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Physio Block 5 - Hema Pt. 3

Total questions: 100

Worksheet time: 50mins

Name
Class
Date
1.

Clonal selection occurs when a B lymphocyte encounters:

a)

Chemotactic factors

b)

Cytokines

c)

T lymphocytes

d)

Antigen

2.

The titers of agglutinins in human blood usually reach their highest level at:

a)

Immediately at birth

b)

Infancy

c)

Late childhood to adolescence

d)

Middle age

3.

Which immunoglobulin crosses the placenta to provide passive immunity to the fetus?

a)

IgA

b)

IgM

c)

IgE

d)

IgG

4.

The basic immunoglobulin unit is composed of:

a)

Two different heavy and two different light chains

b)

Two identical heavy and two identical light chains

c)

Two identical heavy and two different light chains

d)

Two different heavy and two identical light chains

5.

Immunologic unresponsiveness to self-antigens is known as:

a)

Diversity

b)

Memory

c)

Clonal expansion

d)

Tolerance

6.

Presentation of antigen via MHC class I molecules results in activation of:

a)

Helper T cells

b)

B lymphocytes

c)

Macrophages

d)

Cytotoxic T cells

7.

Cell-mediated adaptive immunity is primarily carried out by:

a)

Neutrophils

b)

B cells

c)

Macrophages

d)

T cells

8.

Acute inflammation is characterized mainly by the influx of:

a)

Lymphocytes

b)

Macrophages

c)

Plasma cells

d)

Neutrophils

9.

Which hypersensitivity reaction is NOT transferable by serum?

a)

Type I

b)

Type II

c)

Type III

d)

Type IV

10.

Which immunoglobulin is most involved in anaphylaxis?

a)

IgA

b)

IgE

c)

IgG

d)

IgM

11.

The most lethal complication of an acute transfusion reaction is:

a)

Agglutination

b)

Hemolysis

c)

Sepsis

d)

Renal failure

12.

The coagulation pathway initiated by tissue thromboplastin is the:

a)

Intrinsic pathway

b)

Extrinsic pathway

c)

Common pathway

d)

Fibrinolytic pathway

13.

Which test evaluates the extrinsic coagulation pathway?

a)

Bleeding time

b)

Clotting time

c)

PTT

d)

PT (INR)

14.

Hemophilia A is caused by deficiency of:

a)

Factor IX

b)

Factor VII

c)

Factor VIII

d)

Factor XIII

15.

Which factor stabilizes the fibrin clot?

a)

Factor X

b)

Thrombin

c)

Factor XIII

d)

Calcium

16.

The most essential regulator of red blood cell production is:

a)

Anemia

b)

Vitamin B12

c)

Erythropoietin

d)

Tissue oxygenation

17.

The major source of erythropoietin in adults is the:

a)

Liver

b)

Spleen

c)

Bone marrow

d)

Kidney

18.

The most common cause of iron deficiency anemia worldwide is:

a)

Malabsorption

b)

Poor dietary intake

c)

Increased hemolysis

d)

Chronic blood loss

19.

Which vitamin deficiency leads to megaloblastic anemia?

a)

Vitamin K

b)

Vitamin A

c)

Vitamin B12

d)

Vitamin C

20.

Removal of the ileum most likely causes anemia due to deficiency of:

a)

Iron

b)

Folate

c)

Vitamin B12

d)

Vitamin K

21.

Reticulocytes normally comprise what percentage of circulating RBCs?

a)

0–0.1%

b)

0.5–2%

c)

5–10%

d)

10–15%

22.

The first identifiable cell in erythropoiesis is the:

a)

Reticulocyte

b)

Erythrocyte

c)

Erythroblast

d)

Proerythroblast

23.

A rise in hematocrit without an increase in RBC mass is termed:

a)

Absolute polycythemia

b)

Secondary polycythemia

c)

Relative polycythemia

d)

Physiologic polycythemia

24.

Physiologic polycythemia is most commonly seen in:

a)

Chronic smokers

b)

Heart failure patients

c)

Deep sea divers

d)

People living at high altitude

25.

