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COMMON MCQ Hematology 2017
COMMON MCQ Hematology 2017
COMMON MCQ Hematology 2017
Dr.Abdulrauf
1- The following are recognized causes of microcytic blood picture except:
a. Dysphagia.
b. Ringed sideroblasts in the bone marrow examination.
c. Low serum ferritin.
d. Splenomegaly.
e. pica.
5- An asymptomatic 82 year old male, who underwent a routine medical check up,
was found to have the following findings on his complete blood count; haemoglobin
of 8.5g/dl, MCV of60 fl MCHC of 24g/fl. Platelets of 230×10^9/l, WBC of
6.5×10^9/l. Which of the following statements regarding this patients cases is
false:
7- 40 years old female patient presented with headache, general weakness dyspnea
on exertion and palpitation. On examination she was pale; pulse was 110/min, B.P
120/75 mmHg. Her haemoglobin is 6.3gm%, WB 5.9/mm³ and platelets 210/mm³.
The following statements are true except:
a-microangiopatic
b-hereditary spherocytosis
c-Malaria
d-mitral valve incompetence
e-Thalassemia
a. Raised LDH.
b. Indirect hyper bilirubinemia.
c. Reticulocytosis.
d. High serum Haptogolbin.
e. Low haematocrit.
14- the following are recognized complications of sickle cell anaemia except:-
16- An 18 year old black girl presents with repeated attacks of chest pain and
anemia. Physical examination revealed an anemic girl who was underweight Hb 6.2
normochromic normocytic red cells. She mentioned that her cousin was also anemia
and that he was repeatedly transfused in the past. WBCs 13000, platelets 561,
LDH 1032, all of the following are true regarding patients case except:
17- A 21 year old black female presented with a tow days history of sever chest
pain and fever, she is known to have similar attacks since childhood which usually
resolve with antibiotics, analgesia and hydration. On examination she was in pain
and jaundiced. Abdominal examination was unremarkable. Her haemoglobin was
6.3g/dl, WBC 12.4, Plt 322, Total bilirubin 2.4 mg/dl SGPT 23, SGOT 33, ALP 221,
reticulocyte count was 10%. Periphery blood film showed target cells, crescent
(sickle) shaped RBCs. The following is true about the management of this patient:
18- 35years black Libyan male present to medical out patient department complain
from sever bone pain in the spine, ribs, and both arms also patient has sweating,
patient had previous history of admission to hospital due to same illness many
times .On examination patient looks ill, pale, and jaundice pulse 120beat/min,
temperature 38c. Investigation:- Hb 6.8g/dl, total bilirubin 5mg/dl, indirect
bilirubin 4.3mg/dl. Which of the following is wrong statement:-
19- A 16 year old female, presented with an acute attack of bone aches and
chest pain. Her brother has a similar condition. Haemoglobin electrophoresis
shows:
• Hb A 0%(N 97-99)
• Hb A2 2%(N 1-2)
• Hb F 10%(N<1)
• Hb S 88%(N=0)
a. β- thalassemia major.
e. α- thalassemia.
21- A previously healthy 38 year old woman presented with 2 weeks history of
fatigue and malaise. Physical examination shows slight sclera icterus and a mildly
enlarged spleen. There is no lymphadenopathy. Laboratory studies: haemoglobin
7.2g/dl. Reticulocyte count 9.8% A peripheral blood smear shows polychromasia,
occasional spherocytosis, and a rare nucleated erythrocyte. All of the following are
true regarding patients case except:
a. History of upper GIT bleeding will explain the bone marrow findings.
b. Hepatomegaly is a characteristic feature in this patient.
c. Raised reticulocyte count will be the predominant finding.
d. Corticosteroids are used in treating such patients.
e. Such patients usually have a good prognosis.
a-liver disease
B-alcoholic abuse
c-hypothyroidisim
d-thalassemia
e-folate deficenct
a-malabsorption syndrome
b-thalassemia
c-Phenytoin therapy
d-alcohol
e-pregnancy
a-pernicious anemia
b-Tropical sprue
c-Zollinger-Ellison syndrome
d-chronic pancreatitis
e-gasterectomy
30- The following are true about vitamin B12 deficiency anemia except:
a-raised MCV
b-low reticulocyte count for degree of anemia
c-elevated serum iron
d-low serum ferritin
e-bone marrow shows neutrophil hyper segmentation
39- A 58 year old lady presented with headache fatigability, dyspnea on moderate
exertion for the last 6 months. On examination, she looks pale, with smooth red
tongue, no koilonychias, no lymphadenopathy, and no splenomegaly, HB 6gm%, WBC
3.6/mm³, platelets 150.000/mm³, MCV 110fl. The following are true except:
40- In patients with idiopathic thrombocytopenic purpura all are false except:
a. Purpura.
b. Onset of symptoms soon after birth.
c. Autosomal dominant inheritance.
d. Hemarthrosis is uncommon.
e. Bleeding few seconds after trauma.
