 9 / L and the normal differential white blood count the number of leukocytes in the blood up to 15 x 10 9 / L and the normal differential white blood count the number of leukocytes in the blood up to 29 x 10 9 / L and an increase in the number of eosinophils the number of leukocytes in the blood up to 29 x 10 9 / L and moderate anemia the number of leukocytes in the blood up to 29 x 10 9 / L and accelerated erythrocyte sedimentation
the number of leukocytes in the blood up to 29 x 10 9 / L and the normal differential white blood count
115
Procedure for treating infection in a patient with severe acute neutropenia: (3) A. we take blood culture and other samples of infections B. treated with a broad-spectrum antibacterial drug parenterally C. treated with glucocorticoids D. treated with an antifungal drug parenterally E. treated with G-CSF 5 ug / kg body weight per day sc
A. we take blood culture and other samples of infections B. treated with a broad-spectrum antibacterial drug parenterally E. treated with G-CSF 5 ug / kg body weight per day sc
116
A patient with myelodysplastic syndrome (MDS) is treated: A. as soon as the disease is diagnosed B. only when patients have problems C. one month after the diagnosis D. when severe thrombocytopenia occurs E. never
B. only when patients have problems (bleeding, anemia, infections)
117
The characteristics of myelodysplastic syndromes are: (3) macrocytic anemia it is most common in younger people it is most common in the elderly the disease often progresses to acute myeloblastic leukemia the disease often progresses to acute lymphoblastic leukemia
macrocytic anemia it is most common in the elderly the disease often progresses to acute myeloblastic leukemia
118
The following tests are needed to define myelodysplastic syndrome: (3) complete blood count and cytological examination of bone marrow; bone marrow staining on iron; haemostasis investigations; serum and urine electrophoresis; cytogenetic testing;
complete blood count and cytological examination of bone marrow; bone marrow staining on iron; cytogenetic testing;
119
Typical chromosomal abnormalities of malignant lymphomas: (3) determine the natural course of the disease are irrelevant for determining the natural course of the disease allow differential diagnostic identification of lymphoma allow prediction of treatment success are irrelevant to the prediction of treatment success
determine the natural course of the disease allow differential diagnostic identification of lymphoma allow prediction of treatment success
120
The following tests are needed to diagnose malignant lymphoma: (+1) cytological and histological examination of the affected tissue determination of cellular markers on lymphoma cells cytogenetic and molecular genetic investigations biochemical blood tests cytochemical staining
cytological and histological examination of the affected tissue determination of cellular markers on lymphoma cells cytogenetic and molecular genetic investigations biochemical blood tests
121
In malignant lymphoma, the most commonly affected are: (3) lymph nodes in the neck and supraclavicular cavities lymph nodes in the armpits lymph nodes in the groin enlarged spleen lymph nodes in the interstitium
lymph nodes in the neck and supraclavicular cavities lymph nodes in the armpits enlarged spleen
122
In disseminated plasmacytoma, the patient most often has problems due to: (3) back pain renal failure frequent pneumonia arterial hypertension heart failure
back pain renal failure frequent pneumonia
123
The characteristics of chronic lymphocytic leukemia are: (3) A.symmetrically enlarged lymph nodes in the neck, armpits and groin B.enlarged spleen C.pancytopenia in the blood D.in the blood of more than 4.0 x 10 9 / L lymphocytes E.occurs before the age of 50 years
A.symmetrically enlarged lymph nodes in the neck, armpits and groin B.enlarged spleen D.in the blood of more than 4.0 x 10 9 / L lymphocytes
124
The characteristics of chronic lymphocytic leukaemia of clinical stage C are: a. haemoglobin <100 g /L or platelet count <100 x 10-9/L b. average survival less than 2.5 years c. all peripheral lymph nodes very enlarged d. very enlarged spleen e. haemoglobin <70 g /L
a. haemoglobin <100 g /L or platelet count <100 x 10-9/L
125
Large B cell lymphoma and follicular lymphoma: When we decide to treat it, we treat it with: fludarabine chlorambucil R-CHOP imatinib interferon alpha
R-CHOP (rituximab-cyclophosphamide, doxorubicin, vincristine and prednisone)
126
The following signs of the disease are present in the clinical developmental stage IIIB of Hodgkin's disease: (1+) A. the lymph nodes above the diaphragm are enlarged B. the lymph nodes above and below the diaphragm are enlarged C. general signs of the disease are present D. the disease has spread to the bone marrow E. conc. hemoglobin <100 g / L
B. the lymph nodes above and below the diaphragm are enlarged C. general signs of the disease are present
127
