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[OS 216] Hema E1 > 2013 Block A > Flashcards

2013 Block A Flashcards

1
Q

Premature infants develop iron deficiency anemia more than normal infants because:

a. Absorption of iron is deficient
b. infants with low birth weight have reduced iron stores
c. usually the mother has reduced iron stores
d. food intake is deficient

A

B

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2
Q

The following is associated with microcytic, hypochromic red cells

a. renal failure
b. thalassemia
c. cirrhosis
d. folic acid deficiency

A

B

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3
Q

The most common cause of iron deficiency in a new born is

a. low birth weight
b. mother has iron deficiency anemia
c. frequent phlebotomy for diagnostic purposes
d. . decreased iron intake

A

C

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4
Q

The gold standard to determine body iron content is

a. . serum iron
b. total iron binding capacity
c. serum ferritin
d. hemosiderin determination in the bone marrow

A

D

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5
Q

The most common cause of iron deficiency anemia in males is

a. deficient iron intake
b. deficient iron absorption
c. blood loss
d. impaired metabolism of iron

A

C

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6
Q

Iron supplement should be given to a pregnant woman because of

a. increased requirement by mother and fetus
b. presence of iron deficiency state before pregnancy
c. defective iron absorption because of morning sickness
d. decreased intake of iron during pregnancy because of idiosyncrasies

A

A

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7
Q

Which of the following laboratory measurements is useful to determine response to iron in an iron deficient patient?

a. serum iron determination
b. hemoglobin determination
c. hematocrit determination
d. reticulocyte count

A

D

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8
Q

Which of the following is rich in iron?

a. cereal
b. meat
c. green leafy vegetable
d. fish

A

B

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9
Q

Iron therapy is often continued for 6 months even if the hemoglobin has normalized because

a. it acts as prophylaxis against future blood loss
b. most diet is usually deficient in iron
c. iron stores in the body has to be replenished
d. it contributes to the wellbeing of the patient

A

C

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10
Q

Which of the following is false

a. Packed RBC is potentially infected if kept at room temperature for a long period of time
b. an infected donor can transmit his infection to the recipient
c. improperly performed phlebotomy during blood donation is a potential source of infected blood
d. platelet concentrate should be stored at 5°C

A

D

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11
Q

Which of the following is a reason for permanent donor deferment?

a. presence of upper respiratory tract infection
b. ingestion of anti-pyretics
c. history of malaria
d. history of anemia

A

C

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12
Q

Why is refrigerated centrifuge used in separating blood components

a. to keep the optimum temperature constant during spinning
b. for easier separation of the components
c. to evenly pack the red cells
d. to harvest more platelets

A

A

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13
Q

The shelf life of packed RBC in the blood bank refrigerator depends on

a. health of the donor
b. the amount of blood donated
c. the storage temperature
d. the type of anticoagulant used

A

D

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14
Q

Platelet concentrates need to be constantly agitated because

a. the lifespan of platelets can be prolonged
b. platelets tend to aggregate
c. agitation prevents infection
d. the storage time can be prolonged

A

B

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15
Q

increased levels of homocysteine is a risk factor for the development of thrombosis because it

a. causes damage to the endothelium of blood vessels
b. combines with platelet to initiate coagulation
c. increases the levels of all coagulation factors
d. decreases anti-fibrinolytic activity

A

A

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16
Q

Oral contraceptive is not given to a woman who have a high predisposition for thrombosis because it

a. damages the arterial blood vessel
b. causes elevation of coagulation factors
c. increases fibrinolysis
d. promotes platelet adhesion

A

B

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17
Q

Which of the following is not associated with a hypercoagulabe state

a. Protein C deficiency
b. Protein S deficiency
c. Anti-thrombin 3 deficiency
d. increased fibrinolysins

A

D

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18
Q

The most serious complication of Deep Vein thrombosis is

a. pulmonary embolism
b. cyanosis of the lower extremity
c. varicose ulcers
d. arterial thrombosis

