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نماذج اسئلة الهيئة السعودية للتخصصات الصحية للاخصائيين والاطباء بالمختبرات
نماذج اسئلة الهيئة السعودية للتخصصات الصحية للاخصائيين والاطباء بالمختبرات
By Dr Mohammad A. Emam
Contents
Body fluids................................................................................. 2
Clinical Chemistry.................................................................... 4
INSTRUMENTATION....................................................................................................................4
BLOOD GASES, PH AND ELECTROLYTES...............................................................................5
GLUCOSE, HEMOGLOBIN, IRON AND BILIRUBIN................................................................7
CALCULATIONS, QC AND STATISTICS...................................................................................9
CREATININE, UA, BUN AND AMMONIA...............................................................................10
PROTEINS, ELECTROPHORESIS AND LIPIDS.......................................................................11
CLINICAL ENZYMOLOGY........................................................................................................13
CLINICAL ENCOCRINOLOGY..................................................................................................14
General.....................................................................................17
Hematology..............................................................................19
BASIC HEMATOLOGY CONCEPTS / LABORATORY PROCEDURES................................19
NORMOCYTIC NORMOCHROMIC ANEMIAS........................................................................20
HYPOCHROMIC MICROCYTIC ANEMIAS.............................................................................24
MACROCYTIC NORMOCHROMIC ANEMIA..........................................................................25
QUALITATIVE / QUANTITATIVE WBC DISOREDERS.........................................................26
LYMPHOPROLIFERATIVE / MYELOPROLIFERATIVE DISORDERS.................................29
COAGULATION AND PLATELETS..........................................................................................35
Immunohematology................................................................40
Immunology.............................................................................41
Microbiology............................................................................43
ANTIBIOTICS, ANTIMICROBIALS, STERILIZATION AND DISINFECTION.....................43
BASIC TECHNIQUES..................................................................................................................44
BASIC BACTERIOLOGY............................................................................................................46
GRAM POSITIVE COCCI............................................................................................................47
GRAM NEGATIVE COCCI..........................................................................................................49
GRAM POSITIVE BACILLI.........................................................................................................49
ENTEROBACTERECIAE & PSEUDOMONAS..........................................................................50
RICHETTSIAE, CHLAMYDIA AND MYCOPLASMA.............................................................52
SPIROCHETES..............................................................................................................................53
BORDETELLA & BORRELIA.....................................................................................................53
ANEROBIC BACTERIA...............................................................................................................54
BRUCELLA...................................................................................................................................55
MYCOBACTERIA........................................................................................................................55
MISCELLANEOUS.......................................................................................................................56
MYCOLOGY.................................................................................................................................57
VIROLOGY...................................................................................................................................60
26th Shawual 1425.................................................................. 64
mohammad_emam@hotmail.com 1
CLINICAL & CHEMICAL PATHOLOGY MCQ BODY FLUIDS
Body fluids
1. **Doctor sending a sample requesting for lecithin 1. (c) Amniotic fluid sample is used to measure
spingomyelin ratio what is the sample? lecithin: sphingomyelin ratio (L/S). L/S > 2:1
a. Blood. (or 2.5:1) denotes acceptable lung maturity.
b. CSF
c. Amniotic fluid.
d. Urine
2. ***Cytological examination of pleural effusion in a 60 yrs 2. (d) Lung cancer: 75% of malignant pulmonary
old man revealed the presence of malignant cells. The effusions are due to 3 causes; lung cancer (30%),
most likely primary tumor will be: breast cancer (25%) & lymphoma (20%).
a. Lymphoma. Practically, cytological examination only
b. Mesothelioma. establishes the presence of malignant effusion,
c. Cancer colon. however, in most cases it cannot identify the
d. lung cancer. primary site of the tumor.
Regarding mesothelioma, it is a rather a rare
tumor of the pleura.
4. ****Which is not a reducing sugar in urine? 4. (c) A reducing substance is the one that reduces
a. Glucose. alkaline cupric sulfate to red coprous oxide.
b. Galactose. Most important are glucose, lactose, fructose,
c. Sucrose. galactoses and pentoses (e.g. ribose, xylose and
d. Fructose. arabinose) while sucrose will not reduce alkaline
cupric sulfate.
5. ***Red urine is due to? 5. b. Rifampicin is a well known drug to cause red
a. INH urine.
b. Rifampicin
c. Pyrizinamide.
6. **Urine strips detect all except 6. Fat droplets. Occur with glomerulonephritis and
nephritic syndrome but are not detected by the
routine urine strips.
7. **If urine is left for long time which is affected more? 7. Urea. The most labile constituent of urine is
urea. Bacterial action decrease urea and increase
ammonia and pH.
8. **Abnormal constituent of urine includes? 8. (c) Although also glucose and protein are
a. Urea abnormal constituents of urine, yet they
b. Glucose normally present in trace amounts below the
c. Cholesterol. detection limit of ordinary methods.
d. Uric acid
e. Protein.
mohammad_emam@hotmail.com 2
CLINICAL & CHEMICAL PATHOLOGY MCQ BODY FLUIDS
9. ****Calcium in urine stone is present in all of the 9. (b) In 2ry hyperparathyroidism, hypocalcemia
following except: due to e.g. chronic renal failure is the cause of
a. UTI increased parathormone. Stones due to
b. Secondary hyperparathyroidism. hyperparathyroidism only occur with the 1ry or
3ry disease.
Calcium is precipitated in stones with oxalate (at
acid or neutral pH), or less commonly with urate
(at acidic pH) or with phosphate (at normal urine
pH). Causes of hypercalciurea include:
- ↑intestinal calcium absorption (↑P
level→↑vit D→↑Ca absorption Or in case
of hypervitaminosis D.
- Lack of renal tubular reabsorption e.g. with
furosamide.
- Loss of Ca from bone (due to mobilization
as in 1ry & 3ry hyperparathyroidism, due to
bone destruction or due to Cushing's and
thyrotoxicosis)
Otherwise, UTI causes stones at alkaline pH
where ammonium is high and mixed stones form
due to obstructing Ca stone which favors
infection and precipitation of ammonia salts.
mohammad_emam@hotmail.com 3
CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY
Clinical Chemistry
INSTRUMENTATION
1. ******Difference between ELISA & RIA is ? 1. (a) Both techniques apply almost the same
a. ELISA technique uses an enzyme. methodology, .ELISA technique uses an enzyme
b. ELISA is used by bacteriologists while RIA by label and RIA uses radioisotopic label.
virologists
3. ***Which of the following not seen in chemistry lab? 3. (d) Electron microscope.
a. Analytic balance.
b. Centrifuge
c. Spectrophotometer
d. Electron microscope,
e. Turbidimeter.
4. **The washing is must in all heterogenous ELISA 4. (b) In ELISA, the first washing is used to
techniques because? remove the unbound (free) sample antigen. The
a. It remove the excess binding second washing removes unreacted free label
b. Increase the specificity (not excess binding in either of the 2 washings)
c. Increase the sensitivity. If washing is not complete, this will ↑false high
→ ↓ specificity.
If the question comes as It avoids excess
binding, then this will be the choice.
5. **The enzyme in ELISA is present in the? 5. (a) The conjugate is the second antibody
a. Conjugate conjugated with the enzyme.
b. Microplate
c. Buffer.
6. **A standard microplate in an ELISA has? 6. (a) 96 wells are present in the microplate (8 rows
a. 96 wells x 12 columns).of these, 1 is used for the blank, 2
b. 98 wells for the –ve controls, 2 for the +ve controls and 4
c. 92 wells. for the cutoff control (COC). The remaining 85
for tests.
7. Five ml of a colored solution has an absorbance of 0.500. 7. (b) According to Beer's law, absorbance is
The absorbance of 10ml of the same colored solution will proportional to the final concentration (whatever
be: the volume is)
a. 1.000
b. 0.500
c. 0.250
8. a dichromatic analysis is carried to increase: 8. (a) Di- (bi) chromatic photometry measures
a. Specificity absorbance of the sample at 2 different
b. Linearity wavelengths. This corrects for interfering
c. Sensitivity. substances increasing specificity of the method.
mohammad_emam@hotmail.com 4
CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY
11. Acidemia is associated with 11. Acid in urine and increased HCO2-.
Increased hydrogen ion in the blood is termed
academia. If the cause is metabolic, there will be
compensatory hyperventilation →↓H+ back to
normal while HCO3- drops. Furthermore, if renal
function is normal, H+ will be excreted.
If the cause is respiratory, renal compensation
will cause H+ excretion and HCO3- retention and
generation lowering H+ back to normal.
12. ***To correct acidosis, the kidneys: 12. (c). See 11.
a. secrete more H+ in urine.
b. Synthesis bicarbonate to ECF
c. Both a and b
13. **A buffer is made of ? 13. (c) A buffer system is made of a weak acid and
a. Strong acid & strong salt its salt with a strong base of a weak base and its
b. Strong acid & weak salt salt with a strong acid.
c. Weak acid & strong salt
d. Weak acid & weak salt.
15. ***What is the base: acid ratio at pH 7 for acid of pK6? 15. (d) According to Henderson Hasselbalch's
a. 0.01 equation, pH = pK + Log base/acid. By
b. 0.1 compensation, Log (base / acid)= 1, thus base:
c. 1.0 acid = 10:1.1
d. 10
e. 100
16. ***Which is more serious? 16. (c) Critical K+ values are <2.5 or > 6.5 mEq/L
a. Glucose 15mmol/l Critical glucose <40mg or >450mg (2.2 &
b. pH 7.25 acidosis. 25mmol respectively),
c. Potassium 1.5 mmol/l critical pH <7.2 or >2.6
d. Sodium 150 mmol/l critical Na+ <120 or > 160mEq/L
17. ******Metabolic acidosis can result from: 17. (a) Ingestion of certain medicines or chemicals
e.g. metformin.(glucophage).
