Pathophys questions 1-50 PART 1

1.

1 point

18. A patient after terminal ileum resection would be likely to suffer from which of the following conditions

Sideroblastic anemia

Megaloblastic anemia

Sideropenic anemia

Microcytic anemia

2.

1 point

39. If hematocrit is not >70%, the blood viscosity

Is connected with significant risk of intravascular blood clots (thrombosis)

Increases the workload of the heart

Improves tissue perfusion and oxygenation of the blood

Decreases blood flow in the blood vessels and deteriorates the rheological parameters of the blood

3.

1 point

20. Hemoglobinuria can not appear

After intravascular destruction of erythrocytes

Following the transfusion of incompatible blood

When haptopglobin capacity is saturated by free hemoglobin

After the erythrophagocytosis by macrophages in the spleen

4.

1 point

2. Hyposplenism

Is defined as a type of bone marrow failure, connected to spleen hyperactivity

Is defined as the presence of accessory spleens

Is a situation, in which blood cells are not sequestrated by an enlarged spleen

Can be characterised by anemia, leukopenia and thrombocytopenia

5.

1 point

12. Sideroblastic anemia is a subtype of

Megaloblastic anemias

Hemolytic anemia

Anemias caused by a lack of erythropoietin

Anemias caused by heme synthesis disorders

6.

1 point

25. Sideroblastic anemias may occur due to

Decreased intake of iron

High rate of ineffective hemotapoiesis

Normal heme synthesis

Lead intoxification

7.

1 point

25. Sideroblastic anemias may occur due to

Magnesium intoxification

Decreased intake of iron

High rate of ineffective hemotapoiesis

Disturbances in the heme synthesis

8.

1 point

19. In the diagnosis of anemia

Decreased level of transferrin shows that the anemia is sideropenic

Positive direct Coombs test signifies autoimmune hemolytic anemia

Increased level of haptoglobin signifies anemia of hemolytic origin

Decreased amount of reticulocytes suggests that the anemia is caused by insufficient production of red blood cells, which is typical for thalassemia or sickle cell anemia

9.

1 point

14. Among others, sideropenic anemia is characterised by

Macrocytosis

Hypercellularity of bone marrow

Hypocellularity of bone marrow

Microcytosis

10.

1 point

24. The plasma erthropoietin level in secondary polyglobular is

Unchanged

Increased

Decreased

11.

1 point

17. Microcytic anemia often develops in patients with

Thalassemia major

Aplastic anemia

The deficiency of intrinsic factor

Thalassemia minor

12.

1 point

29. Pronounced sideropenic anaemia is not accompanied by

macrocytosis

decreased serum ferritin concentration

decreased hemoglobin concentration

decreased serum iron concentration

13.

1 point

9. Which of the following is not among the primary functions of blood plasma

Maintenance of red cell size

Transport of hormones

Transport of O2

Transport of chylomicrons

14.

1 point

36. Which of the following is true for paroxysmal nocturnal hemoglobinuria

Is caused by a lack of spectrin in the erythrocyte membrane

It is caused by a defect of protective proteins in the erythrocyte membrane

It develops as a result of overproduction of complement proteins

Complement activation as well as an increase of blood pH during sleep play a role in the pathogenesis of the disease

15.

1 point

5. Hyperviscous syndrome is characterised by

No release of activated coagulation factors from the place of their origin

Increased release of activated coagulation factors from the place of their origin

Being an acute life-threatening situation

Decreased heart work

16.

1 point

14. Among others, sideropenic anemia is characterised by

Normo/Hypercellularity of bone marrow

Macrocytosis

Hypercellularity of bone marrow

Hypocellularity of bone marrow

17.

1 point

27. Macrocytic anaemia cannot accompany

hepatic failure

hereditary spherocytosis

severe hypothyroidism

folic acid defficiency

18.

1 point

4. Warm antibodies

Are often directed against muscle proteins

Are not often directed against erythrocyte antigens

Can be detected using the Coombs test

Are generated during febrile state

19.

1 point

36. Which of the following is true for paroxysmal nocturnal hemoglobinuria

It develops as a result of overproduction of complement proteins

Complement activation as well as a decrease of blood pH during sleep play a role in the pathogenesis of the disease

Is caused by a lack of spectrin in the erythrocyte membrane

It is not caused by a defect of protective proteins in the erythrocyte membrane

20.

1 point

23. Paroxysmal nocturnal hemoglobinuria is not

Hemolysis is not involved in the pathogenesis of this disease

Caused by a somatic mutation of the hemopoietic stem cell

Characterised by hemolysis during increased levels of pCO2

Characterised by defective synthesis of the glycosylphophatidylinositol anchor

21.

1 point

13. Production of erythropoietin in a patient with polycythemia rubra vera is

Unchanged

Decreased

Increased

22.

1 point

31. Combination of schistocytes in the peripheral blood and neurological symptoms can be caused by

TTP (thrombotic thrombocytopenic purpura)

AIHA

paraoxysmal nocturnal hemoglobinuria

sickle cell anaemia

23.

1 point

34. Paroxysmal nocturnal hemoglobinuria is not a disease

Accompanied attacks of hemolysis following exposure to cold

Caused by mutation of hemolytic stem cells

Which can progress into acute leukemia

In which red blood cells have an increased sensitivity to complement

24.

1 point

33. normal oxygen saturation of arterial blood, together with elevated red blood cell count, can be present in

decreased erythropoietin production

polycythemia vera

multiple myeloma

in all cases of secondary polyglobulia

25.

