2008 module exam

Question 1

What will be less in a long term renal failure patient?

Answer 1

Erythroblasts

Question 2

What is a correct order?

a. Yolk sac, liver & spleen & secondary lymphoid tissue, bone marrow
b. Amnion, lymphoid tissue, spleen
c. Placenta, spleen, BM, lymphoid

Answer 2

a. Yolk sac, liver & spleen & secondary lymphoid tissue, bone marrow

Question 3

If platelet deficiency, which lineage is affected?

a. Myeloblast
b. Monoblast
c. Megakaryoblast
d. lymphoblast

Answer 3

c. Megakaryoblast

Question 4

Child with swollen lymph nodes, heterophile positive blood. what virus does he have?

Answer 4

EBV

Question 5

A man with tropical spastic paraparesis, what virus does he have?

Answer 5

HTLV-1

Question 6

A chinese baby with nasopharyngeal carcinoma, what virus does he have?

Answer 6

EBV

Question 7

In porphyria cutanea trada, taking sulfonamide, an antibiotic, provokes the symptoms ..why?

a. It promotes immunoglobulin synthesis
b. It activates cytochrome 450 pathway

Answer 7

b. It activates cytochrome 450 pathway

Question 8

What is the purpose of giving hemin as a treatment for porphyria?

Answer 8

It inhibits delta-ALA synthase

Question 9

What’s the most important enzyme in porphyrin synthesis

Answer 9

Delta-ALA synthase

Question 10

If there is an increase in heme production, what occurs as a form of regulation?

Answer 10

Increase synthesis of globin

Question 11

What is the compound in which hemoglobin Fe has six bonds?

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

Answer 11

a. Oxyhemoglobin

Question 12

What molecule is a negative effector in O2 binding to hemoglobin?

a. Carbon dioxide
b. Carbon monoxide

Answer 12

a. Carbon dioxide (Bohr Effect)

Question 13

What is produced by RBC to control hemoglobin affinity to oxygen?

Answer 13

2,3 bisphosphoglycerate

Question 14

What enzyme deficiency induces RBC hemolysis?

Answer 14

Glucose 6 phosphate dehydrogenase

Question 15

Describe the oxygen affinity curve of myoglobin versus hemoglobin. (picture question)

Answer 15

myoglobin= hyperbola
hemoglobin= sigmoid

Question 16

Where is folate absorbed?

a. Terminal ilium
b. Duodenum
c. Juejenum
d. Large intestine
e. Stomach

Answer 16

c. Juejenum

Question 17

What will be highly excreted in a patient with ATP:cobalamine adenosyl transferase deficiency?

a. Melanoic acid
b. Hemocysteine
c. Methylmelanolic acid

Answer 17

c. Methylmelanolic acid

Question 18

In patient with pancreatic insufficiency, which molecule will interfere with cobalamine absorption?

Answer 18

Haptocorrin

Question 19

In which case is hepcidin inhibited?

Answer 19

Increased erythropoiesis

Question 20

What do type 2 hypersensitivity reactions target?

Answer 20

Membrane bound antibiotic

the drug is adsorbed into plasma membrane

Question 21

What immunoglobulin causes hemolytic anemia in fetus?

Answer 21

IgG

Question 22

Which is true about blood grouping?

a. People with blood group B have anti-B Ab
b. People with blood group A don’t express anti A Ab
c. AB are universal donors

Answer 22

b. People with blood group A don’t express anti A Ab

Question 23

Anemia in Patient with gastric bypass due to morbid obesity + (picture of hypersegmented neutrophil). What is the cause?

Answer 23

B12 deficiency

Question 24

Patient with macrocytic anemia. Tests show Positive anti-intrinsic factor .Positive antibodies against parietal cells. What is the patient most likely to suffer from?

a. MDS
b. Thalassemia major
c. Pernicious anemia

Answer 24

c. Pernicious anemia

Question 25

Patient who is known to have long standing anemia and is transfusion dependent .She developed spleenomagaly & bronze discoloration .What does she likely suffer from? a. MDS b. Thalassemia major c. Pernicious anemia

Answer 25

b. Thalassemia major

Question 26

Increased creatinine level is a side effect of which drug?

