front 1 A skin biopsy 6 hours after bacterial cellulitis shows the earliest leukocyte influx expected in acute inflammation. Which cell type should predominate first? A) Basophils B) Monocytes C) Eosinophils D) Neutrophils | back 1 D. Neutrophils |
front 2 A child with helminth infection and asthma has increased leukocytes with large red cytoplasmic granules. Which association best matches this cell? A) Viral killing; lymph nodes B) Allergy; parasites; chronic inflammation C) Acute bacteria; pus formation D) Antibody production; plasma cells | back 2 B. Allergy; parasites; chronic inflammation |
front 3 Which statement best matches eosinophils with their classic microscopic and tissue features? A) Red granules B) Blue granules C) No granules D) Tertiary granules | back 3 A. Red granules |
front 4 A healthy adult female has blood centrifuged for hematocrit measurement. Which packed red-cell volume is expected? A) 20–30% B) 25–35% C) 35–45% D) 50–60% | back 4 C. 35–45% |
front 5 Which hemoglobin-chain pairing correctly describes adult hemoglobin A? A) Two alpha; two beta B) Two alpha; two gamma C) Two alpha; two delta D) Two beta; two delta | back 5 A. Two alpha; two beta |
front 6 Which hemoglobin-chain pairing correctly describes adult hemoglobin A2? A) Two beta; two gamma B) Two alpha; two delta C) Two alpha; two beta D) Two gamma; two delta | back 6 B. Two alpha; two delta |
front 7 Which hemoglobin-chain pairing correctly describes fetal hemoglobin? A) Two alpha; two beta B) Two beta; two delta C) Two alpha; two delta D) Two alpha; two gamma | back 7 D. Two alpha; two gamma |
front 8 A patient with sickle cell disease has abnormal polymerizing hemoglobin. Which mutation best explains the disease? A) Alpha-chain deletion B) Gamma-chain persistence C) Beta-globin point mutation D) Delta-chain duplication | back 8 C. Beta-globin point mutation |
front 9 In sickle cell anemia, which amino-acid substitution occurs in the abnormal beta-globin chain? A) Valine to glutamic acid B) Glutamic acid to valine C) Lysine to arginine D) Glycine to proline | back 9 B. Glutamic acid to valine |
front 10 Which hemoglobin mutation name is classically present in sickle cell anemia? A) HbC B) HbA2 C) HbF D) HbS | back 10 D. HbS |
front 11 During hematopoiesis, which progenitor gives rise to erythroid colony-forming units? A) Multipotential myeloid stem cell B) Mature erythrocyte C) Circulating reticulocyte D) Megakaryocyte lineage | back 11 A. Multipotential myeloid stem cell |
front 12 Which erythropoiesis transition occurs earliest in normal red-cell maturation? A) Reticulocyte to erythrocyte B) Normoblast to reticulocyte C) Proerythroblast to basophilic erythroblast D) Band cell to neutrophil | back 12 C. Proerythroblast to basophilic erythroblast |
front 13 Which late erythropoiesis sequence is correctly ordered? A) Reticulocyte before erythrocyte B) Erythrocyte before normoblast C) Myelocyte before reticulocyte D) Band before erythrocyte | back 13 A. Reticulocyte before erythrocyte |
front 14 A patient living at high altitude develops increased red-cell production. Which organ-hormone pairing drives this response? A) Liver; thrombopoietin B) Spleen; histamine C) Marrow; PDGF D) Kidney; erythropoietin | back 14 D. Kidney; erythropoietin |
front 15 A patient with chronic blood loss develops small pale red cells. Which deficiency best matches this microcytic anemia? A) Folate deficiency B) Iron deficiency C) Vitamin B12 deficiency D) EPO deficiency | back 15 B. Iron deficiency |
