Mahmoud
Sewilam
1. The earliest recognizable form of RBCs is : Proerythroblast Early normoblast Intermediate Intermediate normoblast Late normoblast Reticulocyte 4. Target cells are found in : Thalassaemia Haemoglobin C disease Iron deficiency anemia Liver disorders All of the above
7. Polychromasia corresponds to increased : Red cells Reticulocytes Ovalocytes Lymphocytes basophils
10. Reticulocytes count is decreased in : Iron deficiency anemia Aplastic anemia Megaloblastic anemias receiving proper treatment Hereditary hemolytic anemia 13. In adults, the normal range for mean corpuscular volume is : 68 – 68 – 88 88 fl 78 – 78 – 98 98 fl 88 – 88 – 108 108 fl 58 – 58 – 98 98 fl 78 – 78 – 99 99 fl
Clinical Patholog Pathology, y, X-Rays, ECG Haematology MCQs RED BLOOD CELLS 2. The mature red cell is biconcave disc with a diameter of : 5.2 µm 9.2 µm 7.2 µm 10.3 µm 5. Spherocytes are NOT NOT found found in one of the following condition : Congenital spherocytosis Autoimmune hemolytic anemia Hemolytic disease of the newborn Blood transfusion Iron deficiency anemia 8. Reticulocytes are NOT increased in one of the following conditions : Haemorrhage Haemolysis In response to specific hematinics used in treatment of anemias Aplastic anemia Thalassemia 11. The normal RBC count for adult female is : 2.8 – 2.8 – 3.8 3.8 x / L 3.8 – 3.8 – 4.8 4.8 x / L 2.8 – 2.8 – 3.8 3.8 x / L 3.8 – 3.8 – 4.8 4.8 x / L 4.8 – 4.8 – 5.8 5.8 x / L
12. The normal Hb level for an adult male is : 13 – 13 – 19 19 g/dl 11 – 11 – 16 16 g/dl 12 – 12 – 16 16 g/dl 15 – 15 – 18 18 g/dl 13 – 13 – 17 17 g/dl
14. In adult males, the normal range for packed cell volume is: 30 – 30 – 50 50 % 40 – 40 – 60 60 % 40 – 40 – 50 50 % 45 – 45 – 55 55 % 50 – 50 – 65 65 %
15. In adult females, the normal range for packed cell volume is : 25 – 25 – 45 45 % 35 – 35 – 55 55 % 35 – 35 – 45 45 % 30 – 30 – 40 40 % 40 – 40 – 65 65 %
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3. The normal red cell life span is approximately : 10 days 120 weeks 120 days 200 days 30 days 6. Anisocytosis means : Increased reticulocytes Presence of immature WBCs Variation in the shape of RBCs Presence of immature erythroid erythroid cells Variation in size of RBCs
9. Reticulocytes can be seen in : Haemorrhage Haemolysis Hypoplastic anemia with hyperactive foci in the bone marrow In response to treatment of anemias All of the above
Mahmoud Sewilam 16. In adults, the normal range for mean corpuscular hemoglobin is : 22-32 pg 27-37 pg 27 – 27 – 32 32 pg 29 – 29 – 42 42 pg 27 – 27 – 39 39 pg 18. Microcytic hypochromic anaemias is a feature of all these except : Iron deficiency anemia Thalassaemias Sideroblastic Sideroblastic anemias Acute blood loss Chronic blood loss
21. All these findings help in the diagnosis of iron deficiency anemia except except:: Decreased iron stores Decreased TIBC Decreased serum iron Decreased transferrin saturation index Decreased serum ferritin level 24. All of the following investigate iron status except Serum iron TIBC RDW % saturation of transferrin Serum ferritin 27. in iron deficiency anemia , all of the following is true except : decreased serum iron increased increased MCV decreased serum ferritin decreased transferrin saturation index decreased BM iron stores
Clinical Patholog Pathology, y, X-Rays, ECG 17. RDW indicates : Hypochromia Microcytosis Poikilocytosis Anisocytosis Reticulocytosis
ANEMIA 19. Causes of microcytic hypochromic anemias include all of the following except : Sideroblastic Sideroblastic anemia Autoimmune hemolytic anemia Iron deficiency anemia Anemia of chronic disorders Thalassemias 22. Regarding the iron status in iron deficiency, which of the following is false : Decreased serum iron Increased TIBC Decreased serum ferritin Increased transferrin saturation saturation index Decreased BM iron stores 25. Serum iron decreases in : ß thalassaemia major ß thalassaemia minor sidroblastic sidroblastic anemia anemia of chronic disorders all of the above
28. to detect the cause of the iron deficiency anemia, which of the following is done ? stool analysis for parasites stool analysis for occult blood urine analysis for hematuria all of the above
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20. Microcytic hypochromic anaemias is NOT NOT found found in one of the following conditions : Thalassemia Sideroblastic Sideroblastic anemia Iron deficiency anemia Anemia of chronic disorders Autoimmune hemolytic anemia 23. Which of the following parameters reflects iron stores : Serum iron TIBC RDW % saturation of transferrin Serum ferritin
26. hypochromic anamia is present in all of the following except : thalassemia thalassemia major anemia of chronic disorders sideroblastic anemia lead poising congenital spherocytosis 29. all these can be used for diagnosis of ß thalassemia major except : increased serum serum iron level increased TIBC increased transferrin saturation saturation index increased serum ferritin level increased Hb F level
Mahmoud Sewilam 30. ß thalassemia major is characterized by all of the following except : Severe anemia (microcytic hypochromic) Leucocyte and platelet counts are normal Effective erythropoiesis Shortened red cell life span Hb electrophoresis shows: increased HbF , HbA2 is normal or high
Clinical Pathology, X-Rays, ECG 31. α thalassemia is 32. The peripheral blood smear characterized by which of of a silent carrier of α these phenotypic categories : thalassemia typically appears as : silent carrier Normocytic , normochromic α thalassemia trait Macrocytic, normochromic Hb H disease Microcytic , hypochromic Hb Bart’s Macrocytic , hpochromic All of the above
33. Sideroblastic anemia is NOT characterized by : Ineffective erythropoiesis Ring sideroblasts Decreased serum ferritin Increased iron stores in bone marrow Dimorphic red cells 36. All these can cause macrocytic anemias except : Liver disease Aplastic anemia Thalassemias Acute hemolytic anemia Acute blood loss
34. Anemia of chronic disorders is found in cases of : Lung abscess Rheumatoid arthritis Chronic renal failure Tuberculosis All of the above
35. Direct Coomb’s test is negative in : Lymphoproliferative disorders Collagen diseases Rh incompatibility Congenital spherocytosis
37. Laboratory diagnosis of megaloblastic anemia is by all of the following except : Blood picture : pancytopenia megaloblastic erythropoiesis Positive intrinsic factor antibodies Positive antiparietal cell anti bodies Increased serum vit.B12 40. which of the following in NOT a cause of normochromic normocytic anemia : acute blood loss aplastic anemia anemia due to chronic disorders hemolytic anemia thalassemia 43. Laboratory evidence of hemolysis includes all of the following except : Hyperbilirubinaemia (indirect) Reticulocytosis Increased urine urobilinogen Increased haptoglobin Bone marrow show erythroid hyperplasia 3
38. In megaloblastic anaemia one of the following is not true : Mild thrombocytopenia Mild leucopenia Hypochromia Decreased serum vitamin B12 or folate macrocytosis
39. causes of macrocytic anaemias include : liver diseases aplastic anemia pernicious anemia autoimmune hemolytic anemia all of the above
42. Laboratory findings in aplastic anemia include all of the following except : Low reticulocyte count Normocellular bone marrow High ESR Low neutrophil count Low Hb level
41. aplastic anemia is a condition characterized by : B12 deficiency Increased reticulocyte count Pancytopenia Hypocellular BM Both C & D
44. Which of the following is NOT true for congenital spherocytosis : Increased serum bilirubin Increased osmotic fragility Positive direct Coomb’s test Increased reticulocytes Negative indirect Coomb’s test
Mahmoud Sewilam 45. Which of the following is NOT found in G6PD deficiency : Hemoglobinemia Hemoglobinuria Low enzyme level during the hemolytic attacks Increased reticulocyte count Anemia
48. Causes of warm autoimmune hemolytic anemia include all of the following except: Idiopathic Chronic lymphatic leukemia Viral infections Collagen disorders as SLE Hereditary
