week 1 extra Q's

Question 1

the rate-limiting step of heme synthesis requires which of the following?

a. vitamin B3
b. vitamin B4
c. vitamin B5
d. vitamin B6

Answer 1

d. vitamin B6

AKA pyridoxal phosphate

Question 2

Which porphyrins is normally important for humans?

a. type I porphyrins
b. type II porphyrins
c. type III porphyrins
d. c. type IV porphyrins

Answer 2

c. type III porphyrins

Question 3

Which of the following induces ALAS1 gene?

a. cytochrome P450 metabolized drugs
b. hemin
c. availability of intracellular iron

Answer 3

a. cytochrome P450 metabolized drugs

Question 4

Which of the following controls ALAS2?

a. cytochrome P450 metabolized drugs
b. vitamin C
c. availability of intracellular iron

Answer 4

c. availability of intracellular iron

Question 5

A mutation in which of the following causes X-linked sideroblastic anemia?

a. ALAS1
b. ALAS2
c. ALAD

Answer 5

b. ALAS2

Question 6

Iron is added to ____ via ferrochelatase

a. uroporphyrinogen III
b. uroporphyrinogen IV
c. protoporphyrin IV
d. protoporphyrin IX

Answer 6

d. protoporphyrin IX

Question 7

Which of the following causes the photosensitivity in porphyrias?

a. tetrapyrrole intermediates
b. elevated ALA
c. increase ALA synthase activity

Answer 7

a. tetrapyrrole intermediates

Question 8

Which of the following enzymes is most active in moving phosphatidylserine?

a. floppase
b. flippase
c. scramblase

Answer 8

b. flippase

Question 9

Which of the following enzymes is inhibited by calcium and toxins?

a. flippase
b. floppase
c. scramblase

Answer 9

a. flippase

Question 10

T/F: lipid rafts have a higher amount of cholesterol than the rest of the plasma membrane

Answer 10

true

Question 11

What occurs when the receptor and effector are organized in rafts?

a. the signal is promoted
b. the signal is slowed down
c. the signal is prevented

Answer 11

a. the signal is promoted

Question 12

Which of the following is taken up by nucleoside transporter (hENT1)

a. valine
b. adenine
c. adenosine
d. thymidine

Answer 12

c. adenosine

Question 13

Which of the following is responsible for the lateral (horizontal) composition of the cytoskeleton?

a. alpha spectrin
b. band 3 protein
c. AE-1
d. glycophorin D

Answer 13

a. alpha spectrin

Question 14

Which of the following is responsible for the vertical composition of the cytoskeleton?

a. alpha spectrin
b. beta spectrin
c. glycophorin C

Answer 14

c. glycophorin C

Question 15

Genetic testing revealed that the ankyrin of a patient is mutated, which the most likely diagnosis?

a. hereditary spherocytosis
b. hereditary elliptocytosis

Answer 15

a. hereditary spherocytosis

Question 16

Genetic testing revealed that the alpha spectrin of a patient is mutated, which the most likely diagnosis?

a. hereditary spherocytosis
b. hereditary elliptocytosis

Answer 16

b. hereditary elliptocytosis

Question 17

Which the following is caused by weakened horizontal linkages?

a. hereditary spherocytosis
b. hereditary elliptocytosis

Answer 17

b. hereditary elliptocytosis

Question 18

Genetic testing revealed that the AE-1 of a patient is mutated, which the most likely diagnosis?

a. hereditary spherocytosis
b. hereditary elliptocytosis

Answer 18

a. hereditary spherocytosis

Question 19

Which TWO of the following chains are found in adult hemoglobin?

a. α chains
b. β chains
c. γ chains
d. δ chains

Answer 19

a. α chains
&
b. β chains

Question 20

Which TWO of the following chains are found in fetal hemoglobin?

a. α chains
b. β chains
c. γ chains
d. δ chains

Answer 20

a. α chains
&
c. γ chains

Question 21

Why is carbon monoxide (CO) poisonous?

a. its hydrophobic, and thus gets stuck in the pocket of the globin
b. it binds more tightly than oxygen and carbondioxide

Answer 21

b. it binds more tightly than oxygen and carbondioxide

Question 22

Which of the following contains the oxidized form of iron (Fe3)?

a. Oxyhemoglobin
b. Deoxyhemoglobin
c. Carboxyhemoglobin
d. Methemoglobin

Answer 22

d. Methemoglobin

Question 23

Which of the following states is more stable when bounded with oxygen?

