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Question 1
Correct
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Which one of the following is necessary to activate plasminogen to plasmin?
Your Answer: tPA
Explanation:In circulation, plasminogen adopts a closed, activation resistant conformation. Upon binding to clots, or to the cell surface, plasminogen adopts an open form that can be converted into active plasmin by a variety of enzymes, including tissue plasminogen activator (tPA), urokinase plasminogen activator (uPA), kallikrein, and factor XII (Hageman factor).
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This question is part of the following fields:
- Haematology
- Medicine
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Question 2
Correct
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In the normal adult, haematopoiesis is present
Your Answer: Axial skeleton and proximal ends of long bones
Explanation:In children, haematopoiesis occurs in the marrow of the long bones such as the femur and tibia. In adults, it occurs mainly in the pelvis, cranium, vertebrae, and sternum.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 3
Incorrect
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Which clotting factor is responsible for stabilization of the fibrin clot by formation of covalent cross-linkages?
Your Answer: Factor XIIa
Correct Answer: Factor XIIIa
Explanation:Factor XIII or fibrin stabilizing factor is an enzyme of the blood coagulation system that crosslinks fibrin. Deficiency of this factor (FXIIID) affects clot stability.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 4
Correct
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Which one of the following is true about bone marrow?
Your Answer: At birth the bone marrow is entirely red marrow and is converted to yellow marrow with age
Explanation:The two types of bone marrow are red marrow, which consists mainly of hematopoietic tissue, and yellow marrow, which is mainly made up of fat cells. Red blood cells, platelets, and most white blood cells arise in red marrow. Both types of bone marrow contain numerous blood vessels and capillaries. At birth, all bone marrow is red. With age, more and more of it is converted to the yellow type; only around half of adult bone marrow is red.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 5
Correct
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Where is Vitamin B 12 absorbed?
Your Answer: Terminal ileum
Explanation:Protein-bound vitamin B12 must be released from the proteins by the action of digestive proteases in both the stomach and small intestine. Gastric acid releases the vitamin from food particles; therefore antacid and acid-blocking medications (especially proton-pump inhibitors) may inhibit absorption of B12. B12 must be attached to Intrinsic Factor (IF) for it to be efficiently absorbed, as receptors on the enterocytes in the terminal ileum of the small bowel only recognize the B12-IF complex; in addition, intrinsic factor protects the vitamin from catabolism by intestinal bacteria.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 6
Correct
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Question 7
Incorrect
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The extrinsic coagulation pathway is initiated by activation of which clotting factor?
Your Answer: Factor XII
Correct Answer: Factor VII
Explanation:The tissue factor pathway (extrinsic) begins following damage to the blood vessel. FVII leaves the circulation and comes into contact with tissue factor (TF) expressed on tissue-factor-bearing cells (stromal fibroblasts and leukocytes), forming an activated complex (TF-FVIIa).
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This question is part of the following fields:
- Haematology
- Medicine
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Question 8
Correct
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In the clotting mechanism, activation of factor IX can occur through the direct actions of:
Your Answer: Factor VIIa & XIa
Explanation:Factor IX is processed to remove the signal peptide, glycosylated and then cleaved by factor XIa (of the contact pathway) or factor VIIa (of the tissue factor pathway). When activated into factor IXa, in the presence of Ca2+, membrane phospholipids, and a Factor VIII cofactor, it hydrolyses one arginine-isoleucine bond in factor X to form factor Xa. Factor IX is inhibited by antithrombin.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 9
Incorrect
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Which of the following factors is directly responsible for the breakdown of fibrinogen to fibrin?
Your Answer: Tissue plasminogen activator
Correct Answer: Thrombin
Explanation:Prothrombin (coagulation factor II) is proteolytically cleaved to form thrombin in the coagulation cascade, the clotting process. Thrombin in turn acts as a serine protease that converts soluble fibrinogen into insoluble strands of fibrin, as well as catalysing many other coagulation-related reactions.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 10
Correct
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Question 11
Correct
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Which of the following conditions is procoagulant?
Your Answer: Factor V Leiden
Explanation:Factor V Leiden is a genetic mutation of one of the clotting factors in the blood, Factor V. This mutation makes Factor V resistant to inactivation by activated Protein C, which normally helps to regulate clot formation. As a result, individuals with Factor V Leiden are at increased risk of developing abnormal blood clots (thrombophilia), making it a procoagulant condition.
The other conditions listed are associated with bleeding tendencies rather than increased clotting:
- Afibrinogenemia: A rare genetic disorder where there is a complete lack of fibrinogen, leading to bleeding problems.
- Hemophilia: A group of inherited bleeding disorders where blood does not clot properly due to the lack of sufficient blood-clotting proteins (factors VIII or IX).
