Week 2 Flashcards
Question: What is B12 anemia?
A) A type of autoimmune disease
B) A type of macrocytic anemia
C) A bacterial infection
D) A skin condition
Answer: B) A type of macrocytic anemia
Question: What is the role of B12 in erythropoiesis?
A) It regulates heart rate
B) It stimulates brain function
C) It enhances the immune system
D) It is a nutritional requirement for the formation of red blood cells (RBCs)
Answer: D) It is a nutritional requirement for the formation of red blood cells (RBCs)
Question: What does B12 contribute to in the body?
A) Synthesis of DNA
B) Synthesis of RNA
C) Regulation of blood pressure
D) Formation of bones
Answer: A) Synthesis of DNA
Question: What happens when there is a deficiency of B12 in the body?
A) DNA synthesis and cell division continue normally
B) RNA replication is impaired
C) Hemoglobin synthesis is blocked
D) DNA synthesis and cell division are delayed
Answer: D) DNA synthesis and cell division are delayed
Question: What is the consequence of asynchronous development in B12 deficiency?
A) Formation of small erythrocytes
B) Overproduction of hemoglobin
C) Normal-sized erythrocytes
D) Decreased hemoglobin production
Answer: B) Overproduction of hemoglobin
Question: What is pernicious anemia characterized by?
A) Deficiency of red blood cells
B) Excess iron absorption
C) Absence of intrinsic factor (IF)
D) Overproduction of intrinsic factor (IF)
Answer: C) Absence of intrinsic factor (IF)
Question: What causes B12 anemia?
A) Excessive dietary intake of B12-rich foods
B) Inability of the gut to absorb B12
C) Lack of iron in the diet
D) Overproduction of intrinsic factor
Answer: B) Inability of the gut to absorb B12
Question: What is the consequence of B12 deficiency when intrinsic factor is lacking?
A) Increased B12 absorption
B) Rapid excretion of B12
C) Poor quality RBCs, often macrocytic
D) Enhanced neuronal function
Answer: C) Poor quality RBCs, often macrocytic
Question: What is the treatment for B12 anemia caused by insufficient dietary intake?
A) Subcutaneous injections
B) Boost dietary intake of B12-rich foods
C) High-dose oral replacement
D) Blood transfusions
Answer: B) Boost dietary intake of B12-rich foods
Question: What is the primary source of B12 in the diet?
A) Fruits and vegetables
B) Animal meat, dairy products, and eggs
C) Grains and cereals
D) Legumes and nuts
Answer: B) Animal meat, dairy products, and eggs
Question: What is another name for “Anemia of Chronic Disease”?
A) Hemolytic anemia
B) Aplastic anemia
C) Iron-Deficiency Anemia
D) Anemia of chronic inflammation
Answer: D) Anemia of chronic inflammation
Question: How is “Anemia of Chronic Disease” categorized in terms of cell size and hemoglobin content?
A) Microcytic-hypochromic
B) Macrocytic-hyperchromic
C) Normocytic-normochromic
D) Hypercytic-hypochromic
Answer: C) Normocytic-normochromic
Question: Which of the following is NOT a type of normocytic-normochromic anemia?
A) Aplastic anemia
B) Hemolytic anemia
C) Iron-deficiency anemia
D) Anemia of chronic disease
Answer: C) Iron-deficiency anemia
Question: What conditions are associated with “Anemia of Chronic Disease”?
A) Allergic reactions
B) Heart disease
C) Chronic infections, chronic inflammatory diseases, and malignancies
D) Neurological disorders
Answer: C) Chronic infections, chronic inflammatory diseases, and malignancies
Question: What is the primary cause of “Anemia of Chronic Disease”?
A) Iron overload
B) Chronic inflammation
C) Vitamin deficiency
D) Genetic mutations
Answer: B) Chronic inflammation
Question: What is the mechanism of disease in “Anemia of Chronic Disease”?
A) Increased erythrocyte life span
B) Enhanced iron absorption
C) Dysregulation of iron homeostasis and cytokine involvement
D) Overproduction of erythropoietin
Answer: C) Dysregulation of iron homeostasis and cytokine involvement
Question: Which cytokine inhibits the production of erythropoietin in the kidney and promotes the degradation of RBCs?
A) TNF-a (tumor necrosis factor alpha)
B) IFN-y (interferon gamma)
C) IL-10
D) IL-6
Answer: A) TNF-a (tumor necrosis factor alpha)
Question: What is the primary treatment approach for “Anemia of Chronic Disease”?
