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HEMA LEC > MIDTERMS - REVIEW QUESTIONS > Flashcards

MIDTERMS - REVIEW QUESTIONS Flashcards

1
Q

Which of the following is an erythrocyte progenitor?

a. pronormoblast
b. reticulocytes
c. CFU -E
d. Orthochromic normoblast

A

C . CFU - E

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2
Q

Which of the following is the most mature normoblast?
a. Orthrochormic normoblast
b. Basophilic normoblast
c. Pronormoblast
d. Polychromatic normoblast

A

A. Orthochromic normoblast

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3
Q

Erythroid precursor: the cell is medium sized compared to other, the ratio is 1:1, the nuclear chromatin is condensed and chunky throughout the nucleus, No nucleoli are seen, The cytoplasm is a muddy, blue-pink color

a. Reticulocyte
b. Pronormoblast
c. Orthochromatic normoblast
d. Polychromatic normoblast

A

D Polychromatic normoblast

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4
Q

Which of the following is not related to the effects of erythropoeitin

a the number of divisions of normoblast
b the formation of pores in sinusoidal endothelial cells for marrow egrees
c The time between mitoses of normoblasts
d The production of antiapoptotic molecules by erythroid progenitors

A

B the formation of pores in sinusoidal endothelial cells for marrow egrees

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5
Q

Hypoxia stimulates RBC production by

a. Inducing more pluripotent stem cells into the erythroid lineage
b. Stimulating EPO production by the kidney
c. Increasing the number or RBC mitoses
d. Stimulating the production of fibronectin by macrophages of the bone marrow

A

B. Stimulating EPO production by the kidney

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6
Q

In the bone marrow , RBC precursors are located
a. In the center of the hematopoietic cords
b. Adjacent too megakaryotes along the adventitial cells lining
c. Surrounding fat cells in apoptotic islands
d. Surrounding macropahges in erythroid islands

A

D. Surrounding macropahges in erythroid islands

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7
Q

Which of the following determines the timing of egrees of RBC from the bone marrow
a. Maturing normoblast slowly lose receptors for adhesive molecules that bind them to stroma cells
b. Stroma cells decrease production of adhesive molecules over time as RBC matures
c. Endothelial cells of the venous sinus form pores at specified intervals of time allowing of free egrees
d. periodic apoptosis of pronormoblast in the marrow cords occur

A

A. Maturing normoblast slowly lose receptors for adhesive molecules that bind them to stroma cells

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8
Q

What single feature of normal RBCs is most responsible for
limiting their life span?
a. Loss of mitochondria
b. Increased flexibility of the cell membrane
c. Reduction of hemoglobin iron
d. Loss of the nucleus

A

d. Loss of the nucleus

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9
Q

. Intravascular or fragmentation hemolysis is the result of
trauma to RBCs while in the circulation.
a. True
b. False

A

a. True

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10
Q

Extravascular hemolysis occurs when:
a. RBCs are mechanically ruptured
b. RBCs extravasate from the blood vessels into the tissues
c. Splenic macrophages ingest senescent cells
d. Erythrocytes are trapped in blood clots outside the
blood vessels

A

c. Splenic macrophages ingest senescent cells

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11
Q

Which RBC process does not require energy?
a. Oxygen transport
b. Cytoskeletal protein deformability
c. Preventing the peroxidation of proteins and lipids
d. Maintaining cytoplasm cationic electrochemical gradients

A

a. Oxygen transport

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12
Q

What pathway anaerobically generates energy in the form of
ATP?
a. Hexose monophosphate pathway
b. Rapoport-Luebering pathway
c. Embden-Meyerhof pathway
d. 2,3-BPG pathway

A

c. Embden-Meyerhof pathway

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13
Q

Which is true concerning 2,3-BPG?
a. The least abundant of RBC organophosphates
b. Enhances O2 release from hemoglobin
c. Source of RBC glucose
d. Source of RBC ATP

A

b. Enhances O2 release from hemoglobin

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14
Q

To survive, the RBC must detoxify peroxides. What
hexose-monophosphate shunt product(s) accomplishes
detoxification?
a. ATP
b. 2,3-BPG
c. Pyruvic and lactic acid
d. NADPH and reduced glutathione

A

d. NADPH and reduced glutathione

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15
Q

Which of the following helps maintain RBC shape?
a. Membrane phospholipids
b. Cytoskeletal proteins
c. GPI anchor
d. Glycocalyx

A

b. Cytoskeletal proteins

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16
Q

The glycolipids of the RBC membrane:
a. Provide flexibility.
b. Carry RBC antigens.
c. Constitute ion channels.
d. Attach the cytoskeleton to the lipid layer

A

b. Carry RBC antigens.