1 point

3. Cold antibodies

Can not lead to acrocyanosis (if the temperature of the external environment is low)

Are generated during long term exposure to cold environment

Are usually of the IgG type

Are usually of the IgM type

26.

1 point

6. Splenectomy is accompanied by

Lack of Howell-Jolly bodies in erythrocytes

Thrombocytopenia

Increased number of granulocytes in peripheral blood

Anemia

27.

1 point

3. Cold antibodies

Are usually of the IgG type

Can lead to acrocyanosis (if the temperature of the external environment is low)

Are generated during long term exposure to cold environment

Are usually of the IgD type

28.

1 point

37. Paroxysmal nocturnal hemoglobinuria is a disease, which is

Hereditary with an autosomal dominant inheritance

A multifactoral hereditary disease

Hereditary with autosomal recessive inheritance

Acquired

29.

1 point

16. Paroxysmal nocturnal hemoglobinuria is

Characterised by the presence of pathological hemoglobin

The result of hemopoietic stem cell damage

The manifestation of a parasitic infection

Caused by defective glycolytic enzymes

30.

1 point

6. Splenectomy is accompanied by

Thrombocytopenia

Anemia

Presence of Howell-Jolly bodies in erythrocytes

Decreased number of granulocytes in peripheral blood

31.

1 point

11. Splenomegaly can not be caused by

Lienal vein thrombosis

Portal vein thrombosis

Budd-Chiari syndrome

Renal vein thrombosis

32.

1 point

32. hemolytic anaemia caused by autoimmune disorders can be diagnosed by

testing the osmotic resistance of erythrocytes

electrophoresis of serum immunoglobulins

the Coombs test (direct antiglobulin test)

a genetic test (sequencing of globin chains)

33.

1 point

17. Microcytic anemia often develops in patients with

The deficiency of intrinsic factor

Sideropenia

Aplastic anemia

Thalassemia major

34.

1 point

7. The combination of decreased plasma haptoglobin, anemia and positive Coombs test points to a diagnosis of

Intracorpuscular hemolytic anemia

Anemia in DIC

Lead poisoning

Autoimmune hemolytic anemia

35.

1 point

30. the lack of vitamin B12 and folic acid

does not influence erythropoiesis

also influences cells other than blood cells

causes only disturbances in the red blood cell production

influences only the metabolism of blood cells

36.

1 point

4. Warm antibodies

Are often directed against erythrocyte antigens

Are generated during febrile state

Can not be detected using the Coombs test

Are often directed against muscle proteins

37.

1 point

40. Methemoglobin

Is a type of hemoglobin with mutated globin chains

Is caused by hypoxia

Contains divalent iron (Fe2+)

Contains trivalent iron (Fe3+)

38.

1 point

15. Haptoglobin is

Increased after extravascular hemolysis

Decreased after intravascular hemolysis

Excreted into urine in PNH (paroxysmal nocturnal hemoglobinuria)

A degradation product of hemoglobin

39.

1 point

26 Anaemia caused by the lack of both vitamin B12 and tetrahydrofolate is morphologically characterized by

macrocytosis

microcytosis

normocytosis

lack of presence of megaloblasts in bone marrow

40.

1 point

26 Anaemia caused by the lack of both vitamin B12 and tetrahydrofolate is morphologically characterized by

presence of megaloblasts in bone marrow

microcytosis

lack of presence of megaloblasts in bone marrow

normocytosis

41.

1 point

5. Hyperviscous syndrome is characterised by

Decreased heart work

Increased release of activated coagulation factors from the place of their origin

Decreased release of activated coagulation factors from the place of their origin

Being a chronic life-threatening situation

42.

1 point

38. In anemia, the arterial oxygen tension (paO2) is

Increased

Approx. 40mmHg

Normal

Decreased

43.

1 point

21. Not in pernicious anemia

There are often antibodies against the intrinsic factor

DNA synthesis in erythroblasts is compromised

The incorporation of iron into the hemoglobin is defective

The size of erythrocytes often surpasses 100fL

44.

1 point

1. Blood viscosity is

Linearly proportional to hematocrit

Decreased when hematocrit decreases

Is independent of the hematocrit

Increased when hematocrit increases

45.

1 point

8. Chronic lead poisoning leads to

Microcytic anemia

Coombs test positivity

Ethanol test positivity

Macrocytic anemia

46.

1 point

28. anaemia and reticulocytosis can be symptomatic of which of the following

bone marrow infiltration by a tumour

pernicious anaemia

fanconi anaemia

AIHA (Autoimmune Hemolytic Anaemia)

47.

1 point

10. Which of the following plasma proteins are not synthesised primarily in the liver

C-reactive protein

Angiotensinogen

Alpha 2-macroglobin

Angiotensin II converting enzyme

48.

1 point

22. Which of the following applies to the latent phase of sideropenic anemia

Hemoglobin level in serum is decreased

The ferritin level in serum is decreased

The binding capacity of transferrin is decreased

The level of iron in serum is normal

49.

1 point

2. Hyposplenism

Can not be characterised by anemia, leukopenia and thrombocytopenia

Is defined as a type of bone marrow failure, connected to spleen hyperactivity

Is a situation, in which blood cells are sequestrated by an enlarged spleen

Is defined as the presence of accessory spleens

50.

1 point

35. The direct antiglobulin (Coombs) test is positive in which of the following conditions

TTP

AIHA

Anemia cause by lead intoxication

Beta thalassemia