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What is the primary trigger for increased erythropoietin (EPO) levels leading to polycythemia? A) High oxygen levels B) Hypoxia C) Nutritional deficiencies D) Trauma E) Hereditary conditions
B) Hypoxia Explanation: Hypoxia is the primary trigger for increased erythropoietin (EPO) levels, which can lead to polycythemia as the body attempts to increase oxygen-carrying capacity.
What effect does cooperative binding have on hemoglobin? A) Decreases the affinity of heme groups for oxygen B) Increases the affinity of the first heme group only C) Increases the affinity of the remaining heme groups for oxygen D) Has no effect on oxygen binding E) Causes hemoglobin to release oxygen more slowly
C) Increases the affinity of the remaining heme groups for oxygen Explanation: Cooperative binding in hemoglobin means that when one heme binds to an oxygen molecule, it induces a conformational change that increases the affinity of the remaining heme groups for oxygen.
1/119
p.10
Anemia and Polycythemia

What is the primary trigger for increased erythropoietin (EPO) levels leading to polycythemia?
A) High oxygen levels
B) Hypoxia
C) Nutritional deficiencies
D) Trauma
E) Hereditary conditions

B) Hypoxia
Explanation: Hypoxia is the primary trigger for increased erythropoietin (EPO) levels, which can lead to polycythemia as the body attempts to increase oxygen-carrying capacity.

p.6
Hemoglobin Synthesis and Function

What effect does cooperative binding have on hemoglobin?
A) Decreases the affinity of heme groups for oxygen
B) Increases the affinity of the first heme group only
C) Increases the affinity of the remaining heme groups for oxygen
D) Has no effect on oxygen binding
E) Causes hemoglobin to release oxygen more slowly

C) Increases the affinity of the remaining heme groups for oxygen
Explanation: Cooperative binding in hemoglobin means that when one heme binds to an oxygen molecule, it induces a conformational change that increases the affinity of the remaining heme groups for oxygen.

p.10
Anemia and Polycythemia

What is Polycythemia Vera also known as?
A) Secondary Polycythemia
B) True Polycythemia
C) Anemia
D) Hemolytic Anemia
E) Iron Deficiency Anemia

B) True Polycythemia
Explanation: Polycythemia Vera, also known as True Polycythemia, is a pathologic condition where RBC production becomes excessive due to genetic aberrations.

p.9
Formation of Blood Cells

What does the Hematocrit (Hct) or Packed Cell Volume (PCV) measure?
A) The number of red blood cells per liter of blood
B) The average volume of a single red blood cell
C) The ratio of the volume of red cells to the volume of whole blood
D) The average amount of hemoglobin in a red blood cell
E) The concentration of hemoglobin in red blood cells

C) The ratio of the volume of red cells to the volume of whole blood
Explanation: Hematocrit (Hct) or Packed Cell Volume (PCV) measures the ratio of the volume of red cells to the volume of whole blood.

p.6
Hemoglobin Synthesis and Function

What is the relaxed state (R state) of hemoglobin characterized by?
A) Low affinity for oxygen
B) High affinity for oxygen
C) No affinity for oxygen
D) Equal affinity for oxygen and carbon dioxide
E) High affinity for carbon dioxide

B) High affinity for oxygen
Explanation: The relaxed state (R state) of hemoglobin is characterized by a high affinity for oxygen, with heme groups in a position that facilitates oxygen binding.

p.12
Blood Types and Transfusion Compatibility

Which blood type is considered the universal donor?
A) Type A
B) Type B
C) Type AB
D) Type O
E) Type A+

D) Type O
Explanation: Type O blood does not have any antigens, so there is no risk of reacting with the blood types of any recipient, making it the universal donor.

p.2
Hematopoiesis

What type of stem cells are non-committed and intermediate before becoming committed stem cells?
A) Pluripotent HSC
B) Multipotent HSC
C) Committed stem cells
D) Totipotent stem cells
E) Unipotent stem cells

A) Pluripotent HSC
Explanation: Pluripotent Hematopoietic Stem Cells (HSC) or Multipotent HSC are non-committed, intermediate stage cells that eventually become committed stem cells, which produce colonies of specific types of blood cells.

p.11
Anemia and Polycythemia

What is the expected RBC count in secondary polycythemia?
A) 4-5 million/mm3
B) 5-6 million/mm3
C) 6-7 million/mm3
D) 7-8 million/mm3
E) 8-9 million/mm3

C) 6-7 million/mm3
Explanation: In secondary polycythemia, the RBC count can increase to 6-7 million/mm3, which is about 30% above normal.

p.10
Conditions Affecting Red Blood Cells

Which condition is characterized by a defective cytoskeleton causing increased red cell fragility?
A) Sickle Cell Disease
B) Hookworm infections
C) Hereditary spherocytosis
D) Iron deficiency
E) Vitamin B12 deficiency

C) Hereditary spherocytosis
Explanation: Hereditary spherocytosis is a condition where a defective cytoskeleton causes increased red cell fragility, leading to hemolytic anemia.

p.13
Blood Types and Transfusion Compatibility

Which blood type is considered the universal recipient?
A) Type O
B) Type A
C) Type B
D) Type AB
E) Type D

D) Type AB
Explanation: Individuals with blood type AB are considered universal recipients because they lack both anti-A and anti-B antibodies in their plasma, allowing them to receive blood from any other type.

p.13
Composition of Blood

True/False: RBCs are the most numerous of the formed elements of blood.

