2015 module exam Flashcards
(85 cards)
1
Q
Which mutation is found in HbSS?
A) glu6val
B) glu26val
C) glu6lys
A
A) glu6val
2
Q
How many alpha mutations are in HbH hemoglobin?
A) 2
B) 3
C) 4
A
B) 3
3
Q
Hb Bart's Hydrops fetalis syndrome results from deletions of how many and what type of globin? A) 4, gamma globin B) 4, alpha globin C) 4, beta globin D) 2, gamma globin
A
B) 4, alpha globin
4
Q
In HPFH, the switch from what to what is impaired? A) gamma to beta B) alpha to beta C) epsilon to gamma D) alpha to gamma
A
A) gamma to beta
HPFH= Hereditary Persistence of Fetal Hemoglobin
5
Q
A patient underwent hypoxia while having an already-existing renal disease. Which hematopoietic cell decreases in this condition? A) Neutrophils B) Lymphocytes C) Monocytes D) Proerythroblasts
A
D) Proerythroblasts
6
Q
what drug is used to prevent myelosuppression and mucositis during treatment with antimetabolites? A) MTX B) cytosine arabinoside C) leucovorin D) 6 – mp
A
C) leucovorin
7
Q
Which of the following molecules is associated with lipid rafts?
A) Sphingomyelin
B) AE1 transporters
C) Glut1
A
A) Sphingomyelin
8
Q
Which of the following molecules activates FXII? A) Kallikrein B) HMW kininogen D) Pre-kallikrein E) Hagemanfactor
A
A) Kallikrein
9
Q
Which of the following is responsible for T cell death upon its presentation to a self- antigen?
A) Positive selection
B) Negative selection
C) ADCC
A
B) Negative selection
10
Q
Which of the following immunoglobulins results in hemorrhagic disease of the newborn? A) IgM B) IgA C) IgG D) IgE
A
C) IgG
11
Q
In a man with Hereditary spherocytosis, which of the following is expected? A) high conjugated bilirubin B) gallstone C) low reticulocytes D) hypocellular BM
A
B) gallstone
12
Q
What blood type combination would cause hemolytic disease of the newborn?
A) Rh+ dad Rh- mom
B) Rh+ dad and Rh+ mom
C) Rh- dad Rh+ mom
A
A) Rh+ dad Rh- mom
13
Q
A patient just came in from road traffic accident, what will you give him?
A) Packed RBC when 2 liters of blood is lost
B) FFP as a volume expander of blood
C) Packed RBC when 10% of his blood is lost
A
A) Packed RBC when 2 liters of blood is lost
14
Q
What happens if you give IgA to an IgA deficient recipient?
A) Bacterial contamination
B) Graft vs host disease
C) Anaphylactic reaction
D) delayed hemolytic transfusion reaction
A
C) Anaphylactic reaction
15
Q
What is reduced with gamma irradiation? A) Graft vs host disease B) Bacterial contamination C) Viral infections D) Acute hemolytic transfusion reaction
A
A) Graft vs host disease
16
Q
What would be the strongest evidence to suggest iron-deficiency anemia?
A) Low transferrin saturation
B) Low hemosiderin
C) Low serum iron
A
A) Low transferrin saturation
17
Q
A patient came with severe blood loss and there was no time to type his blood type. What blood group can be used immediately in this emergency? A) A + B) O- C) O+ D) AB+
A
B) O-
18
Q
How do you store platelets?
A) 20C, 5 days
B) 20C, 30 days
C) -20 C, 5 days
A
A) 20C, 5 days
19
Q
If a person has a blood group A then which antibodies are present in that person's blood? A) anti-A antibodies B) anti-B antibodies C) anti-O antibodies D) anti-H antibodies
A
B) anti-B antibodies
20
Q
There are few different markers that we use in the clinic to assist our differential to microcytic anemia. Which of the following types would have a reduced ferritin level? A) Myelodysplasia B) Anemia of chronic disease C) Sideroblastic anemia D) Thalassemia E) Iron deficiency anemia
A
E) Iron deficiency anemia
21
Q
Which of the following fusion protein would result in the development of chronic myeloid leukemia?