A

A

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19
Q

Arterial thrombosis is initiated by

a. platelet adhesion and aggregation
b. increased coagulation factors
c. defective fibrinolysis
d. blood stagnation

A

A

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20
Q

Thromboxane A promotes the development of thrombosis by

a. inducing vasodilation
b. inducing vasoconstriction
c. damage to endothelium
d. neutralizing anti-Thrombin III

A

B

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21
Q

Certain tumors have a predisposition to develop thrombosis because

a. they cause erosion of blood vessels
b. . they have an effective fibrinolytic activity
c. they express excess tissue factor that activates coagulation
d. they are associated with defective platelet function

A

C

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22
Q

Indication for anticoagulation in a patient with Protein C deficiency

a. recurrent thromboembolism
b. pregnancy
c. concomitant diabetes mellitus
d. presence of hypertension

A

A

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23
Q

Antiphospholipid Antibody Syndrome (APAS) should be suspected in this condition

a. recurrent Deep Vein Thrombosis
b. recurrent fetal loss
c. pulmonary embolism
d. arteriosclerosis in the young

A

B

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24
Q

In this condition, thrombosis occurs because the endothelium of the blood vessels is altered by the deposition of immune complexes

a. severe sepsis
b. vasculitis
c. pregnancy
d. . massive trauma

A

B

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25
Q

Which of the following promotes the development of a thrombus

a. plasmin
b. thrombomodulin
c. heparin
d. tissue factor activation

A

D

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26
Q

Prophylactic anticoagulant is used in orthopedic surgery to prevent venous thrombosis which may develop as a result of

a. immobilization
b. venous stasis
c. extensive surgery
d. arteriosclerosis

A

A

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27
Q

One of the more common causes of aplastic anemia is:

a. exposure to benzene compounds
b. exposure to ionizing radiation
c. overwhelming infection
d. genetic inheritance

A

A

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28
Q

An infectious state that is occasionally associated with bone marrow suppression is:

a. strep throat
b. hepatitis
c. chicken pox
d. pheumococcal pnemonia

A

B

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29
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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30
Q

For children and young adults with severe aplastic anemia, the treatment of choice is:

a. immunosuppresive therapy
b. bone marrow transplant
c. androgen
d. supportive therapy

A

B

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31
Q

The primamry cause of anemia of chronic renal disease is:

a. hemolysis
b. decreased erythropoietin production
c. suppression of erythropoiesis by uremic toxins
d. bloss loss in the urine

A

B

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32
Q

A patient presents with anemia, leukopenia, and thrombocytopenia. The bone marrow shows cellular marrow with 15% blasts. The most likely diagnosis is:

a. Refractory anemia
b. Refractory anemia with ringed sideroblasts
c. Refractory anemia with excess blasts
d. Acute leukemia

A

C

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33
Q

The differential diagnosis of patients who present with pancytopenia and cellular marrow include the following:

a. Hypersplenism
b. PNH
c. MDS
d. AOTA

A

D

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34
Q

Which congenital anomaly has a predispostion to Acute Leukemia?

a. Kleinfelter’s syndrome
b. Cleft lip and palate
c. Hemagioendothelioma
d. Persistent thymus

A

A

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35
Q

The diagnositic tool of choice for polycythemia vera is:

a. reticulin stain
b. chromosomal studies
c. red cell volume studies
d. leukocyte alkaline phosphatase score

A

C

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36
Q

A low to absent leukocyte alkaline phosphatse score is virtually diagnostic of:

a. chronic granulocytic leukemia
b. essential thrombocytosis
c. polycythemia vera
d. myelofibrosis

A

A

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37
Q

A chronic lymphocytic leukemia patient only presents with lymphoctosis on work up. His treatment consist of:

a. observation
b. interferon
c. chlorambucil
d. systemic chemotherapy

A

A

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38
Q

Which of the following is true of Cobalamin deficiency

a. May be a problem among long term vegetarians
b. This is primarily N5 - methyltetrahydrofolate, which is transported to cells
c. Readily absorbed in the proximal jejunum
d. May be a problem among patients on hemodialysis

