B4M1 23-24

Question 1

Which essential property of hematopoietic stem cells is required to avoid stem cell depletion?
A. Self-renewal
B. Pluripotency
C. Restricted differentiation potential
D. Commitment to specialized cell population

Answer 1

A. Self-renewal

Question 2

Which of the following characteristics best describes Interleukin-3 ?
A. It induces growth for specific types of stem cells.
B. It is controlled by factors outside the bone marrow.
C. It promotes growth of all types of stem cells.
D. It causes one type of stem cell to differentiate.

Answer 2

C. It promotes growth of all types of stem cells.

Question 3

Which stage is the last nucleated erythrocyte stage in the maturation of red cells?
A. Reticulocyte
B. Rubricyte
C. Rubriblast
D. Metarubricyte

Answer 3

D. Metarubricyte

Question 4

If eosinophils function to kill helminthic and other parasites, which of the following is a
function of basophils?
A. kill bacteria
B. phagocytose virus
C. regulate adaptive immunity
D. release histamine during allergy

Answer 4

D. release histamine during allergy

Question 5

Which of the following statements correctly describes the general features of eosinophils?
A. Once eosinophils migrate to the tissues, they are able to return to the peripheral circulation.
B. From the blood, eosinophils move towards areas localized in the inner most organs.
C. The half life of eosinophils in blood is about 4 hours.
D. The highest eosinophil counts occur early in the morning.

Answer 5

A. Once eosinophils migrate to the tissues, they are able to return to the peripheral circulation.

Question 6

Which of the following characteristics must an erythrocyte membrane possess to be effective
in hemoglobin delivery?
A. It is able to change in shape.
B. It is firm and strong.
C. It is thick and rounded.
D. It is round and coarse.

Answer 6

A. It is able to change in shape.

Question 7

A person who lives in high attitudes will have increased red blood cell production due to
increased production of a hormone that comes from which of the following organs:
A. Liver
B. Bone marrow
C. Spleen
D. Kidney

Answer 7

D. Kidney

Question 8

Which of the following differentiates the granules found in eosinophils to those found in
neutrophils?
A. The presence of peroxidase.
B. The presence of phagocytic and bactericidal cationic proteins.
C. The lack of lysozyme.
D. The lack of B-glucuronidase.

Answer 8

C. The lack of lysozyme.

Question 9

What is the principal growth factor for basophilic growth?
A. IL-1
B. GM-CSF
C. Eosinophilic factor A
D. IL-3

Answer 9

D. IL-3

Question 10

Which of the following is the leukocyte picture seen in starvation?
A. Neutrophilia
B. Neutropenia
C. Lymphocytosis
D. Lymphopenia

Answer 10

B. Neutropenia
D. Lymphopenia

Question 11

AZ, 6 years old, female, was so excited because it was the first time she tried crabs for
dinner. After a few minutes of eating crabs, she suddenly felt abdominal pain and developed
shortness of breath. At the ER, AZ was noted to have urticaria. The physician ordered a CBC
test. Which of the following would be seen in the CBC results?
A. Neutrophilia
B. Lymphocytosis
C. Basophilia
D. Presence of band cells and monocytosis

Answer 11

C. Basophilia

Question 12

Which statement best describes agranulocytes?
A. They are characterized by the presence of large cytoplasmic granules.
B. They lack visible cytoplasmic granules under a light microscope.
C. They are primarily involved in allergic reactions and histamine release.
D. They are the most abundant type of white blood cells in the human body.

