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hematology Quiz sobre anaemia colloquium , criado por nisha gurung em 27-05-2020.

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anaemia colloquium

Questão 1 de 60

1

Which of the following is NOT true for the erythrocytes:

Selecione uma ou mais das seguintes:

  • 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

Explicação

Questão 2 de 60

1

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

Selecione uma ou mais das seguintes:

  • thrombophillia

  • sickle cell anemia

  • megaloblastic anemia

  • enzimopenic hemolytic anemia

  • thallasaemia

Explicação

Questão 3 de 60

1

G6PD is an intraerytocytic enzyme necessary for production of what:

Selecione uma ou mais das seguintes:

  • succinyl Co-A

  • methylmalonil Co A

  • pyruvate

  • NADPH

  • NAD

Explicação

Questão 4 de 60

1

Which of the following are proteins from the membrane cytoskeleton of the RBCs?

Selecione uma ou mais das seguintes:

  • ankirin and spectrin

  • vicin and convicin

  • vincristin and vinblastinn

  • NAD+ and NADPH

  • alpha and beta globine

Explicação

Questão 5 de 60

1

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?

Selecione uma ou mais das seguintes:

  • iron deficiency anemia

  • megaloblastic anemia

  • mircospherocytosis

  • thallasaemia major

  • aplastic anemia

Explicação

Questão 6 de 60

1

What type of anemia is assosiciated with quantitative defects in hemoglobin production:

Selecione uma ou mais das seguintes:

  • membranopathic hemolytic

  • enzymopathic hemolytic

  • hemoglionpathies

  • immune hemolytic

  • thallassemia

Explicação

Questão 7 de 60

1

Damage to the duodenum. preventing nutrient absorption would cause which of the following forms of anemia:

Selecione uma ou mais das seguintes:

  • iron deficiency anemia

  • vit B12 deficiency anemia

  • PK deficiency anemia

  • G6PD deficiency anemia

  • folic acid deficiency anemia

Explicação

Questão 8 de 60

1

Damage to the ileum, preventing nutrient absorption would cause which of the following forms of anemia:

Selecione uma ou mais das seguintes:

  • iron deficiency anemia

  • vit B12 deficiency anemia

  • PK deficiency anemia

  • G6PD deficiency anemia

  • folic acid deficiency anemia

Explicação

Questão 9 de 60

1

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:

Selecione uma ou mais das seguintes:

  • spleen

  • liver

  • bone marrow

  • small vessels

Explicação

Questão 10 de 60

1

A patient presents with jaundice. Lab tests show anemia, decreased haptoglobin hemoglobinemia, hemoglobinuria.. Which of the following is most likely:

Selecione uma ou mais das seguintes:

  • intravascular hemolysis

  • extravascular hemolysis

  • mircospherocytosis

  • acute hepatitis

  • acute cholecystitis

Explicação

Questão 11 de 60

1

After an acute blood loss which of the following will be seen :

Selecione uma ou mais das seguintes:

  • thrombocytopenia

  • leucopenia

  • reticulcytosis

  • thrombocytosis

  • leukocytosis

Explicação

Questão 12 de 60

1

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:

Selecione uma ou mais das seguintes:

  • G6PD deficiency anemia

  • sickle cell anemia

  • thallaseamia

  • autoimmune haemolytic anemia

  • microsperocytosis

Explicação

Questão 13 de 60

1

What change is seen in 6 position of the beta globine chain in sickle cell anemia:

Selecione uma ou mais das seguintes:

  • glycine for valine

  • valine for glycine

  • valine for glutamatic acid

  • gluamatic acid for valine

  • none of the above

Explicação

Questão 14 de 60

1

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:

Selecione uma ou mais das seguintes:

  • autoimmune haemolytic anemia with warm autoantibiodies

  • autoimmune haemolytic anemia with cold autoantibodies

  • CMV liver infection

  • paraoxysmal cold hemoglobinuria

  • march hemoglobinuria

Explicação

Questão 15 de 60

1

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:

Selecione uma ou mais das seguintes:

  • haemolytic anemia with cold autoantibodies

  • haemolytic anemia with warm autoantibodies

  • microphserocytosis

  • sickle cell anemia

  • malaria

Explicação

Questão 16 de 60

1

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?

