108 clinical MCQs in Hematopathology. What percentage of normal adult haematopoietic bone marrow is fat?. Kenya, Africa and global revision.
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Q1. What percentage of normal adult haematopoietic bone marrow is fat?
Answer: 10%
Explanation: Adult marrow is roughly half hematopoietic cells, half fat. ---
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Q2. In iron deficiency anemia, which is typically decreased?
- Serum ferritin
- Total iron-binding capacity
- Serum iron
- Transferrin saturation
- All of the above Answer:
Answer: Serum ferritin
Explanation: Ferritin reflects iron stores and drops early; TIBC rises in IDA. ---
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Q3. NOT a characteristic finding in megaloblastic anemia?
- Hypersegmented neutrophils
- Macro-ovalocytes
- Howell-Jolly bodies
- Microcytosis
- Anisocytosis Answer:
Answer: Hypersegmented neutrophils
Explanation: Megaloblastic anemia produces macrocytosis, not microcytosis. ---
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Q4. Hemoglobin variant protecting against severe malaria?
Answer: HbS
Explanation: Sickle trait carriers have reduced risk of severe P. falciparum malaria. ---
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Q5. Characteristic chromosomal abnormality in CML?
- t(15;17)
- t(8;21)
- t(9;22)
- inv(16)
- t(14;18) Answer:
Answer: t(15;17)
Explanation: This is the Philadelphia chromosome, forming BCR-ABL1. ---
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Q6. Most common cause of macrocytic anemia in alcoholics?
- Folate deficiency
- Vitamin B12 deficiency
- Direct toxic effect of alcohol on erythropoiesis
- Liver disease
- Hypothyroidism Answer:
Answer: Folate deficiency
Explanation: Alcohol is directly marrow-toxic, causing macrocytosis independent of nutrition. ---
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Q7. In beta-thalassemia major, which hemoglobin is typically increased?
Answer: HbA
Explanation: Fetal hemoglobin rises to compensate for absent HbA production. ---
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Q8. Most common cause of acquired hemolytic anemia?
- G6PD deficiency
- Autoimmune hemolytic anemia
- Hereditary spherocytosis
- Paroxysmal nocturnal hemoglobinuria
- Sickle cell disease Answer:
Answer: G6PD deficiency
Explanation: The other options are inherited causes; AIHA is the leading acquired cause. ---
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Q9. NOT a typical feature of myelodysplastic syndromes?
- Cytopenias
- Dysplastic changes in blood cells
- Increased blast percentage
- Hyperproliferative bone marrow
- Increased risk of transformation to AML Answer:
Answer: Cytopenias
Explanation: MDS marrow is usually normo/hypercellular but produces ineffective, dysplastic cells — not a true hyperproliferative state. ---
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Q10. What is the Philadelphia chromosome?
- t(9;22)
- t(15;17)
- t(8;21)
- inv(16)
- t(14;18) Answer:
Answer: t(9;22)
Explanation: Fusion of BCR (ch22) and ABL1 (ch9). ---
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Q11. Most common presenting symptom in acute leukemia?
- Fatigue
- Fever
- Bleeding
- Bone pain
- Lymphadenopathy Answer:
Answer: Fatigue
Explanation: Caused by marrow failure leading to anemia. ---
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Q12. NOT a risk factor for developing MDS?
- Advanced age
- Prior chemotherapy
- Radiation exposure
- Benzene exposure
- Obesity
Answer: Advanced age
Explanation: The others are established marrow-damaging risk factors; obesity is not. ---
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Q13. Most common cause of vitamin B12 deficiency in Western countries?
- Dietary deficiency
- Pernicious anemia
- Malabsorption due to gastrectomy
- Crohn's disease
- Tapeworm infestation Answer:
Answer: Dietary deficiency
Explanation: Autoimmune loss of intrinsic factor is the leading cause in Western populations. ---
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Q14. NOT a typical feature of sickle cell disease?
- Vaso-occlusive crises
- Aplastic crises
- Splenic sequestration
- Hemolytic anemia
- Microcytosis
Answer: Vaso-occlusive crises
Explanation: SCD is a normocytic hemolytic anemia. ---
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Q15. Most common cause of hereditary hemochromatosis?
