Batch 14 family

‫االمانة االكاديمية‬
Hematology exam

1. Prognostic indicators at diagnosis in acute lymphoblastic leukemia include

age and biologic properties of the leukemic blasts which of the following
is another prognostic indicator at diagnosis for ALL:
A. Splenomegaly
B. The presence of down syndrome
C. The presence of ever
D. Initial white blood cell count
E. thrombocytopenia
2. Auer rods are typically seen with which form of leukemia:
A. Acute lymphoblastic leukemia
B. Acute myeloid leukemia
C. Chronic lymphocytic leukemia
D. Chronic myeloid leukemia
E. Hairy cell leukemia
3. A 60 year old male presents with bruising and tiredness.finger breth
splenomegaly and his results reveal :Hb ,wbc count 100*10’9\L,platelet
900*1’9\L>>numerous myelocyte and 4%blast the following is likely to be
present in this patient :
A. Translocation (:21)
B. Deletion chromosome 13
C. Deletion 11q13
D. Normal chromosomal analysis
E. Translocation(9;22)
4. A 42-year-old man presented wit tiredness ,breathlessness and nose
bleeds for three weeks .on examination there were several bruises on his
arms and legs ,2cm splenomegaly and fundal hemorrhage .investigation
revealed hb 7.2 g\dl (11’5-16.5), white cell count 13.8 *10 ‘9\L(4-
11)platelet count 24*10’9LL (150-400).white cell predominantly
myeloblast and promyelocyte. Which of the following investigations
would be of most prognostic value:
A. CSF examination
B. Cytochemistry
C. Cytogenic karyotyping
D. Immunophenotyping
E. Bone marrow trephine biopsy
5. Which of the following conditions is most likely to be associated with
thrombocytopenia:
A. Hemophilia A
B. Hereditary hemohrrgic telangectasia
C. Pernicious anaemia
D. Iron deficiency anemia
E. uremia
6. Which of the following ststements concerning abnormalities of the hb
molecules is true:
A. Alpha thalassemia is due to a deficiency of beta chain production
B. HbS is caused by a single base mutation of beta chain
C. Genes for the alpha and beta chains are located on the same
chromosome
D. In thalassemia, persistence of HbF is an adverse prognostic sign
E. Bone marrow examination is the investigation of choice to diagnose
hemoglobinopathy
7. Which of the following patient with Hodgkin has the worst prognosis:
A. 25-year-old man with inguinal lymphadenopthy
B. 25-year-old woman with mediastinal and inguinal lymphadenopathy
C. 25-year-old women with mediastinal and inguinal lymphadenopathy
D. 25-year-old man with cervical and imguinal lymphadenopathy
 E. 25-year-old man with cervical and mediastinal lymphadenopathy
8. Regard B-cell CLL:
A. Thrombocytopenia is always autoimmune
B. Reed Sternberg cell is diagnostic in lymph node biopsy
C. Immunuphenotyping by flowcytometry is important ffor diagnosis.
D. Late transformation to ALL occurs in the majority o patient.
E. Diffuse infiltration o bone marrow indicates good prognosis.
9. Which of these statement is true regarding normal adult bone marrow:
A. It is composed off 90%hemopoietic cells,10%fat
B. Hemopoietic growth actors are involved in differentiation, ,and
maturation of blood cells
C. It is present as red marrow in all bones
D. It secrete erythropoietin
E. Blast constitute more than 20%of nucleated cells in normal bone
marrow
10.Which of following is a feature of a chronic extravascular hemolysis:
A. A raised serum conjugated bilirubin
B. Low reticulocyte count
C. Hypocellular bonemarrow
D. Hemoglobinuria
E. gallstone
11.The following is true regarding herdetary spherocytosis:
A. It is caused by an inherited deect in HB molecule
B. It is inherited as sex linked
C. Rbc appear oval in peripheral blood film
D. Osmotic fragility is increased
E. Hyposplenism is a feature.
12.Which one of the following is not true about sickle cell anemia:
A. The oxygen dissociation curve is shifted to the right (i.e the HB give
up oxygen more easily than normal)
B. It’s associated with stunted growth
C. It may cause ankle ulcer
D. It is associated with stroke
 E. It is associated with atrophy of the spleen
13.Which one of the following is not a cause of polycythemia:
A. Mutation of JAK-2
B. Renal disease
C. Congenital heart disease
D. Hemoglobin abnormality
E. ironovverload
14.Which of the following is not a typical feature of primary myelofibrosis:
A. It cauuses a leuko-erythroblastic blood film
B. The red cell mass is increased
C. It may be associated with a raised platelet count.
D. It may be complicated by gout.
E. It may cause massive splenomegaly
15.Which one of the following does not cause pancytopenia:
A. Iron deficiency
B. Folate deficiency
C. Aplastic anemia
D. Acute myeloid leukemia
E. chloramphenicol
16.Which of the following is not true concerning von willebrand disease:
A. There is either a reduced level or abnormal function o von willebrand
actor(Vwf)
B. Actor VIII levels may be reduced as vWF is the carrier for factor VIII
protein
C. It is the most common inherited bleeding disorder and inheritance is
usalyy autosomal dominant
D. Plasma derived factor VIII concentrates contain vWF and are the
treatment of choice in most cases
E. Oint bleeding and muscle hematoma are characteristic
17.Which of the following is not a typical feature of disseminated
intravascular coagulation (DIC)
A. Reduced platelet count
B. Fibrinogen concentration is increased
 C. High levels of ffibrin degradation product(d-dimer)
D. PT and APTT are often prolonged
E. Thrombin time is prolonged
18.Which one of these infections is not tested for in blood products:
A. Hepatitis C
B. Hepatitis B
C. Gonorrhea
D. HIV
E. syphilis
19.Hemolytic disease of newborn (HDN):
A. Is a cause of a positive direct coomb’s test in the mother.
B. Occurs when the mother is rhesus positive and the baby is negative
C. Is a cause of kernicterus
D. When it’s due to ABO incompatibillity ,severity increases in
successive pregnancies.
20.The following is not a feature in paroxysmal nocturnal hbeuria:
A. Hemolysis is intravascular
B. It’s an inherited disorder
C. Haptoglonin level in the blood is reduced
D. Deep vein thrombosis is a complication
E. Ha;s test is positive
21.The following is not a complication of blood transfusion:
A. Septicemia
B. Hepatitis c inection
C. Circulatory overload
D. Fat embolism
E. urticaria
22.Hypochromic microcytic RBCs are not seen in:
A. Chronic blood loss.
B. Thalassemia
C. Rheumatoid arthritis
D. Lead poisoning
E. Liver disease
23.The following clinical features suggesting delayed hemolytic transfusion
reaction Exccept:
A. Onset within minutes of starting the transfusion.
B. Rigors and fever
C. Chest and lumbar pain
D. Jaundice
E. Development of hypotension and shock.
24.The following statement is true about blood and blood products:
A. Whole blood is essential for treatment o anemia
B. Platelet preparation has 5 weeks shelflife
C. Crypprecipitate contains fibrinogen.
D. Fresh frozen plasma is used to correct heparin overdose
E. Packed RBC preparation is stored at room temperature.
25.The following investigations are important to diagnose multiple myeloma
except:
A. Bone marrow aspirate.
B. Plasma electrophoresis
C. Abdommial ultrasound
D. Skletel survey
E. Urine test
26.Which of the following is not a cause of a neutrophil leucocytosis:
A. Myocardial infarct.
B. Trauma
C. Athma
D. Corticosteroid therapy
E. Bacterial infection
27.Which of the following finding could most often follow atrophic gastritis:
A. Decreased serum ferriin
B. Increased reticulocyte count
C. Decreased serum folate
D. Increase neutrophil segmentaition
E. Decreased MCV in RBCs
28.In hemophilia A:
 A. There is prologation of PT.
B. Skin hemorrhage is the commonest presentation
C. Crypoprecipitate is not recommended for treatment
D. Antibodies to f VIII form in some patient
E. The factor level does not affect the severity of the disease
29.Iron deficiency anemia is associated with:
A. Raised total iron binding capacity.
B. Positive perl’s reaction in the bone marrow
C. Reticulocytosis.
D. Hypersegmented neutrophils
E. Diseases of terminal ileum
30.Normal APTT occurs in:
A. Hemophilia A
B. Thrombasthenia
C. Afibrinogenemia
D. Liver failure
E. Heparin therapy
31.The following is true about ITP:
A. Intracranial hemorrhage is common
B. Menorrhagia is rare
C. It’s due destruction of platelet
D. Megakaryocyte numbers are reduced in bone marrow
E. Characterized by abnormal platelets function
32.In autoimmune hemolytic anemia ,the following type of immunologic
tissue injury is involoved:
A. Type I (anaphylactic).
B. Type II (cytotoxic)
C. Type III(immune complex)
D. Type IV (cell mediated)
E. None of the above
33.The pathognomic abnormality in b-thalssemia is:
A. High level of Hb A2
B. Low level of HbF
 C. Normal HbA
D. Low serum unconugated bilirubin.
E. High urobilinogen in urine.