Selecione uma ou mais das seguintes:

  • HA with warm antibodies

  • HA with cold antibodies

  • hereditary speherocytosis

  • drug induced haemolytic anemia (penicillin type)

  • drug induced HA (hapten type)

Explicação

Questão 17 de 60

1

Which of the following is used to diagnose autoimmune hemolytic anemia by detecting autoantibodies and /or complement bound to the RBC:

Selecione uma ou mais das seguintes:

  • DAT (direct coombs test)

  • PTT

  • APTT

  • D-dimers

  • IAT (indirect coombs test)

Explicação

Questão 18 de 60

1

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:

Selecione uma ou mais das seguintes:

  • vit K def

  • vit C def

  • folic acid def

  • vit B12 def

  • iron def

Explicação

Questão 19 de 60

1

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:

Selecione uma ou mais das seguintes:

  • vit K def

  • Vit C def

  • folic acid def

  • Vit B12 def

  • iron def

Explicação

Questão 20 de 60

1

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:

Selecione uma ou mais das seguintes:

  • vit K def

  • vit c def

  • folic acid def

  • Vit B12 def

  • iron def

Explicação

Questão 21 de 60

1

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:

Selecione uma ou mais das seguintes:

  • Diphilobotrum latum parasitosis

  • lime disease

  • malaria

  • HCV infection

  • EBV infection

Explicação

Questão 22 de 60

1

Which of the following is associated with anemia, thrombocytopenia, leukopenia and reduction of all cellular elements of the blood?

Selecione uma ou mais das seguintes:

  • hereditary HA

  • iron def anemia

  • aplastic anemia

  • thallasemia

  • autoimmune anemia

Explicação

Questão 23 de 60

1

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?

Selecione uma ou mais das seguintes:

  • serum ferritin concentration

  • serum transferin concentration

  • serum iron concentration

  • urine homocystein

  • serum hepcidin concentration

Explicação

Questão 24 de 60

1

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?

Selecione uma ou mais das seguintes:

  • serum ferritin concentration

  • serum transferin concentration

  • serum iron concentration

  • urine homocystein

  • serum folate concentration

Explicação

Questão 25 de 60

1

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?

Selecione uma ou mais das seguintes:

  • spinach and broccoli

  • black tea

  • chicken, fish and beef

  • fresh citrus fruits

  • iron fortified cereals

Explicação

Questão 26 de 60

1

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?

Selecione uma ou mais das seguintes:

  • haemolytic anemia

  • aplastic anemia

  • vit B12 def anemia

  • iron def anemia following acute blood loss

Explicação

Questão 27 de 60

1

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?

Selecione uma ou mais das seguintes:

  • haemolytic anemia

  • aplastic anemia

  • vit B12 def anemia

  • iron def anemia following acute blood loss

Explicação

Questão 28 de 60

1

Which is usually the first sign of folate deficiency?

Selecione uma ou mais das seguintes:

  • low RBC concentration

  • low hemoglobin concentration

  • hypersegmented neutrophils

  • low folate concentration

  • high MCV

Explicação

Questão 29 de 60

1

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?

Selecione uma ou mais das seguintes:

  • heme

  • haemoglobin

  • DNA

  • methylmalonic acid

  • alfa - globine chain

Explicação

Questão 30 de 60

1

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?

