HEMATO DSE

Question 1

1. Pernicious anemia is caused by deficiency of ________ .

(a) Folic acid
(b) Vitamin B12
(c) Vitamin B6
(d) Vitamin B1

Answer 1

(b) It is a megaloblastic anemia caused by poor absorption
of vitamin B12 or extrinsic factor, due to absence of an
intrinsic factor in the parietal cells of the lining mucosa of
stomach.

Question 2

2. The deficiency of vitamin B12 in pernicious anemia is caused by
   lack of

(a) von Willebrands factor
(b) Extrinsic factor of Castle
(c) Intrinsic factor of Castle
(d) Christmas factor

Answer 2

(c) The yet unidentified intrinsic factor of castle is produced
by the parietal cells of stomach mucosa. It has been proved
that absence of this factor leads to poor absorption of
vitamin B12.

Question 3

4. Aplastic anemia usually results in
   (a) Polycythemia (b) Agranulocytosis
   (c) Neutropenia (d) Pancytopenia

Answer 3

(d) It is characterized by failure of the hematopoietic precursor
cells in the bone marrow to produce adequate numbers of
all types of blood cells thus leading to pancytopenia.

Question 3

3. The average daily requirement of vitamin B12 for an adult is about

(a) 2.4 µg
(b) 1 mg
(c) 1 g
(d) 1 dL

Answer 3

(a) Vitamin B12 is a nutrient that helps keep the body’s nerve
and blood cells healthy and helps make DNA. As per the
FDA guidelines,The recommended dietary intake as per the
FDA (USA) guidelines is about 2.4 µg for a normal healthy
adult.

Question 4

5. Which amongst the following antibiotics is strongly associated
   with pancytopenia?
   (a) Chloramphenicol (b) Sulfonamides
   (c) Ciprofloxacin (d) Penicillins

Answer 4

(a) Chloramphenicol has been strongly implicated in causing
aplastic anemia leading to pancytopenia due to its effect on
the hematopoietic cells.

Question 5

6. All of the following except ____ are lab findings associated with
   thalassemia.

(a) Macrocytic normochromic RBCs
(b) Hypochromic microcytic RBCs
(c) Nucleated RBCs in circulating blood
(d) Elevated WBC count up to 10,000–25,000 per cc of blood

Answer 5

(a) Macrocytic normochromic red blood cells are a feature of
pernicious anemia.

Question 6

7. The characteristic radiographic change produced in the skulls of
   thalassemic persons is termed as ________ appearance.

(a) Cotton wool (b) Ground glass
(c) Hair on end (d) Peau d’ orange

Answer 6

(c) This appearance is produced due to extreme thickening
of diploe and the trabeculae between the inner and outer
cortical plates becoming elongated.

Question 7

8. Sickle cell anemia occurs almost exclusively in blacks and in
   whites of ______ origin.

(a) Mediterranean
(b) Slavic
(c) Russian
(d) American

Answer 7

(a) Sickle cell anemia is a hereditary type of Mendelian
dominant, nonsex-linked chronic hemolytic anemia
that occurs almost exclusively in blacks and in whites of
mediterranean origin.

Question 8

9. Compared to the normal 120 day lifespan of normal erythrocytes,
   the sickle-shaped RBCs have a lifespan of only

(a) 30–40 days
(b) 10–20 days
(c) 3–5 days
(d) 50–60 days

Answer 8

(b) In this disease, normal adult hemoglobin HbA is genetically
altered to sickle hemoglobin HbS. This altered hemoglobin
molecule undergoes gelation or crystallization to distort
the shape of RBC to sickle shape when it is deoxygenated
as happens in cases of exercise, infection, pregnancy or
administration of general anesthesia

Question 9

10. Ground sections of teeth stained by blood pigments in infants
    suffering from erythroblastosis fetalis shows the presence of

(a) Bilirubin
(b) Biliverdin
(c) Bilinogen
(d) Hemoglobin

Answer 9

(a) It is a congenital hemolytic anemia brought about by Rh
factor incompatibility between mother’s blood and that of
the infant. Fetal hemolysis occurs when mother’s antibodies to Rh factor leaks through the placenta. The bilirubin
produced due to hemolysis gets deposited in the teeth of
infants giving them a green, brown or bluish discoloration.