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17
Q

RBC membranes block passage of most large molecules
such as proteins, but allow passage of small molecules
such as the cations Na$, K$, and Ca$$. What is the term
for this membrane property?
a. Semipermeable
b. Deformable
c. Intangible
d. Flexible

A

a. Semipermeable

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18
Q

RBC membrane phospholipids are arranged:
a. In a hexagonal lattice.
b. In chains beneath a protein exoskeleton.
c. In two layers whose composition is asymmetric.
d. So that hydrophobic portions are facing the plasma.

A

c. In two layers whose composition is asymmetric.

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19
Q

RBC membrane cholesterol is replenished from the:
a. Plasma.
b. Mitochondria.
c. Cytoplasm.
d. EMB pathway.

A

a. Plasma.

20
Q

The hemoglobin iron ion may become oxidized to the $3
valence state by several pathological mechanisms. What
portion of the Embden-Meyerhof pathway reduces iron to
the physiologic $2 valence state?
a. Methemoglobin reductase pathway
b. Hexose monophosphate pathway
c. Rapoport-Luebering pathway
d. The 2,3-BPG shunt

A

a. Methemoglobin reductase pathway

21
Q

Which of the following is an example of a transmembrane
or integral membrane protein?
a. Glycophorin A
b. Ankyrin
c. Spectrin
d. Actin

A

a. Glycophorin A

22
Q

Abnormalities in the horizontal and vertical linkages
of the transmembrane and cytoskeletal RBC membrane
proteins may be seen as:
a. Shape changes.
b. Methemoglobin increase.
c. Reduced hemoglobin content.
d. Enzyme pathway deficiencies

A

a. Shape changes.

23
Q

A hemoglobin molecule is composed of:
a. One heme molecule and four globin chains
b. Ferrous iron, protoporphyrin IX, and a globin chain
c. Protoporphyrin IX and four globin chains
d. Four heme molecules and four globin chains

A

d. Four heme molecules and four globin chains

24
Q

Normal adult Hb A contains which polypeptide chains?
a. a and Beta
b. a and delta
c. a and gamma
d. a and episilon

A

a. a and Beta

25
Q

A key rate-limiting step in heme synthesis is suppression of:
a. Aminolevulinate synthase
b. Carbonic anhydrase
c. Protoporphyrin IX reductase
d. Glucose 6-phosphate dehydrogenase

A

a. Aminolevulinate synthase

26
Q

Which of the following forms of hemoglobin molecule has
the lowest affinity for oxygen?
a. Tense
b. Relaxed
c. arterial
d. venous

A

A. Tense

27
Q

Using the normal hemoglobin-oxygen dissociation curve in
Figure 10-7 for reference, predict the position of the curve
when there is a decrease in pH.
a. Shifted to the right of normal with decreased oxygen
affinity
b. Shifted to the left of normal with increased oxygen affinity
c. Shifted to the right of normal with increased oxygen
affinity
d. Shifted to the left of normal with decreased oxygen affinity

A

b. Shifted to the left of normal with increased oxygen affinity

28
Q

The predominant hemoglobin found in a healthy newborn is:
a. Gower-1
b. Gower-2
c. A
d. F

A

d. F

29
Q
  1. What is the normal distribution of hemoglobins in healthy
    adults?
    a. 80% to 90% Hb A, 5% to 10% Hb A2, 1% to 5% Hb F
    b. 80% to 90% Hb A2, 5% to 10% Hb A, 1% to 5% Hb F
    c. *95% Hb A, )3.5% Hb A2, 1% to 2% Hb F
    d. *90% Hb A, 5% Hb F, )5% Hb A2
A

c. *95% Hb A, )3.5% Hb A2, 1% to 2% Hb F

30
Q

Which of the following is a description of the structure of
oxidized hemoglobin?
a. Hemoglobin carrying oxygen on heme; synonymous
with oxygenated hemoglobin
b. Hemoglobin with iron in the ferric state (methemoglobin) and not able to carry oxygen
c. Hemoglobin with iron in the ferric state so that carbon
dioxide replaces oxygen in the heme structure
d. Hemoglobin carrying carbon monoxide; hence “oxidized”
refers to the single oxygen

A

b. Hemoglobin with iron in the ferric state (methemoglobin) and not able to carry oxygen

31
Q

. In the quaternary structure of hemoglobin, the globin
chains associate into:
a. “ tetramers in some cells and # tetramers in others
b. A mixture of “ tetramers and # tetramers
c. “ dimers and # dimers
d. Two alpha beta dimer

