Blood

1. Blood is a connective tissue comprised of cellular elements and an

extracellular matrix comprised primarily of water. What is the name of the
blood's extracellular matrix:
(a) Hematocrit.
(b) Fibrinogen.
(c) Buffy coat.
(d) Plasma.

2. Albumin is a ……………………in the blood plasma:

(a) Hormones.
(b) Electrolytes.
(c) Plasma protein.
(d) RBCs.

3. The amount of blood in the human body is about …………….liters:

(a) 2
(b) 7
(c) 5
(d) 12

4. The red cell count is normally about …………….. million cells per cubic
millimeter:
(a) 7
(b) 5
(c) 9
(d) 15

5. The Buffy coat which represents < 1% of the whole blood is comprised of:
(a) Erythrocytes and platelets.
(b) Leukocytes and platelets.
(c) Leukocytes and clotting factors.
(d) None of the above.

6-The function of plasma albumins is:

(a) Contributing to the clotting process.
(b) Body defense.
(c) Maintenance of the blood's osmotic pressure.
(d) Transport of metal minerals.
(e) Source of energy.
7. If the hematocrit is 40, then the volume occupied by the:
(a) Red blood cells is 60% of the total blood volume.
(b) White blood cells is 40% of the total blood volume.
(c) Red blood cells is 40% of the total blood volume.
(d) Plasma and other cellular elements is 40% of the total blood volume.

8- Hamatocrite value is increased in

a) Overhydration
b) Anemia
c) Polycythemia
d) Females than males
e) Infection and inflammation

9-Thalassemia is an example of:

Deficiency anemia.
Pernicious anemia.
Hemolytic anemia.
Aplastic anemia.
Hemorrhagic anemia.

10. Antibodies are:

(a) gamma globulins.
(b) a type of plasma electrolyte
(c) produced by B lymphocytes.
(d) Both (a) and (c).

11-Red blood cells

a-are the least among all blood cell types
b-are more in males compared to females
c-their membrane is disc shaped biconvex
d-their membrane contain antigen which is unified in all blood typins
e-are synthesized in liver and kidney

12-All of the following are granulocytes except

a- lymphocytes
b-monocytes
c- a&b
d-esinophils
e-neutrophils
13- Which type of white blood cells increases in parasitic infection?
a) Lymphocytes
b) Monocytes
c) Basophils
d) Esinophils
e) neutrophils

14- Regarding clotting pathways

a- in the living body it is intrinsic and extrinsic mechanism
b- outside the body is intrinsic
c- calcium is important in intrinsic but not extrinsic pathway
d- intrinsic pathway need tissue factor
e- intrinsic pathway is faster and stronger than extrinsic

15- Erythropoiesis , which one is incorrect

a- require erythropoietin hormone synthesized in kidney and liver
b- tissue hypoxia is the most important stimulant
c- occurs in active marrow
d- needs vit B12 and iron
e- occurs in a rate faster than RBCs destruction

16. Which is the most abundant type of cellular element in the blood:
(a) Erythrocytes.
(b) Monocytes
(c) Platelets
(d) Lymphocytes.

17. Erythropoiesis:
(a) is accomplished in the bone marrow upon stimulation by erythropoietin.
(b) is accomplished in the kidneys in response to reduced O2 delivery to the
kidneys.
(c) refers to increased RBC count.
(d) refers to RBC destruction.

18. The hormone controlling erythropoiesis is produced in …….…..:

(a) Pancreas.
(b) Brain.
(c) Heart.
(d) kidney.

19. The hormone controlling erythropoiesis is produced in …….…..:

(a) Pancreas.
(b) Brain.
(c) Heart.
(d) Kidney.
(e) Bone marrow

20. Which type of anemia is caused by a genetic abnormality:

(a) Pernicious.
(b) Hemorrhagic.
(c) Sickle-cell.
(d) Nutritional.