A

A

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39
Q

Site of absorption of folic acid

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

A

A

40
Q

The following is/are cause/s of megaloblastic anemia secondary to folate and cobalamine defiency in temperate countries:

a. alcoholism and pernicious anemia
b. tropical sprue
c. infestation by Diphyllobothrium latum
d. a and c

A

A

41
Q

Treatment of folate deficiency

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

A

A

42
Q

Normal lifespan of red blood cells in the circulation:

a. 90-120 days
b. 60-90 days
c. 120-150 days
d. 30-60 days

A

A

43
Q

The following is/are characteristic/s of intravascular as compared to extravascular hemolysis:

a. Presence of hemosiderin in the urine
b. Polychromatophilia
c. Reticulocytosis
d. All of the above

A

A

44
Q

The presence of schistocytes in the peripheal blood smear may be caused by which of the following syndromes:

a. Microangiopathy
b. Severe liver disease
c. Unstable hemoglobin
d. Thalassemia

A

A

45
Q

The following is/are true of warm antibodies causing autoimmune hemolytic anemias:

a. Antibodies react at body temperature
b. Majority are IgMs
c. More commone in adult women
d. A and C

A

D

46
Q

Pathogenesis of autoimmune hemolytic anemias:

a. immune adherence of rbc to phagocytes mediated by the antibody
b. intravascular hemolysis
c. Complement activation
d. A and C

A

D

47
Q

Initial treatment of significant autoimmune hemolytic anemias consists of the following:

a. Glucocorticoids
b. Immunosuppressants
c. Splenectomy
d. All of the above

A

A

48
Q

The following is true of immune hemolytic anemias:

a. Often transient in children
b. Often transient in adults
c. Usually lasts for years in children with exacerbations and remissions
d. Most patients are not controlled by steroids alone

A

A

49
Q

Site of iron absorption

a. proximal small intestine
b. gastric wall
c. large intestine
d. liver

A

A

50
Q

This can cause transient aplastic crisis in hemolytic anemias

a. Parvovirus B19
b. Epstein-Barr virus
c. Cytomegalovirus
d. HIV-1

A

A

51
Q

This finding of the following is highly atypical of Aplastic Anemia:

a. hepatosplenomegaly
b. bleeding
c. infection
d. anemia

A

A

52
Q

The use of whole blood is indicated in the following situation:

a. for acute correction of anemia
b. to replace coagulation factors in neonates with disseminated intravascular coagulopathy
c. exchange transfusion for neonatal hyperbilirubinemia
d. to provide a fresh source of platelets and red cells for bleeding patients

A

C

53
Q

Transfusion-associated cytomegalovirus infection can be prevented by the following, except:

a. use of cmv negative blood donors
b. irradiation of blood products
c. use of white blood cell filters
d. use of blood warmers

A

D

54
Q

The treatment for neonatal anemia by blood transfusion depends on:

a. absolute hemoglobin level
b. severity of symptoms
c. availability of CMV negative blood
d. severity of symptoms and presence of co-morbid conditions that interfere with oxygen delivery

A

D

55
Q

Method to limit donor exposure in neonates include:

a. giving larger volume of blood products to decrease the interval of transfusions
b. frequent monitoring of complete blood counts after each transfusion
c. using packed red blood cell aliquots from a single donor unit
d. use of whole blood to optimize the delivery of red cells, coagulation factors and platelets

A

C

56
Q

Transfusion associated graft-vs-host disease

a. occurs only with transfusion of fresh frozen plasma
b. does not occur in neonates
c. its occurrence is proportional to the number of white cells in the transfused blood product
d. is a non-serious, reversible condition not requiring aggressive clinical condition

A

C

57
Q

Antibody cluster determinants

a. are specific cell surface antigens that are differentially expressed during hematopoietic differentiation
b. are of very limited use in distinguishing AML from ALL by cell surface immunophenotyping
c. does not distinguish myeloblasts from normal hematopoietic precursors
d. are less sensitive and specific for the identification of AML compared to the use of histochemical stains

