Clinical Biochemistry 1st SCT

1. Which depicts the sensitivity?

a. TP/(FP+TP)

b. TP/(FN+TP)

c. TN/(FP+TN)

d. TN/(FN+TN)

b

2. The following changes may occur in blood specimens during storage

a. K is released from RBC

b. The blood absorbs CO2 from the air and the pH decreases

c. In the RBCs glucose is produced, that leaks out through the membrane and increases plasma glucose level

d. Labile enzymes loose activity

a, d

1/ Glycolysis in the red blood cells

2/ Release of K+ and LDH from red blood cells

3/ Loss of CO2 from the specimen

5/ Labile enzymes loose activity

3. Trueness of analytical methods

a. Good reproducibility

b. Difference between the measured and true value

c. Small random error

d. Bias

b, d

(systematic error, bias)

4. What error may result from prolonged sample storage?

a. Preanalytical

b. Analytical

c. Postanalytical

d. None

a

5. The following statement(s) is(are) true for imprecision

a. It is measured by repeated analysis (n=15-20 samples) within optimal and routine conditions

b. Expressed as CV(%)=SD*100/mean

c. Expressed as CV(%)=mean*100SD

d. It is measured as a deviation from the true value

a, b

20 x 2 x 2 Approach - Replication measurements by repeated analysis:

• For at least 20 days

• 2 runs per day

• 2 replicates per run for a given sample

Expressed as: CV (%) = (SD / mean) x 100

6. If reference values show normal distribution reference limits can be calculated:

a. Mean ±2SD

b. By cutting 2.5% of the values (events) from the upper and lower take of the distribution curve

c. By logarithm transformation of the data

d. Setting positive

a, b

Reference limit:

(2.5th till 97.5th percentile)

mean ±2SD

16. Which hormone has the major role in the development of paraneoplastic thrombocytosis?

a. Calcitonin

b. Erythropoietin

c. G-CSF

d. Thrombopoietin

d

17. The following tumor markers are enzymes

a. NSE

b. AFP

c. CEA

d. PSA

a, d

ALP, CK, LD, NSE, PAP, PSA

18. The serum concentration of which tumor markers are used in the calculation of the ROMA score(%)

a. CEA and CA 125

b. CEA and HE4

c. CA-125 and HE4

d. CA-125 and SCC

c

ROMA score (%) (Risk of Ovarian Malignancy Algorithm):

Predicts the risk of ovary cancer with high sensitivity both in pre- and post-menopause using the serum concentration of CA-125 and HE4.

19. Staining method in which detects bone marrow iron stores?

a. GAPA

b. PAS

c. Prussian blue

d. Sudan black

c

20. Which result reflects a healthy adult hemoglobin ratio?

a. HbA2: 2.0%, HbF: 4%

b. HbA2: 6.0%, HbF: 1%

c. HbA2: 8.0%, HbF: 4%

d. HbA2: 2.0%, HbF: 0.8%

d

HbA - 96-98%

HbA2 - 1.5-3.2%

HbF - 0.5-0.8%

21. Which statement(s) is(are) true for hemoglobin H disease?

a. It is a type beta thalassemia

b. It is a type of alpha thalassemia

c. Beta globin chains are accumulated

d. Alpha globin chains are accumulated

b, c

α-thalassaemia intermedia (HbH)

22. Which test are used in evaluation of iron homeostasis

a. Serum ferritin concentration

b. Transferrin saturation

c. Determination of the maintenance of RBCs

d. Crychemolysis test

a, b

23. Laboratory sign(s) of hemolysis

a. Elevated conjugated bilirubin

b. Decreased free haptoglobin

c. Elevated LDH activity

d. Elevated alkaline phosphatase activity

b, c

- Decreased free haptoglobin

- Elevated LDH activity

- Elevated UN-conjugated bilirubin

- Elevated urine UBG

- Elevated reticulocyte count

24. What is sideroblast

a. Myeloid precursor containing iron deposits in the bone marrow

b. Erythroid precursor containing iron deposits in the bone marrow

c. Myeloid cell containing iron deposits in the peripheral blood

d. Erythoid cell containing iron deposits in the peripheral blood

b

Sideroblasts are nucleated erythroblasts (precursors to mature red blood cells) with granules of iron accumulated in the mitochondria surrounding the nucleus. Normally, sideroblasts are present in the bone marrow, and enter the circulation after maturing into a normal erythrocyte.

