06 Clinical Pathology MCQS, With Answers

Mahmoud

Sewilam

1. The earliest recognizable form of RBCs is :  Proerythroblast Early normoblast  Intermediate Intermediate normoblast  Late normoblast  Reticulocyte  4. Target cells are found in : Thalassaemia  Haemoglobin C disease  Iron deficiency anemia  Liver disorders  All of the above 

7. Polychromasia corresponds to increased : Red cells  Reticulocytes  Ovalocytes  Lymphocytes  basophils 

10. Reticulocytes count is decreased in :  Iron deficiency anemia Aplastic anemia  Megaloblastic anemias  receiving proper treatment Hereditary hemolytic  anemia 13. In adults, the normal range for mean corpuscular volume is :  68 –  68 –  88  88 fl  78 –  78 –  98  98 fl 88 –  88 –  108  108 fl  58 –  58 –  98  98 fl  78 –  78 –  99  99 fl 

Clinical Patholog Pathology, y, X-Rays, ECG Haematology MCQs RED BLOOD CELLS 2. The mature red cell is biconcave disc with a diameter of : 5.2 µm  9.2 µm  7.2 µm   10.3 µm 5. Spherocytes are NOT NOT found  found in one of the following condition : Congenital spherocytosis  Autoimmune hemolytic  anemia Hemolytic disease of the  newborn Blood transfusion  Iron deficiency anemia  8. Reticulocytes are NOT increased in one of the following conditions : Haemorrhage  Haemolysis  In response to specific  hematinics used in treatment of anemias Aplastic anemia  Thalassemia  11. The normal RBC count for adult female is :  2.8 –  2.8 –  3.8  3.8 x   / L  3.8 –  3.8 –  4.8  4.8 x   / L 2.8 –  2.8 –  3.8  3.8 x   / L  3.8 –  3.8 –  4.8  4.8 x   / L  4.8 –  4.8 –  5.8  5.8 x   / L 

12. The normal Hb level for an adult male is :  13 –  13 –  19  19 g/dl 11 –  11 –  16  16 g/dl  12 –  12 –  16  16 g/dl  15 –  15 –  18  18 g/dl  13 –  13 –  17  17 g/dl 

14. In adult males, the normal range for packed cell volume is:  30 –  30 –  50  50 %  40 –  40 –  60  60 % 40 –  40 –  50  50 %  45 –  45 –  55  55 %  50 –  50 –  65  65 % 

15. In adult females, the normal range for packed cell volume is :  25 –  25 –  45  45 %  35 –  35 –  55  55 % 35 –  35 –  45  45 %  30 –  30 –  40  40 %  40 –  40 –  65  65 % 

1

3. The normal red cell life span is approximately :  10 days 120 weeks  120 days  200 days  30 days  6. Anisocytosis means : Increased reticulocytes  Presence of immature WBCs  Variation in the shape of  RBCs Presence of immature  erythroid erythroid cells Variation in size of RBCs 

9. Reticulocytes can be seen in : Haemorrhage  Haemolysis  Hypoplastic anemia with  hyperactive foci in the bone marrow In response to treatment of  anemias All of the above 

Mahmoud Sewilam 16. In adults, the normal range for mean corpuscular hemoglobin is : 22-32 pg  27-37 pg  27 –  27 –  32  32 pg  29 –  29 –  42  42 pg  27 –  27 –  39  39 pg  18. Microcytic hypochromic anaemias is a feature of all these except : Iron deficiency anemia  Thalassaemias  Sideroblastic Sideroblastic anemias  Acute blood loss  Chronic blood loss 

21. All these findings help in the diagnosis of iron deficiency anemia except except:: Decreased iron stores  Decreased TIBC  Decreased serum iron  Decreased transferrin  saturation index Decreased serum ferritin  level 24. All of the following investigate iron status except  Serum iron  TIBC RDW   % saturation of transferrin Serum ferritin  27. in iron deficiency anemia , all of the following is true except : decreased serum iron  increased increased MCV  decreased serum ferritin   decreased transferrin saturation index decreased BM iron stores 

Clinical Patholog Pathology, y, X-Rays, ECG 17. RDW indicates : Hypochromia  Microcytosis  Poikilocytosis  Anisocytosis  Reticulocytosis 

ANEMIA 19. Causes of microcytic hypochromic anemias include all of the following except : Sideroblastic Sideroblastic anemia  Autoimmune hemolytic  anemia Iron deficiency anemia  Anemia of chronic disorders  Thalassemias  22. Regarding the iron status in iron deficiency, which of the following is false : Decreased serum iron  Increased TIBC  Decreased serum ferritin  Increased transferrin  saturation saturation index Decreased BM iron stores  25. Serum iron decreases in : ß thalassaemia major  ß thalassaemia minor  sidroblastic sidroblastic anemia   anemia of chronic disorders all of the above 

28. to detect the cause of the iron deficiency anemia, which of the following is done ?  stool analysis for parasites  stool analysis for occult blood urine analysis for hematuria  all of the above 

2

20. Microcytic hypochromic anaemias is NOT NOT found  found in one of the following conditions : Thalassemia  Sideroblastic Sideroblastic anemia  Iron deficiency anemia  Anemia of chronic disorders  Autoimmune hemolytic  anemia 23. Which of the following parameters reflects iron stores : Serum iron  TIBC  RDW  % saturation of transferrin  Serum ferritin 

26. hypochromic anamia is present in all of the following except : thalassemia thalassemia major  anemia of chronic disorders  sideroblastic anemia  lead poising  congenital spherocytosis  29. all these can be used for diagnosis of ß thalassemia major except : increased serum serum iron level  increased TIBC  increased transferrin  saturation saturation index increased serum ferritin  level increased Hb F level 

Mahmoud Sewilam 30. ß thalassemia major is characterized by all of the following except : Severe anemia (microcytic  hypochromic) Leucocyte and platelet  counts are normal Effective erythropoiesis  Shortened red cell life span  Hb electrophoresis shows:  increased HbF , HbA2 is normal or high

Clinical Pathology, X-Rays, ECG 31. α thalassemia is 32. The peripheral blood smear characterized by which of of a silent carrier of α these phenotypic categories : thalassemia typically appears as : silent carrier  Normocytic , normochromic  α thalassemia trait  Macrocytic, normochromic  Hb H disease  Microcytic , hypochromic  Hb Bart’s   Macrocytic , hpochromic All of the above 

33. Sideroblastic anemia is NOT characterized by : Ineffective erythropoiesis  Ring sideroblasts  Decreased serum ferritin  Increased iron stores in bone  marrow  Dimorphic red cells 36. All these can cause macrocytic anemias except : Liver disease  Aplastic anemia  Thalassemias  Acute hemolytic anemia  Acute blood loss 