Selecione uma ou mais das seguintes:

  • iron and vit B12

  • folate

  • vit B12

  • folate and vit B12

  • folate and iron

Explicação

Questão 31 de 60

1

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 :

Selecione uma ou mais das seguintes:

  • lactoferin

  • transcobalamin

  • ghrelin

  • intrinsic factor

  • Rh factor

Explicação

Questão 32 de 60

1

What is the lower limit of normal Hb concentration in venous blood as defined by World Health Organization for males and females:

Selecione uma ou mais das seguintes:

  • 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

Explicação

Questão 33 de 60

1

What 'test. is performed in the initial evaluation of anemia after patient's history and physical exam?

Selecione uma ou mais das seguintes:

  • PTT - prothrombin time

  • CBC - complete blood count

  • DBC - differential blood count

  • bleeding time

  • PTT - partial thromboplastin time

Explicação

Questão 34 de 60

1

Which of the followings in not included in the differential diagnosis for mycrocytic hypochromic anemia:

Selecione uma ou mais das seguintes:

  • thallasemia

  • iron def anemia

  • anemia in malignancy

  • anemia of chronic disease

  • megaloblastic anemia

Explicação

Questão 35 de 60

1

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?

Selecione uma ou mais das seguintes:

  • vit A def

  • folate def

  • vit B12 def

  • vit C def

  • vit K def

Explicação

Questão 36 de 60

1

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?

Selecione uma ou mais das seguintes:

  • vit A def

  • folate def

  • vit B12 def

  • vit C def

  • vit K def

Explicação

Questão 37 de 60

1

What test is performed to exclude hemolysis in the evaluation of normocytic normochronic anemia?

Selecione uma ou mais das seguintes:

  • reticulocyte count

  • serum ferritin

  • serum transferrin

  • complete blood count

  • serum transferin receptor

Explicação

Questão 38 de 60

1

What lab differences show iron deficiency anemia from anemia of chronic disease?

Selecione uma ou mais das seguintes:

  • reticulocyte count

  • serum ferritin

  • serum iron

  • serum bilrubin

  • serum haptoglobin

Explicação

Questão 39 de 60

1

Which organ is responsible for producing 99% of body erythropoietin?

Selecione uma ou mais das seguintes:

  • spleen

  • liver

  • kidneys

  • bone marrow

  • adrenal glands

Explicação

Questão 40 de 60

1

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?

Selecione uma ou mais das seguintes:

  • autoimmune haemolytic anemia

  • aplastic anemia

  • thallasemia

  • sickle cell disease

  • pernitious anemia

Explicação

Questão 41 de 60

1

What is the most common cause for aplastic anemia?

Selecione uma ou mais das seguintes:

  • drugs containing gold

  • chloramphenicol

  • benzene

  • radiation

  • idiopathic

Explicação

Questão 42 de 60

1

Which therapy is considered in patient with aplastic anemia younger than 40 years?

Selecione uma ou mais das seguintes:

  • immunosupression

  • best supportive care

  • autologious stem cell transplantation

  • allogenic stem cell transplantation

  • splenectomy

Explicação

Questão 43 de 60

1

Which therapy is considered in patient with aplastic anemia older than 40. years?

Selecione uma ou mais das seguintes:

  • immunosupression

  • best supportive care

  • autologious stem cell transplantation

  • allogenic stem cell transplantation

  • splenectomy

Explicação

Questão 44 de 60

1

Which of the following will be NOT increased in patient with haemolytic anemia?

Selecione uma ou mais das seguintes:

  • ferritin

  • reticulocytes

  • serum iron

  • LDH

  • direct bilirubin

Explicação

Questão 45 de 60

1

Which of the following is associatated with hyposplenism ( asplenia), possibly megaloblastic anemia and iscaemic crises?