Metformin causes lactic acidosis.
Generally, metabolic acidosis is due to either
addition of H+ (↑AG), ↓ excretion of H+ or
loss of HCO3-
mohammad_emam@hotmail.com 5
CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY
19. H+ homeostasis is altered by; 19. In actively contracting muscle, 8% of the pyruvate
New a. Excessive change of pyruvate to lactate. New is utilised by the citric acid cycle and the
remaining molecules are reduced to latctate. This
lactate is oxidized by the liver to pyruvate which
,through gluconeogenesis, becomes glucose. If
lactate is not efficiently reutilized in such a way, it
accumulates in the blood causing lactic acidosis.
20, ***Main extracellular ions? 20, b. Na is the major ECF cation, Cl is the major ECF
21, a. Na & K 21, anion, K is the major ICF cation and proteins
22, b. Na & Cl 22, followed by phosphates are the major anions.
24, **Main electrolyte in blood is? 24,
25, ***Electrolytes in ECF 25,
26. a. Na is a major cation 26.
b. Cl is a major cation
d. HCO3 is a major anion.
***Main intracellular cation is;
**In serum:
a. Sodium is the main cation.
b. Bicarbonate.
***Intracellular fluid contains:
a. More potassium less sodium than extracellular fluid..
b. Sodium and potassium in equal amount.
28. Regarding concentration of urine; 28. a. Approximately 80% of the water and NaCl
New a. Proximal tubules return 75% of filtered water. New contenet together with glucose, phosphate, and
1 1
b. Distal convoluted tubules deliver 40-60L of fluid to amino acids are reabsorbed in the proximal tubule.
collecting tubules / day. About 20% of the tubular fluid enters the loop of
c. Osmotic pressure in renal cortex is higher than in medulla. Henle where water is passively aborbed; 6ml per
d. ADH acts on all parts of nephrone. minute of concentrated tubular fluid now enters the
e. Aldosterone increase Na excretion. distal tubule, where there is an active reabsorption
of sodium. The fluid leaves the distal tubule at a
rate of approximately 1ml per minute passing into
the collecting ducts in the form of urine.
Aldosteron is relased due to ineffective arterial
pressure in the kidney. It causes sodium
reabsorption which raises plasma osmolality. ADH
increases permeability of distal and collecting
tubules to water→ urine concentration.
mohammad_emam@hotmail.com 6
CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY
28. Regarding buffer systems; 28. b. Acids are substances that tare capable of
New b. An acid is a substance that releases H+ New donating protons. When a strong acid is added to a
3 3
c. Buffering involves change of strong acid to base. buffer, the salt reacts with the acid forming weak
acid, and its salt (not base).
29. **Glucose level to diagnose hypoglycemia in newborn is. 29. - 25-30 g/dl
In newborn babies, glucose tends to be lower than
in adults. Critical low level in newborn is 30mg/dL
30. ***About GTT, which is correct according to WHO 30. (c) WHO recommendations for GTT include:
recommendations?
a. Should not be done in pregnant women,
b. Should not be done after giving heavy carbohydrate
diet for 3 days.
c. Should be done after 4-6 hrs fasting.
31. **With age renal threshold for glucose? 31. (b) With age, the renal ability to reabsorb filtered
a. Increased glucose is decreased leading to appearance of
b. Decreased glucose in the urine at lower plasma levels.
c. Not changed
32. **All are inborn error of glycogen metabolism except? 32. (b) Essential fructosuria is due to aldolase B defect
a. Essential fructosuria leading to accumulation of fructose-1-P
b. Phenyl ketonuria Galactosemia (serious) is due to decreased
c. Galactosemia Galactose-6-P uridyl transferase leading to
d. Glycogen storage disease decreased glycogen synthesis.
Types of glycogen storage diseases (GSD) include:
Type I (VonGierke's): ↓ G6P
Type II (Pompe's): ↓ lysosomal maltase
Type III (Cori's) : ↓debranching enzyme.
Type IV (Anderson's): Absent debranching
enzyme
Type V (McArdle's): ↓ muscles
phosphorylation.
mohammad_emam@hotmail.com 7
CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY
33. *****HBA1c (Glycosylated hemoglobin) is? 33. (b) GlycHb (RR 4-6%) is formed by non
a. Not present in healthy normal individuals. enzymatic attachment of glucose to N-terminal
b. ↑ in prolonged sustained hyperglycemia valine of B-chain of Hb. Three types occur, HbA1a,
HbA1b, HbA1c, Both total and HbA1a are used.
Time averaged blood glucose = GlycHbx33.3-86
(mg/dL)
GlycHb reflects 8-12 weeks of blood glucose
while fructosamine reflects 2-4 weeks.
34. ***Glycogen differs from starch in: 34. It is a highly branched structure
35. **Cellulose is not metabolized in humans because of 35. Glucose units in cellulose are combined by
absence of which enzyme? cellobiose bridges. These are hydrolyzed by
cellobiase which is lacking in animal and human
gut.
36. **Xylose test is done to detect the function of: 36. c. Xylose is absorbed from proximal small
a. Stomach. intestine independent on pancreas..
b. Pancreas.
c. Upper small intestine.
d. Lower small intestine.
e. Large intestine
37. ****Von Gerke's disease is caused by deficiency of: 37. (a) See 32.
a. Glucose 6 phosphatase
b. Glucose 6 phosphate dehydrogenase
38. What happens if sucrose is given parentrally: 38. It will be secreted unchanged or metabolized
39. ***Which of these is not a ketone body? 39. (c) Ketone bodies are formed by condensation of 2
a. Acetone. acetyl Co A → Acetoacetic acid which gives B
b. Acetoacetic acid. hydroxyl butyric acid by reduction or acetone by
c. Butyric acid. decarboxylation.
d. B-hydroxy butyric acid. Butyric acid is a fatty acid
e. None of the above.
42. *** Increased jaundice is diagnosis by 42. (a) Estimation of jaundice depends on serum
a. T. bilirubin bilirubin, other mentioned tests help to identify the
b. AST cause of jaundice.
c. ALT
d. ALP
mohammad_emam@hotmail.com 8
CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY
45. **How much water should be added to 500ml of a solution 45. (c) Using the formula:
of 10% NaOH to bring it to 75%? C1 x V1 = C2 x V2
a. 666ml 10 x 500 = 7.5 x V2
b. 125ml V2 = 666mL
c. 166ml Thus, 166 mL of DW should be added.
d. 250ml
e. 375ml
46. When calculated osmolarity can not be accounted as a 46. Calculated osmolarity = 2 X Na + Glu + Urea
measurement for osmolarity? (All in mmol/L)
a. per 100gm/l When calculated osmolarity is less than
b. Urea 20 mm/l measurement for osmolarity, this denotes
increased osmolar gap (OG). This occurs with:
- Factitious hyponatremia (due to
decreased water)
- Unmeasured osmotically active
compounds e.g. alcohols, sugars, and
ketones.
48. **External QC program means? 48. (b) In EQC, participants receive QC material to
a. An external person come & does the QC test be tested inside their labs. Results are sent to
b. A QC person goes to another lab & does the test.. supplier to be compared to other labs' results.
EQC will be most practically implemented
during the regular visit of the lab coordinator.
This will give opportunity for errors to be
investigated on site and corrected rapidly
(Monica)
49. **We select 2SD value to plot LJ curves because? 49. (c) QC results follow a Gaussian distribution,
a. They are easy to calculate, thus 95% of these results normally fall within
b. They cover 97.5% of normal population, ±5% of the mean. Therefore, 2.5 out of 100
c. Patient value rarely go beyond these limits. (1:40) are acceptable to be above +2s and 2.5
our of 100 are acceptable below -2s.
mohammad_emam@hotmail.com 9
CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY
50. Sensitivity and specificity are 50. (b) Sensitivity & specificity can be adjusted
a. Directly related. according to cutoff level. Sensitivity can be
b. Inversely related. increased by choosing a higher cutoff to include
c. They mean the same. more TP, this meanwhile will include more FP
thus ↓specificity. However, this is not always
the case as highly specific highly sensitive tests
as well as poorly specific poorly sensitive exist.
51. A carryover in chemistry analyzer means a disturbance in 51. (b) Carryover is due to contamination by a
readings because: previous sample. It is calculated by measuring a
a. The analyzer was carried and placed at a different place. high standard and a low standard each 3 times
b. The previously measured solution was still in the cuvette then applying the following formula:
c. The current solution is overflowing in the cuvette. Carry over = (contaminated low – actual low) /
contaminated high – actual high)
52. STAT test means: 52. (c) Stat refers to immediate or as initial dose.
a. Start at.
b. Standardize and test.
c. Short turn around time
54. **Low GFR occurs in all except: 54. (b) low GFR occurs with:
a. Congestive heart failure. - Hemorrhage.
b. Urethral obstruction. - Dehydration.
- Renal loss of fluids e.g. diuretics.
- Ineffective blood volume, e.g. ↓CO,
systemic VD, renal vasoconstriction.
56. ****Nephrotic syndrome is characterized by all except: 56. (a) Nephrotic syndrome consists of:
a. Hypocholesterolemia. - Heavy proteinuria.
b. Hypoalbuminemia. - Hypoalbuminemia.
c. Albuminuria. - Oedema.
d. Hypertriglyceridemia. - Hypercholesterolemia (Almost always
e. None of the above present).
Hypertriglyceridemia is present in 50% of
cases.
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CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY
57. ****Ureate excretion by the kidney is inhibited by: 57. (b) Thiazide diuretics cause relatively urate
a. Probenecid. retention, glucose intolerance and hypokalemia
b. Thiazide diuretics. and interfere with water excretion and may
cause hyponatremia.
