Physiology

Question 1

Which type of blood cell can come from either myeloid or lymphoid progenitor cells?

Answer 1

Dendritic cells

Question 2

The common myeloid progenitor (CMP) cell can develop into the megakaryocyte erythroid progenitor (MEP)- what mature cells can these differentiate into?

Answer 2

Platelets or erythrocytes

Question 3

The common myeloid progenitor (CMP) cell can develop into the granulocyte macrophage progenitor (GMP)- what mature cells can these differentiate into?

Answer 3

Granulocytes (neutrophils, basophils, eosinophils) and monocytes (macrophages)

Question 4

Other than dendritic cells, what mature cells can common lymphoid progenitor cells differentiate into?

Answer 4

B cells, T cells or natural killer cells

Question 5

At what stage in erythropoiesis is the nucleus lost?

Answer 5

Just before becoming a reticulocyte (late normoblast phase)

Question 6

What do reticulocytes contain than mature erythrocytes do not?

Answer 6

RNA

Question 7

Which cell is this describing: a segmented nucleus (polymorph) which has neutral staining granules?

Answer 7

Neutrophils

Question 8

Which cell is this describing: a bi-lobed cells with bright orange/red granules?

Answer 8

Eosinophils

Question 9

Which cell is this describing: contains large deep purple granules obscuring the nucleus?

Answer 9

Basophils

Question 10

What chains is adult haemoglobin composed of?

Answer 10

2 x alpha and 2 x beta chains

Question 11

What chains is foetal haemoglobin composed of?

Answer 11

2 x alpha and 2 x gamma chains

Question 12

Which of the following does oxygen bind to: Fe2+ or Fe3+?

Answer 12

Fe2+

Question 13

When hypoxia is sensed by the kidneys, what is produced in order to stimulate erythrocyte production?

Answer 13

Erythropoietin

Question 14

Where does destruction of erythrocytes normally take place?

Answer 14

Spleen

Question 15

When an erythrocyte is destroyed, a haem group is broken down into what two things?

Answer 15

Iron and bilirubin

Question 16

In erythrocytes, glutathione reacts with hydrogen peroxide to form water and GSSG- what is the rate-limiting enzyme in this process?

Answer 16

Glucose-6-phosphate dehydrogenase

Question 17

How is the majority of CO2 transported in the blood?

Answer 17

As bicarbonate

Question 18

In what direction does foetal haemoglobin shift the oxygen-haemoglobin dissociation curve?

Answer 18

To the left

Question 19

Shifting the oxygen-haemoglobin dissociation curve to the right suggests what?

Answer 19

There is less oxygen bound to haemoglobin, and more given to the tissues

Question 20

Shifting the oxygen-haemoglobin dissociation curve to the left suggests what?

Answer 20

There is more oxygen bound to haemoglobin, and less given to the tissues

Question 21

What must happen to the pH for the oxygen-haemoglobin dissociation curve to shift right?

Answer 21

Decreased

Question 22

What must happen to the 2, 3-DPG for the oxygen-haemoglobin dissociation curve to shift right?

Answer 22

Increased

Question 23

What must happen to the temperature for the oxygen-haemoglobin dissociation curve to right?

Answer 23

Increased

Question 24

What must happen to the pH for the oxygen-haemoglobin dissociation curve to be shifted left?

Answer 24

Increased

Question 25

What must happen to the 2, 3-DPG for the oxygen-haemoglobin dissociation curve to be shifted left?

Answer 25

Decreased

Question 26

What must happen to the temperature for the oxygen-haemoglobin dissociation curve to be shifted left?

Answer 26

Decreased

Question 27

How much iron is absorbed per day? Where is most iron absorbed?

Answer 27

1mg, mostly absorbed in the duodenum

Question 28

Where can iron be taken to once it has been absorbed?

Answer 28

To the liver for storage or to the bone marrow to make haem

Question 29

How much iron is lost per day?

Answer 29

1mg

Question 30

What is iron bound to in the plasma?

Answer 30

Transferrin

Question 31

What are some examples of drugs which may limit the absorption of iron?

Answer 31

PPIs and calcium supplements

Question 32

What molecule is responsible for facilitating iron export from cells and passing it onto transferrin for transport elsewhere?

Answer 32

Ferroportin

Question 33

What molecule is the major negative regulator of iron uptake, that works by degrading ferroportin so iron is effectively 'trapped' inside cells?

Answer 33

Hepcidin

Question 34

If there is plentiful iron, what happens to the levels of hepcidin and ferroportin?

Answer 34

Increased hepcidin, decreased ferroportin

Question 35

If there is iron deficiency, what happens to the levels of hepcidin and ferroportin?

Answer 35

Decreased hepcidin, increased ferroportin

Question 36

Transferrin will only bind to iron in what state- Fe2+ or Fe3+?

Answer 36

Fe3+

Question 37

If someone is in iron overload, what happens to transferrin saturation?

Answer 37

Increased

Question 38

If someone is iron deficient, what happens to transferrin saturation?

Answer 38

Decreased

Question 39

What molecule is a spherical intracellular protein that stores many Fe3+ ions?

Answer 39

Ferritin

Question 40

Why is an increase in serum ferritin not specific for iron overload?

Answer 40

It is an acute phase protein

Question 41

What happens to the level of serum ferritin in iron deficiency?

Answer 41

Decreased

Question 42

What happens to the level of serum ferritin in iron overload?

Answer 42

Increased

Question 43

What is the lifespan of a red blood cell?

Answer 43

120 days

Question 44

What is the lifespan of a platelet?

Answer 44

7-10 days

Question 45

What is the lifespan of a neutrophil?

Answer 45

7-8 hours

Question 46

Which type of lymphocyte is responsible for mediating humoral immunity?