A

A

58
Q

the identification of leukemia subtypes are currently based on:

a. exclusively on bone marrow morphology
b. a combination of marrow morphology and histochemical stains
c. a combination of marrow morphology, histochemical stains and pattern of surface antigen expression
d. a combination of clinical presentation, morphology, histochemical stains, immunophenotyping and cytogenetics

A

D

59
Q

Disseminated intravascular coagulopathy in Acute Promyelocytic Leukemia is most commonly due to:

a. Gram positive bacterial sepsis
b. the release of thromboplastin from cytoplasmic granules of leukemic blasts
c. hyperleukocytosis
d. NOTA

A

B

60
Q

Tumor Lysis Syndrome:

a. occurs in patients with leukemia
b. only occurs following induction chemotherapy of leukemia
c. is most frequently associated with hyperleukocytosis
d. is an irreversible condition

A

C

61
Q

Single most indicator for prognosis of ALL is

a. sex
b. age
c. WBC count on diagnosis
d. organ function

A

C

62
Q

Testicular leukemia

a. more common in AML
b. usually occurs bilaterally
c. frequently followed by systemic relapse
d. best prevented by prophylactic irradiation in all males with leukemia

A

C

63
Q

Chronic Leukemia

a. common in childhood
b. has predominantly relatively mature cells
c. thrombocytopenia and neutropenia
d. elevated leukocyte alkaline phosphatase levels

A

B

64
Q

Achievement of true remission in CML requires

a. amelioration of leukocytosis and organomegaly
b. predominance of relatively mature cell
c. destruction of Philadelphia positive chromosome cells
d. control of Philadelphia positive chromosome cells

A

C

65
Q

Standard treatment for remission induction of AML

a. L-asparaginase and Vinaristine
b. cytarabine and anthracycline
c. high dose cytarabine
d. cyclosporine and doxorubicin

A

B

66
Q

The following is a lymphoblastic biochemical tumor marker

a. beta 2 microglobulin
b. CA-125
c. LDH
d. carcinoembryogenic marker

A

D

67
Q

B symptoms in lymphoma

a. night sweats, anorexia, pruritus
b. pruritus, fever, weight loss
c. fever, night sweats, weight loss
d. anorexia, pruritus, weight loss

A

C

68
Q

Fatal transfusion reactions are most frequently caused by

a. clerical errors
b. improper refrigeration
c. overheated blood
d. mechanical trauma

A

A

69
Q

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

a. slow the transfusion rate and call the doctor
b. administer medication to stop the treatment
c. stop the transfusion but keep the line open with saline
d. first inform the laboratory to begin investigation

A

C

70
Q

Most appropriate for Vitamin K deficiency and hemorrhage

a. factor VIII
b. cryoprecipitate
c. fresh frozen plasma
d. platelets

A

C

71
Q

Amount of platelet mass sequestered in spleen:

a. 1/4
b. 1/3
c. 1/2
d. 2/3

A

B

72
Q

The key organ in the pathophysiology of Immune Thrombocytopenic Purpura (ITP)

a. liver
b. spleen
c. bone marrow
d. kidneys

A

B

73
Q

Which of the following is a common finding in ITP?

a. lymphadenopathy
b. hepatosplenomegaly
c. splenomegaly
d. mucosal bleeding
A

D

74
Q

A 20 year old female is suspected to have chronic ITP. The expected bone marrow finding is:

a. megakaryocytic  hyperplasia b. hypocellular marrow with increased lymphocytes and plasma cells c. granulocytic hyperplasia with all stages of myeloid maturation seen
d. few to absent megakaryocytes
A

A

75
Q

Which of the following is a feature of chronic ITP?

a. usually follows a viral infection
b. thrombocytopenia is more severe than acute ITP
c. eosinophilia is common
d. recurrent course of illness
A

D

76
Q

This is suggestive of bleeding due to platelet disorder rather than coagulopathy:

a. small, multiple ecchymoses
b. hemarthroses
c. muscle bleeding
d. delayed bleeding
A

A

77
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

78
Q

Which of the following is not a vitamin K dependent coagulation factor?