Probenecid is a uricosuric agent like allopurinol.
58. Chronic glomerulonephritis is diagnosed by: 58. (d) In chronic glomerulonephritis, there is
a. Blood urea. persistent deterioration of renal functions ending
b. Creatinine. with renal failure.
c. Proteinuria
d. All of the above
60. ******In cystic fibrosis, which is deficient? 60. (d) Alpha 1 antitrypsin
a. Beta globulin
b. Macroglobulin
c. Albumin
d. Alpha 1 antitrypsin
e. Alpha 2 antitrypsin.
61. ***Diet rich in phenylalanine should be restricted in? 61. (a) In phenylketonuria, there is ↓ phenylalanine
a. Phenyl ketonuria hydroxylase leading to accumulation of
b. Tyrosinemia phenylpuruvate and its derivatives and their
c. Maple syrup disease excretion in urine. Diet rich in phenylalanine
should be restricted to prevent brain damage.
62. ***In phenylketonuria, diet should be low in: 62. (a) Phenylalanine (see 61)
a. Phenylalanine.
b. Carbohydrate.
c. Lipids.
62. Hypoalbuminemia is associated with all except? 62. (a) Tetanus is clostridial infection caused be C.
a. Tetanus tetani has nothing to do with albumin.
b. hypocalcaemia
c. oedema
d. toxic effect of sulfonamide
64. **Gluconic amino acids include: 64. (a) Ketogenic amino acids are: Leucine and
a. Alanine. lysine,
b. Methionine. Mixed amino acids are: Isoleucine,
c. Valine. phenylalanine, threonine, tryptophan and
d. Glutamic acid. tyrosine.
e. All of the above. Gluconic amino acids are all the other amino
acids.
mohammad_emam@hotmail.com 11
CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY
67. ***In plasma protein electrophoresis, the protein that will 67. Albumin.
go first is (moves furthest from application)?
69. **All of the following are lipoproteins except? 69. (d) Although phospholipids are not lipoproteins,
a. Phospholipid they are ingredients of lipoproteins, conferring
b. VLDL the hydrophilic properties.
d. Sphingomylin
e. LDL
f. HDL
70. What is the proposition of pulmonary surfactant? 70. (b) Dipalmityl lecithin (a lecithin phospholipid
a. Phospholipid acid with 2 palmetic acid residues) is the chemical
b. Dipalmityl lecithin composition of pulmonary surfactant.
c. Phosphatidyl choline,
71. **HDL is good cholesterol because? 71. (a) HDL is composed of 20% cholesterol, 30%
a. It has more protein & phospholipids in it phospholipids and 50% proteins.
b. It has no cholesterol in it,.
c. It has less TG in it.
72. ***Which lipoprotein has highest concentration of 72. (b) VLDL are the TG rich lipoproteins
cholesterol? HDL has 20% cholesterol.
a. VLDL IDL has cholesterol and TG in equal amounts.
b. LDL LDL is the richest lipoprotein in cholesterol
c. IDL esters.
d. HDL
74. ****Which is not associated with abetalipoproteinemia: 74. (b) Hereditary spherocytosis is due to spectrin
a. Acanthocytes in the peripheral blood. deficiency.
b. Hereditary spherocytosis. Abetalipoproteinemia is a lipoprotein
c. Malabsorption and fatty stools abnormality of absent LDL due to autosomal
recessive abnormality in the synthesis of apoB +
failure of chylomicron formation leading to
malabsorption of fats + fat soluble vitamins +
adrenal dysfunction. 50-70% of RBCs have
spinal projections (acanthocytes)
mohammad_emam@hotmail.com 12
CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY
80. **Regarding lipoprotein metabolism: 80. Although cholesterol can be synthesized by all
nucleated cells, however, cholesterol in VLDL,
IDL and LDL is of hepatic origin
CLINICAL ENZYMOLOGY
83. ***The better for diagnosis of acute pancreatitis is? 83. (b) Lipase elevation is of a greater magnitude (2-
a. Amylase 10 xN) and duration than amylase in acute
b. Lipase pancreatitis. When lipase method is optimized,
c. ALP the test is more sensitive and specific than
d. ACP amylase for detection of acute pancreatitis.
84. **Activities of some enzyme increased in some disease 84. (b) That’s why enzymes are measured for the
conditions because they are? most part by their activity rather than
a. Non functional enzymes concentration.
b. Functional enzymes
c. Neither
85. ***In MI, which is the last enzyme to be raised and lasts 85. (d)
long? Onset (h) Peak (h) Duration
a. CK (d)
CK 6-12 20-30 2-6
b. CK-MB. CK-MB 3-10 12-24 1.5-3
c. AST. AST 6-12 20-30 2-6
d. LDH LDH 6-12 24-72 7-14
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CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY
87. **MI is diagnosed by: 87. (a) CK-MB is specific for cardiac muscle, CK-
a. CKMB BB for brain and CK-MM for skeletal muscle.
b. CKBB
c. CKMM
d. LDH
88. **Elevation of LDH is caused by: 88. (d) LDH is present in the cells of the heart, liver,
a. Myocardial disease muscles, blood and malignancies.
b. Liver disease
c. Prostatic disease
d. many organ disease because it has many distribution
89. ****Myoglobin ↑ in injury of: 89. (a) muscle whether cardiac or skeletal is the
a. muscle. source of myoglobin.
b. Liver
CLINICAL ENCOCRINOLOGY
90. *****ADH is? 90. (b) ADH is produced by the hypothalamus and
a. Produced by posterior pituitary stored and secreted from the posterior pituitary.
b. Produced in the hypothalamus.
91. **The method used to estimating insulin is? 91. (d) Immunoassay (multiple labels) is used for
a. Electrophoresis the measurement of insulin.
b. Kinetic estimation.
c. Spectrophotometer.
d. Radioimmuno assay.
92. *****After the insulin dose, the patient soon comatozed 92. (b) Hypoglycemia (glucose <3mmol/l)
due to
a. Hyperglycemia
b. Hypoglycemia (glucose <3mmol/l)
c. ketonuria
c. Ketoacidosis is the cause of coma
d. Lactic acidosis,
93. **While using the pregnancy test we are measuring? 93. (b) α subunit of HCG is very similar to α
a. B-HCG subunit of TSH and FSH and identical to LH.
b. Total HCG Although β subunits of HCG and LH are very
c. B-HCG & LH similar, antibodies can be made to the β subunit
d. B-HCG & FSH. of HCG that do not cross react with LH or other
pituitary hormones. Most EIA use 2 monoclonal
antibodies against different sites of HCG
molecule one for carboxyl terminal of β chain
and the other to the α chain, i.e. react with intact
HCG.
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CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY
94. ****Water deprivation test is used in the diagnosis of: 94. (b) Water intake is restricted the patient loses 3-
a. Anterior pituitary disease. 5% of body weight or until 3 consecutive hourly
b. Posterior pituitary disease. determination of urine osmolarity are within
c. Hypothyroidism. 10% of each other. Measure urine osmolality,
plasma vasopressin and increased urine
osmolality with exogenous vasopressin.
Urine Pl. VP After VP
osmol
Normal >800 >2 ↑
DI <300 Undetectab ↑
le
Nephrogeni <300 >5 No change
c DI
95. ****24 hours urine for VMA is used for diagnosis of 95. (b) Catecholamines are oxidized to VMA and
diseases of: metanephrins. 24hour urinary metanephrins is
a. Adrenal cortex. the best single test for pheochromocytoma.
b. Adrenal medulla Specificity and sensitivity approach 100% when
both VMA and metanephrines are measured.
96. ***Hypertension is found in all of the following endocrinal 96. (d) Hypertension secondary to endocrinal causes
diseases except: occurs in:
a. Cushing's syndrome. - Pheochromocytoma.
b. Pheochromocytoma. - Crohn's syndrome
c. Adrenal medulla hyperplasia. - Cushing's syndrome.
d. Addisson's disease. Addison is associated with hypos
(hypotension, hypokalemia, hyponatremia and
hypocortisol)
98. **While anti-PSA is coated on to the well in total PSA 98. (a) different antibodies.
estimation, the antibodies coated in free PSA is?
a. The same antibodies that is coated for total PSA
b. Same antibodies in large amount
c. Same antibodies in very low amount
d. Different antibodies.
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CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY
mohammad_emam@hotmail.com 16
CLINICAL & CHEMICAL PATHOLOGY MCQ General
General
1. ****The difference between plasma and serum is that 1. (a) Plasma contains fibrinogen which is
plasma: consumed during the clot formation to separate
a. Contains fibrinogen. serum.
b. Doesn’t contain fibrinogen.
c. Has more water.
d. Has less water.
2. ******Best way to separate the serum? 2. (a) leave the blood to clot at R.T for I hr, then
a. leave the blood to clot at R.T for I hr, then centrifuge centrifuge
b. by adding citrate.
c. by adding EDTA
5. **Cardiac anatomical anomalies associated with Fallot 5. (b) Fallot's tetralogy is composed of PS+VSD +
tetralogy include all of the following except: Rt aorta + RVH.
a. VSD
b. ASD
6. Hemolysed blood is unsuitable for performing which 6. Hemolysis is visible at Hb> 3.1 μmol/L
tests? It increases LDH, K, ACP, cholesterol, ALT and
AST.
Hemolysis don’t increase serum albumin,
bilirubin, ALP, amylase, lipase, Ca, Cl, P, Mg,
Na, creatinine, glucose, UA or urea.
7. ****Hemolysis causes? 7. a.
a. Increased serum K
b. Increased serum Na
c. Increased HCO3-
d. Decreased K
8. After hemolysis: 8.
a. Sodium leaks out of RBCs.
b. K leaks into cells.
c. Bicarbonate gets into RBCs.