Answer 46

B cells

Question 47

Which type of lymphocyte is responsible for mediating cell mediated immunity?

Answer 47

T cells

Question 48

Which type of lymphocyte has anti-viral/anti-tumour properties?

Answer 48

Natural killer cells

Question 49

What are blast cells? Where are these located in adults?

Answer 49

Nucleated precursor cells located in the bone marrow of adults

Question 50

What is the name of the platelet precursor cell?

Answer 50

Megakaryocyte

Question 51

What is the name of the immediate erythrocyte precursor cell?

Answer 51

Reticulocyte

Question 52

What are myelocytes?

Answer 52

Nucleated precursor cells between neutrophils and blasts

Question 53

Embryonically, haemopoietic stem cells originate in which germ layer?

Answer 53

Mesoderm

Question 54

Where does haemopoiesis take place in adults?

Answer 54

In the bone marrow of the axial skeleton, pelvis and long bones

Question 55

What is the only lymphoid cell that can be recognised down a microscope?

Answer 55

Plasma cell

Question 56

What is the only investigation that can be used to differentiate between B, T and natural killer cells?

Answer 56

Immunophenotyping

Question 57

The presence of Howell-Jolly bodies suggests what pathology?

Answer 57

Hyposplenism

Question 58

What is meant by the term hypersplenism?

Answer 58

Splenomegaly, fall in one or more cellular components of blood, correction of cytopenias by splenectomy

Question 59

What is meant by primary haemostasis?

Answer 59

The formation of a platelet plug

Question 60

What is meant by secondary haemostasis?

Answer 60

The formation of a fibrin clot

Question 61

What is fibrinolysis?

Answer 61

The breaking down of a fibrin clot to avoid occlusion of a blood vessel

Question 62

Platelets are formed in the bone marrrow from which precursor cells?

Answer 62

Megakaryocytes

Question 63

When there is endothelial damage in a vessel, collagen is exposed and produces what factor, that platelets bind to?

Answer 63

Von-Willebrand's factor

Question 64

The process of platelets sticking to exposed collagen via binding with Von Willlebrand's factor is known as what?

Answer 64

Platelet adhesion

Question 65

The process of platelets which are already bound to exposed collagen producing chemicals to attract more platelets to the site of injury is known as what?

Answer 65

Platelet aggregation

Question 66

What is a vascular cause for failure of primary haemostasis?

Answer 66

Loss of collagen with ageing

Question 67

What are some platelet causes for failure of primary haemostasis?

Answer 67

Reduced number or reduced function of platelets

Question 68

What is the Von-Willebrand's factor cause for failure of primary haemostasis?

Answer 68

Inherited low levels

Question 69

What is the most common cause of reduced function of platelets?

Answer 69

Anti-platelet and NSAID drugs

Question 70

What are some potential consequences of failure of primary haemostasis?

Answer 70

Spontaneous bruising/purpura, mucosal bleeding, intracranial/retinal haemorrhages

Question 71

What is the screening test for primary haemostasis function?

Answer 71

Platelet count

Question 72

What process starts the extrinsic pathway of the coagulation cascade?

Answer 72

Tissue factor activates factor VII

Question 73

In the common coagulation pathway, tissue factor and factor VII activate which other clotting factors?

Answer 73

V and X

Question 74

In the common coagulation pathway, factors V and X active which clotting factor to form what?

Answer 74

Prothrombin to form thrombin (factor II)

Question 75

In the common coagulation pathway, factor II (thrombin) is responsible for activating what clotting factor?

Answer 75

Fibrin (factor I)

Question 76

When thrombin (factor II) is first generated, what factors does it activate in order to amplify the process?

Answer 76

VIII, IX, XI and XII

Question 77

In the common coagulation pathway factors VIII, IX, XI and XII get reactivated by thrombin and work to activate which other clotting factors?

Answer 77

V and X

Question 78

Which clotting factors are involved in the intrinsic pathway and in what order do they activate each other?

Answer 78

XII - XI - IX - VIII

Question 79

Which electrolyte is a common co-factor in activating a lot of clotting factors in the coagulation cascade?

Answer 79

Calcium

Question 80

Is deficiency of a single clotting factor more likely to be inherited or acquired?

Answer 80

Inherited

Question 81

Is deficiency of multiple clotting factors more likely to be inherited or acquired?

Answer 81

Acquired

Question 82

Most clotting factors are produced where?

Answer 82

In the liver

Question 83

What is the best screening test to assess the function of the extrinsic pathway, i.e. tissue factor and factor VII?

Answer 83

Prothrombin time (PT)

Question 84

What is the best screening test to assess the function of the intrinsic pathway, i.e. factors VIII and IX?

Answer 84

Activated partial thromboplastin time (APTT)

Question 85

If all clotting factors are low, which will be increased- PT, APTT or both?

Answer 85

Both

Question 86

If only factors VIII or IX are low, which will be increased- PT, APTT or both?

Answer 86

APTT

Question 87

What molecule is responsible for converting fibrin into fibrin degradation products in fibrinolysis?

Answer 87

Plasmin

Question 88

How is plasmin formed?

Answer 88

Plasminogen is converted to plasmin via tissue plasminogen activator (tPA)

Question 89

Fibrin degradation products are measured in the lab as what?

Answer 89

D-dimers

Question 90

Which naturally occurring anticoagulant is responsible for turning off thrombin and some other clotting factors directly?

Answer 90

Anti-thrombin III

Question 91

Which naturally occurring anticoagulant is responsible for turning off factors V and VIII?

Answer 91

Protein C

Question 92

What is a co-factor that helps out protein C?

Answer 92

Protein S

Question 93

When haemostasis has been achieved, thrombin binds to thrombomodulin and this has what effect?

Answer 93

Activates protein C and switches off haemostasis