51. Laboratory diagnosis of cold autoimmune hemolytic anemia include : Evidence of chronic hemolysis with exacerbations especially when the patient is chilled Normochromic normocytic anemia with polychromasia Cold antibodies in serum Positive indirect Coomb’s test All of the above 54. In ABO incompatibility disease of the newborn, all of the following are true except The disease is milder because A and B antigens are week in the fetus It can occur in the first pregnancy without prior sensitization Anemia and mild jaundice Blood film shows spherocytes and reticulocytes
Clinical Pathology, X-Rays, ECG 46. In G6PD deficiency 47. In pyruvate kinase enzyme diagnosis is established by deficiency all of the estimation of the enzyme : following are true except : In between attacks (6 weeks It is inherited as an after the attack) autosomal recessive trait During the attack RBC morphology is normal Immediately after the attack Diagnosis is established by enzyme essay At any time irrespective of the attack Resulting anemia is normochromic normocytic After ingestion of fava beans Resulting anemia is macrocytic 49. Laboratory diagnosis of 50. Causes of cold autoimmune warm autoimmune hemolytic anemia include all hemolytic anemia includes of the following except : all of the following except : Idiopathic Mild normochromic Mycoplasma pneumonia normocytic anemia Viral infections as infectious Blood film shows nucleated mononucleosis RBCs, polychromasia, and Lymphoproliferative spherocytes disorders as non-Hodgkin’s Laboratory evidence of lymphoma hemolysis Bacterial infections Positive direct Coomb’s test Positive indirect Coomb’s test 52. Haemolytic disease of the 53. In Rh hemolytic disease of newborn may be due to all of the newborn, laboratory the following except: features of cord blood include all of the following Rh incompatibility (mostly except : anti-D) Anemia, reticulocytosis, ABO incompatibility normoblastemia Minor group incompatibility Jaundice Rh incompatibility (mostly Increased indirect serum anti-C) bilirubin None of the above Direct Coomb’s test is positive Indirect Coomb’s test is positive 56. Sickle cell disease is 55. Normal hemoglobin pattern characterized by all of the in adult life is all of the following except : following except : Results from a genetic HbA : 96 – 98 % abnormality in Hb structure HbA2 : 2-3.4 % Marked normocytic HbF : < 1 % normochromic anemia HbS : < 1 % Hb electrophoresis shows SS
Coombs’ test is strongly positive
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pattern Hb electrophoresis shows AS pattern Sickle cells in the stained film
Mahmoud Sewilam 57. Normal hemoglobin electrophoresis pattern found in : Sickle cell disease Beta thalassemia intermedia Beta thalassemia trait Beta thalassemia major Alpha thalassemia trait
60. Polycythemia occurs in all of the following conditions except: Hypoxic lung disease Renal ischemia Polycythemia rubra vera Liver disease
62. Decreased ESR could be found in all of the following except : Polycythemia Hypofibrinogenemia Sickle cell anemia Aplastic anemia Disseminated intravascular coagulation 65. ESR is high in the following conditions except : Paraproteniemia Collagen diseases Active tuberculosis Tissue damage Afibrogenemia 68. ESR is considered a : Diagnostic test Specific test Crude test Monitoring test Non of the above
Clinical Pathology, X-Rays, ECG 58. Immune hemolytic anemia 59. Alloimmune hemolytic can occur in all of the anemia can occur in all of following except : the following except : Lyphoproliferative disorders Lymphoproliferative disorders Viral infections Rh incompatibility Collagen disorders ABO incompatibility Iron deficiency anemia Minor group incompatibility
Polycythemia 61. Laboratory features of secondary polycythemia are all of the following except : Erythrocytosis Normal leucocytes and platelet counts Normal leucocyte alkaline phosphatase Increased serum erythropoietin Increased arterial oxygen saturation ESR 63. Low ESR could be found in all except : Polycythemia Hypofibrinogenemia Pregnancy Old specimen Sickle cell anemia
66. ESR is high in all of the following conditions except : Multiple myeloma Collagen disease Pyogenic infections Hypofibrinogenemia Active tuberculosis 69. Reference range of ESR in an healthy adult male is : st 3 - 12 mm/ 1 hr st Up to 20 mm/ 1 hr st Up to 30 mm/ 1 hr st 1 – 10 mm/ 1 hr st 0 – 5 mm/ 1 hr
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64. ESR is low in : Rheumatoid arthritis Polycythemia Malignancy Pregnancy Tuberculosis
67. ESR is a diagnostic specific test in : Rheumatoid arthritis Myeloprolfirative disorders Infectious mononucleosis tuberculosis non of the above 70. Marked rise in ESR is seen in all of the following except Myeloma Collagen disease Active tuberculosis Malignancy Acute leukemia
Mahmoud
Sewilam
71. Reference range for total leucocytic count in healthy adults is : 10 – 26 x L 5 – 13 x L 4 - 10 x L 2 – 6 x L 74. The term that denotes total leucocytic count below 4 x L is : Leucopenia Leucocytosis Agranulocytosis Leukemoid reaction
77. Presence of immature myeloid and erythroid cells in peripheral blood is termed : Leukemoid reaction Hemolytic reaction Leucoerythroblastic reaction Febrile reaction Drug induced reaction
Clinical Pathology, X-Rays, ECG LEUCOCYTES 72. Reference range for neutrophils absolute count in healthy adult is : 1-4 x L 2-7 x L 0.2-0.5 x L 4-11 x L 75. Leucoerythroblastic reaction means : Presence of immature myeloid and erythroid cells in peripheral blood Presence of immature myeloid and erythroid cells in bone marrow Presence of blasts in peripheral blood Presence of blasts in bone marrow 78. Neutrophilia is afeature of all of the following disorders except : acute pyogenic infections tissue damage or necrosis e.g. infarction , trauma corticosteroid therapy pregnancy parasitic infections
80. neutrophilia is a feature of all of the following disorders except: acute hemorrhage acute pyogenic infections cortisone therapy infectious mononucleosis acute hemolysis
81. neutophilia is a feature of all of the following disorders except: bacterial infection myocardial infarction metastatic carcinoma acute hemorrhage chronic lymphocytic leukemia
83. Neutropenia is likely to occur in : Typhoid, brucella , tuberculosis Felty’s syndrome Intake of anti-bacterial drugs Megaloblastic anemiathe All of the above
84. Neutropenia is likely to occur in : Post-splenectomy Megaloblastic anemia Burns Bacterial infections Acute hemorrhage
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73. The term that denotes total leucocytic count above 10 x L is : Leucopenia Leukocytosis Agranulocytosis Leukemoid reaction 76. A leucoerythroblastic reaction is Left shift in peripheral blood Right shift in peripheral blood Both right and left shift in peripheral blood Left shift and nucleated RBCs in peripheral blood Non of the above
79. neutrophilia is a feature of all of the following disorders except: malignancy of all types myeloproliferative disorders e.g. polycythemia vera and myelofibrosis metabolic disorders e.g. uremia , eclampsia … etc. acute hemorrhage or hemolysis antibiotic therapy 82. neutropenia is likely to occur in : intake of anti-inflammatory drugs viral infections e.g. hepatitis, influenza, HIV SLE Part of a general pancytopenia All of the above 85. Anticonvulsant therapy may cause : Neutrophilia Neutropenia Lymphocytosis Lymphopenia Non of the above
Mahmoud Sewilam 86. Lymphocytosis occurs in all of the following disorders except: Infectious mononucleosis Tuberculosis Chronic lymphatic leukemia Lymphoma Pregnancy 89. The following conditions are associated with lymphocytosis except : Cytomegalovirus infection Lymphoma Infectious mononucleosis Myocardial infarction Chronic lymphocytic leukemia 92. Lymphopenia is prominent in : Chronic lymphocytic leukemia AIDS Infectious mononucleosis
Toxoplasmosis Non of the above
95. Eosinophilia is present in : Allergic disease Tuberculosis Protozoal infections Chronic lymphocytic leukemia Non of the above 98. Absolute monocyte count >1000/cmm is found in all of the following disorders except: Tuberculosis Brucellosis Subacute bacterial endocarditis Protozoal infections Acute follicular tonsillitis 101. Agranulocytosis is associated with : Leucopenia Neutrophil count < 2x /L Neutrophil count < 1x /L Neutrophil count < 0.5x /L Non of the above
