WBC RBC clinical pathology
1. During the third month of embryogenesis, Hematopoietic Stem Cells migrate to
A. Bone Marrow
B. Yolk Sac
C. Axial skeleton
D. Liver
2. After puberty, Hematopoiesis occurs in
A. Bone Marrow
B. Yolk Sac
C. Axial skeleton
D. Liver
3. True of Hematopoietic stem cells, except
A. A single SC must be able to generate all mature blood cells
B. Must be capable of self-renewing
C. CFU-Mg will cause differentiation into monoblast
D. Under stressful conditions, HSCs are mobilized from BM to peripheral blood
4. What is the normal value for Basophils?
A. 0-0.2%
B. 0-0.5%
C. 40-70%
D. 0.1-0.6%
5. True of Agranulocytosis, Except
A. The most common cause of agranulocytosis is drug toxicity
B. May be an idiosyncratic reaction to anti-psychotic drugs or diuretics
C. May be associated with monoclonal proliferations of large granular lymphocytes
(so-called LGL leukemia)
D. All of the above
E. None of the above
6. Leukocytosis mechanisms may be influenced by the ff factors, except:
A. The rate of intravasation of cells from the tissue to blood.
B. The size of the precursor and storage cell pools in the bone marrow, thymus,
circulation, and peripheral tissues.
C. The rate of release of cells from the storage pools into the circulation.
D. The marginal pool
7. The ff are well-known causes of monocytosis, except:
A. Bacterial endocarditis
B. Malaria
C. Viral infection
D. SLE
8. Persistent basophilia is seen in the following:
A. ALL
B. AML
C. CLL
D. CML
9. Dohle bodies can be described as:
A. granules, which are coarser and darker than normal neutrophilic granules
B. patches of dilated endoplasmic reticulum that appear as sky-blue cytoplasmic
"puddles."
C. Vacuolations
D. All of the above
E. None of the above
10. What is the prototype for Acute Lymphoblastic Leukemia (ALL)?
A. T cell
B. NK cell
C. B cell
D. Monocyte
11. What is the prototype for thymic lymphomas?
A. T cell
B. NK cell
C. B cell
D. Monocyte
12. What is the most common mutation in T cell-ALL?
A. ETV6
B. NOTCH2
C. NOTCH3
D. None of the above
13. What is the most common chromosomal abnormality in ALL?
A. Hypoploidy
B. Hyperploidy
C. Translocations
D. None of the above
14. Which of the ff will have a (+) Myeloperoxidase stain?
A. AML
B. ALL
C. CLL
D. None of the above
15. Classify this: Large blasts with irregular sizes. Most common in adults.
A. ALL-L3
B. ALL-L4
C. ALL-L7
D. ALL-L2
16. A 60 year old male, presents with fatigue, gum bleeding, and petechiae. Peripheral
smear showed 22% blasts along
with rod-like structures in the blast cytoplasm. Diagnosis?
A. AML
B. ALL
C. CLL
D. None of the above
17. What are these structures called (#16)?
A. Azurophil rods
B. Auer rods
C. Azure rods
D. None of the above
18. Which type of AML (WHO) has a 'very favorable" prognosis?
A. T(15;17)(q22:11-12); RARA/PML fusion gene
B. AML, therapy related
C. Inv(16)(p13;q22); CBFB/MYH11
D. None of the above
19. What type of AML (FAB) is known as undifferentiated acute myeloblastic leukemia?
A. M1
B. M3
C. M2
D. M0
20. The following statements are related to CML, except:
A. There is a balanced inversion between the short arms of 9 and 22 chromosomes [t
(9;22)(q34;q11)]
B. breakpoint cluster region (BCR) is located on Ch22
C. Tyrosine kinase inhibitors for treatment
D. Abelson murine leukemia (ABL) 1 is located on Ch9
E. None of the above
21. The conjugated protein that serves as vehicle for transportation of oxygen and carbon
dioxide.
A. Ferritin
B. Hemoglobin
C. Protoporphyrin IX
D. Bilirubin
22. This red cell index indicates the average volume of red cell
A. Mean Cell Volume
B. Mean Cell Hemoglobin
C. Hct/RBC (x10¹³/L)
D. Both A & C
E. Both B & C
23. This red cell index shows the average concentration of hemoglobin in a given volume of
packed red cells.
A. Mean Cell Hemoglobin
B. Mean Cell Hemoglobin Concentration
C. Hct/RBC (x1012/L)
D. Both A & C
E. Both B & C
24. A microcytic anemia with defective synthesis of globin chains.
A. Anemia of chronic inflammation
B. Thalassemia
C. Iron deficiency anemia
D. Sickle cell disease
25. Which is true about hemolytic anemias?
A. The general mechanism is an increased destruction/loss of circulating red blood
cells.
B. There is decreased production of red blood cells, and the marrow is hypocellular.
C. There is reticulocytosis as a compensatory response by the bone marrow.
D. Both A&C
26. Which is not a common feature among the hemolytic anemias?
A. Shortened RBC lifespan
B. Increase in erythropoiesis
C. Caused by decreased synthesis of red blood cells
D. Accumulation of hemoglobin degradation products
27. This normocytic, hyperchromic anemia is due to defects in the red cell membrane
skeleton involving spectrin, ankyrin,
band 4.2, and band 3.