21. Pernicious anemia develops from a deficiency of:

(a) Intrinsic factor.
(b) carbonic anhydrase.
(c) cobalt.
(d) several hormones.

22. Erythropoietin:
(a) is secreted by the bone marrow.
(b) stimulates red blood cell production.
(c) converts prothrombin to thrombin.
(d) is deficient in iron deficiency anemia.

23. All of the following are causes of anemia except:

(a) Dietary deficiency of folic acid.
(b) Deficiency of intrinsic factor.
(c) Living at high altitude.
(d) Carbon monoxide poisoning.

24. Aplastic anemia is caused by:

(a) iron deficiency.
(b) acute loss of blood.
(c) Destruction of the bone marrow.
(d) Vitamin B12 deficiency.

25. All the following are functions of white blood cells except:
(a) Activation of factor XII, which triggers the clotting cascade.
(b) Production of antibodies.
(c) Destruction of cancer cells.
(d) Phagocytosis of foreign invaders and cellular debris.

26. Which leukocyte contains histamine in its granules:

(a) Basophils.
(b) Eosinophils.
(c) Monocytes
(d) Lymphocytes

27. WBC that attacks parasites are:

(a) Neutrophils.
(b) Eosinophils.
(c) Monocytes.
(d) Lymphocytes

28. Granulocytes include:

(a) Neutrophils.
(b) Eosinophils.
(c) Basophils.
(d) All of the above

29. ……………….. leave the blood after circulating for only a day or two and
become macrophages:
(a) Monocytes.
(b) Eosinophils.
(c) Basophils.
(d) Lymphocytes.

30. The chemical signal that makes platelet sticky upon aggregation is:
(a) ADP.
(b) ATP.
(c) Prostacyclin.
(d) Thromboxane.

31. What chemical signal released by healthy endothelial tissue that prevents
over growth of platelet plugs:
(a) ATP.
(b) Thrombopoietin.
(c) Prostacyclin.
(d) Thromboxane A2.

32. Concerning thrombin:

(a) Stimulates conversion of fibrinogen to fibrin
(b) Activates factor XIII (fibrin-stabilizing factor).
(c) Enhances platelet aggregation.
(d) All of the above

33. Which is the correct sequence of events leading to clot formation:

(a) prothrombin-thrombin-fibrin-fibrinogen.
(b) fibrin-prothrombin-fibrinogen-thrombin.
(c) prothrombin-thrombin-fibrinogen-fibrin.
(d) fibrin-thrombin-prothrombin-fibrinogen.
(e) fibrinogen-thrombin-fibrin-prothrombin.

34. Which is not a required factor in the intrinsic clotting mechanism:

(a) Calcium ions.
(b) Factor XII.
(c) Platelet factor 3.
(d) Factor VII.

35-The most abundant plasma protein is

a- albumin
b- globulin
c- fibrinogen
d- prothrombin
e- immunoglobulin

36-Which blood cell can be described as being a biconcave disc?

a-platelet
b-neutrophil
c-eosinophil
d-erythrocyte

37-Which of the following statements about erythrocytes is correct?

a) They fight infection.
b) They clot blood.
c) They lack a nucleus.
d) They are produced in the spleen.

38- Red blood cells survive around _____ days.

a-120
b-240
c-10
d-360

39- The hormone controlling erythropoiesis (erythropoietin hormone) is

produced in the
a-pancreas
b-brain
c-heart
d-kidney
e-bone marrow

40-The hormone erythropoietin stimulates red blood cell production in the

red bone marrow. Where in the body is erythropoietin produced?
a) Spleen
b) Kidney
c) Liver
d) Thyroid

41-Which dietary component(s) is/are needed for DNA synthesis, and thus
greatly influence the production of red blood cells?
a-Calcium
b-Iron
c-vitamin B12 and folic acid
d-Protein

42-Thalassemia is an example of:

a-Deficiency anemia.
b-Pernicious anemia.
c-Hemolytic anemia.
d-Aplastic anemia.
e-Hemorrhagic anemia.