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CLINICAL & CHEMICAL PATHOLOGY MCQ General
12. **Changes in blood stored more than 5 hrs at room temp. 13. (a) Storage of blood has the following effects:
include? 1- ↓CO2, ACP & Glucose
a. Decreased glucose & increased lactate. 2- ↑pH & ammonia
b. Increased glucose & decreased lactate 3- Changes in RBC permeability →↑K,P &Mg
c. Failure of Na & K pump, 4- Na-K pump is inhibited at 4 °c but not at
25°c. leading to ↑K in refrigerated samples.
5- Phosphorylation→↑P released from organic
P.
6- Loss of enzyme activity.
7- Light→↓ bilirubin, δALA and porphyrins.
14. Plasma or serum should be separated at the earliest for the 14. a. Continued glycolysis cause glucose values to
estimation of glucose because: decreases with time unless cells are separated.
a. The glucose values decreases with time.
b. Glucose value increases with time.
c. Lysis of blood occurs.
Best place to put a needle for blood collection is puncture proof container.
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CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
Hematology
3 The needle used for bone marrow biopsy is? 3 (b) Jamshedi trephine is used for biopsy.
a. 18 gauge needle
b. Jamshedi needle
c. Menghini needle
d. Westermani needle,
4 **Hyperplastic B.M with M/E ratio 6:1 is seen in: 4 (c) Hyperplasia is diagnosed when fat>cells. In
a. Megaloblastic hyperplasia. hyperplastic BM, an M/E ratio > 2:1 denotes
b. Normoblastic hyperplasia myeloid hyperplasia and <2:1 denotes erythroid
c. Lymphoid hyperplasia hyperplasia.
5 **Best method to assess BM cellularity is: 5 (a) Trephine biopsy is preferred over bone
a. Trephine biopsy marrow aspiration in that it demonstrates the
b. M:E ratio is enough. architecture of the bone marrow cellularity.
c. By high power.
6 ***Which Hbs have the same electrophoretic mobility on 6 HbS, C, D and Hb Punjab (also Hb lepore) occur
alkaline cellulose acetate? at the same position on cellulose acetate at
pH8.6 . Also Hb C, E and C harlum occur at the
position of Hb A2
8 ******When using and electronic cell coulter counter, 8 (d) A high titer of cold agglutinin cause falsely
which of the following results can occur in the presence of ↑MCV, MCH and MCHC and falsely ↓ RBC
cold agglutinins: count.
a. ↑MCV & ↓MCHC To correct, incubate at 37°c for 15-30 minutes
b. ↓MCV & ↓MCHC and rerun the specimen.
c. ↓MCV & ↑MCHC
d. ↑MCV & ↑MCHC
e. ↑MCV & decreased RBC
f. ↑MCV & normal RBC
h. ↓MCV and RBC
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CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
11 **By coulter, TLC= 22.5x109/L If NRBC are 200 per 100 11 (d) using the correction formula :
leucocytes, so corrected leucocytic count equals: Corrected WBC= WBC X 100 / (NRBC+100)
a. 11.5 x 109/L Corrected WBC= 22.5 X 100 / (200 + 100 )
b. 22.3 x 109/L = 7.5 x 109/L
c. 22.7 x 109/L
d. 7.5 x 109/L
12 ****The main antioxidant in RBCs is: 12 b. Reduced glutathione acts as antioxidant
a. NADPH through its SH group.
b. Reduced glutathione
13 ***Newborn with MCV 100fl, is considered. 13 b. MCV in the first week is normally 108fl.
a. Macrocytosis. After 2 months, it is 96fl.
b. Normal
14. Hemoglobin breakdown takes place in: 14. a. Normally 6gm of Hb is broken down per day
New a. RES New into;
b. Hepatocytes. - Globin peptides: hydrolysed and the
c. Renal tubules. amino acids enter into the body amino acid
pool.
- Iron: reutilized.
- Porphyrin ring: broken down in the
reticuloendothelial cells of the liver, spleen
and bone marrow to bile pigments.
16 **In A sickle cell disease patient under general anesthesia, 16 Tourniquet should not be avoided.
all true except? A sickle cell patient needs transfusion to reduce
HbS below 30% prior to general anesthesia.
During anesthesia, the patient should be
hyperoxygenated and rapidly induced. Limb
tourniquet should be avoided.
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CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
19 Fanconi's anemia 19
23 **In HUS, all are true except: 23 (e) HUS occurs in children following VTEC
a. occurs mainly in children. enteritis (also after salmonella, shigella,
b. Is usually preceded by some sort of enteritis. streptococcal infection, as an autoimmune
c. Fragmented RBCs are seen. disease and following drugs e.g. cycloserine. It
d. Uremia is usual. is charectarized by:
e. Anti IgG is positive in 10% of cases. - Thrombosis in small vessels.
- Fragmentation of RBCs.
- Reduced platelets (consumptive).
- Uremia.
25 HUS 25
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CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
29 **In hereditary spherocytosis all are true except: 29 c. Hereditary spherocytosis is an autosomal
a. Autosomal dominant. dominant membrane defect (anykrin) not due to
b. Treated by splenectomy. a defect is in hemoglobinization of RBCs. Parts
c. Defect is in hemoglobinization of RBCs of the defective membrane is removed by the
spleen leading to reduced cell surface and
causing spherocytic cells. Splenectomy
improves the condition.
31 **In sickle cell anemia patient with iron overload, this 31 (c) Yersina enterocolitica occurs in iron
organism is isolated from blood: overloaded patients treated with desferrioxamine
a. Salmonella. (see p376 Kumar)
b. Strept pneumoniae
c. yersinia enterocolitica.
33 *****Microangiopathic hemolytic anemia is present in all 33 (b) In MAHA there is intravascular hemolysis
except: and fragmentation of the RBCs due to abnormal
a. TTP microcirculation leading to fibrin deposition,
b. Meningococcal septicaemia. platelet deposition and vasculitis e.g in;
c. HUS - HUS
- TTP
- Renal pathology
- Preeclampsia
- Autoimmune diseases e.g PAN, SLE.
- Carcinomatosis.
- Septicemia
Meningococcal septicaemia.cause thrombosis of
small blood vessels leading to petichiae and
adrenal failure (Waterhouse-Fridrechson
syndrome)
34 ****The following enzyme increases in hemolytic anemia: 34 (b) LD1&2 are characteristically increased in
a. Total ACP HA. ACP although is present in high
b. LDH concentration inside RBCs (tartarate resistant) is
c. ALP not characteristically increased.
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CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
35 ****In G6PD deficiency avoid all the following drugs 35 (e) Agents causing HA in G6PD deficiency
except: include:
a. Salicylic acid - Antimalareals e.g. primaquine.
b. Primaquine. - Sulphonamides and Sulphones (dapsone).
c. Dapsone. - Analgesics e.g. salicylic acid
d. Trimethoprim. - Antihelmenthics e.g. niridazol.
e. Folic acid - Miscellaneous e.g. vitamin K analogues,
probanecid.
36 ***A patient with hemolytic anemia has all the following 36 (c) In hemolytic anemia there is;
exept: - Hyperbilirubinemia and hemiglubinuria.
a. Bilirubinemia. - ↑urobilinogen and stercobilinogen→ dark
b. Dark urine. urine.
c. Hypertension. - ↓ Haptoglin and hemopexin.
- Hemosiderinemia and hemosiderinuria.
- Methemoglobenemia.
41. Which is true regarding DAT b. DAT involves testing patient's cells without
New a. It is positive in all IHA. prior exposure to antibody in vitro. For
b. may detect complement attached to RBCs. investigation of AIHA, antiglobulin reagents
specific for IgG, IgM and IgA are available.
Monoclonal antibodies specific for the
complement C3d is also available.
2-6% of AIHA are DAT- negative. This may be
due to nature of antibody or its presence in
below detection levels. In such patients
diagnosis depends on careful screening of a
concentrated ether eluate made from the patient's
RBCs or by manual polybrene test or by more
complex techniques e.g. RIA, complement
fixing antibody consumption (CFAC) test and
ELISA and enzyme linked antiglobulin test
(ELAT).
A positive DAT does not necessarily mean that
the patient has AIHA. Causes of positive DAT
include;
1. An auto-antibody on the red cell surface with
or without hemolytic anemia.
2. An allo-antibody on the red cell surface, e.g.
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CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
44 **Hb variant with fusion of delta and beta gene segments 44 Hb Lepore is the result of fusion of β & δ chains
is: which combine with α chain (β δ2,α2)
Other abnormal patterns include HbH (β4) and
HbSS (Bs, Bs)
46 ****In iron deficiency anemia, all are present except: 46 None or choose something appropriate.
a. ↑ iron absorption. Iron absorption is adjusted to body needs. It is
b. Microcytis hypochromic blood film, increased in iron deficiency anemia and
pregnancy.
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CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
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CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
58 Urinary excretion of radioactive Vit B12 after oral and 58 After a loading dose of IV B12, oral radioactive
parenteral administration B12 is given and amount absorbed is measured
by total body counting or 24h urine sample.
Radioactive B12 may be given alone or + IF.
Dicopac test uses 2 isotopic forms of B12, one
bound to IF and one unbound.
Interpretation: B12 aborbed is low and corrected
by IF in PA. B12 abroption is low and not
corrected by IF in intestinal causes.
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CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
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CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
72 Where can you find hypogranular leucocytes? 72 In myeloid leukemia (M3 varient)
73 IL1 & 2. 73
74 Toxic granulation and Dohle bodies. 74 In toxic granulation, granules are heavy dark
red. This occurs with infection, toxemia and
irradiation.
Dohle bodies are small round blue peripheral
granules that occur with infection and May-
Hegglin syndrome.
