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[OS 216] Hema E1 > 2017 Block B > Flashcards

2017 Block B Flashcards

1
Q 
The most common cytogenetic abnormality in myelodysplastic syndrome (MDS) involves chromosome number
A. a.5
B. b.7
C. c.8
D. d.20
A

A

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2
Q

One-year survival rate of patient with severe aplastic anemia is

A

C. Less than 20%

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3
Q 
The clinical manifestation that distinguishes aplastic anemia from leukemia
A. severity of pallor
B. severity of bleeding
C. CNS involvement
D. presence of hepatosplenomegaly
A

D

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4
Q

Acquired aplastic anemia in contrast to inherited form of bone marrow failure appears to be caused largely by:
A. immune-mediated destruction of marrow cells
B. loss of hematopoietic stem cells due to DNA damage
C. low threshold for apoptosis
D. NOTA

A

A

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5
Q

The HLA antigen frequently increased in aplastic anemia is

A

B. DR15

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6
Q

This disease condition can co-exist with aplastic anemia

a. myelodysplastic syndrome
b. paroxysmal nocturnal hemoglobinuria
c. acute leukemia
d. myelofibrosis

A

B

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7
Q

The bone marrow of a patient with aplastic anemia more often shows

A

C

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8
Q

An infectious state that is occasionally associated with bone marrow failure is

a. varicella zoster infection
b. hepatitis
c. strep throat
d. typhoid fever

A

B

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9
Q

The abnormality that may be noted in a differential count in aplastic anemia

A

A. Relative lymphocytosis

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10
Q

Peripheral blood cell morphology in aplastic anemia is usually: a. normocytic, normochromic

b. microcytic, hypochromic
c. macrocytic, normochromi
d. microcytic, normochromic

A

A

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11
Q

The best way to distinguish between Aplastic Anemia and MDS is:

a. Cellularity of the bone marrow
b. Severity of pancytopenia
c. Abnormal karyotype
d. All of the above

A

C

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12
Q

Progressive cytopenia in Fanconi’s anemia is due to

A

B. DNA damage

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13
Q 
The following are the most important variables in disease outcome in Myelodysplastic syndrome EXCEPT:
A. # of blasts in the peripheral blood 
B. # of blasts in the bone marrow
C. cytogenetic abnormality
D. severity of cytopenia
A

A

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14
Q

In stem cell transplantion for aplastic anemia

A

C. Bone marrow is a better source of stem cells than peripheral blood

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15
Q

Anemia of chronic renal failure:
A. A.usually microcytic normochromic
B. erythropoietin deficiency is usually seen when creatinine is >2mg
C. supplemental iron should be avoided as much as possible
D. erythropoietin alpha dose of 30-75/kbbw per week is usually required

A

B

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16
Q

Anemia of chronic disease (2012)

a. reticulocyte count is usually normal or increased
b. iron level is normal
c. iron binding capacity is increased
d. ferritin value is elevated

A

D

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17
Q

The proposed mechanism for anemia of chronic inflammatory condition include:
A. increased red cell survival
B. decreased responsiveness to erythropoietin
C. decreased levels of erythropoietin
D. AOTA

A

B

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18
Q

Leukocyte-reduction filters can do all of the following except a. reduce the risk of CMV infection

b. prevent or reduce the risk of HLA alloimmunization
c. prevent febrile, nonhemolytic transfusion reactions
d. prevent transfusion associated graft versus host disease (TA-GVHD)

A

D

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19
Q

Blood type selected when patient cannot wait for ABO matching

A

C. Type O

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20
Q 
Apheresis can be used to collect all of the following except:
A. Leukocytes
B. Macrophages
C. Hematopoietic progenitor cells
D. Platelets
A

B

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21
Q

Transfused plasma resulting in immediate erythema, itching, and hives best typify the following transfusion reaction

a. immediate hemolytic transfusion reaction (IHTR)
b. delayed hemolytic transfusion reaction (DHTR)
c. allergic reaction
d. anaphylactoid reaction

A

C

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22
Q

Patients at greatest risk of developing transfusion associated circulatory overload may include:

a. children
b. elderly people
c. patients with chronic normo-volemic anemia
d. all of the above