Clinical Pathology, X-Rays, ECG 87. Absolute lymphocytosis 88. Absolute lymphocytosis occurs in all of the following occurs in all of the following disorders except : disorders except: Infectious mononucleosis Tissue necrosis Infectious lymphocytosis Chronic lymphatic leukemia Cytomegalovirus infection Pertussis Lymphoma Infectious mononucleosis Acute pyogenic infection Tuberculosis 90. Lymphocytosis occurs in all 91. Lymphocytosis is observed of the following disorders in all of the following except: disorders except : Infectious mononucleosis Lymphoma Lymphoma Tuberculosis Cytomegalovirus infection Cytomegalovirus infection Protozoal infections Corticosteroid therapy Tuberculosis Infectious mononucleosis 93. Lymphopenia occurs in all of the following disorders except : Severe BM failure Corticosteroid and immunosuppressive drugs Irradiation Hodgkin’s disease Parasitic diseases 96. Reactive eosinophilia occurs in : Drug allergies Neoplasms Parasitic infections All of the above None of the above 99. Monocytosis can be observed in Tuberculosis Malignancy Chronic myelomonocytic leukemia All of the above
94. Eosinophilia is NOT present in : Allergic diseases Drug sensitivities Hodgkin disease Myxedema Myeloproliferative disorders
102. All of the following present with pancytopenia except : Hypersplenism Systemic lupus erythematosus Aleukemic leukemia Malaria Aplastic anemia
103. Pancytopenia can result from : Systemic lupus erythematosus Hairy cell leukemia Paroxysmal nocturnal hemoglobinuria Hypersplenism All of the above
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97. Monocytosis is present in : Bilharzial infestation Protozoal infections Skin diseases Drugs Non of the above 100. Basophilia is found in all of the following disorders except : Polycythemia vera Myxedema Xanthemata Chronic myeloid leukemia Chronic lymphatic leukemia
Mahmoud Sewilam 104. All of the following present with pancytopenia except: Splenomegaly Aplastic anemia Megaloblastic anemia Iron deficiency anemia Acute leukemia
Clinical Pathology, X-Rays, ECG 105. Pancytopenia is present 106. A patient with EBV in all of the following except: infection may develop all of the following except : Acute leukemia Neutrophilia Chronic granulocytic leukemia Lymphocytosis Hypersplenism Autoimmune hemolytic anemia SLE Lymph node enlargement None of the above Mild thrombocytopenia
107. Infectious mononucleosis is associated with all of the following except : EBV Fever , sore throat Atypical lymphocytes Absence of heterophil antibodies Normal hemoglobin RBCs
108. Leukemoid reaction is due to all of the following except: Pyogenic infection Acute bleeding Acute hemolysis Gangrene Chronic myeloid leukemia 111. In Leukemoid reaction, all are true except : Increased total leucocytic count up to 50,000/cmm Occurs in severe infections Characterized by the presence of immature WBCs in peripheral blood Philadelphia chromosome positive NAP score is high 113. FAB classification classifies acute leukemia according to : Cytogenetic abnormalities Immunological characteristics Both cytogenetic and immunological abnormalities Morphological characteristics Morphological, phenotypic and cytogenetic characteristics
LEUKEMIA 109. Leukemoid reaction is 110. Leukemoid reaction is characterized by the characterized by : following except : Presence of Philadelphia Leucocytosis chromosome Increased band forms Low NAP score Shift to the right High basophilia Increased NAP score Shift to the left Neurophilia High eosinophilia 112. Leukemia is a malignant proliferation of hematopoietic cells in the : Bone marrow then infiltrate peripheral blood and lymph nodes Lymph nodes then infiltrate peripheral blood and bone marrow Peripheral blood then infiltrate bone marrow and lymph nodes Bone marrow and doesn’t infiltrate lymph nodes Lymph nodes and doesn’t infiltrate bone ma rrow or peripheral blood.
114. WHO classification for acute leukemia classifies it according to : Morphological characteristics Cytogenetic abnormalities Both cytogenetic and immunophenotypic abnormalities Morphological, immunophenotypic and cytogenetic characteristics
Morphological and immunophenotypic characteristics
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115. The least number of bone marrow blast cell required to diagnose acute leukemia is Blast cells ≥ 30 % Normoblasts ≥ 25 % Blast cells ≥ 20 % Blast cells and normoblasts ≥ 30 % Blast cells ≥ 60 %
Mahmoud Sewilam 116. Diagnosis and classification of acute leukemia needs : Complete blood picture Bone marrow examination Immunophenotyping Cytochemical stain All of the above
Clinical Pathology, X-Rays, ECG 117. In acute myeloid leukemia, all of the following can be found except : Myeloblasts Megakaryoblasts Lymphoblasts Erythroblasts
118. All of the following are a must to diagnose acute myeloid leukemia except : More than 20 % blasts in Bone marrow Blast cells in peripheral blood Myeloperoxidase positivity Presence of myeloid antigens on blast cells
119. Presence of Auer rods in the blast cells indicated that they are : Lymphoblasts Myeloblasts Of no significance Bilineage Biphenotypic
120. Peroxidase stain positivity indicates : Myeloblastic leukemia T-Lymphocytic leukemia Common acute lymphoblastic leukemia Megakaryoblastic leukemia B-lymphoblastic leukemia
121. Acute lymphoblastic leukemia can present with all of the following except : Anemia Hypercellular bone marrow Increased promyelocytes in peripheral blood Thrombocytopenia
122. In subacute leukemia, we can find the following except Leucopenia Thrombocytopenia Absence of blast cells in peripheral blood 10 % blast cells in bone marrow
123. In acute lymphoblastic leukemia, all of the following can be found except: Lymphoblast cells in peripheral blood Hypercellular bone marrow Blasts are myeloperoxidase positive Lymphadenopathy
125. Diagnosis of acute leukemia requires the presence of at least : 20 % blast cells in peripheral blood 90 % blast cells in peripheral blood 20 % blast cells in bone M. 90 % blast cells in bone M. 128. Neutrophil alkaline phosphatase score is diagnostic in : Chronic lymphocytic leukemia Acute lymphoblastic leukemia Acute myeloid leukemia Chronic myeloid leukemia All of the above
126. Lymphoproliferative disorders include all of the following except: Hairy cell leukemia Chronic lymphocytic leukemia Non Hodgkin’s lymphoma Chronic myeloid leukemia
124. All of the following is a must to diagnose acute lymphoblastic leukemia except : More than 20 % blasts in bone marrow Blast cells in peripheral blood Myeloperoxidase negativity Presence of lymphoid antigens on blast cells 127. Neutrophil alkaline phosphatase in acute leukemia : Constantly low Constantly high Variable Used mainly to diagnose lymphoblastic leukemia Non of the above 130. Neutrophil alkaline phosphatase score is low in: Pyogenic infection Polycythemia Chronic myeloid leukemia Acute myeloid leukemia Non of the above
129. Neutrophil alkaline phosphatase score is elevated in all of the following disorders except : Pregnancy Severe infection Chronic myeloid leukemia Polycythemia rubra vera Severe aplastic anemia
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Mahmoud Sewilam 131. Chronic myeloid leukemia is characterized by Splenomegaly Marked leukocytosis Myelocyte bulge Basophilia All of the above
134. In chronic phase of chronic myeloid leukemia all of the followings are present except: Philadelphia chromosome Splenomegaly Blast cells are more than 20 % in bone marrow High total leucocytic count Thrombocytosis 137. The characteristic cytogenetic abnormality in chronic myeloid leukemia is: t (8,21) t (9.22) t (15,17) t (12,21) t (8,14)
140. chronic lymphocytic leukemia is disease of: old age only middle age female children only elder female middle and old age
143.In chronic myeloid leukemia (chronic phase) one criterion of the following can be found : Thrombocytopenia Leucopenia High neutrophil alkaline phosphatase Thrombocytosis
Lymphocytosis
