Hematology

What percentage of iron is absorbed in the duodenum and what percentage in the jejunum?
1. 10 percent
2. 25 percent
3. 50 percent
4. 90 percent
Most infants require iron supplements for the first BLANK of life?
1. Week
2. Month
3. 6 months
4. Year
Physiologic anemia is most common in what period of life?
1. 2 to 4 weeks
2. 3 to 5 months
3. 4 to 8 months
4. First 2 weeks
Oral iron therapy will raise the hemoglobin by how many grams per deciliter per week?
1. 0.5 gms
2. 1.5 gms
3. 2 to 3 gms
4. No significant change in 1 week
What is the most common cause of aplastic anemia?
1. Unknown
2. Chloramphenicol
3. Chemical Toxins
4. Chemotherapy
In hemolytic anemia, bone marrow can compensate for reduced red cell life span up to what percentage of normal?
1. 1/8th of normal
2. 1/4th of normal
3. 1/2 of normal
4. 3/4ths of normal
Hereditary spherocytosis is inherited as what type of disease, and how is the diagnosis made?
1. Autosomal recessive and osmotic fragility test
2. Autosomal dominant and PCR
3. Autosomal dominant and osmotic fragility test
4. X-linked recessive and PCR
In hereditary spherocytosis, aplastic crisis may be a signified by WHAT?
1. Improvement in anemia
2. Decreased Howell-Jolly bodies
3. Improvement in jaundice
4. Chest pain
The gene for sickle cell disease is carried by what percentage of the black population?
1. 1 to 2 percent
2. 5 percent
3. 8 to 10 percent
4. 15 to 20 percent
What type of anemia is sickle cell anemia?
1. microcytic
2. macrocytic
3. normocytic
How is the presence of hemoglobin S demonstrated?
1. Hemoglobin electrophoresis
2. Spectrophotometry at 940 nm
3. PCR
4. Sodium metabisulfite
What type of anemia is Cooley's anemia?
1. Microcytic, hypochromic, hemolytic anemia
2. Microcytic, hyperchromic, hemolytic anemia
3. Normocytic, hypochromic, hemolytic anemia
4. Macrocytic, hyperchromic, hemolytic anemia
T or F: Thalassemia major requires frequent transfusions leading to excessive iron stores and organ damage?
1. True
2. False
Platelet adhesion receptors on the platelet surface bind to what?
1. Macrophage Fc receptors
2. Cadhedrins
3. Matrix molecules on the endothelial cells
4. Monodimeric Integrin
Platelet alpha granules release all EXCEPT which?
1. von Willebrand’s factor
2. Fibrinogen
3. Thrombospondin
4. Calcium
Platelet dense granules release all EXCEPT which?
1. ADP
2. Fibrinogen
3. Serotonin
4. Calcium
5. Thromboxane A2
What substance may correct the platelet dysfunction associated with renal failure?
1. Desmopressin
2. Fibrinogen
3. Heparin
4. von Willebrand’s factor
T or F: Procoagulants are proteases and other factors that interact to form a thrombus; primarily by converting fibrinogen to fibrin and assisting clot formation?
1. True
2. False
What initiates the intrinsic pathway?
1. Factor 12
2. Factor 10
3. Factor 7
4. Factor 3
What initiates the extrinsic pathway?
1. Factor 12
2. Factor 10
3. Factor 7
4. Factor 3
What factor is the beginning of the final common pathway?
1. Factor 12
2. Factor 10
3. Factor 7
4. Factor 3
All of the coagulation proteins reach normal adult levels by what age?
1. 1 - 2 weeks
2. 1 - 2 months
3. 3 - 6 months
4. 6 - 12 months
Which clotting factors are the final common pathway?
1. Factors 10-5-2-1-13-stable clot
2. Factors 12-11-9-10-8
3. Factors 3-7-10
Which is NOT true of Protein C and S?
1. Protein C is 30 % of adult levels at birth
2. Protein S is 50 % of adult levels at birth
3. Protein S is free or bound to C4b binding protein
4. Protein C is free in circulation as Protein S
5. Only Protein C is Vit K dependent
The definitive clot is NOT composed of WHAT?