44- The following laboratory results are classical findings in Hemophilia except:
a. Prolonged APTT.
b. Prolonged PT.
c. Normal fibrinogen level.
d. Reduced factor VIII.
e. Normal vWF.
a. Autosomal inheritance.
b. Hemarthrosis.
c. Menorrhagia.
d. Prolonged bleeding time.
e. Increased factor VIII level in the blood.
47- A 24 years old female presented with 2 weeks history of skin petechia and
menorrhagia. She has no history of similar problem or any significant medical
history. She has no history of drug intake. On examination, she looks well, with
slight pallor and petechia all over her skin, cardiac, chest and abdominal
examination was within normal. Her investigations showed haemoglobin of 10g/dl,
WBC of 8×10^9/l, Platelets, 12×10^9/l, ESR was 7 mm/hr. Other routine
investigations were normal. Bone marrow aspiration showed a reactive bone marrow.
The following are true regarding her condition except:
48- A 34 year old lady, previously healthy, presented with a 4 day history of
petechia all over the body, her last menstrual period was heavier and longer than
usual. Her complete blood count showed; haemoglobin of 12g/dl, WBC of 9×10^9/l,
platelets of 41×10^9/l bone marrow examinations showed a reactive bone marrow
with excess of megakaryocytes. There is no evidence of chronic liver disease or
portal hypertension. Which of the following statements is true:
a. History of upper respiratory tract infection 2 weeks ago is present in
80% of pateints.
b. Moderate splenomegaly is present in 90% of cases.
c. Positive antinuclear antibody test would alert that this patient could be
case of systemic lupus erythematosus.
d. Platelets transfusion should be commenced immediately and continued till
the platelets count is more than 50×10^9/l.
e. Haemophilus influenza vaccine is contraindicated in this cases.
49- A 35 year old female presented with a 5 day history of gum bleeding and
purpura she gave a history of sore throat a week earlier, physical examination
revealed petechial and bruises around vein-puncture sites. Concerning this patient
which of the following statements is correct:
50- A 27 year old nurse gives history of heavy menstruation and purpuric rash for
few weeks. Her past medical and drug history is uneventful. Physical examination:
she looks healthy with petechiae all over the body CBC shows: Hb 11g/dl, WBC
5.6×10^9/l, platelets 33×10^9, ultrasound revealed normal sized liver and spleen.
The following are true except:
51- A 25 year old female presents with prolonged epistaxis, she gave a history of
heavy periods and her sister has history of bleeding disorder. Physical examination
apart from pallor was normal. Haemoglobin was 9.5g/dl, WBC were 7000/cmm, with
a normal differential count and platelets were 300000/cmm. The following
statements are correct except:
52- A 22 year old male presented with acute abdomen. Assessment revealed an
acute appendicitis. Appendectomy was performed but the patient developed
prolonged bleeding the wound afterwards. He did not have any previous history of
bleeding diathesis in the past. There was no history of any drug intake. The
following statements are true about his condition, except:
a. A similar history in his sister would support the diagnosis of factor VIII
deficiency.
b. Splenomegaly with prolonged prothrombin time suggests an underlying
liver disease.
c. Prolonged bleeding time, reduced factor VIII level and reduced vWF are
consistent with the diagnosis of von willebrands disease.
d. Cryoprecipetate is not effective in the treatment of haemophilia B.
e. Hemarthrosis is recognized complication.
53- A 44 year old woman presented with epistaxis, her CBC shows:
• Hgb 12.4g/dl
• WBC 8.1×10^9/l
• Platelets 24×10^9/l
All of the following may be used in the management of this cases except:
a. Platelets transfusion.
b. Pridnisolne.
c. Rituximab.
d. Chlorambucil.
e. High dose immunoglobin.