The characteristics of diffuse large B cell lymphoma are: (3) A. is the most common B lymphoma, rapid progression, especially with enlarged lymph nodes and concomitant involvement of other organs B. confirmation of the diagnosis is histological examination of the affected tissue and determination of cellular markers on lymphoma cells C. usually treated with glucocorticoids only D. often found in a blood smear of hair cells to confirm the diagnosis E. it is usually treated with a combination of R-CHOP (rituximab-cyclophosphamide, doxorubicin, vincristine and prednisone)
A. is the most common B lymphoma, rapid progression, especially with enlarged lymph nodes and concomitant involvement of other organs B. confirmation of the diagnosis is histological examination of the affected tissue and determination of cellular markers on lymphoma cells E. it is usually treated with a combination of R-CHOP (rituximab-cyclophosphamide, doxorubicin, vincristine and prednisone)
128
The most effective treatment for disseminated plasmacytoma in most patients is: A. treatment with high doses of glucocorticoids B. induction treatment with cytotoxic drugs and autologous hematopoietic stem cell transplantation C. treatment with a combination of R-CHOP (rituximab-cyclophosphamide, doxorubicin, vincristine and prednisone) D. interferon alpha treatment E. treatment with allogeneic hematopoietic stem cell transplantation
B. induction treatment with cytotoxic drugs and autologous hematopoietic stem cell transplantation
129
The most effective supportive treatment and prevention of complications in a patient with disseminated plasmacytoma is: (combination) A. regular administration of bisphosphonates to reduce osteoclastic activity B. irradiation with ionizing rays of osteolytic changes on statically important parts of the skeleton C. administration of iv immunoglobulins in patients with frequent infections D. continuous treatment with glucocorticoids E. administration of interferon alpha
A, B, C
130
The most common histological type of Hodgkin's lymphoma is: lymphocyte predominance nodular sclerosis shape with different cells form with a small number of cells all four histological types are evenly represented
nodular sclerosis
131
With the onset of so-called hairy cell leukemia neutropenia and hair cells in the blood (combinations) A. enlarged spleen B. "Dry puncture" of the bone marrow C. enlarged lymph nodes in the neck and armpits D. enlarged spleen and liver
A. enlarged spleen B. "Dry puncture" of the bone marrow C. enlarged lymph nodes in the neck and armpits
132
The 68-year-old patient had a fever for 2 days without chills, limb pain, and serous nasal discharge. He had several enlarged individual, movable, painless lymph nodes in his neck and armpits. We did not feel the enlarged organs in the abdomen. In the blood picture, he had a hemoglobin concentration of 138 g / L, reticulocyte count 58 x 10 9 / L, leukocyte count 58.8 x 10 9 / L, lymphocyte count 55.3 x 10 9 / L, platelet count 156 x 10 9 / L and Gumprecht shadows in a blood smear. The patient most likely has: A. hairy cell leukemia B. large cell diffuse B lymphoma C. chronic lymphocytic leukemia D. lymphoplasmocytoid lymphoma E. disseminated by plasma cells
C. chronic lymphocytic leukemia (smudge cells)
133
A 62-year-old patient who was being treated for high blood pressure and had low back pain for 2 months was found to have greatly accelerated erythrocyte sedimentation rate (93 mm / hour). Examination of the patient revealed reduced mobility of the spine in the lower back with limited anterior tilt, inclination, and lateral tilt. In the blood picture, she had a hemoglobin concentration of 108 g / L, a reticulocyte count of 32 x 10 9 / L, a leukocyte count of 6.2 x 10 9 / L, and a platelet count of 172 x 10 9 / L. In the proteinogram, the concentration of beta globulins was increased (monoclonal tooth 32 g / L). Skeletal radiographs revealed diffuse demineralization of the axial skeleton, compression fractures of the 4th and 5th bodies of the lumbar vertebrae, and osteolysis in the pelvis and skull. The patient most likely has: A. chronic lymphocytic leukemia B. large cell diffuse B lymphoma C. heavy chain disease D. lymphoplasmocytoid lymphoma E. disseminated by plasma cells
E. disseminated by plasma cells
134
Which of the investigative methods is not crucial in the classification, diagnosis, and subsequent treatment of acute leukemias? A. cytological examination of the bone marrow B. bone marrow biopsy (histological examination) C. Immunophenotype of leukemic cells D. cytogenetic characteristics (abnormalities) of leukemic cells E. molecular-genetic characteristics (abnormalities) of leukemic cells
B. bone marrow biopsy (histological examination)
135
"Philadelphia chromosome", a translocation between chromosomes 9 and 22 (t (9; 22)) is characterized by: A. acute myeloid leukemia and acute lymphocytic leukemia B. acute myeloid leukemia and non-Hodgkin’s lymphomas C. acute lymphocytic leukemia and chronic lymphocytic leukemia D. chronic myeloid leukemia and chronic lymphocytic leukemia E. acute lymphocytic leukemia and chronic myeloid leukemia
E. acute lymphocytic leukemia and chronic myeloid leukemia
136
What clinical features of the disease can be seen in a patient with newly diagnosed acute leukemia? A. subcutaneous and mucosal bleeding (purpura) B. dyspnoea due to pneumonia and / or septic condition C. gingival hypertrophy D. clinical picture of cerebral hemorrhage E. rapidly progressing body failure (weight loss, fatigue…)