A) Blood transfusions
B) Iron supplementation
C) No treatment unless symptomatic
D) Erythropoietin injections
Answer: C) No treatment unless symptomatic
Question: What is the typical clinical manifestation of “Anemia of Chronic Disease”?
A) Severe fatigue and weakness
B) Cardiovascular symptoms
C) Fewer and milder symptoms compared to other anemias
D) Neurological deficits
Answer: C) Fewer and milder symptoms compared to other anemias
Question: Why do individuals with “Anemia of Chronic Disease” tend to have adequate hemoglobin levels despite their anemia?
A) They have a higher rate of erythropoiesis
B) They receive frequent blood transfusions
C) Chronic disease limits physical activity
D) They have a genetic predisposition for higher hemoglobin levels
Answer: C) Chronic disease limits physical activity
Question: What is the term for abnormally small erythrocytes due to a lack of hemoglobin?
A) Macrocytic
B) Hypochromic
C) Microcytic
D) Normocytic
Answer: C) Microcytic
Question: What is the characteristic of erythrocytes in hypochromic anemia?
A) Abnormally large erythrocytes
B) Reduced hemoglobin content in erythrocytes
C) High hemoglobin content in erythrocytes
D) Increased erythrocyte count
Answer: B) Reduced hemoglobin content in erythrocytes
Question: What is the most common type of anemia in both developed and developing countries?
A) Aplastic anemia
B) Hemolytic anemia
C) Iron-deficiency anemia
D) Hereditary anemia
Answer: C) Iron-deficiency anemia
Question: What happens when there is not enough iron available for hemoglobin synthesis?
A) Erythrocyte production continues normally with normal hemoglobin content
B) Erythrocyte production is halted
C) Erythrocytes become larger in size
D) Hemoglobin content of erythrocytes increases
Answer: A) Erythrocyte production continues normally with normal hemoglobin content
Question: Which population groups are at a higher risk of iron deficiency anemia?
A) Elderly individuals
B) Adolescents
C) Childbearing age women and children
D) Athletes
Answer: C) Childbearing age women and children
Question: What is the primary cause of iron deficiency anemia in females?
A) Gastrointestinal disorders
B) Menorrhagia
C) Hemolytic anemia
D) Iron-rich diet
Answer: B) Menorrhagia
Question: In which stage of iron deficiency anemia do hemoglobin-deficient red blood cells enter circulation, leading to clinical manifestations?
A) Stage 1
B) Stage 2
C) Stage 3
D) Stage 4
Answer: C) Stage 3
Question: What are early symptoms of iron deficiency anemia?
A) Koilonychia and glossitis
B) Numbness and tingling
C) Fatigue, weakness, and pale skin
D) Mental confusion and memory loss
Answer: C) Fatigue, weakness, and pale skin
Question: What is a sensitive indicator for heme synthesis used to evaluate iron deficiency anemia?
A) Serum ferritin levels
B) Transferrin saturation
C) Total iron binding capacity
D) Free erythrocyte protoporphyrin (FEP)
Answer: D) Free erythrocyte protoporphyrin (FEP)
Question: What is the first step in treating iron deficiency anemia?
A) Blood transfusion
B) Eliminating the source of blood loss
C) Parenteral iron replacement
D) Dietary modifications
Answer: B) Eliminating the source of blood loss
Question: What is the genetic mutation that characterizes Sickle Cell Disease by replacing one amino acid with another in hemoglobin?
A) Valine replaces glutamine
B) Glutamine replaces valine
C) Hemoglobin S replaces hemoglobin A
D) Hemoglobin A replaces hemoglobin S
Answer: A) Valine replaces glutamine
Question: Under what conditions does hemoglobin S polymerize, leading to sickling of red blood cells?
A) High oxygenation and hydration
B) Low oxygenation and dehydration
C) Low oxygenation and high blood pH
D) High oxygenation and stress
Answer: B) Low oxygenation and dehydration
Question: What triggers the sickling process in individuals with Sickle Cell Disease?
A) Increased oxygen levels
B) High blood pH
C) Dehydration and decreased oxygen
D) Acute illness and temperature changes
Answer: D) Acute illness and temperature changes
Question: What is the primary consequence of sickled red blood cells clogging blood vessels?
