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Blood Module - 3rd year > week 1 extra Q's > Flashcards

week 1 extra Q's Flashcards

1
Q

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

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

A

d. vitamin B6

AKA pyridoxal phosphate

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2
Q

Which porphyrins is normally important for humans?

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

A

c. type III porphyrins

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3
Q

Which of the following induces ALAS1 gene?

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

A

a. cytochrome P450 metabolized drugs

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4
Q

Which of the following controls ALAS2?

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

A

c. availability of intracellular iron

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5
Q

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

a. ALAS1
b. ALAS2
c. ALAD

A

b. ALAS2

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6
Q

Iron is added to ____ via ferrochelatase

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

A

d. protoporphyrin IX

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7
Q

Which of the following causes the photosensitivity in porphyrias?

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

A

a. tetrapyrrole intermediates

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8
Q

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

a. floppase
b. flippase
c. scramblase

A

b. flippase

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9
Q

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

a. flippase
b. floppase
c. scramblase

A

a. flippase

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10
Q

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

A

true

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11
Q

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

A

a. the signal is promoted

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12
Q

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

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

A

c. adenosine

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13
Q

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

A

a. alpha spectrin

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14
Q

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

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

A

c. glycophorin C

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15
Q

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

a. hereditary spherocytosis
b. hereditary elliptocytosis

A

a. hereditary spherocytosis

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16
Q

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

a. hereditary spherocytosis
b. hereditary elliptocytosis

A

b. hereditary elliptocytosis

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17
Q

Which the following is caused by weakened horizontal linkages?

a. hereditary spherocytosis
b. hereditary elliptocytosis

A

b. hereditary elliptocytosis

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18
Q

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

a. hereditary spherocytosis
b. hereditary elliptocytosis

A

a. hereditary spherocytosis

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19
Q

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

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

A

a. α chains
&
b. β chains

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20
Q

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

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

A

a. α chains
&
c. γ chains

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21
Q

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

A

b. it binds more tightly than oxygen and carbondioxide

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22
Q

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

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

A

d. Methemoglobin

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23
Q

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

a. T state
b. R state

A

b. R state

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24
Q

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

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

A

b. negative effectors of O2 binding

they negatively effect affinity

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25
Q

Which of the following is a positive effector of O2 binding?

a. CO2
b. O2
c. H+
d. 2,3-BPG

A

b. O2

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26
Q

Which of the following processes provides energy for methemoglobin reductase?

a. pentose phosphate pathway
b. 2,3- bisphosphoglycerate pathway
c. glycolysis

A

c. glycolysis

it provides NADH for the enzyme, not the RBC

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27
Q

A mutation in which of the following usually presents at 3 months of age?

a. α globin
b. β globin
c. γ globin

A

b. β globin

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28
Q

Which of the following is given to treat methemoglobinemia?

a. methylene blue
b. leukomethylene blue
c. cytochrome b5

A

a. methylene blue

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29
Q

Which of the following does monocarboxylate transporter (MCT1) export out of RBC’s?

a. pyruvate
b. H2O2
c. lactate

A

c. lactate

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30
Q

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

A

b. 2,3-BPG

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31
Q

Which of the following processes provides NADPH in RBC’s?

a. pentose phosphate pathway
b. 2,3- bisphosphoglycerate pathway
c. glycolysis

A

a. pentose phosphate pathway

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32
Q

Which is used to maintain glutathione in its reduced state (GSH)?

a. NAD+
b. NADH
c. NADPH
d. ATP

A

c. NADPH

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33
Q

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

A

a. not enough NADPH in RBC

NADPH helps deal with oxidative stress

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34
Q

Which of the following does eating too many fava beans result in?

a. more point mutations
b. lower GSH
c. lower H2O2

A

b. lower GSH

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35
Q

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

A

false, they share a stem cell origin with granular leukocytes

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36
Q

Which of the following is the major blood-forming organ in the second trimester?

a. liver
b. yolk sac
c. bone marrow

A

a. liver

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37
Q

Which of the following is the major blood-forming organ in the third week of gestation?

a. liver
b. yolk sac
c. bone marrow

A

b. yolk sac

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38
Q

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

A

false, some leukopoiesis also occurs

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39
Q

hematopoietic stem cells are a type of

a. totipotent stem cells
b. multipotent stem cells

A

b. multipotent stem cells

also called pluripotent stem cells

40
Q

Which of the following isn’t derived from myeloid stem cells?