front 16 A patient with impaired DNA synthesis develops enlarged red-cell precursors. Which deficiency best matches macrocytic anemia? A) Folate deficiency B) Iron deficiency C) Histamine deficiency D) PDGF deficiency | back 16 A. Folate deficiency |
front 17 Which classification correctly divides white blood cells into two major groups? A) Platelets and erythrocytes B) Myeloid and erythroid cells C) Granulocytes and agranulocytes D) Plasma cells and stem cells | back 17 C. Granulocytes and agranulocytes |
front 18 Which set contains only granulocytes? A) Monocytes; lymphocytes; NK cells B) Basophils; eosinophils; neutrophils C) Platelets; monocytes; neutrophils D) B cells; T cells; basophils | back 18 B. Basophils; eosinophils; neutrophils |
front 19 Among granulocytes, which cell type is classically described as having tertiary granules? A) Neutrophils B) Basophils C) Eosinophils D) Monocytes | back 19 A. Neutrophils |
front 20 After leaving marrow, neutrophils can occupy which two peripheral compartments? A) Formation; storage B) Circulating; marginating C) Erythroid; megakaryocytic D) B-cell; T-cell | back 20 B. Circulating; marginating |
front 21 A neutrophil tethers to vascular endothelium during inflammation. Which adhesion molecule is involved in this binding? A) E-selectin B) P-selectin C) Integrin beta-chain D) L-selectin | back 21 D. L-selectin |
front 22 Which cell is the first recognizable precursor in granulocyte development? A) Myeloblast B) Promyelocyte C) Metamyelocyte D) Band cell | back 22 A. Myeloblast |
front 23 Which granulocyte maturation sequence is correctly ordered after the myeloblast stage? A) Myelocyte; promyelocyte; band; metamyelocyte B) Promyelocyte; myelocyte; metamyelocyte; band C) Band; metamyelocyte; myelocyte; promyelocyte D) Metamyelocyte; band; promyelocyte; myelocyte | back 23 B. Promyelocyte; myelocyte; metamyelocyte; band |
front 24 Which two leukocyte classes are agranulocytes? A) Neutrophils and basophils B) Eosinophils and monocytes C) Lymphocytes and monocytes D) Platelets and lymphocytes | back 24 C. Lymphocytes and monocytes |
front 25 The bipotential CFU-GM progenitor can differentiate into which two lineages? A) Platelets or erythrocytes B) Monocytes or neutrophils C) B cells or T cells D) Eosinophils or basophils | back 25 B. Monocytes or neutrophils |
front 26 Which marrow-derived platelet precursor normally remains in bone marrow rather than circulating intact? A) Megakaryocyte B) Reticulocyte C) Myeloblast D) Normoblast | back 26 A. Megakaryocyte |
front 27 Which list correctly names the four platelet granule types? A) Primary; secondary; tertiary; azurophilic B) Alpha; beta; gamma; delta C) Dense; clear; red; blue D) Alpha; delta; gamma; lambda | back 27 D. Alpha; delta; gamma; lambda |
front 28 Which major lymphocyte types should be grouped together? A) B cells; T cells; NK cells B) Monocytes; neutrophils; NK cells C) Basophils; eosinophils; B cells D) Platelets; T cells; monocytes | back 28 A. B cells; T cells; NK cells |
front 29 A patient undergoes splenic immune activation after a bloodstream infection. Which set best summarizes normal spleen functions? A) Store bile; activate neutrophils B) Make EPO; filter lymph C) Activate lymphocytes; filter blood antigens D) Produce platelets; degrade heme | back 29 C. Activate lymphocytes; filter blood antigens |
front 30 A patient with chronic hypoxemia develops increased erythropoiesis. Which kidney-derived hormone mediates this response? A) Erythropoietin B) Thrombopoietin C) Angiotensin II D) Aldosterone | back 30 A. Erythropoietin |