A) Increased blood circulation
B) Decreased viscosity of blood
C) Pain, vascular occlusion, and organ infarction
D) Improved oxygen delivery to tissues
Answer: C) Pain, vascular occlusion, and organ infarction
Question: Which type of crisis occurs when the spleen holds a large amount of blood due to hemolysis of sickled red blood cells?
A) Aplastic crisis
B) Sequestration crisis
C) Hyperhemolytic crisis
D) Vaso-occlusive crisis
Answer: B) Sequestration crisis
Question: In which crisis does the bone marrow fail to begin erythropoiesis despite the body needing more erythrocytes?
A) Aplastic crisis
B) Sequestration crisis
C) Hyperhemolytic crisis
D) Vaso-occlusive crisis
Answer: A) Aplastic crisis
Question: What is the consequence of vaso-occlusion in the brain for individuals with Sickle Cell Disease?
A) Increased oxygenation of brain tissues
B) Improved cognitive function
C) Stroke
D) Improved memory
Answer: C) Stroke
Question: What type of anemia is typically associated with Sickle Cell Disease?
A) Microcytic-hypochromic
B) Macrocytic-normochromic
C) Normocytic-normochromic
D) Hypochromic-normocytic
Answer: C) Normocytic-normochromic
Question: What triggers the sickling process in individuals with Sickle Cell Disease?
A) Increased oxygen levels
B) High blood pH
C) Dehydration and decreased oxygen
D) Acute illness and temperature changes
Answer: D) Acute illness and temperature changes
Question: What is the consequence of sickled red blood cells having a lower oxygen affinity?
A) Improved oxygen delivery to tissues
B) Increased viscosity of blood
C) Reduced intracellular pH
D) Increased erythrocyte longevity
Answer: B) Increased viscosity of blood
Question: What is the primary factor influencing iron absorption?
A) Erythropoietin
B) Tissue oxygenation
C) Iron stores
D) Hemoglobin levels
Answer: C) Iron stores
Question: Which type of anemia can be caused by iron overload, either primary or secondary?
A) Aplastic anemia
B) Sideroblastic anemia
C) Hemolytic anemia
D) Normocytic anemia
D) Normocytic anemia
Question: What is the treatment for iron overload in cases of low to moderate anemia?
A) Therapeutic phlebotomy for iron depletion
B) Iron supplementation
C) Erythropoietin therapy
D) Blood transfusion
Answer: A) Therapeutic phlebotomy for iron depletion
Question: What medication is used to treat iron overload in severe anemia without decreasing the effectiveness of transfusions?
A) Erythropoietin
B) Iron supplementation
C) Deferoxamine (iron chelating medication)
D) Therapeutic phlebotomy
Answer: C) Deferoxamine (iron chelating medication)
Question: What is the initial compensation for a reduction in the number of circulating erythrocytes?
A) Decreased plasma volume
B) Movement of interstitial fluid out of the blood
C) Increase in blood viscosity
D) Decreased heart rate
Answer: B) Movement of interstitial fluid out of the blood
Question: What is the consequence of “thinner” blood flowing faster and with more turbulence?
A) Decreased stroke volume
B) Decreased heart rate
C) Hyperdynamic circulatory state
D) Increased blood viscosity
Answer: C) Hyperdynamic circulatory state
Question: What cardiovascular changes can occur due to the hyperdynamic circulatory state caused by anemia?
A) Decreased stroke volume
B) Decreased heart rate
C) Cardiac dilation and heart valve insufficiency
D) Increased blood viscosity
Answer: C) Cardiac dilation and heart valve insufficiency
Question: What is the consequence of reduced oxygen-carrying capacity of the blood?
A) Increased oxygen delivery to tissues
B) Ischemia
C) Improved tissue oxygenation
D) Decreased heart rate
Answer: B) Ischemia
Question: What is a common symptom experienced by individuals with anemia due to the body’s attempt to increase oxygen intake?
A) Decreased respiration rate
B) Decreased respiration depth
C) Exertional dyspnea
D) Reduced heart rate
Answer: C) Exertional dyspnea
Question: How does the body respond to tissue hypoxia caused by anemia?
A) By decreasing the rate and depth of respiration
B) By reducing the release of oxygen from hemoglobin
C) By increasing the rate and depth of respiration
D) By slowing down the heart rate
Answer: C) By increasing the rate and depth of respiration
Question: What can anemia-induced tissue hypoxia lead to in terms of symptoms?