A, B, C, D, E
137
The diagnosis of disseminated intravascular coagulation syndrome in a patient with acute leukemia is confirmed by: A. arterial blood gas analysis B. blood count C. hemostasis tests D. basic biochemical investigations E. Doppler examination of arteries and veins
C
138
In which form of acute leukemia is there a high risk of threatening bleeding due to DIK (CID) syndrome with the breakdown of leukemia cells in the first treatment: acute monoblastic leukemia acute myelomonocytic leukemia acute megakaryocytic leukemia acute promyelocytic leukemia acute erythroblastic leukemia
acute promyelocytic leukemia
139
In the treatment of acute leukemias with transfusions of concentrated erythrocytes, treatment is performed in order to maintain the approximate value of hemoglobin greater than: 60 g / L 70 g / L 90 g / L 110 g / L 120 g / L
b. 70 g/L With transfusions of concentrated erythrocytes, hemoglobin is maintained above 70 g/l. This is the level where prolonged anemia can impair the functioning of key organ systems
140
According to cellular immune markers (immunophenotype) on lymphoblastic cells of patients with acute lymphocytic leukemia we distinguish: B ALL in T ALL B ALL in M ​​ALL M ALL in Ph ALL B ALL in Ph ALL Ph ALL in T ALL
B ALL in T ALL
141
Clonal cytogenetic abnormalities in patients with acute lymphocytic leukemia (ALL) are characterized by: (3) A. they are present in more than half of patients B. they are present only exceptionally C. have a major impact on the treatment and course of the disease D. the most common abnormality is the t (9; 22) - Philadelphia chromosome E. have a certain prognostic significance only in patients older than 65 years
A. they are present in more than half of patients C. have a major impact on the treatment and course of the disease D. the most common abnormality is the t (9; 22) - Philadelphia chromosome
142
Lymphoblasts in patients with acute lymphocytic leukemia (ALL) outside the bone marrow most commonly form leukemic infiltrates in: pancreas heart muscle orbits central nervous system kidneys
central nervous system
143
Secondary acute leukemia is the result of all of the above except: infections with certain RNA viruses (eg HTLV-1; human T-leukemia virus type 1) prior treatment with alkylating cytostatics (eg cyclophosphamide, melphalan) exposure to benzene and certain chemical compounds irradiation with ionizing rays exposure to heavy metals (eg lead, mercury)
exposure to heavy metals (eg lead, mercury)
144
Hematopoietic stem cells for autologous or allogeneic hematopoietic stem cell transplantation (PKMC) can be obtained from: (combination) cerebrospinal fluid umbilical cord blood peripheral blood liver punctures bone marrow
umbilical cord blood peripheral blood bone marrow
145
Multipotent hematopoietic stem cells are characterized by a cellular immune marker (antigen) on their membrane: CD 4 CD8 CD20 CD34 CD56
CD34
146
In the case of allogeneic hematopoietic stem cell transplantation (PKMC), an appropriate hematopoietic stem cell (CMC) donor may: (3) antigenically HLA fully compliant brother antigenically otherwise HLA non-compliant brother, but with the same blood type antigenically HLA fully compliant sister antigenically otherwise HLA non-compliant nurse but with the same blood type antigenically HLA compliant unrelated donor
antigenically HLA fully compliant brother antigenically HLA fully compliant sister antigenically HLA compliant unrelated donor
147
If the patient has one sibling, it is likely that only this will be a suitable donor of hematopoietic stem cells: 20% 25% 30% 40% 50%
25%
148
The graft response to tumor / leukemia (GVT / GVL) is characterized by: induction chemotherapy consolidation treatment with chemotherapy immunosuppressive drugs used in hematology allogeneic hematopoietic stem cell transplants autologous hematopoietic stem cell transplants
allogeneic hematopoietic stem cell transplants
149
The most common indications for treatment with allogeneic hematopoietic stem cell transplantation (allogeneic PKMC) are: acute myeloid and acute lymphocytic leukemia lymphoproliferative diseases myeloproliferative diseases myelodysplastic syndromes autoimmune diseases
acute myeloid and acute lymphocytic leukemia
150
The most common indications for treatment with autologous hematopoietic stem cell transplantation (autologous PKMC) are: acute myeloid and acute lymphocytic leukemia plasmacytoma aplastic anemia myelodysplastic syndromes autoimmune diseases
plasmacytoma
151
For the first 10-14 days after hematopoietic stem cell transplantation (PKMC), the most common infections in patients with severe bone marrow aplasia are: A. viral infections B. mycobacterial infections C. fungal infections D. parasitic infections (eg toxoplasmosis) E. bacterial infections
E. bacterial infections
152
The most common complications of treatment with allogeneic hematopoietic stem cell transplantation (allogeneic PKMC) include ALL BUT: acute graft-versus-host disease (aGVHD) chronic graft-versus-host disease (cGVHD) venoocclusive liver disease acute autoimmune thyroiditis the occurrence of opportunistic infections