34. Anemia of chronic disorders is found in cases of : Lung abscess  Rheumatoid arthritis  Chronic renal failure  Tuberculosis  All of the above 

35. Direct Coomb’s test is negative in : Lymphoproliferative  disorders Collagen diseases  Rh incompatibility   Congenital spherocytosis

37. Laboratory diagnosis of megaloblastic anemia is by all of the following except : Blood picture : pancytopenia  megaloblastic erythropoiesis Positive intrinsic factor  antibodies Positive antiparietal cell anti  bodies Increased serum vit.B12  40. which of the following in NOT a cause of normochromic normocytic anemia : acute blood loss  aplastic anemia   anemia due to chronic disorders hemolytic anemia  thalassemia  43. Laboratory evidence of hemolysis includes all of the following except : Hyperbilirubinaemia  (indirect) Reticulocytosis   Increased urine urobilinogen Increased haptoglobin  Bone marrow show  erythroid hyperplasia 3

38. In megaloblastic anaemia one of the following is not true : Mild thrombocytopenia   Mild leucopenia  Hypochromia Decreased serum vitamin  B12 or folate macrocytosis 

39. causes of macrocytic anaemias include : liver diseases  aplastic anemia   pernicious anemia autoimmune hemolytic  anemia all of the above 

42. Laboratory findings in aplastic anemia include all of the following except : Low reticulocyte count  Normocellular bone marrow  High ESR  Low neutrophil count  Low Hb level 

41. aplastic anemia is a condition characterized by : B12 deficiency  Increased reticulocyte count   Pancytopenia Hypocellular BM  Both C & D 

44. Which of the following is NOT true for congenital spherocytosis : Increased serum bilirubin  Increased osmotic fragility  Positive direct Coomb’s test  Increased reticulocytes  Negative indirect Coomb’s  test

Mahmoud Sewilam 45. Which of the following is NOT found in G6PD deficiency : Hemoglobinemia  Hemoglobinuria  Low enzyme level during the  hemolytic attacks  Increased reticulocyte count  Anemia

48. Causes of warm autoimmune hemolytic anemia include all of the following except: Idiopathic  Chronic lymphatic leukemia  Viral infections   Collagen disorders as SLE  Hereditary

51. Laboratory diagnosis of cold autoimmune hemolytic anemia include :  Evidence of chronic hemolysis with exacerbations especially when the patient is chilled Normochromic normocytic  anemia with polychromasia  Cold antibodies in serum  Positive indirect Coomb’s test All of the above  54. In ABO incompatibility disease of the newborn, all of the following are true except The disease is milder because A  and B antigens are week in the fetus It can occur in the first pregnancy  without prior sensitization Anemia and mild jaundice  Blood film shows spherocytes and  reticulocytes 

Clinical Pathology, X-Rays, ECG 46. In G6PD deficiency 47. In pyruvate kinase enzyme diagnosis is established by deficiency all of the estimation of the enzyme : following are true except : In between attacks (6 weeks It is inherited as an   after the attack) autosomal recessive trait During the attack RBC morphology is normal   Immediately after the attack  Diagnosis is established by  enzyme essay  At any time irrespective of the attack Resulting anemia is  normochromic normocytic After ingestion of fava beans   Resulting anemia is macrocytic 49. Laboratory diagnosis of 50. Causes of cold autoimmune warm autoimmune hemolytic anemia include all hemolytic anemia includes of the following except : all of the following except : Idiopathic  Mild normochromic  Mycoplasma pneumonia  normocytic anemia Viral infections as infectious   Blood film shows nucleated mononucleosis RBCs, polychromasia, and  Lymphoproliferative spherocytes disorders as non-Hodgkin’s Laboratory evidence of  lymphoma hemolysis Bacterial infections  Positive direct Coomb’s test  Positive indirect Coomb’s  test 52. Haemolytic disease of the 53. In Rh hemolytic disease of newborn may be due to all of the newborn, laboratory the following except: features of cord blood include all of the following  Rh incompatibility (mostly except : anti-D)  Anemia, reticulocytosis, ABO incompatibility  normoblastemia Minor group incompatibility  Jaundice   Rh incompatibility (mostly Increased indirect serum  anti-C) bilirubin None of the above   Direct Coomb’s test is positive Indirect Coomb’s test is  positive 56. Sickle cell disease is 55. Normal hemoglobin pattern characterized by all of the in adult life is all of the following except : following except : Results from a genetic  HbA : 96 –  98 % abnormality in Hb structure  HbA2 : 2-3.4 % Marked normocytic HbF : < 1 %  normochromic anemia  HbS : < 1 % Hb electrophoresis shows SS 







Coombs’ test is strongly positive 

4

pattern Hb electrophoresis shows AS pattern Sickle cells in the stained film

Mahmoud Sewilam 57. Normal hemoglobin electrophoresis pattern found in : Sickle cell disease  Beta thalassemia intermedia  Beta thalassemia trait  Beta thalassemia major  Alpha thalassemia trait 

60. Polycythemia occurs in all of the following conditions except: Hypoxic lung disease  Renal ischemia  Polycythemia rubra vera  Liver disease 

62. Decreased ESR could be found in all of the following except : Polycythemia  Hypofibrinogenemia  Sickle cell anemia  Aplastic anemia  Disseminated intravascular  coagulation 65. ESR is high in the following conditions except : Paraproteniemia  Collagen diseases  Active tuberculosis   Tissue damage Afibrogenemia  68. ESR is considered a :  Diagnostic test  Specific test Crude test   Monitoring test Non of the above 

Clinical Pathology, X-Rays, ECG 58. Immune hemolytic anemia 59. Alloimmune hemolytic can occur in all of the anemia can occur in all of following except : the following except : Lyphoproliferative disorders  Lymphoproliferative  disorders Viral infections  Rh incompatibility  Collagen disorders  ABO incompatibility  Iron deficiency anemia   Minor group incompatibility

Polycythemia 61. Laboratory features of secondary polycythemia are all of the following except : Erythrocytosis  Normal leucocytes and  platelet counts Normal leucocyte alkaline  phosphatase Increased serum  erythropoietin Increased arterial oxygen  saturation ESR  63. Low ESR could be found in all except :  Polycythemia Hypofibrinogenemia   Pregnancy Old specimen  Sickle cell anemia 

66. ESR is high in all of the following conditions except : Multiple myeloma  Collagen disease  Pyogenic infections   Hypofibrinogenemia Active tuberculosis  69. Reference range of ESR in an healthy adult male is : st 3 - 12 mm/ 1  hr  st Up to 20 mm/ 1  hr  st Up to 30 mm/ 1  hr  st 1 –  10 mm/ 1  hr  st 0 –  5 mm/ 1  hr 