Answer 12

B. They lack visible cytoplasmic granules under a light microscope.

Question 13

Which of the following is the characteristic morphology of a monocyte?
A. Small, round cell with a large round nucleus and a small amount of cytoplasm
B. Large cell with a kidney-shaped or horseshoe-shaped nucleus and abundant cytoplasm
C. Small cell with a multilobed nucleus and abundant cytoplasmic granules
D. Large cell with a single round nucleus and minimal cytoplasmic volume

Answer 13

B. Large cell with a kidney-shaped or horseshoe-shaped nucleus and abundant cytoplasm

Question 14

Which of the following statements accurately describes the physiologic purpose of functional
circulating fragments of megakaryocytes?
A. maintain the integrity of blood volume
B. form hemodynamic plugs
C. accelerate blood loss from injured vessels
D. promote coagulation of plasma factors

Answer 14

D. promote coagulation of plasma factors

Question 15

The chromatin observed when viewing a megakaryocyte under high magnification is
characterized to have which distinctive pattern?
A. scattered and hazy
B. pyknotic with central condensation
C. fine and concentric
D. linear and coarse

Answer 15

D. linear and coarse

Question 16

Which part of a complete blood count (CBC) calculates the blood’s red blood cell
percentage?
A. Hemoglobin
B. Hematocrit
C. Leukocytes
D. Blood components

Answer 16

B. Hematocrit

Question 17

Which is the role of platelets in the process of blood clotting?
A. Platelets play a crucial role in blood clotting by forming a plug at the site of injury, releasing
clotting factors, and promoting the formation of fibrin strands to stabilize the clot.
B. The creation of collagen strands to stabilize the clot, the release of clotting factors, and the
formation of a plug at the site of injury are all ways in which platelets contribute significantly to
blood clotting.
C. Platelets regulate blood vessel hemostasis by dilatation of blood vessels to prevent blood
from leaking.
D. Platelets normally take 1-2 hours to adhere to the injured site to promote blood clotting.

Answer 17

A. Platelets play a crucial role in blood clotting by forming a plug at the site of injury, releasing

Question 18

In order to directly compute for the Mean Corpuscular Volume (MCV), which of the following
data would you directly need?
A. Hematocrit and white blood cell count
B. Hemoglobin and platelet count
C. Hematocrit and red blood cell count
D. Hemoglobin and mean corpuscular volume concentration

Answer 18

C. Hematocrit and red blood cell count

Question 19

You were interpreting results of a patient’s complete blood count and noted that there is a
reduction of the absolute neutrophil count (ANC). What would occur as a direct result?
A. Lymphocytosis
B. Neutropenia
C. Monocytosis
D. Decreased Platelet Count

Answer 19

B. Neutropenia

Question 20

I. 2 succinyl-CoA + 2 glycine → pyrrole
II. 4 pyrrole → protoporphyrin IX
III. protoporphyrin IX + Fe++ → heme
IV. heme + polypeptide → hemoglobin chain (α or β)
V. 2 α chains + 2 β chains → hemoglobin A

In the figure shown above, which step is considered the rate-limiting step in the synthesis of
hemoglobin?
A. V
B. IV
C. I
D. III

Answer 20

C. I

Question 21

What would result if formation of complexes with metal ions bound to the nitrogen atom of
the pyrrole rings occurs?
*A. Formation of porphyrin
B. Formation of isomeric proteins
C. Conformational changes in a polypeptide chain
D. Construction of a tetramer

Answer 21

A. Formation of porphyrin

Question 22

Which of the following is the biochemical structure of hemoglobin composed of?
A. 2 units of succinyl-coA and 2 units of glycine
B. Protoporphyrin IX and ferrous iron
*C. 4 polypeptide heme chains
D. 2 different polypeptide units forming a pentamer

Answer 22

C. 4 polypeptide heme chains

Question 23

This form of hemoglobin has lost its capacity to carry oxygen and carbon dioxide due to the
oxidation of iron from ferrous state to the ferric state:
A. Carboxyhemoglobin
B. Hemoglobin
*C. Methemoglobin
D. Sulfhemoglobin

Answer 23

C. Methemoglobin

Question 24

In the chemistry of hemoglobin, it is pointed out that O2 molecules combine loosely and
reversibly with the heme portion of hemoglobin. When PO2 is _______ as in the pulmonary
capillaries, O2 _______ with hemoglobin.
A. low, binds
*B. high, binds
C. low, unbinds
D. high, unbinds