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CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
mohammad_emam@hotmail.com 29
CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
84 **Acute monocytic leukemia is associated with? 84 e. Monoblasts are +ve for NS & butyrate estrase.
a. Lymphadenopathy There is also tissue infiltration (gums with
b. soft tissue involvement hypertrophy)
c. Good prognosis compared with other leukemias,
d. More lysozyme level in urine & serum
e. +ive for non specific estrase,
85 **All may cause leukemia except: 85 (b) Alkylating agents (not methotrexate) are the
a. Ionising radiation. chemotherapeutics known to predispose to
b. Methotrexate. leukemia.
c. Down's syndrome. Ionising radiation predispose to AML. Down's
d. Benzene. syndrome is associated with increased incidence
e. Fungus. of ALL. Benzene & petroleum derivatives are
associated with increased incidence e.g.
showmakers.
In 1999, three different children with leukemia
suddenly go into remission upon receiving a triple
antifungal drug cocktail for their secondary fungal
infections. In 1997 a clue was found that leukemia,
whether acute or chronic, is intimately associated with
the yeast, Candida albicans. 50 years ago, it was
stated that "it has been established that histoplasmosis
and such reticuloendothelioses as leukemia, Hodgkin's
disease, lymphosarcoma, and sarcoidosis are found to
be coexistent much more frequently than is
statistically justifiable on the basis of coincidence." It
is believed by some that cancer is a "chronic,
intracellular, infectious, biologically induced spore
(fungus) transformation disease." Grains such as corn,
wheat, barley, sorghum, and other foods such as
peanuts, are commonly contaminated with cancer-
causing fungal poisons, or "mycotoxins." One of
them, called aflatoxin, just happens to be the most
carcinogenic substance on earth. If this is indeed a
problem, Kaufmann asserts, then cereal for breakfast
and soda pop for dinner may not be conducive to a
cancer-free lifestyle.
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CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
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CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
98 **A 68 years old man with TLC of 23,000 has the 98 b. Adult T cell leukemia (CD25 and CD5)
following markers, CD1…%, CD2…% kappa chain +,
what is the diagnosis?
a. Adult T cell leukemia
b. CLL
c. Lymphosarcoma cell leukemia
99 ***In CLL: 99 ?
a. RAI classification III is either I or II with hemolytic According to RAI classification, III is 0 or I or II
anemia. but Hb is < 11g/dl due to marrow failure not
b. 5% terminate by Richter's syndrome. hemolysis.
c. 30% of lymphocytes agglutinate RBCs
100 ***TRAP stain is helpful in diagnosis of: 100 Hairy cell leukemia
Tartarate resistant alkaline phosphatase (TRAP)
is used for diagnosis of HCL
101 *****Bone marrow necrosis occurs with: 101 c. Hodgkin or a. Metastatic carcinoma***?
a. Metastatic carcinoma.
b. Chrome lymphoproliferative disorder.
c. Hodgkin
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CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
102 *****In MM, extramedullary plasmacytoma is likely to be 102 b. Extramedullary plasmacytoma occurs
present in: most commonly in nasopharyngeal sinuses.
a. Lungs. Heart, lung and kidney (nodular
b. CNS glomerulosclerosis) originate from tissues
underlying mm of GIT and URT.
103 *****In lymphocyte predominant CLL: 103 c. Lymph node effacement may be nodular or
a. Reed Sternberg cells are abundant. diffuse.
b. Bad in prognosis. In lymphocyte predominant HL according to
c. Lymph node effacement may be nodular or diffuse. Rye classification;
- Nodal architecture is lost
- Small homogenous lymphocytes.
- RS cells are little with no nucleoli.
***In CML *(AML)treatment, which is true: a. Folinic acid protects against the megaloblastic
a. Folinic acid protects against the megaloblastic effects effects of methotrexate .
of methotrexate .
b. Citrovorum and folinic acid are synonymous.
c. Trimethoprim if used frequently causes folic acid
deficiency or megaloblastic anemia.
d. There is ↓ methyl THF in B12 deficiency.
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CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
106 **BM transplantation and graft vs host disease 106 All (skin, liver, GIT damage)
In GVHD, lymphocytes (allogenic) cause skin
rash, liver damage, and diarrhea. Acute if occurs
<100days chronic if after 100 days (scleroderma
like syndrome).
107 Haploid transplantation. 107 Haploid identical match is when the donor is a
parent and genetic match is at least 1/2 identical
Synergic transplantation is an all allogenic
transplant from identical twin.
UBMT or MUD = unrelated BM transplant =
matched unrelated donor.
108 Use of P32 for PRV. 108 P32 is a β emitter which is taken up by bone and
may be used to give prolonged myelo-
suppression (2yrs) in old patients. Effect may
take 2-3 months and lasts 6-36 months. But due
to side effects, it shouldn’t be used below 70
years. Single dose is sufficient to reduce spleen
size. Little risk of neutropenia and
thrombocytopenia.
115 CLL when reach LN resemble which type of LN? 115 Low grade small cell Hodgkin lymphoma.
CLL are small mature uniform. Well
differentiated lymphoma has small mature
lymphocytes.
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CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
118 Binet clinical staging of lymphoma stage IIB 118 Lymphocytosis and Involvement of 2 or more
chains.
Lymphocytosis is not included.
118 In Hodgkin disease all are true except 118 Chest X ray is rarely helpful
New New Staging in HL influences both treatment and
1 1
prognosis. Clinical staging is followed by
cervical, thoracic, abdominal and pelvic XR, CT
or MRI scanning. BM aspirate and trephine are
performed to detect marrow involvement.
118 In Non Hodgkin disease, which is true? 118 e. Most NHL are B cell in origin. Paradoxically,
New a. Most are T cells. New aggressive tumors respond more dramatically to
2 2
b. Good risk patients are sensitive to chemotherapy. treatmet and are more likely to be cured than
c. BM is uncommonly involved. indolent tumors. Bone marrow is commonly
d. Histological classification is not as important as in HD. involved leading to BM failure. Treatment of
e. None of the above. NHL depends principally on the histological
classification (more than six histological
classifications for NHL).
118 In CML, which is not present? 118 a. In CML NAP score is low (<20, whereas an
New a. NAP is highly positive. New elevated or normal score (20-130) occurs in a
3 3
b. Splenometally is present in 80% of cases. leukemoid reaction), splenomegally (often
c. WBC is commonly 500x109 at presentation. massive) occurs in over 90% of cases, WBC are
d. BCR +ve but Philadelphia negativecases may occur. often greater than 100x109 or more at
presentation. 5% of CML are Ph-negative and
about half of these patients have a BCR-ABL
gene that is molecularly identical to the BCR-
ABL gene of Ph-positive CML.
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CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
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CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
129 ***ITP occurs in all except: 129 ??e. All of the above.
a. hypersplenism, ITP has no identifiable antecedent. The question
b. Sarcoidosis. may be about autoimmune thrombocytopenia
c. SLE. not ITP See 124.
d. Quinidine.
e. All of the above.
131 In Bernar Soulier syndrome, all are right except: 131 a. Normal aggregation with ristocetin
a. Normal aggregation with ristocetin In Bernard Soulier syndrome there is ↓
b. Giant platelets adhesion (due to ↓ GPIb receptor that binds
c. ↓glycoprotein FVIII→ ↓ ristocetin adhesion.
On blood film there is large megathrombocytes.
Swiss cheese platelets are seen on EM
132 **In vW disease, all are true except: 132 c. In vW disease there is:
a. BT is prolonged. ↑PTT
b. PT is normal. ↑BT (variable)
c. PTT is normal ↓ platelet aggregation with ristocetin
d. Platelet aggregation is normal
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CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
135 **Which test is used to diagnose factor XIII deficiency? 135 d. In FXIII deficiency there is normal clotting by
a. PTT. extrinsic and intrinsic tests and TCT. However
b. PT clots are friable and dissolve in 5M urea within
c. Thrombin time few houls.
d. Clot stability with urea
136 To differentiate between hemophilia A and B? 136 a. Individual factor assay. Also, thromboplastin
a. Individual factor assay. generation test (TGT) and plasma correction
b. ↑PT tests can be used.
c. ↑PTT
137 ****Which is wrong regarding heparin? 137 b. its action can be reversed by vit K . Heparin
a. Acts on thrombin. acts on ATIII (potentiates its action and directly
b. its action can be reversed by vit K binds thrombin).
138 ****Regarding protein C. which is wrong? 138 b. protein C inactivates FV and VIII and
a. Acts on thrombomodulin. activates thrombolysis. Protein S is a cofactor of
b. acts independent on protein S. activated protein C.
140 Regarding protein C all wrong except: 140 Its main function is inactivation of F Va and
VIIIa
NB: Questions from 85 to 104 were found in papers named Anne/Hematology Quiz and may not be encountered in previous
exams unless labeled by star (*)
A blood smear shows 80 nucleated red cells per 100 leukocytes. c. 10.0 x 109 /L
9
The total leukocytic count is 18 x 10 /μl. The true WBC
expressed in SI units is:
a. 17.2 x 109 /L
b. 9.0 x 109 /L
c. 10.0 x 109 /L
d. 13.4 x 109 /L
Which of the following tests is used to monitor red cell d. Reticulocytic count.
production?
a. PCV
b. TIBC
c. Schilling test.
d. Reticulocytic count.
mohammad_emam@hotmail.com 38
CLINICAL & CHEMICAL PATHOLOGY MCQ Hematology
Which of the following conditions will increase ESR? b. Increased fibrinogen level.
a. Erythrocytosis.
b. Increased fibrinogen level.
c. Decreased IgG level.
d. Reticulocytosis.
The formula for cell count using hemocytometer is?
