Haematology questions mcq PDF

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Hematology MCQs ans

WK2012

1. Which of the following is not associated with thrombotic thrombocytopenic purpura ? A. B. C. D. E.

thrombosis thrombocytopenia microangiopathic hemolytic anemia neurologic deficits renal failure

2. A patient who is suspected of having acute viral hemorrhagic fever reveals history of tick bite. Which of the following is the most possible causative agent ? A. B. C. D. E.

Hantavirus Rift Valley virus Crimean Congo virus Marburg virus Ross River virus

3. Which of the following is false regarding heparin ? A. Subcutaneous injection of heparin is avoided because of hematomas formation. B. Heparin is usually stored in the mast cells. C. Heparin binds to plasma anti thrombin III and inhibits activated thrombin. D. Protamine sulfate can be used to counteract heparin overdose. E. Partial thromboplastin time is measured to monitor heparin use. 4. Which of the following requires IL-2 and IL-4 in the conversion of unilineage progenitor cell into mature circulating cell ? A. B. C. D. E.

Neutrophil Eosinophil Basophil B lymphocyte T lymphocyte

5. The mean cell volume of the patient is 90 fl and the reticulocyte production index is low. Which of the following is the most possible cause of anemia in this patient ?

A. B. C. D. E.

thalassemia vitamin B12 deficiency aplastic anemia sideroblastic anemia iron deficiency anemia

6. A patient is presented with weakness of legs, arms, trunk, tingling and numbness that progressively worsens. Peripheral blood smear shows macrocytic anemia. Which of the following is not the factor causing this condition ? A. B. C. D. E.

Chronic atrophic gastritis Ileal resection Tapeworm infestation Alcoholism Exposure to nitrous oxide

7. Which of the following is not a good prognostic factor in patient with acute lymphoblastic leukemia ? A. B. C. D. E.

Immunophenotype – mature B cell Gender – female Chromosomal number – hyperploidy Age – 4 to 10 years old Expression of ZAP 70

8. A patient is suffered from vitamin K deficiency. Which of the coagulation factors will not be affected ? A. B. C. D. E.

Factor II Factor VII Factor VIII Factor IX Factor X

9. A 30 year old patient had presented with fever and posterior cervical lympadenopathy over the past two years. Which is the most probably causative organism ? A. B. C. D.

Trypanosoma cruzi Trypanosoma brucei rhodesiense Trypanosoma brucei gambiense Leishmania donovani

E. Oncocherca volvulus 10.A 40 year old patient is presented with unilateral palpebral edema and ipsilateral lymphadenopathy. He later develops megaesophagus and megacolon as complications. Which of the following vector is responsible for this parasitic infection ? A. B. C. D. E.

Glossina morsitans Ixodes scapularis Rhodnius prolixus Simulium damnosum Anopheles

11.A patient shows prolonged prothrombin time and activated partial thromboplastin time. Blood test otherwise is normal. Which of the following is the most probably diagnosis for this patient’s condition ? A. B. C. D. E.

Hemophilia A Thrombocytopenia Von Wille brand factor disease Vitamin K deficiency Hypofibrinogenemia

12.Which of the following will be present in chronic bacterial infection ? A. B. C. D. E.

Neutrophilia Basophilia Lymphocytosis Eosinophilia Monocytosis

13.Which of the following subtypes of Hodgkin’s lymphoma is common in young women and has good prognosis ? A. B. C. D. E.

Nodular sclerosis Mixed cellularity Lymphocyte predominance Lymphocyte depletion Lymphocyte rich

14.Which of the following is not the criteria in the international prognostic index for non Hodgkin’s lymphoma ? A. B. C. D. E.

Number of extranodal sites LDH level Lymphocyte count Performance status Age

15.Which of the following is the most suitable anti malarial drug for pregnant women ? A. B. C. D. E.

Atovaquone and proguanil Quinine and doxycycline Quinine and clindamycin Primaquine Mefloquine

16.The typical Reed-Sternberg cells are either infrequent or absent. Instead, lymphocytic and histiocytic cells or "popcorn cells" are seen within a background of inflammatory cells, which are predominantly benign lymphocytes. Which type of Hodgkin’s lymphoma best suit the description ? A. B. C. D. E.