Which leukocyte is most involved in parasitic infections?

a)

Neutrophil

b)

Basophil

c)

Eosinophil

d)

Monocyte

26.

The most abundant leukocyte in peripheral blood is the:

a)

Lymphocyte

b)

Monocyte

c)

Eosinophil

d)

Neutrophil

27.

Which cytokine primarily activates macrophages?

a)

IL-4

b)

IL-5

c)

IFN-γ

d)

TNF-β

28.

Delayed-type hypersensitivity reactions peak at:

a)

1–2 hours

b)

6–8 hours

c)

12–18 hours

d)

24–48 hours

29.

The immune mechanism responsible for graft rejection is mainly:

a)

Humoral immunity

b)

Complement activation

c)

Cell-mediated immunity

d)

Innate immunity

30.

Cyclosporine prevents graft rejection by:

a)

Destroying lymphoid tissue

b)

Blocking complement

c)

Acting as IL-2 receptor antibody

d)

Inhibiting T-helper cell activation

31.

Which cell presents antigen to both CD4 and CD8 T cells?

a)

Neutrophil

b)

Eosinophil

c)

Basophil

d)

Dendritic cell

32.

MHC class II molecules are expressed on:

a)

All nucleated cells

b)

Virally infected cells

c)

Professional antigen-presenting cells

d)

Platelets

33.

Antigen processing of intravesicular antigens utilizes:

a)

CD8 T cells

b)

CD4 T cells

c)

MHC class I

d)

MHC class II

34.

Which antibody activates complement most efficiently?

a)

IgA

b)

IgM

c)

IgE

d)

IgD

35.

The membrane attack complex consists of:

a)

C3b

b)

C1q

c)

C5a

d)

C5b–C9

36.

Binding of antibody and complement to microbes to enhance phagocytosis is called:

a)

Chemotaxis

b)

Opsonization

c)

Diapedesis

d)

Signal transduction

37.

Which WBC survives for months after phagocytosis?

a)

Neutrophil

b)

Eosinophil

c)

Basophil

d)

Macrophage

38.

The primary site of platelet destruction is the:

a)

Liver

b)

Bone marrow

c)

Spleen

d)

Kidney

39.

Which condition prolongs bleeding time but has normal clotting time?

a)

Hemophilia A

b)

Vitamin K deficiency

c)

Thrombocytopenia

d)

DIC

40.

The intrinsic coagulation pathway is initiated by exposure to:

a)

Tissue factor

b)

Collagen

c)

Fibrin

d)

Prothrombin

41.

Vitamin K is required for hepatic synthesis of:

a)

Fibrin

b)

Fibrinogen

c)

Globulin

d)

Prothrombin

42.

Body iron is stored primarily in the form of:

a)

Hemoglobin

b)

Cytochrome

c)

Hemosiderin

d)

Ferritin

43.

Plasminogen deficiency predisposes to:

a)

Increased bleeding

b)

Hypocoagulation

c)

Increased fibrinolysis

d)

Thrombosis

44.

The major function of red blood cells is:

a)

Acid-base buffering

b)

Immune defense

c)

CO2 hydration reaction

d)

Transport of hemoglobin

45.

Which platelet factor causes vasoconstriction?

a)

ADP

b)

Thromboxane A₂

c)

Serotonin

d)

Fibrinogen

46.

What prevents clotting of blood within intact vessels?

a)

Fibrin

b)

Serotonin

c)

Fibrinogen

d)

Heparin

47.

Which antibody is most abundant in secretions such as saliva and breast milk?

a)

IgG

b)

IgM

c)

IgA

d)

IgE

48.

Protection against intracellular microorganisms is provided by:

a)

Antibodies

b)

Complement

c)

Cell-mediated immunity

d)

Innate immunity alone

49.

The T-helper subset responsible for eosinophil-mediated immunity is:

a)

TH1

b)

TH2

c)

TH17

d)

TH4

50.

