23192935
Descripción
Test por nisha gurung, actualizado hace más de 1 año
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Creado por nisha gurung
hace alrededor de 4 años
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Pregunta 1
Pregunta
Which of the following is NOT true for the erythrocytes:
Respuesta
-
RBC are most numerous in blood
-
Mature RBC contain no organelles, particularly no mitochondria
-
RBCs contain no protein, but can synthesize proteins necessary for their survival
-
RBC cytoplasm has heme and enzymes to prevent and repair the oxidative damage
-
RBC produce 2,3 DPG which helps with 02 unloading in tissue
Pregunta 2
Pregunta
The pentose phosphate pathway in RBC metabolizes about 5-10% of the glucose entering the cell and produces NADPH. G6PD deficiency stops this pathway and thus would cause which of the following
Respuesta
-
thrombophillia
-
sickle cell anemia
-
megaloblastic anemia
-
enzimopenic hemolytic anemia
-
thallasaemia
Pregunta 3
Pregunta
G6PD is an intraerytocytic enzyme necessary for production of what:
Respuesta
-
succinyl Co-A
-
methylmalonil Co A
-
pyruvate
-
NADPH
-
NAD
Pregunta 4
Pregunta
Which of the following are proteins from the membrane cytoskeleton of the RBCs?
Respuesta
-
ankirin and spectrin
-
vicin and convicin
-
vincristin and vinblastinn
-
NAD+ and NADPH
-
alpha and beta globine
Pregunta 5
Pregunta
Splenomegaly is found on routine physical examination. Blood tests show mild hemolytic anemia. Osmotic fragility test is positive. The patient is consulted on spl enectomy. Which of following, is most likely?
Respuesta
-
iron deficiency anemia
-
megaloblastic anemia
-
mircospherocytosis
-
thallasaemia major
-
aplastic anemia
Pregunta 6
Pregunta
What type of anemia is assosiciated with quantitative defects in hemoglobin production:
Respuesta
-
membranopathic hemolytic
-
enzymopathic hemolytic
-
hemoglionpathies
-
immune hemolytic
-
thallassemia
Pregunta 7
Pregunta
Damage to the duodenum. preventing nutrient absorption would cause which of the following forms of anemia:
Respuesta
-
iron deficiency anemia
-
vit B12 deficiency anemia
-
PK deficiency anemia
-
G6PD deficiency anemia
-
folic acid deficiency anemia
Pregunta 8
Pregunta
Damage to the ileum, preventing nutrient absorption would cause which of the following forms of anemia:
Respuesta
-
iron deficiency anemia
-
vit B12 deficiency anemia
-
PK deficiency anemia
-
G6PD deficiency anemia
-
folic acid deficiency anemia
Pregunta 9
Pregunta
A patient presents with jaundice. Testing reveals anemia, decreased haptoglobin, no signs of hemoglobinemia and hemoglobiuria. If extravasal hemolysis is suspected what is the major organ involved:
Respuesta
-
spleen
-
liver
-
bone marrow
-
small vessels
Pregunta 10
Pregunta
A patient presents with jaundice. Lab tests show anemia, decreased haptoglobin hemoglobinemia, hemoglobinuria.. Which of the following is most likely:
Respuesta
-
intravascular hemolysis
-
extravascular hemolysis
-
mircospherocytosis
-
acute hepatitis
-
acute cholecystitis
Pregunta 11
Pregunta
After an acute blood loss which of the following will be seen :
Respuesta
-
thrombocytopenia
-
leucopenia
-
reticulcytosis
-
thrombocytosis
-
leukocytosis
Pregunta 12
Pregunta
An African American is recently successfully recovered from malaria after a mission trip in Central Africa. He presents with haemolytic anemia. He said he ate many broad beans . Blood tests show Heinz bodies. Which of the following is most likely:
Respuesta
-
G6PD deficiency anemia
-
sickle cell anemia
-
thallaseamia
-
autoimmune haemolytic anemia
-
microsperocytosis
Pregunta 13
Pregunta
What change is seen in 6 position of the beta globine chain in sickle cell anemia:
Respuesta
-
glycine for valine
-
valine for glycine
-
valine for glutamatic acid
-
gluamatic acid for valine
-
none of the above
Pregunta 14
Pregunta
A child feels unwell after a day at the ski slopes — fever, paleness, jaundice, dark urine, abdominal pains. Tests show haemolytic anemia with biphase autoantibodies (Donath — Landsteiner) What is the correct diagnosis:
Respuesta
-
autoimmune haemolytic anemia with warm autoantibiodies
-
autoimmune haemolytic anemia with cold autoantibodies
-
CMV liver infection
-
paraoxysmal cold hemoglobinuria
-
march hemoglobinuria
Pregunta 15
Pregunta
A patients presents with Rayno- phenomena after therapy for mycoplasma pneumoniae infection. Lab tests show anemia, spherocytes, erythrocytes clumping. Which type of anemia do you suspect:
Respuesta
-
haemolytic anemia with cold autoantibodies
-
haemolytic anemia with warm autoantibodies
-
microphserocytosis
-
sickle cell anemia
-
malaria
Pregunta 16
Pregunta
A pateint being treated for syphilis presents with tiredness. Lab tests show haemolytic anemia ( HA) and positive direct DAT with IgG bound to the RBC membranes. Which diagnosis is most likely?
