2017 module exam Flashcards by Survive Medical School

Drug-induced hemolytic anemia is caused by penicillin. What is the mechanism of action for this?

A. Production of IgE

B. Production of IgM and IgG

C. Activation of cytotoxic T cell

D. Production of Th1

B. Production of IgM and IgG

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Parvovirus B19 infects which cells?

A. Erythroid precursors

B. B lymphocytes

C. Myeloblasts

D. Neutrophils

A. Erythroid precursors

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Which antibody stimulates mast cell degranulation? A. IgM B. IgA C. IgE D. IgD

C. IgE

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What inhibits hepcidin synthesis in response to renal hypoxia?

A. Erythroferrone

B. Erythropoietin

C. HJV

D. BMP

A. Erythroferrone

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What cells of the bone marrow secrete IL-7?

A. Stromal cells

B. T lymphocytes

C. Dendritic cells

D. B lymphocytes

A. Stromal cells

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What may result if hemojuvelin is mutated and nonfunctional?

A. Anemia

B. Hypoferremia

C. Hemochromatosis

D. Hepcidin synthesis will increase

C. Hemochromatosis

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What is the first cell in erythropoiesis to undergo ribosome synthesis?

A. Basophilic erythroblast

B. Orthochromatophilic erythroblast

C. Normoblast

D. Late erythroblast

A. Basophilic erythroblast

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What is the most common cause of Infectious Mononucleosis?

A. HTLV I

B. EBV

C. HIV

D. Parvovirus B19

B. EBV

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Patient’s blood type was being identified. If patient’s RBCs had: No agglutination with anti-A, Agglutination with anti-B, Agglutination with anti-Rh. what is the patient’s blood type??

A. B negative

B. B positive

C. AB positive

D. A negative

B. B positive

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What blood is compatible with the patient in the previous case?

A. AB positive

B. A positive

C. O negative

D. AB negative

C. O negative

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What toxic substances are released during respiratory burst?

A. H2O2

B. Defensins

C. Lysozymes

D. CO2

A. H2O2

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What hypersensitivity reaction best describes RBC hemolysis?

A. Anaphylactic

B. Cytotoxic

C. Immune complex

D. Delayed

B. Cytotoxic

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Which of the following protects cobalamin while in the stomach?

A. Transcobalamin I

B. Cubilin

C. Haptocorrin

D. Intrinsic Factor

C. Haptocorrin

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A 33 year old female complains of fever and night sweats. Imaging reveals presence of mediastinal lymph node enlargement. A biopsy reveals the presence of binucleated cells with prominent nucleoli embedded in polynuclear environment. What is the most likely diagnosis?

A. Hodgkin’s lymphoma

B. Burkitt’s lymphoma

C. Follicular lymphoma

D. Diffuse large B cell lymphoma

A. Hodgkin’s lymphoma

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Which enzyme is inhibited by lead (Pb2+) poisoning?

A. ALA synthase

B. Porphobilinogen synthase

C. Hydroxymethylbilane synthase

D. G6PD

B. Porphobilinogen synthase

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Which of the following is released during degranulation of neutrophils?

A. Major basic protein

B. Cationic protein

C. Defensins

D. Heparin

C. Defensins

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Which of the following imparts antiplatelet aggregation?

A. ADPase

B. Thromboxane A2

C. Serotonin

D. Fibronectin

A. ADPase

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Phospholipase A2 from snake venom will cause damage to which of the following?

A. Cytoskeleton

B. RBC plasma membrane

C. Glycocalyx

B. RBC plasma membrane

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Patient has low RBC count, high MCV, high homocysteine levels, and normal methylmalonic acid levels. There are no signs of neurological symptoms. What is the most likely diagnosis?

A. Vitamin B12 deficiency

B. Folate deficiency

C. Iron deficiency anemia

D. Thalassemia

B. Folate deficiency

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Patient presented with prolonged APTT. What is the next step that is most appropriate for diagnosis?