True
Explanation: RBCs make up 40-45% of the formed elements in blood, making them the most numerous compared to WBCs and platelets.

p.9
Hemoglobin Synthesis and Function

What does a high Mean Cell Hemoglobin Concentration (MCHC) indicate?
A) Microcytosis
B) Hypochromic
C) Normochromic
D) Hyperchromic
E) Anisocytosis

D) Hyperchromic
Explanation: A high Mean Cell Hemoglobin Concentration (MCHC) indicates hyperchromic red blood cells, meaning they have a higher than normal concentration of hemoglobin.

p.9
Conditions Affecting Red Blood Cells

What condition is characterized by the presence of drepanocytes or sickle cells?
A) Liver diseases
B) Hemoglobinopathies
C) Malaria
D) Babesiosis
E) Chagas disease

B) Hemoglobinopathies
Explanation: Hemoglobinopathies, such as sickle cell disease, are characterized by the presence of drepanocytes or sickle cells.

p.10
Anemia and Polycythemia

What does a high reticulocyte count in anemia indicate?
A) Decreased erythropoiesis
B) Increased rate of erythropoiesis
C) Normal red cell production
D) Low red cell destruction
E) Stable hemoglobin levels

B) Increased rate of erythropoiesis
Explanation: A high reticulocyte count in anemia suggests an increased rate of erythropoiesis, reflecting the body's attempt to compensate for red cell loss.

p.6
Hemoglobin Synthesis and Function

In what state is the central iron atom of hemoglobin usually found when binding oxygen?
A) Ferric state
B) Ferrous state
C) Elemental iron
D) Oxidized state
E) Reduced state

B) Ferrous state
Explanation: The central iron atom in hemoglobin is usually in the ferrous state when binding oxygen, which is crucial for forming a coordination bond with an oxygen molecule.

p.9
Red Blood Cell Structure and Function

What is the Mean Cell Volume (MCV) used to determine?
A) The average concentration of hemoglobin in red blood cells
B) The average volume of a single red blood cell
C) The number of red blood cells per liter of blood
D) The amount of hemoglobin in the volume of blood
E) The ratio of the volume of red cells to the volume of whole blood

B) The average volume of a single red blood cell
Explanation: Mean Cell Volume (MCV) is used to determine the average volume of a single red blood cell, expressed in femtoliters.

p.6
Hemoglobin Synthesis and Function

What is the maximum concentration of hemoglobin in cells?
A) 20 g/100ml
B) 34 g/100ml
C) 50 g/100ml
D) 10 g/100ml
E) 40 g/100ml

B) 34 g/100ml
Explanation: The maximum concentration of hemoglobin in cells is 34 g/100ml, which is the metabolic limit of the cell’s hemoglobin-forming mechanism.

p.8
RBC Destruction and Hemolysis

Where are aging RBCs primarily removed from circulation?
A) Liver
B) Kidneys
C) Spleen
D) Bone marrow
E) Lungs

C) Spleen
Explanation: Aging RBCs are primarily removed from circulation by macrophages in the spleen, where most aged and abnormal RBCs rupture due to the spleen's structure.

p.11
Anemia and Polycythemia

What triggers secondary polycythemia?
A) High iron levels
B) Low oxygen levels in the air
C) Excessive hydration
D) High carbon dioxide levels
E) Low blood pressure

B) Low oxygen levels in the air
Explanation: Secondary polycythemia is triggered by hypoxia, such as too little oxygen in the breathed air at high altitudes, leading to increased EPO levels and RBC production.

p.10
Anemia and Polycythemia

Which of the following is a symptom of anemia?
A) Increased energy
B) Weight gain
C) Shortness of breath
D) High blood pressure
E) Increased appetite

C) Shortness of breath
Explanation: Shortness of breath is a symptom of anemia due to the decreased oxygen-carrying capacity of the blood.

p.8
Iron Metabolism

What is the primary function of hepcidin?
A) To increase iron absorption in the intestine
B) To regulate iron homeostasis by inhibiting ferroportin
C) To promote the release of iron from storage sites
D) To enhance the production of red blood cells
E) To decrease inflammation in the body

B) To regulate iron homeostasis by inhibiting ferroportin
Explanation: Hepcidin is a liver hormone that regulates iron homeostasis by inhibiting ferroportin, which is an iron exporter in duodenal enterocytes, macrophages, and other iron-exporting cells.

p.13
Conditions Affecting Red Blood Cells

True/False: Autoimmunity and immunodeficiency are two different terms for the same set of general disorders.

