Pathology Hematology V

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Which of the following hematological findings is not seen in acute leukemia?

1 point

Normochromic normocytic anemia

Thrombocytopenia in most cases

Blood film shows variable numbers of blasts

BM usually shows infiltration with 10% leukemic blasts

Clear selection

Which one of the following infections is not associated with lymphocytosis?

1 point

Acute pyogenic infections

Infectious mononucleosis

Hepatitis

Brucellosis

Clear selection

All the following statements are true for Essential thrombocythemia EXCEPT:

1 point

It is characterized by a sustained increase in platelet count >400-10/L

There is megakaryocytic proliferation in the bone marrow

Other causes of thrombocytosis need to be fully excluded

Thrombosis (venous or arterial) is a risk in less than 10% of the patients

Clear selection

Which of the following features is not consistent with Primary myelofibrosis?

1 point

It has good prognosis

Leukoerythroblastic blood film is found

The red cells show characteristic tear-drop' poikilocytes Heral

Increased megakaryocytes are frequently seen in the bone marrow

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Which of the following features is not a criterion of accelerated phase of chronic myeloid leukemia?

خياراته تختلف

1 point

Blasts range (10-19%) in peripheral blood film and/or bone marrow

Eosinophils >,= 20%

Platelet count < 100x 10°/L unrelated to therapy

Persistent increase in platelet count>1000 10/L unresponsive to therapy

Clear selection

All the following statements are true for Chronic lymphocytic leukemia (CLL) EXCEPT:

1 point

CLL. is a low grade clonal myeloproliferative neoplasm

Immunophenotyping shows CD5 lymphocytes

Smudge cells are seen in peripheral blood smears

CLL may transform to immunoblastic lymphoma

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Who of the following individuals is not accepted as healthy blood donor?

1 point

Donor with history of brucellosis before 3 years

A 59 year-old donor for the first time

Donor with blood transfusion before 5 months

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In blood donation; state whether the following statements are true or false:

4 points

True

False

Donor with history of hepatitis C is deferred permanently.

Age of the donor should be between 18-65 years

e. Donors with brucellosis are deferred for 2 years from last febrile episode

A 36year-old female with Hb level 13 gm/dl, and her weight is 46 Kg is accepted for donation.

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In reactions due to bacterial pyrogens or bacteria, MARK the following as TRUE or FALSE:

5 points

True

False

This reaction has a very high mortality rate

As little as 10 ml of contaminated blood may contain sufficient microorganisms to produce the reaction.

Visual inspection of the blood units may reveal clots or hemolysis which indicate the presence of contar nation

The reaction may start with shaking chills following a latent period of 30 minutes or more

The commonest microorganism cultured from contaminated blood units is staph.

True

False

This reaction has a very high mortality rate

As little as 10 ml of contaminated blood may contain sufficient microorganisms to produce the reaction.

Visual inspection of the blood units may reveal clots or hemolysis which indicate the presence of contar nation

The reaction may start with shaking chills following a latent period of 30 minutes or more

The commonest microorganism cultured from contaminated blood units is staph.

Clear selection

The following criterion is consistent with Chronic lymphocytic leukemia:

1 point

CLL is a clonal myelooproliferative disorder

Immunophenotyping shows CD5" and CD23" lymphocytes

Peripheral blood lymphocytosis exceeds 3000 cells/mm.

Involvement of LN, spleen and liver rarely occurs during the disease course.

There is no increased risk of CLL in the close relatives of the patient.

Clear selection

Which of the following features is a criterion of accelerated phase of chronic myeloid leukemia?

1 point

Blasts range (5-10%) in peripheral blood film and/or bone marrow

Eosinophils >,= 20%

Basophilia >,= 20%

Platelet count < 150 10^9L unrelated to therapy

Persistent increase in platelet count >400 x 10^9/L unresponsive to therapy

Clear selection

For the past 6 months, a 35-year-old female has had excessively heavy menstrual flow. She has also noticed increasing numbers of pinpoint hemorrhages on her lower extremities in the past month. Physical examination reveals no organomegaly or lymphadenopathy. A complete blood count (CBC) shows a hemoglobin concentration of 14.2 g/ dL, platelet count of 19,000/μL, and white blood cell count of 6000/μL. The most likely basis of her bleeding tendency is:

1 point

a. Suppression of pluripotent stem cells.

b. Defective platelet-endothelial interactions.

c.Abnormalities in production of platelets by megakaryocytes.

d.Destruction of antibody-coated platelets by the spleen.

Clear selection

-A young adult patient has just been diagnosed with Von Willebrand disease.
Which of the following statements should you make to advise the patient of potential consequences of this disease?

1 point

a. You may need an allogeneic bone marrow transplant.

b. Expect increasing difficulties with joint mobility.

c. Anticoagulation is needed to prevent deep venous thrombosis.

d. You may have excessive bleeding following tooth extraction.

e. A splenectomy may be necessary to control the disease.

Clear selection

A 13-year-old male has less than 1% factor VIII activity measured in plasma. If he does not receive transfusions of factor VIII concentrate, which of the following manifestations of this deficiency is most likely to ensue?

1 point

a. Splenomegaly.

b. Conjunctival petechiae.

c. Hemolysis.

d. Hemochromatosis.

e. Hemarthroses.

Clear selection

All of the following conditions are associated with a prolonged bleeding time EXCEPT:

1 point

a. von Willebrand disease.

b. Deficiency of factor IX.

c. Long-term treatment with aspirin.

d. Idiopathic thrombocytopenic purpura.

e. Defect in platelet adhesion.