Which graft is almost always associated with immune rejection?

a)

Autograft

b)

Isograft

c)

Allograft

d)

Xenograft

51.

Which immunologic mechanism is responsible for erythroblastosis fetalis?

a)

Cytokine release from T cells

b)

Antibody to cell surface antigens

c)

Soluble immune complexes

d)

IgE-mediated reaction

52.

An Rh-negative mother is most likely to develop antibodies against Rh antigen during:

a)

The first pregnancy with an Rh-positive fetus

b)

The second pregnancy with an Rh-positive fetus

c)

Any pregnancy regardless of Rh status

d)

Only during delivery

53.

Which Rh genotype combination can produce an Rh-negative offspring?

a)

DD × DD

b)

DD × Dd

c)

Dd × Dd

d)

DD × dd

54.

Which immunoglobulin is primarily produced during the primary immune response?

a)

IgG

b)

IgA

c)

IgE

d)

IgM

55.

Secondary immune responses are more effective primarily because of:

a)

Complement activation

b)

Mast cell degranulation

c)

Clonal selection

d)

Immunologic memory

56.

Which cell type is the effector cell of humoral immunity?

a)

Helper T cell

b)

Cytotoxic T cell

c)

Plasma cell

d)

Macrophage

57.

Which immune cell releases histamine during allergic reactions?

a)

Eosinophil

b)

Neutrophil

c)

Mast cell

d)

Macrophage

58.

Which complement fragment is a potent chemotactic factor?

a)

C3b

b)

C1q

c)

C5a

d)

C9

59.

Which WBC count is expected to increase most during bacterial infection?

a)

Lymphocytes

b)

Neutrophils

c)

Eosinophils

d)

Basophils

60.

Which leukocyte count is most elevated in viral infections?

a)

Neutrophils

b)

Eosinophils

c)

Lymphocytes

d)

Basophils

61.

The main reservoir of monocytes is the:

a)

Blood

b)

Bone marrow

c)

Spleen

d)

Lymph nodes

62.

Diapedesis refers to the process of:

a)

Phagocytosis

b)

Chemotaxis

c)

Opsonization

d)

WBC passage through vessel walls

63.

Which factor initiates the intrinsic coagulation pathway?

a)

Tissue factor

b)

Collagen exposure

c)

Thrombin

d)

Prothrombin

64.

Which laboratory test primarily evaluates platelet function?

a)

PT

b)

PTT

c)

Bleeding time

d)

INR

65.

Which coagulation factor is deficient in Hemophilia B?

a)

Factor VIII

b)

Factor IX

c)

Factor XI

d)

Factor XIII

66.

The prothrombinase complex consists of factor Xa, calcium, and:

a)

Factor IXa

b)

Factor IIa

c)

Factor Va

d)

Factor XIIIa

67.

Which condition results in decreased erythropoietin production?

a)

Chronic hypoxia

b)

High altitude

c)

Chronic kidney disease

d)

Polycythemia vera

68.

Polycythemia vera is characterized by:

a)

Increased erythropoietin levels

b)

Secondary hypoxia

c)

Bone marrow hyperplasia

d)

Reduced RBC mass

69.

Which RBC morphology is expected in iron deficiency anemia?

a)

Macrocytic normochromic

b)

Microcytic hypochromic

c)

Normocytic normochromic

d)

Macrocytic hyperchromic

70.

Which anemia is caused by antigen–antibody reaction?

a)

Aplastic anemia

b)

Sickle cell anemia

c)

Hereditary spherocytosis

d)

Erythroblastosis fetalis

71.

Which antibody class does not activate complement?

a)

IgG

b)

IgM

c)

IgA

d)

None of the above

72.

Which immune response provides defense against extracellular bacteria?

a)

Cell-mediated immunity

b)

Humoral immunity

c)

Innate immunity only

d)

NK cell activity

73.

Which cell is responsible for antibody production?

a)

B lymphocyte

b)

Plasma cell

c)

Helper T cell

d)

Macrophage

74.