a. T state
b. R state

Answer 23

b. R state

Question 24

Which of the following increase the supply of oxygen to the tissues?

a. positive effectors of O2 binding
b. negative effectors of O2 binding

Answer 24

b. negative effectors of O2 binding

they negatively effect affinity

Question 25

Which of the following is a positive effector of O2 binding? a. CO2 b. O2 c. H+ d. 2,3-BPG

Answer 25

b. O2

Question 26

Which of the following processes provides energy for methemoglobin reductase? a. pentose phosphate pathway b. 2,3- bisphosphoglycerate pathway c. glycolysis

Answer 26

c. glycolysis | it provides NADH for the enzyme, not the RBC

Question 27

A mutation in which of the following usually presents at 3 months of age? a. α globin b. β globin c. γ globin

Answer 27

b. β globin

Question 28

Which of the following is given to treat methemoglobinemia? a. methylene blue b. leukomethylene blue c. cytochrome b5

Answer 28

a. methylene blue

Question 29

Which of the following does monocarboxylate transporter (MCT1) export out of RBC's? a. pyruvate b. H2O2 c. lactate

Answer 29

c. lactate

Question 30

Which of the following controls hemoglobin affinity for oxygen? a. 1,3-BPG b. 2,3-BPG c. 1,5-BPG d. 2,5-BPG

Answer 30

b. 2,3-BPG

Question 31

Which of the following processes provides NADPH in RBC's? a. pentose phosphate pathway b. 2,3- bisphosphoglycerate pathway c. glycolysis

Answer 31

a. pentose phosphate pathway

Question 32

Which is used to maintain glutathione in its reduced state (GSH)? a. NAD+ b. NADH c. NADPH d. ATP

Answer 32

c. NADPH

Question 33

Why is anemia common in people w/G6PD? a. not enough NADPH in RBC b. RBC's plasma membrane is defective c. low Heinz body production

Answer 33

a. not enough NADPH in RBC | NADPH helps deal with oxidative stress

Question 34

Which of the following does eating too many fava beans result in? a. more point mutations b. lower GSH c. lower H2O2

Answer 34

b. lower GSH

Question 35

T/F: according to the dualistic theory of hemopoiesis, erythrocytes share a stem cell origin with nongranular leukocytes

Answer 35

false, they share a stem cell origin with granular leukocytes

Question 36

Which of the following is the major blood-forming organ in the second trimester? a. liver b. yolk sac c. bone marrow

Answer 36

a. liver

Question 37

Which of the following is the major blood-forming organ in the third week of gestation? a. liver b. yolk sac c. bone marrow

Answer 37

b. yolk sac

Question 38

T/F: during the hepatic phase of hemopoiesis, only erythroid cells are produced

Answer 38

false, some leukopoiesis also occurs

Question 39

hematopoietic stem cells are a type of a. totipotent stem cells b. multipotent stem cells

Answer 39

b. multipotent stem cells | also called pluripotent stem cells

Question 40

Which of the following isn't derived from myeloid stem cells? a. monocyte b. basophil c. red blood cells d. plasma cells

Answer 40

d. plasma cells

Question 41

Which of the following is most basophilic? a. hemocytoblast b. reticulocyte c. early erythroblast d. late erythroblast

Answer 41

c. early erythroblast | because of the ribosome synthesis

Question 42

Which of the following still contains the nucleus? a. normoblast b. reticulocyte

Answer 42

a. normoblast

Question 43

Which of the following causes higher blood viscosity? a. excess of amino acids b. low levels of vitamin B c. high levels of erythropoietin

Answer 43

c. high levels of erythropoietin

Question 44

eosinophils are derived from a. lymphoid stem cells b. myeloblasts c. monoblasts

Answer 44

b. myeloblasts

Question 45

Which TWO blood cells are the most important source of cytokines? a. T cells b. B cells c. macrophages d. eosinophils

Answer 45

a. T cells & c. macrophages

Question 46

Which of the following stimulates megakaryopoiesis? a. Erythropoietin b. Thrombopoietin c. GM-CSF d. M-CSF

Answer 46

b. Thrombopoietin

Question 47

Which happens to iron during infection? a. increased levels b. decreased levels c. synthesis decreases

Answer 47

b. decreased levels

Question 48

In which state does iron exist intracellularly? a. ferrous iron b. ferric iron

Answer 48

a. ferrous iron (Fe2)

Question 49

Which of the following acts as an iron sensor? a. ferritin b. ferroportin c. transferrin d. hepcidin