front 31 In mature erythrocytes, which metabolic route is dominant and feeds the pathway producing 2,3-BPG? A) TCA cycle; malate shunt B) Beta-oxidation; carnitine shuttle C) Pentose pathway; NADPH route D) Glycolysis; Rapoport-Leubering shunt | back 31 D. Glycolysis; Rapoport-Leubering shunt |
front 32 The hexose monophosphate shunt protects RBCs from oxidative damage by generating which paired products? A) ATP; oxidized glutathione B) NADPH; reduced glutathione C) FADH2; reduced hemoglobin D) NADH; ferric iron | back 32 B. NADPH; reduced glutathione |
front 33 What is involved in the first and what is involved in the rate-limiting step in heme biosynthesis: A) Acetyl-CoA and alanine B) Citrate and serine C) Succinyl-CoA and glycine D) Pyruvate and glutamate | back 33 C. Succinyl-CoA and glycine |
front 34 A blood smear shows malformed spherical RBCs, while another sample shows immature circulating RBCs. Which pairing is correct? A) Spherocytes; reticulocytes B) Schistocytes; normoblasts C) Reticulocytes; spherocytes D) Megakaryocytes; platelets | back 34 A. Spherocytes; reticulocytes |
front 35 A marrow biopsy shows large multinucleated cells releasing cytoplasmic fragments into sinusoids. Which blood element is produced this way? A) Eosinophils B) Monocytes C) Reticulocytes D) Platelets | back 35 D. Platelets |
front 36 A patient has microcytic, hypochromic anemia due impaired hemoglobin synthesis. Which cause set best fits? A) B12; folate; erythroleukemia B) Iron def; thalassemia; lead poisoning C) Bleeding; sickle disease; PK defect D) Splenectomy; malaria; methemoglobinemia | back 36 B. Iron def; thalassemia; lead poisoning |
front 37 A patient develops macrocytic, normochromic anemia from impaired DNA synthesis. Which cause set best fits? A) Iron deficiency; lead poisoning B) Acute bleeding; sickle disease C) B12 deficiency; folate deficiency D) G6PD deficiency; malaria resistance | back 37 C. B12 deficiency; folate deficiency |
front 38 A patient has normocytic, normochromic anemia from red-cell loss or destruction. Which cause set best fits? A) Bleeding; sickle disease; metabolic defects B) Iron deficiency; thalassemia; lead poisoning C) B12 deficiency; folate deficiency D) DMT1 mutation; pyridoxine deficiency | back 38 A. Bleeding; sickle disease; metabolic defects |
front 39 A patient at high altitude has increased erythrocyte 2,3-BPG. What is the main physiologic effect? A) Increased hemoglobin oxygen affinity B) Blocked oxygen release to tissues C) Methemoglobin reduction in RBCs D) Enhanced oxygen unloading to tissues | back 39 D. Enhanced oxygen unloading to tissues remember that 2,3 bpg helps unload o2 onto tissues |
front 40 An inherited RBC enzyme deficiency causes hemolytic anemia, with compensatory increased 2,3-BPG improving tissue oxygen delivery. Which enzyme is deficient? A) Cytochrome b5 reductase B) Glucose-6-phosphatase C) Pyruvate kinase D) Ferrochelatase | back 40 C. Pyruvate kinase |
front 41 Congenital methemoglobinemia can result from hemoglobin M or deficiency of which enzyme? A) Cytochrome b5 reductase B) Glucose-6-P dehydrogenase C) Gamma-ALA synthase D) Pyruvate kinase | back 41 A. Cytochrome b5 reductase |
front 42 Which inherited RBC enzyme deficiency is common in humans partly because it protects against malaria? A) Pyruvate kinase deficiency B) G6PD deficiency C) Cytochrome b5 reductase deficiency D) DMT1 deficiency | back 42 B. G6PD deficiency |