Clear selection

Well-known causes of disseminated intravascular coagulation (DIC) include all of the following conditions EXCEPT:

1 point

a. Retained dead fetus.

b. Prostatic carcinoma.

c. Hemolytic transfusion reaction.

d. Gram-negative sepsis.

e. Heparin administration.

Clear selection

A 45-year-old female has chronic hepatitis C infection with serum concentrations of (GOT) of 310 U/L, (GPT) of 275 U/L, total bilirubin of 7.6 mg/dL, direct bilirubin of 5.8 mg/dL, ALP of 75 U/L.
Which of the following laboratory test results for hemostatic function is most likely to be abnormal?

1 point

a. Immunoassay for plasma von Willebrand factor.

b. Platelet count.

c. Prothrombin time (PT).

d. Fibrin split products.

e. Bleeding time.

Clear selection

A 76-year-old female notices that small,

pinpoint areas of superficial hemorrhage have appeared on her gums and on the skin of her arms and legs over several weeks. She is found to have a normal prothrombin time (PT) and partial thromboplastin time (PTT). Her CBC shows a hemoglobin concentration of 12.7 g/dL, platelet count of 260,000/μL, and WBC count of 8600/μL. Her template bleeding time is 3 minutes. Which o the following conditions best explains these findings?

1 point

a. Macronodular cirrhosis

b. Meningococcemia.

d. Metastatic carcinoma.

d. Chronic renal failure.

e. Vitamin C deficiency.

Other:

Clear selection

A 25-year-old man has a lifelong hemorrhagic diathesis. The Prothrombin time (PT) and bleeding time are normal, but the Partial thromboplastin time (PTT) is prolonged. The most likely cause of the bleeding disorder is:

1 point

A-Factor VII deficiency.

B-A platelet functional disorder.

C-Abnormalities in the blood vessel wall

D-Factor X deficiency.

E-Factor VIII deficiency.

Clear selection

A 24-year-old woman presents with multiple pinpoint bleeding spots on both of her legs. Physical examination reveals no organomegaly. A bone marrow biopsy reveals a normocellular marrow with increased numbers of megakaryocytes. What is the correct diagnosis?

1 point

A-Disseminated intravascular coagulopathy

B-Thrombotic thrombocytopenic purpura

C-Immune thrombocytopenic purpura.

D-Vitamin K deficiency.

E-Meningococcal septicemia

Clear selection

A 60-year-old man presented pallor and large splenomegaly. Blood film showed prlolymphocytes. Diagnosis of prolymphocytic leukemia is made by appearance of:

1 point

A->55% prolymphocytes in blood film

B->11% prolymphocytes in blood film

C->11% prolymphocytes in the bone marrow

D-≤10% prolymphocytes in blood film

E->55% prolymphocytes in bone marrow

Clear selection

A 22 year old female presented with 3 week history of fever and bone pain. Her physical exam revealed cervical lymphadenopathy and multiple bleeding spots.Her blood counts revealed many blasts in the peripheral blood.The best test to differentiate whether she is a case of acute lymphoblastic leukemia or acute myeloid leukemia is:

1 point

A-the presence of Philadelphia chromosome

B-the presence of splenomegaly on ultrasound of abdomen

C-immunophenotyping of blast cells

D-the count of white blood cells in peripheral blood

E-the number of blasts in bone marrow aspirate

Clear selection

patient presented with jaundice,,hepatomegaly ,flapping tremor and GIT bleeding.Which ONE of these statements is TRUE concerning vitamin K deficiency?

1 point

A-cause prolonged PT and PTT

B-Vitamin K is derived from meat products

C-Causes prolonged partial thromboplastin time

D-bleeding treated with cryoprecptate

E-it is mainly related to decrease of oral intake vitamin K

Clear selection

Hereditary spherocytosis mostly results from various mutations involving:

1 point

A-Band 3 and Ankyrin

B-Band 3 and Actin

C-Spectrin and Band 3

D-Spectrin and Ankyrin

E-Ankyrin and Actin

Clear selection

Which of the following defects is associated with hemophilia?

1 point

Deficiency of hemoglobin

Deficiency of hemoglobin A

A defective gene in the X chromosome

defective gene in the Y chromosome

Absence of the X chromosome

Clear selection

Which of the following signs or symptoms is indicative of immediate hemolytic reaction and associated with high risk of mortality?

1 point

Flushing of the face with chest tightness

Lumber pain

Nausea and vomiting

Persistent hypotension and oliguria

Clear selection

Regarding Transfusion transmitted infections; all the following informations are true EXCEPT:

1 point

Treponema pallidum is unlikely to survive more than 3 weeks at 4-6 °C

Brucella abortus remains viable in stored blood for months

P. falciparum remains viable in stored blood at 4°C up to 2 weeks

The mean incubation period of HIV is 4.5 years

Clear selection

Massive transfusion leads to the following complications EXCEPT:

1 point

Thrombocytopenia

Reduction in the levels of coagulation factors, particularly F V and F VIII

Hypokalemia

Citrate toxicity

Clear selection

Moobilize peripheral blood before BMT =>

1 point

G-CSF

Clear selection

Massive splenomegaly :

1 point

Chronic myeloid leukemia

Hodgkin’s lymphoma

Myeloproliferative disorder

all of the above

Clear selection

Bone marrow examination is not recommended for the diagnostic workup of:

1 point

Aplastic anemia.

Myelodysplasia

Anemia of chronic disease

Acute leukemia.

Myelofibrosis

Clear selection

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