a. monocyte
b. basophil
c. red blood cells
d. plasma cells

A

d. plasma cells

41
Q

Which of the following is most basophilic?

a. hemocytoblast
b. reticulocyte
c. early erythroblast
d. late erythroblast

A

c. early erythroblast

because of the ribosome synthesis

42
Q

Which of the following still contains the nucleus?

a. normoblast
b. reticulocyte

A

a. normoblast

43
Q

Which of the following causes higher blood viscosity?

a. excess of amino acids
b. low levels of vitamin B
c. high levels of erythropoietin

A

c. high levels of erythropoietin

44
Q

eosinophils are derived from

a. lymphoid stem cells
b. myeloblasts
c. monoblasts

A

b. myeloblasts

45
Q

Which TWO blood cells are the most important source of cytokines?

a. T cells
b. B cells
c. macrophages
d. eosinophils

A

a. T cells
&
c. macrophages

46
Q

Which of the following stimulates megakaryopoiesis?

a. Erythropoietin
b. Thrombopoietin
c. GM-CSF
d. M-CSF

A

b. Thrombopoietin

47
Q

Which happens to iron during infection?

a. increased levels
b. decreased levels
c. synthesis decreases

A

b. decreased levels

48
Q

In which state does iron exist intracellularly?

a. ferrous iron
b. ferric iron

A

a. ferrous iron (Fe2)

49
Q

Which of the following acts as an iron sensor?

a. ferritin
b. ferroportin
c. transferrin
d. hepcidin

A

c. transferrin

50
Q

Which of the following exports iron from cells to plasma?

a. ferritin
b. ferroportin
c. transferrin
d. hepcidin

A

b. ferroportin

51
Q

What occurs when hepcidin is high?

a. high ferroportin
b. high iron levels
c. anemia
d. less iron stored

52
Q

Which of the following is a negative regulator of hepcidin synthesis?

a. erythropoietic signals
b. iron signals
c. inflammation

A

a. erythropoietic signals

53
Q

How does inflammation control hepcidin transcription?

a. SMAD
b. neogenin
c. serum HJV
d. JAK-STAT3

A

d. JAK-STAT3

54
Q

Which of the following down-regulates hepcidin expression?

a. SMAD
b. serum HJV
c. JAK-STAT3

A

b. serum HJV

55
Q

Which of the following delivers vitamin B12 to body tissues?

a. transcobalamin I
b. transcobalamin II
c. cubilin
d. amnioless

A

b. transcobalamin II

56
Q

Which of the following protects vitamin B12 from stomach acid?

a. transcobalamin I
b. transcobalamin II
c. cubilin
d. amnioless

A

a. transcobalamin I

57
Q

Where is vitamin B12 stored?

a. myelin sheath
b. fat cells
c. kidney
d. pancreas

A

c. kidney

and liver!

58
Q

Which of the following is resistant against pancreatic proteases?

a. haptocorrin
b. intrinsic factor

A

b. intrinsic factor

59
Q

A deficiency in which of the following enzymes causes homocysteinemia?

a. methylmalonyl-COA mutase
b. methionine synthase
c. hydroxymethyl- transferase

A

b. methionine synthase

homocysteinemia= elevation of the homocysteine

60
Q

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

A

a. passive diffusion

61
Q

Which of the following methods is most useful in cellular absorption of Monoglutamate folate?

a. passive diffusion
b. folate transporters & receptors

A

b. folate transporters & receptors

low concentrations

62
Q

describe the relationship between hypoxia-induced factor (HIP) and erythropoietin

a. directly proportional
b. indirectly proportional

A

a. directly proportional

63
Q

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

A

c. a pregnant women

lower because the volume increased; dilution

64
Q

In which of the following can the body not make heme?

a. sideroblastic anemia
b. pernicious anemia
c. megaloblastic anemia

A

a. sideroblastic anemia

65
Q

In which of the following is the globin chain defective?

a. sideroblastic anemia
b. anemia of inflammation
c. thalassemia
d. megaloblastic anemia

A

c. thalassemia

66
Q

Which of the following is most easily absorbed?

