Blood Physiology MCQ PDF

# BLOOD ## 1-Plasma proteins - Are formed in liver only - Have a level of 7.2 gm/L - Represent 85% of the buffering power of blood - None of the above ## 2-Albumin - Has the lowest molecular weight and highest concentration - Decreased in liver diseases and in renal diseases - Increased its synthe...

# BLOOD ## 1-Plasma proteins - Are formed in liver only - Have a level of 7.2 gm/L - Represent 85% of the buffering power of blood - None of the above ## 2-Albumin - Has the lowest molecular weight and highest concentration - Decreased in liver diseases and in renal diseases - Increased its synthesis in burns and nephrosis - All of the above ## 3- Albumin - Is normally filterd freely by the kidneys due to its relatively small molecular size - Is positively charged at the normal pH of blood and acts as a cation - Is responsible for the transport function due to its elongated shape - Is important for the regulation of fluid exchange across capillary membrane ## 4- The most important function of albumin is: - Acting as an antibody - Contributing to the clotting process - Contributing to the effective osmotic pressure of plasma - Responsible for viscosity of blood ## 5- Which of the following substances is present in plasma but not in serum? - Globulins - Fibrinogen - Erythrocytes - Inorganic ions ## 6- One of the following is not a function of plasma protein: - Transport of hormones - Maintenance of colloidal osmotic pressure - Buffering of blood - Phagocytosis of bacteria ## 7- Concerning the synthesis of plasma proteins: - All types are formed by the liver only - Albumin, globulins and 50% of fibrinogen are formed by the liver - Gamma globulins are formed by plasma cells in the lymphoid organs - Gamma globulins are released from activated T-lymphocytes ## 8-Gamma globulins: - Are formed by plasma cells of lymphoid tissue - Are formed by red blood corpuscles - Have the highest concentration of the plasma proteins - Have the highest molecular weight ## 9-The amount of plasma proteins (in g/100ml) is near to: - 10 - 7 - 1 - 30 ## 10-The plasma proteins perform all the following functions except: - They exert an osmotic force. - They have a buffering action. - They increase the capillary permeability. - They play a role in the body defense mechanisms. ## 11- The A/G ratio is important clinically in detecting: - Liver disease. - Cardiac disease. - Nervous disease. - Lung disease. ## 12-The osmotic function of plasma proteins depends mainly on: - Albumin - Globulin - Fibrinogen - Prothrombin ## 13-Human plasma albumin: - Contributes more to plasma colloid osmotic pressure than globulin. - Filters freely at the renal glomerulus. - Is positively charged at the normal pH of blood. - Carries carbon dioxide in blood. ## 14-Red blood corpuscles are: - Biconcave flexible round corpuscles of diameter 7.2 μ - The volume of one RBC = 80 μ³ - RBCs contain hemoglobin, ribosomes and mitochondria - RBCs are the only cellular constituent of blood ## 15-Concerning the RBC: - It has a diameter of about 7.5 micrometer - Its life span is 120 days - Is produced by the liver and spleen in fetus - All the above are correct ## 16-The membrane of RBCs allows the following except: - Increase the inner tension with the increase in volume - Pass within small capillaries without rupture - Increase the surface area for gas exchange - Keep hemoglobin ## 17-Erythrocyte Sedimentation Rate (ESR) is increasedin: - anemia - hypofibrinogenemia - men relative to women - polycythemia ## 18-Erythropoeisis: - Occurs in the liver during the first 5 years of life - Above 20 occurs in the bone marrow of all bones - Is affected by vitamin K deficiency - Is stimulated at high altitude ## 19- Concerning erythropoiesis all is correct, except: - Is decreased after bone marrow depression - Needs healthy liver for formation of globin - Needs healthy kidney for formation of 15% of erythropoietin - Is stimulated by testosterone hormone ## 20-Erythropoietin is essential for: - Leukopoiesis. - Formation of prothrombin. - Formation of red blood corpuscles. - None of the above. ## 21-Erythropoietin hormone: - Is secreted mainly by the liver - Is secreted mainly by the pancreas - Stimulates RBCs formation - Stimulates WBCs formation ## 22-Erythropoietin hormone: - Is secreted