34.A 70 year-old man presented with severe backache, O\E only pale and no
other abnormality ,bone marrow aspirate reveald plasma cell 35% what is
the next most important investigation:
A. Protein electrophoresis
B. Liver function test
C. CT abdomen
D. Tumor markers
E. Complete blood count
35.The coagulation results were obtained from a 26- year- old male
patient ,prothrombin time (PT)13 sec (control 12s),activated
partialthromboplastin time (APTT)60 sec(control 36s)this result suggest
the following diagnosis EXCEPT:
A. Factor VII deficiency
B. Factor XI deficiency
C. Factor X deficiency
D. Factor IX deficiency
E. Factor VIII defficiency
36.Burkitt’s ymphoma is characterized histologicaly by:
A. Blast cells
B. Cleaved lymphocytes
C. Starry sky appearance.
D. Epithelioid granuloma
E. Follicle formation
37.A pregnant lady presented with palpitations and dizziness.O\E very
pale .no organomegaly,hb g\dl ,MCV 62Fl.THE mos likely diagnosis is:
A. Pernicious anemia
B. Hemolytic anemia
C. Iron deficiency anemia
D. Megaloblastic anemia
 E. Sideroblastic anemia
38.Diagnosis of aplastic anemia is established by:
A. BM aspirate
B. Trephine biopsy
C. Bone CT scan
D. Erythropoietin level
E. Hb electrophoresis
39.Gross splenomegaly is a striking feature of which of the following:
A. Chronic lymphocytic leukemia
B. Acute myelomonocytic leukemia
C. Acute myeloid leukemia
D. Chronic myeloid leukemia
E. Burkitt’s lmphoma
40.Cause of red cell macrocytosis do not include:
A. Reticulocytosis
B. Pregnancy
C. Anemia of chronic disease
D. Liver disease
E. Hypothyroidism

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