Answer 24

B. high, binds

Question 25

This behavior of hemoglobin permits hemoglobin to maximize both the quantity of O2 loaded at the PO2 of the lungs and the quantity of O2 released at the PO2 of the peripheral tissues A. Hemoglobin hydration B. Hemoglobin transition C. Cooperative transition *D. Cooperative binding

Answer 25

D. Cooperative binding

Question 26

Which types of globin chains are the most common and form adult hemoglobin? A. Alpha and lambda B. Alpha and gamma C. Alpha and delta *D. Alpha and beta

Answer 26

D. Alpha and beta

Question 27

Which of the following correctly describes the most important feature of hemoglobin? A. Its ability to transform molecular oxygen to ionic oxygen *B. Its ability to combine loosely and reversibly with oxygen C. Its ability to deliver oxygen to hypoxic tissues D. Its ability to gather oxygen and deliver to hypoxic tissues

Answer 27

B. Its ability to combine loosely and reversibly with oxygen

Question 28

Which of the following correctly describes lymphocytes? A. B cells are a minor population (30% to 40% of the lymphocytes), probably have a short life span measured in days (with the exception of memory B cells), and are distinguished by the presence of considerable immunoglobulin on their surface membranes. B. Majority of circulating lymphocytes are B cells that have a life span of months to years. C. B cells are a major population (60% to 80% of the lymphocytes), probably have a short life span measured in days (with the exception of memory B cells), and are distinguished by the presence of considerable immunoglobulin on their surface membranes. *D. Majority of circulating lymphocytes are T cells that have a life span of months to years.

Answer 28

D. Majority of circulating lymphocytes are T cells that have a life span of months to years.

Question 29

How do eosinophils function during a parasitic infection? A. They generate reducing agents which are toxic to helminths.. B. They mediate immediate hypersensitivity reactions. C. They express chemokine receptor CCRE. *D. They release cationic proteins and oxidants from granules.

Answer 29

D. They release cationic proteins and oxidants from granules.

Question 30

Which of the following is the rate limiting factor in causing blood coagulation? A. Formation of prothrombin activator B. Sufficient amount of ionic Calcium C. Conversion of prothrombin to thrombin D. Polymerization of fibrinogen molecules into fibrin fibers

Answer 30

A. Formation of prothrombin activator

Question 31

This coagulation factor belongs to the Vitamin K dependent group and needs this vitamin for its synthesis in the liver: A. Proaccelerin B. Proconvertin C. Plasma thromboplastin antecedent D. Fibrin stabilizing factor

Answer 31

B. Proconvertin

Question 32

It is a single chain Υ globulin produced in the liver and is present in the serum: A. Fibrinogen *B. Prekallikrein C. Anti-hemophilic B factor D. Hageman factor

Question 33

This factor is a lipoprotein found in most tissues of the body, with an increased concentration in the lungs and brain: A. III B. IV C. V D. VII

Answer 33

A. III

Question 34

Among the substances listed below, which one is an anticoagulant? A. Thrombomodulin B. Platelet phospholipids C. Thromboplastin D. Prothrombin

Answer 34

A. Thrombomodulin

Question 35

Glycocalyx, a mucopolysaccharide adsorbed to the surface of the endothelium, exerts its intravascular anticoagulant property by: A. removing thrombin from the blood. B. preventing contact activation of the intrinsic clotting system. C. inactivating activated Factors V and VIII. D. repelling clotting factors, preventing clotting activation.