1. Macrophages
2. Platelet aggregates
3. Stable tiny fibrin polymers
Levels of the vitamin K dependent factors (2, 7, 9, 10) are only what percentage of adult levels during the newborn period?
1. 10%
2. 20%
3. 50%
4. 75%
Which is NOT a protease inhibitors (aka natural anticoagulant)?
1. Protein C
2. Protein S
3. Fibrinogen
4. Antithrombin 3
Antithrombin 3 interacts with endogenous WHAT, to neutralize the actions of thrombin?
1. Heparin
2. Protein S
3. Fibrinogen
Activated protein C in the presence of protein S inhibits the activity of what 2 factors?
1. Factors 5 and 7
2. Factors 2 and 8
3. Factors 10 and 9
Deficiencies or excesses in antithrombin 3, protein S, and protein C can cause deep venous thrombosis, mesenteric venous thrombosis, pulmonary emboli?
1. Excesses
2. Deficiencies
Protein C deficiency is familial, and is inherited how?
1. X-linked recessive
2. autosomal with incomplete penetrance
T or F: The treatment of infantile protein C deficiency is coumadin?
1. True
2. False
T or F: These are all anticoagulants: A1 anti trypsin, Alpha 2 macroglobulin, Alpha-2 antiplasmin, C1 esterase inhibitor, Heparin cofactor 2.
1. True
2. False
In evaluation of the bleeding patient, what might the presence of large platelets mean?
1. Platelet autoantibodies
2. Bone marrow suppression
3. Rapid production and destruction
True or false: in neonates, the bleeding time is difficult to accurately obtain and is rarely done?
1. True
2. False
Prothrombin time measures the intrinsic or the extrinsic pathway?
1. Extrinsic
2. Intrinsic
3. Both
Rank in relative incidence (most common...least common): antithrombin 3 deficiency, protein C deficiency, protein S deficiency?
1. AT3...Pro S...Pro C
2. Pro S...AT3...Pro C
3. AT3...Pro C...Pro S
What is the incidence of classical hemophilia A?
1. 1 in 1,000
2. 1 in 10,000
3. 1 in 50,000
4. 1 in 100,000
Which is NOT true for Vit K deficiency?
1. Increased PTT and PT
2. Normal Fibrin split products
3. Decreased fibrinogen
4. Normal platelets
Which is NOT true for Hemophilia A?
1. Increased PTT
2. Increased PT
3. Normal Fibrin split products
4. Normal platelets
In patients with severe liver deficiency, what factor is usually decreased?
1. Factor 10
2. Factor 7
3. Factor 5
4. Factor 2
Hemorrhagic disease of the newborn is rarely seen currently, and was usually due to what?
1. Maternal antiplatelet antibodies
2. Vitamin K deficiency
3. Transfusion reaction
Which of the following is NOT a cause of Late hemorrhagic disease of the newborn (occurs between 1-3 months of age)?
1. CF
2. Biliary disease
3. Prolonged TPN
4. Alpha-1 antitrypsin deficiency
5. Malabsorption
Factor 8 actually circulates in the plasma as 2 separate peptides: what are they?
1. von Willebrand’s factor and Factor 8 coagulant protein
2. Factor 8 procoagulant and coagulant protein
3. Factor 8A and Factor 8B
Bleeding caused by deficiency of factor 8 in newborns is NOT which of the following?
1. Intracranial bleeding
2. GI Bleeding
3. Post circumsicion bleeding
4. Umbilical bleeding
What percent factor 8 is usually present with frequent severe spontaneous bleeding?
1. 6-30 percent
2. 2-5 percent
3. 30-50 percent
T or F: on unit of Factor 8 is the amount of activity in one ml of normal plasma?
1. True
2. False
Factor 8 must be given 2 times a day because of its half-life; what is the dose?
1. Wt x 0.3 x desired level equals units of factor 8 concentrate
2. Wt x 0.5 x desired level equals units of factor 8 concentrate
3. Wt x desired level equals units of factor 8 concentrate
Factor 8 inhibitors (circulating neutralizing antibodies) are present in what percent of patients?