- HFE gene mutation
- Transferrin receptor 2 mutation
- Ferroportin mutation
- Hepcidin deficiency
- Ceruloplasmin deficiency Answer:
Answer: HFE gene mutation
Explanation: C282Y mutation in HFE accounts for most cases. ---
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Q16. Which best describes the Philadelphia chromosome?
- t(9;22)
- t(15;17)
- t(8;21)
- inv(16)
- t(14;18) Answer:
Answer: t(9;22)
Explanation: Diagnostic translocation for CML. ---
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Q17. Primary growth factor for megakaryocyte differentiation and platelet production?
- Erythropoietin
- Granulocyte colony-stimulating factor
- Thrombopoietin
- Interleukin-3
- Stem cell factor Answer:
Answer: Erythropoietin
Explanation: TPO is the main regulator of megakaryopoiesis and platelet output. ---
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Q18. NOT a typical feature of vitamin B12 deficiency?
- Megaloblastic anemia
- Hypersegmented neutrophils
- Glossitis
- Microcytosis
- Neurological symptoms Answer:
Answer: Megaloblastic anemia
Explanation: B12 deficiency causes macrocytosis, plus unique neurological features (unlike folate deficiency). ---
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Q19. Most common cause of hereditary spherocytosis?
- Spectrin deficiency
- Ankyrin deficiency
- Band 3 deficiency
- Protein 4.1 deficiency
- Glycophorin A deficiency Answer:
Answer: Spectrin deficiency
Explanation: Ankyrin defects (isolated or combined with spectrin) are the most frequent cause. ---
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Q20. Characteristic immunophenotype of chronic lymphocytic leukemia?
- CD5+, CD23+
- CD10+, CD19+
- CD15+, CD30+
- CD103+, CD25+
- CD56+, CD16+ Answer:
Answer: CD5+, CD23+
Explanation: This co-expression pattern (with CD19) is classic for CLL. ---
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Q21. NOT a typical feature of polycythemia vera?
- Increased red cell mass
- JAK2 V617F mutation
- Splenomegaly
- Pruritus after warm bath
- Thrombocytopenia
Answer: Increased red cell mass
Explanation: PV typically causes thrombocytosis, not thrombocytopenia. ---
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Q22. Most common cause of warm autoimmune hemolytic anemia?
- Chronic lymphocytic leukemia
- Systemic lupus erythematosus
- Idiopathic
- Lymphoma
- Mycoplasma pneumoniae infection Answer:
Answer: Chronic lymphocytic leukemia
Explanation: About half of warm AIHA cases have no identifiable underlying cause. ---
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Q23. NOT a typical feature of paroxysmal nocturnal hemoglobinuria?
- Intravascular hemolysis
- Venous thrombosis
- Aplastic anemia
- Positive direct antiglobulin test
- Flow cytometry showing CD55 and CD59 deficiency Answer:
Answer: Intravascular hemolysis
Explanation: PNH hemolysis is complement-mediated, not antibody-mediated, so DAT is negative. ---
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Q24. Primary mechanism of action of imatinib in CML?
- Inhibition of BCR-ABL tyrosine kinase
- Induction of apoptosis through CD20 binding
- Inhibition of DNA synthesis
- Disruption of microtubule function
- Inhibition of mTOR signaling Answer:
Answer: Inhibition of BCR-ABL tyrosine kinase
Explanation: Imatinib is a targeted tyrosine kinase inhibitor against the BCR-ABL fusion protein. ---
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Q25. Characteristic immunophenotype of acute myeloid leukemia?
- CD34+, CD117+, MPO+
- CD19+, CD20+, CD10+
- CD3+, CD5+, CD7+
- CD56+, CD16+, CD57+
- CD138+, CD38+, CD56+ Answer:
Answer: CD34+, CD117+, MPO+
Explanation: MPO positivity confirms myeloid lineage; CD34/CD117 mark blast/progenitor cells. ---
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Q26. NOT a typical feature of beta-thalassemia major?
- Microcytic anemia
- Ineffective erythropoiesis
- Increased HbA2
- Hepatosplenomegaly
- Extramedullary hematopoiesis Answer:
Answer: Microcytic anemia
Explanation: Raised HbA2 is characteristic of thalassemia trait/minor; major shows predominantly elevated HbF. ---
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Q27. Most common cause of acquired factor VIII inhibitors?