A) Increased heart rate
B) Decreased respiration rate
C) Reduced dizziness
D) Improved fatigue
Answer: A) Increased heart rate
Question: What is a common symptom of anemia related to tissue hypoxia?
A) Rapid and pounding heart rate
B) Decreased heart rate
C) Increased energy levels
D) Decreased rate and depth of respiration
Answer: A) Rapid and pounding heart rate
Question: What does a Complete Blood Count (CBC) measure?
A) Red blood cells and white blood cells only
B) Red blood cells, white blood cells, and platelets only
C) Red blood cells, white blood cells, hemoglobin, hematocrit, and platelets
D) Hemoglobin and hematocrit only
Answer: C) Red blood cells, white blood cells, hemoglobin, hematocrit, and platelets
Question: What does MCV (Mean Corpuscular Volume) measure in terms of red blood cells?
A) Their size
B) Their color
C) Their oxygen-carrying capacity
D) Their shape
Answer: A) Their size
Question: What term is used to describe small-sized red blood cells with an MCV of less than 80?
A) Normocytic
B) Hyperchromic
C) Hypochromic
D) Microcytic
Answer: D) Microcytic
Question: What term is used to describe red blood cells with a normal size and an MCV of 80-95?
A) Hyperchromic
B) Microcytic
C) Normocytic
D) Hypochromic
Answer: C) Normocytic
Question: What term describes red blood cells with a very red color and high hemoglobin content?
A) Microcytic
B) Hypochromic
C) Hyperchromic
D) Normochromic
Answer: C) Hyperchromic
Question: Which type of anemia is characterized by small-sized and pale red blood cells with low ferritin levels?
A) B12 anemia
B) Iron deficiency anemia
C) Anemia of chronic disease
D) Folate anemia
Answer: B) Iron deficiency anemia
Question: What is the cause of B12 anemia?
A) Lack of intrinsic factor (IF)
B) Dietary intake of iron
C) Chronic inflammation or cancer
D) Lack of folate in the diet
Answer: A) Lack of intrinsic factor (IF)
Question: What type of anemia is characterized by large, abnormally shaped red blood cells with normal hemoglobin levels?
A) Iron deficiency anemia
B) Folate anemia
C) B12 anemia
D) Anemia of chronic disease
Answer: C) B12 anemia
Question: Which type of anemia is associated with a lack of folate in the diet and affects RNA and DNA synthesis of red blood cells?
A) Iron deficiency anemia
B) Folate anemia
C) B12 anemia
D) Sickle cell anemia
Answer: B) Folate anemia
Question: What type of anemia is characterized by abnormal “sickle” cell shapes in red blood cells and dysfunction of hemoglobin synthesis?
A) Sickle cell anemia
B) Iron deficiency anemia
C) Thalassemia
D) Anemia of chronic disease
Answer: A) Sickle cell anemia
Question: Which type of anemia is associated with a congenital genetic defect of alpha and beta globin synthesis and results in microcytic-hypochromic red blood cells?
A) Iron deficiency anemia
B) B12 anemia
C) Thalassemia
D) Anemia of chronic disease
Answer: C) Thalassemia
Question: What is defined by vasoconstriction and platelet plug formation in response to blood vessel damage?
A) Secondary hemostasis
B) Tertiary hemostasis
C) Primary Hemostasis
D) Quaternary hemostasis
Answer: C) Primary Hemostasis
Question: What are the three mechanisms that lead to vasoconstriction during primary hemostasis?
A) Endothelin release, myogenic reflex, and nociceptor activation
B) Platelet aggregation, ADP secretion, and serotonin release
C) Fibrinogen activation, glycoprotein IIb-IIIa expression, and vWf binding
D) Hemoglobin release, muscle contraction, and endothelial cell activation
Answer: A) Endothelin release, myogenic reflex, and nociceptor activation
Question: What is the function of “von Willebrand factor” (vWf) in platelet plug formation?
A) It activates the coagulation cascade
B) It binds platelets to exposed collagen
C) It secretes ADP and TXA2
D) It inhibits platelet aggregation
Answer: B) It binds platelets to exposed collagen
Question: Which receptor on platelets binds directly to collagen during platelet plug formation?
A) GPIIb/IIIa
B) GPIb
C) GPllb/llla
D) vWf receptor
Answer: B) GPIb
Question: What happens when platelets are activated during platelet plug formation?