1. 1 to 2 percent
2. 6 to 8 percent
3. 10 to 20 percent
4. 20 to 30 percent
Currently, in a pregnant hemophilia carrier female, it is possible to make the diagnosis for an at risk male infant by amniocentesis or chorionic villus sampling at how many weeks gestation?
1. 6 to 8 weeks
2. 13 to 16 weeks
3. 16 to 20 weeks
4. After 24 weeks
T or F: In Factor 8 and 9 deficiency, as well as von Willebrand's, the PT is normal and the PTT is increased?
1. True
2. False
Factor 9 deficiency (Christmas factor or hemophilia B) accounts for what percent of all hemophilia?
1. 5 percent
2. 10 percent
3. 15 percent
4. 20 percent
What is the treatment of Factor 13 deficiency?
1. Factor 13 concentrate
2. Cryoprecipitate
3. FFP
4. Whole blood
Factor 13 deficiency has a coagulation profile demonstrating all of these EXCEPT?
1. Normal PT
2. Elevated PTT
3. Elevated bleeding time
4. Normal platelet count
What is the dose of Factor 9 concentrate for treating a Factor 9 deficiency?
1. 1 unit per kg raises level by 1%
2. 0.5 unit per kg raises level by 1%
3. 0.3 unit per kg raises level by 1%
What is hemophilia C?
1. Factor 13 deficiency
2. Factor 11 deficiency
3. Factor 10 deficiency
4. Factor 9 deficiency
How is von Willebrand's disease inherited?
1. Autosomal dominant
2. Autosomal recessive
3. X-linked recessive
What is the single most common inherited bleeding disorder in human beings?
1. Hemophilia A
2. Hemophilia B
3. von Willebrand's
4. Protein C deficiency
True or false:Factor 8 is also decreased in VWD?
1. True
2. False
Where is the gene for von Willebrand's disease located?
1. Chromosome 5
2. Chromosome 10
3. Chromosome 12
Where is von Willebrand's disease produced?
1. 15% plts/megakaryocytes; 85% endothelial cells
2. 50% plts/megakaryocytes; 50% endothelial cells
3. Reticuloendothelial system
Type 1 von Willebrand's disease accounts for 80 % of cases: one normal and one abnormal allele result in WHAT?
1. Decreased amts of strucurally normal VWF
2. Increased amts of strucurally abnormal VWF
3. Decreased amts of strucurally abnormal VWF
4. Barely detectable levels of von Willebrand's factor
Type II von Willebrand's disease has structurally (normal or abnormal) von Willebrand's factor and (increased or normal) amounts of it?
1. Decreased amts of strucurally normal VWF
2. Increased amts of strucurally abnormal VWF
3. Decreased amts of strucurally abnormal VWF
4. Barely detectable levels of von Willebrand's factor
Type III von Willebrand's disease (rare, autosomal recessive) has (increased or normal) amounts of VWF?
1. Decreased amts of strucurally normal VWF
2. Increased amts of strucurally abnormal VWF
3. Decreased amts of strucurally abnormal VWF
4. Barely detectable levels of von Willebrand's factor
Which is NOT a function of von Willebrand's factor?
1. Carrier for Factor 8
2. Mediates platelet adhesion to injured subepithelium
3. Bridging the platelet glycoprotein Ib and Ib/IIIa and subepithelial collagen/heparin
4. Stimulates Factor 8 release
Which is NOT part of the coagulation profile in von Willebrand's disease?
1. Normal platelets
2. Normal prothrombin time
3. Normal partial thromboplastin time
4. Increased bleeding time
5. Decreased VWF and Factor 8
Which is NOT true of Vasopressin (desmopressin) in von Willebrand's disease?
1. Contraindicated in Types IIB and III VWD
2. Causes Factor 8 release from endothelium
3. Stimulates platelet alpha granules
Which is NOT true of pseudo- von Willebrand's disease?
1. Increased binding of VWF to plts
2. Structurally abnormal VWF
3. Decreased plasma concentration of VWF
What factor is NOT consumed in DIC when fibrin is formed?
1. Factor 2
2. Factors 5a nd 7
3. Fibrinogen
4. Factor 13

Hematology

Quiz