- Pregnancy
- Autoimmune disorders
- Malignancy
- Idiopathic
- Drug-induced Answer:
Answer: Pregnancy
Explanation: Most cases of acquired hemophilia have no identifiable trigger. ---
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Q28. Characteristic cytogenetic abnormality in follicular lymphoma?
- t(14;18)
- t(11;14)
- t(8;14)
- t(11;18)
- t(3;14) Answer:
Answer: t(14;18)
Explanation: This translocation juxtaposes BCL2 with the IGH promoter, causing BCL2 overexpression. --- Understood — continuing straight through, full sets, nothing skipped. These are 4 distinct question papers in your scan (different units/exam dates), so I'll label each clearly and complete all of them now. --- # SET 2 — HAEMATOPATHOLOGY (30 Qs) ---
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Q29. Leukemoid reactions are almost always a sign of ---
- Severe malaria
- Septicaemia Severe infection/sepsis is the classic trigger for a leukemoid reaction (WBC >50,000 with left shift).
- Leukemia
- Metastatic cancer Answer:
Answer: Severe malaria
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Q30. True statement concerning staging of non-Hodgkin's lymphoma? ---
- Stage I and II are only confined superior to the diaphragm
- All stages have similar prognosis
- Burkitt's lymphoma is classified as ALL-L3
- CT scan is used in imaging studies CT is standard for staging. (A and B are false; C describes FAB classification, not staging.)
Answer: Stage I and II are only confined superior to the diaphragm
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Q31. Which increases dietary iron uptake via the alimentary canal? ---
- Vitamin C in fruit juice Vitamin C reduces ferric (Fe³⁺) to ferrous (Fe²⁺) iron, greatly enhancing absorption.
- Ligand in meat diet
- Phytates in green vegetables
- Gastric acidity (pH 2) Answer:
Answer: Vitamin C in fruit juice Vitamin C reduces ferric (Fe³⁺) to ferrous (Fe²⁺) iron, greatly enhancing absorption.
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Q32. Abnormality of nuclear segmentation in neutrophils ---
- Chediak-Higashi
- May-Hegglin
- Alder-Reilly
- Pelger-Huet Causes hyposegmented, "pince-nez" bilobed neutrophil nuclei.
Answer: Chediak-Higashi
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Q33. 4-year-old African boy, facial mass, "starry sky" pattern, Burkitt's lymphoma — associated translocation involves ---
- bcl-2
- c-abl
- c-myc t(8;14) places MYC under the IGH promoter, driving Burkitt's lymphoma.
- erb-B
- N-myc Answer:
Answer: bcl-2
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Q34. 70-year-old female, tea-and-toast diet, corkscrew hairs, gum bleeding — deficiency of ---
- Thiamine
- Pyridoxine
- Niacin
- Vitamin D
- Vitamin C Classic scurvy: perifollicular haemorrhage, corkscrew hairs, gingival bleeding from poor diet.
Answer: Thiamine
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Q35. Red cell abnormality most indicative of haemolysis ---
- Target cells
- Acanthocytes
- Schistocytes Fragmented RBCs signal mechanical/microangiopathic haemolysis.
- Basophilic stippling
- Heinz bodies Answer:
Answer: Target cells
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Q36. Markedly decreased blood level most characteristic of intravascular haemolysis ---
- Alkaline phosphatase
- Bilirubin
- Haptoglobin Haptoglobin is consumed mopping up free plasma haemoglobin; it drops sharply.
- Lactate dehydrogenase
- Methemoglobin Answer:
Answer: Alkaline phosphatase
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Q37. Osmotic fragility test — dashed curve (shifted toward higher NaCl%) represents ---
- G6PD deficiency
- Thalassemia
- Hereditary spherocytosis Spherocytes have reduced surface-to-volume ratio, so they lyse at higher (less hypotonic) NaCl…
- Drug-induced haemolytic anaemia
- Normal response Answer:
Answer: G6PD deficiency
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Q38. Two days after primaquine, black man develops intravascular haemolysis, bite cells, Heinz bodies — diagnosis ---
- Hereditary spherocytosis
- G6PD deficiency Classic oxidative-stress haemolysis triggered by primaquine; Heinz bodies = denatured Hb.
- Paroxysmal nocturnal hemoglobinuria
- Autoimmune haemolytic anaemia
- Microangiopathic haemolytic anaemia Answer:
Answer: Hereditary spherocytosis
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Q39. 22-year-old wants to know if he has sickle cell trait — best test ---
- Coombs' test
- Metabisulfite test Sickling/solubility test detects HbS directly.