5

64. ESR is low in : Rheumatoid arthritis  Polycythemia  Malignancy  Pregnancy  Tuberculosis 

67. ESR is a diagnostic specific test in : Rheumatoid arthritis  Myeloprolfirative disorders  Infectious mononucleosis   tuberculosis non of the above  70. Marked rise in ESR is seen in all of the following except Myeloma  Collagen disease  Active tuberculosis  Malignancy  Acute leukemia 

Mahmoud

Sewilam

71. Reference range for total leucocytic count in healthy adults is : 10 –  26 x  L   5 –  13 x  L 4 - 10 x  L  2 –  6 x  L  74. The term that denotes total leucocytic count below 4 x L is : Leucopenia  Leucocytosis  Agranulocytosis  Leukemoid reaction 

77. Presence of immature myeloid and erythroid cells in peripheral blood is termed : Leukemoid reaction  Hemolytic reaction  Leucoerythroblastic reaction  Febrile reaction  Drug induced reaction 

Clinical Pathology, X-Rays, ECG LEUCOCYTES 72. Reference range for neutrophils absolute count in healthy adult is : 1-4 x  L   2-7 x  L 0.2-0.5 x  L  4-11 x  L  75. Leucoerythroblastic reaction means : Presence of immature  myeloid and erythroid cells in peripheral blood Presence of immature  myeloid and erythroid cells in bone marrow  Presence of blasts in peripheral blood Presence of blasts in bone  marrow 78. Neutrophilia is afeature of all of the following disorders except :  acute pyogenic infections  tissue damage or necrosis e.g. infarction , trauma corticosteroid therapy  pregnancy  parasitic infections 

80. neutrophilia is a feature of all of the following disorders except:  acute hemorrhage  acute pyogenic infections cortisone therapy  infectious mononucleosis  acute hemolysis 

81. neutophilia is a feature of all of the following disorders except:  bacterial infection  myocardial infarction metastatic carcinoma  acute hemorrhage  chronic lymphocytic  leukemia

83. Neutropenia is likely to occur in : Typhoid, brucella ,  tuberculosis  Felty’s syndrome Intake of anti-bacterial  drugs Megaloblastic anemiathe   All of the above

84. Neutropenia is likely to occur in : Post-splenectomy  Megaloblastic anemia  Burns  Bacterial infections   Acute hemorrhage

6

73. The term that denotes total leucocytic count above 10 x L is : Leucopenia  Leukocytosis  Agranulocytosis  Leukemoid reaction  76. A leucoerythroblastic reaction is Left shift in peripheral blood  Right shift in peripheral  blood  Both right and left shift in peripheral blood Left shift and nucleated  RBCs in peripheral blood Non of the above 

79. neutrophilia is a feature of all of the following disorders except:  malignancy of all types  myeloproliferative disorders e.g. polycythemia vera and myelofibrosis metabolic disorders e.g.  uremia , eclampsia … etc. acute hemorrhage or  hemolysis antibiotic therapy  82. neutropenia is likely to occur in : intake of anti-inflammatory  drugs  viral infections e.g. hepatitis, influenza, HIV SLE  Part of a general  pancytopenia All of the above  85. Anticonvulsant therapy may cause : Neutrophilia  Neutropenia  Lymphocytosis  Lymphopenia   Non of the above

Mahmoud Sewilam 86. Lymphocytosis occurs in all of the following disorders except: Infectious mononucleosis  Tuberculosis  Chronic lymphatic leukemia  Lymphoma  Pregnancy  89. The following conditions are associated with lymphocytosis except : Cytomegalovirus infection  Lymphoma  Infectious mononucleosis  Myocardial infarction  Chronic lymphocytic  leukemia 92. Lymphopenia is prominent in : Chronic lymphocytic  leukemia AIDS   Infectious mononucleosis  

Toxoplasmosis Non of the above

95. Eosinophilia is present in : Allergic disease  Tuberculosis   Protozoal infections  Chronic lymphocytic leukemia Non of the above  98. Absolute monocyte count >1000/cmm is found in all of the following disorders except: Tuberculosis   Brucellosis  Subacute bacterial endocarditis Protozoal infections  Acute follicular tonsillitis  101. Agranulocytosis is associated with :  Leucopenia  Neutrophil count < 2x  /L  Neutrophil count < 1x  /L Neutrophil count < 0.5x /L  Non of the above 

Clinical Pathology, X-Rays, ECG 87. Absolute lymphocytosis 88. Absolute lymphocytosis occurs in all of the following occurs in all of the following disorders except : disorders except: Infectious mononucleosis Tissue necrosis   Infectious lymphocytosis Chronic lymphatic leukemia   Cytomegalovirus infection Pertussis   Lymphoma Infectious mononucleosis   Acute pyogenic infection Tuberculosis   90. Lymphocytosis occurs in all 91. Lymphocytosis is observed of the following disorders in all of the following except: disorders except : Infectious mononucleosis Lymphoma   Lymphoma Tuberculosis   Cytomegalovirus infection Cytomegalovirus infection   Protozoal infections Corticosteroid therapy   Tuberculosis Infectious mononucleosis   93. Lymphopenia occurs in all of the following disorders except : Severe BM failure  Corticosteroid and  immunosuppressive drugs Irradiation  Hodgkin’s disease  Parasitic diseases  96. Reactive eosinophilia occurs in : Drug allergies  Neoplasms  Parasitic infections  All of the above  None of the above  99. Monocytosis can be observed in  Tuberculosis  Malignancy Chronic myelomonocytic  leukemia All of the above 

94. Eosinophilia is NOT present in : Allergic diseases  Drug sensitivities  Hodgkin disease  Myxedema  Myeloproliferative disorders 

102. All of the following present with pancytopenia except :  Hypersplenism  Systemic lupus erythematosus  Aleukemic leukemia  Malaria  Aplastic anemia

103. Pancytopenia can result from :  Systemic lupus erythematosus  Hairy cell leukemia  Paroxysmal nocturnal hemoglobinuria  Hypersplenism All of the above 

7

97. Monocytosis is present in : Bilharzial infestation  Protozoal infections   Skin diseases  Drugs Non of the above  100. Basophilia is found in all of the following disorders except : Polycythemia vera  Myxedema  Xanthemata  Chronic myeloid leukemia  Chronic lymphatic leukemia 

Mahmoud Sewilam 104. All of the following present with pancytopenia except: Splenomegaly  Aplastic anemia  Megaloblastic anemia  Iron deficiency anemia  Acute leukemia 