Clinical Pathology, X-Rays, ECG 132. Neutrophil alkaline 133. Classical chronic myeloid phosphatase is enzyme leukemia is characterized by present in the granules of : all of the following except: Monocytes Hypercellular BM Neutrophilis Marked shift to the left Basophilis Monocytosis Lymphocytes Increased bone marrow megakaryocytes Eosinophilis Low Neutrophil alkaline phosphatase (NAP) score 135. Diagnosis of chronic 136. Myeloperoxidase myeloid leukemia is based reaction is mostly diagnostic on all of the following except in: Complete blood picture Chronic myeloid leukemia Bone marrow examination Acute myeloid leukemia NAP score Chronic lymphocytic leukemia Cytogenic anaylsis Acute lymphoblastic Myeloperoxidase stain leukemia All of the above 138. persistent lymphocytosis 139. in chronic lymphocytic with presence of smear cells leukemia, all of the following in peripheral blood is can be found except : present in cases of : splenomegaly chronic myeloid leukemia lymphocytosis acute lymphoblastic lymphoblasts in peripheral leukemia L1 blood chronic lymphocytic lymphadenopathy leukemia acute lymphoblastic leukemia L2 all of the above 141. patients of chronic 142. Diagnosis of chronic lymphocytic leukemia lymphocytic leukemia is commonly presents with: based on the presence of : DIC Peripheral lymphocytosis with normal marrow Persistent lymphocytosis Lymphocytes > 30 % in Autoimmune hemolytic marrow with persistent anemia lymphocytosis in blood Thrombocytopenia and Leucopenia with relative anemia lymphocytosis Splenomegaly Atypical lymphocytosis Non of the above 144.In chronic myeloid leukemia all of the following are correct except: Marked shift to the left Eosinophilia and basophilia Lymphocytosis Philadelphia chromosome positive Low NAP score
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145. Which of the following is the most helpful to differentiate between leukmoid reaction and chronic myeloid leukemia WBCs count Immature cells Platelet count NAP score RDW
Mahmoud
Sewilam
146. Lymphocytosis is one of the findings in : Acute myeloid leukemia Chronic myeloid leukemia Acute lymphoblastic leukemia Chronic lymphocytic leukemia
149. diagnose of chronic lymphocytic leukemia is essentially based on presence of : lymph node enlargement anemia persistent lymphocytosis with characteristic immunophenotypic findings thrombocytopenia leucocytosis 152. Myeloproliferative disorders include all of the following except : Chronic myeloid leukemia Essential thrombocythaemia Prolymphocytic leukemia Polycythemia rubra vera
155. Regarding total proteins in multiple myeloma : No change in their level Marked decrease in their level Increase in their level Increase only in albumin with decrease in others Decrease in albumin
158. All of the following can be found in multiple myeloma except : Osteolytic lesions Bone marrow infiltrations by plasma cells High serum proteins with high globulins Polyclonal Ig in blood or urine or both High serum calcium
Clinical Pathology, X-Rays, ECG 147.All of the following can be found 148. chronic lymphocytic in peripheral blood in chronic leukemia is characterized by lymphocytic leukemia except: all of the following except : 90 % lymphocytes leukocytosis Smear cells lymphocytosis Leukocytosis Stab cells (Band forms) marked shift to the left anemia splenomegaly 150. in chronic lymphocytic 151. Philadelphia leukemia, which of the chromosome is present in : following can be found : AML persistent lymphocytosis CML thrombocytopenia CLL autoimmune hemolytic Eosinophilic leukemia anemia lymph node enlargement all of the above
153. Regarding the diagnostic triad of multiple myeloma all are correct except : Monoclonal gammopathy Malignant plasma cell infiltration of peripheral blood Osteolytic bone lesions Malignant plasma cell infiltration in bone marrow 156. Regarding immunoglobulins in multiple myeloma : All immunoglobulins are increased All immunoglobulins are decreased Increase of IgG and IgM and decreased other types Increase of IgM and decreased all other types Increase of one type and decreased all other types 159. Bone marrow examination in all of the following except : Aplastic anemia Megaloblastic anemia G6PD deficiency Lipid storage disease Hypersplenism
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154. Multiple myeloma is characterized by : Osteolytic lesions Normal serum protein level No bone affection Lymphocyte cell infiltration in bone marrow Polyclonal gammopathy
157. The following is mostly present in multiple myeloma : Polyclonal gammopathy Monoclonal gammopathy Polyclonal gammopathy And Monoclonal gammopathy Increase serum albumin Decreased serum calcium
160. All these conditions are associated with splenomegaly except : Infectious mononucleosis Leukemia Lymphoma Hairy cell leukemia Sickle cell anemia
Mahmoud Sewilam 161. In hypersplenism, the most likely finding in the peripheral blood is : Normochromic normocytic anemia Thrombocytosis Pancytopenia Lymphopenia All of the above 162. Prothrombin time is used to monitor: Intravenous anticoagulant therapy Oral anticoagulant therapy A and B Platelet function defect
Clinical Pathology, X-Rays, ECG
HAEMOSTASIS 163. Prothrombin time is prolonged in : Hemophilia A Massive liver disease Idiopathic thrombocytopenic purpura Bone marrow failure Thrombocytopenia purpura
165. Activated partial thromboplastin time is prolonged in : Hemophilia B Factor VIII deficiency Blood vessel disease Hemophilia B & factor VIII deficiency None of the above
166. Heparin anticoagulant therapy is best monitored by Prothrombin time Activated partial thromboplastin time Bleeding time Thrombin time None of the above
168. International normalized ration is the best monitor for IV anticoagulant therapy Oral anticoagulant therapy Platelet replacement therapy Cryoglobulin therapy All of the above
169. Bleeding time is prolonged in the following conditions except : Henoch Schonlein purpura Bernard Soulier syndrome Immature thrombocytopenic purpura Disseminated intravascular coagulation Hemophilia A 172. Thrombocytopenia is seen in : Fanconi syndrome Glanzmann’s disease Von Willebrand disease Storage pool diseas None of the above
171. Bleeding time is used clinically to screen for a significant defect in : Coagulation defect Platelet function Fibrinolytic pathway None of the above All of the above
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164. Activated partial thromboplastin time is used to detect : Extrinsic pathway defect Intrinsic pathway defect only Fibrinolytic pathway defect Platelet function defect Intrinsic & common pathway defect 167. Thrombin time measures : Conversion of prothrombin to thrombin Conversion of fibrinogen to fibrin Conversion of factor VII to active factor VII Conversion of plasminogen to plasmin 170. All of the following conditions lead to prolonged bleeding time except : Von Willebrand disease Thrombocytopenia Haemophilia A Henoch Schonlein purpura DIC
173. In immune thrombocytopenic purpura all of the following is correct except : Normal PT Prolonged bleeding time Normal PTT Decreased bone marrow megakaryocytes Decreased platelet life span
Mahmoud Sewilam 174. Routine evaluation of patients with bleeding tendency necessitates :
Through history and clinical examination
TLC
Collagen markers assay
Trephine biopsy
All of the above
Clinical Pathology, X-Rays, ECG 175. Causes of vascular 176. Platelet adhesion defect prupura include : occurs in : ITP Henoch Schonlein purpura Henoch Schonlein purpura Glanzmann’s disease Glanzmann’s disease Bernard Soulier syndrome Bernard Soulier syndrome All of the above None of above
177. Platelet function study with ristocetin shows defective response in : Glanzmann’s disease Von Willebrand disease Bernard Soulier syndrome Bernard Soulier syndrome And Von Willebrand disease
178. Platelet function study with collagen shows defective response in : Glanzmann’s disease Von Willebrand disease Bernard Soulier syndrome Bernard Soulier syndrome And Von Willebrand disease
180. In massive liver disease there is : Prolonged PT and PTT Thrombocytosis Thrombocytopenia Prolonged PT and PTT And Thrombocytopenia Prolonged PT and PTT And Thrombocytosis 183. All the following findings are present in DIC except : Thrombocytopenia Decreased serum FDPs level Decreased serum fibrinogen level Prolonged PT Prolonged PTT 186. In hemophilia B there is : Prolonged PT Prolonged PTT Prolonged TT Bleeding time is prolonged None of the above
181. Thrombocytopenia is a common finding in : Aplastic anemia Massive liver disease ITP Hypersplenism All of the above
184. In DIC : PT and PTT are prolonged TT and BT are prolonged Platelet count and fibrinogen are decreased All of the above
187. In von Willebrand disease : Prolonged PT Prolonged TT Bleeding time is prolonged PTT test is normal Prolonged PT & TT