A) They secrete ADP, TXA2, and serotonin
B) They become inactive and detach from collagen
C) They release fibrinogen
D) They undergo apoptosis
Answer: A) They secrete ADP, TXA2, and serotonin
Question: What is the role of fibrinogen in platelet aggregation?
A) It activates platelets
B) It inhibits platelet aggregation
C) It acts as a “glue molecule” between platelets
D) It causes vasoconstriction
Answer: C) It acts as a “glue molecule” between platelets
Question: What does the aggregation of platelets create during primary hemostasis?
A) A positive charge on the phospholipid layer
B) A neutral charge on the phospholipid layer
C) A NET NEGATIVE CHARGE on the phospholipid layer
D) An increase in blood viscosity
Answer: C) A NET NEGATIVE CHARGE on the phospholipid layer
Question: What is the role of tissue factor in thrombus formation?
A) It promotes platelet aggregation
B) It activates the fibrinolytic system
C) It prevents platelet adhesion
D) It collaborates with platelet factors to activate the coagulation system
Answer: D) It collaborates with platelet factors to activate the coagulation system
Question: Where can arterial thrombi typically form, and what are they composed of?
A) In veins, composed mainly of RBCs
B) In arteries, composed of platelet aggregates held together with fibrin strands
C) In veins, composed of platelet aggregates
D) In arteries, composed mainly of RBCs
Answer: B) In arteries, composed of platelet aggregates held together with fibrin strands
Question: What can thrombi that break off from vessel walls and float in circulation become?
A) Plaque formation
B) Emboli
C) Clotting factors
D) Hemorrhagic complications
Answer: B) Emboli
Question: How can thrombi or emboli affect tissues and cells in the circulatory system?
A) By causing hypertension
B) By promoting plaque formation
C) By blocking small vessels, leading to ischemia
D) By increasing blood flow
Answer: C) By blocking small vessels, leading to ischemia
Question: Which treatment option is used for thrombus prevention and management?
A) Hypertension medication
B) Antiplatelet drugs
C) Anticoagulants like heparin and warfarin
D) Pain relievers
Answer: C) Anticoagulants like heparin and warfarin
Question: What is the role of tPA, uPA, and streptokinase in thrombus management?
A) They activate the coagulation system
B) They promote platelet aggregation
C) They activate the fibrinolytic system to break up clots
D) They increase blood viscosity
Answer: C) They activate the fibrinolytic system to break up clots
Question: What is Virchow’s triad, and what factors does it encompass?
A) A musical composition, three types of instruments
B) A weather phenomenon, temperature, humidity, and wind speed
C) Factors that increase the risk of spontaneous thrombi formation, including injury to blood vessel endothelium, abnormalities in blood flow, and hypercoagulability
D) A type of food, carbohydrates, proteins, and fats
Answer: C) Factors that increase the risk of spontaneous thrombi formation, including injury to blood vessel endothelium, abnormalities in blood flow, and hypercoagulability
Question: What is the pathophysiology of antiphospholipid syndrome (APS)?
A) It is characterized by autoantibodies against platelets
B) It primarily affects males
C) Autoantibodies react with plasma membrane phospholipids and phospholipid-binding proteins, increasing the risk of thrombosis
D) It is not associated with thrombosis
Answer: C) Autoantibodies react with plasma membrane phospholipids and phospholipid-binding proteins, increasing the risk of thrombosis
Question: What is the mechanism of action of ASA (acetylsalicylic acid)?
A) Selective inhibition of COX-2
B) Reversible inhibition of COX-1
C) Non-selective inhibition of COX-1
D) Activation of COX-1
Answer: C) Non-selective inhibition of COX-1
Question: What is the primary indication for using ASA?
A) Allergy relief
B) Hypertension
C) Prevention of platelet aggregation
D) Treatment of bacterial infections
Answer: C) Prevention of platelet aggregation
Question: What adverse effect is associated with chronic ASA use?
A) Hypertension
B) Acid reflux
C) Occult GI blood loss leading to anemia
D) Allergic reactions
Answer: C) Occult GI blood loss leading to anemia
Question: In what special population is ASA contraindicated due to the risk of Reye syndrome?
A) Elderly individuals
B) Pregnant women
C) Children under 18 years old
D) Smokers
Answer: C) Children under 18 years old
Question: When should ASA be held before elective surgery and childbirth?
