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[OS 216] Hema E1 > 2014 Block A > Flashcards

2014 Block A Flashcards

1
Q

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

A. Health of donor
B. The amount of blood donated
C. The storage temperature
D. The type of anticoagulant used

A

D

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2
Q

Oral contraceptive use is not given to women who have high predisposition for thrombosis because it:

A. damages arterial blood vessel
B. causes elevation of coagulation factors
C. increases fibrinolysis
D. promotes platelet adhesion

A

C

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3
Q

Which of the following is not a hypercoagulable state?

A. Protein C deficiency
B. Protein S deficiency
C. Antithrombin III deficiency
D. Increased fibrinolysis

A

D

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4
Q

Certain tumors have a predisposition to tumors because:

A. promote erosion of blood vessels
B. increased fibrinolytic activity
C. release tissue factor that promote coagulation
D. decreased platelet activity

A

C

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5
Q

APAS should be suspected in which of the following:

A. recurrent DVT
B. recurrent fetal loss
C. pulmonary embolism
D. arteriosclerosis in the young

A

B

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6
Q

These agents frequently but not inevitably produce bone marrow aplasia:

A. Benzene
B. Chloramphenicol
C. Insecticides
D. Estrogen

A

A

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7
Q

Treatment of folate deficiency:

A. oral replacement of 1 to 5 gm/day folic acid
B. parenteral folate replacement
C. oral folic acid 1 to 5 gm/day with ferrous supplement
D. A and C

A

A

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8
Q

The following is/are characteristic(s) of intravenous hemolysis in contrast to extravenous hemolysis:

A. Presence of hemosiderin in urine
B. Polychromatophilia
C. Reticulocytosis
D. All of the above

A

A

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9
Q

Pathogenesis of autoimmune hemolytic anemia:

A. immune adherence of RBC to phagocytes mediated by the antibody
B. intravascular hemolysis
C. complement activation
D. A and C

A

D

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10
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

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11
Q 
This finding of the following is highly atypical of Aplastic Anemia:
A.	a.hepatosplenomegaly
B.	b. bleeding
C.	c. infection
D.	anemia
A

A

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12
Q

The identification of leukemia subtypes are currently bases 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 a pattern of surface antigen expression
D. a combination of clinical presentation, morphology, histochemical stains, immunophenotyping, and cytogenetics

A

D

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13
Q

Disseminated Intravascular Coagulation in Acute Promyelocyte Leukemia is most commonly due to:
A. Gram positive bacterial sepsis
B. Release of thromboplastin from cytoplasmic granules of leukemic blasts
C. Hyperleukocytosis
D. None of the above

A

B

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14
Q

Achievement of true remission in CML requires:

A. Amelioration of leukocytosis and organomegaly
B. Amelioration of thrombocytosis
C. Destruction of Philadelphia chromosome positive cells
D. Control of Philadelphia chromosome positive test

A

C

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15
Q

Chloromas are:

A. Solid tumors composed of diffuse tissue infiltration by lymphoblasts
B. Solid tumors composed of diffuse tissue infiltration by myeloblasts
C. Should be surgically removed for optimal management
D. Are occasionally of greenish hue due to the absence of the enzyme peroxidase in the malignant cells

A

B

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16
Q 
Which biochemical marker is considered a tumor marker for lymphoma?
A.	Beta2 microglobulin			
B.	Carcinoembryonic antigen
C.	CA-125
D.	LDH
A

D

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17
Q 
The most common cytogenetic abnormality in myelodysplastic syndrome (MDS) involves chromosome number
A.	a.5
B.	b.7
C.	c.8
D.	d.20
A

A

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18
Q 
IDA anemia produces this type of anemia
A.	Hypochromic, macrocytic
B.	Normochromic, macrocytic
C.	Hypochromic, microcytic
D.	Normochromic, microcytic
A

C

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19
Q

Pregnant women should routinely be given iron because
A. The fetus needs iron
B. The mother has lost iron from her previous monthly menses
C. She will lose blood when she delivers
D. All of the above

A

D

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20
Q 
The gold standard in the diagnosis of iron deficiency anemia is
A.	serum iron
B.	serum ferritin
C.	total iron binding capacity
D.	hemosiderin in bone marrow
A

D

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21
Q 
During the first week of treatment with oral iron, which laboratory parameter should be taken?
A.	hemoglobin
B.	hematocrit
C.	reticulocyte count
D.	red cell indices
A

C

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22
Q

The duration of treatment with oral iron is usually six months because
A. the body’s iron stores have to be replenished
B. this will cover for the future occurrence of bleeding
C. this will facilitate more absorption of iron
D. all of the above