Answer 26

Deferasirox

Question 27

Which drug requires weekly CBC for risk of agranulocytosis& neutropenia?

Answer 27

Deferiprone

Question 28

Patient who requires repeated blood transfusion is given deferoxamine, why?

Answer 28

To excrete Fe

Question 29

Why do RBCs produce NADH? a. To produce ATP b. To reduce methemoglobin c. To reduce lactate

Answer 29

b. To reduce methemoglobin

Question 30

How is phosphatidyl serine kept on the inner surface?

Answer 30

By action of flippase

Question 31

Patient with hereditary spherocytosis. What is the pathogenesis?

Answer 31

cytoskeleton-protein interactions

Question 32

Which is least likely associated with hereditary spherocytosis? a. Spectrin b. GLUT c. Actin d. Band 4.2 e. Band 4.2 f. Anion exchanger g. Ankyrin

Answer 32

b. GLUT | not sure

Question 33

In HbC disease, hemoglobin precipitates due to water loss. What is the cause of water loss? a. Activation of K channels b. Activation of Na channels

Answer 33

a. Activation of K channels

Question 34

In HbS disease, why does it migrate slower in protein electrophoresis? a. Less charge b. Due to its sickle shape

Answer 34

a. Less charge

Question 35

A woman developed anemia after eating 3 falafel sandwiches. CBC given .What is the pathogenesis of this condition?

Answer 35

Oxidative damage to RBC membrane

Question 36

A woman developed anemia after eating 3 falafel sandwiches. What test would you do to confirm your diagnoisis?

Answer 36

Measure G6PD level

Question 37

Cancer patient on chemotherapy has developed petechial rash. Coagulation profile is normal. What must you give him?

Answer 37

Platelets

Question 38

An elderly man developed a chest infection secondary to liver disease. What type of blood transfusion does he require?

Answer 38

Fresh frozen plasma

Question 39

What is released to activate FXII in the intrinsic pathway? a. Acidic Phospholipids b. Tissue factor

Answer 39

a. Acidic Phospholipids (not 100% sure)

Question 40

What mediates fibrinogen to fibrin?

Answer 40

Thrombin

Question 41

What mediates formation of primary hemostatic plug a. Platelets b. Thromboxane c. vWF

Answer 41

a. Platelets

Question 42

what promotes aggregation of platelets? Or what attracts platelets to the site of clot?

Answer 42

Thromboxane & ADP

Question 43

What is the role of vWF?

Answer 43

Binds & stabilizes F VIII

Question 44

What requires vitamin K?

Answer 44

Gla proteins

Question 45

What's the role of bradykinin

Answer 45

Stimulates the release of t-PA from endothelial cells

Question 46

What constitutes the pale region of thrombus? a. Fibrin & platelets b. Fibrin & RBC

Answer 46

a. Fibrin & platelets

Question 47

What does thrombomodulin activates?

Answer 47

Protein C

Question 48

Prolonged APTT that is not corrected by normal plasma. Whats the diagnosis?

Answer 48

Lupus anticoagulant

Question 49

Which of the following supports that the cause of bleeding is due to platelets rather than coagulation problem? a. Hemarthrosis b. Immediate and profuse bleeding after tooth extraction c. Mucocutanous bleeding

Answer 49

c. Mucocutanous bleeding

Question 50

Patient with chest infection .Prolonged PT & APTT .High level of D dimer .Low level of platelets. What is the diagnosis?

Answer 50

DIC

Question 51

Ahmad was treated with anticoagulant, but developed bleeding which was controlled by protamine sulphate. What anticoagulant was he given? a. Heparin b. Warfarin

Answer 51

a. Heparin

Question 52

Why does streptokinase cause systemic fibrinolysis while t-PA doesn't? a. Streptokinase is endogenous b. Because it binds plasminogen c. Streptokinase is more potentiative than t-PA d. streptokinase binds fibrin-bound as well as free plasminogen, while tPA only binds fibrin-bound plasminogen

Answer 52

d. streptokinase binds fibrin-bound as well as free plasminogen, while tPA only binds fibrin-bound plasminogen

Question 53

A girl with an infection was given amoxicillin, 8 days later, she later developed erythematous rash. What will you find? a. Neutropilia b. Esinophilia c. Basophilia

Answer 53

b. Esinophilia

Question 54

how do esinophils kill? a. Cytotoxicity b. phagocytosis

Answer 54

a. Cytotoxicity

Question 55

What is used to mobilize stem cells from the bone marrow of the donor in stem cell transplant?