25. Which of the following cause hypochromatic microcytic anaemia?

a. B12 vitamin deficiency

b. Iron deficiency

c. Iron overload

d. Thalassemia

b, d

26. Characteristic feature(s) in Paroxysomal Nocturnal Hemoglobinuria

a. Autoimmune hemolytic anaemia

b. Haemolytic anaemia characterized by the increased sensitivity of RBC towards complement mediated lysis

c. Primarily affects the gastrointestinal tract

d. Is characterized by elevated LDH

b, d

28. Serum biomarker(s) are used to detect an acute phase reaction

a. CRP

b. haemoglobin

c. PCT

d. Cytokines

a, c, d

PCT = Procalcitonin

29. The followings are NOT characteristics for CRP

a. Reacts with the F-polysaccharide of Streptococcus pneumoniae

b. Synthesized in the kidneys

c. Can initiate opsonization of bacteria

d. Once complexed activation the classical complement pathway

a, b

- Reacts with C-polysaccharide of S. pneumoniae, non-covalently bound pentamer

- Synthesized in the liver

- Can initiate opsonization, phagocytosis and cell lysis

- Once complexed activates the classical complement pathway

31. SI unit of enzyme activity:

a. Katal = mmol/ms

b. Katal = micromole/ms

c. Katal = mol/s

d. Katal = mmol/s

c

katal = mol/s

1 IU = 16.7 nkatal

32. Which molecules are prostaglandin?

a. PGI2

b. LTB2

c. 5-HETE

d. TXA2

a, d

33. The molecules released from the myocardial cells in an acute myocardial infarction appear and reach their peak concentration in the systemic circulation in the following order :

a. ions -> metabolites -> macromolecules

b.

c.

d.

a

Ions - K+ & Phosphate

Metabolites - Lactate & Adenosine

Macromolecules - Enzymes or Proteins

34. General vascular changes in acute inflammation

a. Increased permeability of the vessel wall

b. Decreased permeability of the vessel wall

c. Vasodilation

d. Prolonged Vasoconstriction

a, c

35. Which type of tumor has the highest number of small genetic alterations in it genome

a. Pediatric retinoblastoma

b. Chronic lymphocytic leukemia

c. Lung cancer

d. Prostate cancer

c

36. In which oncogenes can we detect mutation in the case of patients suffering from familial medullary thyroid cancer?

a. RET

b. BRCA1

c. BRCA2

d. APC

a

37. Which substances are involved in the leukocyte endothelial cell interaction?

a. E-selectin

b. K-selectin

c. L-selectin

d. Z-selectin

a, c

38. According to the Gompertzius pattern the doubling time of the tumor cells is short :

a. During the 1-10 doubling

b. During the 10-20 doubling

c. During the 30-33 doubling

d. During the 33-40 doubling

a, b

Short - 1-20 doublings

Long - 30-40 doublings

40. The possible cause(s) of renal failure associated with cancer:

a. Obstruction of the urinary tract (e.g. by prostatic cancer)

b. Direct infiltration of the kidneys (e.g. by lymphoma)

c. Benece-Jones proteinuria (in myeloma)

d. None of them

a, b, c

Renal manifestations: renal failure, nephrotic syndrome, glomerulonephritis:

Causes: obstruction in the urinary tract, hypercalcemia, infiltration of the kidneys by tumor cells, Bence- Jones proteinuria, antibiotics, cytostatic drugs.