When making a blood film by Wdge technique, increasing the
angle of the spreader slide results in the film being:
a. Longer and thicker.
b. Longer and thinner.
c. Shorter and thicker.
d. Shorter and thinner.
What information is required in order to calculate the MCHC? e. None of the above.
a. Hemoglobin and erythrocytic count.
b. Hemoglobin, MCV and RBC
c. Hematocrit and erythrocyte.
d. Hemoglobin and MCV
e. None of the above.
If a case of mismatched indices occurs on the electronic blood
analyzer, which is the most sensitive parameter to be affected
and why?
If your hematology electronic cell counter requires bleaching,
which CBC parameters would be affected and why?
List the most common causes of an inaccurate automated
platelet count.
Describe the principle of the latest hematology analyzer you
have used.
If you suspect a cold agglutination is present in the specimen you
are processing, which 2 parameters would be affected and what
course of action could be taken to resolve the problem?
What are the major morphological features that distinquish P. .
falciparum from P. vivax?
Hemophilia A male married normal female, incidence in offspring: females are carriers, normal males
CD antigens
mohammad_emam@hotmail.com 39
CLINICAL & CHEMICAL PATHOLOGY MCQ Immunohematology
Immunohematology
1. Serum of donner + RBC of patient is called: 1. a. minor cross matching = donor serum +
a. minor cross matching recipient cells.
b. major cross matching Major cross matching = donor cells + recipient
serum.
3. ****A patient received 2 bags of blood intraoperatively, 3. b. Febrile reactions due most frequently to WBC
after 5 hours he developed fever and rigors. This is likely reactive antigens and rarely to platelet antiesn
due to: occur after 30min to 90 minutes after starting
a. Platelet antibodies. transfusion.
b. Leucocyte antibodies
c. Bacterial infection.
4. Unsuitable donor. 4.
5 ****All diagnose hemolytic disease of new born 5 d. In HDN there is polychromasia and
except: NRBCs in peripheral blood of the baby.
a. Retics count. Tests done on cord blood Tests done on maternal blood
b. bilirubin - ABO & D group - ABO & D group
- DAT - Ab screen
c. DAT -Hb - Kleinhauer test.
d. Porphyrins. - Bilirubin
6 **For hemolytic disease all are true except? 6 a. HDN is an alloimmune (not autoimmune)
a. It is autoimmune disease, disease.
b. Child RBC have to cross the placenta to produce the
antibody response,
c. First born child unaffected.
d. Can be diagnosed even in utero,
d. Severity is proportional to antibody titer
10 The blood donor in KSA can not be with all of the 10 e. previous pregnancies
following except: Possibly transmissible infections not routinely
a. donor infected with HIV tested are:
b. donor infected with hepatitis - B. burgdorferi.
c. donor infected with syphilis - Y. enterocolitica
d. donor infected with malaria - P. falciparum.
e. previous pregnancies
mohammad_emam@hotmail.com 40
CLINICAL & CHEMICAL PATHOLOGY MCQ Immunology
Immunology
1. **Antigen & antibody reaction is? 1. b. Immunodiffusion is the process of diffusion in
a. Agglutination semisolid media to detect amount of antibody to
b. precipitation neutralize antigen. Agglutination necessitates an
c. immunodiffusion, indicator system e.g. RBCs or latex particles.
2. **Hook effect in immune assay occurs because the 2. b. The hook effect is the result of very high
concentration of antibodies in the well is? antigen levels giving lower than expected result
a. Too low in a double antibody sandwich assay.
b. Too high
c. Optimum
6. **Lysis in complement fixation test means the test is? 6. b. In CFT, absence of hemolysis indicates that
a. Positive complement was fixed in antigen antibody
b. negative reaction so specific antibody was present.
c. invalid.
7. **All tube for serial dilution for CRP test contain 0.5ml 7. None (something missed in the question).
of saline & 0.5ml of serum is added to Tube 1 & 0.5ml is The titer in the 7th tube = 27 = 128
transferred through the row of tubes & agglutination is So, the concentration of CRP= 128x6= 768mg.
demonstrate in tube 7, If sensitivity of the test is 6mg/l
the concentration of CRP in serum is?
a. 36mg
b. 42mg
c. 6mg
d. 48mg
e. 384mg..
8. **CRP is tested because it is increased in? 8. b. CRP is a sensitive non specific indicator of
a. Bacterial infection acute injury, bacterial infection or inflammation.
b. viral infection
c. other infection.
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CLINICAL & CHEMICAL PATHOLOGY MCQ Immunology
10. ******Which of the following reagin test for syphilis? 10. a. Reagin = Antibody against cardiolipin.
a. VDRL Reagenic tests are VDRL, RPR and
b. TPHA Wassermann (CFT).
c. TPT
11. **Antigenic detection is useful in diagnosis of all of the 11. c. Because L. monocytogens is an intracellular
following escept: organism.
a. B hemolytic Streptococci.
b. H. influenza.
c. Listeria monocytogenes.
12. **Autoimmune disease contain all except? 12. d. In AI diseases there is ↑ autoantibodies →
a. Lesion in B/M immune complex formation → complement
b. low complement level in serum fixation → ↓ complement.
c. immune complex in serum Also there is cell death or altered function.
d. low Ig in serum.
mohammad_emam@hotmail.com 42
CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
Microbiology
.4 The best chemical disinfectant in a TB lab? 4. a. Phenol, although effective against TB, is
a. Gluteraldehyde rarely used being too caustic. Ethanol is not
b. ethanol effective (TB are alcohol resistant).
c. phenol Glutaraldehyde is used to sterilize respiratory
d. hypochlorate, equips and is effective against TB.
.5 ***What is lab safety level you will employ for the culture 5. d. Biosafety levels are designed according to
of brucella? risk group of the lab;
a. Routine precaution Risk Description Biosafety
group level
b. bio safety level 1, 1 Organisms are low risk to lab 1
c. bio safety level 2 workers and community
d. bio safety level 3 (common organisms)
e. no specific measure 2 Moderate risk to lab workers 2
limited risk to community e.g.
staph, strept., vibrio
3 High risk to labo workers, 3
low risk to community (don’t
spread rapidly) e.g. brucella,
TB, Salmonella
4 Viruses, high risk to lab and 4
community
.6 β-lactamase resistant penicillin for staph 6. Cloxacillin.
.8 ***Intrinsic resistance for vancomycin is present in: 8. a. Penicillin-resistant bacteria (both act on cell
a. Penicillin-resistant bacteria wall)
b. C. deficile. Most important use of vancomycinis against
c. Staph sensitive to cloxacin. staph aureus that are resistant to penicillinase
resistant penicillin e.g. nafcillin.
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CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
.12 Cephalosporin resistant bacteria producing beta 12. a. β lactamases are produced by;
lactamase is: B. fragilis.
a. E.coli. N. gonorrhoea.
b. Y. Enterocolitica H. influenza.
Legionella
Enterobactereceae
.15 **A pre-operative medication of antibiotics is indicated 15. b. Gangerous obstructed loop.
in:
a. Acute appendicitis.
b. Gangerous obstructed loop.
c. Abdominal hernia.
.17 ***- Which is the best way to sterilize a bronchoscompe? 17. a. Autoclave.is used for heat resistant parts but
a. Autoclave. ethylene-oxide may be used for heat labile
b. Ethylene-oxide. parts.
c. Gamma rays.
d. None
BASIC TECHNIQUES
.18 **Castanida medium for blood culture contain? 18. Both liquid & solid media in same bottle.
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CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
.20 **If you forget iodine step in gram stain staph aureus will 20. Red
be seen?
.24 ***Gram stain best done in? 24. b. Growth of bacteria on media follows the
a. Lag phase following phases;
b. log phase - Lag phase; phase of accommodation to
c. static phase medium. No net growth
d. death phase. - Log phase; phase of maximum growth.
- Stationary phase; growth equilibrates death
- Decline phase; phase of exhaustion of
medium components. Growth declines.
.26 **Which agar concentration is the best to detect bacterial 26. b. 0.5%
mobility? For solid medium 1.5-2% concentration is
a. 0.01% used.
b. 0.5%
c. 1.5%
d. 2%
e. 4%
.27 ***Best time to read oxidase test is within: 27. b. 10 seconds
a. 5 seconds.
b. 10 seconds.
c. 1 minute.
d. 2 minutes.
e. 5 minutes.
.28 ***In ZN staining used for M. leprae, the decolorizing 28. d. None of the above.
agent used is: 5% H2SO4 or 3% acid alcohol.
a. 5% acetone.
b. 5% acid alcohol.
c. 5% hydrochloric a.
d. None of the above
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CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
.30 ****When urine is preserved for culture it should be: 30. e. (check also for b.) If a delay > 1-2 hours is
a. preserved at room temperature. unavoidable multiplication of bacteria can be
b. Preserved in refrigerator. prevented by;
c. preserved with nitric acid. - Storage in refrigerator at 4°c
d. Preserved with sulfuric acid. - Collected and transported in a container of
e. Preserved with boric acid. boric acid at a concentration of 1.8%
31. Suitable medium for many pathogenic bacteria 31. Brain heart infusion.
.32 Blood culture is indicated in the following: 32. ??d. None of the above
a. Mycobacterium ?? c. Staph. aureus may cause septicemia.
b. Diphtheria
c. Staph. Aureus
d. None of the above
BASIC BACTERIOLOGY
.34 **Cell wall is absent in? 34. a. Mycoplasma is the smallest organism
a. mycoplasma capable of self replication. It possesses cell
b. bacteria constituents of bacteria except cell wall.
c. fungi Instead, there is a triple layer cytoplasmic
c. viruses membrane.