A) 24 hours prior
B) 3 days prior
C) 1 week prior
D) It does not need to be held before surgery or childbirth
Answer: C) 1 week prior
Question: In which condition might ASA use be justified despite the risk of gastrointestinal bleeding?
A) Mild headache
B) Risk of myocardial infarction (MI)
C) Mild toothache
D) Seasonal allergies
Answer: B) Risk of myocardial infarction (MI)
Question: What is the primary mechanism of action of Unfractionated Heparin?
A) Inactivation of factor Xa
B) Binding with antithrombin to inactivate thrombin
C) Activation of platelets
D) Stimulation of red blood cell production
Answer: B) Binding with antithrombin to inactivate thrombin
Question: What is a common adverse effect of Unfractionated Heparin?
A) Hypertension
B) Osteoporosis
C) Elevated cholesterol levels
D) Blurred vision
Answer: B) Osteoporosis
Question: In which population is Unfractionated Heparin preferred due to its inability to cross the placenta?
A) Pregnant women
B) Elderly patients
C) Children
D) Athletes
Answer: A) Pregnant women
Question: What is the primary monitoring parameter for Unfractionated Heparin therapy?
A) Blood pressure
B) Blood glucose levels
C) Activated partial thromboplastin time (aPTT)
D) Serum creatinine
Answer: C) Activated partial thromboplastin time (aPTT)
Question: What is the antidote for Unfractionated Heparin?
A) Insulin
B) Aspirin
C) Warfarin
D) Protamine
Answer: D) Protamine
Question: What is the primary mechanism of action of Fragmented Heparin (Low molecular weight)?
A) Activation of platelets
B) Inactivation of thrombin
C) Inactivation of factor Xa
D) Stimulation of red blood cell production
Answer: C) Inactivation of factor Xa
Question: What is a common adverse effect of Fragmented Heparin (Low molecular weight)?
A) Elevated blood pressure
B) Osteoporosis
C) Dizziness
D) Hemorrhage
Answer: D) Hemorrhage
Question: In which condition should Low molecular weight heparins be avoided?
A) Hemodialysis
B) Venous thromboembolism (VTE)
C) Patients with creatinine clearance (CrCl) <30 ml/min
D) Non-ST elevation acute coronary syndrome
Answer: C) Patients with creatinine clearance (CrCl) <30 ml/min
Question: What is the primary monitoring approach for Low molecular weight heparins?
A) Regular blood pressure checks
B) Continuous electrocardiogram (ECG) monitoring
C) Fixed dosage without laboratory monitoring
D) Frequent blood glucose testing
Answer: C) Fixed dosage without laboratory monitoring
Question: What is the antidote for Low molecular weight heparins?
A) Vitamin K
B) Insulin
C) Aspirin
D) Protamine
Answer: D) Protamine
Question: What is the primary mechanism of action of Warfarin (Coumadin)?
A) Activation of platelets
B) Suppression of coagulation by decreasing vitamin K-dependent clotting factors
C) Inhibition of blood vessel constriction
D) Promotion of platelet aggregation
Answer: B) Suppression of coagulation by decreasing vitamin K-dependent clotting factors
Question: Which condition is a common indication for Warfarin (Coumadin) therapy?
A) Diabetes
B) Hypertension
C) Atrial Fibrillation
D) Migraine
Answer: C) Atrial Fibrillation
Question: What is the primary adverse effect of Warfarin (Coumadin)?
A) Hypertension
B) Increased risk for heart attacks
C) Hemorrhage/increased risk for bleeding
D) Gastrointestinal ulcers
Answer: C) Hemorrhage/increased risk for bleeding
Question: What is the recommended range for the INR (international normalized ratio) in most patients receiving Warfarin therapy?
A) 1.3-1.5
B) 3-5
C) 0.5-0.7
D) 2-3
Answer: D) 2-3
Question: What is the antidote for Warfarin (Coumadin) overdose?
A) Aspirin
B) Insulin
C) Protamine
D) Vitamin K
Answer: D) Vitamin K
Question: What is the primary use of NOACs (Novel Oral Anticoagulants)?
A) Reducing blood pressure
B) Reducing blood glucose levels
C) Reducing the risk of stroke and blood clots in non-valvular atrial fibrillation
D) Treating bacterial infections
Answer: C) Reducing the risk of stroke and blood clots in non-valvular atrial fibrillation
Question: What is the onset of action for NOACs?