Answer 49

c. transferrin

Question 50

Which of the following exports iron from cells to plasma? a. ferritin b. ferroportin c. transferrin d. hepcidin

Answer 50

b. ferroportin

Question 51

What occurs when hepcidin is high? a. high ferroportin b. high iron levels c. anemia d. less iron stored

Answer 51

c. anemia

Question 52

Which of the following is a negative regulator of hepcidin synthesis? a. erythropoietic signals b. iron signals c. inflammation

Answer 52

a. erythropoietic signals

Question 53

How does inflammation control hepcidin transcription? a. SMAD b. neogenin c. serum HJV d. JAK-STAT3

Answer 53

d. JAK-STAT3

Question 54

Which of the following down-regulates hepcidin expression? a. SMAD b. serum HJV c. JAK-STAT3

Answer 54

b. serum HJV

Question 55

Which of the following delivers vitamin B12 to body tissues? a. transcobalamin I b. transcobalamin II c. cubilin d. amnioless

Answer 55

b. transcobalamin II

Question 56

Which of the following protects vitamin B12 from stomach acid? a. transcobalamin I b. transcobalamin II c. cubilin d. amnioless

Answer 56

a. transcobalamin I

Question 57

Where is vitamin B12 stored? a. myelin sheath b. fat cells c. kidney d. pancreas

Answer 57

c. kidney | and liver!

Question 58

Which of the following is resistant against pancreatic proteases? a. haptocorrin b. intrinsic factor

Answer 58

b. intrinsic factor

Question 59

A deficiency in which of the following enzymes causes homocysteinemia? a. methylmalonyl-COA mutase b. methionine synthase c. hydroxymethyl- transferase

Answer 59

b. methionine synthase | homocysteinemia= elevation of the homocysteine

Question 60

Which of the following methods is most useful in absorbing high concentrations of monoglutamate folate in the upper small intestine? a. passive diffusion b. folate transporters & receptors

Answer 60

a. passive diffusion

Question 61

Which of the following methods is most useful in cellular absorption of Monoglutamate folate? a. passive diffusion b. folate transporters & receptors

Answer 61

b. folate transporters & receptors | low concentrations

Question 62

describe the relationship between hypoxia-induced factor (HIP) and erythropoietin a. directly proportional b. indirectly proportional

Answer 62

a. directly proportional

Question 63

Which of the following healthy individuals most likely has a lower hemoglobin level? a. a women b. a man c. a pregnant women d. a teenage boy

Answer 63

c. a pregnant women | lower because the volume increased; dilution

Question 64

In which of the following can the body not make heme? a. sideroblastic anemia b. pernicious anemia c. megaloblastic anemia

Answer 64

a. sideroblastic anemia

Question 65

In which of the following is the globin chain defective? a. sideroblastic anemia b. anemia of inflammation c. thalassemia d. megaloblastic anemia

Answer 65

c. thalassemia

Question 66

Which of the following is most easily absorbed? a. heme iron b. non-heme iron

Answer 66

a. heme iron

Question 67

How are hepcidin and iron stores related? a. directly proportional b. inversely proportional

Answer 67

a. directly proportional

Question 68

Which of the following impares iron absorption? a. grapefruit b. yogurt c. ascorbic acid

Answer 68

b. yogurt

Question 69

Which of the following stores poorly available iron? a. serum ferritin b. hemosiderin c. iron stored in the BM

Answer 69

b. hemosiderin

Question 70

Which of the following is the best test for determining iron deficiency? a. serum iron b. transferrin c. total iron-binding capacity d. serum ferritin

Answer 70

d. serum ferritin

Question 71

Which of the following tests varies significantly (worst test)? a. serum iron b. transferrin c. total iron-binding capacity d. serum ferritin e. bone marrow aspirate

Answer 71

a. serum iron

Question 72

Which of the following tests is the gold standard for determining iron stores? a. serum iron b. transferrin c. total iron-binding capacity d. serum ferritin e. bone marrow aspirate

Answer 72

e. bone marrow aspirate

Question 73

Which of the following diseases can you find increased iron stores and decreased total iron-binding capacity? a. iron deficiency anemia b. anemia of chronic disease c. thalassemia

Answer 73

b. anemia of chronic disease | iron available as ferritin but cannot be utilized

Question 74

Which of the following is has abnormal cholesterol metabolism? a. megaloblastic anemia b. non-megaloblastic anemia

Answer 74

b. non-megaloblastic anemia

Question 75

Which of the following is causes hypersegmented neutrophil synthesis? a. megaloblastic anemia b. non-megaloblastic anemia