A

D

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23
Q

A transfusion reaction that usually appears rapidly that may result in fever, shock or death is:
A. immediate hemolytic transfusion reaction
B. transfusion associated circulatory overload
C. allergic transfusion reaction
D. febrile non-hemolytic transfusion reaction

A

A

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24
Q 
Fatal transfusion reactions are most frequently caused by: 
A. Clerical errors
B. Improper refrigeration 
C. Overheated blood
D. Platelets
A

A

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25
Q

When a suspected hemolytic transfusion reaction occurs, the first thing to do is:

a. Slow the transfusion rate and call the physician
b. Administer medication to stop the reaction
c. Stop the transfusion but keep the intravenous line open with saline
d. First inform the library to begin an investigation

A

C

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26
Q

The following is a symptom of febrile non-hemolytic transfusion reaction:

A

C. Temperature rise of 1°C with transfusion

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27
Q

Pretransfusion irradiation of all blood products in certain patients is done to prevent:
A. Cytomegalovirus
B. Transfusion Associated Graft vs. Host Disease
C. Febrile Non-Hemolytic Transfusion Reaction
D. Hemolytic Transfusion Reaction

A

B

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28
Q

the most common reason for transfusion of leukocyte-poor blood to a recipient

A

C. The recipient has had 2 or more febrile non-hemolytic transfusion reactions

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29
Q

A patient was suspected to have an adverse reaction to a transfusion because he developed urticaria. The most likely etiology for the urticaria is:

A

A. Plasma proteins

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30
Q

A patient was suspected to have an adverse reaction to an RBC transfusion; he experienced febrile non-hemolytic transfusion reaction. The most likely etiology of the reaction is:

A

B. Leukoagglutinins

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31
Q

A patient was suspected to have a transfusion-associated graft- versus-host disease. The following may cause it:

A

Functional T lymphocytes in cellular blood components

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32
Q 
The lifespan of platelets is
A. 12 to 24 hours
B. 7 to 10 days
C. 45 to 60 days
D. 100 to 120 days
A

B

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33
Q

The link between a platelet receptor site in GP1b/9 and collagen fibrils is accomplished by:

A

C. Von Willebrand’s factor

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34
Q

Key organ in pathophysiology of chronic immune thrombocytopenic purpura is:
A. liver
B. spleen
C. bone marrow D. kidneys

A

B

35
Q

A 10y/o girl with petechiae, ecchymosis, and minimal gum bleeding 5 days after upper respiratory tract infection. One of the following is expected:

More than 90% recover in 6 months (acute ITP, post-viral or post- infectious)
The most common target of anti-platelet antibodies in chronic ITP is:

A

C. GP2b/3a

36
Q 
A chronic ITP patient failed to respond to splenectomy. The presence of an accessory spleen is suspected by the presence of this abnormal red cell in the peripheral blood smear.
A. howell-jolly bodies
B. target cells
C. tear-drop cells
D. schistocytes
A

A

37
Q

This disease is due to deficiency in the activity of a specific metalloproteinase (ADMTTS +3)

a. von Willebrand’s disease
b. Henoch-Scholein purpura
c. thrombotic thrombocytopenic purpura d. Hemolytic-uremic syndrome

A

C

38
Q

A bleeding patient was found to have deficient GP2b/3a complex. The diagnosis is:

A

Glanzmann’s thrombasthenia

39
Q 
This screening test reflects the function of the intrinsic pathway of coagulation
A. bleeding time
B. prothrombin time
C. partial thromboplastin time 
D. thrombin time
A

C

40
Q

Which of the ff is not a vitamin K dependent coagulation factor

a. I
b. II
c. VII
d. IX

A

A

41
Q 
Vitamin K deficiency causes abnormality of this screening test. 
A. bleeding time
B. platelet count 
C. PT
D. PTT
A

C

42
Q 
The most common type of leukemia associated with disseminated intravascular coagulation is:
A. Acute promyelocytic leukemia
B. Acute monocytic eukemia
C. Erythroleukemia
D. Acute megakaryocytic leukemia
A

A

43
Q 
Abnormal red cell structure seen in DIC due to microangiopathic anemia:
A. spherocytes
B. target cells
C. dacrocytes
D. schistocytes
A

D

44
Q

This is true regarding bleeding disorders secondary to aspirin.
A. Aspirin impairs platelet release reaction.
B. A severe bleeding disorder
C. Aspirin causes reversible inhibition of cyclooxygenase enzymes.
D. Impaired hemostasis reverses in 24 hours.