A) Delayed (several days)
B) Rapid (hours)
C) Prolonged (weeks)
D) Variable
Answer: B) Rapid (hours)
Question: What is the primary advantage of NOACs over traditional anticoagulants?
A) Fixed dosage
B) Requires frequent blood tests
C) Long duration of action
D) High protein binding
Answer: A) Fixed dosage
Question: What is the antidote available for NOACs in cases of overdose?
A) Andexanet alfa
B) Vitamin K
C) Insulin
D) Protamine
Answer: A) Andexanet alfa
Question: What is the suggested dosing for Andexanet alfa in cases of life-threatening or uncontrolled bleeding due to NOAC use?
A) 100 mg IV bolus
B) 400 mg IV bolus followed by 408 mg/min infusion
C) 800 mg oral dose
D) No antidote available
Answer: B) 400 mg IV bolus followed by 408 mg/min infusion
Question: What is the mechanism of action of Dabigatran?
A) Inhibition of factor Xa
B) Inhibition of antithrombin
C) Inhibition of factor IIa (thrombin)
D) Inhibition of factor XIII
Answer: C) Inhibition of factor IIa (thrombin)
Question: What is the primary adverse effect associated with Dabigatran?
A) Hypertension
B) Hypercholesterolemia
C) Risk of bleeding
D) Gastric ulcers
Answer: C) Risk of bleeding
Question: What is the antidote for Dabigatran in cases of overdose?
A) Vitamin K
B) Protamine
C) Idarucizumab
D) Activated charcoal
Answer: C) Idarucizumab
Question: In what patients is Dabigatran contraindicated due to renal function?
A) Patients with creatinine clearance (CrCl) > 50 ml/minute
B) Patients with creatinine clearance (CrCl) < 30 ml/minute
C) Patients with creatinine clearance (CrCl) > 100 ml/minute
D) Patients with creatinine clearance (CrCl) between 30-50 ml/minute
Answer: B) Patients with creatinine clearance (CrCl) < 30 ml/minute
Question: Which of the following is an advantage of Dabigatran over Warfarin?
A) Delayed onset
B) Requires routine monitoring
C) Numerous drug-drug interactions
D) Lower risk of major bleeding
Answer: D) Lower risk of major bleeding
Question: What is the primary mechanism of action for iron when it is absorbed by mucosal cells of the small intestine?
A) Stored as ferritin within the mucosal cells
B) Transported in the bloodstream as hemoglobin
C) Stored in the brain
D) Excreted from the body through the kidneys
Answer: A) Stored as ferritin within the mucosal cells
Question: What is the recommended dose of regular-release ferrous sulfate for iron deficiency anemia?
A) 50 mg
B) 100 mg
C) 200 mg
D) 60-65 mg of elemental iron
Answer: D) 60-65 mg of elemental iron
Question: What are common side effects associated with iron supplementation?
A) Increased energy
B) Headache
C) Nausea, heartburn, constipation, bloating or diarrhea
D) Improved vision
Answer: C) Nausea, heartburn, constipation, bloating, or diarrhea
Question: In which special population should iron supplementation be avoided, particularly when they receive frequent blood transfusions?
A) Children
B) Pregnant women
C) Elderly adults
D) Athletes
Answer: C) Elderly adults
Question: What is a common indicator of anemia in the elderly known as “anemia of chronic disease”?
A) High serum ferritin
B) High hemoglobin levels
C) Low serum ferritin
D) Low total iron-binding capacity
Answer: A) High serum ferritin
Question: Which of the following is not commonly monitored to assess iron levels and anemia?
A) Hemoglobin and hematocrit
B) RBC count and RBC indices
C) Serum ferritin and transferrin saturation
D) Serum glucose concentration
Answer: D) Serum glucose concentration
Question: What is the primary medical condition for which Recombinant human Erythropoietin (r-HuEPO) is commonly prescribed?
A) Hypertension
B) Anemia due to chronic renal failure
C) Diabetes
D) Cancer
Answer: B) Anemia due to chronic renal failure
Question: What is the mechanism of action of Recombinant human Erythropoietin (r-HuEPO)?
A) It inhibits RBC production
B) It reduces blood viscosity
C) It directly binds to hemoglobin
D) It binds to erythropoietin receptors on proerythroblasts, increasing RBC production
Answer: D) It binds to erythropoietin receptors on proerythroblasts, increasing RBC production
Question: What immediate effect does the administration of r-HuEPO have on blood?
