AMNA INAYAT MEDICAL COLLEGE

MCQ Test blood &cell physiology

Total marks:50 Date:30.8.13

1. Regarding binding of oxygen with hemoglobin (Hb):

a. Oxygen loosely combines with 2 positive bonds of iron in Hb molecule

b. Oxygen firmly binds with 1 of the coordination bonds of iron atom
c. Oxygen is carried to the tissues in molecular form by Hemoglobin
d. Oxygen is released by Hb into the tissues in ionic form
e. Oxygen firmly binds with 2 positive bonds of iron in Hb molecule

2. The 1st step of Heme synthesis takes place in the:

a. Mitochondria
b. Golgi apparatus
c. Rough endoplasmic reticulum
d. Peroxisomes
e. Nucleolus

3. Regarding the blood coagulation test “Prothrombin time”:

a. It is normally about 12 minutes

b. It indicates concentration of thrombin in blood
c. It involves intrinsic clotting pathway
d. It does not involve oxalation of removed blood
e. It shortens with rise in prothrombin concentration

4.A 24 year old African American man comes to the emergency room 3 hours after the onset of severe back and
chest pain which started when he was climbing up a mountain. He had an episode of same symptoms five years
ago. His values are Hb: 11g/dL, TLC: 12,000/mm3, Reticulocyte count: 25%. What is the diagnosis of this
patient?

a. Acute blood loss

b. Sickle cell anemia
c. Anemia of chronic disease
d. End stage kidney disease
e. Chronic blood loss

5. Which of the following treatments would prevent a transfusion reaction?

a. Administration of plasma free blood

b. Administration of washed erythrocytes
c. Treatment with immunoglobulins.
d. Treatment with mannitol.
e. Proper cross-matching of donor red cells with recipient plasma
6. What happens following the presentation of an antigen by a macrophage?

a. Direct generation of antibodies

b. Activation of cytotoxic T cells
c. Increase in phagocytosis
d. Activation of helper T cells.
e. Activation of platelets

7. What causes the release of histamine in an allergic reaction?

a. Binding of IgM to basophils.

b. Binding of IgE to mast cells.
c. Release of histamine by helper T cells.
d. Free radical stimulation of endothelial cells
e. Release of histamine by macrophages

8. Which of the following blood units carries the least risk of inducing an immediate reaction in a type B, Rh+
patient?

a. Type A +ive whole blood.

b. Type O +ive whole blood.
c. Type AB +ive whole blood.
d. Type O +ive packed red cells.
e. Type AB –ive packed red cells

9. The protein responsible for iron transport in plasma is

a. α 1-anti trypsin
b. Ferritin
c. Apo-transferrin
d. Apo-ferritin
e. Ceruloplasmin

10. Prothrombin level falls in the blood due to lack of

a. Vitamin B12
b. Vitamin K
c. Phospholipids
d. Platelets
e. Sodium

11. Bluish tint of the polycythemia person is because of excess of

a. Myoglobin
b. Deoxygenated Hb
c. Oxygenated Hb
d. Reduced Hb
e. Sulphated Hb
12. A 6 year old boy bruises easily and has previously bleeding gums. The maternal grandfather also has a
bleeding disorder. You suspect the deficiency of

a. Prothrombin activator
b. Factor II
c. Factor VIII
d. Factor X
e. Factor XIII

13. Regarding Opsonization:

a. It involves breakdown of antibodies

b. It means neutralization of antigen by antibody
c. Antigen gets attached directly to the phagocyte receptor
d. Antibody makes a bridge between antigen & receptor
e. The antigen is surrounded by edges of cell membrane

14. A 30 years old male is brought to the hospital with history of gastrectomy. His skin appears lemon-yellow.
Investigations reveal hemoglobin 10 g/dl, odd shaped RBCs and Serum Vitamin B12 is low. He is likely to be suffering
from:

a) Blood Loss Anemia

b) Pernicious Anemia
c) Megaloblastic Anemia
d) Hemolytic Anemia
e) Aplastic Anemia

15 The mechanism of action of the following substance involves chemotaxis:

a. Bacterial & viral toxins

b. Fungal & parasitic toxins
c. Regenerative products of inflamed tissues
d. Plasma clotting enzymes
e. Reaction Products caused by inflammation

16. The following lymphokine has a strong stimulatory effect in causing proliferation of Cytotoxic and Suppressor T cells:

a. Interleukin 2
b. Interleukin3
c. Interleukin 4
d. Interleukin 5
e. Interferon Gamma

