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