Respuesta
-
HA with warm antibodies
-
HA with cold antibodies
-
hereditary speherocytosis
-
drug induced haemolytic anemia (penicillin type)
-
drug induced HA (hapten type)
Pregunta 17
Pregunta
Which of the following is used to diagnose autoimmune hemolytic anemia by detecting autoantibodies and /or complement bound to the RBC:
Respuesta
-
DAT (direct coombs test)
-
PTT
-
APTT
-
D-dimers
-
IAT (indirect coombs test)
Pregunta 18
Pregunta
An alcoholic presents with diarrhoea and weight loss. He states he drinks alcoholol and eats only fast food. Lab tests show anemia with MCV 130fl. Which of the following is most likely:
Respuesta
-
vit K def
-
vit C def
-
folic acid def
-
vit B12 def
-
iron def
Pregunta 19
Pregunta
A child from a developing country presents with exhaustion. Blood tests show microcyric, hypochromic anemia, low iron in serum, low ferritin and high transferin in serum. The chlid complaints of burning tongue and Plummer Vilson syndrome. Which of the following is most likely:
Respuesta
-
vit K def
-
Vit C def
-
folic acid def
-
Vit B12 def
-
iron def
Pregunta 20
Pregunta
An elderly patient with terminal ileitis ( Krohn disease) and vitilgo complaints from fatigue. Lab tests show anemia with MCV 127fl. Which of the following is most likely:
Respuesta
-
vit K def
-
vit c def
-
folic acid def
-
Vit B12 def
-
iron def
Pregunta 21
Pregunta
An elderly man, living in Finland goes fishing in his free time. He complaints of fatigue and blood tests show megaloblastic anemia. Which of the following can be suspected:
Respuesta
-
Diphilobotrum latum parasitosis
-
lime disease
-
malaria
-
HCV infection
-
EBV infection
Pregunta 22
Pregunta
Which of the following is associated with anemia, thrombocytopenia, leukopenia and reduction of all cellular elements of the blood?
Respuesta
-
hereditary HA
-
iron def anemia
-
aplastic anemia
-
thallasemia
-
autoimmune anemia
Pregunta 23
Pregunta
A 19 year-old female comes to you for a pre-athletic physical examination . She looks pale. You ask her about her diet and find out that she rarely eats meat but drinks milk and tea, eats lo is of fruits and vegetables. Blood tests show Hb MT,/ , MCV 76f1. Which test do you order next?
Respuesta
-
serum ferritin concentration
-
serum transferin concentration
-
serum iron concentration
-
urine homocystein
-
serum hepcidin concentration
Pregunta 24
Pregunta
A 19 year-old female comes to you for a pre-athletic physical examination . She looks pale. You ask her for her diet and find out that she rarely eats meat but drinks milk and tea, eats lots of fruits and vegetables. Blood tests show Hb 72,/1 , MCV 76fl. Which of the serum proteins do you expect to be elevated?
Respuesta
-
serum ferritin concentration
-
serum transferin concentration
-
serum iron concentration
-
urine homocystein
-
serum folate concentration
Pregunta 25
Pregunta
A 76 year- old lady comes to your practice with mild iron deficiency anemia. Which foods would you recommend as a best source of iron with best absorption rate?
Respuesta
-
spinach and broccoli
-
black tea
-
chicken, fish and beef
-
fresh citrus fruits
-
iron fortified cereals
Pregunta 26
Pregunta
Mrs Smith, a 48 year old woman had a car accident and sustained the following injuries: broken ribs, punctured lung, a ruptured spleen, injuries to her small intestine and. Her spleen, a part of her small intestine including the lower third were removed. What type of anemia do you expect her to develop in the next 7-10 days?
