MID TERM EXAMINATION 4TH -SEME TER TIME ALLOWED 1:00 MINS

SUBJECT : RBCs DISORDERS MCQs TEST: 50 MARKS

NAME: ROLL NO:

Note: select the most appropriate option with respective statement each question carry equal marks.

1. Which ONE of these statements is TRUE about haemoglobin?

A. One molecule contains 10 atom of iron B. It is broken down in macrophages

C. It is different in children and adults

D. It has a low level in blood at birth compared with adult life

2. Which ONE of these statements is TRUE about reticulocytes?

A. They contain DNA not RNA B. They are raised in megaloblastic anaemia

C. They are raised 12 months after splenectomy D. They are raised after haemorrhage

3. Which ONE of these statements is NOT TRUE concerning erythropoietin?

A. 90% of the hormone is made in the liver B. It contains a hypoxia response gene

C. One stimulus to production is a low atmospheric oxygen level

D. Levels in blood are high if a tumour secreting erythropoietin is causing polycythaemia but are low in
severe renal disease or polycythaemia vera

4. Which ONE of these statements is TRUE concerning the therapeutic use of erythropoietin?

A. Side effects include hypotension and bleeding disorders B. The main

indication is in patients with leukaemia
C. Oral or parenteral iron is often needed to optimise the response D. Oral
administration reduces the frequency of treatment

5.Which ONE of these statements is NOT TRUE concerning the biochemistry of haemoglobin?

A Hb is 70% saturated in arterial blood

B As the haemoglobin molecule loads and unloads O2 the individual globin chains in the haemoglobin
molecule move on each other.

C. When O2 is unloaded the β chains are pulled apart, permitting entry of the metabolite 2,3‐
diphosphoglycerate (2,3‐DPG) and resulting in a lower affinity of the molecule for O2.

D The P50 (i.e. the partial pressure of O2 at which haemoglobin is half saturated with O2) of normal blood
is 26.6 mmHg.
6. Which ONE of these conditions is described by this phrase? ‘A clinical state in which circulating
haemoglobin is present with iron in the oxidized (Fe3+) instead of the usual Fe2+ state.’

A. Methaemalbuminuria B. Methaemoglobinaemia

C. Congenital dyserythropoietic anaemia D. Glucose‐6‐phosphate dehydrogenase deficiency

7. Which ONE of these statements is NOT TRUE concerning the red cell?

A. Each cell travels an estimated 480 km in its lifetime

B. It has a maximum diameter of 3.5 µmol so that it can pass through vessels of this size

C. It generates energy as adenosine triphosphate (ATP) by the anaerobic glycolytic (Embden-Meyerhof )
pathway

D. It generates reducing power as NADH by the E-M pathway and as reduced nicotinamide adenine
dinucleotide phosphate (NADPH) by the hexose monophosphate shunt.

8. Which ONE of these is TRUE concerning the red cell membrane?

A. 50% of the membrane is cholesterol

B. Spectrin and ankyrin are extracellular proteins that reinforce the membrane

C. Alterations in serum lipids do not influence the red cell membrane

D. Inherited defects in membrane proteins can cause hereditary spherocytosis and elliptocytosis

9. Which of the following normally contains >10% of body iron?

A. Transferrin B. Heart C. Neutrophils D. Macrophages

10. Which of the following is NOT TRUE about sideroblastic anaemia?

A . A unit of blood contains 200-250 mg iron

B  A man needs to absorb about 1 mg of dietary iron daily

C.  A molecule of transferrin may transport 4 atoms of iron

D  Haemorrhage is the major cause of iron deficiency in the UK

11. Which ONE of the following may be used to treat iron deficiency?

A.  Ferric sulphate B.  Desferrioxamine C. Calcium D Erythropoietin

12. Which ONE of the following organs is not damaged by transfusional iron overload?

A. Liver B. Kidneys C. Parathyroids D. Pituitary E. Heart

13. Which ONE of the following is a feature of iron deficiency?s

 A. Raised serum hepcidin B. Raised serum tran
. C. Raised mean corpuscular volume (MCV) D. Hyperchromic red cells

14. In which ONE of the following is iron absorption favoured?

A. Pregnancy B. Chronic inflammation C. Iron overload D. Phosphates

.15. Which ONE of the following is NOT TRUE about serum iron?

A It is low in inflammatory diseases B It is raised in iron overload

C It shows a diurnal rhythm D It is transported in plasma by ferritin

16. The α-globin genes are encoded on chromosome 16 while-------globin genes are encoded on
chromosome 11

A. δ and β B. Beta only C. γ, δ and β D. γ and δ only

17. During smear preparation Using a spreader (another slide), draw backwards into the drop of blood
(while applying pressure) – maintain an angle.