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179. In ITP there is : Prolonged PT Prolonged PTT Decreased platelet count Increased bone marrow megakaryocytes Decreased platelet count And Increased bone marrow megakaryocytes 182. Normal platelet count ranges from: 150 – 400 x /L 150 – 400 x /L 150 – 400 x /L 150 – 400 x /L 150 – 450 x /L
185. D-dimer assay is valuable in : ITP DIC Hemophilia A Factor VII deficiency Platelet function defect
Mahmoud
Sewilam
188. Whole blood transfusion is indicated in : Anemia of congestive heart failure Exchange blood transfusion Hemophilia A Acute blood loss with hypovolemic shock Both Exchange blood transfusion and Acute blood loss with hypovolemic shock
191. Acute hemolytic transfusion reaction occurs due to : HLA alloimmunization ABO incompatibility Platelet specific antigen Transmission of viral infection None of the above 194. Which of the following is false concerning fresh frozen plasma : Prepared with 6 hours of blood donation Stored at 18 ºC Thawed at 37ºC Can be refrozen Used in hemorrhage due to deficiency of clotting factors
Clinical Pathology, X-Rays, ECG BLOOD TRANSFUSION 189. Advantages of packed 190. Which of the following is RBCs are all of the following false regarding platelet except concentrate : Smaller volume Indicated in bleeding due to thrombocytopenia Large oxygen carrying capacity Stored in refrigerator at 2 – 6º C Less risk of transfusion of virus infection Stored at room temperature (20-24ºC) with continuous Rich in factor VIII gentle agitation Less risk of transfusion of Can be used up to 10 days WBCs after preparation Stored in refrigerator at 2 – 6º C and Can be used up to 10 days after preparation 192. Febrile transfusion 193. Regarding acute lung reaction occurs due to : injury following transfusion, all of the following are true Rh incompatibility except : HLA class I antigens Transfusion related ABO incompatibility Due to antibodies against Platelet specific antigen patient’s leucocytes None of the above Presents with fever and chills Anti Rh D is the main cause 195. Which of the following is 196. Which of the following is false concerning packed present in acute hemolytic RBCs: transfusion reaction : Before use the bag is heated Occurs during the first 30 in very hot water minutes of transfusion Most helpful in anemia of Chills, pain in the back and congestive heart failure dyspnea Can be washed with saline to Hemoglobinemia and remove plasma proteins in hemoglobinuria certain cases Hypotension and shock may develop Used in cases of exchange blood transfusion All of the above Before use the bag is heated in very hot water and Used in cases of exchange blood transfusion
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Mahmoud
Sewilam
197. Prerenal uremia occurs in : Congestive heart failure Renal tumours Chronic renal failure Glomerulonephritis Benign prostatic hyperplasia 200. Which of the following is a test of glomerular function : Measurement of urine specific gravity Measurement of low molecular weight proteins in urine Urinary acidification test Measurement of non protein nitrogenoeus compounds in blood Vasopressin test 203. Concerning urine specific gravity, which one of the following statements is false: It is measured by a urinometer (hydrometer) It reflects the concentrating power of the kidney It is increased in diabetes insipidus It becomes low and fixed in end stage renal diseases It increase after overnight fluid restriction in healthy subjects 206. Congestive heart failure may lead to Increased serum urea Heavy proteinuria Hypernatremia Increased serum creatinine Hyperkalemia 209. Proteinuria in excess of 3 g/day is a typical feature of : Cardiac failure Nephrotic syndrome Acute renal failure Polycystic renal disease Chronic pyelonephritis
Clinical Pathology, X-Rays, ECG RENAL DISEASES MCQs 198. A serum urea value of 60 199. Polyuria with increased mg/dl is equivalent to BUN urine specific gravity is a value of : feature of : 15 mg/dl Pituitary diabetes insipidus 28 mg/dl Nephrogenic D.I. 35 mg/dl Chronic renal failure D.M. 201. Low fixed urine specific 202. Which of the following is gravity at 1010 is a feature a glomerular function test : of : Serum creatinine Acute glomerulonephritis Fluid deprivation test Diabetes insipidus Urinary acidification test Chronic renal failure Urine specific gravity D.M. Urine pH Nephrotic syndrome
204. Which is diagnostic of acute post streptocoocal glomerulonephritis : Increased BUN and serum creatinine Hypocomplementaemia Impaired renal tubular function Oliguria and high urine specific gravity Hematuria and red blood cell casts
205. Creatinine clearance is calculated from serum or plasma creatinine (P in mg/dl) , urine creatinine (U in mg/dl) and urine volume (V in mL/min) as follows : Clearance = UxV/ P Clearance = UxP / V Clearance = U / VxP Clearance = P / VxU
207. Oliguria is a feature of : DM DI Addison’s disease Hysterical polydipsia Acute glomerulonephritis
208. Proteinuria is considered heavy if it is above : 500 mg/day 1 g / day 2 g /day 3 g/day 4 g/day
210.Which of the following laboratory findings is expected in nephrotic syndrome : Hypocholesterolaemia Hypoalbuminemia Decresed serum α2 macroglobulin Oliguria
211.Which of the following laboratory findings is expected in nephritic syndrome : Increased creatinine clearance Hypercholestolremia RBC casts Polyuria Decreased urine specific gravity
Presence of granular casts in urine
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Mahmoud Sewilam 212. One of the following in NOT a feature of chronic renal failure : Increased BUN Increased serum creatinine Increased serum potassium Decreased serum calcium Decreased serum inorganic phosphate 215. Serum urea is NOT increased in : Severe liver disease Congestive heart failure Acute glomerulonephritis Dehydration Chronic renal failure
Clinical Pathology, X-Rays, ECG 213. Hyperuricemia is seen in 214. Increased serum urea : with normal serum creatinine is seen in : Leukemia GIT hemorrhage Nephrotic syndrome Acute glomerulonephritis D.I. Chronic renal failure High protein diet Prostatic enlargement Advanced liver cirrhosis Renal artery stenosis
218. Concerning urinary casts, one of the following statements is NOT true : Hyaline casts may be found in the urine healthy subjects Lipoid casts are found in nephritic syndrome Red blood cell casts are pathognomonic of acute glomerulonephritis White cell casts are found in pyelonephritis 221. which of the following conditions is accompanied by increased urine specific gravity : hysterical polydipsia DM Pituitary D.I. Nephrogenic D.I. Chronic renal failure
219. The aspect of urine remains clear in the presence of increased amount of : Epithelial cells WBCs RBCs Protein Amorphous urate
216. Oliguria occurs in Hypercalcemia Acute glomerulonephritis Diuretic phase of Acute renal failure Nephrogenic D.I. Acute tubular necrosis
217. Concerning serum creatinine, one of the following statements is NOT true It is the end product of muscle creatine It is higher in children that in adults It is higher in males than females It is inversely related to GFR It is increased in acute and chronic glomerulonephritis 220. Which of the following laboratory findings is pathognomonic of acute glomerulonephritis : Oliguria Hematuria Red blood cell casts Pyuria albminuria
222. A patient is oliguric when is urine volume is less than : 1000 mL/24 hours 800 mL/24 hours 700 mL/24 hours 400 mL/24 hours 100 mL/24 hours Calcium and phosphorus
223. Hypocalcemia occurs in cases of : Acute pancreatitis Multiple myeloma Sarcoidosis Milk – alkali syndrome Tertiary hyperparathyroidism
224. Hypercalcemia occurs in : Hypoalbuminemia Chronic renal failure Pseudohypoparathyrodism Anticonvulsant therapy Squamous cell carcinoma of lung
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225.Which of the following conditions is accompanied by hypocalcemia : Primary hyperparathyroidism Secondary hyperparathyroidism Tertiary hyperparathyroidism Multiple myeloma
