1) Which one of the following is NOT true regarding to laboratory diagnosis of iron deficiency anemia a) 1. Increased RDW b) 2. Low MCV c) 3. Low MCH d) 4. High MCH 2) A 25-year-old patient presents to the clinic with episodes of severe pain in the abdomen and joints. Laboratory tests reveal the presence of abnormal red blood cells. Upon examination of a blood smear, the cells appear curved with sharp ends. This finding indicates the presence of a) 1. Sickle cell b) 2. Spherocyte c) 3. Ovalocyte d) 4. Stomatocyte 3) Which of the following morphology is related to red cell change in thalassemia? a) 1. Microcytic hypochromic b) 2. Macrocytic hypochromic c) 3. Normocytichypochromic d) 4. Macrocytic normochromic 4) All of the following are related to causes of non Megaloblastic macrocytic anemias except a) 1. Alcoholism b) 2. Liver disorders c) 3. Hypothyroidism d) 4. Folic acid deficiency 5) All the following are true related to (Hb S) except. a) 1. Insoluble b) 2. Soluble c) 3. Forms crystals when exposed to low oxygen d) 4. Polymerizes into long fibers 6) Which of the following is Not a feature of increased red blood cell destruction? a) 1. High Serum bilirubin b) 2. High urine urobilinogen c) 3. Low Serum haptoglobin d) 4. High serum haptoglobin 7) Osmotic fragility test is done to diagnose. a) 1. Hereditary spherocytosis b) 2. Sickle cell anemia c) 3. IDA d) 4. G6PD anemia 8) Which ONE of the following is NOT a feature of Beta thalassaemia intermedia? a) 1. Have Insignificant increase in bilirubin levels b) 2. See increase in both Hb A2 and Hb F production c) 3. It is usually associated with splenomegaly d) 4. T end to develop iron overload 9) Which of the following conditions the absorption of vit B12 is greatly impaired due to failure or marked reduction of intrinsic factor secretion? a) 1. Fanconi’s anemia b) 2. Sickle cell anemia c) 3. Thalassemia d) 4. Pernicious anemia 10) Which of the following is Not causes of intracellular hemolysis . a) A. Membrane Abnormalities b) B. Metabolic Abnormalities c) C. Hemoglobinopathies d) D. Immune hemolytic 11) The red cell morphology in Aplastic anemias is most often a) A. Normocytic Normochromic b) B. Microcytic Normochromic c) C. Hyper chromic d) D. Macrocytic 12) Red blood cell appear in Sideroblastic anemia as.... a) A. Noromcytic Normochromic b) B. Microcytic Hypochromic c) C. Normocytic Hyper chromic d) D. Macrocytic Normochromic 13) Which of the following is not characteristic of hemolytic anemia? a) A. LDH increased b) B. Reticulocytosis c) C. Increased indirect bilirubin d) D. Bilirubin decreased 14) Which of the following is the most common cause of anemia among hospitalized patients? a) A. Immune hemolytic anemia b) B. Thalassemia c) C. Anemia of chronic disease d) D. Iron deficiency anemia 15) ......facilitates the conversion of ferric to ferrous iron and thus increases its absorption. a) A. Vitamin B12 b) B. Vitamin A c) C. Erythropoietin d) D. Ascorbic acid (vit C) 16) Which ONE of the following is NOT true regarding to laboratory diagnosis of (Hb AS)? a) A. Normal WBCs b) B. Positive solubility test c) C. Normal RBCs morphology except few target cell d) D. Increase in platelets 17) Which white blood cell population Would have the most scatter when analyzed using flow cytometry? a) A. Monocyte b) B. Lymphocyte c) C. Granulocyte d) D. Erythrocyte 18) Which of the following disorders may cause hemolysis as a result of erythrocyte membrane abnormalities? a) A. Stomatocytosis b) B. Hb S disease c) C. Thalassemia d) D. G6PD deficency 19) Prussian blue stain is utilized to demonstrate __________. a) A. Iron store in Bone marrow b) B. Reticulocyte number in Bone marrow c) C. Basophilic stippling d) D. Howell-Jolly body 20) When using flowcytometer, forward scatter measure which of following parameters? a) A. Cell size b) B. Granularity c) C. Cytoplasmic complexity d) D. Clonality 21) The Direct Antihuman Globulin Test (DAT) is typically performed to differentiate between.......... a) A. Immune and no immune hemolytic anemias b) B. Sickle cell anemia and thalassemia c) C. Anemia of chronic disease and iron deficiency anemia d) D. Anemia of chronic disease and hemolytic anemias 22) Which ONE of these statements is TRUE about β-thalassaemia major? a) A. Most of hemoglobin present is Hb A2 b) B. Most of hemoglobin present is Hb F c) C. MCV in range of 80 to 90 fL d) D. Hemoglobin usually is 10 g/dL without transfusions. 