A) P190
B) P210
C) P230
A
B) P210
22
Q
In hypersensitivity type II, which of these mechanisms results in RBCs destruction? A) ADCC B) Major cationic proteins C) Perforin D) Phagocytosis
A
A) ADCC
23
Q
What is the factor used to initiate the intrinsic pathway if we want to make the reaction in a tube (in vitro)? A) prothrombin B) factor Xa C) factor XIIIa D) factor V E) factor XIIa F) factor VII
A
E) factor XIIa
24
Q
Which of the following is an oral anticoagulant with rapid action but short half-life?
A) Heparin
B) Otamixaban
A
B) Otamixaban
Otamixaban is administered by IV, so this is probably wrong.
25
In a patient with septicemia, prolonged APTT and PT, low platelets and fibrinogen, what diagnostic test is performed next?
A) D dimer
B) Blood test
A) D dimer
26
```
Patient with MI was given anticoagulants, what would be a reason for alarm?
A) purpura
B) high creatinine
C) body weight
D) history of jaundice
E) rash
F) nausea
```
A) purpura
27
A woman came to the clinic with a mottled purple leg. She had a previous miscarriage and her APTT was high. What could her diagnosis be?
A) antiphospholipid syndrome
B) DIC
C) TTP
A) antiphospholipid syndrome
28
```
Which of the following is a transfusion hazard associated with platelets transfusion?
A) TRALI
B) Bacterial contamination
C) Febrile non-hemolytic reaction
D) Graft vs host hemolysis
E) Delayed reaction hemolysis
F) Anaphylactic reaction
```
B) Bacterial contamination
29
40 y/o male with spontaneous gum swelling and bleeding. CBC: low Hb, low Plt, Normal WBC
PBS: circulating immature cells
What is the most useful investigation to help in diagnosis?
A) Morphology of BM aspirate
B) immunophenotyping of PB lymphocytes
C) Reticulocyte counts
A) Morphology of BM aspirate
30
Which of the following is a tyrosine kinase inhibitor?
a. clopidogrel
b. imantinib
b. imantinib
31
```
What component if exposed on the outer aspect of the RBC will lead to the removal of the RBC from the circulation?
A) Phosphatidylserine
C) Ankyrin
D) Spectrin
E) Actin
F) Phosphatidylcholine
G) Sphingomyelin
```
A) phosphatidylserine
32
```
Which leukemia is more likely to present with an abnormal tyrosine kinase activity?
A) CLL
B) ALL
C) AML
D) CML
```
D) CML
33
What is the mechanism of action of heparin?
A) direct inhibitor of factor 10A
B) increases activity of antithrombin III
C) direct inhibitor of thrombin
B) increases activity of antithrombin III
34
what is involved in suppressing trilineage hematopoiesis activity in tuberculosis?
A) colony-stimulating factors (CSFs)
B) IL (interleukins)
C) TNF (tumor necrosis factor)
C) TNF (tumor necrosis factor)
35
```
Which molecule chemotactically attracts neutrophils to sites of inflammation?
A) Complement fragments
B) Immunoglobulins
D) Fc receptors
E) Defensins
```
A) Complement fragments
36
```
A gain of function mutation in which gene causes APC resistance and thrombotic disorder?
A) antithrombin
B) protein C
C) FV
D) tissue plasminogen activator
```
C) FV
37
Which of the following irreversibly inhibits ADP-dependent pathway of platelet aggregation?
a. clopidogrel
b. imantinib
c. deferoxamine
d. deferasirox
a. clopidogrel
38
Which one of the following is an iron-chelating factor given as long subcutaneous transfusions?
a. clopidogrel
b. imantinib
c. deferoxamine
d. methotrexate
c. deferoxamine
39
Which one is an iron-chelating factor that is lipophilic and can enter the cell?
a. clopidogrel
b. imantinib
c. leucovorin
d. deferasirox
e. deferoxamine
d. deferasirox
40
```
Which TWO cause photosensitivity/light sensitivity?
A) Protoporphyrin ix
B) ALA Acid
C) PBG
D) Hydroxymethlbilane
```
A) Protoporphyrin ix
&
D) Hydroxymethlbilane
41
What is the mechanism of action for alkylating agents?
A) Cell cycle specific
B) Does not cause secondary cancer
C) Does not cause bone marrow suppression
D) Cross link DNA
D) Cross link DNA
42
```
Which of the following is a folate antagonist?