.35 **Sterol is the main constituent of cell wall of: 35. a. Unlike the cell wall of bacteria,
a. Mycoplasma. mycoplasma cell membrane contains
b. Rickettsia. cholesterol or carotenol in addition to the
c. Chlamydia. usual mural and phospholipids.
d. Leptospira.
e. Staph.
.36 ***Which of the following contains more peptidoglycan? 36. a. The peptidoglycan layer is much thicker in
a. G+ve bacilli. Gram positive than in Gram negative bacteria.
b. G-ve bacilli. Richetsia cell wall similar to that of Gram
c. Chlamydia. negative bacteria. Chalmydia cell wall is
d. Richetsiae. similar to that of Gram negative bacteria but
no muramic acid.
.38 ***Endotoxins are chemically: 38. c. Endotoxins are integral part of G-ve
a. Mucopeptides. bacteria. They are LPS whereas exotoxins are
b. Proteins. polypeptides.
c. Lipopolysaccharides.
d. Polysaccharides.
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CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
.39 ***L forms differ from parent cells in all of the following 39. c.
except:
a. Lack rigid cell wall.
b. Lack regular shape.
c. Cannot grow and multiply on nutrient medium.
d. Lack regular size.
40 ***Bacterial genes are transferred by all of the following 40 c. The transfere of genetic information
means except: between bacterial cells can occur by 3
a. Transformation. methods: conjugation, transduction and
b. Transduction. transformation (see table p16 Jawetz review).
c. Mutation.
d. Conjugation.
.45 ***Differentiate between pathogenic & non pathogenic 45. coagulase test. Pathogenic staph is aureus
staphylococci use species.
.47 ***To differentiate A & B hemolytic streptococci we use 47. a. Group A strept is bacitracin sensitive while
a. bacitracin group B is bacetracin resistant.
b. optochin Optochin is used to differentiate αhemolytic
c. ampicillin strept (pneumococci are sensitive and strept
viridans is resistant)
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CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
.49 **Food poisoning symptom [vomiting] 4 hrs after 49. b. staph aureus enterotoxin
ingestion of food seen in?
a. E.coli
b. staph aureus enterotoxin
c. salmonella typhi
d. vibrio cholera
.50 ***Strept pyogenes cause all except: 50. Toxic shock syndrome (check this answer
118. Streptococcus cause all except: because pyrogenic exotoxin A of strept
pyogenes is similar to TSST of staph).
.51 Pneumococci are typed by 51. Optochin, bile solubility, Quellung test
Pneumococci are optichin sensitive, bile
soluble and Guellung test positive.
.53 **Diagnosis of metastatic staphylococcal lesions: 53. a. Staph don’t produce endotoxins (being
a. Protein A Ab. gram positive). Anti Dnase is used mainly for
b. Anti DNase. strept. Protein A antibody methods are
c. Endotoxins diagnostic for staph disseminated lesions.
.56 **All of the following species of streptococcus are B 56. b. Strept. pyogenes is β hemolytic, Strept.
hemolytic except: avium is α hemolytic, Strept. salivarius is non-
a. Strept. Pyogenes. hemlytic.
b. Strept infrequens.
c. Strept. avium
d. Strept. salivarius
.59 Test used to differentiate staph. aureus 59. b. Coagulase is used to diagnose staph aureus
a. Catalase (positive) from other staph and strept. Catalase
b. Coagulase is used to differentiate staph from strept.,
c. Dnase Dnase and ASOT are used to diagnose strept.
d. ASOT
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CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
.62 ****In N. gonorrhoea causing dissiminated lesion 62. a. Oral penicillin, cirprofloxacin or
(systemic manifestation), which of the following is doxycycline are used in gonococal arthritis.
incorrect.
a. Sensetive to penicillin (G+ve only)
b. Resistant to ampicillin
.64 Neisseria gonorrhoea can cause which of the following? 64. b. N. gonorrhoea may cause septicemia and
a. Osteomyelitis. suppurativeartheritis and hemorrhagic skin
b. Artheritis. papules.
c. Septicemia.
.67 *******Which test is used to ascertain toxigenicity of C. 67. b. Elick's test is in vitro plate test for toxin
49iphtheria? production. Schick test in an ID test for
a. Dick test. susceptibility to diphtheria, if immune →-ve
b. Elick's test. (no reaction).
c. Schick test.
d. None of the above.
.69 ***A CSF culture revealed an organism that is G+ve at 37ْ 69. Listeria.
c and no growth at room temperature. This is most likely Something missed in this question; Listeria is
to be: motile at 25°c not at 37°c. It grows on a wide
range of temperature (3-43°c)
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CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
.72 **Growth of actinomyces israeli on gram stain shows 72. gm +ve branching rods with club ends.
.74 **Madura foot have all except? 74. a. Madura food is a subcutaneous infection
a. Fever. with fungi (e.g. eumycates) or actinomyces.
b. bone involvement There is discharge from sinus tract, bone
c. Draining sinus tract involvement follow. Systemic symptoms are
d. granules in discharge uncommon, and so is LN.
e. Caused by fungus or bacteria.
.78 **IMViC reaction of E.coli & klebsella are? 78. E. coli is ++-- Klebsiella is --++
.79 **Example of NLF colonies on MacConkey agar ? 79. NLF (produce pale colored colonies):
28. Examples of LF colonis on MacConkey agar? Salmonella, shegella, 50seudomonas, proteus
LF (produce pink colored colonies):E.coli,
Klebsiella.
.80 **The following proteous are indole +ive except 80. P. mirabilis
While M. morganii, P. vulgaris, and
50seudomonas50 are all positive.
.85 **Which strain of E. coli cause HUS? 85. a. EHEC 157 = VTEC 157
a. VTEC O157, H7
b. EPEC O157:H7
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CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
.88 **Psuedomonas infections include? 88. May cause UTI, otitis media & eye infection,
Bed sore, burns,
.89 **Psuedomonas is? 89. Motile gm –ive bacilli, NLF, produce
pigmented colonies
.90 **Psuedomonas aerogenosa produce? 90. Blue green pigments,
Pyocyanin & biovirdin.
.92 **An abscess with bluish green discharge caused by? 92. c.
a. Staphlococcus
b. proteus
c. 51seudomonas.
.93 ****Hospital fluids are usually contaminated by: 93. a. Pseudomonas are able to grow in water with
****120. Organism of medical fluids is: traces of nutrients.
a. Pseudomonas.
b. Staph.
c. Strept.
.94 Pigments of pseudomonas aerogenosa 94. Both Fluorescin (pyovirdin) and pyocyanin
.95 **Widal test used in the diagnosis of? 95. a. Typhoid fever
a. Typhoid fever
b. malaria
c. malta fever
d. brucellosis
.97 **On Wilson Blair media salmonella produce? 97. S.typhi large black colonies with metallic
sheen after 24hours, S.paratyphi produce
green colonies after 48hours.
.98 **Media used for the isolation of salmonella are? 98. MacConkey, DCA, Wilson blair,
Also XLD and selenite broth.
.99 ***Culture of choice in the first week of typhoid fever? 99. c. Blood culture are usually positive 90% in
a. Feces. the first week of fever, thereafter rate of
b. urine. posistivity decreases. Stool culture are
c. blood. positive throughout the course of disease.
d. CSF However, it is of less significant being
positive in carriers and dignose gastroenteritis
not enteric fever.
.100 **Color of salmonella & shigella on MacConkey agar is? 100. NLF
.103 Diagnosis of typoid fever in 1st week is done by 103. blood culture
.104 Differentiate between E. coli and salmonella 104. Salmonella is NLF and E.coli is LF
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CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
.105 ****All of the following is correct regarding enteric fever 105. Localized gut disease.
except:
.107 ******Dog bite G-ve bacilli isolated is propably: 107. a. Pasteurella multucida
a. Pasteurella multucida
b. H. influenza.
c. B. Abortus
d. toxocara cannis
.109 ***Enriched media for V.cholera is ? 109. Alkaline peptone water [pH8.6],
.110 ****Loss of fluid in cholera is due to? 110. Adenyl cyclase system activation
This leads to ++cAMP → Chloride and water
loss.
.112 Vibrio vulnificus. 112. This is halophilic cholera i.e. lives in salted
water, infects wounds of shellfish handlers
causing cellulistis (may cause septicemia in
immunocompromized patients).
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CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
SPIROCHETES
.118 **Specific or non specific test for syphilis? 118. Non-specific- RPR, VDRL
Specific- TPI, FTA-ABS, TPHA, MHA-TP
.121 ***Bejel is characterized by all except? 121. Both are OK. Bejel is non venereal disease
a. Non veneral transmission caused by T. pallidum endemicum. It is a
b. Caused by 53ariant of Treponema pallidum. highly infectious skin in fection.
.122 *****Which of the following accurately don't describe 3ry 122. a. Ulcerative skin lesions.
syphilis:
a. Ulcerative skin lesions.
b. Gummas in internal organs.
c. Rare spirochetes in lesions with limited tissue damage..
HEMOPHILUS
.124 **Hemophilus grows 53uxuriantly on? 124. Chocolate media.
.125 ****Satellitism is exhibited by? 125. Hemophilus influenza around staph. Aureus
a. H. influenza.
b. N. meningitides.
c. mycobacteria
.126 **Hemophelus influenza require? 126. X & V factors for their growth
.129 **Factor V & X are essential for growth of. 129. H. Influenza
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CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
.134 ***What type of fever caused by borrelia? 134. a. B. recurrentis and duttoni casue replapsing
a. Relapsing fever. fever. B. burgdorferi cause lyme disease and
b. Q fever Q fever is caused by coxiella burnetti.
c. Rheumatic fever.
d. enteric fever.
ANEROBIC BACTERIA
.135 **Gm +ve bacilli with terminal round spores resembling 135. Clostridium welchii,
match stick are Also called perfrengins.