acute autoimmune thyroiditis
153
The late consequences of hematopoietic stem cell transplantation include: psychoorganic syndrome infertility in men and women occurrence of secondary cancers several years after PKMC endocrine hypofunction post-transplant kidney disease
infertility in men and women occurrence of secondary cancers several years after PKMC endocrine hypofunction (not described in Internal , but part of a combination)
154
Chronic myeloid leukemia is: rare disease common disease the etiology of the disease is known they most commonly affect between 20 and 30 years of age no chromosomal changes are found in it
rare disease
155
Chronic myeloproliferative diseases include: essential thrombocythemia malignant lymphoma acute myeloblastic leukemia diffuse plasma cell amyloidosis
essential thrombocythemia
156
Chronic myeloid leukemia is characterized by: (1+) A. that the disease is acquired B. presence of Philadelphia chromosome C. the disease progresses in three periods D. osteolytic lesions in the skull are observed E. the number of leukocytes at the detection of the disease is reduced
A. that the disease is acquired B. presence of Philadelphia chromosome (t (9; 22) (q 34: q 11)) C. the disease progresses in three periods
157
Which drug significantly improved the effectiveness of treatment of chronic myeloid leukemia? cytosinarabinoside cyclophosphamide imatinib mesylate hydroxyurea chlorambucil
imatinib mesylate
158
The real polycythemia is: (3) chronic myeloproliferative disease it is most common between the ages of 40 and 60 patients complain of headache, dizziness, tinnitus the spleen is never enlarged the hematocrit value is within normal limits
chronic myeloproliferative disease it is most common between the ages of 40 and 60 patients complain of headache, dizziness, tinnitus
159
Itching of the skin after bathing occurs in true polycythemia due to: increased secretion of histamine from blood basophils enlarged spleen increased hematocrit increased platelet count frequent venipunctures
increased secretion of histamine from blood basophils
160
In true polycythemia, the concentration of serum erythropoietin is: normal increased reduced we do not specify it sometimes increased, sometimes decreased
reduced
161
Chronic idiopathic myelofibrosis is:(3) A. clonal myeloproliferative disease B. it is very rarely diagnosed with anemia C. often the first sign is an enlarged spleen D. the platelet count is always increased E. it is characterized by the growth of connective tissue and the formation of new bone tissue in the bone marrow
A, C, E
162
Chronic idiopathic myelofibrosis is considered to be: A. we always start treating it immediately with cytostatics B. we decide on an allogeneic hematopoietic stem cell transplant as soon as possible C. patients often need erythrocyte transfusions D. the drug of choice is imatinib mesylate E. there are many atypical lymphocytes in the blood picture upon detection
C
163
Essential thrombocythemia is characterized by: (3) A. is a clonal myeloproliferative disease B. is caused by radiation with ionizing rays C. it is characterized by the proliferation of megakaryocytes in the bone marrow D. bleeding is due to impaired platelet function E. is a curable disease
A. is a clonal myeloproliferative disease C. it is characterized by the proliferation of megakaryocytes in the bone marrow D. bleeding is due to impaired platelet function
164
In essential thrombocythemia is: A. platelet function is normal B. platelet count is usually above 600 G / L C. the Philadelphia chromosome is present in the bone marrow D. the spleen is greatly enlarged E. anemia is always present
B. platelet count is usually above 600 G / L (Int. p. 1318:> 400 x10 9 / l or more , usually between 1000 and 2000 )
165
Idiopathic hypereosinophilic syndrome is characterized by: (combination) A. more than 1.5 x 10 9 / L peripheral blood eosinophils B. Philadelphia chromosome present in bone marrow C. is a clonal myeloproliferative disease D. the disease affects the heart, lungs, central nervous system, skin, gastrointestinal tract E. the spleen is never enlarged
A. more than 1.5 x 10 9 / L peripheral blood eosinophils C. is a clonal myeloproliferative disease D. the disease affects the heart, lungs, central nervous system, skin, gastrointestinal tract
166
Chronic myelomonocytic leukemia is today classified as: myelodysplastic syndromes myeloproliferative syndromes myelodysplastic - myeloproliferative syndromes lymphoproliferative diseases malignant lymphoma
myelodysplastic - myeloproliferative syndromes
167
Chronic myelomonocytic leukemia includes: is a disease of the elderly there are more than 1 x 10 9 / L monocytes in the blood picture acute leukemia always develops later in the clinical picture, the spleen and liver are enlarged the Philadelphia chromosome is always present in the bone marrow
is a disease of the elderly there are more than 1 x 10 9 / L monocytes in the blood picture in the clinical picture, the spleen and liver are enlarged
168