Respuesta
-
haemolytic anemia
-
aplastic anemia
-
vit B12 def anemia
-
iron def anemia following acute blood loss
Pregunta 27
Pregunta
Mrs Smith, a 48 year old woman had a car accident and sustained the following injuries: broken ribs, punctured lung, a ruptured spleen, injuries to her small intestine. Her spleen, part of her small intestine including the lower third were removed. What type of anemia do you expect her to develop in the next 3-4 years?
Respuesta
-
haemolytic anemia
-
aplastic anemia
-
vit B12 def anemia
-
iron def anemia following acute blood loss
Pregunta 28
Pregunta
Which is usually the first sign of folate deficiency?
Respuesta
-
low RBC concentration
-
low hemoglobin concentration
-
hypersegmented neutrophils
-
low folate concentration
-
high MCV
Pregunta 29
Pregunta
A 47 year old woman is found to have macrocytosis. Upon investigation folate deficiency is diagnosed. The macrocytosis is a result of impaired synthesis of which compound?
Respuesta
-
heme
-
haemoglobin
-
DNA
-
methylmalonic acid
-
alfa - globine chain
Pregunta 30
Pregunta
A 26 year old woman comes to you for a check —up. She has intestinal inflammatory disease ( Crohn's disease) which causies GI bleeding. She has recently had most of her ileum removed. Which nutritional deficiency or combination of deficiencies is most likely in her?
Respuesta
-
iron and vit B12
-
folate
-
vit B12
-
folate and vit B12
-
folate and iron
Pregunta 31
Pregunta
A 61 year old man has just had a surgical resection of his entire stomach because of cancer. This type of surgery puts him at high risk for nutritional anemia because lack of :
Respuesta
-
lactoferin
-
transcobalamin
-
ghrelin
-
intrinsic factor
-
Rh factor
Pregunta 32
Pregunta
What is the lower limit of normal Hb concentration in venous blood as defined by World Health Organization for males and females:
Respuesta
-
12g/dl and 11g/dl
-
11g/dl and 12g/dl
-
13g/dl and 12g/dl
-
12 g/dl and 13 g/dl
-
14 g/dl and 13 g/dl
Pregunta 33
Pregunta
What 'test. is performed in the initial evaluation of anemia after patient's history and physical exam?
Respuesta
-
PTT - prothrombin time
-
CBC - complete blood count
-
DBC - differential blood count
-
bleeding time
-
PTT - partial thromboplastin time
Pregunta 34
Pregunta
Which of the followings in not included in the differential diagnosis for mycrocytic hypochromic anemia:
Respuesta
-
thallasemia
-
iron def anemia
-
anemia in malignancy
-
anemia of chronic disease
-
megaloblastic anemia
Pregunta 35
Pregunta
An alcoholic patient presents with diarrhoea and goit disturbancies. Ankle reflexes are absent. Position sense is impaired. Physical exam reveals a beefy, atrophic tongue. The blood smear slows macrocytosis. Which of the following is most likely?
Respuesta
-
vit A def
-
folate def
-
vit B12 def
-
vit C def
-
vit K def
Pregunta 36
Pregunta
An elderly patient presents with vitilgo and hypothyroidismus. Ankle reflexes are absent. Position sense is impaired. Physical exam reveals a beefy, atrophic tongue.The blood smear shows macrocytosis. Which of the following is most likely?
Respuesta
-
vit A def
-
folate def
-
vit B12 def
-
vit C def
-
vit K def
Pregunta 37
Pregunta
What test is performed to exclude hemolysis in the evaluation of normocytic normochronic anemia?
Respuesta
-
reticulocyte count
-
serum ferritin
-
serum transferrin
-
complete blood count
-
serum transferin receptor
Pregunta 38
Pregunta
What lab differences show iron deficiency anemia from anemia of chronic disease?
Respuesta
-
reticulocyte count
-
serum ferritin
-
serum iron
-
serum bilrubin
-
serum haptoglobin
Pregunta 39
Pregunta
Which organ is responsible for producing 99% of body erythropoietin?
Respuesta
-
spleen
-
liver
-
kidneys
-
bone marrow
-
adrenal glands
Pregunta 40
Pregunta
Which of the following is characterised by peripheral pancytopenia, bone marrow hypocellularity. absence of malignat myelo — or lymphoproliferation and is cured by all ogeneic stem cell transplantation?
Respuesta
-
autoimmune haemolytic anemia
-
aplastic anemia
-
thallasemia
-
sickle cell disease
-
pernitious anemia
Pregunta 41
Pregunta
What is the most common cause for aplastic anemia?