Nodular sclerosis Mixed cellularity Lymphocyte depleted Lymphocyte predominance Lymphocyte rich

17.Which of the following is false regarding Burkitt’s lymphoma ? A. Associated with translocation of c-myc gene on chromosome 18 B. Usually presents with abdominal involvement in HIV patients C. Common in Africa children due to Epstein Barr infection after malaria exposure. D. Histologically characterized by a "starry sky" appearance E. Cyclophosphamide and vincristine can be used as treatment. 18.A patient is presented with fever, vomiting, hypotension and facial edema after his business trip back from Africa. Viral hemorrhagic fever is suspected in this patient. Which of the following family does the suspected virus belong to ?

A. B. C. D. E.

Filovirus Togavirus Adenavirus Bunyavirus Flavivirus

19.A patient is presented with pallor, fatigue and dyspnea. Physical examination shows koilonychias and angular cheilosis. Which of the following is not expected in the laboratory finding of this patient ? A. B. C. D. E.

Low total iron binding capacity High serum transferrin Low iron: total iron binding capacity ratio Low serum ferritin Low transferrin saturation

20.A patient who is infected with hookworms produces signs and symptoms of anemia. Which of the following can be seen in the peripheral blood smear of the patient ? A. B. C. D. E.

21.

Howell Jolly bodies Basophilic stippling Target cells Spherocytes Pappenheimer bodies

NADPH is a product of the hexose monophosphate pathyway (HMP) in the red blood cell. The NADPH is used for the

a.

Synthesis of fatty acids

b.

Reduction of gluthathione

c.

Formation of ATP

d.

Removal of oxygen radicals

e.

Modulation of 2-3-biphosphoglycerate (2,3-BPG) production

22.

Mr XY was found to be anaemia. During history taking, he informed his doctor that he was a strict vegetarian who did not consume any meat, fish of milk products.

a.

Iron deficiency

b.

Vitamin B12 deficiency

c.

Defects in erythropoietin production

d.

Calcium-deficiency

e.

Defects in production of transferring

23.

Koilonychias is a specific features of

a.

Haemolytic anaemia

b.

Sickle cell disease

c.

Thalassaemia major

d.

Iron deficiency anaemia

e.

B12 deficiency anaemia

24.

After seven days of treatment with sulfonamides a patient’s haemoglobin had decreased from 14.7 gm/100ml to 10gm/100ml. The most likely cause of hemolysis in this patient is

a.

Sickle cell disease

b.

Thalassemia minor

c.

Hereditary spherocytosis

d.

Glucose 6-phosphate dehydrogenase deficiency (G6PD)

e.

Coombs positive haemolytic anaemia

25.

Spherocytosis is a common cause of inherited haemolytic anaemia. The most likely cause for spherocytosis is

a.

Abnormal antigenic properties of the integral proteins of the cell membrane

b.

Defects in the peripheral proteins

c.

Increased formation of rolealux

d.

Formation of sickle shaped cells

e.

Decrease in the size of the red blood cells

26.

A 50 year old male who had frequent infections of his upper respiratory tract manisfested with subcutaneous petechiae over his arms and legs. Investigations revealed low haemoglobin and a dry tap marrow. The most likely condition the patient is suffering from

a.

Iron deficiency anaemia

b.

Megaloblastic anaemia

c.

Haemolytic anaemia

d.

Aplastic anaemia

e.

Thalassaemia

27.

Oral iron supplements are given for iron deficiency aneamia. Which of the statement is true regarding the absorption of oral iron supplements?

a.

Absorption occurs in the large intestine

b.

Intrinsic factor is necessary for the iron absorption

c.

Ascorbic acids reduces iron absorption

d.

Absorption is increased in hereditary haemochromatosis

e.

Absorption is better in the ferrous form than in ferric form

28.

a.

Bone marrow responds to iron therapy by increasing erythropoietic activity. Which of the following in bone marrow would most likely indicate erythropoiesis? Myelocytes

b.

Reticulocytes

c.

Ring siderblasts

d.

Target cells

e.

Megakaryoblasts

29.

Graft versus host disease is a complication of transfusion in patients of bone marrow transplantation. This can be best avoided by

a.

Transfusion of packed cells

b.

Irradiating the blood components before transfusion

c.

Transfusing fresh whole blood

d.

Replacement by crystalloids

e.

Getting close relatives to donate blood

30. A 36 year old woman presented with weakness, lassitude and feeling easily tired. Her bone marrow aspirate showed 15% myeloblasts and reduced erythropoiesis. The most likely cause is a.

Acute myeloid leukaemia

b.

Acute lymphoid leukaemia

c.

Myelofibrosis

d.

Myelodysplastic syndrome

e.

Chronic myeloid leukaemia

31. Myelodysplastic syndromes are a group of clonal stem cell disorders. Which of the following type has the poorest prognosis according to the FAB system of classifications? a.