Selecione uma ou mais das seguintes:

  • acanthocytosis

  • G6PD def anemia

  • sickle cell disease

  • thallaseamia

  • pernitious anemia

Explicação

Questão 46 de 60

1

What is the treatment of choice for autoimmune hemolytic anemia:

Selecione uma ou mais das seguintes:

  • chloramphenicol

  • bone marrow transplantation

  • steroids

  • splenectomy

  • blood transfusion

Explicação

Questão 47 de 60

1

Which of the following is a definitive test for G6PD deficiency

Selecione uma ou mais das seguintes:

  • bite cells

  • Heinz bodies

  • electroforesis of hemoglobin

  • G6PD assay

  • target cells

Explicação

Questão 48 de 60

1

Which of the following is a definitive test for thallasemia

Selecione uma ou mais das seguintes:

  • bite cells

  • heinz bodies

  • electroforesis of hemoglobin

  • G6PD assay

  • target cells

Explicação

Questão 49 de 60

1

In which of the following disease there is an excess of alfa — globin chains

Selecione uma ou mais das seguintes:

  • beta-thallaseamia

  • alfa thallasemia minor

  • sickle cell anemia

  • alfa-thallasemia homozygous form

  • G6PD def anemia

Explicação

Questão 50 de 60

1

Which of the following is NOT a symptom of sickle cell anemia

Selecione uma ou mais das seguintes:

  • spleen infraction

  • priapism

  • ischeamic stroke

  • bone and joint infraction

  • brain haemorrhage

Explicação

Questão 51 de 60

1

Which of the following is used in the management of sickle cell disease:

Selecione uma ou mais das seguintes:

  • angiography

  • heparin

  • warfarin

  • aspirin

  • RBC transfusions

Explicação

Questão 52 de 60

1

What is NOT a common reason for death in sickle cell anemia:

Selecione uma ou mais das seguintes:

  • bleeding

  • acute chest syndrome

  • myocardial infraction

  • septicaemia

  • stroke

Explicação

Questão 53 de 60

1

What is the most common reason for death in thallasemia major:

Selecione uma ou mais das seguintes:

  • diabetes mellitus

  • osteoporosis

  • brain haemorrhage

  • cardiac insufficiency

  • cholelithiasis

Explicação

Questão 54 de 60

1

Hemosiderosis because of iron overload is NOT a complication of:

Selecione uma ou mais das seguintes:

  • sickle cell disease

  • thallasemia

  • megaloblastic anemia

  • autoimmune haemolytic anemia

  • microspherocytosis

Explicação

Questão 55 de 60

1

Besides regular blood transfusions in the management of thallasemia are included:

Selecione uma ou mais das seguintes:

  • steroids

  • immunopressors

  • cytostatics

  • iron helating agents

  • NSAID

Explicação

Questão 56 de 60

1

Which of the following is NOT a therapeutic option in thallasemia major:

Selecione uma ou mais das seguintes:

  • stem cell transplantation

  • blood transfusion

  • immunosuppressive therapy

  • splenectomy

  • iron helating agents

Explicação

Questão 57 de 60

1

In which of the following splenectomy is the therapy of first choice:

Selecione uma ou mais das seguintes:

  • autoimmune haemolytic anemia

  • microspherocytosis

  • G6PD def

  • aplastic anemia

  • sickle cell disease

Explicação

Questão 58 de 60

1

How long is the duration of Vit B12 supplementation therapy in patients with pernitious anemia:

Selecione uma ou mais das seguintes:

  • 3-4 years

  • only in haemolytic crises

  • till Hb level> 10g/dl

  • life-long

  • till the reticulocyte crisis

Explicação

Questão 59 de 60

1

Allogeneic stem cell transplantation is a therapeutic option in ALL BUT ONE of the following:

Selecione uma ou mais das seguintes:

  • aplastic anemia

  • beta-thallasemia major

  • sickle cell disease

  • automimmunoe hemolytic anemia

  • none of the above

Explicação

Questão 60 de 60

1

Best donor for allogeneic stem cell transplantation is

Selecione uma ou mais das seguintes:

  • HLA matched related donor

  • HLA matched unrelated donor

  • HLA mismatched donor in 1 allele

  • HLA mismatched donor

  • stem cell from cord blood

Explicação