front 43 A patient with G6PD-deficient red cells is being evaluated for RBC survival. Which change is expected? A) Longer RBC lifespan B) Normal RBC half-life C) Increased platelet survival D) Reduced RBC half-life | back 43 D. Reduced RBC half-life |
front 44 A malnourished patient develops microcytic, hypochromic anemia because the first heme-synthesis reaction slows. Which deficiency best explains this? A) Vitamin B12 deficiency B) Folate deficiency C) Pyridoxine deficiency D) Vitamin C deficiency | back 44 C. Pyridoxine deficiency |
front 45 A child with abdominal pain and microcytic anemia has accumulation of gamma-ALA and protoporphyrin IX. Which exposure best explains this? A) Lead B) Iron C) Phenobarbital D) Malaria | back 45 A. Lead |
front 46 Dietary iron is absorbed as Fe2+ but must become Fe3+ for transport. Which protein performs this oxidation? A) Ferritin B) Hemosiderin C) Transferrin D) Ceruloplasmin | back 46 D. Ceruloplasmin |
front 47 Which iron-handling pairing is correct for blood transport, usual storage, and excess storage? A) Ferritin; transferrin; DMT1 B) Transferrin; ferritin; hemosiderin C) Hemosiderin; ferritin; transferrin D) Ceruloplasmin; DMT1; transferrin | back 47 B. Transferrin; ferritin; hemosiderin |
front 48 A patient has photosensitivity, facial hypertrichosis, and scarring due an inherited heme-synthesis enzyme defect. Which disorder group fits best? A) Porphyrias B) Thalassemias C) Sideroblastic anemias D) Methemoglobinemias | back 48 A. Porphyrias |
front 49 Which variable best correlates with the lifetime of an erythrocyte? A) Plasma transferrin saturation B) Splenic platelet storage C) Glucose-6-P activity D) Serum ceruloplasmin activity | back 49 C. Glucose-6-P activity |
front 50 A patient has microcytic, hypochromic anemia due an inherited SLC11A2 mutation. Which encoded protein is affected? A) Ferroportin B) DMT-1 C) Transferrin D) Ceruloplasmin | back 50 B. DMT-1 |
front 51 delete | back 51 delete |
front 52 A physician evaluating iron deficiency anemia in an adult man worries about occult GI blood loss. Which etiologies best match this concern? A) Ulcers or colon cancer B) Asthma or eczema C) Hemophilia or leukemia D) Malaria or porphyria | back 52 A. Ulcers or colon cancer |
front 53 Phenobarbital induces cytochrome P450 enzymes that use heme. Which compensatory response increases heme synthesis? A) Reduced DMT1 expression B) Induced gamma-ALA synthase C) Blocked bilirubin conjugation D) Increased cytochrome b5 reductase | back 53 B. Induced gamma-ALA synthase |
front 54 During normal heme catabolism, which product is conjugated with glucuronic acid and excreted in bile? A) Protoporphyrin IX B) Gamma-ALA C) Bilirubin D) Hemosiderin | back 54 C. Bilirubin |
front 55 An RBC membrane disorder affects the major erythrocyte cytoskeletal protein. Which protein is most likely defective? A) Ferritin B) Transferrin C) Ceruloplasmin D) Spectrin | back 55 D. Spectrin |
front 56 A patient has hemolytic anemia from unstable erythrocyte membranes. Which defect category best explains this? A) Cytoskeletal protein defects B) Platelet granule defects C) EPO receptor deactivation D) Transferrin transport defects | back 56 A. Cytoskeletal protein defects |
front 57 A bone marrow transplant sample is enriched before infusion to improve engraftment. Which cell population should be increased? A) Reticulocytes B) Stem cells C) Mature erythrocytes D) Megakaryocytes | back 57 B. Stem cells |