Respuesta
-
drugs containing gold
-
chloramphenicol
-
benzene
-
radiation
-
idiopathic
Pregunta 42
Pregunta
Which therapy is considered in patient with aplastic anemia younger than 40 years?
Respuesta
-
immunosupression
-
best supportive care
-
autologious stem cell transplantation
-
allogenic stem cell transplantation
-
splenectomy
Pregunta 43
Pregunta
Which therapy is considered in patient with aplastic anemia older than 40. years?
Respuesta
-
immunosupression
-
best supportive care
-
autologious stem cell transplantation
-
allogenic stem cell transplantation
-
splenectomy
Pregunta 44
Pregunta
Which of the following will be NOT increased in patient with haemolytic anemia?
Respuesta
-
ferritin
-
reticulocytes
-
serum iron
-
LDH
-
direct bilirubin
Pregunta 45
Pregunta
Which of the following is associatated with hyposplenism ( asplenia), possibly megaloblastic anemia and iscaemic crises?
Respuesta
-
acanthocytosis
-
G6PD def anemia
-
sickle cell disease
-
thallaseamia
-
pernitious anemia
Pregunta 46
Pregunta
What is the treatment of choice for autoimmune hemolytic anemia:
Respuesta
-
chloramphenicol
-
bone marrow transplantation
-
steroids
-
splenectomy
-
blood transfusion
Pregunta 47
Pregunta
Which of the following is a definitive test for G6PD deficiency
Respuesta
-
bite cells
-
Heinz bodies
-
electroforesis of hemoglobin
-
G6PD assay
-
target cells
Pregunta 48
Pregunta
Which of the following is a definitive test for thallasemia
Respuesta
-
bite cells
-
heinz bodies
-
electroforesis of hemoglobin
-
G6PD assay
-
target cells
Pregunta 49
Pregunta
In which of the following disease there is an excess of alfa — globin chains
Respuesta
-
beta-thallaseamia
-
alfa thallasemia minor
-
sickle cell anemia
-
alfa-thallasemia homozygous form
-
G6PD def anemia
Pregunta 50
Pregunta
Which of the following is NOT a symptom of sickle cell anemia
Respuesta
-
spleen infraction
-
priapism
-
ischeamic stroke
-
bone and joint infraction
-
brain haemorrhage
Pregunta 51
Pregunta
Which of the following is used in the management of sickle cell disease:
Respuesta
-
angiography
-
heparin
-
warfarin
-
aspirin
-
RBC transfusions
Pregunta 52
Pregunta
What is NOT a common reason for death in sickle cell anemia:
Respuesta
-
bleeding
-
acute chest syndrome
-
myocardial infraction
-
septicaemia
-
stroke
Pregunta 53
Pregunta
What is the most common reason for death in thallasemia major:
Respuesta
-
diabetes mellitus
-
osteoporosis
-
brain haemorrhage
-
cardiac insufficiency
-
cholelithiasis
Pregunta 54
Pregunta
Hemosiderosis because of iron overload is NOT a complication of:
Respuesta
-
sickle cell disease
-
thallasemia
-
megaloblastic anemia
-
autoimmune haemolytic anemia
-
microspherocytosis
Pregunta 55
Pregunta
Besides regular blood transfusions in the management of thallasemia are included:
Respuesta
-
steroids
-
immunopressors
-
cytostatics
-
iron helating agents
-
NSAID
Pregunta 56
Pregunta
Which of the following is NOT a therapeutic option in thallasemia major:
Respuesta
-
stem cell transplantation
-
blood transfusion
-
immunosuppressive therapy
-
splenectomy
-
iron helating agents
Pregunta 57
Pregunta
In which of the following splenectomy is the therapy of first choice:
Respuesta
-
autoimmune haemolytic anemia
-
microspherocytosis
-
G6PD def
-
aplastic anemia
-
sickle cell disease
Pregunta 58
Pregunta
How long is the duration of Vit B12 supplementation therapy in patients with pernitious anemia:
Respuesta
-
3-4 years
-
only in haemolytic crises
-
till Hb level> 10g/dl
-
life-long
-
till the reticulocyte crisis
Pregunta 59
Pregunta
Allogeneic stem cell transplantation is a therapeutic option in ALL BUT ONE of the following:
Respuesta
-
aplastic anemia
-
beta-thallasemia major
-
sickle cell disease
-
automimmunoe hemolytic anemia
-
none of the above
Pregunta 60
Pregunta
Best donor for allogeneic stem cell transplantation is
Respuesta
-
HLA matched related donor
-
HLA matched unrelated donor
-
HLA mismatched donor in 1 allele
-
HLA mismatched donor
-
stem cell from cord blood
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