a. heme iron
b. non-heme iron

A

a. heme iron

67
Q

How are hepcidin and iron stores related?

a. directly proportional
b. inversely proportional

A

a. directly proportional

68
Q

Which of the following impares iron absorption?

a. grapefruit
b. yogurt
c. ascorbic acid

69
Q

Which of the following stores poorly available iron?

a. serum ferritin
b. hemosiderin
c. iron stored in the BM

A

b. hemosiderin

70
Q

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

A

d. serum ferritin

71
Q

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

A

a. serum iron

72
Q

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

A

e. bone marrow aspirate

73
Q

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

A

b. anemia of chronic disease

iron available as ferritin but cannot be utilized

74
Q

Which of the following is has abnormal cholesterol metabolism?

a. megaloblastic anemia
b. non-megaloblastic anemia

A

b. non-megaloblastic anemia

75
Q

Which of the following is causes hypersegmented neutrophil synthesis?

a. megaloblastic anemia
b. non-megaloblastic anemia

A

a. megaloblastic anemia

76
Q

Which of the following is caused by DNA synthesis failure?

a. megaloblastic anemia
b. non-megaloblastic anemia

A

a. megaloblastic anemia

77
Q

A deficiency of which of the following causes neural symptoms?

a. cobalamin
b. folate
c. both

A

a. cobalamin

vitamin B12

78
Q

Which of the following is associated with an increased risk of gastric cancer?

a. megaloblastic anemia
b. non-megaloblastic anemia
c. pernicious anemia

A

c. pernicious anemia

79
Q

Which of the following folate forms participates in purine synthesis?

a. non-polyglutamated dihydrofolate
b. non-polyglutamated tetrahydrofolate
c. polyglutamated diydrofolate
d. polyglutamated tetrahydrofolate

A

d. polyglutamated tetrahydrofolate

80
Q

Which of the following is associated with atrophic glossitis?

a. megaloblastic anemia
b. non-megaloblastic anemia
c. pernicious anemia

A

c. pernicious anemia

81
Q

Where do you find most cobalamin?

a. bound to transcobalamin 1
b. bound to transcobalamin 2

A

a. bound to transcobalamin 1 (aka haptocorrin)

82
Q

Which of the following is associated vitiligo?

a. megaloblastic anemia
b. non-megaloblastic anemia
c. pernicious anemia

A

c. pernicious anemia

83
Q

A deficiency of which of the following causes increased serum methylmalonic acid?

a. cobalamin
b. folate
c. both

A

a. cobalamin

84
Q

A deficiency of which of the following causes increased homocysteine levels?

a. cobalamin
b. folate
c. both

85
Q

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

A

d. gastrectomy

pernicious anemia also likey because it causes decreased intrinsic factor

86
Q

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

A

c. bacterial overgrowth

87
Q

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

A

c. Porphobilinogen Deaminase

88
Q

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

A

b. Uroporphyrinogen Decarboxylase

89
Q

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

A

a. Uroporphyrinogen cosynthase

90
Q

Which of the following is toxic to the brain?

a. ALA
b. ALAD
c. porphyrin

91
Q

how many porphobilinogens do you need to make Uroporphyrinogen III?

a. 1
b. 2
c. 3
d. 4

92
Q

Which TWO enzymes are inhibited by pb?

a. Porphobilinogen Synthase
b. Porphobilinogen Deaminase
c. ALAS1
d. Ferrochelatase

A

a. Porphobilinogen Synthase (ALAD)
&
d. Ferrochelatase

93
Q

Which of the following is more likely to present with symptoms?

a. acquired porphyria cutanea tarda
b. inherited porphyria cutanea tarda

A

a. acquired porphyria cutanea tarda

most people who inherit it never develop symptoms

94
Q

Which of the following inhibits hepcidin secretion in response to anemia?

a. erythropoietin
b. erythroferrone

A

b. erythroferrone

95
Q

Which of the following is made by RBC’s?

a. erythropoietin
b. erythroferrone

A

b. erythroferrone

96
Q

Which of the following is true

a. increased erythropoietin causes increased erythroferrone synthesis
b. increased erythroferron causes increased erythropoietin synthesis

A

a. increased erythropoietine causes increased erythroferrone synthesis

Blood Module - 3rd year (16 decks)

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