A

A

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23
Q 
This food is rich in iron
A.	fruits
B.	vegetables
C.	red meat
D.	fish
A

C

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24
Q

A patient develops iron deficiency anemia after gastroduodenal bypass surgery:
A. because of poor iron absorption
B. because of poor iron utilization
C. because of poor iron intake
D. because of the decrease in the reticulo-endothelial system

A

A

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25
Q 
Parenteral iron is given if:
A.	rapid increase in hemoglobin is desired
B.	malabsorption syndrom exists
C.	the patient requested for it
D.	rapid utilization of iron by the body
A

B

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26
Q

The most common single cause of iron deficiency in women is:
A. poor intake of iron
B. obesity
C. poor release of iron by the reticulo-endothelial system
D. menstrual blood loss

A

D

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27
Q

Chronic ingestion of non-steroidal anti inflammatory medication can cause iron deficieny anemia by:
A. interfering with iron transport
B. reducing the amount of total iron binding capacity
C. inducing occult GI bleeding
D. preventing iron incorporation in the red cells

A

C

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28
Q

A transfusion reaction that usually appears rapidly that may result in fever, shock or death is:
A. immediate hemolytic transfusion reaction
B. transfusion associated circulatory overload
C. allergic transfusion reaction
D. febrile non-hemolytic transfusion reaction

A

A

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29
Q

Type O is considered a universal donor because:
A. It doesn’t contain agglutinogens A and B
B. It doesn’t contain anti A and B antibodies
C. It is the most common bloodtype
D. It is easy to procure

A

A

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30
Q 
The ff blood component should have a cross matching of the donor done before transfusion:
A.	PRBC
B.	Platelets
C.	WBC
D.	FFP
A

A

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31
Q

Reasons why an RH (-) person should not receive RH (+) blood:
A. Prevent incompatibility
B. Prevent autoimmunization to D antigen
C. Prevent Immediate Post-Transfusion reaction
D. Prevent infection

A

B

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32
Q

The most frequent cause of febrile non-haemolytic transfusion reaction is:
A. IgG protein in the transfused blood
B. ABO incompatibility
C. Presence of WBC and cytokines in the transfused blood
D. Presence of malarial parasites in the transfused blood

A

A

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33
Q

The “window period” in the testing for HIV in blood donors represents
A. The time from the infection of the donor up to the time that the anti-body is detected
B. The duration of the HIV laboratory test
C. The incubation period for the reagents
D. The time when the HIV symptoms become manifest

A

A

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34
Q 
What is the optimum storage temperature of PRBCs?
A.	-20 deg Celsius
B.	4-6 deg Celcius
C.	Room temp
D.	0 deg
A

B

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35
Q

Why can thawed fresh frozen plasma not be refrozen?
A. It’s potentially infected
B. it’s lost the activity of the coagulation factors
C. The plastic bag is brittle
D. Cytokines are released in the process of thawing

A

B

36
Q 
In severe IDA with symptoms of high output failure, the best blood product for transfusion is:
A.	PRBC
B.	Fresh whole blood
C.	Whole blood
D.	Heparinised whole blood
A

A

37
Q 
Elderly patients with DVT should be worked out for
A.	vasculitis
B.	malignancy
C.	liver cirrhosis
D.	atherosclerosis
A

B

38
Q 
The most serious complication from DVT is
A.	peripheral vascular disease
B.	myocardial infarct
C.	cerebral venous thrombosis
D.	pulmonary embolism
A

D

39
Q

Diabetes is associated with increased risk of thrombosis because
A. higher blood sugar slows down blood flow
B. it can lead to acquired protein C deficiency
C. homocysteine increases proportionally with blood sugar
D. diabetes can cause endothelial damage

A

D

40
Q 
The most common acute leukemia in children
A.	Pre-T ALL
B.	Pre-B ALL
C.	AML
D.	JMML
A

B

41
Q 
Single most important indicator for ALL
A.	CNS involvement
B.	hepatomegaly
C.	age
D.	WBC count at diagnosis
A

D

42
Q 
Important “sanctuary sites” for ALL
A.	liver and spleen
B.	lymph nodes and CNS
C.	CNS and testes
D.	lymph nodes and liver
A

C

43
Q

Hematopoietic stem cell transplant
A. is the only curative form of treatment for ALL
B. allows intensification of therapy and replacement of diseased marrow with normal precursors
C. utilizes HSC derived from fetal liver, bone marrow, and cord blood
D. is associated with less risk than conventional chemotherapy

A

B

44
Q 
Rouleaux formation is seen in:
A.	Afibrinogenemia		
B.	Paraproteinemia 
C.	sickle cell anemia
D.	autoimmune haemolytic anemia
A