Question 10

11. Patterson Kelly syndrome is one of the manifestations of
    deficiency of
    (a) Vitamin B12
    (b) Folic acid
    (c) Iron
    (d) Calcium

Answer 10

(c) It is a rare condition characterized by iron deficiency anemia,
in conjunction with glossitis and dysphagia.

Question 11

12. Which amongst the following is usually the cause of faulty
    absorption of iron?

(a) Chronic blood loss
(b) Inadequate dietary intake
(c) Achlorhydria
(d) Increased iron requirement

Answer 11

(c) Achlorhydria referes to absence of gastric hydrochloric
acid. In the absence of hydrochloric acid, conversion of
unabsorbable dietary ferric iron to absorbable ferrous state
is impaired.

Question 12

13. An apparent increase in the number of circulating RBCs occurring
    as a result of loss blood fluid with hemoconcentration of cells is
    called as

(a) Relative polycythemia
(b) Polycythemia rubra vera
(c) Secondary polycythemia
(d) True polycythemi

Answer 12

(a) Relative polycythemia is not an actual disease and is usually
caused by loss of blood with resultant hemoconcentration.
It is seen often in cases of chronic vomiting, diarrhea or loss
of electrolytes with accompanying loss of water.

Question 13

15. Cyclic neutropenia refers to a periodic/cyclic reduction in
    circulating

(a) Leukocytes
(b) Polymorphonuclear leukocytes
(c) Lymphocytes
(d) Monocytes

Answer 13

(b) It is a rare idiopathic hematologic disorder characterized by
regular periodic reduction in the neutrophils of the affected
patient. The underlying pathology seems to be related to a
defect in the hematopoietic stem cells in bone marrow.

Question 13

14. Which amongst the following is not a form of leukopenia?

(a) Agranulocytosis
(b) Chédiak-Higashi syndrome
(c) Cyclic neutropenia
(d) Infectious mononucleosis

Answer 13

(d) Infectious mononucleosis is a viral disease caused by
Epstein-Barr virus and is characterized by fever, sore throat,
lymphadenopathy and splenomegaly. Blood investigations
reveal leukocytosis which is invariably a lymphocytosis.

Question 14

16. Infectious mononucleosis is caused by

(a) Epstein-Barr virus
(b) Cytomegalovirus
(c) Varicella zoster virus (d) Staph. aureus

Answer 14

(a) The Epstein-Barr virus is also implicated in the causation
of Burkitt’s lymphoma, nasopharyngeal carcinoma
and lymphoblastic leukemia. An important means of
transmission of this virus in this disease is through deep
kissing which results in exchange of saliva.

Question 15

17. The _________ lymph nodes are usually the first nodes to enlarge
    in infectious mononucleosis.

(a) Axillary
(b) Cervical
(c) Submandibular
(d) Inguinal

Answer 15

(b) Lymphadenopathy is one of the prominent signs of this
disease, with cervical lymph nodes usually the first ones to
enlarge followed by those of axilla and groin.

Question 16

18. The chromosomal abnormality observed in 85% to 90% of patients
    suffering from chronic myeloid leukemia is in

(a) Chromosome 21
(b) Chromosome 27
(c) Chromosome 23
(d) Chromosome 22

Answer 16

(d) Leukemias are believed to arise from a combination of
genetic and environmental factors, with Philadelphia
chromosome an abnormality of chromosome 22 being
observed in 85–90 percent of patients suffering from chronic
myeloid leukemia.

Question 17

19. Lymph node enlargement is not a common occurrence in _______
    leukemia.
    (a) Acute lymphoid
    (b) Chronic myeloid
    (c) Chronic lymphoid
    (d) Acute monocytic

Answer 17

(b) Lymphadenopathy is not generally observed in leukemias
of myeloid series as they involve the cells of granulocyte
series, i.e. PMNL, eosinophils and basophils.

Question 18

20. A positive Paul-Bunnell test showing a titer up to 1:4096 is
    characteristic and pathognomonic of

(a) Leukemia
(b) Infectious mononucleosis
(c) Agranulocytosis
(d) Chédiak-Higashi syndrome

Answer 18

(b) Normal titer of agglutinins and hemolysins in human blood
against sheep RBCs does not exceed 1:8, but in infectious mononucleosis, this is raised to above 1:4096. This is referred
to as a positive Paul-Bunnell test and is pathognomonic of
this disease.