Clinical Pathology, X-Rays, ECG 105. Pancytopenia is present 106. A patient with EBV in all of the following except: infection may develop all of the following except : Acute leukemia  Neutrophilia   Chronic granulocytic leukemia Lymphocytosis  Hypersplenism Autoimmune hemolytic   anemia SLE   Lymph node enlargement None of the above   Mild thrombocytopenia

107. Infectious mononucleosis is associated with all of the following except : EBV   Fever , sore throat Atypical lymphocytes  Absence of heterophil  antibodies Normal hemoglobin RBCs 

108. Leukemoid reaction is due to all of the following except: Pyogenic infection  Acute bleeding  Acute hemolysis   Gangrene Chronic myeloid leukemia  111. In Leukemoid reaction, all are true except : Increased total leucocytic  count up to 50,000/cmm  Occurs in severe infections Characterized by the  presence of immature WBCs in peripheral blood  Philadelphia chromosome positive NAP score is high  113. FAB classification classifies acute leukemia according to :  Cytogenetic abnormalities  Immunological characteristics  Both cytogenetic and immunological abnormalities  Morphological characteristics Morphological, phenotypic and  cytogenetic characteristics

LEUKEMIA 109. Leukemoid reaction is 110. Leukemoid reaction is characterized by the characterized by : following except : Presence of Philadelphia  Leucocytosis chromosome  Increased band forms Low NAP score   Shift to the right High basophilia     Increased NAP score Shift to the left Neurophilia High eosinophilia   112. Leukemia is a malignant proliferation of hematopoietic cells in the : Bone marrow then infiltrate peripheral blood and lymph nodes  Lymph nodes then infiltrate peripheral blood and bone marrow  Peripheral blood then infiltrate bone marrow and lymph nodes   Bone marrow and doesn’t infiltrate lymph nodes Lymph nodes and doesn’t infiltrate bone ma rrow or peripheral  blood.

114. WHO classification for acute leukemia classifies it according to :  Morphological characteristics Cytogenetic abnormalities   Both cytogenetic and immunophenotypic abnormalities  Morphological, immunophenotypic and cytogenetic characteristics 

Morphological and immunophenotypic characteristics

8

115. The least number of bone marrow blast cell required to diagnose acute leukemia is Blast cells ≥ 30 %  Normoblasts ≥ 25 %  Blast cells ≥ 20 %  Blast cells and normoblasts  ≥ 30 % Blast cells ≥ 60 % 

Mahmoud Sewilam 116. Diagnosis and classification of acute leukemia needs : Complete blood picture  Bone marrow examination  Immunophenotyping  Cytochemical stain  All of the above 

Clinical Pathology, X-Rays, ECG 117. In acute myeloid leukemia, all of the following can be found except : Myeloblasts  Megakaryoblasts  Lymphoblasts  Erythroblasts 

118. All of the following are a must to diagnose acute myeloid leukemia except :  More than 20 % blasts in Bone marrow  Blast cells in peripheral blood  Myeloperoxidase positivity Presence of myeloid antigens  on blast cells

119. Presence of Auer rods in the blast cells indicated that they are : Lymphoblasts   Myeloblasts  Of no significance Bilineage  Biphenotypic 

120. Peroxidase stain positivity indicates : Myeloblastic leukemia  T-Lymphocytic leukemia  Common acute  lymphoblastic leukemia Megakaryoblastic leukemia  B-lymphoblastic leukemia 

121. Acute lymphoblastic leukemia can present with all of the following except : Anemia   Hypercellular bone marrow  Increased promyelocytes in peripheral blood Thrombocytopenia 

122. In subacute leukemia, we can find the following except  Leucopenia Thrombocytopenia  Absence of blast cells in  peripheral blood 10 % blast cells in bone  marrow

123. In acute lymphoblastic leukemia, all of the following can be found except: Lymphoblast cells in  peripheral blood  Hypercellular bone marrow Blasts are myeloperoxidase  positive Lymphadenopathy 

125. Diagnosis of acute leukemia requires the presence of at least : 20 % blast cells in  peripheral blood  90 % blast cells in peripheral blood 20 % blast cells in bone M.  90 % blast cells in bone M.  128. Neutrophil alkaline phosphatase score is diagnostic in :  Chronic lymphocytic leukemia Acute lymphoblastic  leukemia Acute myeloid leukemia  Chronic myeloid leukemia  All of the above 

126. Lymphoproliferative disorders include all of the following except: Hairy cell leukemia  Chronic lymphocytic  leukemia  Non Hodgkin’s lymphoma  Chronic myeloid leukemia

124. All of the following is a must to diagnose acute lymphoblastic leukemia except :  More than 20 % blasts in bone marrow Blast cells in peripheral  blood  Myeloperoxidase negativity Presence of lymphoid  antigens on blast cells 127. Neutrophil alkaline phosphatase in acute leukemia : Constantly low  Constantly high  Variable  Used mainly to diagnose  lymphoblastic leukemia Non of the above  130. Neutrophil alkaline phosphatase score is low in: Pyogenic infection  Polycythemia  Chronic myeloid leukemia  Acute myeloid leukemia  Non of the above 

129. Neutrophil alkaline phosphatase score is elevated in all of the following disorders except : Pregnancy  Severe infection  Chronic myeloid leukemia  Polycythemia rubra vera  Severe aplastic anemia 

9

Mahmoud Sewilam 131. Chronic myeloid leukemia is characterized by Splenomegaly   Marked leukocytosis  Myelocyte bulge  Basophilia  All of the above

134. In chronic phase of chronic myeloid leukemia all of the followings are present except: Philadelphia chromosome   Splenomegaly Blast cells are more than 20  % in bone marrow High total leucocytic count  Thrombocytosis  137. The characteristic cytogenetic abnormality in chronic myeloid leukemia is: t (8,21)  t (9.22)  t (15,17)  t (12,21)  t (8,14) 

140. chronic lymphocytic leukemia is disease of: old age only   middle age female children only  elder female  middle and old age 

143.In chronic myeloid leukemia (chronic phase) one criterion of the following can be found : Thrombocytopenia  Leucopenia  High neutrophil alkaline  phosphatase Thrombocytosis  