front 58 A family has excessive RBC production from an EPO receptor mutation causing sustained JAK2-STAT5 signaling. Which negative regulator cannot deactivate the receptor? A) DMT-1 B) Spectrin C) SHP-1 D) Ceruloplasmin | back 58 C. SHP-1 |
front 59 Which mechanism best explains megaloblastic anemia from folate or B12 deficiency? A) Early nuclear extrusion after fewer divisions B) Excess hemoglobin concentration per cell C) Increased splenic platelet sequestration D) Ferric hemoglobin accumulation | back 59 A. Early nuclear extrusion after fewer divisions |
front 60 HbC differs from normal beta-globin by which substitution at the same position affected in HbS? A) Glu-to-Val B) Lys-to-Glu C) Val-to-Glu D) Glu-to-Lys | back 60 D. Glu-to-Lys "C" for crystal, sounds like lysine i guess |
front 61 Why are HbS/HbC patients usually more symptomatic than HbA/HbS patients? A) Less HbS polymerizes in RBCs B) Higher HbS concentration enhances sickling C) HbC prevents oxygen unloading D) HbA increases RBC dehydration | back 61 B. Higher HbS concentration enhances sickling |
front 62 Which disorder group results from imbalanced alpha- and beta-globin chain synthesis? A) Porphyrias B) Methemoglobinemias C) Thalassemias D) Spherocytoses | back 62 C. Thalassemias |
front 63 Absence of all four alpha-globin genes is classically associated with which condition? A) Hydrops fetalis B) HbC disease C) Beta-thalassemia minor D) Congenital methemoglobinemia | back 63 A. Hydrops fetalis |
front 64 In beta-thalassemia, which genotype is expected to cause severe disease? A) β+/β+ B) βA/βS C) β+/βA D) β0/β0 | back 64 D. β0/β0 |
front 65 Compared with HbA, HbF binds 2,3-BPG differently in a way that causes which effect? A) Lower 2,3-BPG affinity; higher oxygen affinity B) Higher 2,3-BPG affinity; lower oxygen affinity C) Lower 2,3-BPG affinity; lower oxygen affinity D) Higher 2,3-BPG affinity; higher oxygen affinity | back 65 A. Lower 2,3-BPG affinity; higher oxygen affinity |
front 66 Patients with beta-thalassemia or sickle cell anemia often have milder disease when which hemoglobin is elevated? A) HbA B) HbA2 C) HbF D) HbC | back 66 C. HbF |
front 67 Mutations in spectrin, ankyrin, or band 3 most directly cause which RBC abnormality? A) Methemoglobin formation B) Spherocyte formation C) HbF persistence D) Porphyrin accumulation | back 67 B. Spherocyte formation |
front 68 Which pairing correctly describes the alpha-globin locus? A) Chromosome 11; epsilon gene B) Chromosome 11; gamma genes C) Chromosome 16; zeta and alpha genes D) Chromosome 16; beta and delta genes | back 68 C. Chromosome 16; zeta and alpha genes |
front 69 Which pairing correctly describes the beta-globin locus? A) Chromosome 11; epsilon and fetal genes B) Chromosome 16; zeta and alpha genes C) Chromosome 11; only beta genes D) Chromosome 16; gamma and beta genes | back 69 A. Chromosome 11; epsilon and fetal genes |
front 70 Normal functional hemoglobin within RBCs contains iron in which form? A) Ferric B) Ferrous C) Hemosiderin-bound D) Transferrin-bound | back 70 B. Ferrous |
front 71 Ferric hemoglobin within RBCs is best described by which term? A) Oxyhemoglobin B) Carboxyhemoglobin C) Deoxyhemoglobin D) Methemoglobin | back 71 D. Methemoglobin |
front 72 Inherited defects in heme-synthesis enzymes produce which disease group? A) Thalassemias B) Porphyrias C) Spherocytoses D) Hemoglobinopathies | back 72 B. Porphyrias |
front 73 Unlike mature RBCs, white blood cells normally have which structural feature? A) Nuclei B) Hemoglobin C) Spectrin D) Reticulin | back 73 A. Nuclei |