Refractory anaemia (RA)

b.

RA with ring siderblasts

c.

RA with excess blasts

d.

RA with excess blasts in transformation

e.

Chronic myelomonocytic leukaemia

32. Whena. Sickle cell trait RBCs break into fragments, they are referred to as schistocytes. These type of cells are seen in b.Thalassaemia c. Microangiopahtic haemolytic anaemia d.Idiopathic thrombocytopenic purpura e. Gilbert’s syndrome 33. A 72 year old male with enlargement of superficial lymph nodes and mild hepatosplenomegaly is diagnosed as having chronic lymphatic leukaemia (CLL). The most important criteria for diagnosis of this disease is the a.

Presence of hypogammaglobulinaemia

b.

Absolute lymphocytosis

c.

Male predominance

d.

Presence of enlarged lymph nodes

e.

Absence of blasts in blood smear 34.Dophle bodies are patches of dilated endoplasmic reticulum that appear as cerulean blue cytoplasmic puddles.

These finding are mostly seen in a. Chronic myeloid leukaemia b.Leukaemoid reaction c. Chediak higashi syndrome d.Infectious mononucleosis e. Granulocytosis 35.A peripheral blood smear showing increase in numbers of neutrophils, band cells, basophils, eosinophils and platelets is most suggestive

a.

Acute myeloid leukaemia

b.

Active lymphoid leukaemia

c.

Chronic myelocyctic leukaemia

d.

The LAP score is high

e.

The myeloid erythroid ratio is reserved

36.

The following pathological features is true regarding non-Hodgkin lymphoma (NHL)

a.

Classical Reed Sternberg (RS) cells are neoplastic cells

b.

B cell phenotype is more common

c.

Contiguous group of lymph nodes are affected

d.

It is not associated with leukaemic phase of disease

e.

Ann Arbor staging is performed

37.

A peripheral blood smear showing increase in numbers of neutrophils, band cells, metamyelocytes, myelocytes, basophils, eosinophils and platelets is most suggestive

a.

Acute myeloid leukaemia

b.

Acute lymphoid leukaemia

c. Chronic myelocytic leukaemia d.Chronic lymphocytic leukaemia e. Hairy cell leukaemia 38.Platelet aggregation is an important event in haemostasis. Which of the following statement is true for platelet aggregation in vascular injury? a.

There will be initial vasodilation

b.

Clotting factors play no role in its formation

c.

Platelets change their shape during the process

d.

Serotonin stimulates platelet aggregation

e. 39.

It is inhibited by thromboxane A2 Hepatin is an anticoagulant produced by the basophils. The most likely mechanism hepatin prevents blood clotting is by

a.

Inhibiting the formation of vitamin K dependent clotting factors

b.

Preventing the activation of platelets

c.

Preventing the aggregation of platelets

d.

Binding to antithrombin III to inactivate thrombin

e.

Activating tissue plasminogen activator

40.

The main vector transmitting malaria in Sabah is Anopheles balabacensis. This vector breeds in

a.

Artificial containers in urban centres

b.

Drains

c.

Temporary collecting of water in jungles

d.

Rock pools in control areas

e.

Water sands

41.

Artemisinin and its derivatives are used in the treatment of severe forms of chloroquine resistant falciparum because they have a. b. c. d. e.

Rapid gametocidal activity The ability to prevent further development of hypnozoites Rapid sporontocidal activity Rapid schizonticidal activity Ability to prevent the development of rings to gametocytes

42.In the laboratory diagnosis of leishmoniasis, the expected parasite stage in vitro is a.

Amastigote

b.

Promastigote

c.

Trypamastigote

d.

Schizont

e.

Tissue cyst

43.

The vector of visceral leishmoniasis has geographical variations. In the Asian region the main vector is

a.

Phlebotamus species

b.

Lutzomyia species

c.

Anopheles species

d.

Mansonia species

e.

Leptothrombidium

44.

Dengue is a common vector born disease prevalent in tropical countries. Which of the following statement is true for dengue fever?

a.

It is caused by a DNA virus

b.

The vector once infected with the virus remains infective for life

c.

The vector prefers polluted water for propagation

d.

Joint symptoms are commoner in dengue fever compared to chikungunya

e.

Diagnosis by genome amplification is best carried out after the seventh day of illness 45. What’s the most appropriate test to diagnose haemophilia? a. b. c. d. e.

Prothrombin time Bleeding time Partial Thromboplastin Time Platelet count Serum D-dimer...