.139 **Stormy fermentation is seen in? 139. b. Cl. Perfringens in litumus milk medium
a. Cl. Histolyticum produces A&G, the acid clots milk and the gas
b. Cl.prefrenges breaks the clot producing stormy
c. Cl.septicum. fermentation.
.140 **Bacteria that can be best identified best by direct 140. a. Vincent bacillus
Gram's film is?
a. Vincent bacillus
b. campylobacter
.141 *****The following combination is isolated from pus from 141. a. B. fragilis.and streptococcus.
deep pyonidal sinus:
a. B. fragilis.and streptococcus milits.
b. B. fragilis and B. abortus.
c. Strept B.hymolitic and streptococcus.
mohammad_emam@hotmail.com 54
CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
.143 **Which one has non clostridium crepitation? 143. Cl. perfrengens (X)
Clostridia producing gas gangarene are;
- .Cl. perfringens (mainly).
- Cl. Novyi.
- Cl. septicum
- Cl. histolyticum.
BRUCELLA
.145 **Malta fever is caused by? 145. Brucella species
Also called undulant fever.
.146 A young Saudi male came with fever & myalgia your 146. a. Other symptoms and signs include;
diagnosis is? - Arthralgia
a. Brucella - Sweating
b. staphylococcus - Heptatosplenomegally.
c. streptococcus
d. gonorrhea
.147 **Bacteremia is seen in: 147. a. Both tetanus and shigellosis are localized
a. Brucella. infections. Brucella enters through the mouth,
b. Tetanus. lung or skin to local lymph nodes to blood to
c. shigellosis liver, spleen and bone marrow to cause type
IV hypersensitivity.
MYCOBACTERIA
.148 **Mycobacterium Leprae 148. can not be culture artificially in the laboratory
.151 **Mycobacterium .T.B is? 151. Acid fast [20% H2SO4], alcohol fast,
.154 **Mycobacteria are acid-alcohol fast because 154. they resist to decolorized by acid & alcohol.
.156 *******Which of the following mycobacteria is related to 156. a. MTB complex include TB, M. africanum,
MTB complex? M. bovis, BCG and M. microtti..
a. Mycobacterium Africanum.
b. M. leprae
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CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
.158 *****Diagnosis by direct staining: 158. a. Acid fast smear is number one rapid test for
a. TB mycobacterium TB. Positive smear has a
b. Hemophylus predictive value of 96%.
.159 Which of the following belongs to PTB family? 159. a. MOTT (mycobacteria other than TB) are
a. M. Kanasasi. classified into;
b. M. Bovis. - Photochromogens: M. kansasii, M. marinum.
c. M. intracellulare. - Scotochromogens: M.scrofulucian, M.
d. M. africanum. szulgai.
- Nonpigmented:
M. avium cellular complex (MAC)
M. phlei, M. fortuitum
MISCELLANEOUS
.160 **Malignant pustule is caused by. 160. Bacillus anthracis
.162 ****Vaginal discharge is absent in? 162. d. G.vaginalis produce fishy smelling
a. Gardnerella infection discharge, TV produce thin bubbly fishy
b. trichomonas vaginalis smelling discharge, Chlamydia produce thin
c. Chlamydia discharge. Cryptococcus is a lung infection.
d. 56ryptococcus.
.163 **Sterile pyuria not seen in? 163. c. Causes of sterile pyuria;
a. TB TB
b. non specific urithritis Mycoplasma
c. urine collection by suprepubic puncture Leptospirosis
d. prior treatment with antibiotic Vaginal contamination
Antibiotics, L forms
Abacterial cystitis
Non infectious disease e.g. tumour, FB
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CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
MYCOLOGY
.168 ******Candida is identified by 168. germ tube test.
.171 *****Tenia capitis is caused by: 171. a. Microsporum ausdonii cause tenia capitis.
a. Microsporum. Trychophyton causes tenia pedis or unguium.
b. Trichophyton.
c. Candida
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CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
PARASITOLOGY
.173 **Malaria affecting large RBC- 173. P.vivax.
In P. vivax, infected cells are enlarged with
schuffner's dots. In P. ovale infected RBCS
are enlarged without Schuffner's dots.
P. malariae cause normal or even reduced
sized RBCs. In P. falciparum cells are normal
with Maurer's clefts.
.178 **A parasite can ingest RBC & present in stool- 178. E.Histolytica.
.185 The following parasite doesn’t not involve GIT in man? 185. b. cysticercosis
a. Ascaris
b. cysticercosis
c. H.nana
d. Tenia
.186 The cigar glycogen is in 186. I. buchlii, but if cigar shaped chromatoid it is
E. histolytica (immature cyst)
.187 **The arthropod vector of malaria is: 187. a. Female anopheles mosquito.
a. Female anopheles mosquito.
b. Culex mosquito.
c. Tsetse fly.
d. None of the above
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CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
.189 A warm that infects man and pass eggs around the anus is 189. Oxyurius vermicularis.
.190 Giardia lamblia is diagnosed in stool by the presence of 190. Cysts or trophozoit
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CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
VIROLOGY
.194 *******HAV all are correct except: 194. b. There is chronic carrier state in young
a. Infection in adults is more severe than children, children.
b. There is chronic carrier state in young children.
c. Vaccination is recommended for high risk group.
.195 **Best sample for the diagnosis for recovery of polio is 195. feaces.
Also from throuat and spinal fluid.
.197 **Latent infection seen in all except? 197. a. Herpes virus (?? HS causes latent infection)
a. Herpes virus
b. adeno virus
c. coxsackie virus
d. retorvirus.
.198 **Which of the following virus causes systemic effect? 198. There may be a missing "except" in this
a. Poliovirus question because adeno cause RTI and
b. adenovirus hemorrhagic cystitis and GE. Influenza and
c. rhinovirus polio also cause systemic effect. Rhino is an
d. Influenzea virus. exception.
.202 ***Who of the following is supposed to transmit CMV 202. d. Neonate with congenital defect due to CMV
infection to hospital staff? infection.
a. pregnant woman having a skin rash in second trimester.
b. HIV patient
c. HCV patient.
d. Neonate with congenital defect due to CMV infection
.203 **All diagnose viral infection except: 203. a. IgM Ab is one serum only.
**Which diagnose viral infection? A high IgG titre in serum in acute and
a. IgM Ab is one serum only. convalescent stage may be due to
b. High IgG titre in serum in acute and convalescent stage. immunization. 2 fold increase in IgG ??. IgE
c. 2 fold increase in IgG is regain of allerty not infection.
d. 4 fold increase in viral specific IgE in acute and
convalescent stage.
e. All of the above
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CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
.204 ****RSV all correct except: 204. a. RSV is a paramyxovirus. It is the most
a. Rectal sample gives the highest yield of the virus. important cause of pneumonia and
b. Form a syncetium in tissue. bronchiolitis in infants.
c. Causes lower respiratory illness in children.
d. Related to paramyxoviruses.
.205 **In a patient with rabies infection, the main histological 205. c. Negri bodies.
characteristic in the brain is:
a. Lewi bodies.
b. Durel bodies.
c. Negri bodies.
d. Amyloid plague
.206 Enteroviruses cannot be isolated from which of the 206. d. enteroviruses isolated from throat e.g. polio,
following specimens? from feces e.g. polio and hepatitis, from CSF
a. Throat swab. e.g. coxsachie virus. Enteroviruses resist
b. Fecal specimens. gastric acidity.
c. Gastric fluid.
d. Urine.
e. CSF.
.209 Ebola virus causes 209. Fever, myalgia, diarrhea, rash, lymphadenitis,
complicated with hemorrhage, encephalitis.
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CLINICAL & CHEMICAL PATHOLOGY MCQ Microbiology
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CLINICAL & CHEMICAL PATHOLOGY MCQ Shawual 1425 Exam
4. ***What is the base: acid ratio at pH 7 for acid of pK6? See Q 15 Chemistry
a. 0.01
b. 0.1
c. 1.0
d. 10
e. 100
5. ******Metabolic acidosis can result from: See Q 17 Chemistry
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CLINICAL & CHEMICAL PATHOLOGY MCQ Shawual 1425 Exam
13. ***Which of the following result shows renal improvement? See Q 53 chemistry
a. urea 9 mmoll
b. creatinine 10 mmol/l
c. urates
d. cholesterol
e. urine osmolarity less than 800 after 12 hrs of water deprivation.
17. ***In MI, which is the last enzyme to be raised and lasts long? See Q 85 chemistry
a. CK
b. CK-MB.
c. AST.
d. LDH
21. ***In Pyruvate Kinase deficiency all correct except? See Q 15 hematology
a. Intermittent attach of anemia.
b. Splenectomy is a choice of treatment.
c. Autosomal recessive.
22. **In A sickle cell disease patient under general anesthesia, all true except? See Q 16 hematology
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CLINICAL & CHEMICAL PATHOLOGY MCQ Shawual 1425 Exam
31. ****All diagnose hemolytic disease of new born except: See Q 5 immunehematology
a. Retics count.
b. bilirubin
c. DAT
d. Porphyrins.
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CLINICAL & CHEMICAL PATHOLOGY MCQ Shawual 1425 Exam
44. ***Who of the following is supposed to transmit CMV infection to hospital See Q 202 Microbiology
staff?
a. pregnant woman having a skin rash in second trimester.
b. HIV patient
c. HCV patient.
d. Neonate with congenital defect due to CMV infection
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CLINICAL & CHEMICAL PATHOLOGY MCQ Shawual 1425 Exam
54. In Non Hodgkin disease, which is true? See Hematology 118 New2
a. Most are T cells.
b. Good risk patients are sensitive to chemotherapy.
c. BM is uncommonly involved.
d. Histological classification is not as important as in HD.
e. None of the above.
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