Which graft involves transplantation between genetically identical individuals?

a)

Allograft

b)

Xenograft

c)

Isograft

d)

Autograft

75.

Which graft has the least risk of immune rejection?

a)

Xenograft

b)

Allograft

c)

Isograft

d)

Autograft

76.

Which cytokine is most important in fever production?

a)

IL-2

b)

IL-4

c)

IL-1

d)

IFN-γ

77.

Which immune cell is most effective at antigen presentation?

a)

B cell

b)

Macrophage

c)

Dendritic cell

d)

Neutrophil

78.

Which immunoglobulin is predominant in colostrum?

a)

IgG

b)

IgM

c)

IgA

d)

IgE

79.

Which antibody is produced in allergic sensitization?

a)

IgG

b)

IgM

c)

IgE

d)

IgA

80.

Which factor converts fibrinogen to fibrin?

a)

Factor X

b)

Thrombin

c)

Factor XIII

d)

Plasmin

81.

Which enzyme dissolves fibrin clots?

a)

Thrombin

b)

Plasmin

c)

Prothrombin

d)

Factor XIII

82.

Tissue plasminogen activator (tPA) is selective for:

a)

Free plasminogen

b)

Platelet-bound plasminogen

c)

Fibrin-bound plasminogen

d)

Circulating thrombin

83.

Which condition causes prolonged PTT with normal PT?

a)

Vitamin K deficiency

b)

Hemophilia A

c)

Liver disease

d)

DIC

84.

Which factor deficiency leads to unstable clots?

a)

Factor VIII

b)

Factor X

c)

Factor XIII

d)

Factor VII

85.

Which RBC index reflects hemoglobin concentration per cell?

a)

MCV

b)

MCHC

c)

RDW

d)

Hematocrit

86.

Which blood group has both anti-A and anti-B antibodies?

a)

Type A

b)

Type B

c)

Type AB

d)

Type O

87.

Which blood type is considered the universal donor for RBCs?

a)

AB positive

b)

O positive

c)

O negative

d)

AB negative

88.

Which blood type is the universal recipient?

a)

O negative

b)

O positive

c)

A positive

d)

AB positive

89.

Which WBC releases major basic protein?

a)

Neutrophil

b)

Eosinophil

c)

Basophil

d)

Monocyte

90.

Which immune mechanism explains delayed hypersensitivity?

a)

Antibody-mediated immunity

b)

Immune complexes

c)

T-cell mediated immunity

d)

Complement activation

91.

Which complement component opsonizes bacteria?

a)

C1q

b)

C3b

c)

C5a

d)

C9

92.

Which immune cell mediates antibody-dependent cell-mediated cytotoxicity (ADCC)?

a)

Helper T cell

b)

Cytotoxic T cell

c)

Natural killer cell

d)

B lymphocyte

93.

Which anemia is characterized by pancytopenia?

a)

Iron deficiency anemia

b)

Hemolytic anemia

c)

Aplastic anemia

d)

Megaloblastic anemia

94.

Which RBC abnormality is seen in vitamin B12 deficiency?

a)

Microcytosis

b)

Hypochromia

c)

Macrocytosis

d)

Spherocytosis

95.

Which hormone stimulates neutrophil production?

a)

Erythropoietin

b)

G-CSF

c)

Thrombopoietin

d)

IL-4

96.

Which platelet-derived substance promotes aggregation?

a)

Serotonin

b)

ADP

c)

Heparin

d)

Plasmin

97.

Which immune cell predominates in chronic inflammation?

a)

Neutrophils

b)

Macrophages

c)

Basophils

d)

Eosinophils

98.

Which condition causes decreased plasma volume leading to relative polycythemia?

a)

Chronic hypoxia

b)

Bone marrow tumor

c)

Dehydration

d)

Erythropoietin excess

99.

Which antibody is pentameric in structure?

a)

IgG

b)

IgA

c)

IgM

d)

IgE

100.

Which immune process ensures survival of only useful lymphocyte clones?

a)

Tolerance

b)

Memory

c)

Clonal selection

d)

Opsonization