Tumors associated: Hodgkin's & Non-Hodgkin's lymphoma, colon cancer., prostate cancer

41. Which statements are true?

a. The "driver" mutation provide selective growth advantage for the transformed epithelial cells compared to their normal counterparts

b. The "driver" mutation have no effect on the tumor development and growth

c. The majority of the "driver" mutation develop in the preneoplastic time

d. The driver genes can be component of 12 major signaling pathways

a, d

(b & c are related to Passenger mutations)

42. Genetic cause(s) of multiple form of enzymes:

a. Post translational modification on protein component

b. The enzymes are coded at multiple gene loci

c. Aggregation of the enzyme molecules

d. Post-translational modification on a non protein component

b

(All or are correct, BUT ONLY B is a GENETIC CAUSE)

1/ Genetic causes (isoenzymes)

a, Enzymes coded at multiple gene loci

b, Alloenzymes

c, Hybrid isoenzymes

2/ Nongenetic causes (isoforms)

a, Post-translational modification on the protein component

b, Post-translational modification on a non-protein component

c, Aggregation of enzyme molecules

43. The following statements are NOT characteristic for carcinoid tumors?

a. They arise from the cells of the APUD series

b. They are of high grade malignancy

c. They distant metastasis very frequently

d. They secrete vasoactive amines (5-HT)

b, c

Arise from APUD cells, mostly in the appendix & ileocecal region, low grade, invasive, rarely gives distant metastasis.

Associated with the secreted vasoactive amines (5-hydroxy tryptamine, histamine, kinins); direct secretion to the systemic circulation.

45. Which tumor markers belong to the oncofetal antigens?

a. AFP

b. CEA

c. CA 15-3

d. PSA

a, b

AFP, CEA, TPA, SCC

46. The most important tumor markers of germ cell tumors:

a. SCC

b. CA-125

c. AFP

d. hCG

c, d

AFP, hCG, LDH, P-ALP

47. The following statements are characteristics for the Tumor lysis syndrome

a. usually associated with hypokalaemia

b. usually associated with hypercalcaemia

c. may be associated with symptoms of cardiac arrhythmias or tetany

d. massive cell lysis induced by chemotherapy

c, d

Massive cell lysis caused by chemotherapy.

Symptoms: Hyperuricemia, Hyperkalemia, Hyperphosphatemia, hypocalcemia.

48. Causes of hyperalbuminemia:

a. Dehydration

b. Venous stasis during blood collection

c. Over-infusion of albumin

d. Inflammation

a, b, c

Increased albumin synthesis does NOT cause hyperalbuminemia!!!

50. which statement is true for CRP

a. Synthesized in the liver

b. An excellent marker of inflammatory disease

c. In inflammation its elevation follows the elevation of erythrocyte sedimentation rate (ESR)

d. It's level is raised in myocardial infarction

a, b, d

(CRP shows an earlier rise (4-6 hours) and more intense increase than ESR)

51. Technic(s) and method(s) which is/are NOT suitable for the differientiation of isoenzymes

and isoforms

a. Zone electrophoresis

b. Phlame photometry

c. Isoelectric focusing

d. Selective inactivation

b

1/ Zone electrophoresis

2/ Isoelectric focusing

3/ Ion exchange chromatography

4/ Selective inactivation

5/ Differences in catalytic properties

6/ Immunochemical methods (monoclonal antibodies)

52. which is a vasodilator

a. NO

b. PGI2

c. TXA2

d. leukotrienes

a, b

55. which are the possible causes of the paraneoplastic hypoproliferative anemia

a. Iron deficiency

b. Megaloblastic anemia

c. Secondary bone marrow damage due to cancer treatment

d. Autoimmune reaction caused by antibodies against erythrocytes

a, b, c

56. which hormone has the major role in the development of paraneoplastic erythrocytosis

a. Calcitonin

b. Erythropoetin

c. G-CSF

d. thrombopoetin

b

60. in hereditary spherocytosis we can see:

a. Macro-ovalocytes in the smear

b. Micro-spherocytes in the smear

c. Reticulocytosis

d. Normal reticulocyte count

b, c

61. Changes in urine components during storage:

a. Destruction of glucose by bacteria

b. Glucose production by bacteria

c. Elavation of Na concentration in the urine

d. Decrease of pH in the urine

a, d

1/ Destruction of glucose by bacteria

2/ Urea is converted to ammonia, pH decreases, phosphate precipitates

3/ Oxidation of urobilinogen and porphobilinogen

62. Reference interval:

a. The interval between the mean ±2SD of the reference sample group

b. It corresponds to the interval btw the mean ±2SD of the reference sample group only if the distribution of the values is normal (gaussian).