- Osmotic fragility test
- Schilling test
- Sucrose haemolysis test Answer:
Answer: Coombs' test
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Q40. Single nucleotide change on chromosome 11, valine replaces glutamic acid at position 6 of β-chain — associated with ---
- G6PD deficiency
- Hereditary spherocytosis
- Paroxysmal nocturnal hemoglobinuria
- Sickle cell anaemia This is the exact molecular defect producing HbS.
- Lead poisoning Answer:
Answer: G6PD deficiency
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Q41. 67-year-old male, prostate nodule, elevated PSA, occasional myelocyte, teardrop cells, nucleated RBCs — best diagnosis ---
- Fanconi's anaemia
- Microangiopathic haemolytic anaemia
- Myelopathic anaemia Leukoerythroblastic picture from marrow infiltration (myelophthisis) by metastatic prostate cancer.
- Autoimmune haemolytic anaemia
- Aplastic anaemia Answer:
Answer: Fanconi's anaemia
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Q42. Megaloblasts result from impaired synthesis of ---
- DNA B12/folate deficiency impairs DNA synthesis → nuclear-cytoplasmic asynchrony.
- RNA
- Glutathione
- β-globin chains
- Decay-accelerating factor Answer:
Answer: DNA B12/folate deficiency impairs DNA synthesis → nuclear-cytoplasmic asynchrony.
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Q43. Serum TIBC is inversely proportional to serum levels of ---
- Bilirubin
- Ferritin Low iron stores (low ferritin) trigger increased transferrin synthesis, raising TIBC.
- Haptoglobin
- Hemopexin
- Iron Answer:
Answer: Bilirubin
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Q44. MCV 70fL, MCH 22pg, MCHC 34% — most consistent diagnosis ---
- Note: a normal MCHC alongside a very low MCV can also be seen in thalassaemia trait — worth knowing both patterns for exams.
- Iron-deficiency anaemia (exam-marked answer) Microcytic, hypochromic picture fits ID
- Pernicious anaemia
- Sideroblastic anaemia
- Thalassemia minor Answer:
Answer: Note: a normal MCHC alongside a very low MCV can also be seen in thalassaemia trait — worth knowing both patterns for exams.
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Q45. Sulphonamide-induced antineutrophil antibodies causing neutropenia — expected bone marrow finding ---
- Atrophic spleen
- Decreased vitamin B12 levels
- Hypoplasia of the bone marrow myeloid series
- Hyperplasia of the bone marrow myeloid series Peripheral immune destruction → compensatory marrow hyperplasia (marrow itself is fine).
- A monoclonal large granular lymphocyte proliferation Answer:
Answer: Atrophic spleen
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Q46. Trichinosis, schistosomiasis, strongyloidiasis characteristically elevate peripheral blood ---
- Basophils
- Eosinophils Classic parasitic (helminth) eosinophilia.
- Macrophages
- Neutrophils
- T lymphocytes Answer:
Answer: Basophils
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Q47. Reactive T immunoblasts in viral lymphadenitis are found in which lymph node region? ---
- Hilum
- Medullary sinuses
- Paracortex T-cell dependent zone of the lymph node.
- Primary follicles
- Secondary follicles Answer:
Answer: Hilum
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Q48. Low-grade NHL resembling CLL cells ---
- Diffuse large cell lymphoma
- Follicular large cell lymphoma
- Immunoblastic lymphoma
- Small lymphocytic lymphoma SLL is the tissue counterpart of CLL.
- Small non-cleaved cell lymphoma Answer:
Answer: Diffuse large cell lymphoma
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Q49. Lacunar cells (Reed-Sternberg variant) are specifically found in ---
- Lymphocyte-predominant Hodgkin's disease
- Lymphocyte-depleted Hodgkin's disease
- Mixed-cellularity Hodgkin's disease
- Nodular sclerosis Hodgkin's disease Lacunar cells are the hallmark RS variant of this subtype.
- Anaplastic Hodgkin's disease Answer:
Answer: Lymphocyte-predominant Hodgkin's disease
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Q50. 28-year-old male, ecchymoses, bleeding gums, DIC picture, blasts with numerous Auer rods (38% of marrow) — diagnosis ---
- Acute erythroid leukemia
- Acute lymphoblastic leukemia
- Acute monocytic leukemia
- Acute myelomonocytic leukemia
- Acute promyelocytic leukemia Classic association of APL (AML-M3) with DIC and bundles of Auer rods.
