: The normal red cell-1

a-is biconvex
.b-has only hemoglobin within the cell membrane
c-has normal MCV of 80-100fl
.d-Is an erythroblast
:Anormal mature erythrocyte has alive span of-2
a-8-2 hours
b-5 days
c-28 days
d-120 days
:Blood smear of pts with prosthetic heart valve may show-3
a-target cells
b-burr cell
c-schistocyte
d-elliptocyte
:The following cells are the myeloid line except-4
a-platelet
b-T lymphocyte
c-promyelocyte
d-Monocyte
:What is the primary function of iron-5
a-Molecular stability
b-Oxygen transport
c-cellular metabolism
d-cofactor
Which of the following influence iron absorption-6
a-amount and type absorption
b-function of GI mucosa and pancreas
c-erythropoesis needs and iron stores
d-all of the above
In iron deficiency anemia there is characteristically-7
a-atrophic gastritis
b-low mean corpuscular volum
c-reduced total iron binding capacity
d-megaloblastic changes in the bone marrow
what is the characteristic finding in lead poising-8
a-basophilic stippling
b-target cell
c-sidroblast
d-spherocyte
The most common cause of hemoglobinopathesis is an abnormality in the globin -9
chain
-a
-b
-c
-d
?What factors contribute to the sickiling of RBCs-10
a-Increase pH and and oxygen
b-decrease pH and oxygenation and dehydration
c-Increase in pH and decrease in oxygenatin
d-decrease in dehydrationand increase in pH and oxygenation
:The condition(s) associated with increase level of Hb F is (are)-11
a-Infancy
b-hemoglobinpathis
c-Thallassemia
d-All of the above
The total blast cell count in the bone marrow is important when characterizing -12
:the acute myeloid leukemia, and must be at least
.a-40% of the total nucleated cells in the marrow
.b-40%of the total white cell in the marrow
c-30%of the total nucleated cell in the marrow
d-30%of the erythroid cells in the marrow
:The techniques used to classify the acute myeloid leukemia are-13
a-immunologic
b-morphologic
c-cytochemical
d-ALL of the above
:The primary cause of death in patients with ALL is-14
a-stroke
b-Infection
c-bleeding
d-liver failure
:The best description of polycythemia vera is that characterized by-15
a-Increase red cell mass
b-leukopenia
c-thrombocytopenia
d-Increase myeloblasts
Prolymphocytic leukemia-16
.a-It is characterized by massive lyphadenopathy and hepatomegaly
b-Its characterized by almost total bone marrow replaement by
prolymphocyte
c-Has comparable prognosis to CLL and HCL
d-All of the above
:Facter 1 is commonly known as-17
a-tissue facter
b-prothrombin
c-Anti hemophilic factor
.d-Fibringen
:The coagulation factor that are vit. K dependent-18
-a
-b
-c
-d
:Which of the following is non vit. K dependent-19
-a
-b
-c
-d
Megaloblasts are the result of impaired synthesis of-20
a-DNA
B-RNA
C-Glutathione
d-BB chain
:chronic myeloid leukemia least likely to be associated with-21
a-splenomegaly
b-basophilia
c-Translocation(8-14)
d-Thrombocytosis
c-low leukocyte alkaline phosphatase
: Intravascular hemolysis results in all the following except-22
.a-Elevated plasma Hb
b-hemoglobiurea
c-jundice
d-hemosidrenurea
e-splenomegaly
Typical findings in a patients with vonwillebrand's disease include all of the -23
:following except
a-decrease level of factor 8
b-Normal platelet count
c-prolongrd bleeding time
d-frequent hemarthrosis and spontaneous joint bleeding
:The following are hemolytic disorders are congenital except-24
a-Thallassemia
b-Mycroangiopathic hemolytic anemia
c-Ovalocytosis
d-G6PD deficiency
: Acute myeloblastic leukemia-25
a-is most common in young adult
b-is associated with presence of a large number of primitive cells in the
marrow and prepheral blood
c-associated with prepheral WBCs count excess 0f 100000/ml
.d-marrow aspirate show decrease cellularity
:Chronic lymphocytic leukemia is associated with-26
a-marked increase in the number of lymphocyte in the prepheral blood
b-The early appearance of anemia
c–An early bleeding tendency
.d-An increase in serum globin concentration
Disseminated intra vascular concentration is a complication of the -27
:following except
a-malignant disease
b-thrombocythemia
c-the over administration of thrombokinase
d-endotoximic shock
:bleeding time is increased in-28
a-vonwillibrand disease
b-Hemophilia A
C-Hemophilia B
d-All of the above
Classic finding in the hemolytic anemia include all of the following -29
:except
a-Increase indirect serum bilirubin
b-Increase direct serum bilirubin
c-Increase reticulocyte count
.d-Marrow erythrocyte hyperplasia

30-Regarding the vegetation in rheumatic heart disease composition, one of the following
items is correct

a) composed of platelet only

b) fibrin only
c) collagen fibers only
d) platelet and fibrin

31-Regarding Aschoff body, all the following are correct; except one

a) it is not a characteristic lesion in rheumatic myocarditis

b) lesion center show hyaline material lymphocytes, giant cells and polymorphs
c) it heals by fibrosis
d) it is scattered on the myocardium