by the kidney 85% and the bone marrow 15% - Is stimulated by cobalt salts and acidosis at high altitude - Stimulates mitosis of the sensitive uncommitted stem cells - Speeds all the steps of development of proerythroblasts to mature RBCs ## 23-Erythropoietin hormone is: - Secreted by the kidney 15% and the liver 85% - Stimulated by acidosis at high altitude - Synthesized and released by red blood cell - Inhibited by adenosine antagonists ## 24-A 36-old-man with end stage renal disease has normocytic normochromic anemia. Which of the following is the most appropriate therapy? - Erythropoietin - Ferrous sulphate - Folic acid - Vitamin B12 ## 25- Concerning erythropoiesis all is correct, except: - Is decreased after bone marrow depression - Needs healthy liver for formation of globin - Needs healthy kidney for formation of 15% of erythropoietin - Is stimulated by testosterone hormone ## 26-The synthesis and release of erythropoietin is increased in a person who goes to live at high altitude because: - Cardiac output is increased - Hematocrit is increased - Partial pressure of oxygen is less - Alveolar ventilation rate is increased ## 27- Concerning polycythemia the following is correct, except: - Occurs in liver disease - Increases the viscosity of the blood - Can occur in someone who lives at high altitude - Can result from a high level of erythropoietin secretion ## 28-Iron deficiency: - Is more common in males than in females - May cause anemia by inhibiting the division of RBCs stem cells - Occurs due to chronic blood loss - May cause large pale erythrocytes to appear in peripheral blood ## 29-Hepcidin: - Stimulates formation of ferroportin molecules in macrophages - Secretion is inhibited by inflammation and hypoxia - Inhibits the release of recycled iron from macrophage - Is a hormone secreted by the enterocyte to regulate iron intestinal absorption ## 30-Whichofthefollowingproteinsisaregulator for iron absorption byenterocytes? - Ferritin - Hemosiderin - Hepcidin - Transferrin ## 31-Most of the iron in the body is presentin: - hemoglobin - myoglobin - ferritin - transferrin ## 32-The major protein that transports iron in the plasma from the site of absorption to cells engaged in erythropoiesisis: - hepcidin - transferrin - ferritin - hemosiderin ## 33-In healthy humans, iron in tissues other than red blood cells is stored principally in combinationwith: - ferritin - transferrin - hepcidin - hemosiderin ## 34-Stomach plays important role in erythropoiesis because It: - Helps absorption of folic acid - Helps absorption of B12 and iron - Secretes erythropoietin - Forms globin part of hemoglobin ## 35-Vitamin B12: - Deficiency produces normocytic anemia. - Needs gastric HCI for its absorption - Is absorbed from the upper part of the small intestine - Is needed for nuclear maturation and cell division. ## 36-Iron absorption is characterized by all of the following EXCEPT: - It needs vitamin C to facilitate its absorption - Heme iron is directly absorbed through heme carrier protein - It occurs at the distal part of the small intestine - Absorbed iron is carried by transferrin in plasma ## 37-Iron: - Is decreased in acute blood loss - Is stored in the liver in the form of transferrin - Needs vitamin C for absorption - Deficiency produces pernicious anemia ## 38-Which of the following statements about iron metabolism is correct? - Ferritin is a plasma protein that transports iron in the blood - Iron is more efficiently absorbed in the ferrous state than in the ferric state - Most iron in the body is stored as hemosiderin - The gastrointestinal rate of iron absorption is extremely high ## 39- Iron absorption: - Occurs when the iron is in the ferric state (Fe³+) - Requires gastric HCl - Is a passive process which depends on the body requirements - Occurs in the lower part of the small intestine ## 40-Synthesis of DNA and cell division requires: - Iron - Vitamin B12 and folic acid - Proteins of plant origin - Vitamin C ## 41-Concerning Vitamin B12 absorption - It needs intrinsic factor secreted by parietal cells of duodenum - It is absorbed by pinocytosis at lower ileum - It is transported in blood bound to transferrin - Deficiency of pancreatic trypsin increases its rate of absorption ## 42-Iron deficiency: - Frequently follows persistent