A

d. Two alpha beta dimer

32
Q

How are the globin chain genes arranged?
a. With a genes and b genes on the same chromosome,
including two “ genes and two # genes
b. With “ genes and # genes on separate chromosomes,
including two “ genes on one chromosome and one
# gene on a different chromosome
c. With “ genes and # genes on the same chromosome,
including four “ genes and four # genes
d. With “ genes and # genes on separate chromosomes,
including four “ genes on one chromosome and two
# genes on a different chromosome

A

b. With “ genes and # genes on separate chromosomes,
including two “ genes on one chromosome and one
# gene on a different chromosome

33
Q
  1. The nature of the interaction between 2,3-BPG and hemoglobin is that 2,3-BPG:
    a. Binds to the heme moiety, blocking the binding of oxygen
    b. Binds simultaneously with oxygen to ensure that it stays
    bound until it reaches the tissues, when both molecules
    are released from hemoglobin
    c. Binds to amino acids of the globin chain, contributing
    to a conformational change that inhibits oxygen from
    binding to heme
    d. Oxidizes hemoglobin iron, diminishing oxygen binding
    and promoting oxygen delivery to the tissues
A

c. Binds to amino acids of the globin chain, contributing
to a conformational change that inhibits oxygen from
binding to heme

34
Q

Iron is transported in plasma via:
a. Hemosiderin
b. Ferritin
c. Transferrin
d. Hemoglobin

A

c. Transferrin

35
Q

What is the major metabolically available storage form of
iron in the body?
a. Hemosiderin
b. Ferritin
c. Transferrin
d. Hemoglobin

A

b. Ferritin

36
Q

The total iron-binding capacity (TIBC) of the serum is an
indirect measure of which iron-related protein?
a. Hemosiderin
b. Ferritin
c. Transferrin
d. Hemoglobin

A

c. Transferrin

37
Q

For a patient with classic iron study values that are equivocal for iron deficiency, which of the following tests would be
most helpful in determining whether iron deficiency is present or not?
a. Zinc protoporphyrin
b. Peripheral blood sideroblast assessment
c. Soluble transferrin receptor
d. Mean cell hemoglobin

A

c. Soluble transferrin receptor

38
Q

What membrane-associated protein in enterocytes transports iron from the intestinal lumen into the enterocyte?
a. Transferrin
b. Ferroportin
c. DMT1
d. Ferrochelatase

A

c. DMT1

39
Q

Iron is transported out of macrophages, hepatocytes, and
enterocytes by what membrane protein?
a. Transferrin
b. Ferroportin
c. DMT1
d. Ferrochelatase

A

b. Ferroportin

40
Q

. Below are several of the many steps in the process from
absorption and transport of iron to incorporation into
heme. Place them in proper order.
i. Transferrin picks up ferric iron.
ii. Iron is transferred to the mitochondria.
iii. DMT1 transports ferrous iron into the enterocyte.
iv. Ferroportin transports iron from enterocyte to plasma.
v. The transferrin receptor transports iron into the cell.
a. v, iv, i, ii, iii
b. iii, ii, iv, i, v
c. ii, i, v, iii, iv
d. iii, iv, i, v, ii

A

d. iii, iv, i, v, ii

41
Q

What is the fate of the transferrin receptor when it has completed its role in the delivery of iron to a cell?
a. It is recycled to the plasma membrane and released into
the plasma.
b. It is recycled to the plasma membrane, where it can bind
its ligand again.
c. It is catabolized and the amino acids are returned to the
metabolic pool.
d. It is retained in the endosome for the life span of the cell.

A

b. It is recycled to the plasma membrane, where it can bind
its ligand again

42
Q

The transfer of iron from the enterocyte into the plasma is
REGULATED by:
a. Transferrin
b. Ferroportin
c. Hephaestin
d. Hepcidin

A

d. Hepcidin

43
Q

What is the percent transferrin saturation for a patient with
total serum iron of 63 &g/dL and TIBC of 420 &g/dL ?
a. 6.7%
b. 12%
c. 15%
d. 80%

A

c. 15%

44
Q

Referring to Figure 11-6, into which quadrant of a Thomas
plot would a patient’s results fall with the following test
results:
Soluble transferrin receptor: increased above reference interval
Ferritin: decreased below reference interval
Hemoglobin content of reticulocytes: within the reference
interval
a. Normal iron status
b. Latent iron deficiency
c. Functional iron deficiency
d. Iron deficiency

A

b. Latent iron deficiency

45
Q

A physician is concerned that a patient is developing iron
deficiency from chronic intestinal bleeding due to aspirin
use for rheumatoid arthritis. The iron studies on the patient show the following results:
How would these results be interpreted?
a. Latent iron deficiency
b. Functional iron deficiency
c. Iron deficiency
d. Equivocal for iron deficiency

A

d. Equivocal for iron deficiency

46
Q
A

HEMA LEC (5 decks)

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