- Hypothrombinemia: A condition characterized by low levels of prothrombin, leading to increased bleeding.
- Christmas disease (Hemophilia B): A form of hemophilia caused by a deficiency of factor IX, resulting in a bleeding tendency.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 12
Correct
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Question 13
Incorrect
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What is the function of Activated protein C?
Your Answer: Activates factor Va-1
Correct Answer: Inactivates factor Va
Explanation:Activated Protein C (APC) is a crucial protein in the regulation of blood coagulation. Its primary functions include:
- Inactivating Factor Va: APC inactivates Factor Va, which is a cofactor for the conversion of prothrombin to thrombin by Factor Xa. By inactivating Factor Va, APC reduces thrombin formation, thereby acting as an anticoagulant.
- Inactivating Factor VIIIa: APC also inactivates Factor VIIIa, another cofactor that assists Factor IXa in the conversion of Factor X to Factor Xa. This further contributes to its anticoagulant effect.
These actions help to regulate blood clotting and prevent excessive thrombosis.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 14
Correct
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With regards to splenic micro-architecture which is not contained within the red pulp
Your Answer: Malpighian corpuscles
Explanation:Red pulp is responsible for mechanical filtration of red blood cells and is composed of sinusoids, which are filled with blood, splenic cords of reticular fibers and a marginal zone bordering on white pulp. White pulp provides an active immune response through humoral and cell-mediated pathways. Composed of nodules, called Malpighian corpuscles. These are composed of: lymphoid follicles, rich in B-lymphocytes and periarteriolar lymphoid sheaths (PALS), rich in T-lymphocytes.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 15
Correct
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The following play a role in regulation of intestinal iron absorption except:
Your Answer: Urinary iron excretion rate
Explanation:The human body’s rate of iron absorption appears to respond to a variety of interdependent factors, including total iron stores, dietary intake, the extent to which the bone marrow is producing new red blood cells, the concentration of haemoglobin in the blood, and the oxygen content of the blood. Classic examples of genetic iron overload includes hereditary hemochromatosis (HH) and the more severe disease juvenile hemochromatosis (JH).
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This question is part of the following fields:
- Haematology
- Medicine
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Question 16
Correct
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Which statement about antithrombin III is true?
Your Answer: It inhibits particularly factor II and X
Explanation:Antithrombin inactivates its physiological target enzymes, Thrombin (Factor II), Factor Xa and Factor IXa. ATIII binds to thrombin and then forms the thrombin-anti thrombin complex or TAT complex. This is a major natural pathway of anticoagulation. This binding of thrombin to AT is greatly enhanced in the presence of heparin.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 17
Correct
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Where is Vitamin B12 mainly stored in the body?
Your Answer: Liver
Explanation:The total amount of vitamin B12 stored in body is about 2–5 mg in adults. Around 50% of this is stored in the liver. Approximately 0.1% of this is lost per day by secretions into the gut, as not all these secretions are reabsorbed.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 18
Correct
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With regard to the spleen which of the following has the correct match?
Your Answer: Periarteriolar lymphoid sheets - T lymphocytes
Explanation:The spleen consists of:Red pulp – responsible for mechanical filtration of red blood cells. Red pulp contains sinusoids, which are filled with blood, splenic cords of reticular fibers and a marginal zoneWhite pulp – responsible for active immune response through humoral and cell-mediated pathways. Composed of nodules, called Malpighian corpuscles. These are composed of: lymphoid follicles, rich in B-lymphocytes and periarteriolar lymphoid sheaths, rich in T-lymphocytes
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This question is part of the following fields:
- Haematology
- Medicine
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Question 19
Correct
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One of the functions of the spleen with regards to red blood cells is:
Your Answer: To filter and remove aged and abnormal red blood cells
Explanation:The spleen plays important roles in regard to red blood cells (also referred to as erythrocytes) and the immune system. It removes old red blood cells and holds a reserve of blood, which can be valuable in case of haemorrhagic shock, and also recycles iron. As a part of the mononuclear phagocyte system, it metabolizes haemoglobin removed from senescent erythrocytes. The globin portion of haemoglobin is degraded to its constitutive amino acids, and the haem portion is metabolized to bilirubin, which is removed in the liver.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 20
Correct
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Stem cell characteristics include the following except
Your Answer: Differentiation and proliferation into progenitor cells committed to multiple cell lines
Explanation:The classical definition of a stem cell requires that it possess two properties:Self-renewal: the ability to go through numerous cycles of cell division while maintaining the undifferentiated state.Potency: the capacity to differentiate into specialized cell types. In the strictest sense, this requires stem cells to be either totipotent or pluripotent to be able to give rise to any mature cell type
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This question is part of the following fields:
- Haematology
- Medicine
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Question 21
Correct
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What is the main function of vitamin E?