Answer: Acute erythroid leukemia
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Q51. 4-year-old female, 55,000 WBC, 86% immature cells, TdT+, PAS+, acid phosphatase+, MPO– — cells originated from ---
- Myeloblasts
- Monoblasts
- Megakaryoblasts
- Lymphoblasts TdT+ with MPO-negative confirms lymphoid (ALL) lineage.
- Erythroblasts Answer:
Answer: Myeloblasts
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Q52. Hairy cell leukemia — most useful diagnostic stain ---
- Myeloperoxidase stain
- Sudan black B
- Acid phosphatase stain Specifically TRAP (tartrate-resistant acid phosphatase) positivity is classic for hairy cell leukemia.
- Leukocyte alkaline phosphatase
- Nonspecific esterase Answer:
Answer: Myeloperoxidase stain
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Q53. 72-year-old male, lymphadenopathy, hepatosplenomegaly, WBC 72,000, small mature lymphocytes with smudge cells on smear — diagnosis ---
- Acute lymphoblastic leukemia
- Atypical lymphocytosis
- Chronic lymphocytic leukemia Smudge cells + elderly patient + marked lymphocytosis = classic CLL.
- Immunoblastic lymphoma
- Prolymphocytic leukemia Answer:
Answer: Acute lymphoblastic leukemia
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Q54. Morphological classification of anaemias is based on ---
- M:E (myeloid:erythroid) ratio
- RBC numbers
- RBC size Microcytic/normocytic/macrocytic classification is based on MCV (cell size).
- Reticulocyte count
- Bone marrow occupancy Answer:
Answer: M:E (myeloid:erythroid) ratio
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Q55. What is affected in HbS (Haemoglobin S)? ---
- Stability
- Function
- Affinity
- Solubility Deoxygenated HbS polymerizes, dramatically reducing solubility → sickling.
- Morphology Answer:
Answer: Stability
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Q56. The term anisocytosis means ---
- Increased cell size
- Increased cell haemoglobin
- Alteration in cell shape
- Increased variation in cell size (Poikilocytosis = variation in shape, not size — a common mix-up.)
- Variation in cell patterns Answer:
Answer: Increased cell size
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Q57. During which childhood age is onset of acute lymphoblastic leukemia most frequent? ---
- 10-12 years
- The neonatal period
- Adolescence
- 3-5 years Peak incidence of childhood ALL is around age 2-5 years. --- # SET 3 — MBML BLOOD TRANSFUSION (CAT 2, June 2025) (30 Qs)
- 16 years Answer:
Answer: 10-12 years
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Q58. Which coagulation factor is deficient in Hemophilia A? ---
- Factor VIII Hemophilia A = Factor VIII deficiency; Hemophilia B ("Christmas disease") = Factor IX.
- Factor IX
- Factor XI
- Factor VII
- Factor XIII Answer:
Answer: Factor VIII Hemophilia A = Factor VIII deficiency; Hemophilia B ("Christmas disease") = Factor IX.
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Q59. Most common cause of prolonged PT with normal aPTT ---
- Hemophilia A
- Factor VII deficiency Factor VII is unique to the extrinsic pathway, measured only by PT.
- Von Willebrand disease
- Lupus anticoagulant
- Heparin therapy Answer:
Answer: Hemophilia A
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Q60. Blood product for thrombocytopenia with active bleeding ---
- Fresh frozen plasma
- Packed red blood cells
- Platelet concentrate Directly replaces the deficient platelets.
- Cryoprecipitate
- Albumin Answer:
Answer: Fresh frozen plasma
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Q61. The crossmatch test primarily detects ---
- ABO incompatibility
- Rh incompatibility
- Irregular antibodies ABO/Rh are already known from typing; the crossmatch's main extra value is catching unexpected/irregular…
- All of the above
- None of the above Answer:
Answer: ABO incompatibility
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Q62. Emergency transfusion, blood type unknown — which product should be given? ---
- AB positive packed RBCs
- O negative packed RBCs Universal donor RBCs, safest when type is unknown (especially in women of childbearing age).