A. 30-45 degrees B. 50 degrees C. 20 degrees D. 60 degrees

18. During smear preparation film should take up the length of the slide?

A.1/2,3/4 B. 1/1, ¼ C. 0.5/4, 2.5/4 D.3.5/4,1.5/4

19. Which ONE of the following is used to monitor transfusion iron overload?

A. Bone marrow biops B. Serum ferritin C. Magnetic resonance imaging D. Lung function

20. Which ONE of these statements is TRUE about β‐thalassaemia major?

A. The major cause of death is liver failure  B. It requires iron chelation at diagnosis

A. It is usually caused by deletion of β globin genes C. It may be diagnosed antenatally

21. Which ONE of these statements is TRUE about β‐thalassaemia major?

A. It presents at birth B. It is caused by a defect in α globin synthesis

B. It is associated with splenomegaly D. Is associated with increased risk of bone infarction

22. What is suitable to prepare ideal smear regarding the concentration of hematocrit.

A. larger drop of blood and lower the hematocrit,

B. smaller drop of blood and lower the hematocrit

C. smaller drop of blood and higher the hematocrit

 C. larger drop of blood and higher the hematocrit

23. Which ONE of the following is NOT TRUE about a-thalassaemia?

A. It may cause haemoglobin H disease B. It is rare except in the Far East

C. It ameliorates β‐thalassaemia D. It is a cause of hydrops fetalis

24. Which ONE of the following statements is TRUE about β‐thalassaemia trait?

A. It is associated with a raised haemoglobin A2 level B. It is associated with iron overload

C. It is associated with a reticulocytosis C. It is associated with splenomegaly

25. α-thalasseaemia caused by mutation in a gene on chromosome 16 (ATR - 16) or on chromosome X (ATR - X)
is responsible for.
A. Mental retardation B. retardation of bones growth
C. splenomagely D. gigantism

26. Overload of________ predisposes to baterial infections,e.g. Klebsiella and fungal infections.

A. Mg2+ B.Calcium C. Iron D. zinc

27.If both of parents are carrier of beta thalassaemia minor then chances of beta thalassaemic major offsprings are.

A. 25 B. 50 C. 75 D. 100

28. Which statement is true about Hb H disease

A. Caused by beta gene deletion B. It is acquired diseases

C. Caused four alpha gene deletion D. It is due to 3 alpha gene deletion

29. Sideroblastic anaemia is diagnosed when _______ or more of marrow erythroblasts are ring sideroblasts.
A. 15 % B. 20 % C.25 % D. 10
30. Which statement is true about normocytic normochromic anemia.
A. RBCs are normal in size than normal B. RBCs contain normal amount of haemoglobin.

C. Have MCV, MCH high But low MCHC C. They have MCV,MCH and MCHC low

31. Which one is not a example of macrocytic anemia

A. Megaloblastic anaemia B. Aplastic anaemia

C. Haemolytic anaemia D. Sideroblastic anemia

32. which one is not a example of normocytic normochromic anemia.

A. Acute blood loss B. Leukaemia C. Bone marrow infiltration D. Myxoedema

33. which one statement is not true about haem iron

 A. meat, B. liver C.spleen D. cereals

34. which not source of non haem iron

A. cereals B. vegetables C. meat D. beans

35. Which statement is not true about the absorbtion of non haem iron

A. The iron status of the body B. Level of phosphorus in serum

C. Presence of absorption inhibitors or facilitators D. The solubility of iron salts

36. How many iron ions can be transported by single molecule of transferrin

A. 3 B. 4 C. 1 D. 2

37. One of the following is not a cause of iron deficiency anemia

A. Chronic blood loss B. peptic ulcer C.Acute blood loss D. oesophageal varices

38. One of the following is not true about lab finding in iron deficiency anemia

A. Low serum ferritin B. High RWD

C. Low iron binding capacity D. High erythrocyte protoporphyrin

39. One the following is not a infectious cause of anemia of chronic disorders

A. Viral infections including HIV infection B. Bacterial including tuberculosis and osteomyelitis

C. sarcoidosis D. Parasitic including malaria

40. One the following is a cancerous cause of anemia of chronic disorders.

A. Systemic lupus erythematosus B. connective-tissue diseases C. Vasculitis D. lymphoma

41. In case of anemia of chronic disorder there is increased level of

A. Iron B. transferrin C. hepcidin D. transferrin saturation

42. In anemia of inflamation decreased in transferrin concentration develops more slowly than decreas in the iron
levels because of

A. longer half-life of transferrin B. direct form consumption

C. iron is present in low quantity D. minimum use of transferring

43. Laboratory findings in scenario of sideroblastic anemia which one is not true

A. Serum iron is increased B. Bone marrow shows increased iron storage

C. TIBC is decreased C. Bone marrow shows erythroid hypoplasia

44. which statement is not true about trephine biopsy

 A. Can be taken before the specimen is transferred into fixative

B. Cannot be examined unless it is decalcified

C. Particularly useful if the bone marrow Aspirate is inadequate

D. Bony core is gently dabbed or rolled across the slide

45. Which one site is not suitable to puncture of the ilium

A. Posterior iliac spines B. Sternum of flat bone

C. anterior iliac spines. D. Center of the oval posterior superior iliac spine

46. Bone marrow aspiration needles, dome-shaped handle and T-bar are intended to provide stability and control
during the operation name as

A. Carney,s Needle B. Islam,s Needle C. James,s Needle D. George,s Needle

47. Bone marrow constitutes about________ % of total body mass of human

A. 6 B.8 C. 4 D.2

48. Which statement is not true about trephine biopsy

A .little less simple than aspiration B. Structure of relatively large pieces of marrow

C. Imprint smears: morphological features of individual cells cannot be observed

D. Superior for diagnosing marrow involvement by lymphoma and non hematological neoplasms

49. One of the following is not a clinical feature of hydrop fetalis

A. May die within a few hours of birth B. Affected infants may born dead
C. Its clinical features are similar to Rh haemolytic diseases D. They are overweight

50. Which combination of genes is associated with alpha thalassaemia, silent carrier

A. αα/ -α B. -α/ -α c αα/ -- D. --/ -α

51. Beta Thalassaemia Major is also named as

A.Nelson,s anemia B. Watson,s anemia C. Cooley's anemia D. Coulter,s anemia