A) Methotrexate
B) leucovorin
C) imantinib
D) deferoxamine
```
A) Methotrexate
43
```
A person had a car accident and started bleeding. His hemoglobin was 50g/l, then 2 packs of packed RBCs were transfused. what is his hemoglobin following the transfusion?
A) 55 g/l
B) 70 g/l
C) 100 g/l
D) 60 g/l
```
B) 70 g/l
44
```
A 6-month old girl slipped and fell. She started bleeding from her mouth. The mother couldn't stop the bleeding, so she took her to the emergency.
Tests showed:
Platelet: 236 x10^9
PT: 12 seconds
APTT: > 120 seconds
What is the diagnosis?
A) Hemophilia A
B) Von Willebrand disease
C) Factor VII deficiency
D) Vitamin K deficiency
```
no answer given
45
What is diminished with leukoreduction?
A) Febrile non-hemolytic reaction
B) Graft vs host disease
C) Lung injury
A) Febrile non-hemolytic reaction
| leukoreduction= Filtration of the blood
46
Exposure of what triggers thrombin formation?
A) internal lamina
B) external lamina
C) connective tissue of subendothelium
C) connective tissue of subendothelium
47
CLL is characterized by which of the following?
A) Monoclonal b cell lymphocytosis
B) monoclonal ig increase
A) Monoclonal b cell lymphocytosis
48
```
What is frequently asymptomatic?
A) AML
B) CML
C) MGUS
D) Bacterial infection
```
C) MGUS
49
```
What causes renal failure and lytic bone lesions?
A) Multiple myeloma
B) MGUS
C) AML
D) CML
```
A) Multiple myeloma
50
```
Which translocation causes acute promyeloid leukemia?
A) t (9:22)
B) t (15:17)
C) t (9:17)
D) t (8:14)
```
B) t (15:17)
51
```
What is the mutation found in Burkitt’s lymphoma?
A) t (8:14)
B) t (14:18)
C) t (9:17)
D) t (9:22)
```
A) t (8:14)
52
```
Where would you find cells expressing CD15 and CD 30?
A) Hodgkin’s lymphoma
B) CML
C) AML
D) ALL
E) Follicular lymphoma
```
A) Hodgkin’s lymphoma
53
Which of the following is an anti-bacterial material present in eosinophils?
A) major basic protein and cationic protein
B) lysozymes
C) defensins
D) granzymes
E) perforins
A) major basic protein and cationic protein
54
Which of the following is present in neutrophilic granules?
A) major basic protein and cationic protein
B) lysozymes
C) defensins
D) granzymes
E) perforins
B) lysozymes
55
```
Where would you find large binucleated cells?
A) Hodgkin’s lymphoma
B) CML
C) AML
D) ALL
E) Follicular lymphoma
```
A) Hodgkin’s lymphoma
56
```
Which of the following has the lowest frequency of Philadelphia chromosome?
A) child ALL
B) adult ALL
C) CML
D) AML
```
D) AML
57
```
A patient comes with intracranial hemorrhage and is on warfarin for treatment of heart disease. What would be administered?
A) FFP
B) Platelet concentrates
C) Packed RBC
D) cryopercipetate
E) filtered Packed RBC
```
A) FFP
58
In a biopsy of AML, what would you see in BM?
A) BM hypoplasia
B) infiltration by blast cells
B) infiltration by blast cells
59
A patient with acute leukemia presentation + bone pain, what cells will u see in BM?
A) B lymphoblasts
B) B lymphocytes
C) neutrophils
A) B lymphoblasts
60
Nucleoid budding, hypolobulated megakaryocytes, and pancytopenia indicate which of the following?
A) AML
B) CML
C) MDS
C) MDS
61
```
What factor is affected in a gain of function mutation that stabilizes 3' UTR causing thrombophilia?
A) Prothrombin
B) Factor V
C) Factor VII
D) Factor Xa
E) Factor
```
A) Prothrombin
62
Patient with low platelet count and large platelets seen on PBS. What do u administer?
A) platelet concentrates
B) FFP
C) Immunoglobulins
C) Immunoglobulins
| ??
63
```
what binds to Vitamin B12 in the duodenum?
A) haptorcorrin
B) gastric intrinsic factor
C) hepcidin
D) food protein
```
B) gastric intrinsic factor
64
What glycoprotein helps thrombin bind to activated protein C?