32-in tetralogy of fallot, one of the following is not correct

a) inter-atrial septal defect

b) inter- ventricular septal defect
c) pulmonary stenosis
d) cyanosis
e) right ventricular hypertrophy
33-All of the following are possible causes of death in myocardial infarction; except one

a-ventricular fibrillation

b-embolism

c-heart failure

d-ruptured heart chamber

e-senile arteriosclerosis

34-The following are predisposing factors of atheroma; except one

a- older age

b-females before menopause

c-high cholesterol

d-smoking

e-sedentary life

35-Mitral incompetence results in the following; except one

a) left ventricular hypertrophy

b) right ventricular hypertrophy
c) left atrial dilatation
d) normal lung vessels
e) murmur at the heart base

36-Heart failure is not caused by one of the following:

a) increased arterial resistance

b) increased atrial tone
c) increased blood volume
d) pump failure
e) myocardial infarction

37-One of the following does not cause heart failure:

a) pericardial haemorrhage
b) atrial flutter
c) rheumatic heart disease
 d) heart ischaemia
e) closed patent ductus arteriosus

38-Atheroma in the coronary arteries can present as any of the following; except one

a) death
b) myocardial infarction
c) heart failure
d) angina pectoris
e) collapsing pulse

39-In hypertension, all of the following are true; except one

a) primary hypertension is more common

b) Cushing syndrome can cause it
c) secondary hypertension commonly is due to renal causes
d) primary hypertension is more serious

40-In essential hypertension, one fact is correct

a) starts above age 45 years

b) 50 percent will develop malignant hypertension
c) it is symptomatic from its starting
d) the common presentation is with encephalopathy

41-The following are signs of right ventricular failure; except one

a) low jugular venous pressure

b) edema of lower limbs
c) hepatomegally
d) ascites
e) pleural effusion

42-One of the following is not correct in acute rheumatic heart disease

a) it is an inflammatory disease
b) it affects heart connective tissue
c) it follows tonsillitis
d) it reoccurs
e) it is not an immune reaction
 ?Which of the following is the commonest histological finding in benign hypertension -43
a. Proliferative end arteritits
b. Necrotizing arteriolitis
c. Hyaline arteriosclerosis
d. Cystic medial necrosis
:All are seen in malignant hypertension, except-44
a. Fibrinoid necrosis
b. Hyaline arteriosclerosis
c. Necrotizing Glomerulonephritis
d. Hyperplastic arteriosclerosis
:In atherosclerosis, increased LDL in monocyte/ macrophage is due to-45
a. LDL receptors on macrophage
b. LDL receptors on endothelium
c. Lipids in LDL get auto-oxidized
d. All of the above
?Which of the following is the least common site of atherosclerotic lesions-46
a. Aortic bifurcation
b. Pulmonary arterial trunk
c. Common carotid artery
d. Middle cerebral artery
Monckeberg’s calcific sclerosis affects the medium sized muscular arteries by involving -47
:the structure of
a. Intima
b. Media
c. Adventitia
d. All of the above
Onion skin thickening of arteriolar wall is-48
:seen in
a. Atherosclerosis
b. Median calcific sclerosis
c. Hyaline arteriosclerosis
d. Hyperplastic arteriosclerosis
A 52 year old male presents to the emergency of a tertiary care hospital with chest pain -49
and syncope. The physician suspects a coronary pathology. Coronary arteriography
demonstrates significant atherosclerotic involvement of the left anterior descending and
circumflex arteries. Which of the following cells provides major proliferative stimuli for the
?cellular components of atherosclerotic plaques
a. Neutrophils
b. Eosinophils
c. Platelets
d. Erythrocytes
Autopsy of a 14 year-old male who died in a motor vehicle accident shows many yellow -50
?spots on the inner surface of the aorta. Which of the following best describes the lesions
a. They are a very uncommon finding for a patient of this age.
b. Their distribution closely mimics that of future atherosclerosis.
c. Once formed, they inevitably progress to atheromas
d. They show predominantly intracellular lipid accumulation.
Section B
:Write short notes on the following

1. A young girl was hypertensive off treatment brought dead with bleeding per nose
and ears.
What is the diagnosis? And what other complications could be found in her eyes,
?kidneys and brain

2. A patient with a history of pharyngitis and heart surgery developed irregular fever
and embolism. What is your diagnosis; clinically and by the lab?

3. A patient died of right heart failure. At autopsy we found mitral stenosis.

?How do you explain that? And what other findings you get

4. What are the clinical features of acute rheumatic heart disease?

1. Define malignant hypertension and mention 4 complications of

hypertension.
2. Enomurate the modifiable major risk factors of atherosclerosis
3. Mention the Clinicopathologic Consequences of Atherosclerosis
.Years old male presents with high fever and tender swelling of left knee joint 7-
:After careful history following factors are revealed
a-presence of bleeding tendency in one of the maternal uncle of the child
.b-bleeding tendency from minor trauma since infancy
.Aspiration from affected joint yeald frank blood
?What is your diagnosis-1
…………………………………………………………………………………………
.………
?What investigations you will do to confirm diagnosis-2
…………………………………………………………………………………………
.………
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.…………
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.…
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..……

:Causes of Aplastic anemia are-

.…………………………………………
..……………………………………………
……………………………………………
.…………………………………………………
.……………………………………………………
..……………………………………………
?Define Acute leukemia-
..………………………………………………………………
?Mention four sign and symptom of Acute leukemia
.…………………………………………………………………
..………………………………………………………………
.…………………………………………………………………
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