A. Factor XII assay

B. Factor XI assay

C. Factor IX assay

D. Factor VIII assay

E. Mixing test

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Patient present with worm infection that leads to blood loss. Also presents with low hemoglobin, low MCV, pencil cells, and target cells. What would most likely be seen in this patient’s iron profile?

A. Normal serum iron, normal serum ferritin, normal TIBC

B. High serum iron, low serum ferritin, low TIBC

C. Low serum iron, low serum ferritin, high TIBC

D. Low serum iron, low serum ferritin, low TIBC

C. Low serum iron, low serum ferritin, high TIBC

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What is a characteristic of G6PD deficiency?

A. High conjugated bilirubin

B. High LDH C. High haptoglobin

D. Low reticulocyte count

B. High LDH

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Hemolytic anemia is characterized by:

A. Low reticulocyte count

B. Increased LDH

C. Increased haptoglobin

D. Low unconjugated bilirubin

E. High conjugated bilirubin

B. Increased LDH

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A 3 year old boy presented with left thigh swelling and pain. He had no fever nor trauma. The coagulation profile showed normal PT but prolonged APTT. What is the most likely diagnosis?

A. vWF disease

B. Liver disease

C. Hemophilia A

D. Factor X deficiency

E. DIC

C. Hemophilia A

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A 15 year old girl with sickle cell disorder. What is likely to be found in the lab investigation? A. High conjugated bilirubin B. Low reticulocyte count C. Hypocellular bone marrow D. Howell jolly bodies E. Bite cells

D. Howell jolly bodies

What gene is affected in sickle cell anemia? A. Alpha gene B. Beta gene C. Gamma gene D. Epsilon gene

B. Beta gene

What genes are affected in hydrops fetalis? A. 2 beta globin genes B. 2 alpha globin genes C. 3 alpha globin genes D. 4 alpha globin genes

D. 4 alpha globin genes

What is a characteristic of Hereditary Spherocytosis? A. High conjugated bilirubin B. High haptoglobin C. Shortened RBC lifespan D. Low reticulocyte count

C. Shortened RBC lifespan

Which of the following is associated with Hb S in sickle cell anemia? A. Glu6Val B. Glu26Lys C. Glu6Lys D. Glu26Val

A. Glu6Val

Patient with liver disease is actively bleeding. What would be the most appropriate to transfuse? A. Whole blood B. Fresh frozen plasma C. Platelet concentrates D. Factor VIII concentrate

B. Fresh frozen plasma

Patient presented with Streptococcus pneumonia sepsis, recurrent chest infections, prolonged PT and APTT. What other feature is most likely to be seen in this patient? A. High fibrinogen B. High vWF C. High D-dimers D. High platelet count

C. High D-dimers

Which of the following is true about alkylating antineoplastic drugs? A. Directly damage DNA via crosslinking B. Cell cycle specific C. Does not cause myelosuppression D. Does not cause secondary cancers

A. Directly damage DNA via crosslinking

Patient presented with granulocytic leukocytosis, basophilia, and normal blast cell count less than 5%. What is the most likely diagnosis? A. Acute Myeloid Leukemia B. Chronic Myeloid Leukemia C. Acute Lymphoblastic Leukemia D. Chronic Lymphocytic Leukemia

B. Chronic Myeloid Leukemia

5 year old boy presented with bone pain, lymphadenopathy and circulating immature cells in his peripheral blood. What would most likely be detected? A. B lymphoblasts B. T lymphocytes C. Myeloid blast cells D. Mature B lymphocytes

A. B lymphoblasts

What is the function of Treg cells? A. Cytotoxic killing of tumor cells B. Activation of B cells C. Suppress immune reaction D. Recruit neutrophils to enhance inflammation

C. Suppress immune reaction

Where do T lymphoblasts mature? A. Bone marrow B. Lymph nodes C. Thymus D. Blood

C. Thymus

Patient presented with lymphadenopathy and anemia. Peripheral blood smear shows increased mature B lymphocytes and spherocytes. What may be the cause for his anemia? A. Pure red cell aplasia B. Acute lymphoblastic leukemia C. Hereditary spherocytosis D. Immune-mediated anemia