23) Which of the following lab findings is matching with anaemia of chronic disease? a) A. The serum iron is low b) B. The serum ferritin is low c) C. The mean cell volume is raised d) D. TIBC is increased 24) Principle of sickling test that ......................... reduces the oxygen tension inducing the typical sickle-shape of red blood cells. a) A. sodium dithionate b) B. Sodium metabisulfite c) C. Drabkin reagent d) D. Supravital stain 25) Which of the following hemglobins is caused by substitution of amino acid (valine) instead of glutamic acid at position No 6 in the beta chain of hemoglobin? a) A. Hb-A b) B. Hb-A2 c) C. Hb –F d) D. Hb –S 26) Which of the following is NOT matching with laboratory diagnosis of (Hb SS)? a) A. Moderate leukocytosis with neutrophilia b) B. Thrombocytopenia is usually present c) C. RDW high d) D. Retics high during hemolytic crisis 27) Which of the following red cell morphology is related to iron deficiency anmeia? a) A. Normocytic Normochromic b) B. Microcytic Hyphochromic c) C. Macrocytic Normochromic d) D. Macrocytic Hyphochromic 28) Which of the follwing investigations is ideal way to diagnose silent carriers patient with thalssemia? a) A. Genetic mapping b) B. CBC c) C. Iron studies d) D. Routine Chemistry Tests 29) Which of the following mutations is found in sickle cell anemia? a) Crossover mutation  b) Chain extension c) Point mutation d) Deletion 30) Which of the following red blood cells is small dark with no area of central pallor? a) A. Stomatocyte b) B. Spherocyte c) C. Acathocyte d) D. Schistocyte 31) The lab reports for a patient with normal MCV show high serum ferritin and low TIBC. What is the most likely cause for this patient’s anaemia? a) A. Fe deficiency b) B. Anemia secondary to inflammation c) C. Thalassemia d) D. Megaloblastic anemia 32) The lab reports for a patient with high MCV and low serum B12. What is the most likely type of anmeia for this patient’s ? a) A. Fe deficiency b) B. Anemia secondary to inflammation c) C. Megaloblastic anemia d) D. Hemoglobinopathy 33) In non-Megaloblastic anemia the red cell appears as a) A. Round b) B. Oval c) C. Elliptical d) D. Cylindrical 34) Which ONE of the following is NOT true regarding to Bart’s Hydrops Fetalis Syndrome? a) A. Fetus dies in utero or shortly after birth b) B. Predominant hemoglobin is Hemoglobin Bart c) C. Increased risk of toxemia and severe postpartum hemorrhage d) D. Have only one functioning alpha chain genes 35) Which of the following is Not related to Silent Carrier State for β Thalassemia a) A. Have normal levels of Hb A2 b) B. Patients have nearly normal beta/alpha chain ratio c) C. No hematologic abnormalities d) D. Have high levels of Hb F 36) Which ONE of the following statements is NOT TRUE about iron deficiency anemia (IDA)? a) A. It is the most common type of anemia b) B. Ferritin is the specific test for IDA diagnosis c) C. High iron binding capacity d) D. It is associated with jaundice 37) Which of the following anemias charctrized by Present of hyper segmented neutrophil ? a) A. Sickle cell anemia b) B. Beta Thalassemia c) C. Megaloblastic anemia d) D. Alpha Thalassemia 38) Which ONE of the following is NOT matching to biochemical findings in Megaloblastic anemia? a) A. Increase in LDH b) B. Normal serum iron c) C. Normal serum ferritin d) D. Decrease in LDH 39) During hemolytic anemia, the increase in MCV is due to __________ a) A. Reticulocytosis b) B. Thrombocytosis c) C. Low reticulocyte d) D. High HDL 40) The ratio of myeloid to erythroid precursors in bone marrow normally is.... a) A. 3 : 1 b) B. 1: 3 c) C. 1 : 5 d) D. 2 : 1 41) Which of the following red blood cells morphology is indicate Megaloblastic anmeia? a) A. Macrocytic Normochromic b) B. Microcytic Hypochromic c) C. Normcytic Normochromic d) D. Macrocytic Hypochromic 42) Which ONE of the following is NOT true regarding to Hemoglobin H Disease? a) A. Have no any functioning alpha chain genes b) B. Born with 10-40% Bart's hemoglobin c) C. Have only one functioning alpha chain genes d) D. Second most severe form alpha thalassemia 43) Which of the following lab findings are indicating iron deficiency anemia (IDA)? a) A. Low serum ferritin, High RDW and High iron binding capacity b) B. High serum ferritin, High RDW and High iron binding capacity c) C. High serum ferritin, Low RDW and High iron binding capacity d) D. Low serum ferritin, High RDW and Low iron binding capacity 44) An adult has a total white blood cell count of 4.0 X 109/L (4.0 X 103 u/L). The differential count is as follows: polymorphonuclear neutrophils (PMNs) 25%, bands 5%, lymphocytes 65%, and monocytes 5%. The absolute value reference range for lymphocytes is 1.0—4.0 X 109/L. Which of the following is true? a) A. The percentage of lymphocytes is normal. b) B. There is an absolute lymphocytosis. c) C. There is a relative lymphocytosis. d) D. There is both an absolute and a relative lymphocytosis. 