17. Ahmad was diagnosed as a severe case of sprue. His blood picture revealed macrocytic anemia of the following type:

a. Sickle cell anemia

b. Hereditary spherocytosis
c. Blood loss anemia
d. Bone marrow aplasia
e. Pernicious anemia
18. Ghazala was diagnosed as a case of classic hemophilia. The best possibility is that:

a. One of her X chromosomes code for deficiency of Factor VIII

b. Her mother was a hemophilia carrier
c. Her autosomes carry the mutant gene for hemophilia
d. She is suffering from von Willebrand’s disease
e. Her father had hemophilia & mother was a hemophilia carrier

19. Major Histocompatibility Complex Protein is present on the surface of:

a. Suppressor T cells
b. T Lymphocytes
c. Cytotoxic T cells
d. Helper T cells
e. B Lymphocytes

20. An allograft is transplanted from:

a. A lower species to a human being

b. One human being to another
c. One identical twin to another
d. One part of the same animal to another part
e. An animal of 1 species to one of another species

21. Lesions called “Hives” are a feature of:

a. Hay fever
b. Asthma
c. Hay fever
d. Anaphylaxis
e. Urticaria

22. A young boy was brought to hospital emergency with complaint of acute pain in right iliac fossa. On history,
examination & clinical investigation, he was diagnosed to have acute appendicitis. His TLC (per microlit.) is likely to be:

a. 4,000
b. 6,000
c. 8,000
d. 10,000
e. 14,000

23. A 34-year-old man with schizophrenia has chronic fatigue for 6 months. He has a good appetite but has developed a
dislike for vegetables since last 1 year because he hears voices that tell him that the vegetables are poisoned. His
physical and neurological examinations are normal. His hemoglobin level is 9.1 g/dl, leukocyte count is 10,000/mm and
Mean Corpuscular Volume is 122fl (normal 77-93 fl). Which of the following is the most likely diagnosis?

a. Acute blood loss b. Aplastic anemia

c. Hemolytic anemia
d. Folic acid deficiency
e. Sickle cell anemia
24. A 5 year old child arrived at the emergency department minutes after being bitten by a black widow spider.
A house officer immediately injected gamma globulin in the form of an antivenom. This type of immunization
is called:
a. Artificial active immunization
b. Artificial Passive immunization
c. Natural active immunization
d. Natural passive immunization
e. Adoptive Immunization
25. A 45-years old man presents to the emergency with a 2-week history of diarrhea that has worsened
progressively over the last several days. He has minimal urine output and is admitted to the hospital to get
rehydrated. His stool specimen is positive for parasitic eggs. Which type of White Blood Cells would be
elevated in number?
a. Eosinophils
b. Neutrophils
c. T lymphocytes
d. B lymphocytes
e. Monocytes
26. By the age of 7 months, the primary site of haematopoiesis in a fetus is:
a. Thymus
b. Liver
c. Spleen
d. Reticuloendothelial system
e. Red marrow
27. The most abundant cells of the blood are:
a. Platelets
b. Erythrocytes
c. Granulocytes
d. Leukocytes
e. Reticuloendothelial cells
28. Very young & very old patients are more likely to develop uncontrolled leukocytosis which may be
indicative of:
a. Physiological jaundice
b. Haemolytic disease
c. Aplastic anemia
d. Leukemia
e. Bleeding disorder

29.Iron deficiency anemia:

a. is of hypochromic, macrocytic type.

b. Is commonly associated with chronic blood loss.
c. Is common cause of anemia in infants below 1 year.
d. May increase the number of megaloblasts.
e. Is more common in males.
30.Polycythemia:

a. Is associated with decrease in blood viscosity.