c. Under no condition does it correspond to the interval btw the mean ±2SD of the reference sample group.

d. ?

b

63. Reference interval

a. Includes all normal values

b. Includes all pathological values

c. Includes the middle 95% of the reference population

d. Mean of normal population, ±SD.

c

64. Specificity of laboratory tests:

a. Number of true positive cases devided by the number of all cases with disease (TP + FP)x 100

b. Number of TP cases devided by the number of all positive ( TP + FP) cases x 100

c. The sum of the TP and the TN cases divided by the total number of tests x 100

d. Number of TN cases divided by the number of all cases without disease (FP + TN) x 100

d

TN

_____________ x 100 = Specificity

TN + FP

66. The meaning of the formula below: TP + TN / total # of tests x 100

a. Diagnostic specificity

b. Diagnostic sensitivity

c. Predictive value for negative results

d. Diagnostic efficiency

d

67. Precision of laboratory tests:

a. Difference of two parallel determinations

b. Deviation from the true value

c. Measure of reproducibility, assessed by repeated analysis of the same sample and expressed as CV%

d. Measure of reproducibility assessed by repeated analysis of the same samlpe and expressed as 2SD.

c

69. what is NOT characeristic during prolonged sample storage

a. Elavation of potassium

b. Elavation of calcium

c. Elavation of LDH

d. Elavation of pH

b, d

70. which depicts the negative predictive value

a. TP/ (FP + TP )

b. TP/ (FN + TP)

c. TN/ (FP + TN)

d. TN/ (FN + TN)

d

71. inaccuracy of analytical methods

a. Poor reproducibility

b. Deviation from the true value

c. The measure of differences among repeated analysis

d. Random error

b

73. Membrane surface proteins participating in the firm adhesion of leukocytes to endothelial cells

a. Cytokines

b. Chemokines

c. Integrins

d. Selectins

c

74. Role of opsonins

a. Tissue destruction

b. A subtype of cytokines

c. Cover the surface of particles to be phagocytosed

d. Promote the attachment of particles to the surface of phagocytes

c, d

77. Hyperalbuminemia can be caused by

a. Dehydration

b. Venous stasis during blood collection

c. Increased albumin synthesis

d. Starving

a, b

1/ Dehydration

2/ Venous stasis during blood collection

3/ Over infusion of albumin

Increased albumin synthesis does NOT cause hyperalbuminemia!

78. Positive acute phase reaction

a. C-reactive protein

b. Transferrin

c. Fibrinogen

d. Ceruloplasmin

a, c, d

Positive Acute Phase Proteins:

Early, sensitive reactants:

a1-antitrypsin

a1-acid glycoprotein (AAG)

Haptoglobin

Fibrinogen

C-reactive protein (CRP)

Late, weak reactants:

Caeruloplasmin

C3, C4 complement components

Negative acute phase proteins:

Pre-albumin

Albumin

Transferrin

79. Procalcitonin is an effective tool in the differential diagnosis of the following clinical situations:

a. Does the patient have a viral or bacterial meningitis

b. Etiology of fever of unknown origin

c. Does the patient have chronic inflammation or acute bacterial infection

d. Does the patient have chronic or acute myeloid leukaemia

a, b, c

PCT is an effective tool in the differential diagnosis of the following clinical situations:

• septic and non-septic ARDS

• toxic and non-toxic pancreatitis

• chronic inflammation versus acute bacterial infection

• etiology of meningitis (viral vs. bacterial)