front 74 Which granulocyte rapidly migrates to infection or tissue damage? A) Basophil B) Eosinophil C) Monocyte D) Neutrophil | back 74 D. Neutrophil |
front 75 Which cell type is especially important against parasites and removes fibrin during inflammation? A) Eosinophil B) Basophil C) Neutrophil D) Lymphocyte | back 75 A. Eosinophil |
front 76 A patient with asthma and allergic disease has increased granulocytes. Which cell is most expected? A) Neutrophils B) Eosinophils C) Monocytes D) NK cells | back 76 B. Eosinophils |
front 77 Increased eosinophils are associated with which condition set? A) Asthma; allergies; autoimmune disease B) Bleeding; hemolysis; iron deficiency C) Thymic maturation; viral killing D) Platelet budding; clot retraction | back 77 A. Asthma; allergies; autoimmune disease |
front 78 Which granulocyte participates in hypersensitivity reactions and stores histamine? A) Neutrophil B) Eosinophil C) Basophil D) Monocyte | back 78 C. Basophil |
front 79 A lymphocyte precursor must mature into a T cell. Which organ is required? A) Thymus B) Spleen C) Bone marrow D) Lymph node | back 79 A. Thymus |
front 80 Which site is responsible for B-cell maturation? A) Thymus B) Bone marrow C) Spleen D) Liver | back 80 B. Bone marrow |
front 81 Tissue macrophages arise from which circulating precursor cell? A) Neutrophils B) Basophils C) Monocytes D) Reticulocytes | back 81 C. Monocytes |
front 82 An RBC enzyme defect blocks phosphoenolpyruvate conversion to pyruvate. Which metabolite is expected to rise? A) Heme B) 2,3-BPG C) Methemoglobin D) Reduced glutathione | back 82 B. 2,3-BPG |
front 83 Erythrocyte glycolysis generates 2,3-BPG through which pathway? A) Hexose monophosphate shunt B) Urea cycle C) Rapoport-Luebering shunt D) Carnitine shuttle | back 83 C. Rapoport-Luebering shunt |
front 84 How does 2,3-BPG promote oxygen delivery to tissues? A) Stabilizes deoxyhemoglobin B) Stabilizes ferric hemoglobin C) Oxidizes ferrous iron D) Activates cytochrome b5 | back 84 A. Stabilizes deoxyhemoglobin |
front 85 Congenital methemoglobinemia is classically caused by deficiency of which enzyme? A) Ferrochelatase B) G6PD C) δ-ALA synthase D) Cytochrome b5 reductase | back 85 D. Cytochrome b5 reductase |
front 86 Inherited hemoglobin M causes methemoglobinemia by stabilizing iron in which state? A) Fe0 B) Fe2+ C) Fe3+ D) Fe4+ | back 86 C. Fe3+ |
front 87 For hemoglobin to bind oxygen normally, iron must be in which form? A) Ferric; Fe3+ B) Ferrous; Fe2+ C) Heme-free; Fe0 D) Oxidized; Fe4+ | back 87 B. Ferrous; Fe2+ |
front 88 Cytochrome b5 is regenerated in RBCs using which reducing agent? A) NADH B) NADPH C) FADH2 D) ATP | back 88 A. NADH |
front 89 Which RBC pathway generates NADPH for antioxidant protection? A) Rapoport-Luebering shunt B) TCA cycle C) Hexose monophosphate shunt D) Beta-oxidation | back 89 C. Hexose monophosphate shunt |
front 90 The chief RBC defense against ROS injury to proteins and lipids is which molecule? A) Ferritin B) Reduced glutathione C) Transferrin D) Methemoglobin | back 90 B. Reduced glutathione |
front 91 Which molecule maintains glutathione in its reduced protective state? A) NADPH B) NADH C) 2,3-BPG D) δ-ALA | back 91 A. NADPH |
front 92 Which enzyme catalyzes the first step of the hexose monophosphate shunt? A) δ-ALA dehydratase B) G6PD C) Ferrochelatase D) Porphobilinogen deaminase | back 92 B. G6PD |