A. Hereditary spherocytosis
B. Defects in the membrane render red cells less deformable
C. Heinz bodies in red blood cells are bitten off, giving the characteristic appearance
D. A & B
E. A & C
28. Describe the red blood cells in a peripheral blood smear in hereditary spherocytosis.
A. Hyperchromic round cells without central pallor
B. Cells with a centrally located disc of hemoglobin surrounded by an area of pallor with
an outer rim of hemoglobin
C. Degmacytes in patients with a functional spleen
D. Normocytic sickle-shaped cells
29. A young male presents with symptoms of anemia after having eaten fava beans. His
mother mentions that he has undergone a splenectomy a year prior. His peripheral blood
smear shows Heinz bodies in red blood cells. If this patien still had a functional spleen, you'd
expect to see degmacytes. This anemia is most likely caused by?
A. G6PD deficiency
B. Defects in spectrin and ankyrin
C. Substitution of glutamate to valine at the 6h codon of beta-globin gene
D. Vitamin B12 deficiency
30. What is the pathogenesis of sickle cell anemia?
A. Deficiency of G6PD renders red cells vulnerable to lysis with oxidative stress
B. Impaired synthesis of globin chains
C. Substitution of valine for glutamic acid on the 6th codon of beta-globin
D. Impaired DNA synthesis
31. A patient's peripheral blood smear shows drepanocytes and Howell-Jolly bodies. This is
most likely a case of?
A. G6PD deficiency anemia
B. Sickle cell anemia
C. Megaloblastic anemia
D. Anemia of chronic inflammation
32. Which statement does not accurately describe sickle cell disease?
A. Triggers include low intracellular pH & low oxygen tension
B. Fetal hemoglobin prevents sickling
C. Microvascular occlusion by sickle cells can lead to vaso-occlusive crises
D. Substitution of glutamine to isoleucine on the 6 codon of alpha-globin
33. This is caused by deletions that result in reduced/absent synthesis of alpha-globin
chains.
A. Alpha-thalassemia
B. Beta-thalassemia
C. Cooley anemia
D. None of the above
34. A pregnant patient has low mean cell volume and low mean cell hemoglobin
concentration. She says she is vegetarian and does not take vitamins. She most likely has
which disease?
A. Iron deficiency anemia
B. Pernicious anemia
C. Hereditary spherocytosis
D. Folate deficiency
35. M.Y., a 12-year-old male presented with pallor, extreme weakness and easy fatigability.
Three days before his symptoms, he had taken an antimalarial. MCV of 90 and an MCHC of
35. What disease does he most likely have?
A. Thalassemia
B. G6PD deficiency anemia
C. Sideroblastic anemia
D. Pemicious anemia
36. In newborns with alpha-thalassemia, excess unpaired gamma (y)-globin chains form y4
tetramers, known as?
A. Hemoglobin Barts
B. Fetal hemoglobin
C. HbH
D. Cooley anemia
37. Which of the following is true about the most severe form of beta-thalassemia?
A. 2 genes are affected
B. 4 genes are affected
C. Beta-thalassemia major
D. Both A & C
38. What is found to be the immediate cause of megaloblastosis?
A. Amino acid substition from glutamate to valine
B. Suppressed synthesis of DNA
C. Autoimmune gastritis
D. Fundic gland atrophy
39. R.M., diagnosed with autoimmune gastritis years ago complains that his tongue looks
"beefy" and shiny. He also complains of tiredness and dyspnea with mild exertion. Which
type of anemia does he most likely have?
A. G6PD deficiency anemia
B. Sickle cell anemia
C. Vitamin B12 deficiency anemia
D. Folate deficiency anemia
40. Type of anemia that may result from impaired production of intrinsic factor.
A. Vitamin B9 deficiency anemia
B. Vitamin B12 deficiency anemia
C. Pemicious anemia
D. Both B & C
41. A cancer patient on methotrexate complains that recently he has been feeling unusually
tired and is looking quite pale. What do you expect to see in his peripheral blood smear?
A. Macrocytic, normochromic red blood cells
B. Microcytic, hypochromic red blood cells
C. Normocytic, normochromic red blood cells
D. Normocytic, hyperchromic red blood cells
42. All of the following are expected findings in a peripheral blood smear of a patient with
megaloblastic anemia except?
A. Macrocytic red blood cells
B. High reticulocyte count or
C. Hypersegmented neutrophils
D. Marked anisocytosis
43. What is the most characteristic finding in a patient with pernicious anemia?
A. Fundic gland atrophy
B. Intestinal metaplasia
C. Atrophic glossitis
D. Neurologic manifestations
44. Which of the following is the most common nutritional disorder in the world?
A. G6PD deficiency anemia
B. Vitamin B9 deficiency anemia
C. Vitamin B12 deficiency anemia
D. Iron deficiency anemia
45. Which of the following statements does not accurately describe iron deficiency anemia?
A. Inadequate hemoglobin production
B. Microcytic hypochromic anemia
C. Low serum ferritin
D. High serum ferritin
46. The peptide hormone synthesized & released from the liver that regulates intestinal iron
absorption and macrophage recycling.
A. Hepcidin
B. Ferritin
C. Transferrin
D. Hemoglobin
47. What is the most common cause of iron deficiency anemia in high-income societies?
A. Lack of iron in diet.
B. Increased demand or requirement
C. Chronic blood loss
D. Impaired absorption
48. What is the average daily dietary intake of iron?
A. 15-20 mg/day
B. 1mg/day
C. 100-120 mg/day
D. 4mcg/day
49. This refers to the abnormally high number of circulating red cells with associate increase
in hemoglobin.
A. Anemia
B. Leukemia
C. Polycythemia
D. Thrombocytopenia
50. The type of polycythemia that results from an intrinsic abnormality of hematopoietic
precursors, independent of erythropoietin.
A. Primary polycythemia
B. Secondary polycythemia
C. Relative polycythemia
D. Both B&C