Mahmoud Sewilam 226. Which of the following is accompanied by hypercalcemia : Hypoalbuminmia Chronic renal failure Pseudohypoparathyrodism Anticonvulsant therapy Sarcoidosis 229. Which of the following laboratory findings is expected in primary hyperparathyrodism : Hypercalcemia and hypophosphatemia Hypocalcemia and hyperphosphatemia Metabolic alkalosis Decreased urinary calcium and phosphate Decreased urinary cyclic AMP 231. Which of the following statements is true about serum sodium It is the main extracellular anion It is increased in addison’s disease It’s increased in renal tubular acidosis It is low in the Syndrome of inappropriate antidiuretic hormone secretion It can be excluded from calculation of the anion gap 234. Hypokalemia is expected to occur in : Mineralocorticoid deficiency Hyperemesis gravidarum Crush injuries Acute renal failure DKA
Clinical Pathology, X-Rays, ECG 227. Hyperphosphatemia 228. Hypophosphatemia occurs in : occurs in Vitamin D deficiency Renal failure Fanconi syndrome Primary hypoparathyrodism Respiratory alkalosis Pseudohypoparathyrodism Primary Fanconi syndrome hyperparathyroidism Metabolic acidosis Chronic renal failure 230. Which of the following laboratory findings is expected in primary hypoparathyrodism : Hypercalcemia and hypophosphatemia Hypocalcemia and hyperphosphatemia Increased alkaline phosphatase Increased urinary calcium Increased urinary cyclic AMP Sodium & Potassium 232. Which of the following 233. Hypernatremia is a endocrinal disorders leads to feature of : hypernatremia ? Cushing’s syndrome Hyperthyroidism Renal tubular acidosis Hypothyroidism Chronic interstitial nephritis Hyperparathyroidism Congestive heart failure Hypoparathyrodism Paralytic ileus Conn’s syndrome
235. Hyperkalemia occurs in : Anorexia nervosa Cushing’s syndrome Burns Use of purgative Insulin therapy
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236. Respiratory acidosis may be seen in cases of : Improperly controlled mechanical ventilation (hyperventilation) Pulmonary fibrosis Anxiety Salicylate poisoning Chronic renal failure 239. Which of the following conditions leads to metabolic alkalosis? Treatment with carbonic anhydrase inhibitors Severe diarrhea Severe vomiting High intestinal fistulae Ethylene glycol poisoning
Clinical Pathology, X-Rays, ECG Acid base balance MCQs 237. Which of the following conditions is accompanied by metabolic alkalosis : Chronic renal failure Methanol poisoning Aspirin overdose Ethylene glycol poisoning Pyloric stenosis 240. Vomiting may lead to : Increased arterial pH Increased arterial H+ concentration Hyperchloraemia Hypernatraemia Hyperkalemia
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238. Hyperchloremic acidosis with normal anion gap occurs in : Ureteric implantation into colon DKA Lactic acidosis Salicylate overdose Methanol poisoning
Mahmoud
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241. Which of the following is associated with conjugated hyperbilirubinmia ? Dubin-Johnson syndrome Gilbert’s Syndrome Crigler Najjar syndrome Neonatal Jaundice Hemolytic anemia 244. Which of the following is associated with monoclonal gammopathy ? Rheumatoid arthritis SLE Tuberculosis Liver Cirrhosis Multiple myelomatosis
Clinical Pathology, X-Rays, ECG Hepatobiliary MCQs 242. Which is a cause of unconjugated hyperbilirubinemia ? Dubin-Johnson syndrome Rotor Syndrome Primary biliary cirrhosis Cancer head pancreas Gilbert’s syndrome 245. Of the following serum results, which are the most indicative of biliary tract involvement (and not parenchymal cell damage)? ALT = 1500 U/L (N:5-40) ALT=500 U/L, AST= 3000 U/L (N:5-40) LDH = 700 U/L (N:100 500) ALP = 650 U/L (N:30-100), GGT =130 U/L (N:10-50) Total bilirubin = 4 mg/dl , direct bilirubin= 1 mg/dl
247. One of the following is a feature of hemolytic jaundice : Pale stool Dark brown urine Conjugated hyperbilirubinemia Increased serum ALP and GGT Increased urine urobilinogen
248. Obstructive jaundice is accompanied by : Increased excretion of conjugated bilirubin in urine Increased excretion of unconjugated bilirubin in urine Increased urinary urobilinogen excretion Almost equally increased serum conjugated and unconjugated bilirubin Increased serum unconjugated bilirubin
250. Which of these findings is expected in cases of acute viral hepatitis: Prolongation of prothrombin time Serum albumin is low AST/ALT ratio more than 1 Serum IgA is usually
251. Which of these enzymes is most valuable to confirm the hepatic origin of an elevated serum alkaline phosphatase in a pregnant women: Aspartate aminotransferase (AST) Creatine kinase (CK) Lactate dehydrogenase (LDH) 5 nucleotidase
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243. Which of the following conditions is associated with bilirbinuria ? Hemolytic anemia Gilbert’s syndrome Rotor syndrome Crigler-Najjar syndrome Neonatal Jaundice 246. Which of these statements is NOT true about bilirubin? It is derived exclusively from breakdown of hemoglobin It is bounded in the unconjugated from serum albumin It’s reabsorbed in the small intestine after bacterial metabolism to urobilinogen It is normally undetectable in urine Normally, most of bilirubin in serum is unconjugated. 249. Urinary urobilinogen is usually increased in case of : Extrahepatic biliary obstruction Primary biliary cirrhosis Acute hemolysis crisis Icteric stage of acute hepatitis Women receiving oral contraceptives
252. In follow up of acute viral hepatitis , which enzymes is the earliest indicator of recovery ? ALT AST ALP GGT LDH
Mahmoud Sewilam increased ALT/AST ratio is more than 1
253. Detection of low titer HBcAb IgG and positive HBsAb denotes : HBV past infection with immunity to HBV HBV carrier status HBV vaccination HBV acute infection HBV chronic infection
256. Super infection of HDV and HBV is diagnosed by : Positive HDV Ab IgM and HBc Ab IgG and negative HBsAg Positive HBs Ab and positive HDV Ab IgG Negative HBs Ag and positive HDV Ab IgM Positive HDV Ab IgG and HBcAb IgG None of the above
Clinical Pathology, X-Rays, ECG
Alanine aminotransferase (ALT)
Hepatitis markers 254. Co – infection of HDV and HBV is diagnosed by : Positive HBsAg and HBcAb IgG Positive HDV Ab IgM and HBcAb IgM Positive HBsAb and positive HDV Ab IgM Negative HBs Ab and positive HDV Ab IgM None of the above
257. As regard hepatitis B which of the following is true : Persistence of HBsAg >6 months is an indicator of chronicity Serum HBcAg indicates viral replication It is transmitted through feco-oral route Positive HBcAb and +ve HBsAb denotes post vaccination HBsAb indicated viral replication
255. Super infection of HDV on HBV infection is diagnosed by : Positive HDV Ab IgG and HBcAb IgG Positive HBs Ab and HDV Ab IgM Negative HBs Ag and positive HDV Ab IgM Positive HDV Ab IgM and HDV Ab IgG Positive HBc Ab IgG,HBs Ag and HDV Ab IgM 258. As regard hepatitis B which of the following is not true :
Persistence of HBsAg > 6 months is an indicator of chronicity Positive HBeAg indicates viral replication Positive HBsAB indicates immunity Positive HBvAb and +ve HBsAb denotes post vaccination HBcAb is the only marker in the window gap
259. As regards HBc Ab, which of the following is false: It is an important serologic marker in the window gap High titer IgG despite positive HBsAb indicates persistent viral load Low titer IgG with positive HBsAb indicates past infection and immunity Negative HBcAb IgG with positive HBsAb denotes post vaccination
260. The most definitive diagnostic test for HCV infection is : HCV Ab IgG by ELIZA HCV Ab IgM by ELIZA Recombinant immunoblot assay (RIBA) Viral RNA by PCR
261. Which of the following tests is clinically significant for HCV infection HCV Ab by ELIZA HCV Ab by RIBA HCV RNA BY PCR Serotyping and quantitation of viral load All of the above
262. Carrier state in viral infection means : The virus is hidden in the host cell and can’t be detected
263. PCR is used to detect : Viral antigen Viral particles
264. Primary biliary cirrhosis could be differentiated from primary sclerosing cholangitis by :
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after recovery The virus is secreted by the host after clinical recovery The virus does not remain in the host after recovery None-of the above All of the above
265. The following is true for hepatocellular carcinoma : Mall elevation of AFP occurs in primary hepatoma Mild elevation of AFP plus elevation of CEA occurs in secondary liver cancer Normal level of CEA with increased levels of AFP occur in colorectal cancer without hepatic malignancy All of the above.