A

A

45
Q 
A 20 year old male had laboratory test done because of prolonged bleeding following dental extraction. Results were as follows: normal platelet count, bleeding time and prothrombin time, but prolonged PTT which was corrected by mixing test. The most likely diagnosis is:
A. von willebrand’s disease
B. hemophilia
C. chronic ITP
D. Glanzmann’s thrombasthenia
A

B

46
Q

This progenitor stem cell marker is virtually absent in aplastic anemia:

A

CD34 (myeloplastic)

47
Q

This virus is associated with aplastic crisis in patients with congenital hemolytic anemia:

A

C. Parvo B19

48
Q

A 30 y/o male was diagnosed with aplastic anemia 5 years ago. He gradually experienced pallor, jaundice, reddish urine. Urinalysis showed no signs of rbc. What test would be helpful?
A. bone marrow aspiration and biopsy B. leukemia immunophenotyping
C. urine hemosiderin
D. flow cytometry for CD55, CD59

A

D

49
Q

The most important antigen lacking in PNH cell is:

A

C. Membrane inhibitor of reactive lysis

50
Q

The underlying pathophysiology in Paroxysmal Nocturnal Hemoglobinuria (PNH) is:
A. Hereditary
B. Lack of glycosyl phosphatidyl inositol-linked cell surface
membrane proteins
C. Tumor necrosis factor and gamma interferon elaborated by
cytotoxic T cells
D. Presence of red cell antibodies

A

B

51
Q 
Rouleaux formation is seen in: 
A. Afibrinogenemia
B. Paraproteinemia
C. sickle cell anemia
D. autoimmune haemolytic anemia
A

B

52
Q 
Microcytosis is best defined as: 
A. high RDW
B. low MCV 
C. high MCH 
D. low MCHC
A

B

53
Q 
On a peripheral blood smear, red cells will normally have a central pallor that occupies:
A. 1/3 of its diameter 
B. 1⁄2 of its diameter
C. 2/3 of its diameter 
D. D.3/4 of its diameter
A

A

54
Q

A neoplasm of immunosecreting terminally differentiated B lymphocytes is

a. B-cell chronic lymphocytic leukemia
b. B-cell acute lymphocytic leukemia
c. multiple myeloma
d. Chronic myelogenous leukemia

A

C

55
Q 
The presence of Auer rod is definite evidence that the cell is:
A. Leukemic 
B. Immature 
C. Myeloid 
D. Differentiated
A

C

56
Q 
According to the WHO classification, the diagnosis of AML requires the presence of \_\_\_\_\_ blasts in the marrow
A. ≥ 10%
B. ≥ 20%
C. ≥30%
D. ≥ 40%
A

B

57
Q

Anemia in Multiple Myeloma is largely due to:

a. Intravascular hemolysis
b. Myeloid stem cell defect
c. Marrow replacement by neoplastic cells
d. Depletion of iron stores

A

C

58
Q

Neoplastic cells with accumulated immunoglobulins in the cytoplasm are said to be in:

A

Plasmacytomas

59
Q 
The gold standard in the diagnosis of iron deficiency anemia is
A. serum iron
B. serum ferritin
C. total iron binding capacity
D. hemosiderin in bone marrow
A

D

60
Q

A patient develops iron deficiency anemia after gastroduodenal bypass surgery:
A. because of poor iron absorption
B. because of poor iron utilization
C. because of poor iron intake
D. because of the decrease in the reticulo-endothelial system

A

A

61
Q 
Parenteral iron is given if:
A. rapid increase in hemoglobin is desired
B. malabsorption syndrom exists
C. the patient requested for it
D. rapid utilization of iron by the body
A

B

62
Q

Infants should be given iron supplements as early as 2 months of age because

a. they are easily prone to colic
b. human and cow’s milk are poor sources of iron
c. they bleed easily
d. they have poor iron absorption

A

B

63
Q

A donor who has ingested aspirin on the day of donation is temporarily deffered because

a. he has fever
b. he is infected
c. aspirin alters the quality of platelets
d. aspirin causes a hypercoagulable state

A

C

64
Q

This is a cause for permanent deferral of a blood donor

a. upper respiratory infection
b. hepatitis B
c. fever
d. ingestion of contraceptive pill

A

B

65
Q

Fresh frozen plasma is stored at

A

-20°C.

