BLOOD

1. With respect to the clotting mechanism

a. Activated protein C inactivates VIIIa, Va and the inhibitor of tPA
b. The intrinsic system is activated by tissue thromboplastin
c. Ca is required for the activation of IX
d. V is required for the full activation of VII
e. XIIIa stabilizes thrombin

2. Immunoglobulins
a. Are produced in greatest quantities by activated memory B cells
b. There are 5 types of heavy chain
c. Fc portion mediates reactions initiate by antibodies
d. J chains are found in IgA and IgE
e. Variable segments are only found on the heavy chain

3. Haemoglobin F
a. α chains are replaced with delta chains
b. has a higher oxygen content at the same pO2 as adults
c. has a higher affinity for 2,3, DPG
d. is replaced by adult Hb during adolescence
e. is able to displace oxygen from myoglobin

4. Given an Hb of 140g/L how many mLs of O2 is carried in 1L of 100%

a. 5mL
b. 100mL
c. 200mL
d. 500mL
e. 1L

5. In a healthy person in standard conditions with a pO2 of 60mmHg which is the

correct Hb saturation
a. 75%
b. 90%
c. 95%
d. 57%
e. 85%

6. Which is true of CD4+ cells

a. Are derived from the bone marrow
b. Do not have Fc receptors
c. Have class MHC II receptors
d. Can be inactivated by cyclosporin
e. Are unaffected by cytokines
7. Which is true of Hb
a. Abnormalities can lead to haemolysis in conditions such as spherocytosis
and sickle cell anaemia because of increased RBC fragility
b. HbF has a lower affinity for 2,3 DPG and thus oxygen compared to HbA
c. Is the major oxygen and CO2 carrier
d. Colours the blood: oxygenated (red) methaemoglobin (blue)
e. In normal venous blood carries 6 atoms of oxygen per molecule and so is
saturated 75% with oxygen

8. Which is true of the blood types

a. Are determined by RBC surface agglutinogens
b. When incompatible between recipient and donor at transfusion usually
results in recipient heamoagglutination
c. Can help determine parenthood, eg the child of a parent who are both type
B must be type B
d. Are determined by plasma agglutinins
e. Rh incompatibility between mother and foetus may necessitate intrauterine
transfusion of the foetus with maternal compatible blood

9. anticlotting mechanisms include

a. conversion of thrombin to protein C activator
b. AT III inactivation of VIIIa
c. Inactivation of tPA
d. Inhibition of fibrinogen degradation products by thrombin
e. TXA2, prostacyclin activity, the latter promoting vascular spasm and
platelet aggregation, the former the reverse

10. Which of the following has the greatest effect on the ability of the blood to
transport oxygen
a. The capacity of the blood to dissolve oxygen
b. The amount of Hb in the blood
c. The pH of plasma
d. The CO2 content of RBC
e. The temperature of the blood

11. The Haldane effect describes

a. The shift to the right of the HbO2 dissociation curve caused by increased
CO2 in the blood
b. The enhanced loading of CO2 in the presence of deoxygenated Hb
c. The shift of chloride ions into RBC to balance HCO3 shift from those cells
d. The action of carbonic anhydrase on carbonic acid
e. None of the above
12. With regard to CO2 carriage in the blood
a. Dissolved CO2 has an insignificant role in the carriage of CO2 in the blood
b. HCO3 production is fast in plasma
c. Ionic dissociation of carbonic acid in the RBC is fast without an enzyme
d. The CO2 concentration in blood is independent of the saturation of Hb
with oxygen
e. The majority of CO2 is carried in the blood in the forms of dissolved CO2
and carbamino compounds

13. With regard to the normal HbO2 dissociation curve, which is true
a. PaO2 = 60mmHg, SaO2 = 80%
b. PaO2 = 40mmHg, SaO2 = 75%
c. PaO2 = 30mmHg, SaO2 = 40%
d. Acidosis shifts curve to the left
e. Decreased CO2 shifts curve to the right

14. regarding the Rh antigen system

a. Rh + individuals have C,D, E antigens
b. 50% caucasions are D +
c. do not develop anti D antibodies without exposure of D – individuals to
D + RBC

15. Regarding granulocytes

a. All have cytoplasmic granules
b. Basophils are identical to mast cells
c. Eosinophils phagocytose viruses
d. Neutrophils have a half life of 4 days

16. Regarding HbF

a. Fe3+ binds O2
b. HbF has no β chain
c. Globin is synthesised from porphyrin

17. increased 2,3 DPG occurs in all of the following except

a. chronic hypoxia
b. acidosis
c. androgens
d. thyroid hormones
e. none of the above
ANSWERS
1. A
2. C
3. B
4. C
5. B
6. B
7. ?D +E
8. A
9. A
10. B
11. B
12. C
13. B
14. C
15. A
16. B
17. E