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Hematology, Rodaks, 1

Total questions: 38

Worksheet time: 19mins

Name
Class
Date
1.

The megakaryocyte progenitor that undergoes endomitosis is:

a)

MK-I

b)

BFU-Meg

c)

CFU-Meg

d)

LD-CFU-Meg

2.

The growth factor that is produced in the kidney and induces growth and differentiation of committed megakaryocyte progenitors is:

a)

IL-3

b)

IL-6

c)

IL-11

d)

TPO

3.

What platelet organelle sequesters ionic calcium and binds a series of enzymes of the eicosanoid pathway?

a)

Dense granules

b)

Alpha-Granules

c)

Dense Tubular System

d)

SCCS

4.

What platelet membrane receptor binds fibrinogen and

supports platelet aggregation?

a)

GP Ib/IX/V

b)

GP IIb/IIIa

c)

GP Ia/IIa

d)

P2Y1

5.

What platelet membrane phospholipid flips from the inner

surface to the plasma surface on activation and serves as the assembly point for coagulation factors?

a)

Phosphatidylethanolamine

b)

Phosphatidylinositol

c)

Phosphatidylcholine

d)

Phosphatidylserine

6.

What is the name of the eicosanoid metabolite produced from endothelial cells that suppresses platelet activity?

a)

TXA2

b)

Arachidonic Acid

c)

COX-1

d)

Prostacyclin

e)

PGI2

7.

Which of the following molecules is stored in platelet dense granules?

a)

Serotonin

b)

Fibrinogen

c)

Platelet Factor 4

d)

Platelet-derived growth factor

8.

What plasma protein is essential to platelet adhesion?

a)

VWF

b)

Factor VIII

c)

Fibrinogen

d)

P-selectin

9.

Reticulated platelets can be enumerated in peripheral blood to detect:

a)

Impaired production in disease states

b)

Abnormal organelles associated with diseases such as

leukemia

c)

Increased platelet production in response to need

d)

Inadequate rates of membrane cholesterol exchange with the plasma

10.

Platelet adhesion refers to platelets:

a)

Sticking to other platelets

b)

Releasing platelet granule constituents

c)

Providing the surface for assembly of coagulation factors

d)

Sticking to surfaces such as subendothelial collagen

11.

What intimal cell synthesizes and stores VWF?

a)

Smooth muscle cell

b)

Endothelial cell

c)

Fibroblast

d)

Platelet

12.

What subendothelial structural protein triggers coagulation through activation of factor VII?

a)

Thrombomodulin

b)

Nitric oxide

c)

Tissue factor

d)

Thrombin

13.

What coagulation plasma protein should be assayed when platelets fail to aggregate properly?

a)

Factor VIII

b)

Fibrinogen

c)

Thrombin

d)

Factor X

14.

What role does vitamin K play for the prothrombin group

factors?

a)

Provides a surface on which the proteolytic reactions of the factors occur

b)

Protects them from inappropriate activation by compounds such as thrombin

c)

Accelerates the binding of the serine proteases and their cofactors

d)

Carboxylates the factors to allow calcium binding

15.

What is the source of fibrinopeptides A and B?

a)

Plasmin proteolysis of fibrin polymer

b)

Thrombin proteolysis of fibrinogen

c)

Proteolysis of prothrombin by factor Xa

d)

Plasmin proteolysis of cross-linked fibrin

16.

What serine protease forms a complex with factor VIIIa, and what is the substrate of this complex?

a)

Factor VIIa, factor X

b)

Factor Va, prothrombin

c)

Factor Xa, prothrombin

d)

Factor IXa, factor X

17.

What protein secreted by endothelial cells activates fibrinolysis?

a)

Plasminogen

b)

Tissue plasminogen activator (TPA)

c)

Plasminogen activator inhibitor-1 (PAI-1)

d)

Carboxypeptidase B2 (CPB2) / (TAFI)

18.

What two regulatory proteins form a complex that digests activated factors V and VIII?

a)

TFPI and Xa

b)

Antithrombin and protein C

c)

Activated protein C (APC) and protein S

d)

Thrombomodulin and plasmin

19.

Coagulation factor VIII circulates bound to:

a)

VWF

b)

Factor IX

c)

Platelets

d)

Factor V

20.

Most coagulation factors are synthesized in:

a)

The liver

b)

Monocytes

c)

Endothelial cells

d)

Megakaryocytes

21.