D. Immune-mediated anemia

If thrombin synthesis is induced, which of the following will be produced in high levels? A. Factor V B. Fibrin C. Factor X

B. Fibrin

Patient has anemia, thrombocytopenia, and circulating B lymphoblast cells in the peripheral blood. What is the best diagnostic test for the scenario? A. Morphology of bone marrow aspirate B. Immunophenotyping of lymphoblasts C. Cytogenetic analysis D. DNA mapping

no answer given

What is the stem cell niche? A. Growth factors B. Bone marrow microenvironment

B. Bone marrow microenvironment

Which molecule is important in platelet aggregation? A. GP 1b B. GP 2b/3a C. GP 2a

B. GP 2b/3a

A 2 year old child came to the emergency department with difficulty breathing. His CBC was normal. On HB electrophoresis, HbF was very high and HbA was mildly increased. What will be the effect of blood transfusions? A. Increased ineffective erythropoiesis B. Suppress endogenous erythropoiesis C. Reduced iron stores D. Increased HbF

B. Suppress endogenous erythropoiesis

What chemotactically attracts neutrophils? A. Lysozymes B. Cationic protein C. Complement fragments D. Viral components

C. Complement fragments

An asymptomatic 55 year old male had the following: increased WBC count, normal hemoglobin levels, and increased platelet count. Physical examination reveals splenomegaly. Peripheral blood smear reveals granulocytic leukocytosis, with all stages of maturation present, frequent basophils, and occasional circulating blast cells. What is the pathogenic mechanism for the above disease? A. Uncontrolled tyrosine kinase activity B. Genetic instability causing uncontrolled blast cell proliferation C. Gain of function mutation JAK2 gene D. Benign reactive hematopoietic activity E. Ineffective hematopoiesis

A. Uncontrolled tyrosine kinase activity

Heparin acts on which molecule to carry out its effect? A. Antithrombin III B. Topoisomerase II

A. Antithrombin III

Which of the following will most likely result in an anaphylactic reaction? A. Donor’s IgA antibodies B. IgA deficient recipient

B. IgA deficient recipient

Female patient with a swollen left leg had a history of 3 abortions. Her APTT is prolonged. What would you most likely detect in this patient?

Lupus anticoagulant

What is the reason for symptoms of a patient with neonatal purpura fulminans?

Cannot inhibit Factor VIII

What is the mechanism of action of hydroxyurea in treating sickle cell anemia? A. Increases polymerization of Hb S B. Decreases amount of circulating Hb S

B. Decreases amount of circulating Hb S

Why are hemoglobinopathies usually diagnosed in early childhood?

Because the switch from gamma globins to beta globins occurs several months after birth

Patient CBC indicates high hemoglobin, high hematocrit, high platelet count, and JAK 2 mutation. Which of the following features is most likely to be present? A. Oxidative stress to RBCs B. Aplasia C. Panmyelosis

C. Panmyelosis

Why is the fetus not affected in the first pregnancy in terms of hemolytic disease of the newborn? A. Mother predominantly produces anti-Rh IgM B. Rh D is not that immunogenic

A. Mother predominantly produces anti-Rh IgM

Why are the oxygen saturation curve of hemoglobin and myoglobin different?

Cooperativity

The following figure demonstrates the reaction between hemoglobin and CO2. How does this affect hemoglobin? A. Decreases hemoglobin’s affinity to O2 B. Methemoglobin is produced C. CO2 binds to hemoglobin D. Hemoglobin tetramer dissociates

A. Decreases hemoglobin’s affinity to O2

What is homing of stem cells? A. Apoptosis of stem cells B. Movement of stem cells to bone marrow microenvironment

B. Movement of stem cells to bone marrow microenvironment

What is the reason for the production of alloantibodies in hemolytic disease of the newborn?

Exposure to foreign Rh+ RBCs

For what disorder is methylene blue medication used for and what enzyme is involved?