Lymphocytosis

Clinical Pathology, X-Rays, ECG 132. Neutrophil alkaline 133. Classical chronic myeloid phosphatase is enzyme leukemia is characterized by present in the granules of : all of the following except: Monocytes Hypercellular BM   Neutrophilis Marked shift to the left   Basophilis Monocytosis   Lymphocytes Increased bone marrow   megakaryocytes Eosinophilis   Low Neutrophil alkaline phosphatase (NAP) score 135. Diagnosis of chronic 136. Myeloperoxidase myeloid leukemia is based reaction is mostly diagnostic on all of the following except in: Complete blood picture Chronic myeloid leukemia   Bone marrow examination Acute myeloid leukemia   NAP score Chronic lymphocytic   leukemia Cytogenic anaylsis   Acute lymphoblastic Myeloperoxidase stain  leukemia All of the above  138. persistent lymphocytosis 139. in chronic lymphocytic with presence of smear cells leukemia, all of the following in peripheral blood is can be found except : present in cases of : splenomegaly  chronic myeloid leukemia  lymphocytosis   acute lymphoblastic lymphoblasts in peripheral  leukemia L1 blood chronic lymphocytic  lymphadenopathy  leukemia  acute lymphoblastic leukemia L2 all of the above  141. patients of chronic 142. Diagnosis of chronic lymphocytic leukemia lymphocytic leukemia is commonly presents with: based on the presence of : DIC Peripheral lymphocytosis   with normal marrow Persistent lymphocytosis   Lymphocytes > 30 % in Autoimmune hemolytic  marrow with persistent anemia lymphocytosis in blood Thrombocytopenia and  Leucopenia with relative  anemia lymphocytosis Splenomegaly  Atypical lymphocytosis  Non of the above  144.In chronic myeloid leukemia all of the following are correct except: Marked shift to the left  Eosinophilia and basophilia  Lymphocytosis  Philadelphia chromosome positive  Low NAP score 

10

145. Which of the following is the most helpful to differentiate between leukmoid reaction and chronic myeloid leukemia WBCs count  Immature cells  Platelet count  NAP score  RDW 

Mahmoud

Sewilam

146. Lymphocytosis is one of the findings in : Acute myeloid leukemia   Chronic myeloid leukemia  Acute lymphoblastic leukemia Chronic lymphocytic leukemia 

149. diagnose of chronic lymphocytic leukemia is essentially based on presence of : lymph node enlargement  anemia   persistent lymphocytosis with characteristic immunophenotypic findings thrombocytopenia   leucocytosis 152. Myeloproliferative disorders include all of the following except : Chronic myeloid leukemia   Essential thrombocythaemia  Prolymphocytic leukemia Polycythemia rubra vera 

155. Regarding total proteins in multiple myeloma : No change in their level  Marked decrease in their  level Increase in their level  Increase only in albumin  with decrease in others Decrease in albumin 

158. All of the following can be found in multiple myeloma except : Osteolytic lesions   Bone marrow infiltrations by plasma cells High serum proteins with high  globulins  Polyclonal Ig in blood or urine or both High serum calcium 

Clinical Pathology, X-Rays, ECG 147.All of the following can be found 148. chronic lymphocytic in peripheral blood in chronic leukemia is characterized by lymphocytic leukemia except: all of the following except : 90 % lymphocytes leukocytosis  Smear cells lymphocytosis  Leukocytosis Stab cells (Band forms) marked shift to the left   anemia splenomegaly  150. in chronic lymphocytic 151. Philadelphia leukemia, which of the chromosome is present in : following can be found : AML  persistent lymphocytosis   CML thrombocytopenia   CLL autoimmune hemolytic  Eosinophilic leukemia  anemia lymph node enlargement  all of the above     

153. Regarding the diagnostic triad of multiple myeloma all are correct except : Monoclonal gammopathy   Malignant plasma cell infiltration of peripheral blood  Osteolytic bone lesions  Malignant plasma cell infiltration in bone marrow 156. Regarding immunoglobulins in multiple myeloma : All immunoglobulins are  increased All immunoglobulins are  decreased Increase of IgG and IgM and  decreased other types  Increase of IgM and decreased all other types Increase of one type and  decreased all other types 159. Bone marrow examination in all of the following except : Aplastic anemia  Megaloblastic anemia  G6PD deficiency   Lipid storage disease Hypersplenism 

11

154. Multiple myeloma is characterized by : Osteolytic lesions  Normal serum protein level  No bone affection  Lymphocyte cell infiltration  in bone marrow Polyclonal gammopathy 

157. The following is mostly present in multiple myeloma : Polyclonal gammopathy  Monoclonal gammopathy  Polyclonal gammopathy  And Monoclonal gammopathy Increase serum albumin  Decreased serum calcium 

160. All these conditions are associated with splenomegaly except : Infectious mononucleosis  Leukemia  Lymphoma   Hairy cell leukemia Sickle cell anemia 

Mahmoud Sewilam 161. In hypersplenism, the most likely finding in the peripheral blood is : Normochromic normocytic  anemia Thrombocytosis  Pancytopenia   Lymphopenia  All of the above 162. Prothrombin time is used to monitor: Intravenous anticoagulant  therapy Oral anticoagulant therapy  A and B  Platelet function defect 

Clinical Pathology, X-Rays, ECG

HAEMOSTASIS 163. Prothrombin time is prolonged in : Hemophilia A  Massive liver disease  Idiopathic thrombocytopenic  purpura Bone marrow failure  Thrombocytopenia purpura 

165. Activated partial thromboplastin time is prolonged in : Hemophilia B  Factor VIII deficiency  Blood vessel disease   Hemophilia B & factor VIII deficiency None of the above 

166. Heparin anticoagulant therapy is best monitored by Prothrombin time  Activated partial  thromboplastin time Bleeding time   Thrombin time None of the above 

168. International normalized ration is the best monitor for IV anticoagulant therapy   Oral anticoagulant therapy Platelet replacement therapy   Cryoglobulin therapy  All of the above

169. Bleeding time is prolonged in the following conditions except : Henoch Schonlein purpura  Bernard Soulier syndrome  Immature thrombocytopenic  purpura Disseminated intravascular  coagulation Hemophilia A  172. Thrombocytopenia is seen in : Fanconi syndrome   Glanzmann’s disease  Von Willebrand disease Storage pool diseas   None of the above

171. Bleeding time is used clinically to screen for a significant defect in : Coagulation defect  Platelet function  Fibrinolytic pathway  None of the above  All of the above 

12

164. Activated partial thromboplastin time is used to detect : Extrinsic pathway defect  Intrinsic pathway defect  only Fibrinolytic pathway defect  Platelet function defect  Intrinsic & common  pathway defect 167. Thrombin time measures : Conversion of prothrombin  to thrombin Conversion of fibrinogen to  fibrin Conversion of factor VII to  active factor VII Conversion of plasminogen  to plasmin 170. All of the following conditions lead to prolonged bleeding time except : Von Willebrand disease  Thrombocytopenia  Haemophilia A  Henoch Schonlein purpura  DIC 

173. In immune thrombocytopenic purpura all of the following is correct except : Normal PT  Prolonged bleeding time  Normal PTT  Decreased bone marrow  megakaryocytes Decreased platelet life span 

Mahmoud Sewilam 174. Routine evaluation of patients with bleeding tendency necessitates : 