66
Q

This blood component requires continuous agitation during storage:

A

Platelet concentrates

67
Q

What is the purpose of doing a cross-match before transfusion?

a. To detect autoantibodies present in the recipient
b. To prevent alloimmunization
c. To detect alloantibodies in the recipient
d. To avoid sensitization of the recipient

A

C

68
Q 
The ff blood component should have a cross matching of the donor done before transfusion:
A. PRBC
B. Platelets
C. WBC 
D. FFP
A

A

69
Q

Reasons why an RH (-) person should not receive RH (+) blood:
A. Prevent incompatibility
B. Prevent autoimmunization to D antigen
C. Prevent Immediate Post-Transfusion reaction
D. Prevent infection

A

B

70
Q

The “window period” in the testing for HIV in blood donors represents
A. The time from the infection of the donor up to the time that the anti- body is detected
B. The duration of the HIV laboratory test
C. The incubation period for the reagents
D. The time when the HIV symptoms become manifest

A

A

71
Q

Why can thawed fresh frozen plasma not be refrozen?
A. It’s potentially infected
B. it’s lost the activity of the coagulation factors
C. The plastic bag is brittle
D. Cytokines are released in the process of thawing

A

B

72
Q

Cirrhosis of the liver can result in thrombosis because

a. the liver releases large amounts of coagulation factors
b. the liver cannot synthesize coagulation factors
c. hepatic clearance of activated coagulation factors is poor
d. toxic substances not metabolized by the liver cause damage in blood vessles

A

C

73
Q

Elderly patients who develop deep vein thrombosis should be worked up for

a. vasculitis
b. malignancy
c. atherosclerosis
d. liver cirrhosis

A

B

74
Q

The most serious complication of deep vein thrombosis is

a. myocardial infarction
b. cerebrovascular thrombosis
c. peripheral vascular disease
d. pulmonary embolism

A

D

75
Q

The initiating event in the formation of arterial thrombus is

a. activation of factor X
b. adherence of platelets to damaged blood vessels promoting aggregation
c. activation of anti-thrombin III
d. increased synthesis of prothrombin

A

B

76
Q 
The most common acute leukemia in children 
A. Pre-T ALL
B. Pre-B ALL 
C. AML
D. JMML
A

B

77
Q 
The single most significant prognostic factor in children with ALL is:
A. the presence of CNS involvement 
B. extent of hepatomegaly
C. age at diagnosis
D. initial W BC at diagnosis
A

D

78
Q

Chronic myelogenous leukemia is associated with:

A

Reduced leukocyte alkaline phosphatase levels

79
Q

Current source of hematopoietic stem cells include the following EXCEPT :

A

Fetal liver

80
Q

Site of absorption of folic acid

a. proximal jejunum
b. gastric mucosa
c. distal ileum
d. cecum

A

A

81
Q

Treatment of folate deficiency

a. oral replacement with 1 or 5 mg/day folic acid
b. parenteral folate replacement
c. oral folic acid 1 or 5 mg/day with ferrous supplement
d. a and c

A

A

82
Q

Primary site of erythropoietin production during fetal life:

A

Hepatic

83
Q

Hallmark of the common forms of alpha thalassemia:

a. elevated Hgb A
b. elevated Hgb A2
c. elevated HgbF
d. low Hgb A2

A

D

84
Q

Definitive management may be achieved through splenectomy: a. hereditary spherocytosis

b. G6PD deficiency
c. thalassemia
d. sickle cell hemoglobinopathy

A

NA

[OS 216] Hema E1 (7 decks)

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