The 40-year-old patient felt tightness under the left costal arch for a month. He visited a doctor who found a high white blood cell count and referred him to a hematology clinic. On examination, we felt an enlarged spleen 12 cm below the left costal arch, and the liver 3 cm below the right costal arch. Laboratory tests: leukocytes 353 x 10 9 / L, Hb 117 g / L, platelets 360 x 10 9 / L. The differential blood count was dominated by neutrophils at different stages of maturation, the most numerous being segmented neutrophils and myelocytes. Uric acid values ​​and LDH activity were increased. The karyotype of the bone marrow, there is an a Philadelphia chromosome (t (9; 22)) Which of the following diagnoses would be more correct? A. acute myeloblastic leukemia B. chronic myeloid leukemia C. essential thrombocythemia D. chronic myelomonocytic leukemia E. chronic lymphocytic leukemia
B. chronic myeloid leukemia
169
Primary hemostasis is: A. the process of platelet clot formation at the site of vascular wall injury B. the process of fibrin formation in the clot C. activity of coagulation inhibitors D. activity of the fibrinolytic system E. bleeding at the site of vascular wall injury
A. the process of platelet clot formation at the site of vascular wall injury
170
The hemostasis system under normal conditions allows for effective cessation of bleeding. Choose the main factors: (1+) A. platelets and vascular wall B. leukocytes C. coagulation and fibrinolytic proteins D. coagulation and fibrinolysis inhibitors E. endothelial cells
A. platelets and vascular wall C. coagulation and fibrinolytic proteins D. coagulation and fibrinolysis inhibitors
171
The size of the hemostatic clot determines: A. platelet activity and coagulation, B. platelet activity, coagulation, fibrinolysis, C. coagulation activity, D. fibrinolysis activity E. vascular wall activity
B. platelet activity, coagulation, fibrinolysis,
172
Platelets participate in the process of primary hemostasis with three events: A. adhesion or adhesion to subedothelial tissues B. platelet aggregation or adhesion C. secretion or excretion from granules D. dissolving the clot E. inhibition or inhibition of coagulation
A. adhesion or adhesion to subedothelial tissues B. platelet aggregation or adhesion C. secretion or excretion from granules
173
Platelet aggregation is the connection of two adjacent platelet receptors. What is a binding molecule? A. Von Willebrand factor B. fibrinogen C. ADP and serotonin D. Protein C E. coagulation factors
B. fibrinogen
174
Determine the properties of endothelial cells: (combination) A. have anticoagulant properties, B. they are completely inert and are the boundary between blood and tissue, C. have procoagulant properties, D. have fibrinolytic properties
A. have anticoagulant properties, C. have procoagulant properties, D. have fibrinolytic properties
175
Coagulation proteins are formed: (1+) A. in the liver, B. in the kidneys, C. in macrophages, megakaryocytes, platelets, endothelial cells D. in the bone marrow
A. in the liver, C. in macrophages, megakaryocytes, platelets, endothelial cells
176
Which of the statements is correct? A. Studies have shown that coagulation takes place in vitro by intrinsic and extrinsic pathways. In vivo, the course is different. B. Studies have shown that coagulation takes place in vitro by intrinsic and extrinsic pathways. In vivo, the course is the same, but more complicated. C. Studies have shown that coagulation takes place in vitro by intrinsic and extrinsic pathways. In vivo it takes place only in an intrinsic way. D. Studies have shown that coagulation takes place in vitro by intrinsic and extrinsic pathways. In vivo, it takes place only by the extrinsic route. E. Studies have shown that coagulation takes place in vitro by intrinsic and extrinsic pathways. In vivo, we don’t know how it goes.
B. Studies have shown that coagulation takes place in vitro by intrinsic and extrinsic pathways. In vivo, the course is the same, but more complicated.
177
Petechiae are: minor bleeding in the skin or mucous membranes bleeding into the muscles bleeding into the joints bleeding into body cavities bleeding in haemophilia
minor bleeding in the skin or mucous membranes
178
Spontaneous bleeding into the joints is found almost exclusively in: leukemia hemophilia thrombocytopenia prostate cancer plasmacytoma
hemophilia
179
Bleeding that occurs for the first time in an adult is mostly: congenital obtained abundant occult irrelevant
obtained
180
A 20-year-old girl developed venous thrombosis in the second half of her pregnancy. What could be the cause? A. hereditary deficiency of coagulation inhibitors B. pregnancy C. a combination of hereditary deficiency of coagulation inhibitors and pregnancy D. hemophilia E. multiple pregnant
A. hereditary deficiency of coagulation inhibitors B. pregnancy C. a combination of hereditary deficiency of coagulation inhibitors and pregnancy SE SOLO 1 C
181
Choose the correct statement! A. The pathogenesis of bleeding can only be determined through laboratory tests. B. The pathogenesis of bleeding is determined through a clinical examination. C. Diagnosis of bleeding includes history, clinical examination, and laboratory. D. Laboratory tests are only important to determine the cause of the bleeding . E. History is the only criterion for determining the cause of bleeding .