Clinical Pathology, X-Rays, ECG
Viral genome Viral envelope None of the above
266. Tumor markers for liver metastasis include : CEA ALP Transaminases All of the above None of the above.
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Increased ALP and GGT Evidence of hepatic dysfunction Increased total IgM Frequently progresses to chronic hepatitis Positive AMA
Mahmoud
Sewilam
267. hyperglycemia occurs in one of the following conditions Addison’s syndrome Gilbert’s Syndrome Cretinism Pheochromocytoma Insulinoma 270. Alimentary glucosuria occurs in one of the following conditions : Renal failure Advanced liver disease Congenital heart disease Pregnancy Type I D.M. 273. One of the following statements is true about impaired glucose tolerance: An OGTT is not required to assign a patient to this class Fasting plasma glucose level is ≥ 126 mg/dl 2 hour post load plasma glucose level is ≥140 <200 mg/dl Patients never revert to normal glucose tolerance or develop overt DM Microvascular disease is common, but there is increased incidence of atherosclerotic disease 276. Which one of the following laboratory findings is expected in DKA : Hypokalemia Hypernatremia Hypophosphatemia Prerenal uremia High total co2
Clinical Pathology, X-Rays, ECG DM MCQs 268. Hypoglycemia occurs in : Down syndrome Hemochromatosis Cerebrovascular accidents Cushing’s syndrome Insulinoma
271. Which of the following leads to a lag storage curve in the OGTT: Insulinoma Mal-absorption syndrome Thyrotoxicosis Prolactinoma Cretinism 274. One of the following statements is true about glycated hemoglobuin : HbA1 represents 5 – 8 % of HbA Hb1Ac represents 15% of HbA1 It is minimal value in the monitoring of DM It reflects glycemic control over the previous 1-2 weeks It should be monitored yearly
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269. Renal glucosuria is found in: Pregnancy Thyrotoxicosis Mal-absorption Advanced liver disease Cretinism 272. Which of the following leads to a flat response in the OGTT : Mal-absorption syndrome Hyperpituitarism Acromegaly Thyrotoxicosis Hemochromatosis 275. Which of the following leads to hyperglycemia : Glomerulonephritis Hemochromatosis Iron deficiency anemia Mediterranean fever Obstructive jaundice
Mahmoud
Sewilam
277. One of the following is cause of elevated total and free T4: Pregnancy Viral hepatitis Grave’s diseases Heroin addiction Oestrogen therapy 280. In primary hyperthyroidism, which of the following statements is true : All patients have decreased total and free T4 and T3 level T3 uptake is decreased FTI is decreased All patients have increased TRH There is a blunted response to TRH stimulation 283. Which of the following statements is true concerning TSH : It is increased in primary hyperthyroidism It is increased in secondary hyperthyroidism It is decreased in primary hypothyroidism It is increased in secondary hypothyroidism It is decreased in severe cases of non thyroid illness
Clinical Pathology, X-Rays, ECG Thyroid MCQs 278. One of the following is a cause of elevated total and free T3 : Pregnancy Viral hepatitis Pituitary adenoma Heroin addiction Oestrogen therapy 281. The first trimester of pregnancy is accompanied by which changes in thyroid function tests : Decreased TBG Decreased total T4 and T3 Decreaqsed or undetectable TSH Increased TSH Positive antimicrosomal antibodies
284. Which of the following is true in primary hypothyroidism ? FT3 is the most sensitive indicator of thyroid function TSH increase may precede the decrease in the thyroid hormone Reverse T3 is increased Positive thyroid stimulating immunoglobulins are diagnostic of the causative disease With treatment, TSH returns to normal prior to T4
286. In the acute phase of non – thyroid illness, which statements is true : Total T3 is increased Free T3 is increased Reverse T3 is increased TSH is increased Thyroid replacement therapy is indicated
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279. One of the following is a cause of low free T4 : Androgen therapy Liver cirrhosis Mal-nutrition Nephrotic syndrome Hashimoto thyroiditis 282. Which is a cause of depressed TSH in an euthyroid patient Subclinical hyperthyroidism Subclinical hypothyroidism Secondary hypothyrodism Grave’s disease Hashimoto’s thyroiditis
285. TSH is NOT a reliable indicator of thyroid function in case of : Primary hypothyroidism Primary hyperthyroidism First 6 months of treatment of primary hyperthyroidism Third trimester of pregnancy TBG excess
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287. Epidemic cerebrospinal meningitis is caused by : E.coli Pneumococci Hemophilius influenza Neisseria meningitides Mycobacterium tuberculosis
290. Group (B) β hemolytic streptoccoi are most likely to cause : Acute diarrhea Acute rheumatic fever Neonatal meningitis Acute glomerulonephritis Infective endocarditis 293. All are true for septic meningitis except : Aspect of CSF is turbid Protein level in CSF increase Glucose level in CSF decrease CSF could be bloody White cell count in CSF is normal
Clinical Pathology, X-Rays, ECG CSF MCQs 288. The most valuable test for the diagnosis of tuberculosis meningitis is : Positive tuberculin test Positive gram stained smear of CSF Low CSF glucose level High CSF protein level Positive Ziehl – Neelsen stained smear of CSF 291. Neonatal meningitis is most likely caused by : Pnemoccoci Hemophilius influenza Mycobacterium tuberculosis E.coli Neisseria meningitis
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289. For septic meningitis all of the following are correct except : Aspect is clear Increase white cell count in CSF Increase protein level in CSF Decreased glucose level in CSF Positive culture 292. Swimming pool meningitis occurs due to infection by : E.coli Amoeba Babesia Pneumococci Neisseria meningitides
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Sewilam
294. The earliest marker for diagnosis of acute myocardial infarction within the first 2 hours of onset of chest pain is : CK-MB AST Myoglobin cTnT LDH 297. to diagnose AMI , the ration of CK – MB isoenzyme to total CK must exceed : 4% 6% 8% 10 % 20 %
Clinical Pathology, X-Rays, ECG
Cardiac markers 295. Total CK activity is NOT increased in : Duchene myopathy Hyperthyroidism Diabetic ketoacidosis Severe muscle exercise Acute myocardial infarction
298. The most specific marker for diagnosis of AMI is : Myoglobin CK-MB AST LDH Cardiac troponins
300. One of the following cardiac markers is most useful in ruling out MI : CK – MB mass LDH isoenzymes c.Troponins (I or T) myoglobin CK-total
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296. Which of the following markers may show increased levels 12 days after an acute myocardial infarction: Total CK CK-MB AST LDH cTnI 299. A specific marker which can be used to diagnose AMI in a patient presenting 8 days after the onset of chest pain AST Total LDH Flipped LDH ration Cardiac troponin I Cardiac troponin T
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Sewilam
301. As regard ANA testing in SLE cases which of the following is true ? Done by indirect immunoflurosence It is a sensitive screening test for the disease Its specificity can be improved by detection of high titres All of the above
304. Children with insulin dependent DM have : Anti-IgG Fc antibodies Anti-microsomal antibodies Anti-parietal cells antibodies Antinuclear antibodies None of the above
307. Sero-negative rheumatoid arthritis (RA) includes the following : Early RA Juvenile RA Arthritis with certain systemic diseases All of the above None of the above
310. Which of the following is a non organ specific autoimmune disease ? Myasthenia graves Insulin dependent diabetes Rheumatoid arthritis Hasimoto’s thyroiditis Pernicious anemia
Clinical Pathology, X-Rays, ECG
Serology MCQs 302. In cases of rheumatoid arthritis which of the following statements is false : Negative RF by routine lab procedures excludes diagnosis RF by Rose Waaler is more specific than latex fixation test RFs are antiglobulins against autologous IgG None of the above 305. An autoimmune disease characterized by the over production of thyroid hormones : Lupus erythematosus Myasthenia graves DiGeorge disease Grave’s disease Hemolytic anemia 308. The pathogenic antibody in Grave’s disease has specific for : Nuclei Thyroid peroxidase Thyroglobulin TSH receptors TSH