front 93 Which porphyrin type is most common in nature? A) Type I B) Type II C) Type III D) Type IV | back 93 C. Type III |
front 94 Which porphyrin is the most common in the human body? A) Bilirubin B) Heme C) Porphobilinogen D) Protoporphyrinogen | back 94 B. Heme |
front 95 Known G6PD variant genes most often contain which mutation types? A) Nonsense; frameshift deletions B) Missense; in-frame deletions C) Duplications; promoter insertions D) Translocations; trinucleotide repeats | back 95 B. Missense; in-frame deletions |
front 96 Heme synthesis begins with which two starter substrates? A) Glycine; succinyl CoA B) Alanine; acetyl CoA C) Serine; pyruvate D) Glutamate; citrate | back 96 A. Glycine; succinyl CoA |
front 97 The first intermediate formed from glycine and succinyl CoA in heme synthesis is what? A) Protoporphyrin IX B) Porphobilinogen C) δ-Aminolevulinic acid D) Uroporphyrinogen III | back 97 C. δ-Aminolevulinic acid |
front 98 Producing one heme molecule requires how many glycines and succinyl CoA molecules? A) Two of each B) Four of each C) Six of each D) Eight of each | back 98 D. Eight of each |
front 99 Heme regulates its own synthesis by repressing which enzyme? A) δ-ALA synthase B) Ferrochelatase C) Uroporphyrinogen decarboxylase D) Coproporphyrinogen oxidase | back 99 A. δ-ALA synthase |
front 100 δ-ALA dehydratase converts δ-ALA into which pyrrole product? A) Porphobilinogen B) Heme C) Biliverdin D) Protoporphyrin IX | back 100 A. Porphobilinogen |
front 101 Lead poisoning directly inhibits which two heme-synthesis enzymes? A) G6PD and ferrochelatase B) δ-ALA dehydratase and ferrochelatase C) Porphobilinogen deaminase and G6PD D) Cytochrome b5 and DMT-1 | back 101 B. δ-ALA dehydratase and ferrochelatase |
front 102 A child with lead toxicity develops impaired heme synthesis. Which metabolites accumulate? A) δ-ALA and protoporphyrin IX B) Heme and bilirubin C) Glycine and succinyl CoA D) Ferritin and transferrin | back 102 A. δ-ALA and protoporphyrin IX |
front 103 Which nutrient increases absorption of nonheme iron from the digestive tract? A) Vitamin B12 B) Folate C) Vitamin C D) Vitamin K | back 103 C. Vitamin C |
front 104 Which pairing correctly describes iron absorption and transport states? A) Absorbed Fe3+; transported Fe2+ B) Absorbed Fe2+; transported Fe3+ C) Absorbed Fe0; transported Fe2+ D) Absorbed Fe3+; transported Fe0 | back 104 B. Absorbed Fe2+; transported Fe3+ |
front 105 A patient with excess porphyrin production develops skin symptoms after sunlight exposure. Which symptom best fits? A) Photosensitivity B) Hemarthrosis C) Night blindness D) Splenomegaly | back 105 A. Photosensitivity |
front 106 Iron is carried in blood when apotransferrin binds iron to form which complex? A) Ferritin B) Transferrin C) Hemosiderin D) Ceruloplasmin | back 106 B. Transferrin |
front 107 Ferrous iron leaves the endosome and enters cytoplasm through which transporter? A) Band 3 B) Ferrochelatase C) DMT-1 D) Ankyrin | back 107 C. DMT-1 |
front 108 An SLC11A2 mutation disrupts DMT-1 function. Which anemia pattern is expected? A) Macrocytic normochromic anemia B) Iron-deficiency anemia C) Aplastic anemia D) Megaloblastic anemia | back 108 B. Iron-deficiency anemia |
front 109 How does heme regulate hemoglobin synthesis? A) Stimulates globin synthesis B) Blocks transferrin binding C) Degrades spectrin D) Inhibits bilirubin conjugation | back 109 A. Stimulates globin synthesis |
front 110 Normal heme degradation ultimately forms which pigment? A) Stercobilin B) Ferritin C) Bilirubin D) Protoporphyrin IX | back 110 C. Bilirubin |