57- the following are poor prognostic feature in acute leukemia except :-
a-young age
b-male sex
c-high leukocytes levels at diagnosis
d-CNS involvement at the diagnosis
e-cytogenic abnormalities
61- The following are typical finding in patients with chronic myeloid leukaemia
except:
a. Splenomegaly.
b. Leucopenia.
c. Thrombocytosis.
d. Anemia.
e. Philadelphia chromosome positive in blood cells.
66- A 54 year old lady suffering from chronic myeloid leukaemia on treatment for
5 years, presented this time with increasing fatigue, left abdominal discomfort.
Her WBC count is 80×10^9/l, which was normal 3 months ago, platelet count is
elevated compared to previous readings. Which of the following statements
regarding this patients case is true:
67- A 50 old lady presented with a six weeks history of tiredness and upper
abdominal discomfort. On examination she was pale and abdominal examination
revealed hepato-splenomegaly. Her haemoglobin was 7.1g/dl, WBC 71×109/l, with
neutrophilia , platelet count qf/770×109/l. The following are correct except:
68- A 60 year old male presented with brusising and tiredness, examination
reveals 4 finger breadth splenomagely and his results reveal:
• Platelets 900×10^9/l
Blood film reaveals a neutrophilla, basophilla,numerous myelocytes and 4%
myeloblasts. Which of the following is likely to be presented in this patient?
69- an 80 year old man presets with early satiety and left hypochondrial
discomfort. O/E tenderness at left hypochondrial, splenomegaly of 10cm below
costal margin. CBC: Hb 11g/dl, WBC 86,000/ul, platelet 560,000/ul. Which of the
following is most likely diagnosis:-
a. Involvement of the cervical and inguinal lymph nodes puts the patient into
stage III.
b. Presence of reed Stemberg Cells in the tissue biopsy confirms the
diagnosis.
c. Normal LDH does not excludes the diagnosis.
d. Infertility could complicate treatment.
e. Stage IV disease should be treated with radiotherapy alone.
77- A 33 year old female patient presented to the medical OPD with generalized
weakness fever, night sweat and loss of weight for 6 weeks. On examination, she is
pale, no bruises but has non tender bilateral cervical lymphadenopathy . The
following are true except:
a-pathological fractures
b-hyperviscosity syndrome
c-hypercalcaemia
d-normal ESR
e-Raynauds phenomena
82- 70 years old male patient presented with back pain constipation, generalized
fatigability and dyspnea on exertion. On examination he was febrile, pale
dehydrated, no lymphadenopathy and no organomegaly. CBC show Hb of 7.8gm%,
WBC 10.000/mm³,platlets 300000/mm³, ESR 98mm/hr, Urea 72 mg%, Creatinine
1.4mg%, serum Ca 11.9 mg/dl(elevated). The following are true except:
83- A 64 year old man presented with back pain, fatigue and shortness of breath
on exertion. On physical examination, he has pallor but is otherwise normal. He
denies blood loss, and stool is negative for occult blood. He is anemic (haemoglobin
8.4g/dl) with normochromic, normocytic indicates, and his serum creatinine level is
2.9mg/dl(N up to 1.3mg/dl. All of the following are true regarding patients case
except:
84- A 60 year old female presented with bone pain and pallor. The laboratory data
revealed:
• Hb 10.1g/dl (N12-16)
85- A 60 year old farmer presented complaining of persistent low back pain of 3
months duration, he feels unwell with general malaise and recurrent chest
infections for the same duration, physical examination was unremarkable apart
from pallor and bony tenderness. Hb 7.8gm%, normocytic normochromic, ESR 110 in
1st hr. The following are true except:
89- A 50 year old women presented with a 6 months history of dragging left
hypochondrail pain and tiredness. Physical examination reveals pallor ad an enlarged
spleen that was felt below the umbilicus Hb 6.8g/dl, WBC 13×10^9/l, platelets
576×10^9/l. blood film: nucleated RBCs and teardrop shaped red cells were
seen,all of the following are true regarding pateints case except:
a. The most likely diagnosis is myelofibrosis.
b. The liver is likely to enlarge as the disease progresses.
c. Transformation on to acute leukaemia occurs.
d. The philadephia chromosome is likely to be positive.
e. Blood transfusion and allopurinol are useful supportive measures.