B

45
Q 
Microcytosis is best defined as:
A.	high RDW
B.	low MCV
C.	high MCH 
D.	low MCHC
A

B

46
Q 
On a peripheral blood smear, red cells will normally have a central pallor that occupies:
A.	1/3 of its diameter
B.	½ of its diameter
C.	2/3 of its diameter
D.	D.3/4 of its diameter
A

A

47
Q 
According to the WHO classification, the diagnosis of AML requires the presence of \_\_\_\_\_ blasts in the marrow
A.	≥ 10%
B.	≥ 20%
C.	≥ 30%
D.	≥ 40%
A

B

48
Q 
The clinical manifestation that distinguishes aplastic anemia from leukemia
A.	severity of pallor
B.	severity of bleeding
C.	CNS involvement
D.	presence of hepatosplenomegaly
A

D

49
Q

Acquired aplastic anemia in contrast to inherited form of bone marrow failure appears to be caused largely by:
A. immune-mediated destruction of marrow cells
B. loss of hematopoietic stem cells due to DNA damage
C. low threshold for apoptosis
D. NOTA

A

B

50
Q 
The following are the most important variables in disease outcome in Myelodysplastic syndrome EXCEPT:
A.	# of blasts in the peripheral blood
B.	# of blasts in the bone marrow
C.	cytogenetic abnormality
D.	severity of cytopenia
A

A

51
Q

Anemia of chronic renal failure:
A. A.usually microcytic normochromic
B. erythropoietin deficiency is usually seen when creatinine is > 2mg
C. supplemental iron should be avoided as much as possible
D. erythropoietin alpha dose of 30-75/kbbw per week is usually required

A

B

52
Q

The proposed mechanism for anemia of chronic inflammatory condition include:
A. increased red cell survival
B. decreased responsiveness to erythropoietin
C. decreased levels of erythropoietin
D. AOTA

A

B

53
Q 
The lifespan of platelets is 
A.	12 to 24 hours
B.	7 to 10 days
C.	45 to 60 days
D.	100 to 120 days
A

B

54
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

55
Q 
This screening test reflects the function of the intrinsic pathway of coagulation
A.	bleeding time
B.	prothrombin time
C.	partial thromboplastin time
D.	thrombin time
A

C

56
Q 
Vitamin K deficiency causes abnormality of this screening test.
A.	bleeding time
B.	platelet count
C.	PT
D.	PTT
A

C

57
Q 
Abnormal red cell structure seen in DIC due to microangiopathic anemia:
A.	spherocytes
B.	target cells
C.	dacrocytes
D.	schistocytes
A

D

58
Q 
a male who had a tooth extraction experiences continuous bleeding. Labs show increased platelet, normal PT, other parameters normal. He most likely has:
A.	hemophelia
B.	Von Willebrand’s 
C.	leukemia
D.	DIC
A

B

59
Q 
A 30 y/o male was diagnosed with aplastic anemia 5 years ago. He gradually experienced pallor, jaundice, reddish urine. Urinalysis showed no signs of rbc. What test would be helpful?
A.	bone marrow aspiration and biopsy
B.	leukemia immunophenotyping
C.	urine hemosiderin
D.	flow cytometry for CD55, CD59
A

D

60
Q

The underlying pathophysiology in Paroxysmal Nocturnal Hemoglobinuria (PNH) is:
A. Hereditary
B. Lack of glycosyl phosphatidyl inositol-linked cell surface membrane proteins
C. Tumor necrosis factor and gamma interferon elaborated by cytotoxic T cells
D. Presence of red cell antibodies

A

B

61
Q 
Apheresis can be used to collect all of the following except:
A.	Leukocytes
B.	Macrophages
C.	Hematopoietic progenitor cells
D.	Platelets
A

B

62
Q 
Fatal transfusion reactions are most frequently caused by:
A.	Clerical errors
B.	Improper refrigeration
C.	Overheated blood
D.	Platelets
A

A

63
Q

When a suspected hemolytic reaction occurs, the first thing to do is:
A. Slow the transfusion rate and call the physician
B. Administer medication to stop the reaction
C. Stop the transfusion but keep the intravenous line open with saline
D. First inform the library to begin an investigation

A

C

64
Q

Pretransfusion irradiation of all blood products in certain patients is done to prevent:
A. Cytomegalovirus
B. Transfusion Associated Graft vs. Host Disease
C. Febrile Non-Hemolytic Transfusion Reaction
D. Hemolytic Transfusion Reaction

A

C

65
Q

The following describes the clonal cell in Multiple Myeloma
A. Bilobed nucleus with prominent eosinophilic nucleoli
B. Large mononuclear cell, fine chromatin material with minimal cytoplasm
C. Round cell with round indented nucleus and perinuclear clearing
D. Small round cell with clumped chromatin material and minimal to moderate cytoplasm