C. Diagnosis of bleeding includes history, clinical examination, and laboratory.
182
Choose the correct statement! The INR is used to assess the disorder: extrinsic coagulation intrinsic coagulation fibrinolysis platelet function vascular walls
extrinsic coagulation
183
Tests to assess primary hemostasis are: (3) determination of platelet count Prothrombin time closing time Partial thromboplastin time aggregometry
determination of platelet count closing time aggregometry
184
Closing time is: A. Screening test to assess platelet function B. Allows you to estimate the platelet count C. In vivo examination to assess vascular wall function D. Test to assess the activity of the intrinsic coagulation system E. Test to assess the activity of the extrinsic coagulation system
A. Screening test to assess platelet function
185
We use aggregometry to estimate: A. platelet count B. hemoglobin concentration in the blood C. platelet function "in vitro" D. phagocytic capacity of leukocytes E. spleen function
C. platelet function "in vitro"
186
We speak of thrombocytopenia when the platelet count is: increased reduced normal at a platelet count below 300 x 10 9 / L at a platelet count above 300 x 10 9 / L
reduced (<140 × 10 ^ 9 / l)
187
Idiopathic thrombocytopenic purpura is a disease: children adults children and adults men women
children and adults
188
Acute idiopathic thrombocytopenic purpura is primarily a disease: children adults children and adults men women
children
189
Chronic idiopathic thrombocytopenic purpura is primarily a disease: children adults, more often women adults, more often men children and adults men
adults, more often women
190
Can life-threatening bleeding occur in patients with idiopathic thrombocytopenic purpura? no yes, at less than 1% yes, at 10% yes, at 20% yes, at 30%
yes, at less than 1%
191
Thrombocytopenia may be due to: (combination) A. stem cell defects in the bone marrow (eta n ol) B. bone marrow infiltration with leukemia, lymphoma C. idiopathic thrombocytopenic purpura D. hemolytic anemia E. hemophilia
A. stem cell defects in the bone marrow (eta n ol) B. bone marrow infiltration with leukemia, lymphoma C. idiopathic thrombocytopenic purpura
192
What bleeding is characteristic of thrombocytopenia? (combination) Petechiae in the skin and mucous membranes Deep subcutaneous hematomas Purpura in the skin and mucous membranes Ecchymosis in the skin and mucous membranes Bleeding into the joints
Petechiae in the skin and mucous membranes Purpura in the skin and mucous membranes Ecchymosis in the skin and mucous membranes
193
Treatment of patients with idiopathic thrombocytopenic purpura is indicated by platelet count: (3) A. under 100 x 10 9 / L B. under 30 x 10 9 / L C. below 50 x 10 9 / L if bleeding is present D. below 50 x 10 9 / L and if risk factors for bleeding such as arterial hypertension, ulcer disease are present E. only below 10 x 10 9 / L
B. under 30 x 10 9 / L C. below 50 x 10 9 / L if bleeding is present D. below 50 x 10 9 / L and if risk factors for bleeding such as arterial hypertension, ulcer disease are present
194
Heparin-induced thrombocytopenia (HIT) occurs: (1+) A. more often after treatment with standard heparin B. more often after treatment with low molecular weight heparin C. between 5 and 14 days after starting heparin treatment D. in 50% of patients treated with heparin
A. more often after treatment with standard heparin C. between 5 and 14 days after starting heparin treatment
195
With what changes in the blood picture should we consider the possibility of thrombotic thrombocytopenic purpura? A. leukopenia and anemia B. leukopenia and thrombocytopenia C. microangiopathic hemolytic anemia and thrombocytopenia D. microcytic anemia E. thrombocytopenia
C. microangiopathic hemolytic anemia and thrombocytopenia (smear schizocytes)
196
The correct statements are: (1+) A. in the mild form of hemophilia, there is no increased incidence of bleeding after injury and surgery B. in mild hemophilia, spontaneous bleeding is rare C. in moderate hemophilia, spontaneous bleeding is absent D. in moderate hemophilia, spontaneous bleeding is uncommon
B. in mild hemophilia, spontaneous bleeding is rare D. in moderate hemophilia, spontaneous bleeding is uncommon
197
A patient with known haemophilia A seeks help for knee pain. There are no external signs of bleeding on examination. How do we act? A. observed until signs of bleeding and then treated by replacement of the missing coagulation factor, B. we immediately replace the missing coagulation factor, then decide on other procedures C. first we paint the knee, then we perform the other measures D. do along the knees, then other measures E. we give an analgesic and send the patient home
B. we immediately replace the missing coagulation factor, then decide on other procedures
198
It is a bleeding in the knee in hemophilia B after cycling. Treatment includes: (combination) A. stopping bleeding B. rest and cold not lining C. physiotherapy after remediation of bleeding D. nonsteroidal antirheumatic drugs and a spirin due to knee pain E. prohibition of every sport activity
a. stop bleeding, b. dormancy and cold packs, c. physiotherapy after bleeding repair,
199
Antibodies to coagulation factor VIII are produced: a. in haemophilia A after treatment b. in the elderly, but rarely c. in venous thrombosis d. in haemophilia B e. In von Willebrand disease
a. in haemophilia A after treatment e. In von Willebrand disease (type III)
200
The 20-year-old patient has frequent nosebleeds and menorrhagia, otherwise healthy. Choose one of the options! A. suspected haemophilia, or a carrier of haemophilia, B. suspected of von Willebrand's disease, C. bleeding is insignificant and accidental D. suspected of acquired haemophilia E. suspected immune thrombocytopenia
B. suspected of von Willebrand's disease,
201
Choose the correct statements: A. type 1 von Willebrand disease is the most common. Bleeding is usually not severe B. Type 2 von Willebrand's disease is as common as type 1, bleeding is rare C. Type 3 von Willebrand's disease is very rare, bleeding is as severe and severe as in haemophilia
A. type 1 von Willebrand disease is the most common. Bleeding is usually not severe C. Type 3 von Willebrand's disease is very rare, bleeding is as severe and severe as in haemophilia
202
In von Willebrand's disease, bleeding occurs due to: A. reduced von Willebrand factor (VWF) concentrations B.from the modified VWF building C. decreased F VIII activity (too little vWf to bind and protect against blood proteolysis)
A. reduced von Willebrand factor (VWF) concentrations B.from the modified VWF building C. decreased F VIII activity (too little vWf to bind and protect against blood proteolysis)
203
Acquired deficiency of coagulation factors II, VII, X can be in: (1+) liver disease in vitamin K deficiency in vitamin C deficiency treatment or coumarin poisoning chronic inflammation (eg rheumatoid arthritis)
liver disease in vitamin K deficiency treatment or coumarin poisoning
204
Disseminated intravascular coagulation occurs as a complication in many diseases. It is characterized by the occurrence of all of the above EXCEPT: thrombosis bleeding thrombocytopenia organ and tissue ischemia normal D-dimer value
normal D-dimer value
205
Disseminated intravascular coagulation is an expected complication in all of the following EXCEPT: sepsis severe injuries and operations malignant tumors burns treatment with unfractionated heparin
treatment with unfractionated heparin
206
Disseminated intravascular coagulation is characterized by laboratory changes: (1+) thrombocytopenia coagulation disorders activated fibrinolysis INR more than 5
thrombocytopenia coagulation disorders activated fibrinolysis
207
In a previously healthy man, prolonged bleeding occurs after major prostate surgery. Which of the options is most likely? hemophilia B hemophilia A von Willebrand disease local hyperfibrinolysis thrombocytopenia
local hyperfibrinolysis
208
Choose the correct statements! (3) antithrombin (AT) is a key inhibitor of coagulation. AT is a key inhibitor of fibrinolysis. AT deficiency is associated with thrombosis. AT deficiency is hereditary or acquired.