- AB positive fresh frozen plasma
- O positive packed RBCs Answer:
Answer: AB positive packed RBCs
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Q63. Cryoprecipitate contains high concentrations of all EXCEPT ---
- Fibrinogen
- Factor VIII
- Factor XIII
- Von Willebrand factor
- Factor IX Cryoprecipitate = fibrinogen, FVIII, FXIII, vWF, fibronectin — not Factor IX.
Answer: Fibrinogen
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Q64. A positive direct antiglobulin test (DAT) indicates ---
- Antibodies in patient's serum
- Antibodies bound to patient's RBCs DAT (direct Coombs) detects antibody/complement already coating the patient's own RBCs.
- ABO incompatibility
- Rh incompatibility
- Hemolytic transfusion reaction Answer:
Answer: Antibodies in patient's serum
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Q65. Most serious immediate complication of blood transfusion ---
- Febrile non-hemolytic reaction
- Allergic reaction
- Acute hemolytic reaction Usually ABO-mismatch mediated — can be rapidly fatal.
- Transfusion-associated circulatory overload
- Delayed hemolytic reaction Answer:
Answer: Febrile non-hemolytic reaction
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Q66. Most sensitive lab test for detecting DIC ---
- Platelet count
- Fibrinogen level
- D-dimer Highly sensitive (though not specific) for ongoing fibrinolysis/DIC.
- PT/aPTT
- Factor assays Answer:
Answer: Platelet count
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Q67. Von Willebrand disease is characterized by ---
- Prolonged PT only
- Prolonged aPTT only
- Prolonged bleeding time and aPTT vWF deficiency impairs platelet adhesion (↑bleeding time) and stabilizes Factor VIII (↑aPTT).
- Prolonged PT and aPTT
- Normal coagulation tests Answer:
Answer: Prolonged PT only
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Q68. Mechanism of action of warfarin ---
- Direct thrombin inhibition
- Factor Xa inhibition
- Vitamin K antagonism Blocks synthesis of factors II, VII, IX, X (and proteins C/S).
- Platelet aggregation inhibition
- Fibrinogen depletion Answer:
Answer: Direct thrombin inhibition
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Q69. A patient on heparin therapy should be monitored using ---
- PT/INR
- aPTT Unfractionated heparin acts on the intrinsic pathway, monitored by aPTT.
- Bleeding time
- Platelet count
- D-dimer Answer:
Answer: PT/INR
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Q70. Heparin-induced thrombocytopenia (HIT) typically occurs ---
- Within 24 hours
- 5-10 days after starting heparin Immune-mediated (anti-PF4/heparin antibodies) — onset delayed, not immediate.
- After 3 weeks of therapy
- Only with high-dose heparin
- Only with low molecular weight heparin Answer:
Answer: Within 24 hours
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Q71. Which blood group system is most important after ABO and Rh? ---
- Kell Highly immunogenic; second most clinically significant system after ABO/Rh.
- Duffy
- Kidd
- MNS
- Diego Answer:
Answer: Kell Highly immunogenic; second most clinically significant system after ABO/Rh.
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Q72. The ratio of FFP:Platelets:RBCs in massive transfusion protocol is typically ---
- 1:1:1 Balanced resuscitation ratio, shown to reduce mortality in trauma.
- 1:1:2
- 1:2:3
- 2:1:3
- 1:1:4 Answer:
Answer: 1:1:1 Balanced resuscitation ratio, shown to reduce mortality in trauma.
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Q73. Antithrombin III deficiency predisposes to ---
- Bleeding disorders
- Thrombotic disorders AT-III normally inhibits thrombin and Factor Xa; deficiency = hypercoagulable state.
- Platelet dysfunction
- Hemolytic anemia
- Iron deficiency Answer:
Answer: Bleeding disorders
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Q74. The most common inherited bleeding disorder is ---
- Hemophilia A
- Hemophilia B
- Von Willebrand disease Most common inherited bleeding disorder overall (~1% of population).
- Factor V Leiden
- Protein C deficiency Answer:
Answer: Hemophilia A
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Q75. Factor V Leiden mutation causes ---
- Bleeding tendency
- Resistance to activated protein C Mutated Factor V can't be cleaved/inactivated normally by activated protein C → thrombophilia.