Methemoglobinemia ; NADPH-dependent methemoglobin reductase

What is the main cause of drug-induced acute hepatic porphyria? A. Stimulate CYP450 activity and increase demand for heme B. Inhibits ALA Synthase

A. Stimulate CYP450 activity and increase demand for heme

This diagram shows the sequence of steps in heme biosynthesis. What enzyme catalyzes the first step and what happens if this first step is bypassed? ## Footnote A. ALA Synthase ; heme synthesis is suppressed B. ALA Synthase ; heme overproduction

B. ALA Synthase ; heme overproduction

Patient suffers from beta thalassemia major and requires regular blood transfusions. What is a likely consequence of the regular blood transfusions? ## Footnote A. Increased ineffective erythropoiesis B. Increased fetal hemoglobin C. Oxidative damage to RBCs D. Suppress endogenous erythropoiesis

D. Suppress endogenous erythropoiesis

Where are self-reactive B cells deleted? A. Bone marrow B. Liver C. Spleen D. Lymph nodes

A. Bone marrow

Which of the following is responsible for mast cell degranulation? A. IgE B. IgM C. Defensins D. Major basic protein E. TNF alpha

A. IgE

A newborn female patient presented with fulminant purpura. She has a brother with a similar condition. What is the underlying mechanism? A. High multimeric molecular weight vWF B. Decreased fibrinogen C. Decreased production of plasminogen D. Inability to inhibit Factor VIII E. Thrombocytopenia

D. Inability to inhibit Factor VIII

What is the best diagnostic finding of Chronic Myeloid Leukemia? A. Detect ABL//BCR fusion protein with antibodies B. Conventional karyotyping

A. Detect ABL//BCR fusion protein with antibodies

How Tc cells kill tumor cells?

Apoptosis

Patient presented with back-to-back follicles in lymph node and T (14:18). What is the diagnosis?

Follicular lymphoma

What is a characteristic of pre-conventional thought in Kohlberg Theory? A. Abeer is scared of skipping class because she will have a problem with B. Doha disagrees with school rules but does not want to have a protest without school approval C. Reem does not like skipping school because she is scared of what her friends are going to say about her

A. Abeer is scared of skipping class because she will have a problem with

Dr. Ahmed tells the truth to his patients because he believes that it is his duty to do so and that all doctors should tell the truth to his patients. What philosophy does this demonstrate? ## Footnote A. Virtue ethics B. Unitarism C. Beneficiace D. Kumatlism

D. Kumatlism

If plasma volume increases, which of the following occurs? A. Hematocrit decreases B. RDW increases C. MCV increases D. Hemoglobin increases

A. Hematocrit decreases

How do eosinophils kill worms? A. Cytotoxicity B. Phagocytosis C. Complements D. Opsonization

A. Cytotoxicity

What mediates transfusion reaction of incompatible ABO blood donor & recipient?

Antibodies specific to glycoproteins found on RBCs

What transports iron into the blood?

Ferroportin

Why is CSF used in stem cell donors?

Mobilization (to move stem cells from bone marrow to peripheral blood)

Act on both free and fibrin-bound plasminogen ## Footnote A. Alteplase B. Warfarin C. Heparin D. Enoxaparin E. Streptokinase F. Clopidogrel

E. Streptokinase

Irreversibly inhibits ADP dependent pathway of platelets ## Footnote A. Alteplase B. Warfarin C. Heparin D. Enoxaparin E. Streptokinase F. Clopidogrel

F. Clopidogrel

Drug used to prevent myelosuppression and mucositis during antimetabolite treatment A. Busulfan B. Imatinib C. Leucovorin D. Doxorubicin E. Cyclophosphamide

C. Leucovorin

Adverse effect is cardiotoxicity A. Busulfan B. Imatinib C. Leucovorin D. Doxorubicin E. Cyclophosphamide

D. Doxorubicin

Tyrosine kinase inhibitor A. Busulfan B. Imatinib C. Leucovorin D. Doxorubicin E. Cyclophosphamide

B. Imatinib

Anchors spectrin dimers to RBC plasma membrane A. AE1 B. 4.1 band C. 4.2 band D. Spectrin dimers E. GLUT-1 F. Flippase G. Scramblase H. Ankyrin