loss of blood from the body - Is more common in men than in women - Cause anemia by inhibiting the rate of multiplication of RBC stem cells - May cause large pale erythrocytes to appear in peripheral blood ## 43-About iron deficiency anaemia: - It is more common in adult men - It is characterized by large pale erythrocytes - It is typically found following chronic blood loss from the body - It occurs in gastric diseases associated with lack of intrinsic factor ## 44-Vitamin B12 deficiency may: - Result from disease of the proximal part of the ileum - Result in anemia with small RBCs well filled with haemoglobin - Cause a reduction in the circulating platelet level - Cause pathological changes in the central nervous system ## 45-A18-year-old girl was prescribed iron supplement by her doctor as she was thought to take a diet deficient in iron. Lack of iron often causes: - Polycythemia - Hypochromic anemia - Pernicious anemia - Normochromic anemia ## 46- Vitamin B12 or folic acid deficiency produces: - Erythroblastic cells of the bone marrow to become smaller than normal - The adult red blood cells to become smaller than normal - The adult red blood cells to have a thicker membrane than normal - The adult red blood cells to become larger than normal ## 47- Macrocytic anemia is due to: - Chronic blood loss - Bone marrow depression - Vitamin B12 or folic acid deficiency - Acute blood loss ## 48-Severe depression of the bone marrow may result in: - Microcytic hypochromic anaemia. - Increased number of granulocytes. - Aplastic anaemia, leucopenia, and thrombocytopenia. - Increased coagulability of the blood. ## 49-All the following conditions cause anaemia except: - Erythroblastosis fetalis. - Vitamin B12 deficiency. - Hypothyroidism. - Living at high altitudes. ## 50-Which of following produces anemia secondary to destruction of red blood cells? - Bone marrow aplasia - Living at high altitude - Presence of hemoglobin S - Total gastrectomy ## 51-Haemolytic anaemia may be caused by all the following except: - Iron deficiency. - Abnormal haemoglobin. - Congenital spherocytosis. - Deficiency of G-6-P dehydrogenase ## 52-Causes of Micromocytic Hypochromic anemia, all are true except: - Iron deficiency - Acute bleeding - Partial gastrectomy - Excessive menses ## 53-Hemolytic anemia includes all of the following, EXCEPT : - congenital spherocytosis. - sickle cell anemia. - pernicious anemia. - thalassemia. ## 54-Conditions cause normocytic normochromicanemia, except: - Acute hemorrhage - Hemolytic anemia - Aplastic anemia - Folic acid deficiency anemia ## 55-Microcytic hypochromic anemia is due to: - Decrease vitamin B12 intake - Decrease iron intake - Diseases of the heart - Diseases of the lung ## 56-Macrocytic anemia is due to: - Chronic blood loss - Bone marrow depression - Iron deficiency - Vitamin B12 or folic acid deficiency ## 57-A patient having RBCs count. 4 million/mm³, PCV 30% & Hb content 9g/dl, is complaining of: - Microctic hyperchromic anemia - Normocytic hypochromic anemia - Microcytic hypochromic anemia - Megaloblastic anemia ## 58-A patient who has HV 35%, RBCs count 3.5 million/mm³& Hb content 11g/dl will be treated by: - Oral iron supplement - Vitamin B12 / folic acid supplement - Blood transfusion - None of the above ## 59-Normocytic Normochromic anemia is characterized by: - Normal RBCs count, normal RBCs size and normal hemoglobin content - Normal RBCs count, normal RBCs size and low hemoglobin content - Normal RBCs count, normal RBCs size and normal PCV - Normal RBCs size, low RBCs count and low hemoglobin content ## 60-Bleeding from a small cut in the skin is characterized by all except - Is normally diminished by local vascular spasm - Ceases within about four minutes in normal people - Is prolonged in severe factor VIII (antihaemophilic globulin) deficiency - Is greater from warm skin than from cold skin ## 61-When a blood vessel wall is injured, platelets induce the following, except: - Vascular spasm and temporary plug formation - Exposure of platelet phospholipid (PL) - Initiation of extrinsic pathway of coagulation - Stabilization of fibrin and clot retraction ## 62-Release of alpha granules in platelets lead to: - Release of PDGF that help the repair of the injured vessel - Activation of cyclooxygenase enzyme