a. Factor I
b. Factor II
c. Factor VII
d. Factor IX
e. Factor X

A

A

79
Q

Vitamin K deficiency causes abnormality of this screening test:

a. Bleeding time
b. Platelet count
c. Prothrombin time
d. Partial thromboplastin time
A

C

80
Q

A 26 year old pregnant woman had a retained dead fetus of one week duration. An expected laboratory finding is:

    a. presence of fragmented red cells in the peripheral blood smear
b. elevated fibrinogen
c. low fibrin degradation products
d. normal platelet count
A

A

81
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

82
Q

This is true regarding bleeding disorder secondary to aspirin:

a. aspirin prevents platelet adhesion
b. aspirin causes reversible inhibition of cyclooxygenase enzyme
c. usually presents with severe bleeding manifestations
d. a single dose of aspirin impairs hemostasis for 5-7 days

A

A

83
Q

The following is true regarding treatment of DIC except:

a. correct any reversible cause
b. fresh frozen plasma and platelet concentrates are given for actively bleeding patients
c. heparin is used for patients with acrocyanosis and incipient gangrene
d. warfarin is effective for chronic DIC

A

D

84
Q

Female carrier of hemophilia marries normal male:

a. all daughters are carriers
b. all sons are hemophiliac
c. half the daughters are carriers
d. half the sons are carriers
A

C

85
Q

Normal female marries hemophiliac

a. all daughters are carriers
b. half the daughters are carriers
c. half the sons are hemophiliacs
d. all sons are hemophiliacs
A

A

86
Q

In von WIllebrand’s disease

a. the bleeding time is usually normal
b. Factor VII clotting levels are normal
c. Women are affected more severely than men
d. Platelet aggregation is often abnormal
A

D

87
Q

Rouleaux formation is seen in:

a. aplastic anemia
b. essential thrombocytopenia
c. myelodysplastic syndrome
d. multiple myeloma

A

D

88
Q

According to the WHO classification, the diagnosis of acute myeloid leukemia requires the finding of more than ___ blasts in the bone marrow:

a. 10%
b. 20%
c. 30%
d. 40%

A

B

89
Q

Hemophilia A is inherited as:

a. autosomal dominant
b. X-linked recessive
c. autosomal recessive
d. X-linked dominant

A

B

90
Q

Laboratory diagnosis of hemorrhagic disease of the newborn:

a. Normal PT, normal PTT
b. Prolonged PT, normal PTT
c. Prolonged PT, prolonged PTT
d. Normal PT, prolonged PTT
A

C

91
Q

Mode of delivery of a hemophiliac baby:

a. Normal vaginal delivery
b. Outlet forceps extraction
c. Vacuum extraction
d. Cesarean section
A

D (or A?)

92
Q

One of the following is not a cause of Vitamin K deficiency in the new born period

a. Low vitamin K content of milk
b. Adequate Vitamin K stores from the mother
c. Relatively sterile gut
d. Relatively immature liver
A

B

93
Q

Prevention of Hemorrhagic Disease of the Newborn is achieved by:

a. Fresh frozen plasma transfusion at birth
b. Routine Vitamin K prophylaxis at birth
c. Cryosupernate transfusion at birth
d. Crede’s prophylaxis at birth
A

B

94
Q

Mode of inheritance of von Willebrand’s disease

a. Autosomal dominant
b. X-linked recessive
c. Autosomal recessive
d. X-linked dominant
A

A

95
Q

The ideal choice of platelet concentrates for Neonatal Alloimmune thrombocytopenia is:

a. Random platelets
b. Type-specific platelets
c. Apheresis platelets
d. Maternal platelets
A

D

96
Q 
What is the most frequent subtype of ALL in children?
	a. T cell ALL
	b. B precursor ALL
	c. Mature B cell ALL
	D. NK cell ALL
A

B

97
Q

These patients have high risk ALL except:

a. Infants
b. Adolescents
c. Children aged 2 to 13 years
d. Positive for Philadelphia chromosome
A

C

[OS 216] Hema E1 (7 decks)

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