A) Thrombomodulin
B) Prothrombin
C) Factor 8
A) Thrombomodulin
65
Myoglobin and hemoglobin curve, why is it shaped the way it is?
A) Myoglobin has Fe3+ iron but Hb doesn't
B) Myoglobin binds CO2 Hb doesn’t
C) Myoglobin has no cooperativity
C) Myoglobin has no cooperativity
66
```
A man was traveling and had a car accident, which resulted in bleeding and severe anemia. He needed a blood transfusion. His blood group is (O positive) and received group (A positive) blood transfusion. What will happen?
A) agglutination of donor’s blood
B) Agglutination of recipient’s blood
C) Both will agglutinate.
D) No agglutination occurs.
```
A) agglutination of donor’s blood
67
What is true about O2 binding to hemoglobin?
a. Cooperativity is present, due to iron moving relative to the plane of heme
b. No cooperativity present
a. Cooperativity is present, due to iron moving relative to the plane of heme
68
Suppression of which hormone will help in the treatment of microcytic anemia in patients with rheumatoid arthritis?
A) Hepicidin
B) Erythropoietin
C) TSH
B) Erythropoietin
69
Why is G-CSF given to stem cell donors?
mobilize stem cell to peripheral blood of donor
70
During treatment for malignancy, suppression of myeloid lineage occurred. What do you give the patient?
A) G –CSF
B) TNF
A) G –CSF
71
Mutation in which part of the vWF gene will lead to thrombocytopenia?
A) Gp1B
B) heparin
C) ADAMTS13
A) Gp1B
&
C) ADAMTS13
72
What induces hypersensitivity cytotoxicity towards RBCs?
drugs adsorbed to RBCs
73
Which of the following is an anti-bacterial material present in eosinophils?
A) granzymes
B) lysozymes
C) defensins
D) major basic protein and cationic protein
E) perforins
D) major basic protein and cationic protein
74
```
Which of the following is present in neutrophilic granules? A) major basic protein and cationic protein
B) lysozymes
C) defensins
D) granzymes
E) perforins
```
B) lysozymes
75
```
Which of the following has the lowest frequency of Philadelphia chromosome?
A) child ALL
B) adult ALL
C) CML
D) AML
```
D) AML
76
How do you store platelets?
A) 20C, 5days
B) 20C, 30days
C) -20 C, 5 days
A) 20C, 5days
77
```
A patient comes with intracranial hemorrhage and is on warfarin for treatment of heart disease. What would be administered?
A) Platelet concentrates
B) FFP
C) Packed RBC
D) cryoprecipitate
E) filtered Packed RBC
```
B) FFP
78
Patient with burning sensation in hands. CBC showed high hemoglobin, WBCs, and platelets. What would the investigation of the BM reveal?
Panmyelosis
| why not ET?
79
How does methylene blue reduce methemoglobin?
a- by NADPH-dependent methemoglobin reductase
b- by Cytochrome B5 NADH dependent methemoglobin reductase
a- by NADPH-dependent methemoglobin reductase
80
```
What protects vitamin B12 from denaturation in the stomach?
A) haptocorrin
B) gastric intrinsic factor
D) hepcidin
E) food protein
```
A) haptocorrin
81
What is the most important thing for the RBCs to help withstand the mechanical sheer force of moving through small blood vessels?
A) covalent linking between membrane lipids to integral proteins
B) covalent linking of rafts to spectrin
C) binding of cytoskeleton to hemoglobin
D) binding of integral membrane proteins to cytoskeleton
D) binding of integral membrane proteins to cytoskeleton
82
A 66-year-old female presented with dizziness & spontaneous bleeding. Her CBC findings show anemia & thrombocytopenia, her BM aspiration shows mononuclear megakaryocytes & erythroid cells with nuclear budding. What could be the issue?
myelodysplastic syndrome
83
Characteristic of B cell diffuse lymphoma
A) Indolent lymphoma
B) Malignant cell expressCD20
C) t (14,18)
B) Malignant cell expressCD20
84
Factor V Leiden mutation leads to thrombotic diseases. Which molecule controls normal factor V function?
Protein C
85
What do eosinophils secrete during respiratory burst?
reactive oxidative intermediates