and prostaglandin production - Release of factor XIII that help clot stabilization - All of the above ## 63-Aggregation of platelets: - Depends on ADP & TxA2 - Is a self-propagative process, thus the plug propagates to nearby smooth endothelium - Platelet adhere to each other by the help thrombin - A and b are correct ## 64-Prolonged bleeding time may be due to all of the following, except: - Thrombocytopenia - Thrombo-athenia - Liver disease - Excessive oral intake of aspirin ## 65-Thromboxane A2: - Causes platelet aggregation - Is metabolized to prostacyclin - Is directly inactivated by binding to aspirin - Converts prothrombin to thrombin ## 66- Platelets assist in arresting bleeding by the following, except: - Releasing factors promoting blood clotting - Adhering together to form plugs when exposed to collagen - Liberating high concentrations of calcium - Releasing factors causing vasodilation ## 67-Regarding blood platelets, the following are true, EXCEPT: - they are formed in the bone marrow, - are more numerous than RBCs.. - activity is decreased by administration of aspirin. - number increases after splenectomy. ## 68-Adhesion of platelets to subendothelial collagen is impaired in the absence of: - von Willebrand factor - plasmin - heparin - antithrombinIII ## 69-Purpura is characterized by: - Normal bleeding time - Normal clot retraction - Prolonged clotting time - Normal prothrombin time ## 70-Coagulation factors: - Of the B-globulin are formed in liver - Of the prothrombin group are unstable on storage - Of the fibrinogen group need vitamin K for their formation - A and c are correct ## 71-Contact of the blood with sub- endothelial collagen produces: - Inhibition of platelets - Activation of factor VII - Activation of factor XII - Activation of factor IX ## 72-Intrinsic pathway of blood coagulation: - Is activated by a tissue factor - Can occur in silicon-coated test tube - Is activated by exposed collagen - Is rapid and extensive ## 73-The extrinsic pathway is triggered by the release of: - factor VII - tissue factor - tissue factor pathway inhibitor - contact factor ## 74-Extrinsic pathway: - Is rapid and extensive; it lasts after 1-6 minutes - Thromboplastin activates factor V which in turn activates factor IX, X - Thrombin activated by this pathway will activate the intrinsic pathway - Activated factor VII by this pathway will activate factor VIII directly - b and c are correct ## 75-The test that screens the extrinsic pathway is: - prothrombin time (PT) - activated partial thromboplastin time (aPTT) - thrombin time - clot lysis time ## 76-Thrombin is characterized by all of the following EXCEPT: - Has a direct proteolytic activity on prothrombin - Activates factors I, II, V, VIII, XIII - Help platelet activation and fusion - When activated, it turns into threads which polymerize ## 77-Fibrinogen - Is a soluble, globular, active protein - Is a high molecular weight protein formed by liver - Becomes deficient in patients taking excessive oral antibiotics - Becomes activated with removal of 2 polypeptide chains ## 78-Factor IX: - Is a co-factor in the coagulation cascade - Requires prostacyclin for its activity - Acts by converting factor X to Xa - Deficiency causes hemophilia A ## 79- Factor XI: - Is produced by platelets - Is a member of the extrinsic pathway - Activates factor X - Deficiency causes hemophilia C ## 80-Which of the following statements about blood coagulation is correct? - Absence of Ca²+ promotes blood coagulation - Patients with hemophilia A usually have a normal bleeding time - von Willebrand factor suppresses platelet adhesion - von Willebrand factor suppresses blood coagulation ## 81-Tissue thromboplastin - Is needed for activation of factor VII - Can cause blood clotting in vitro - Is obtained from phospholipids of membrane of traumatized cells - A and c are correct ## 82-Prostacyclin - Formed by the action of cyclooxygenase on arachidonic acid in platelets - Causes vasoconstriction and platelet aggregation - It prevents the platelet plug to propagate & occlude the blood vessel - All of the above ## 83-The enzyme that ultimately lyses fibrin is: - Plasminogen - ΤΡΑ - Urokinase - plasmin ## 84-Prolongation of prothrombin time doesnot occur when there is a deficiency of only - factor VIII - factorIX - factorX - vitamink ## 85-Antithrombin-III is characterized by all EXCEPT: - Is a serine protease inhibitor - Its anti-clotting role is helped by the presence of vitamin K - Is secreted by intact endothelium - It inhibits clotting factors IX, X, XI, XII ## 86-Protein C - Is inhibited by thrombin-thrombomodulin complex - It activates factors V and VIII - It removes the inhibitor of plasminogen activator - Is inactivated by protein S ## 87-Protein C: - Is a major physiological anticoagulant - Decreases the formation of plasmin - Is activated by prothrombin to activated protein C - In its activated form degrades factor VII ## 88-Thrombomodulin: - Is secreted by RBCs - Is activated by heparin - Activates platelets - Binds with thrombin forming a complex that activates protein C ## 89- Which of the following is a feature of protein S: - It is synthesized by the endothelium - Its synthesis requires vitamin C - It functions as a cofactor to protein C - It is involved in the inactivation of factor IXa ## 90-Anticlotting mechanism includes the following limiting reaction: - inactivation of factor XII - removal of activated clotting factors by the kidney - binding of antithrombin III with active clotting factor VII, IX and X - the interaction between thromboxane A2 and prostacyclin limits clotting to the site of injury ## 91-Concerning Anticlotting mechanisms: - Heparin inhibits the activity of IXa, Xa, XIa and XIIa - Smooth vascular endothelium inactivates some activated clotting factors - Plasminogen changes fibrinogen to its degradation products - Thrombomodulin-thrombin complex activates protein S ## 92-Vitamin K deficiency - Is observed in newly born infants due to lack of colonic bacteria - Is observed in elderly patients treated by massive oral antibiotics - Is observed in patients with bile duct obstruction - All of above ## 93-Vitamin K dependent clotting factors include: - Factor IX - Factor XI - Fibrinogen - Plasminogen ## 94-Regarding haemostasis: - Vitamin K deficiency leads to prolongation of the bleeding time - Hemophilia A is due to deficiency of Christmas factor - Thrombocytopenic purpura occurs if the platelet count is below 50,000/mm³ - Vitamin B12 deficiency leads to prolongation of coagulation time ## 95- What condition leads to deficiency in factor IX that can be corrected by an intravenous injection of vitamin K? - hemophilia A - bile duct obstruction - deficiency of antithrombin III - thrombocytopenic purpura ## 96-A male patient with a bleeding time of 3 minutes and prothrombin time 30 seconds. Which haemostatic abnormality is expected in this patient? - platelet production - platelet function - extrinsic pathway of blood coagulation - intrinsic pathway of blood coagulation ## 97- A 5 year-old boy bleeds easily by slightest trauma. The maternal grandfather has a bleeding disorder. On examination, small hemorrhages are observed under skin. This patient, most probably has a deficiency of: - factor X. - factor VIII. - prothrombin. - Platelets ## 98- Obstruction of common bile duct by a stone will increase bleeding tendency due to: - Decreased formation of factor XII in the liver - Decreased platelet count - Decreased synthesis of vitamin k in the liver - Decreased synthesis of prothrombin ## 99- Factor VII: - Is a cofactor in the coagulation cascade - Initiates the process of coagulation with tissue thromboplastin - Is vitamin-K- independent - Is produced by platelets ## 100- Conditions are accompanied by excessive bleeding, except: - Hemophilia - Thrombocytopenia - Liver failure - Vitamin B12 deficiency ## 101-Hemophilia, a recessive X-linked disease is: - Present in both sexes equally - Of the A-type, is caused by lack of factor VIII - Characterized by prolonged bleeding time - b and c are correct ## 102- In Hemophilia there is: - Blood coagulation acceleration - Erythrocyte destruction - Prolonged bleeding time - Prolonged coagulation time ## 103-About the action of anticoagulants, all are true except: - Dicumarol interferes with the synthesis of prothrombin in the liver - Oxalates form insoluble salts with Ca²+ - Citrates and other chelating agents bind Ca²* - Heparin blocks the action of antithrombin III ## 104- In vitro, blood clotting is prevented by addition of: - dicumarol - heparin - calcium chloride - plasminogen ## 105- Which anticoagulant is preferred for storage of donated blood? - Citrate - Coumarin - Heparin - Oxalate ## 106-About the action of anticoagulants, all of the following is true except: - Dicumarol interferes with the synthesis of prothrombin in the liver - Oxalates form insoluble salts with Ca²+ - Citrates and other chelating agents bind Ca2+ - Heparin blocks the action of antithrombin III ## 107-Haemolytic disease of the newborn - Affects mainly babies of Rh-negative mothers - Occurs mainly in babies who lack D agglutinogen - Causes jaundice which clears rapidly after birth. - Can be treated by transfusing the affected baby with Rh-positive blood ## 108-Severe reactions are likely after transfusion of blood group - O to a group AB person - A to a group O person - A to a group AB person - O Rh- negative to a group AB Rh-positive person ## 109-All regarding the ABO and rhesus (Rh) systems are true, except: - A person of group O is a universal donor - A person who is group AB has anti-A and anti-B antibodies - The presence of the D antigen means that the subject is Rh+ve - Second Rh+ve baby of Rh-ve mother is at greater risk than the first ## 110-Erythroblastosis fetalis: - Affects mainly babies ofRh-positive mothers - Occurs mainly in babies who lack D agglutinogens - Occurs mainly during the 1s¹ pregnancy - Can be prevented by injecting the mother with anti-D antibodies just after delivery ## 111-Blood type O persons are considered universal donors due to: - Type O blood has the commonest distribution - Their RBCs contain neither A nor B agglutinogens - Their RBCs may contain the Rh-factor - Their plasma contains both alpha and beta agglutinins ## 112-A person has type O+ blood, then which of the following is true? - He has no agglutinins at all - He has no A agglutinogen - He has no Rh agglutinogen - None of the above ## 113-A group B Rh-ve person can receive blood for second time from: - Group AB Rh-ve. - Group O Rh -ve. - Group O Rh +ve. - Group B Rh+ve. ## 114-Blood type AB are considered universal recipients because - Type AB blood has the commonest distribution. - Their R.B.Cs contain neither A nor B agglutinogens. - Their R.B.Cs may contain the Rh factor. - Their plasma contains neither alpha or beta agglutinins. | **1** | **D** | **21** | **C** | **41** | **B** | **61** | **C** | **81** | **D** | **101** | **B** | |---|---|---|---|---|---|---|---|---|---|---|---| | **2** | **D** | **22** | **D** | **42** | **A** | **62** | **D** | **82** | **D** | **102** | **D** | | **3** | **D** | **23** | **D** | **43** | **C** | **63** | **A** | **83** | **D** | **103** | **D** | | **4** | **C** | **24** | **A** | **44** | **D** | **64** | **C** | **84** | **A** | **104** | **B** | | **5** | **B** | **25** | **C** | **45** | **B** | **65** | **A** | **85** | **B** | **105** | **A** | | **6** | **D** | **26** | **C** | **46** | **D** | **66** | **D** | **86** | **C** | **106** | **D** | | **7** | **C** | **27** | **A** | **47** | **C** | **67** | **B** | **87** | **A** | **107** | **A** | | **8** | **A** | **28** | **C** | **48** | **C** | **68** | **A** | **88** | **D** | **108** | **B** | | **9** | **B** | **29** | **C** | **49** | **C** | **69** | **D** | **89** | **C** | **109** | **B** | | **10** | **C** | **30** | **C** | **50** | **C** | **70** | **A** | **90** | **D** | **110** | **D** | | **11** | **A** | **31** | **A** | **51** | **A** | **71** | **C** | **91** | **A** | **111** | **B** | | **12** | **A** | **32** | **B** | **52** | **B** | **72** | **C** | **92** | **D** | **112** | **B** | | **13** | **A** | **33** | **A** | **53** | **C** | **73** | **B** | **93** | **A** | **113** | **B** | | **14** | **A** | **34** | **B** | **54** | **D** | **74** | **C** | **94** | **C** | **114** | **D** | | **15** | **A** | **35** | **D** | **55** | **B** | **75** | **A** | **95** | **B** | | **16** | **A** | **36** | **C** | **56** | **D** | **76** | **D** | **96** | **C** | | **17** | **D** | **37** | **C** | **57** | **C** | **77** | **B** | **97** | **B** | | **18** | **D** | **38** | **B** | **58** | **B** | **78** | **C** | **98** | **D** | | **19** | **C** | **39** | **B** | **59** | **D** | **79** | **D** | **99** | **B** | | **20** | **C** | **40** | **B** | **60** | **C** | **80** | **B** | **100** | **D** | # BLOOD