Iron is transported in plasma via:

a)

Hemosiderin

b)

Ferritin

c)

Transferrin

d)

Hemoglobin

22.

What is the major metabolically available storage form of iron in the body?

a)

Hemosiderin

b)

Ferritin

c)

Transferrin

d)

Hemoglobin

23.

The total iron-binding capacity (TIBC) of the serum is an indirect measure of which iron-related protein?

a)

Hemosiderin

b)

Ferritin

c)

Transferrin

d)

Hemoglobin

24.

For a patient with classic iron study values that are equivocal for iron deficiency, which of the following tests would be most helpful in determining whether iron deficiency is present or not?

a)

Zinc protoporphyrin

b)

Peripheral blood sideroblast assessment

c)

Soluble transferrin receptor

d)

Mean cell hemoglobin

25.

What membrane-associated protein in enterocytes transports iron from the intestinal lumen into the enterocyte?

a)

Transferrin

b)

Ferroportin

c)

DMT1

d)

Ferrochelatase

26.

Iron is transported out of macrophages, hepatocytes, and enterocytes by what membrane protein?

a)

Transferrin

b)

Ferroportin

c)

DMT1

d)

Ferrochelatase

27.

Below are several of the many steps in the process from absorption and transport of iron to incorporation into heme. Place them in proper order.

i) Transferrin picks up ferric iron.

ii) Iron is transferred to the mitochondria.

iii) DMT1 transports ferrous iron into the enterocyte.

iv) Ferroportin transports iron from enterocyte to plasma.

v) The transferrin receptor transports iron into the cell.

a)

v, iv, i, ii, iii

b)

iii, ii, iv, i, v

c)

ii, i, v, iii, iv

d)

iii, iv, i, v, ii

28.

What is the fate of the transferrin receptor when it has completed its role in the delivery of iron to a cell?

a)

It is recycled to the plasma membrane and released into the plasma.

b)

It is recycled to the plasma membrane, where it can bind its ligand again.

c)

It is catabolized and the amino acids are returned to the metabolic pool.

d)

It is retained in the endosome for the life span of the cell.

29.

The transfer of iron from the enterocyte into the plasma is REGULATED by:

a)

Transferrin

b)

Ferroportin

c)

Hephaestin

d)

Hepcidin

30.

Into which quadrant of a Thomas plot would a patient’s results fall with the following test results:


Soluble transferrin receptor: increased above reference interval Ferritin: decreased below reference interval

Hemoglobin content of reticulocytes: within the reference interval

a)

Normal iron status

b)

Latent iron deficiency

c)

Functional iron deficiency

d)

Iron deficiency

31.

A physician is concerned that a patient is developing iron deficiency from chronic intestinal bleeding due to aspirin use for rheumatoid arthritis. The iron studies on the patient show the following results above. How would these results be interpreted?

a)

Latent iron deficiency

b)

Functional iron deficiency

c)

Iron deficiency

d)

Equivocal for iron deficiency

32.

During the second trimester of fetal development, the primary site of blood cell production is the:

a)

Bone marrow

b)

Spleen

c)

Lymph nodes

d)

Liver

33.

The best source of active bone marrow from a 20-year-old would be:

a)

Iliac crest

b)

Femur

c)

Distal radius

d)

Tibia

34.

Which one of the following morphologic changes occurs during normal blood cell maturation:

a)

Increase in cell diameter

b)

Development of cytoplasm basophilia

c)

Condensation of nuclear chromatin

d)

Appearance of nucleoli

35.

Which one of the following cells is a product of the CLP?

a)

Megakaryocyte

b)

T lymphocyte

c)

Erythrocyte

d)

Granulocyte

36.

Which one of the following cytokines is required very early

in the differentiation of a hematopoietic stem cell?

a)

IL-2

b)

IL-8

c)

EPO

d)

FLT3 Ligand

37.

When a patient has severe anemia and the bone marrow is unable to effectively produce red blood cells to meet the increased demand, one of the body’s responses is:

a)

Extramedullary hematopoiesis in the liver and spleen

b)

Decreased production of erythropoietin by the kidney

c)

Increased apoptosis of erythrocyte progenitor cells

d)

Increase the proportion of yellow marrow in the long bones

38.

Hematopoietic stem cells produce all lineages of blood cells in sufficient quantities over the lifetime of an individual because they:

a)

Are unipotent

b)

Have the ability of self-renewal by asymmetric division

c)

Are present in large numbers in the bone marrow niches

d)

Have a low mitotic potential in response to growth

factors