antithrombin (AT) is a key inhibitor of coagulation. AT deficiency is associated with thrombosis. AT deficiency is hereditary or acquired.
209
Arrange the treatment elements of disseminated intravascular coagulation in order of importance! a. heparin b. trasfusion platelets and plasma c. treatment of the underlying disease The correct order of answers is: a, b, c The correct order of answers is: b, c, a The correct order of answers is: c, b, a The correct order of answers is: a, c, b The correct order of answers is: b, a, c
The correct order of answers is: c, b, a
210
An 18-year-old boy visited a doctor for bleeding from both nostrils and tiny spotted bleeding in the skin of the shin, abdomen and in the oral mucosa. He had a bit of a cold for the last three days and did not intend to have a fever. The water did not burn him, he did not notice diarrhea, the stool was of a normal color. His throat didn't hurt, he had no trouble swallowing. He has not been receiving any medication recently. Clinical status was within normal limits except for tiny petechiae and purpura in the skin of the tibia, abdomen, and oral mucosa. He had an anterior nasal tamponade in both nostrils, which was done in a personal physician’s office. Laboratory tests : in the blood picture are L 6.4 x 10 9 / L, Hb 145 g / L, MCV 85 fl, and no. platelets Tr 4 x 10 9 / L. All biochemical investigations were within normal limits. Inflammatory parameters were not increased. Which of the following diagnoses would be the most correct as a working diagnosis? A. acute idiopathic thrombocytopenic purpura B. chronic idiopathic thrombocytopenic purpura C. thrombotic thrombocytopenic purpura D. heparin-induced thrombocytopenia E. disseminated intravascular coagulation
A. acute idiopathic thrombocytopenic purpura
211
The 20-year-old girl was brought to the internal medicine emergency by her parents due to the growing confusion and drowsiness that had occurred in the last 2-3 days. At home, she also mentioned headaches, slightly worse eyesight and paretic changes in the fingers of her left hand, which disappeared within a few hours and then appeared in the fingers of her right hand. In addition, small hemorrhages were observed in the skin of the tibia. She was healthy before that. In clinical status, it was occasionally disoriented, otherwise eupnoic, febrile up to 37.5 ° C. Heart and lung status within normal limits. The abdomen is soft, without enlarged organs, in the skin of the shin a few tiny petechiae. Laboratory, microbiological tests: leukocytes L 5.6 x 10 9 / L, hemoglobin Hb concentration 85 g / L, MCV 90 fL, platelet number Tr 15 x 10 9 / L, no. reticulocytes 150 x 10 9 / L, in DKS the presence of numerous fragmented erythrocytes (schizocytes) . Coombs tests negative. LDH activity was increased, urea and creatinine were within normal limits, as were hemostasis tests. Microbiological tests remained negative. Which of the following diagnoses would be the most correct as a working diagnosis? A. chronic idiopathic thrombocytopenic purpura B. thrombotic thrombocytopenic purpura C. heparin-induced thrombocytopenia D. disseminated intravascular coagulation
B. thrombotic thrombocytopenic purpura
212
What applies to hemophilia C ?: (3) it is a lack of blood clotting factor XII it is a lack of blood clotting factor XI in hemostasis tests, prolonged PD is prolonged in hemostasis tests, aPTT is prolonged bleeding is generally not as extensive as in haemophilia A and B.
it is a lack of blood clotting factor XI in hemostasis tests, aPTT is prolonged bleeding is generally not as extensive as in haemophilia A and B.