45) A pre-operative, 20-year-old female has a mild microcytic anemia, with target cells and stippled red cells observed on the blood smear. Her hemoglobin A2 level is quantified at 5%. What do these findings suggest? a) A. Iron-deficiency anemia b) B. Heterozygous alpha-thalassemia c) C. Heterozygous beta-thalassemia d) D. Hemoglobin S/beta-thalassemia 46) Which of the following statements about folic acid is not true? a) A. yellow in colour b) B. water soluble c) C. found in vegetables d) D. Not destroyed by cooking 47) Which of the following is matched with morphology of Type 2 sideroblasts? a) A. Contains 5 or more siderotic granules, but not in a perinuclear b) B. Contains 5 or more siderotic granules, in a perinuclear c) C. Contains fewer than 5 siderotic granules not in a perinuclear d) D. Contains fewer than 5 siderotic granules, in a perinuclear 48) Which of the following statements about vitamin B12 is not true? a) A. water-soluble b) B. Absorbed in the last part of the small intestine c) C. Destroyed by cooking d) D. stores of about 2-3 mg are enough for 2-4 years 49) A pre-operative, 20-year-old female has a mild microcytic anemia, with target cells and stippled red cells observed on the blood smear. Her hemoglobin A2 level is quantified at 5%. What do these findings suggest? a) A. Heterozygous beta-thalassemia b) B. Iron-deficiency anemia c) C. Heterozygous alpha-thalassemia d) D. Hemoglobin S/beta-thalassemia 50) Which of the follwing findings is not matching with Hemochromatosis a) A. Low transferrin b) B. High total iron binding capacity c) C. Normal hrmglobin d) D. High transferrin saturation percentage 51) Which of the following is NOT matching with Bone Marrow in iron deficency anmeia Except. a) A. Normal to Hypercellular b) B. RBCs precursors are increased c) C. Iron satin is positive d) D. Iron satin is Negative 52) Which of the following alpha thalassemia subtypes May be confused with iron deficiency anemia a) A. Alpha Thalassemia Minor b) B. Silent Carrier State c) C. Hemoglobin H Disease d) D. Hydrops Fetalis Syndrome 53) An old man is admitted to hospital with chronic headaches and presents with episodes of Neurologic symptoms: memory loss, numbness and tingling in toes and fingers. These symptoms are linked to which defficiency? a) A. B12 deficiency b) B. Vitamin C deficiency c) C. Folate deficiency d) D. Fe deficiency 54) Which of the following Iron Profiles finding is not indicates Sideroblastic Anemia? a) A. Increased ferritin levels b) B. High total iron-binding capacity c) C. Serum Iron is High d) D. High transferrin saturation 55) Which of the following complications that can occur in Beta thalassemia Intermedia? a) A. iron overloads b) B. protrusion upper teeth c) C. changes in skull d) D. Mongoloid facial features 56) Which of the following is the first stage of iron deficiency? a) A. Progressive depletion of iron stores b) B. Gradual decline in transferrin functioning c) C. Slowing in iron serum d) D. low serum ferritin 57) Angular stomatitis is inflammation that is characterized by __________. a) A. cracking of corners of mouth b) B. smooth tongue c) C. craving ice d) D. spoon-shaped fingernails 58) Which of the following is NOT a common cause of B12 deficiency? a) A. Inadequate Intake b) B. Increased Need in pregnancy c) C. Impaired Absorption d) D. Increased Need in lactation 59) A 7 years -old child is brought to the clinic for a routine examination.Have pallor, variable degree of jaundice, abdominal enlargement, hepatosplenomegaly and also noted therer is characteristic changes in her hand bones. Her CBC results are as follows: WBC 4.5 x 109/L ; RBC 2.70 X 1012/L ; hemoglobin (4.7 g/dL); hematocrit 0.25 L/L (25%); MCV 63.5 fl_; MCHC 23.8 g/dL; Abnormal RBC morphology present included pencil forms,basophilic stippling, polychromasia &NRBCs.and target cells. What is a possible diagnosis of this case? a) A. Beta Thalassemia Intermedia b) B. Hydrops Fetalis c) C. Beta Thalassemia Major d) D. Hemoglobin H Disease 60) A fourteen year old white male was referred to a large medical center . He was seen in the Pediatric Hematology clinic where blood was drawn for CBC and Reticulocyte count. The CBC results were as follows: RBC 1.14 x 106/μl , WBC 3.6 x 103 /μl , Hematocrit 12.7% , Hemoglobin 4.4 g/dl, MCV 111.4 fl ,MCH 38.7 pg , MCHC 34.7 g/dl and RDW 22.1% What is this toddler's most probable diagnosis? a) A. Folic acid deficiency b) B. Hereditary spherocytosis c) C. Iron deficiency d) D. Beta Thalassemia Major

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