• extent and severity of peritonitis

• etiology of fever of unknown origin

• monitoring the effectiveness of therapy

80. make the proper order based on increasing amino acid concentration

a. CSF < cells < plasma

b. CSF < plasma < cells

c. Cells < CSF < plasma

d. Plasma < CSF < cells

b

83. in which phase of the leukocyte-endothel interaction play selectins a role:

a. Transmigration

b. Initial contact, rolling

c. Adhesion

d. Chemotaxis

b

84. inflammatory mediators synthesized in cells

a. NO

b. Prostaglandins

c. Anaphylaxis

d. Cytokines

a, b, d

86. Possible causes of hypoalbuminaemia

a. Increased loss of proteins via the kidneys (nephrosis)

b. Stasis of blood collection

c. Starvation

d. Dehydration

a, c

87. In most of the cases of paraproteinaemia the following changes are charecteristic for the electrophoretic patteren of

plasma proteins

a. The albumin fraction is greatly elevated

b. The alfa-1-globulin fraction is greatly elavated

c. In the gamma-globulin region an intensive and sharp monoclonal band is visible

d. In the gamma globulin region there is a diffuse increase of gamma globulins

c

Albumin decreases, alpha-1 decreases.

Sharp band in the gamma globulin region - NOT diffuse!

97. which oxygen radical is synthesized DIRECTLY by the NADPH-oxidase enzyme

a. Superoxide ion (O2-)

b. Hydrogen peroxide (H2O2)

c. Hydrochlorus radical (OCl")

d. Hydroxyl radical (OH")

a

98. which molecules are prostaglandins

a. PGl2

b. LTB-4

c. 5-HETE

d. TXA2

a, d

99. plasma total protein concentration may increase

a. In case of dehydration of patient

b. In case of stasis during venipunture

c. In case of starvation

d. In case of hepatic failure

a, b

101. which molecules released from destroyed cells enter the systemic circulation mainly via the slow lymphatic drainage.

a. Ions

b. Metabolites

c. Macromolecules

d. None of them

c

102. in which tissue homogenate can we measure the highest relative activity of the creatine kinase (CK. enzyme)

a. Heart

b. Liver

c. Skeletal muscle

d. Red blood cells

c

Heart - highest is GOT

Liver - highest is GPT

RBC - highest is LDH

105. the effect of histamine

a. Platelet activation

b. Endothelial cell contraction in venules

c. Leukocytic activation

d. Increased vascular permeabiltiy

b, d

Effects:

- Arteriolar dilation,

- Endothelial cell contraction in venules

- Increased vascular permeability

106. which proteins belong to the group of negative acute phase proteins

a. CRP

b. Haptoglobin

c. Fribrinogen

d. Transferrin

d

Prealbumin

Albumin

Transferrin

110. which is the most important and frequent clinical application of tumor markers

a. screening

b. diagnosis of tumors

c. follow-up

d. estimation of prognosis

c

All of these are applications of tumor markers, but follow-up (Monitoring patients with diagnosed disease) is the MOST important

111. the level of procalcitonin is raised in

a. myocardial infarction

b. leukemia

c. sepsis

d. decreased thyroid function

c

Serum procalcitonin is increased in sepsis and severe bacterial infections.

It is absent (<0.1 μg/L) in the serum of healthy individuals.

112. the DNA sequencing is:

a. A screening method

b. A cheap mutaion detection method

c. Can detect all small-scale mutation

d. A method that characterizes every mutation

d (maybe c)

- A reference method!

- Expensive and time consuming!

113. which statements is / are true

a. Purity of the isolated DNA : A260nm/A280nm

b. Purity of the isolated DNA : A280nm/A260nm

c. Ratio < 1,7 indicates protein contamination

d. Ratio > 1,7 indicates protein contamination

a, c

DNA - 260nm

Protein - 280nm

260 / 280 should be 1.7-1.9.

Less than 1.7 indicates protein contamination.