213
The 75-year-old gentleman visited a doctor due to a gradual decline in strength over the past six months, poor appetite and weight loss. On clinical examination, he had pale yellow skin, and a spindle-shaped systolic murmur was heard at the base of the heart. There were no other abnormalities. About d take him the blood for testing. Examination results showed pancytopenia (Hb 54 g / L, PVE (MCV) 132 fL, reticulocytes 14x109 / L, leukocytes 2.4x109 / L, neutrophils 1.4x109 / L, platelets 82x109 / L). Thus, the blood count was accompanied by greatly increased lactate dehydrogenase activity and a slightly increased bilirubin concentration (LDH 62.8 ukat / L, total bilirubin 22 umol / L, conjugated 7 umol / L). Which of the following diagnoses would be most likely? A. Autoimmune hemolytic anemia B. Megaloblastic anemia due to B12 deficiency in atrophic gastritis C. Aplastic anemia D. Refractory anemia (MDS) E. Hypersplenism in alcoholic liver cirrhosis
B. Megaloblastic anemia due to B12 deficiency in atrophic gastritis
214
Myeloproliferative diseases include: (1+) true polycythemia idiopathic myelofibrosis chronic myeloid leukemia myelodysplastic syndrome essential thrombocythemia
true polycythemia idiopathic myelofibrosis chronic myeloid leukemia essential thrombocythemia
215
Lymphoproliferative diseases include: (1+) mantle cell lymphoma monoclonal gammopathy of undetermined significance Gaucher disease large B cell lymphoma chronic lymphocytic leukemia
mantle cell lymphoma monoclonal gammopathy of undetermined significance large B cell lymphoma chronic lymphocytic leukemia
216
Pale skin is always the result of anemia: hold not true
not true
217
Ledinal anemia: A. can be treated with erythropoietin immediately ( when all Hb F as less W and 110 g / l) B. it is treated with iron replacement ( also together with EPO to achieve the target serum ferritin concentration> 100qg / l) C. anemia and osteodystrophy significantly affect morbidity (in principle logically correct, but not directly in the Internal)
TUTTE
218
Connect the concepts to get the disease + the appearance of bleeding + the site of bleeding! A. hemophilia B. Von Willebrand's disease C. thrombocytopenia D. petechiae E. muscles, joints F. hematoma G. bleeding H. mucous membranes I. skin, mucous membranes Answer: a + e + i / b + f + g / c + d + x (h) a + f + i / b + e + x / c + e + g a + d + i / b + d + g / c + d + i a + e + x / b + f + i / c + f + g a + d + i / b + e + g / c + d + i
a + e + i / b + f + g / c + d + x
219
Chloroma (granulocytic sarcoma) is: a. mixed acute myeloid leukaemia and acute lymphocytic leukaemia b. solid leukaemic tumour outside the bone marrow c. amyloid accumulation in leukaemic cells d. leukaemic infiltrate in the gonads (testes or ovary) e. leukaemic infiltrate in long bones of the skeleton
b. solid leukaemic tumour outside the bone marrow
220
Myeloproliferative disorders include: a. real polycythemia b. idiopathic myelofibrosis c. chronic myeloid leukaemia d. myelodysplastic syndrome e. essential thrombocythaemia
a. real polycythemia b. idiopathic myelofibrosis c. chronic myeloid leukaemia e. essential thrombocythaemia
221
It is a real polycythemia: a. chronic myeloproliferative disease b. most common between the ages of 40 and 60 c. patients complain of headaches, dizziness, tinnitus d. the spleen is never enlarged e. the haematocrit value is within normal limits
a. chronic myeloproliferative disease b. most common between the ages of 40 and 60 c. patients complain of headaches, dizziness, tinnitus
222
Hemophilia C a. It is a deficiency of blood clotting factor XII b. It is a deficiency of blood clotting factor XI c. In haemostasis tests, the PD is prolonged d. in haemostasis tests, aPTC is prolonged e. Bleeding is usually not as extensive as in haemophilia A and B
b. It is a deficiency of blood clotting factor XI d. in haemostasis tests, aPTC is prolonged e. Bleeding is usually not as extensive as in haemophilia A and B
223
What can cause erythrocytosis? a. extreme obesity b. liver disease
a. extreme obesity
224
In an adult, all blood cells are formed in the blood marrow from a single germ cell. Platelets also have antigens A, B and 0 on their surface. a. both statements are correct b. the first statement is correct, the second statement is incorrect, c. the first statement is incorrect, the second statement is correct d. both are incorrect
a. both statements are correct
225
What is NOT prevented by irradiating platelets before transfusion? a. bacterial infections b. viral infections c. allergic reactions d. graft-versus-host reactions
c. allergic reactions
226
After a transfusion, blood has a limited shelf life. This requires planning donations throughout the year. a. the first statement is correct, the second statement is incorrect b. first statement false, second correct c. both statements are correct d. both are incorrect
c. both statements are correct
227
What blood can we give to a patient we don't know who needs an emergency transfusion? a. full blood b. erythrocyte c. blood group 0 d. AB blood group e. Rh - f. Rh+ g. h. kell - i. kell + j. Rh is not important
b. erythrocyte c. blood group 0 j. Rh is not important
228
Essential thrombocytosis: (Int. P. 1318 ) a. greatly enlarged spleen ( usually less than 5 cm below the costal arch) b. always accompanied by anemia ( when anemia is present, it is normochromic and normocytic) c. It is detected due to arterial and venous thrombosis, bleeding and thrombosis are also common, and there are more than 400 platelets .
c. It is detected due to arterial and venous thrombosis, bleeding and thrombosis are also common, and there are more than 400 platelets .