43- Severe reactions are likely after transfusion of blood group:

A. A to a group B person.
B. O to a group AB person.
C. B Rh-negative to a group B Rh-positive person.
D. A to a group AB person.
E. O Rh-negative to a group AB Rh-positive person.

44- Regarding erythroblastosis fetalis:

a-The fetus is Rh negative.
b-The mother is Rh positive.
c-The father is Rh negative.
d-mother is RH negative.
e-It is associated with shrunken liver and spleen.

45- Erythroblastosis fetalis, also known as hemolytic disease of the newborn,

most often occurs in ______________ mothers carrying ______________
fetuses.
a-Rh+; Rh-
b-Rh-; Rh+
c-Type A; type O
d-Type B; Type A

46- Erythroblastosis fetalis, most often occurs in ______________ mothers

carrying ______________ fetuses.
a- Rh+; Rh-
b- Rh-; Rh+
c- Rh+; Rh+
d- Type B; Type A
e- Rh-; Rh-
47- Vitamin K dependent coagulation factors are:
1-Factor II, VII and IX.
2-Factor X and XI.
3-Factor VII and XI.
4-Factor II, VII and XI.
5-Factor XI and XII.

48- The final step in the clotting of blood is the conversion of

a-prothrombin to thrombin
b-prothrombin activator to thrombin
c-fibrin to fibrinogen
d-fibrinogen to fibrin

49- Choose the correct order for the steps of hemostasis.

a-blood coagulation, platelet plug formation, blood vessel spasm
b-platelet plug formation, blood coagulation, blood vessel spasm
c-blood vessel spasm, platelet plug formation, blood coagulation
d-blood vessel spasm, blood coagulation, platelet plug formation

50- Cells responsible for specific immunity are

a-monocytes
b-neutophils
c-basophils
d-lymphocytes
e-esinophils

51-Antibodies are defense substances produced by the _____ cells.

a-T-lymphocyte
b-monocyte
c-B-lymphocyte
d-leukocyte

52-The type of white blood cell that is often the first to arrive at the site of
infection is a granulocyte which is
a-basophil
b-eosinophil
c-neutrophil
d-monocyte

53-Which type of condition is directly related to bone marrow suppression?

A-aplastic anemia
B-anemia
C-sickle cell anemia
D-megaloblastic anemia

54. What' forms the meshwork of a clot:

(a) Red blood cells.
(b) Fibrin
(c) Platelets.
(d) Thrombin.

55. All the followings are true concerning heparin except:

(a) It is normally present in the body.
(b) It is present in basophils.
(c) It is present in mast cells.
(d) It stimulates the coagulation of blood.

56. The condition that results from inadequate amounts of platelets is:
(a) Hemophilia.
(b) Leukopenia.
(c) Thrombocytopenia.
(d) Hageman disorder

57. Hemophilia results from:

(a) A deficiency of platelets.
(b) Iron deficiency.
(c) Vitamin B12 deficiency.
(d) Inability to produce one of the factors in the clotting cascade.

58. The deficiency of vitamin can cause a bleeding tendency:

(a) A
(b) B
(c) K
(d) D

59. The Plasma protein amount is:

(a) 10 gm%.
(b) 6-8 mg%.
(c) 6-8 gm%
(d) 20 gm%.

60. The coagulation (clotting) time is prolonged in:

(a) Purpura.
(b) Haemophilia.
(c) Anemia.
(d) None of the above.

61. The bleeding time is prolonged in:

(a) Thrombocytopenia (platelets deficiency).
(b) Haemophilia.
(c) Factor XII deficiency.
(d) Factor X deficiency.

62. Purpura is:

(a) Caused y deficiency of platelets.
(b) Caused by deficiency of WBCs.
(c) Caused by deficiency of vitamin K.
(d) Caused by deficiency of factor XII.

63. Dicumarol causes:

(a)Inhibition of factor VIII.
(b)Inhibition of vitamin K action.
(c)Precipitation of Ca++.
(d) None of the above.