Through history and clinical examination



TLC



Collagen markers assay



Trephine biopsy



All of the above

Clinical Pathology, X-Rays, ECG 175. Causes of vascular 176. Platelet adhesion defect prupura include : occurs in : ITP Henoch Schonlein purpura     Henoch Schonlein purpura Glanzmann’s disease   Glanzmann’s disease Bernard Soulier syndrome   Bernard Soulier syndrome All of the above  None of above

177. Platelet function study with ristocetin shows defective response in :  Glanzmann’s disease  Von Willebrand disease Bernard Soulier syndrome   Bernard Soulier syndrome And Von Willebrand disease

178. Platelet function study with collagen shows defective response in :  Glanzmann’s disease  Von Willebrand disease Bernard Soulier syndrome   Bernard Soulier syndrome And Von Willebrand disease

180. In massive liver disease there is : Prolonged PT and PTT  Thrombocytosis  Thrombocytopenia  Prolonged PT and PTT  And Thrombocytopenia  Prolonged PT and PTT  And Thrombocytosis 183. All the following findings are present in DIC except : Thrombocytopenia  Decreased serum FDPs level  Decreased serum fibrinogen  level  Prolonged PT Prolonged PTT  186. In hemophilia B there is : Prolonged PT  Prolonged PTT  Prolonged TT  Bleeding time is prolonged  None of the above 

181. Thrombocytopenia is a common finding in : Aplastic anemia  Massive liver disease  ITP  Hypersplenism  All of the above 

184. In DIC :  PT and PTT are prolonged TT and BT are prolonged  Platelet count and fibrinogen  are decreased All of the above 

187. In von Willebrand disease : Prolonged PT  Prolonged TT  Bleeding time is prolonged  PTT test is normal  Prolonged PT & TT 

13

179. In ITP there is :  Prolonged PT  Prolonged PTT Decreased platelet count  Increased bone marrow  megakaryocytes Decreased platelet count  And Increased bone marrow megakaryocytes 182. Normal platelet count ranges from: 150 –  400 x  /L  150 –  400 x  /L  150 –  400 x  /L  150 –  400 x  /L  150 –  450 x  /L 

185. D-dimer assay is valuable in : ITP  DIC  Hemophilia A  Factor VII deficiency  Platelet function defect 

Mahmoud

Sewilam

188. Whole blood transfusion is indicated in : Anemia of congestive heart  failure  Exchange blood transfusion Hemophilia A  Acute blood loss with  hypovolemic shock Both Exchange blood  transfusion and Acute blood loss with hypovolemic shock

191. Acute hemolytic transfusion reaction occurs due to : HLA alloimmunization  ABO incompatibility  Platelet specific antigen  Transmission of viral  infection None of the above  194. Which of the following is false concerning fresh frozen plasma : Prepared with 6 hours of  blood donation Stored at 18 ºC  Thawed at 37ºC  Can be refrozen  Used in hemorrhage due to  deficiency of clotting factors

Clinical Pathology, X-Rays, ECG BLOOD TRANSFUSION 189. Advantages of packed 190. Which of the following is RBCs are all of the following false regarding platelet except concentrate : Smaller volume Indicated in bleeding due to   thrombocytopenia  Large oxygen carrying capacity Stored in refrigerator at 2 –   6º C Less risk of transfusion of  virus infection Stored at room temperature  (20-24ºC) with continuous Rich in factor VIII  gentle agitation Less risk of transfusion of   Can be used up to 10 days WBCs after preparation Stored in refrigerator at 2  –   6º C and Can be used up to 10 days after preparation 192. Febrile transfusion 193. Regarding acute lung reaction occurs due to : injury following transfusion, all of the following are true Rh incompatibility  except :  HLA class I antigens Transfusion related  ABO incompatibility   Due to antibodies against Platelet specific antigen  patient’s leucocytes None of the above  Presents with fever and  chills  Anti Rh D is the main cause 195. Which of the following is 196. Which of the following is false concerning packed present in acute hemolytic RBCs: transfusion reaction : Before use the bag is heated Occurs during the first 30   in very hot water minutes of transfusion Most helpful in anemia of Chills, pain in the back and   congestive heart failure dyspnea  Can be washed with saline to  Hemoglobinemia and remove plasma proteins in hemoglobinuria certain cases Hypotension and shock may  develop Used in cases of exchange  blood transfusion  All of the above Before use the bag is heated  in very hot water and Used in cases of exchange blood transfusion

14

Mahmoud

Sewilam

197. Prerenal uremia occurs in : Congestive heart failure  Renal tumours  Chronic renal failure  Glomerulonephritis  Benign prostatic hyperplasia  200. Which of the following is a test of glomerular function : Measurement of urine  specific gravity Measurement of low  molecular weight proteins in urine Urinary acidification test  Measurement of non protein  nitrogenoeus compounds in blood Vasopressin test  203. Concerning urine specific gravity, which one of the following statements is false: It is measured by a  urinometer (hydrometer) It reflects the concentrating  power of the kidney It is increased in diabetes  insipidus It becomes low and fixed in  end stage renal diseases It increase after overnight  fluid restriction in healthy subjects 206. Congestive heart failure may lead to Increased serum urea  Heavy proteinuria  Hypernatremia  Increased serum creatinine  Hyperkalemia  209. Proteinuria in excess of 3 g/day is a typical feature of : Cardiac failure  Nephrotic syndrome  Acute renal failure   Polycystic renal disease Chronic pyelonephritis 

Clinical Pathology, X-Rays, ECG RENAL DISEASES MCQs 198. A serum urea value of 60 199. Polyuria with increased mg/dl is equivalent to BUN urine specific gravity is a value of : feature of : 15 mg/dl Pituitary diabetes insipidus     28 mg/dl Nephrogenic D.I. 35 mg/dl Chronic renal failure   D.M.  201. Low fixed urine specific 202. Which of the following is gravity at 1010 is a feature a glomerular function test : of : Serum creatinine  Acute glomerulonephritis  Fluid deprivation test  Diabetes insipidus  Urinary acidification test   Chronic renal failure Urine specific gravity   D.M. Urine pH  Nephrotic syndrome 

204. Which is diagnostic of acute post streptocoocal glomerulonephritis : Increased BUN and serum  creatinine Hypocomplementaemia  Impaired renal tubular  function Oliguria and high urine  specific gravity Hematuria and red blood  cell casts

205. Creatinine clearance is calculated from serum or plasma creatinine (P in mg/dl) , urine creatinine (U in mg/dl) and urine volume (V in mL/min) as follows : Clearance = UxV/ P  Clearance = UxP / V  Clearance = U / VxP  Clearance = P / VxU 