Answer 35

D. repelling clotting factors, preventing clotting activation.

Question 36

While reviewing for a module quiz in Hematology, your 12-year old sister asked you why blood normally does not clot inside the blood vessels. Which of the following explanations would correctly answer her question? A. Presence of abundant heparin, which is an anticoagulant, in the vascular system B. The plasma contains a large amount of circulating plasmin that digests the clot. C. The rapid flow of blood inside the blood vessels instantly dislodges the clot. D. Due to the smooth endothelium, adsorbed glycocalyx and thrombomodulin

Answer 36

D. Due to the smooth endothelium, adsorbed glycocalyx and thrombomodulin

Question 37

When a blood vessel is injured, prevention of major blood loss is achieved by clot or thrombus formation. Upon healing of the injured blood vessel, the thrombus is lysed through: A. Polymerization which converts insoluble fibrinogen to soluble fibrin. B. Activation of plasminogen to plasmin by tissue plasminogen activator. C. The catalytic action of thrombin in cleaving small peptides from fibrin. D. Activation of the series of serine protease-mediated cleavage events.

Answer 37

B. Activation of plasminogen to plasmin by tissue plasminogen activator.

Question 38

APTT is used to assess the intrinsic coagulation mechanism, by measuring which of the following factors? A. Factor XIII B. Factor III C. Factor VII D. Factor VIII

Answer 38

D. Factor VIII

Question 39

A patient with low levels of fibrinogen undergoes a capillary fragility test. Which of the following would indicate a positive result? A. Whitening of the forearm B. Very few amounts of petechiae above the pressure point C. Numerous petechiae in the forearm D. Moderate amount of paresthesia at the forearm region

Answer 39

C. Numerous petechiae in the forearm

Question 40

What is the most important in-vivo activator of Factor X? A. Factor VIIa + Tissue Factor complex B. Factor IXa + Factor VIIIa complex C. Factor VIIIa + Tissue Factor complex D. Factor IXa + Factor VIIa complex

Answer 40

B. Factor IXa + Factor VIIIa complex

Question 41

Heme is synthesized by the incorporation of ferrous ion (Fe++) into protoporphyrin III being catalyzed by the enzyme: A. Ferroxidase B. Ferrochelatase C. Ferroreductase D. Ferroamidase

Answer 41

B. Ferrochelatase

Question 42

Where does heme synthesis occur? A. Cytoplasm B. Ribosomes C. Membrane D. Mitochondrial matrix

Answer 42

D. Mitochondrial matrix

Question 43

The committed step for the synthesis of heme is catalyzed by which enzyme? A. Reductase B. Oxidase C. Synthase D. Lyase

Answer 43

C. Synthase

Question 44

By weight, which of the following is the major location of heme synthesis: A. Liver B. Intestines C. Stomach D. Mouth

Answer 44

A. Liver

Question 45

Which of the following amino acids is the starting material for heme synthesis? A. Aspartate B. Glutamine C. Glycine D. Histidine

Answer 45

C. Glycine

Question 46

Which of the following is the first hemostatic response to blood vessel injury? A. Growth of fibrous tissue B. Formation of platelet plug C. Blood clot production D. Vascular constriction

Answer 46

D. Vascular constriction

Question 47

With normally functioning platelets, at which level is spontaneous bleeding generally expected? A. Platelet count of >50,000 -100,000 per microliter B. Platelet count of 20,000 - 50,000 per microliter C. Platelet count of <20,000 per microliter D. Platelet count of <10,000 per microliter

Answer 47

C. Platelet count of <20,000 per microliter

Question 48

Factor X is also known as: A. Prothrombin B. Stuart-Prower Factor C. Hageman Factor D. Tissue Factor

Answer 48

B. Stuart-Prower Factor

Question 49

Which of the following events is generally associated with primary hemostasis? A. Endothelin release B. Platelet activation C. Fibrin polymerization D. Release of thrombomodulin

Answer 49

B. Platelet activation

Question 50

Secondary hemostasis refers to _____ at the site of injury. A. formation of platelet plug B. arteriolar vasoconstriction C. clot stabilization D. deposition of fibrin

Answer 50

D. deposition of fibrin