A) Decreases reticulocyte count
B) Reduces erythrocyte levels
C) Increases blood viscosity
D) Increases reticulocyte count
Answer: D) Increases reticulocyte count
Question: What significant side effect is associated with r-HuEPO administration?
A) Anemia
B) Hypotension
C) Increased blood pressure
D) Elevated cholesterol levels
Answer: C) Increased blood pressure
Question: In which group of patients is the use of EPO typically not recommended, and it even has a black box warning?
A) Patients with hypertension
B) Cancer patients receiving palliative care
C) Patients with diabetes
D) Patients with infectious diseases
Answer: B) Cancer patients receiving palliative care
Question: Under what condition do patients on dialysis have strict parameters before they can receive EPO?
A) If they have high cholesterol
B) If they have high blood pressure
C) If they have a high threshold for hemoglobin
D) If they have low platelet counts
Answer: C) If they have a high threshold for hemoglobin
Question: What is the primary mechanism of action of Cyanocobalamin (B12 Supplement)?
A) Reducing blood pressure
B) Promoting DNA development in red blood cell production
C) Enhancing bone density
D) Suppressing appetite
Answer: B) Promoting DNA development in red blood cell production
Question: Which of the following is a common adverse effect associated with Cyanocobalamin (B12 Supplement) use?
A) Muscle pain
B) Vision changes
C) Tingling sensation in hands and feet
D) Hair loss
Answer: C) Tingling sensation in hands and feet
Question: In which condition or situation is Cyanocobalamin typically used?
A) Osteoporosis
B) Type 2 diabetes
C) Pernicious Anemia or insufficient dietary B12 intake
D) Hypertension
Answer: C) Pernicious Anemia or insufficient dietary B12 intake
Question: Which route of administration is typically used for Cyanocobalamin in cases of pernicious anemia?
A) Oral (PO)
B) Intravenous (IV)
C) Intramuscular (IM)
D) Subcutaneous (SC)
Answer: B) Intramuscular (IM)
Question: What is the recommended initial daily dose of Cyanocobalamin for treating pernicious anemia?
A) 500 mcg
B) 1000-2000 mcg
C) 2500 mcg
D) 5000 mcg
Answer: B) 1000-2000 mcg
Question: Why should Cyanocobalamin not be administered with folic acid in cases of B12 deficiency?
A) It enhances the effect of Cyanocobalamin
B) Folic acid can alleviate neurologic deficits
C) Folic acid may mask the presence of B12 deficiency
D) Folic acid has no effect on B12 deficiency
Answer: C) Folic acid may mask the presence of B12 deficiency
Question: What is the primary mechanism of action of hydroxyurea?
A) Stimulation of red blood cell production
B) Inhibition of ribonucleotide reductase (RR)
C) Promotion of platelet count increase
D) Activation of white blood cells
Answer: B) Inhibition of ribonucleotide reductase (RR)
Question: What is one common adverse effect associated with hydroxyurea use that may lead to a decrease in white blood cell count?
A) Lowered hemoglobin levels
B) Increased platelet count
C) Skin hyperpigmentation
D) Neutropenia
Answer: D) Neutropenia
Question: What is the purpose of hydroxyurea increasing the production of fetal hemoglobin (HbF)?
A) To promote the synthesis of red blood cells
B) To stimulate the immune system
C) To prevent sickle hemoglobin from forming clumps
D) To induce melanonychia
Answer: C) To prevent sickle hemoglobin from forming clumps
Question: In which patient populations is the use of hydroxyurea typically recommended?
A) Individuals with hypertension
B) Pregnant women
C) Patients with frequent painful episodes due to hemoglobin SS or Sβ0 thalassemia
D) People with allergies
Answer: C) Patients with frequent painful episodes due to hemoglobin SS or Sβ0 thalassemia
Question: What dosing modifications should be considered for pregnant or lactating females in relation to hydroxyurea?
A) Higher daily doses are recommended
B) No dose modifications are necessary
C) Pregnant or lactating females should not use hydroxyurea
D) Lower daily doses are recommended
Answer: C) Pregnant or lactating females should not use hydroxyurea
Question: What is the typical daily dose of hydroxyurea for patients with hemoglobin SS or Sβ0 thalassemia who experience frequent painful episodes?
A) 5–10 mg/kg/day
B) 15–20 mg/kg/day
C) 10–15 mg/kg/day
D) 20–25 mg/kg/day
Answer: C) 10–15 mg/kg/day