114. The plasma total protein concentration may increase in the following cases

a. Hypergammaglobulinaemia

b. Paraproteinaemia

c. Catabolic states

d. Haemodilution

a, b

1/ Hemoconcentration

- dehydration

- stasis

- posture

2/ Increased synthesis of plasma proteins:

- hypergammaglobulinemia

- paraproteinemia

115. which protein(s) bind(s) PSA in blood

a. Haptoglobin

b. α1-antichymotrypsine

c. α1-acid glycoprotein

d. α2-macroglobulin

b

Protease, in serum it can be free and complexed with alpha1-antichymotripsin and human kallikrein 2.

116. hypercalcaemia (high serum calcium concentration) can be caused by the following changes in cancer patients

a. The tumor secretes anti diuretic hormone (ADH)

b. The tumor secretes parathormone (PTH)

c. The tumor secretes osteclast activating factor

d. None of them

b, c

117. which endocrine gland(s) is/are affected in multiple endocrin neoplasia type IIA (MEN IIA)

a. Thyreoid (medullay cancer)

b. Pancreatic islets

c. Adrenal cortex

d. Adrenal medulla

a, d

- Thyroid (medullary cell carcinoma)

- Adrenal medulla (pheochromocytoma)

- Parathyroid

120. the following tumor markers are oncofetal antigens

a) SCC

b) CA-19-9

c) TPA

d) NSE

a, c

AFP, CEA, TPA, SCC

121. during metastasis formation the downregulation of which adhesion molecule play a key role in deattachment of tumor

cells from each other (in „loosening" up)

a. L-selectin

b. P-selectin

c. ICAM-1

d. E-cadherin

d

122. the following statements are characteristic features of the paraneoplastic syndromes (PS)

a. PS can be present in 40-50% of tumors

b. PS is relatively frequently associated with lung tumors

c. Recognition of PS alerts to a new diagnosis of cancer

d. PS may cause severe symptoms requring special palliative therapy

c, d

Importance:

- Recognition of PS alerts to a new diagnosis of cancer

- PS may cause severe symptoms -> palliative therapy

- PS may cause symptoms that can be confused with the direct

Frequency: 10-15%

Development of PS:

- expression of a new gene

- cellular dedifferentiation

- arrested differentiation

123. which disease(s) can be screened by the serum calcitonin measurement (among the high risk induviduals)

a. Familial papillary carcinoma of the thyroid gland

b. Familial adenoma of the parathyroid gland

c. Familial medullary carcinoma of the thyroid gland

d. Familial phaeochromocytoma

c

124. the following statements are NOT characteristic for the tumor lysis syndrome

a. Usually associated with hypokalemia

b. Usually associated with hyperkalemia

c. May be associated with symptoms of cardiac arrythmias or tetani

d. Massive cell lysis induced by chemotherapy

a

125. which of the following genes play importanst role in the development and progression of colorectal cancer

a. ERBB-1

b. P53

c. KRAS

d. APC

b, c, d

126. Retinoblastoma 1 (RB1) gene

a. Is a tumorsupressor gene

b. Plays important role in cell cycle regulation

c. Has a DNA repair function

d. Is a oncogene

a, b

127. which gene mutation is associated with familial male breast cancer

a. BRCA1

b. BRCA2

c. C-MYC

d. ATM

b

128. mutation of the HNPCC1 gene is predisposition factor for:

a. Colorectal

b. Endometrial

c. Ovarian

d. Bladder

a, b, c

129. relative risk of cancers in relatives of cancer probands is higher than 10% for

a. Ovarian cancer

b. Male breast cancer

c. Lung cancer

d. Female breast cancer

a, d

134. what can be the cause of an elevated serum Ca2+ concentration in cancer patients

a. Ectopic production of ADH

b. Ectopic production of serotonin

c. Ectopic production of PTH or PTHrP

d. The presence of osteolytic bone metastasis

c, d

135. the tumor markers suggested for use in 1° gastric(stomach) cancers

a. CA 19-9

b. CA 15-3

c. CEA

d. CA 72-1

a, c

CEA < CA 19-9 < CA 72-4

137. what is the proper frequency of tumor marker determinations

a. Before and 2-10 days after the beginning of the therapy

b. In intervals of 3 months during the 1st and 2nd year after beginning of the therapy

c. In intervals of 6 months during the 3rd, 4th and 5th year after beginning of the therapy

d. 2 months after the first occurence of a significant increase of the corresponding tumor marker

a, b, c

(2-4 WEEKS after the first occurrence...)