Question 19

21. Purpura is defined as a purplish discoloration of
    (a) Bones
    (b) Eyes
    (c) Skin
    (d) Teeth

Answer 19

(c) Purpura is defined as a purplish discoloration of skin and
mucous membranes owing to spontaneous extravasation
of blood

Question 20

22. Indicate which amongst the following is not a clotting factor?
    (a) Calcium (b) Hageman factor
    (c) von Willebrand factor (d) Christmas factor

Answer 20

(c) von Willebrand’s factor is not a factor but the name of a
hereditary disease characterized by tendency for excessive
bleeding in patients who have a normal platelet count,
normal clotting and prothrombin time and normal serum
fibrinogen levels. Only the bleeding time is prolonged.

Question 21

23. Which of the following tests is normal in idiopathic thrombocytopenic purpura?

(a) Clotting time
(b) Bleeding time
(c) Tourniquet test
(d) Capillary fragility

Answer 21

(a) Thrombocytopenia is a hematologic disorder that is
characterized by a markedly decreased number of
circulating blood platelets. The idiopathic form of this
disorder is believed to be an autoimmune disease in which
the body forms antibodies against its own platelets.

Question 22

24. The clotting factor deficient in hemophilia C is
    (a) Factor VIII (b) Factor XI
    (c) Factor X (d) Factor IX

Answer 22

(b) Hemophilia is classified into three types based on the
deficiency of clotting factors into—hemophilia A (factor
VIII), hemophilia B (factor IX) and hemophilia C (factor
XI). Out of these, hemophilia A is the most common

Question 23

25. Christmas disease is also known as

(a) von Willebrand’s disease
(b) Hemophilia A
(c) Hemophilia C
(d) Hemophilia B

Answer 23

(d) Hemophilia B is also known a Christmas disease so named
after the name of the first patient in whom it was discovered.
Even the clotting factor which is deficient (factor IX or
plasma thromboplastin component) is sometimes referred
to as christmas factor.

Question 24

26. Which of the tests is abnormal in hemophilia?

(a) Prothrombin time
(b) Bleeding time
(c) Platelet aggregation
(d) Clotting time

Answer 24

(d) The characteristic defect of hemophilia is abnormally
prolonged coagulation time, with bleeding and
prothrombin time as well as platelet aggregation being
normal

Question 25

27. Parahemophilia is due to absence of factor

(a) V
(b) Calcium
(c) VII
(d) XII

Answer 25

(a) Factor V also called proaccelerin or labile factor is one of
the substances responsible for conversion of prothrombin
to thrombin. Parahemophilia is thought to be transmitted as
an autosomal recessive trait with both sexes being affected.

Question 26

28. Pseudohemophilia is also known as

(a) Christmas disease
(b) Bleeder’s disease
(c) von Willebrand’s disease
(d) Idiopathic thrombocytopenic purpura

Answer 26

(c) It is an inherited disease transmitted as an autosomal
dominant trait with both sexes being affected. This disease is
caused by a decrease in all the three functional components
of factor VIII, while classic hemophilia is caused by
deficiency of only one of the three functional components
of factor VIII.

Question 27

29. Congenital aplastic anemia associated with a variety of congenital
    defects including bone defects, hypogenitalism and generalized
    olive brown skin pigmentation is called

(a) Fanconi syndrome
(b) Reye syndrome
(c) Down syndrome
(d) Patterson Kelly syndrome

Answer 27

(a) Primary aplastic anemia is one of the primary components of this syndrome. Apart from Fanconi’s syndrome,
dyskeratosis congenita is also many times associated with
aplastic anemia

Question 28

30. Cooley’s anemia is also known as

(a) Sickle cell anemia
(b) Thalassemia
(c) Erythroblastosis fetalis (d) Sprue

Answer 28

(b) Also called erythroblastic anemia, thalassemia occurs in two
types—α thalassemia when there is deficient synthesis of
the α chain on hemoglobin and β thalassemia when there
is deficient synthesis of the β chain.