A

C

66
Q

The following anemic patient with high creatinine likely has multiple myeloma:
A. Normal serum calcium and high uric acid
B. High serum calcium and lytic lesion on bone scan
C. >30% plasma cell on bone marrow aspirate and lytic lesions on skeletal survey
D. 10% plasma cell on bone marrow aspirate and elevated serum immunoglobulin

A

C

67
Q 
In multiple myeloma, prognosis is best correlated with:
A.	CRP and B microglobulin
B.	LDH and serum creatinine
C.	ESR and LDH
D.	Serum calcium and LDH
A

A

68
Q 
Lymphomas and Multiple Myeloma are disorders of the following lineage:
A.	Myeloid
B.	Lymphoid
C.	Stromal cells
D.	Unknown
A

B

69
Q 
The diagnostic test for the thalassemias is:
A.	Auto hemolysis test
B.	Coombe’s test
C.	Hemoglobin electrophoresis
D.	Osmotic fragility test
A

C

70
Q

The definitive diagnostic procedure for Hereditary Spherocytosis:

A. Hemoglobin electrophoresis
B. Hann’s test
C. Osmotic fragility test
D. Coomb’s test

A

C

71
Q

The following treatment option offers a clinical cure for Hereditary Spherocytosis:

A. PRBC transfusion
B. Splenectomy
C. Folic acid
D. Iron chelation

A

B

72
Q

In Beta thalassemia major, this hemoglobin is markedly elevated:

A. Hb A 1
B. Hb A 2
C. Hb H
D. Hb F

A

D

73
Q

The clinical triad of hemolytic anemia does not include

A. Splenomegaly
B. Hepatomegaly
C. Jaundice
D. Pallor

A

B

74
Q

The objective of supertransfusion and hypertransfusion in thalassemia major is:

A. to increase the patient’s Hb level
B. to increase the patient’s RBC in blood
C. to increase the patient’s iron stores
D. to suppress erythropoiesis

A

D

75
Q

In Tumor Lysis Syndrome, what is the metabolic imbalance encountered:

A. increase K, low PO4, low Ca, high uric acid
B. increase K, high PO4, high Ca, high Uric Acid
C. increase K, high PO4, low Ca, high Uric Acid
D. decrease K, high PO4, low Ca, high Uric Acid

A

C

76
Q

In chronic lymphocytic anemia, the proliferating cells in the blood are:

A. large with round nuclei, prominent nucleoli, and scant cytoplasm
B. large with indented nuclei, prominent nucleoli, and abundant cytoplasm
C. small with irregular nuclei, inconspicuous nucleoli, and vacuolated cytoplasm
D. small with round nuclei, inconspicuous nucleoli, and scant cytoplasm

A

D

77
Q 
Red cell hyperchromasia is seen only in:
A.	myelodysplastic syndrome
B.	sickle cell disease
C.	spherocytosis
D.	polycythemia
A

D

78
Q

The only indication for Fresh Whole Blood in neonates:

A. hemodialysis
B. exchange transfusion
C. hypovolemic shock
D. uremia

A

B

79
Q

Choice of blood for exchange transfusion in ABO incompatibility:

A. Type O Rh positive PRBC
B. Type-specific Rh positive FWB
C. Type O Rh positive FWB
D. Type-specific positive PRBC

A

C

80
Q 
Hemophilia A and B are both inherited as:
A.	Autosomal recessive
B.	Autosomal dominant
C.	x-linked recessive
D.	x-linked dominant
A

C

81
Q 
.Mode of delivery of a hemophiliac baby:
A.	Normal vaginal delivery
B.	Outlet forceps extraction
C.	Vacuum extraction
D.	Cesarean section
A

D

82
Q 
Treatment of bleeds in Von Willebrand's Disease
A.	Platelet concentrate
B.	Stored plasma
C.	Cryoprecipitate
D.	Cryosupernate
A

C

83
Q 
Treatment for Hemophilia B:
A.	FFP
B.	Cryoprecipitate
C.	Cryosupernate
D.	Platelets
A

C

84
Q

(+) Anti-A testing reagent (-) Anti-B testing reagent

a. blood type A
b. blood type B
c. blood type O
d. blood type AB

A

A

85
Q

(-) Anti-A testing reagent (+) Anti-B testing reagent

a. blood type A
b. blood type B
c. blood type O
d. blood type AB

A

B

86
Q

(-) Anti-A testing reagent (-) Anti-B testing reagent

a. blood type A
b. blood type B
c. blood type O
d. blood type AB

A

C

[OS 216] Hema E1 (7 decks)

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