Answer 55

CSF

Question 56

What cause trilineage suppression in TB?

Answer 56

TNF

Question 57

What is homing is mediated by?

Answer 57

Adhesion molecules

Question 58

What is involved in respiratory burst?

Answer 58

Oxygen reactive mediators

Question 59

A woman with petechial rash & menorrhagia .high WBC, low RBC & platelets, petechial rash. PBS shows immature cells .What is likely the diagnosis? a. Megaloblastic anemia b. Immune mediated reaction c. BM infiltration d. Acute leukemia

Answer 59

d. Acute leukemia

Question 60

How will you confirm the diagnosis of Acute leukemia? a. Biopsy of skin with petechial rash b. VB12 level c. Restocitin d. Coagulation profile e. BM examination

Answer 60

e. BM examination

Question 61

A child with joint pain and bleeding, whats the diagnosis?

Answer 61

F VIII defeciency

Question 62

A patient with high RBC. High hematocrit. High WBC, high platelets. What's the diagnosis?

Answer 62

PV

Question 63

Whats the abnormality in PV?

Answer 63

JAK kinase gain of function

Question 64

What is characterized by philadelphia chromosome?

Answer 64

CML

Question 65

What causes CML to develop into its blast crisis? a. Chromosomal trisomies b. P 53 mutation c. Chr 16 inversion

Answer 65

a. Chromosomal trisomies

Question 66

Which conditionis associated with intracytoplasmic rods?

Answer 66

AML

Question 67

Abnormality associated with AML a. RARA transcription factor activation b. P53 gene deletion c. 2 philadelphia chromosomes d. Chromosome 16 inversion

Answer 67

d. Chromosome 16 inversion

Question 68

Where do thymocytes mature?

Answer 68

Thymus

Question 69

What is the difference between Th1 & Th2?

Answer 69

Th1 activate cell mediated immunity while Th2 doesn't

Question 70

What produces cytokines to activate production of antibodies? a. Th1 b. Th2

Answer 70

Tb. Th2

Question 71

What suppresses T cell function activation?

Answer 71

T reg

Question 72

Patient with lymphadenopathy, light chain restriction, spherocytes, anemia .What is the pathogenesis of anemia?

Answer 72

Immune mediated destruction

Question 73

Patient with lymphadenopathy. Biopsy shows binucleated cells. What's the diagnosis?

Answer 73

Hodgkin lymphoma

Question 74

A patient with lymphadenopathy – follicular pattern. What is the most important diagnostic test? a. Cytochemistry b. Cytogenic analysis

Answer 74

b. Cytogenic analysis

Question 75

What is multiple myeloma? a. Bence Jones proteins in urine b. Low calcium level c. Polyclonal indication in gel electrophoresis

Answer 75

a. Bence Jones proteins in urine

Question 76

A febrile patient with atypical lymphocytes. What is the cause?

Answer 76

Viral infection

Question 77

A woman with neutrophilia, fever, & cough. What is the cause?

Answer 77

Bacterial infection

Question 78

A patient with metastatic prostate cancer. Normal MCV, low Hb, normal platelets, low WBC. What is mechanism of disease? a. Chronic blood loss b. Ineffective erythropoiesis c. Suppressed erythropiotic activity d. Chronic blood loss

Answer 78

c. Suppressed erythropiotic activity

Question 79

A man with microcytic hypochromic anemia .What might be the cause?

Answer 79

Chronic blood loss

Question 80

What is true about Mercaptopurine?

Answer 80

Inhibits DNA synthesis

Question 81

Premature baby with bleeding, what's the cause?

Answer 81

vit k deficiency

Question 82

Which immunoglobulin is most commonly associated with multiple myeloma?

Answer 82

IgG

Question 83

If you suspect suppressed erythropiotic activity, what test must you use to confirm your diagnosis? a. Erythropoietin level b. Ferritin level c. BM examination

Answer 83

c. BM examination