311. Which of the following statements about antimitochondrial antibodies is false : found in patients with primary biliary cirrhosis (PBC) found in some patients of chronic active hepatitis can’t differentiate PBC from primary sclerosing cholangitis accompanied by a rise in serum IgM in patients with PBC none of the above
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303. Hasimoto’s disease and Graves’s disease are similar in that both : Affect RBCs Affect the liver Are forms of cellular immunity Affect the thyroid gland Are accompanied by histamine release
306. Rheumatoid arthritis is an autoimmune disorder in which the body’s immune system act against it’s own : Lymphocytes Neutrophils RBC IgG DNA 309. Direct immunofloresent examination of renal biopsy shows linear depositon along the glomerular basement membrane Minimal change nephropathy Membranous nephropathy Membranoproliferative glomerulonephritis Anti-GBM nephritis IgA nephropathy 312. patients with SLE show the following findings normocytic normochromic anemia high EST thrombocytopenia leucopenia all of the above
Mahmoud Sewilam 313. specificity of ANA testing by immunofluorence can be increased by : determination of titre determination of pattern using more than on substrate all of the above none of the above 316. all of the following is true for IC glomerulonephritis except diminished serum complement levels detection of circulating immune complexes patient’s serum may be positive for ANA or antiDNA linear deposits of immunoglobulins and complement in the glomeruli all of the above 319. Anti-n DNA antibodies are all of the following except : Diagnostic for SLE Correlate with SLE activity Indicate kidney affection Cannot be used for follow up None of the above 322. For diagnosis and follow up of SLE which is false : Serum ANA is used for screening Anti-nDNA & Anti-Sm are diagnostic For activity , ESR , C3 , C4 & CIC are done For follow up ANA titre is done CBC , urine analysis & kidney function are done in follow up
Clinical Pathology, X-Rays, ECG 314. anti-n-DNA antibodies in 315. in rheumatoid arthritis, SLE are : detection of RF by latex agglutination test is : associated with kidney affection sensitive but not specific used in diagnosis and follow results in high incidence of up false negative detected by IIF technique both sensitive and specific all of the above none of the above none of the above 317. in individuals with IC 318. Anti-GBM antibodies glomerulonephritis which of can cause the following tests should be Glomerulonephritis done : Goodpastur’s syndrome ANA Idiopathic pulmonary Anti-DNA hemosiderosis Serum complement level All of the above Detection of CIC None of the above All of the above
320. In SLE all of the following indicate activity except : Elevated ESR High C3 and C4 High anti n – DNA titre High levels of circulating immune complexes None of the above 323. In systemic lupus erythematosus, all are true except : Serum complement is frequently reduced CICs levels donot correlate with disease activity High titre ANAs by IIF is a sensitive screening test High titre anti-ds-DNA is associated with renal affection Anti-Sm antibodies are specific
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321. In SLE all of the following autoantibodies support the diagnosis except : ANA Anti-n DNA Anti-Smith Anti-smooth muscle Anti RNP 324. The following is true about rheumatoid arthritis : RFs are antiglobulins directed against the Fc fragment of autologous IgG Rose Waaler test for detection of RF is specific yet not sensitive Serum complement levels are usually normal A negative RF does not exclude diagnosis of rheumatoid arthritis All of the above .
Mahmoud Sewilam 325. All are true concerning immune hemolytic anamias except : It may be drug induced such as by penicillin and methyl dopa Diagnosis is by anti-globulin test (Coombs test) Rh incompatibility is not an example of alloantibody – induced hemolytic anemia Warm anti-body type is either idiopathic or secondary to SLE , leukemia , etc…. None of tha bove 328. ANA and rheumatoid factor may be associated with all of the following conditions except : Rheumatoid arthritis Sjogren’s syndrome SLE ITP None of the above
Clinical Pathology, X-Rays, ECG 326. All of the following are 327. Any of the following are diagnostic importance in consistent with diagnosis of autoimmune disease except : autoimmune hepatitis except : Lesions are detected by biopsy Positive ANA Immune complexes are Positive ASMA found in serum Positive AMA Decreased levels of serum Positive HBsAg complement None of the above Decreased serum gamma globulin levels All of the above
331. Children with insulin dependent D.M. usually have serum antibodies to : Mitochondria Thyroid microsomes Gastric parietal cells Nuclear antigens None of the above
332. Is SLE which of the following is false : Circulating immune complexes level correlates with disease activity Serum complement is frequently decreased Positive ANA is found in 95 % of active untreated cases Anti-DNA is associated with kidney affection ANA titre correlate with disease activity
334. In Hashimoto’s thyroiditis which of the following is true : Inflammatory disorder of unknown etiology Euothyrodism is early in the disease Late in the disease hypothyroidism often occur Autoantibodies to thyroglobulin and thyroid microsomal antigens are found All of the above
329. Which of the antibodies are most useful for the diagnosis of pernicious anemia : Anti-parietal cell Anti-thyroid peroxidase Anti- nuclear Anti-IgG Fc Anti – TSH receptor
335. In autoimmune chronic hepatitis which of the following is true : Non organ specific autoimmune disease Positive anti – Ro and anti – La antibodies Positive HBsAg Positive Anti-Sm antibodies Positive anti smooth antibodies
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330. Which of the following antibodies are most use for diagnosis of Sjogren syndrome: Anti-cardiolipin antibodies Anti-neutrophil cytoplasmic antibodies (ANCA) Anti-ssA(RO), anti-ssB(La) antibodies Anti-mitochondrial antibodies Anti-glomerular basement membrane antibodies 333. In autoimmune chronic hepatitis which of the following is true : Organ specific autoimmune disease Positive anti-Ro anti-La antibodies Positive HBsAg Positive anti-Sm antibodies Positive ANCA
336. In primary biliary cirrhosis which of the following is false : Anti mitochondrial antibodies are positive AMA can’t differentiate it from primary sclerosing cholangitis Bilirubin is elevated IgM is increased Alkaline phosphatase is usually elevated
Mahmoud Sewilam 337. All of the following are consistent with diagnosis of autoimmune hepatitis except : HCV Ab positive Positive liver specific antibodies Positive anti-LKM antibodies Polyclonal hypergammaglobulinemia Positive ANA
340. All of the following organisms can produce diarrhea except : Vibrio cholera Campylobacter Staphylococcus aureus Bifidibacterium Rota virus 343. All of the following organism cause food poising except : Staphylococcus aurues Clostridium botulinum Bacillius cereus Salmonella enteritidis Salmonella typhi
Clinical Pathology, X-Rays, ECG 338. In rheumatoid arthritis 339. A positive ANA test can which of the following is be found in all of the false : following except : RFs are antiglobulins SLE directed against the Fc Sjogren’s syndrome fragment of autologous IgG Rheumatoid arthritis Rose Waaler test for Scleroderma detection of RF is specific yet Multiple sclerosis not sensitive Serum complement levels are usually normal A negative RF by lab procedure does exclude diagnosis of rheumatoid arthritis None of the above Stool analysis 341. All of the following 342. Infantile diarrhea can be organisms produce diarrhea used by : except : Enteropathogenic E.coli Salmonella enteritidis Giardia Enteropathogenic E.coli Yersinia enterocolitica Yersinia enterocolitica Vibrio cholera Bacillus cereus Salmonella enteritidis Clostridium botulinum
Other Available Books By The Author:
Internal Medicine : Clinical
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X-Rays Of Internal Medicine
Clinical Pathology
Psychiatry 29