138. characteristic feature of the ideal tumor marker

a. Produced specifically by either malignant or premalignant tissue

b. Long half life

c. Rise and fall of the marker concentration follows progression and regression

d. Produced in an organ specific manner

a, c, d

• Produced specifically by either malignant or premalignant tissue

• Produced in all patients with a specific tumor type

• Produced in an organ specific manner

• Measurable in an easily accessible body fluid

• Concentration in body fluid correlates with tumor volume or biological behavior of the tumor

• Short half-life for the post-therapy follow-up

• Rise and fall of the marker concentration should predict progression and regression

• A cheap, simple, standardized and reproducible assay should be available

140. which tumor markers can be used for cancer screening in certain risk groups

a. CA 19-9

b. Calcitonin

c. CA 72-4

d. AFP

b, d

- PSA

- CA-125

- AFP

- hCG

- Calcitonin

141. which three elements of lifestyle play the most important role in the development of cancer in the population

a. Excessive consumption of alcohol

b. Smoking

c. Sedentary lifestyle (physical inactivity)

d. Inappropriate diet

b, c, d

142. which of following statements are true

a. Transferrin saturation decreases in iron overload

b. Tranferrin saturation increases in iron overload

c. Ferritin concentration decreases in iron overload

d. Ferritin concentration increases in iron overload

b, d

143. characteristic features of iron metabolism

a. Serum iron concentration correlates with the saturation of iron stores

b. Iron is recycled in an almost closed system

c. Huge amount of iron is excreted through the kidneys

d. Free iron is toxic physiologically iron is bound to proteins

b, d

• Iron is continually recycled through an almost closed system.

• There is no significant iron excretion.

• Body stores are determined by control of intestinal absorption.

• Free iron is toxic - physiologically iron is all protein-bound (transport: transferrin, storage: ferritin, hemosiderin).

144. iron uptake into the cells

a. Is mediated through ferritin

b. Is mediated through transferrin receptor

c. Is an example for receptor mediated endocytosis

d. Is an example for simple diffusion

b, c

Which of the following disorder(s) cause hypochromic microcytic anemia

a. B12 vitamin deficiency

b. Iron deficiency

c. Thalassemia

d. Folic acid deficiency

b

146. characteristic alterations in thalasemias

a. Low platelet count

b. Low MCV

c. Low MCH

d. Low WBC

b, c

147. haemolytic anemia is characterised by

a. Decreased serum free haptoglobin

b. Increased serum haptoglobin

c. Increased serum conjugated bilirubin

d. Increased serum unconjugated bilirubin

a, d

148. which of the following cause RBC membrane defect

a. Iron deficiency

b. Hereditary sphaerocytosis

c. B12 deficiency

d. Hereditary elliptocytosis

b, d

- Spherocytosis

- Elliptocytosis

- Stomatocytosis

- Pyropoikilocytosis

149. the iron transporting protein is

a. Albumin

b. Ceruloplasmin

c. Transferrin

d. Ferritin

c

150. iron absorption is increased in case of

a. Ferrous iron

b. Alkalic pH - antacids, pancreatic enzymes

c. Iron deficiency

d. Acidic pH - HCl, ascorbic acid

a, c, d

1. Ferrous iron

2. Organic iron

3. Acidic pH - HCl, ascorbic acid

4. Substances enhancing solubility (sugar, amino acids)

5. Iron deficiency

6. Increased erythropoiesis

7. Pregnancy

8. Primary hemochromatosis