207. Oliguria is a feature of : DM  DI  Addison’s disease  Hysterical polydipsia  Acute glomerulonephritis 

208. Proteinuria is considered heavy if it is above : 500 mg/day  1 g / day  2 g /day  3 g/day  4 g/day 

210.Which of the following laboratory findings is expected in nephrotic syndrome : Hypocholesterolaemia  Hypoalbuminemia  Decresed serum α2 macroglobulin  Oliguria 

211.Which of the following laboratory findings is expected in nephritic syndrome : Increased creatinine clearance  Hypercholestolremia  RBC casts  Polyuria  Decreased urine specific gravity 



Presence of granular casts in urine

15

Mahmoud Sewilam 212. One of the following in NOT a feature of chronic renal failure : Increased BUN  Increased serum creatinine  Increased serum potassium  Decreased serum calcium  Decreased serum inorganic  phosphate 215. Serum urea is NOT increased in : Severe liver disease  Congestive heart failure  Acute glomerulonephritis  Dehydration  Chronic renal failure 

Clinical Pathology, X-Rays, ECG 213. Hyperuricemia is seen in 214. Increased serum urea : with normal serum creatinine is seen in : Leukemia  GIT hemorrhage   Nephrotic syndrome Acute glomerulonephritis   D.I. Chronic renal failure   High protein diet Prostatic enlargement   Advanced liver cirrhosis Renal artery stenosis 

218. Concerning urinary casts, one of the following statements is NOT true : Hyaline casts may be found  in the urine healthy subjects  Lipoid casts are found in nephritic syndrome Red blood cell casts are  pathognomonic of acute glomerulonephritis White cell casts are found in  pyelonephritis 221. which of the following conditions is accompanied by increased urine specific gravity :  hysterical polydipsia DM  Pituitary D.I.  Nephrogenic D.I.  Chronic renal failure 

219. The aspect of urine remains clear in the presence of increased amount of : Epithelial cells   WBCs RBCs   Protein Amorphous urate 

216. Oliguria occurs in  Hypercalcemia  Acute glomerulonephritis Diuretic phase of Acute  renal failure Nephrogenic D.I.  Acute tubular necrosis 

217. Concerning serum creatinine, one of the following statements is NOT true It is the end product of  muscle creatine  It is higher in children that in adults It is higher in males than  females  It is inversely related to GFR  It is increased in acute and chronic glomerulonephritis 220. Which of the following laboratory findings is pathognomonic of acute glomerulonephritis : Oliguria   Hematuria Red blood cell casts   Pyuria albminuria 

222. A patient is oliguric when is urine volume is less than : 1000 mL/24 hours  800 mL/24 hours   700 mL/24 hours 400 mL/24 hours   100 mL/24 hours Calcium and phosphorus

223. Hypocalcemia occurs in cases of :  Acute pancreatitis  Multiple myeloma Sarcoidosis   Milk –   alkali syndrome Tertiary hyperparathyroidism 

224. Hypercalcemia occurs in :  Hypoalbuminemia  Chronic renal failure  Pseudohypoparathyrodism  Anticonvulsant therapy Squamous cell carcinoma of  lung

16

225.Which of the following conditions is accompanied by hypocalcemia : Primary hyperparathyroidism  Secondary hyperparathyroidism  Tertiary hyperparathyroidism   Multiple myeloma

Mahmoud Sewilam 226. Which of the following is accompanied by hypercalcemia : Hypoalbuminmia  Chronic renal failure  Pseudohypoparathyrodism  Anticonvulsant therapy  Sarcoidosis  229. Which of the following laboratory findings is expected in primary hyperparathyrodism : Hypercalcemia and  hypophosphatemia Hypocalcemia and  hyperphosphatemia Metabolic alkalosis   Decreased urinary calcium and phosphate Decreased urinary cyclic  AMP 231. Which of the following statements is true about serum sodium It is the main extracellular  anion It is increased in addison’s  disease It’s increased in renal  tubular acidosis It is low in the Syndrome of  inappropriate antidiuretic hormone secretion It can be excluded from  calculation of the anion gap 234. Hypokalemia is expected to occur in : Mineralocorticoid deficiency  Hyperemesis gravidarum  Crush injuries  Acute renal failure  DKA 

Clinical Pathology, X-Rays, ECG 227. Hyperphosphatemia 228. Hypophosphatemia occurs in : occurs in Vitamin D deficiency Renal failure     Fanconi syndrome Primary hypoparathyrodism   Respiratory alkalosis Pseudohypoparathyrodism   Primary Fanconi syndrome hyperparathyroidism  Metabolic acidosis Chronic renal failure  230. Which of the following laboratory findings is expected in primary hypoparathyrodism : Hypercalcemia and  hypophosphatemia Hypocalcemia and  hyperphosphatemia Increased alkaline  phosphatase Increased urinary calcium  Increased urinary cyclic  AMP Sodium & Potassium 232. Which of the following 233. Hypernatremia is a endocrinal disorders leads to feature of : hypernatremia ? Cushing’s syndrome  Hyperthyroidism  Renal tubular acidosis  Hypothyroidism  Chronic interstitial nephritis  Hyperparathyroidism  Congestive heart failure  Hypoparathyrodism  Paralytic ileus   Conn’s syndrome

235. Hyperkalemia occurs in : Anorexia nervosa  Cushing’s syndrome  Burns  Use of purgative  Insulin therapy 

17

Mahmoud

Sewilam

236. Respiratory acidosis may be seen in cases of : Improperly controlled  mechanical ventilation (hyperventilation) Pulmonary fibrosis  Anxiety  Salicylate poisoning  Chronic renal failure  239. Which of the following conditions leads to metabolic alkalosis? Treatment with carbonic  anhydrase inhibitors Severe diarrhea  Severe vomiting  High intestinal fistulae  Ethylene glycol poisoning 

Clinical Pathology, X-Rays, ECG Acid base balance MCQs 237. Which of the following conditions is accompanied by metabolic alkalosis :  Chronic renal failure  Methanol poisoning Aspirin overdose  Ethylene glycol poisoning  Pyloric stenosis  240. Vomiting may lead to : Increased arterial pH  Increased arterial H+  concentration Hyperchloraemia  Hypernatraemia  Hyperkalemia 

18

238. Hyperchloremic acidosis with normal anion gap occurs in :  Ureteric implantation into colon DKA  Lactic acidosis  Salicylate overdose  Methanol poisoning 

Mahmoud

Sewilam

241. Which of the following is associated with conjugated hyperbilirubinmia ? Dubin-Johnson syndrome  Gilbert’s Syndrome  Crigler Najjar syndrome  Neonatal Jaundice  Hemolytic anemia  244. Which of the following is associated with monoclonal gammopathy ? Rheumatoid arthritis  SLE  Tuberculosis  Liver Cirrhosis   Multiple myelomatosis