- Warfarin resistance
- Heparin resistance
- Platelet dysfunction Answer:
Answer: Bleeding tendency
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Q76. Transfusion-related acute lung injury (TRALI) is most commonly caused by ---
- Bacterial contamination
- Volume overload
- Donor antibodies against recipient leukocytes Anti-HLA/anti-neutrophil antibodies in donor plasma trigger pulmonary leukocyte…
- ABO incompatibility
- Viral contamination Answer:
Answer: Bacterial contamination
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Q77. The shelf life of platelet concentrates at room temperature is ---
- 3 days
- 5 days Stored at room temp with agitation; limited shelf life due to bacterial contamination risk.
- 7 days
- 14 days
- 21 days Answer:
Answer: 3 days
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Q78. Which factor is NOT part of the intrinsic coagulation pathway? ---
- Factor VIII
- Factor IX
- Factor XI
- Factor VII Factor VII belongs to the extrinsic pathway (tissue factor pathway).
- Factor XII Answer:
Answer: Factor VIII
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Q79. Protein S functions as a cofactor for ---
- Protein C Protein S enhances activated Protein C's ability to inactivate Factors Va and VIIIa.
- Antithrombin III
- Factor V
- Factor VIII
- Plasminogen Answer:
Answer: Protein C Protein S enhances activated Protein C's ability to inactivate Factors Va and VIIIa.
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Q80. The most common cause of acquired coagulation disorder is ---
- Liver disease Liver synthesizes nearly all clotting factors; hepatic dysfunction is the leading acquired cause overall.
- Vitamin K deficiency
- DIC
- Massive transfusion
- Medication-induced Answer:
Answer: Liver disease Liver synthesizes nearly all clotting factors; hepatic dysfunction is the leading acquired cause overall.
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Q81. Leukoreduction of blood products primarily prevents ---
- Hemolytic reactions
- Febrile non-hemolytic reactions Removes donor leukocytes/cytokines responsible for these fevers.
- Allergic reactions
- TRALI
- Bacterial contamination Answer:
Answer: Hemolytic reactions
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Q82. The normal platelet count range is ---
- 50,000-100,000/μL
- 100,000-300,000/μL
- 150,000-450,000/μL Standard accepted normal range.
- 200,000-500,000/μL
- 300,000-600,000/μL Answer:
Answer: 50,000-100,000/μL
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Q83. Which condition requires irradiated blood products? ---
- Immunocompromised patients
- Intrauterine transfusion
- Patients receiving directed donations from relatives
- All of the above All carry risk of transfusion-associated graft-versus-host disease; irradiation inactivates donor lymphocytes.
- None of the above Answer:
Answer: Immunocompromised patients
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Q84. Post-transfusion purpura typically occurs ---
- Within 24 hours
- 5-10 days post-transfusion Anti-platelet alloantibody (commonly anti-HPA-1a) mediated destruction, delayed onset ~1 week. --- # SET…
- 2-3 weeks post-transfusion
- Only in males
- Only with platelet transfusions Answer:
Answer: Within 24 hours
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Q85. What is haemostasis? ---
- Production of new blood cells
- Process by which bleeding stops from damaged blood vessels
- Normal body condition
- None of the above Answer:
Answer: Production of new blood cells
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Q86. Which vitamin is essential for synthesis of several coagulation factors? ---
- Vitamin C
- Vitamin B
- Vitamin D
- Vitamin K Needed for γ-carboxylation of factors II, VII, IX, X.
Answer: Vitamin C
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Q87. Fibrinogen is also known as which coagulation factor? ---
- Factor XIII
- Factor I
- Factor II
- Factor III Answer:
Answer: Factor XIII
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Q88. NOT one of the four major physiologic events of haemostasis ---
- Fibrinolysis The core haemostatic sequence is vascular spasm → platelet plug → coagulation; fibrinolysis is the later…
- Platelet plug formation
- Vasoconstriction
- Coagulation Answer:
Answer: Fibrinolysis The core haemostatic sequence is vascular spasm → platelet plug → coagulation; fibrinolysis is the later…
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Q89. First step in haemostasis when a blood vessel is injured ---
- Platelet plug formation
- Vascular spasm
- Coagulation
- Fibrinolysis Answer:
Answer: Platelet plug formation
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Q90. Mineral essential for the clotting process ---
- Sodium
- Phospholipid
- Iron
- Calcium Factor IV; required cofactor at multiple steps of the cascade.