front 111 The first step of heme degradation releases which gaseous product? A) CO B) NO C) O2 D) CO2 | back 111 A. CO |
front 112 In the liver, bilirubin reacts with UDP-glucuronate to form which water-soluble product? A) Urobilinogen B) Bilirubin monoglucuronide C) Stercobilin D) Protoporphyrin IX | back 112 B. Bilirubin monoglucuronide |
front 113 Intestinal bacteria deconjugate bilirubin diglucuronide into which compound? A) Urobilinogen B) UDP-glucuronate C) Biliverdin D) Hemosiderin | back 113 A. Urobilinogen |
front 114 Most intestinal urobilinogen is converted into which fecal pigment? A) Bilirubin B) Heme C) Stercobilin D) Ferritin | back 114 C. Stercobilin |
front 115 Which organ determines whether circulating RBCs remain viable? A) Liver B) Kidney C) Thymus D) Spleen | back 115 D. Spleen |
front 116 Which pairing correctly links spectrin to the RBC membrane bilayer? A) Ankyrin; assisted by band 3 B) DMT-1; assisted by ferritin C) Transferrin; assisted by ceruloplasmin D) Actin; assisted by HbF | back 116 A. Ankyrin; assisted by band 3 |
front 117 Which RBC cytoskeletal protein helps stabilize ankyrin-band 3 membrane attachment? A) Band 4.2 B) Glycophorin C C) Ferrochelatase D) Globin | back 117 A. Band 4.2 |
front 118 Band 4.1 anchors spectrin by binding which two proteins? A) Ankyrin and band 3 B) Glycophorin C and actin C) Ferritin and transferrin D) DMT-1 and ceruloplasmin | back 118 B. Glycophorin C and actin |
front 119 Leukemias are best described as which hematopoietic abnormality? A) Excess platelet granule release B) Complete erythrocyte maturation C) Incomplete hematopoietic cell development D) Accelerated bilirubin conjugation | back 119 C. Incomplete hematopoietic cell development |
front 120 In sickle-cell anemia, which beta-globin substitution produces HbS? A) E6K B) G6V C) E6V D) V6E | back 120 C. E6V |
front 121 HbC is caused by which beta-globin substitution? A) E6V B) E6K C) K6E D) V6K | back 121 B. E6K |
front 122 Which feature is characteristic of HbC protein within RBCs? A) Hemoglobin precipitation B) Ferric iron stabilization C) Increased HbF switching D) Decreased globin synthesis | back 122 A. Hemoglobin precipitation HbC disease causes abnormal hemoglobin that tends to precipitate/crystallize inside RBCs. This makes RBCs less flexible and more likely to be removed by the spleen, causing mild hemolytic anemia. |
front 123 An imbalance with excess production of one hemoglobin subunit over another causes which disease class? A) Porphyrias B) Methemoglobinemias C) Thalassemias D) Leukemias | back 123 C. Thalassemias |
front 124 Alpha-thalassemias usually arise from which genetic defect? A) β-promoter point mutations B) Complete α-globin gene deletions C) δ and β deletions D) Missense ferrochelatase mutations | back 124 B. Complete α-globin gene deletions |
front 125 Which thalassemia type is generally more severe? A) α-thalassemia B) β-thalassemia C) δ-thalassemia D) γ-thalassemia | back 125 B. β-thalassemia |
front 126 Which β-thalassemia genotype ranking is most severe to least severe? A) β+/β+ > β+/β0 > β0/β0 B) β0/β0 > β+/β0 > β+/β+ C) β+/β0 > β0/β0 > β+/β+ D) β+/β+ > β0/β0 > β+/β0 | back 126 B. β0/β0 > β+/β0 > β+/β+ |
front 127 Excess β-chains in thalassemia can form which homotetramer A) HbS B) HbC C) HbF D) HbH | back 127 D. HbH |
front 128 Excess α-chain production damages which RBC cytoskeletal protein? A) Band 4.1 B) Ankyrin C) DMT-1 D) Ceruloplasmin | back 128 A. Band 4.1 |