Clinical Pathology, X-Rays, ECG Hepatobiliary MCQs 242. Which is a cause of unconjugated hyperbilirubinemia ?  Dubin-Johnson syndrome  Rotor Syndrome Primary biliary cirrhosis  Cancer head pancreas  Gilbert’s syndrome  245. Of the following serum results, which are the most indicative of biliary tract involvement (and not parenchymal cell damage)? ALT = 1500 U/L (N:5-40)  ALT=500 U/L, AST= 3000  U/L (N:5-40) LDH = 700 U/L (N:100 500) ALP = 650 U/L (N:30-100),  GGT =130 U/L (N:10-50) Total bilirubin = 4 mg/dl ,  direct bilirubin= 1 mg/dl

247. One of the following is a feature of hemolytic  jaundice : Pale stool  Dark brown urine  Conjugated  hyperbilirubinemia  Increased serum ALP and GGT Increased urine  urobilinogen

248. Obstructive jaundice is accompanied by :  Increased excretion of conjugated bilirubin in urine  Increased excretion of unconjugated bilirubin in urine  Increased urinary urobilinogen excretion Almost equally increased  serum conjugated and unconjugated bilirubin Increased serum  unconjugated bilirubin

250. Which of these findings is expected in cases of acute viral hepatitis: Prolongation of  prothrombin time Serum albumin is low  AST/ALT ratio more than  1  Serum IgA is usually

251. Which of these enzymes is most valuable to confirm the hepatic origin of an elevated serum alkaline phosphatase in a pregnant women:  Aspartate aminotransferase (AST)  Creatine kinase (CK) Lactate dehydrogenase (LDH)   5 nucleotidase

19

243. Which of the following conditions is associated with bilirbinuria ?  Hemolytic anemia Gilbert’s syndrome Rotor syndrome  Crigler-Najjar syndrome  Neonatal Jaundice  246. Which of these statements is NOT true about bilirubin? It is derived exclusively  from breakdown of hemoglobin It is bounded in the  unconjugated from serum albumin It’s reabsorbed in the small  intestine after bacterial metabolism to urobilinogen It is normally undetectable  in urine Normally, most of bilirubin  in serum is unconjugated. 249. Urinary urobilinogen is usually increased in case of : Extrahepatic biliary  obstruction  Primary biliary cirrhosis Acute hemolysis crisis   Icteric stage of acute hepatitis Women receiving oral  contraceptives

252. In follow up of acute viral hepatitis , which enzymes is the earliest indicator of recovery ?  ALT AST  ALP  GGT  LDH 



Mahmoud Sewilam increased ALT/AST ratio is more than 1

253. Detection of low titer HBcAb IgG and positive HBsAb denotes : HBV past infection with  immunity to HBV HBV carrier status  HBV vaccination  HBV acute infection  HBV chronic infection 

256. Super infection of HDV and HBV is diagnosed by : Positive HDV Ab IgM and  HBc Ab IgG and negative HBsAg Positive HBs Ab and  positive HDV Ab IgG Negative HBs Ag and  positive HDV Ab IgM Positive HDV Ab IgG and  HBcAb IgG None of the above 

Clinical Pathology, X-Rays, ECG 

Alanine aminotransferase (ALT)

Hepatitis markers 254. Co –  infection of HDV and HBV is diagnosed by : Positive HBsAg and HBcAb  IgG Positive HDV Ab IgM and  HBcAb IgM Positive HBsAb and  positive HDV Ab IgM  Negative HBs Ab and positive HDV Ab IgM None of the above 

257. As regard hepatitis B which of the following is true : Persistence of HBsAg >6  months is an indicator of chronicity Serum HBcAg indicates  viral replication It is transmitted through  feco-oral route Positive HBcAb and +ve  HBsAb denotes post vaccination HBsAb indicated viral  replication

255. Super infection of HDV on HBV infection is diagnosed by : Positive HDV Ab IgG and  HBcAb IgG Positive HBs Ab and HDV  Ab IgM Negative HBs Ag and  positive HDV Ab IgM Positive HDV Ab IgM and  HDV Ab IgG Positive HBc Ab IgG,HBs  Ag and HDV Ab IgM 258. As regard hepatitis B which of the following is not true : 









Persistence of HBsAg > 6 months is an indicator of chronicity Positive HBeAg indicates viral replication Positive HBsAB indicates immunity Positive HBvAb and +ve HBsAb denotes post vaccination HBcAb is the only marker in the window gap

259. As regards HBc Ab, which of the following is false: It is an important serologic  marker in the window gap High titer IgG despite  positive HBsAb indicates persistent viral load Low titer IgG with positive  HBsAb indicates past infection and immunity Negative HBcAb IgG with  positive HBsAb denotes post vaccination

260. The most definitive diagnostic test for HCV infection is : HCV Ab IgG by ELIZA  HCV Ab IgM by ELIZA  Recombinant immunoblot  assay (RIBA)  Viral RNA by PCR

261. Which of the following tests is clinically significant for HCV infection  HCV Ab by ELIZA  HCV Ab by RIBA HCV RNA BY PCR   Serotyping and quantitation of viral load  All of the above

262. Carrier state in viral infection means :  The virus is hidden in the host cell and can’t be detected

263. PCR is used to detect : Viral antigen  Viral particles 

264. Primary biliary cirrhosis could be differentiated from primary sclerosing cholangitis by :

20

Mahmoud 







Sewilam

after recovery The virus is secreted by the host after clinical recovery The virus does not remain in the host after recovery None-of the above All of the above

265. The following is true for hepatocellular carcinoma : Mall elevation of AFP  occurs in primary hepatoma Mild elevation of AFP plus  elevation of CEA occurs in secondary liver cancer Normal level of CEA with  increased levels of AFP occur in colorectal cancer without hepatic malignancy All of the above. 

Clinical Pathology, X-Rays, ECG   

Viral genome Viral envelope None of the above

 

 



266. Tumor markers for liver metastasis include : CEA  ALP  Transaminases  All of the above  None of the above. 

21

Increased ALP and GGT Evidence of hepatic dysfunction Increased total IgM Frequently progresses to chronic hepatitis Positive AMA

Mahmoud

Sewilam

267. hyperglycemia occurs in one of the following conditions  Addison’s syndrome  Gilbert’s Syndrome Cretinism  Pheochromocytoma  Insulinoma  270. Alimentary glucosuria occurs in one of the following conditions : Renal failure  Advanced liver disease  Congenital heart disease  Pregnancy  Type I D.M.  273. One of the following statements is true about impaired glucose tolerance: An OGTT is not required to  assign a patient to this class Fasting plasma glucose level  is ≥ 126 mg/dl 2 hour post load plasma  glucose level is ≥140