A. AE1

ATP-dependent causing asymmetrical plasma membrane phospholipids A. AE1 B. 4.1 band C. 4.2 band D. Spectrin dimers E. GLUT-1 F. Flippase G. Scramblase H. Ankyrin

F. Flippase

Erythema infectiosum caused by A. Measles B. CMV C. HIV D. HTLV I E. EBV F. Parvovirus B19

F. Parvovirus B19

Tropical spastic paraparesis A. Measles B. CMV C. HIV D. HTLV I E. EBV F. Parvovirus B19

D. HTLV I

Iron storage molecule that stains with Prussian Blue stain A. Ferroportin B. Transferrin C. Transcobalamin II D. Cubilin E. Hemosiderin F. Hepcidin

E. Hemosiderin

Transports iron out of duodenal enterocytes A. Ferroportin B. Transferrin C. Transcobalamin II D. Cubilin E. Hemosiderin F. Hepcidin

A. Ferroportin

What factor if deficient can result in severe Hemophilia A? A. Factor V B. Factor VIII C. Factor X D. Prothrombin E. Factor XII

B. Factor VIII

What factor initiates coagulation inside of a plain test tube? A. Factor V B. Factor VIII C. Factor X D. Prothrombin E. Factor XII

E. Factor XII

Abnormal hemoglobin present in 50% of severe cases of beta thalassemia A. Hb S B. Hb H C. Hb E D. Hb E / Beta E. Hb F F. Hb Bart’s

D. Hb E / Beta

Homotetramer of gamma globin chains A. Hb S B. Hb H C. Hb E D. Hb E / Beta E. Hb F F. Hb Bart’s

F. Hb Bart’s

Homotetramer of beta globin chains seen with supravital stain A. Hb S B. Hb H C. Hb E D. Hb E / Beta E. Hb F F. Hb Bart’s

B. Hb H

Anemia due to defect of heme biosynthesis in erythroid precursors A. Sideroblastic anemia B. Iron deficiency anemia C. Anemia of chronic disease D. Megaloblastic anemia E. Aplastic anemia

A. Sideroblastic anemia

Pancytopenia and hypocellular bone marrow due to destruction of hematopoietic stem cells in the bone marrow A. Sideroblastic anemia B. Iron deficiency anemia C. Anemia of chronic disease D. Megaloblastic anemia E. Aplastic anemia

E. Aplastic anemia

Oval macrocytic RBCs and hypersegmented neutrophils A. Sideroblastic anemia B. Iron deficiency anemia C. Anemia of chronic disease D. Megaloblastic anemia E. Aplastic anemia

D. Megaloblastic anemia

Underproduction of RBCs due to impaired utilization of iron A. Sideroblastic anemia B. Iron deficiency anemia C. Anemia of chronic disease D. Megaloblastic anemia E. Aplastic anemia

C. Anemia of chronic disease

Present in extravascular hemolysis A. Spherocytes B. Elliptocytes C. Howell Jolly bodies D. Heinz bodies E. RBC agglutination

A. Spherocytes

Cold autoimmune hemolytic anemia A. Spherocytes B. Elliptocytes C. Howell Jolly bodies D. Heinz bodies E. RBC agglutination

E. RBC agglutination

Used in crossmatching A. ABO blood group B. Rh blood group C. Ab screening D. Crossmatching E. DAT F. IAT G. Autoantibodies H. Alloantibodies

F. IAT | (not sure)

Used in antibody screening A. ABO blood group B. Rh blood group C. Ab screening D. Crossmatching E. DAT F. IAT G. Autoantibodies H. Alloantibodies

E. DAT | (not sure)

Its most immunogenic antigen is antigen D A. ABO blood group B. Rh blood group C. Ab screening D. Crossmatching E. DAT F. IAT G. Autoantibodies H. Alloantibodies

B. Rh blood group

More common in platelet concentrate transfusions A. Circulatory overload B. Graft vs. Host disease C. Bacterial contamination D. Alloimmunization E. Febrile non-hemolytic reaction F. TRALI G. Hemolytic transfusion reaction