b. Is a myelo-proliferative disorder.
c. May cause an increase in the mass of RBCs in blood.
d. Is seen with increase in ESR.
e. Is a contagious disease.
31.Beta Thalassemia is associated with:
a) An increase in alpha chain synthesis of hemoglobin molecule.
b) A decrease in beta chain synthesis.
c) An increase in beta chain synthesis.
d) An increase in alpha and beta chain synthesis.
e) More fetal hemoglobin.
32.Erythropoietin:
a) May decrease the life span of RBCs.
b) Is not released on breakdown of RBCs.
c) May stimulate the stem cells.
d) Is formed mainly in liver.
e) Is lipid in nature.
33.Bilirubin is:
a. Not bound with Albumin.
b. Is a useful body pigment.
c. Converted into biliverdin in gall bladder.
d. Not conjugated in liver.
e. Converted into colorless urobilinogen.
34.Factor VIII is synthesized in:
a. Endothelium.
b. Hepatocytes.
c. Kupffer cells.
d. Histiocytes.
e. Platelets.
35.Vitamin K dependent coagulation factors are:
a. Factor II, VII and X.
b. Factor X and XI.
c. Factor VII and XI.
d. Factor II, VII and XI.
e. Factor XI and XII.
36.Regarding immunoglobulins:
a. They are produced by T lymphocytes.
b. They do not cause agglutination.
c. They inactivate complement system.
d. They are not gamma globulins.
e. They may cause precipitation.
37.A lady presented with shock due to Post partum hemorrhage, her blood group was unknown but became coagulated
when mixed with serum containing anti-A antibodies and similarly her serum coagulated with B positive blood. The most
suitable blood group to be transfused in this case is:
a. O negative.
b. O positive.
c. A positive.
d. AB positive.
e. B positive.
38.Regarding erythroblastosis fetalis:
a. The fetus is Rh negative.
b. The mother is Rh positive.
c. The father is Rh negative.
d. Many of the fetal RBCs are nucleated.
e. It is associated with shrunken liver and spleen.
39.A blood smear shows hypochromic, microcytic RBCs with moderate Poikilocytosis. Most likely diagnosis is:
a. Anemia of chronic disease.
b. Autoimmune hemolytic anemia.
c. Folate deficiency anemia.
d. Iron deficiency anemia.
e. Microangiopathic hemolytic anemia.
40. The process in which the cells that die as a result of an acute injury, swell & burst due to loss of cell membrane integrity is
called:

a. Rigor Mortis
b. Osmosis
c. Necrosis
d. Apoptosis
e. Hydrolysis

41.A young boy complaining of tiredness and shortness of breath is diagnosed with anemia. His blood picture shows
microcytic and hypochromic anemia with normal count of WBCs & platelets & normal shape of RBCs.This picture is seen
in:

a. Aplastic anemia
b. Sickle cell anemia
c. Megaloblastic anemia
d. Blood loss anemia
e. Thalassemia

42.Regarding the complement system:

a. Complement system components are normally present among plasma proteins

b. The complement products make the invading organisms adhere to each other, this is called opsonization
c. They activate macrophages causing them to secrete histamine and heparin
d. Fragment C1 initiates chemotaxis
e. The complement system is ineffective against all viruses
43. A survivor of the Hiroshima blast during the Second World War presented to hospital with pale look and
purplish patches on the thin skin area. His hemoglobin is below normal. He is most likely suffering from:
a. iron deficiency anemia
b. sickle cell anemia
c. megaloblastic anemia
d. hereditary spherocytosis
e. aplastic anemia
44. The principal enzyme for replicating DNA is:

a. DNA ligase
b. DNA polymerase
c. DNA helicase
d. DNA transferase
e. DNA replicase
45. Kishan Lal, a pure vegetarian comes to Avicenna OPD with complaint of exertional dyspnea. On examination he has
pallor. Initial lab tests show Hb 7.4g/dl, MCV is 115 fL. What is the most probable cause of megaloblastic anemia in this
patient?

a. Folic acid deficiency

b. Vitamin B12 deficiency
c. Iron deficiency.
d. Hemolysis.
e. G6PD deficiency

46. Four nitrogenous bases include following 2 purines:

a. Adenine & Cytosine

b. Guanine & Thymine
c. Adenine & Thymine
d. Guanine & Cytosine
e. Adenine & Guanine
47. Asim, a 5 years old boy falls from his bicycle and receives a cut over the knee. His tissue macrophages & fibroblasts
will move to the site of injury for repair by:

a. Ciliary movement
b. Ameboid movement
c. Chemotaxis
d. Margination
e. Whip- like movement

48. Long term hypoxia may serve as a growth inducer of the following blood cells:

a. Basophils
b. Monocytes
c. Macrophages
d. Red blood cells
e. Platelets

49. Red blood cells can pass from bone marrow to blood capillaries by diapedesis during:

a. Basophil erythroblast stage

b. Mature erythrocyte stage
c. Reticulocyte stage

c. Proerythroblast stage
d. Orthochromatic erythroblast stage
50. Regarding Erythropoietin & erythropoiesis:

a. It is formed mainly in liver & partly in kidneys

b. Hypoxia can stimulate erythropoiesis in the absence of erythropoietin
c. Relief from hypoxia inhibits erythropoietin induced erythropoiesis
d. Erythropoietin mainly stimulates production of hematopoietic stem cells
e. Erythropoietin is over stimulated in patients with renal disease