64. Erythroblastosis fetalis occurs in:

(a) Rh -ve mother and Rh -ve fetus.
(b) Rh -ve mother and Rh +ve fetus.
(c) Rh +ve mother and Rh -ve father.
(d) Rh -ve mother and Rh -ve father.

65. The 1st line of defense against bacterial infection is:

(a) The neutrophils.
(b) The monocytes.
(c) The basophils.
(d) The lymphocytes.

66. All the followings are true concerning incompatible blood transfusion
except:
(a) Hemolytic jaundice.
(b) Hypertension.
(c) Acute renal failure.
(d) Fever.

67. Concerning WBCs, all the followings are true except:

(a) Eosinophils increase in parasitic infestations.
(b) Neutrophils are the least abundant.
(c) Basophils resemble mast cells.
(d) B-Iymphocytes secrete antibodies.

68. The RBCs in iron deficiency anemia are:

(a) Normocytic normochromic.
(b) Microcytic hypochromic.
(c) Macrocytic hyperchromic.
(d) Spherocytic.

69. Lack of maturation of RBCs is caused by:

(a) Iron deficiency.
(b) Vitamin B12 deficiency
(c) Irradiation.
(d) None of the above.

70. All the followings cause hemolytic anemia except:

(a) Congenital spherocytosis.
(b) Iron deficiency.
(c) Sickle cells.
(d) G6 PDH deficiency

71. Concerning erythrocyte sedimentation rate:

(a) It is of value in prognosis not diagnosis.
(b) Is increased in infections and cancers.
(c) Is essential for diagnosis of certain diseases
(d) Both (a) and (b).

72. One haem molecule can carry

A_ one O2 molecule

B_ 2 O2 molecules

C_ 3 O2 molecules

D_ 4 O2 molecules

73_ Hb is formed of

A_ one haem subunit and one globin polypeptide chain

B_ 4 haem subunits and one globin polypeptide chain

C_ one haem subunit and 4 globin polypeptide chains

D_ 4 haem subunits and 4 globin polypeptide chains

74_ Iron included in Hb is in the form of;

A_ ferric

B_ ferrus

C_ oxidized form

D_ reduced and oxidized forms

75_ Physiological jaundice is;

A _ due to rapid destruction of all blood cells after birth

B_ due to Rh incompatibilty between mother and fetus

C_ due to increased bilirubin following RBCs hemolysis after birth

D_ usually severe condition and not self limiting

76_ RBCs membrane is characterized by

A_ freely permeable

B_ plastic and deformable

C_ elastic and stretchable

D_ convex giving the cell its spherical shape

77_ G6PD deficiency leads to

A_ spherocytosis

B_ thalassemia

C_ sickle cell anemia

D_ favism

78_ Hb represents
A_ 15% of cell volume

B_ 30 Pg /dL

C_ 90 g / mm3

D_ 33% of cell volume

E_ 15 mg/ dL

79_ The chemical signal that makes platelet sticky upon aggregation is:
(a) ADP.
(b) ATP.
(c) Prostacyclin.
(d) Thromboxane.

80_What chemical signal released by healthy endothelial tissue that prevents

over growth of platelet plugs:
(a) ATP.
(b) Thrombopoietin.
(c) Prostacyclin.
(d) Thromboxane A2.

81_Concerning thrombin:
(a) Stimulates conversion of fibrinogen to fibrin
(b) Activates factor XIII (fibrin-stabilizing factor).
(c) Enhances platelet aggregation.
(d) All of the above

82_Which is the correct sequence of events leading to clot formation:

(a) prothrombin-thrombin-fibrin-fibrinogen.
(b) fibrin-prothrombin-fibrinogen-thrombin.
(c) prothrombin-thrombin-fibrinogen-fibrin.
(d) fibrin-thrombin-prothrombin-fibrinogen.
(e) fibrinogen-thrombin-fibrin-prothrombin.