C. Bacterial contamination

More common in elderly A. Circulatory overload B. Graft vs. Host disease C. Bacterial contamination D. Alloimmunization E. Febrile non-hemolytic reaction F. TRALI G. Hemolytic transfusion reaction

A. Circulatory overload

Due to labeling error A. Circulatory overload B. Graft vs. Host disease C. Bacterial contamination D. Alloimmunization E. Febrile non-hemolytic reaction F. TRALI G. Hemolytic transfusion reaction

G. Hemolytic transfusion reaction

Inhibits t-PA A. TAFI B. TPFI C. PAI-1 D. Antiplasmin E. Nitric Oxide

C. PAI-1

Inhibits platelet function and promotes vasodilation A. TAFI B. TPFI C. PAI-1 D. Antiplasmin E. Nitric Oxide

E. Nitric Oxide

Stimulated by thrombopoietin A. Neutrophils B. Eosinophils C. Megakaryocytes D. Monocytes E. B lymphocytes F. Thymocytes G. Cytotoxic T cells

C. Megakaryocytes

Stimulated by macrophage colony stimulating factor A. Neutrophils B. Eosinophils C. Megakaryocytes D. Monocytes E. B lymphocytes F. Thymocytes G. Cytotoxic T cells

D. Monocytes

Causes apoptosis of tumor cells A. Neutrophils B. Eosinophils C. Megakaryocytes D. Monocytes E. B lymphocytes F. Thymocytes G. Cytotoxic T cells

G. Cytotoxic T cells

Patient presented with M protein of 18 g/L. She had normal-low calcium levels and normal total serum protein A. MGUS B. Plasma cell myeloma C. Plasmacytoma D. Follicular lymphoma E. Amyloidosis F. Light chain disease

A. MGUS

Patient presented with spontaneous fracture, Bence Jones protein in the urine, and monoclonal spike due to IgG with kappa light chain paraprotein. A. MGUS B. Plasma cell myeloma C. Plasmacytoma D. Follicular lymphoma E. Amyloidosis F. Light chain disease

B. Plasma cell myeloma

2 year old boy presented with intracranial hemorrhage. He has a normal coagulation profile. A. Hemophilia A B. ITP C. Factor V D. DIC E. Vitamin K deficiency F. Platelet dysfunction G. Factor XIII

G. Factor XIII

17 year old girl presented with prolonged bleeding after tooth extraction. She has had recurrent episodes of epistaxis since childhood. Her coagulation profile and CBC are both normal A. Hemophilia A B. ITP C. Factor V D. DIC E. Vitamin K deficiency F. Platelet dysfunction G. Factor XIII

F. Platelet dysfunction

Patient with an infection was on multiple antibiotics. He was then taken to the ICU where he is now recovering from the infection. One week later, his PT and APTT are prolonged. His CBC is normal. A. Hemophilia A B. ITP C. Factor V D. DIC E. Vitamin K deficiency F. Platelet dysfunction G. Factor XIII

E. Vitamin K deficiency

An elderly woman presented with recurrent infections and hypogammaglobulinemia A. Polycythemia vera B. Plasma cell myeloma C. Acute lymphocytic leukemia D. Chronic lymphocytic leukemia E. Chronic myeloid leukemia F. Follicular lymphoma G. Hodgkin’s lymphoma

B. Plasma cell myeloma or D. Chronic lymphocytic leukemia

35 year old male has BCR-ABL fusion gene. A. Polycythemia vera B. Plasma cell myeloma C. Acute lymphocytic leukemia D. Chronic lymphocytic leukemia E. Chronic myeloid leukemia F. Follicular lymphoma G. Hodgkin’s lymphoma

E. Chronic myeloid leukemia

Patient’s tests indicate presence of CD 19, CD 10, and TDT A. Polycythemia vera B. Plasma cell myeloma C. Acute lymphocytic leukemia D. Chronic lymphocytic leukemia E. Chronic myeloid leukemia F. Follicular lymphoma G. Hodgkin’s lymphoma

C. Acute lymphocytic leukemia

2017 module exam Flashcards

(114 cards)