Your Answer: It is an antioxidant
Explanation:Vitamin E has many biological functions, the antioxidant function being the best known. Other functions include enzymatic activities, gene expression, and neurological function(s).
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This question is part of the following fields:
- Haematology
- Medicine
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Question 22
Incorrect
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All of the following are Vitamin K-dependent clotting factors except:
Your Answer: Factor II
Correct Answer: Factor XI
Explanation:Activated Vitamin K is used to gamma carboxylate (and thus activate) certain enzymes involved in coagulation: Factors II, VII, IX, X, and protein C and protein S. Inability to activate the clotting cascade via these factors leads to the bleeding symptoms
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This question is part of the following fields:
- Haematology
- Medicine
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Question 23
Incorrect
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Why is tissue plasminogen activator (tPa) a valuable treatment used in myocardial infarction and stroke?
Your Answer: It directly lyses fibrin
Correct Answer: It forms plasmin from its inactive precursor
Explanation:tPA is a serine protease involved in the breakdown of blood clots. It functions by converting plasminogen, an inactive precursor, into plasmin, an active enzyme. Plasmin then degrades fibrin, the main protein component of blood clots, leading to clot dissolution. This mechanism is particularly valuable in the treatment of myocardial infarction (heart attack) and ischemic stroke, where timely dissolution of the clot can restore blood flow to affected tissues and reduce damage.
Therefore, the correct answer is:
- It forms plasmin from its inactive precursor
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This question is part of the following fields:
- Haematology
- Medicine
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Question 24
Correct
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Which of the following is a precursor to the tissue macrophage?
Your Answer: Monocyte
Explanation:Monocytes are a type of white blood cell, or leukocyte. They are the largest type of leukocyte and can differentiate into macrophages or dendritic cells.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 25
Incorrect
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Regarding Iron stores, which of the following contains the highest proportion of total body iron?
Your Answer: Ferritin
Correct Answer: Haemoglobin
Explanation:Most well-nourished people in industrialized countries have 4 to 5 grams of iron in their bodies. Of this, about 2.5 g is contained in the haemoglobin needed to carry oxygen through the blood, and most of the rest (approximately 2 grams in adult men, and somewhat less in women of childbearing age) is contained in ferritin complexes that are present in all cells, but most common in bone marrow, liver, and spleen.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 26
Correct
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Platelets are stored in this body organ.
Your Answer: Spleen
Explanation:Megakaryocyte and platelet production is regulated by thrombopoietin. Each megakaryocyte produces between 1,000 and 3,000 platelets during its lifetime. An average of 1011 platelets are produced daily in a healthy adult. Reserve platelets are stored in the spleen, and are released when needed by splenic contraction induced by the sympathetic nervous system.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 27
Correct
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Which of the following is true regarding platelets?
Your Answer: Normally have a half-life of about 8 days
Explanation:Platelets have no cell nucleus: they are fragments of cytoplasm that are derived from the megakaryocytes of the bone marrow, and then enter the circulation. They have a half life of 5-9 days.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 28
Correct
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5-methyltetrahydrofolate (Methyl THF) is converted to THF with the help of which of the following?
Your Answer: B 12
Explanation:MTR, also known as methionine synthase, is a methyltransferase enzyme, which uses the Vitamin B12 to transfer a methyl group from 5-methyltetrahydrofolate to homocysteine, thereby generating tetrahydrofolate (THF) and methionine. This functionality is lost in vitamin B12 deficiency, resulting in an increased homocysteine level and the trapping of folate as 5-methyl-tetrahydrofolate, from which THF (the active form of folate) cannot be recovered. THF plays an important role in DNA synthesis so reduced availability of THF results in ineffective production of cells with rapid turnover, in particular red blood cells, and also intestinal wall cells which are responsible for absorption.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 29
Correct
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Transport of Iron into enterocytes occurs via which membrane transporter?
Your Answer: Divalent metal transporter 1(dmt1)
Explanation:To be absorbed, dietary iron can be absorbed as part of a protein such as haem protein or iron must be in its ferrous Fe2+ form. A ferric reductase enzyme on the enterocytes’ brush border, duodenal cytochrome B (Dcytb), reduces ferric Fe3+ to Fe2+. A protein called divalent metal transporter 1 (DMT1), which can transport several divalent metals across the plasma membrane, then transports iron across the enterocyte’s cell membrane into the cell.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 30
Correct
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In adults, the major site of haematopoiesis is?
Your Answer: The axial skeleton
Explanation:Bone marrow is the flexible tissue in the interior of bones. In humans, red blood cells are produced by cores of bone marrow in the heads of long bones.
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This question is part of the following fields:
- Haematology
- Medicine
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