Answer: Sodium
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Q91. Deficiency of factor VIII leads to which disorder? ---
- Hemolysis
- Hemophilia A
- Hemophilia B
- Thrombocytopenia Answer:
Answer: Hemolysis
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Q92. Which factor is known as the "Christmas factor"? ---
- Factor IX Named after Stephen Christmas, first patient diagnosed with Hemophilia B.
- Factor VIII
- Factor X
- Factor VII Answer:
Answer: Factor IX Named after Stephen Christmas, first patient diagnosed with Hemophilia B.
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Q93. Which of the following is a natural anticoagulant? ---
- Heparin Endogenous heparan sulfate/heparin potentiates antithrombin III.
- Factor VII
- Factor IX
- Fibrinogen Answer:
Answer: Heparin Endogenous heparan sulfate/heparin potentiates antithrombin III.
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Q94. Main function of von Willebrand factor ---
- Activates fibrinogen
- Binds platelets to collagen Mediates platelet adhesion to exposed subendothelial collagen; also stabilizes Factor VIII.
- Inhibits thrombin
- Cross-links fibrin Answer:
Answer: Activates fibrinogen
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Q95. Which test screens for platelet and blood vessel function? ---
- RBC count
- CBC
- Bleeding time
- APTT Answer:
Answer: RBC count
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Q96. Which pathway does warfarin primarily affect? ---
- Intrinsic
- Extrinsic Factor VII (extrinsic pathway) has the shortest half-life, so PT/INR (extrinsic) is most sensitive to warfarin, though all…
- Common
- Fibrinolytic Answer:
Answer: Intrinsic
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Q97. What is the end product of the coagulation cascade? ---
- Platelet plug
- Soluble fibrinogen
- Insoluble fibrin clot
- Plasmin Answer:
Answer: Platelet plug
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Q98. Which factor stabilizes the fibrin clot by cross-linking fibrin? ---
- Factor Xa
- Factor XIIIa Fibrin-stabilizing factor — cross-links fibrin monomers into a stable clot.
- Factor IIa
- Factor VIIIa Answer:
Answer: Factor Xa
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Q99. Which of the following is responsible for fibrinolysis? ---
- Tissue plasminogen activator Converts plasminogen to plasmin, which degrades fibrin.
- Factor XIII
- Tissue factor
- Phospholipid Answer:
Answer: Tissue plasminogen activator Converts plasminogen to plasmin, which degrades fibrin.
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Q100. Which color vial is used for coagulation studies? ---
- Red
- Purple
- Light blue Sodium citrate anticoagulant tube, used for PT/aPTT.
- Green Answer:
Answer: Red
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Q101. What is the main cause of increased PT (prothrombin time)? ---
- Increased factor VII
- Increased factor VIII
- Decreased factor VII Factor VII deficiency (or early warfarin effect) prolongs PT specifically.
- Decreased factor I Answer:
Answer: Increased factor VII
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Q102. Which of the following is NOT released by activated platelets? ---
- Serotonin
- ADP
- Urea Serotonin, ADP, and Ca²⁺ are all released from platelet dense granules; urea is not a platelet product.
- Ca²⁺ ions Answer:
Answer: Serotonin
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Q103. What is the function of antithrombin III? ---
- Activates platelets
- Inhibits thrombin Also inhibits Factor Xa; potentiated by heparin.
- Cross-links fibrin
- Activates factor VII Answer:
Answer: Activates platelets
-
Q104. Which test is used to monitor heparin therapy? ---
- APTT
- Bleeding time
- Thrombin time Answer:
Answer: APTT
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Q105. What is the main abnormality in von Willebrand disease? ---
- Platelet deficiency
- Lack of von Willebrand factor
- Factor IX deficiency
- Excess fibrinogen Answer:
Answer: Platelet deficiency
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Q106. Which of the following is NOT a step in haemostasis? ---
- Vascular spasm
- Platelet plug formation
- Leukocyte migration Part of inflammation, not the haemostatic sequence.
- Coagulation Answer:
Answer: Vascular spasm
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Q107. Which factor converts prothrombin to thrombin? ---
- Factor VII
- Factor Xa Prothrombinase complex (Factor Xa + Va + Ca²⁺ + phospholipid) converts prothrombin (II) to thrombin (IIa).
- Factor XIII
- Factor IX Answer:
Answer: Factor VII
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Q108. Which of the following is a screening test for the extrinsic pathway?
- APTT
- Bleeding time
- Thrombin time Answer:
Answer: APTT