83_ Which is not a required factor in the intrinsic clotting mechanism:

(a) Calcium ions.
(b) Factor XII.
(c) Platelet factor 3.
 (d) Factor VII.
84_Vitamin K dependent coagulation factors are:
1-Factor II, VII and IX.
2-Factor X and XI.
3-Factor VII and XI.
4-Factor II, VII and XI.
5-Factor XI and XII.

85_The final step in the clotting of blood is the conversion of

a-prothrombin to thrombin
b-prothrombin activator to thrombin
c-fibrin to fibrinogen
d-fibrinogen to fibrin

86_ Choose the correct order for the steps of hemostasis.

a-blood coagulation, platelet plug formation, blood vessel spasm
b-platelet plug formation, blood coagulation, blood vessel spasm
c-blood vessel spasm, platelet plug formation, blood coagulation
d-blood vessel spasm, blood coagulation, platelet plug formation
87_All the followings are true concerning heparin except:
(a) It is normally present in the body.
(b) It is present in basophils.
(c) It is present in mast cells.
(d) It stimulates the coagulation of blood.

88_The condition that results from inadequate amounts of platelets is:

(a) Hemophilia.
(b) Leukopenia.
(c) Thrombocytopenia.
(d) Thrombocytopathia

89_ Hemophilia results from:

(a) A deficiency of platelets.
(b) Iron deficiency.
(c) Vitamin B12 deficiency.
(d) Inability to produce one of the factors in the clotting cascade.

90_The deficiency of vitamin can cause a bleeding tendency:

(a) A
(b) B
 (c) K
(d) D

91_The coagulation (clotting) time is prolonged in:

(a) Purpura.
(b) Haemophilia.
(c) Anemia.
(d) Vitamen c deficiency

92_. The bleeding time is prolonged in:

(a) Thrombocytopenia (platelets deficiency).
(b) Haemophilia.
(c) Factor XII deficiency.
(d) Factor X deficiency.

93_. Purpura is:

(a) Caused by deficiency of platelets.
(b) Caused by deficiency of WBCs.
(c) Caused by deficiency of vitamin K.
(d) Caused by deficiency of factor XII.

94_. Dicumarol causes:

(a)Inhibition of factor VIII.
(b)Inhibition of vitamin K action.
(c)Precipitation of Ca++.
(d) decresed vitamen K level in blood
Von Willibrand factor (VWF) is synthesized in 17_
A_ Liver
B_ Bone marrow
C_ Endothelium
D_ platelets
95__ which of the followings is an in _ vivo anticoagulant
A_ Heparin
B_ Citrate
C_ EDTA
D_ Oxalat
Prolonged bleeding time occurs in case of: ^96
A_ hemophilia
B_ purpura
C_ liver diseases
 D_ use of heparin
E_ all of the above

Epistaxis ( nasal bleeding) is a sign of _79 _

A_ prolonged bleeding time
B_ prolonged clotting time
C_ hemophilia
D_ purpura
98_ Which of the followings is important for platelet adhesion?
A_ thromboxane A2
B_ thrombin
C_ factor 8
D_ prostacyclin
what is the substance used as an anticoagulant?99 _
A_ streptokinase
B_ fibrinolysin
C_ Protein C
D_ cumarin
100__ which of the followings has fibrinolytic activity?
A_ heparin
B _ thrombin when bound to thrombomodulin
C_ dicumarol
D_ tissue thromboblastin

Thrombin has all the following functions except_101

A_ activates factors 5,8
B_ increase fibrin formation
C_ fibrinolytic when bound to thrombomodulin
D_ inhibits platelets aggregation
102__ Which of the following substances is not released by active platelets?
A_ PGI2
B_ TXA2
C_ thromboblastin
D_ Serotonin
Which of the followings causes prolonged 103_E_ platelet activating factor
clotting time
A_ hypocalcemia
B_ scurvy
C_ thrombocytopenia
D_ Aspirin
E_ hemophilia