Answer 75

a. megaloblastic anemia

Question 76

Which of the following is caused by DNA synthesis failure? a. megaloblastic anemia b. non-megaloblastic anemia

Answer 76

a. megaloblastic anemia

Question 77

A deficiency of which of the following causes neural symptoms? a. cobalamin b. folate c. both

Answer 77

a. cobalamin | vitamin B12

Question 78

Which of the following is associated with an increased risk of gastric cancer? a. megaloblastic anemia b. non-megaloblastic anemia c. pernicious anemia

Answer 78

c. pernicious anemia

Question 79

Which of the following folate forms participates in purine synthesis? a. non-polyglutamated dihydrofolate b. non-polyglutamated tetrahydrofolate c. polyglutamated diydrofolate d. polyglutamated tetrahydrofolate

Answer 79

d. polyglutamated tetrahydrofolate

Question 80

Which of the following is associated with atrophic glossitis? a. megaloblastic anemia b. non-megaloblastic anemia c. pernicious anemia

Answer 80

c. pernicious anemia

Question 81

Where do you find most cobalamin? a. bound to transcobalamin 1 b. bound to transcobalamin 2

Answer 81

a. bound to transcobalamin 1 (aka haptocorrin)

Question 82

Which of the following is associated vitiligo? a. megaloblastic anemia b. non-megaloblastic anemia c. pernicious anemia

Answer 82

c. pernicious anemia

Question 83

A deficiency of which of the following causes increased serum methylmalonic acid? a. cobalamin b. folate c. both

Answer 83

a. cobalamin

Question 84

A deficiency of which of the following causes increased homocysteine levels? a. cobalamin b. folate c. both

Answer 84

c. both

Question 85

While performing the Schilling test, you find that the patient has a normal B12 level when given B12 and intrinsic factor. Which of the following is most likely? a. celiac disease b. ileal disease c. bacterial overgrowth d. gastrectomy

Answer 85

d. gastrectomy | pernicious anemia also likey because it causes decreased intrinsic factor

Question 86

While performing the Schilling test, you find that the patient has a normal B12 level when given B12 and antibiotics. Which of the following is most likely? a. celiac disease b. ileal disease c. bacterial overgrowth d. gastrectomy

Answer 86

c. bacterial overgrowth

Question 87

A deficiency in which of the following enzymes leads to Acute Intermittent Porphyria? a. Uroporphyrinogen cosynthase b. Uroporphyrinogen Decarboxylase c. Porphobilinogen Deaminase d. Porphobilinogen Synthase

Answer 87

c. Porphobilinogen Deaminase

Question 88

A deficiency in which of the following enzymes leads to Porphyria Cutanea Tarda? a. Uroporphyrinogen cosynthase b. Uroporphyrinogen Decarboxylase c. Porphobilinogen Deaminase d. Porphobilinogen Synthase

Answer 88

b. Uroporphyrinogen Decarboxylase

Question 89

A deficiency in which of the following enzymes leads to congenital erythropoietic porphyria? a. Uroporphyrinogen cosynthase b. Uroporphyrinogen Decarboxylase c. Porphobilinogen Deaminase d. Porphobilinogen Synthase

Answer 89

a. Uroporphyrinogen cosynthase

Question 90

Which of the following is toxic to the brain? a. ALA b. ALAD c. porphyrin

Answer 90

a. ALA

Question 91

how many porphobilinogens do you need to make Uroporphyrinogen III? a. 1 b. 2 c. 3 d. 4

Answer 91

d. 4

Question 92

Which TWO enzymes are inhibited by pb? a. Porphobilinogen Synthase b. Porphobilinogen Deaminase c. ALAS1 d. Ferrochelatase

Answer 92

a. Porphobilinogen Synthase (ALAD) & d. Ferrochelatase

Question 93

Which of the following is more likely to present with symptoms? a. acquired porphyria cutanea tarda b. inherited porphyria cutanea tarda

Answer 93

a. acquired porphyria cutanea tarda | most people who inherit it never develop symptoms

Question 94

Which of the following inhibits hepcidin secretion in response to anemia? a. erythropoietin b. erythroferrone

Answer 94

b. erythroferrone

Question 95

Which of the following is made by RBC's? a. erythropoietin b. erythroferrone

Answer 95

b. erythroferrone

Question 96

Which of the following is true a. increased erythropoietin causes increased erythroferrone synthesis b. increased erythroferron causes increased erythropoietin synthesis

Answer 96

a. increased erythropoietine causes increased erythroferrone synthesis