False
Explanation: Autoimmunity and immunodeficiency are distinct concepts. Autoimmunity refers to the immune system attacking the body's own cells, while immunodeficiency involves a weakened immune response.

p.4
Formation of Blood Cells

At what age does the bone marrow of long bones stop producing RBCs?
A) 5 years
B) 10 years
C) 15 years
D) 18-25 years
E) 30 years

D) 18-25 years
Explanation: The bone marrow of long bones, except for the proximal portions of the humerus and tibia, becomes fatty and stops producing RBCs beyond the age of 20 years.

p.12
Blood Types and Transfusion Compatibility

Why is Type AB blood considered the universal recipient?
A) It has no antigens
B) It has no antibodies
C) It has both A and B antigens
D) It has only A antigens
E) It has only B antigens

B) It has no antibodies
Explanation: Type AB blood is considered the universal recipient because it does not have antibodies against A or B antigens, allowing it to receive blood from any type.

p.8
RBC Destruction and Hemolysis

What happens to hemoglobin from phagocytized RBCs?
A) It is excreted in urine
B) It is converted into glucose
C) It is broken down into heme and globin
D) It is stored in the liver
E) It is used to produce antibodies

C) It is broken down into heme and globin
Explanation: Hemoglobin from phagocytized RBCs is broken down by macrophages into heme and globin. The heme is further processed into bilirubin and released into the blood, while the iron is recycled.

p.10
Anemia and Polycythemia

What is a common symptom of anemia due to decreased oxygen-carrying capacity?
A) Increased appetite
B) Weight gain
C) Fatigue
D) High blood pressure
E) Increased energy

C) Fatigue
Explanation: Fatigue is a common symptom of anemia due to the decreased oxygen-carrying capacity of the blood.

p.13
Hemoglobin Synthesis and Function

Which of the following describes the shift to the right of Hgb-O2 affinity?
A) ↑ pH
B) ↓ body temperature
C) ↓ 2,3-DPG concentration
D) ↑ in body temperature
E) ↑ pH

D) ↑ in body temperature
Explanation: A shift to the right in the hemoglobin-oxygen affinity curve is associated with an increase in body temperature, among other factors like increased 2,3-DPG concentration and decreased blood pH.

p.4
Hematopoiesis

How does bone marrow cellularity change with age?
A) It increases steadily
B) It remains constant
C) It fluctuates randomly
D) It steadily drops
E) It increases and then drops

D) It steadily drops
Explanation: The amount of stem cells in the bone marrow needed for RBC synthesis steadily drops as we age.

p.8
RBC Destruction and Hemolysis

What is the lifespan of red blood cells (RBCs)?
A) 30-60 days
B) 60-90 days
C) 100-120 days
D) 150-180 days
E) 200-220 days

C) 100-120 days
Explanation: The lifespan of RBCs is 100-120 days, after which they must be replaced due to increased fragility and limited ability to repair damage.

p.6
Hemoglobin Synthesis and Function

Which type of hemoglobin is predominant in adults?
A) Hemoglobin F
B) Hemoglobin A
C) Hemoglobin A2
D) Hemoglobin Gower 1
E) Hemoglobin Portland

B) Hemoglobin A
Explanation: Hemoglobin A (α2β2) is the predominant form of hemoglobin in adults, making up 95-98% of the total hemoglobin.

p.9
Anemia and Polycythemia

What is a common cause of anemia related to the bone marrow?
A) Renal insufficiency
B) Iron deficiency
C) Megaloblastic anemia
D) Aplastic anemia
E) Hemoglobinopathies

D) Aplastic anemia
Explanation: Aplastic anemia is caused by hypoproliferation of red cells due to damaged or destroyed bone marrow, often from prolonged radiation or chemical exposure.

p.4
Stages of Erythropoiesis

At which stage of erythropoiesis does hemoglobin first appear?
A) Proerythroblast
B) Basophil erythroblast
C) Polychromatic erythroblast
D) Reticulocyte
E) Mature erythrocyte

C) Polychromatic erythroblast
Explanation: Hemoglobin first appears in the polychromatic erythroblast stage, where the cells become filled with hemoglobin.

p.9
Red Blood Cell Structure and Function

What does a high Red Cell Distribution Width (RDW) indicate?
A) Microcytosis
B) Macrocytosis
C) Normocytosis
D) Anisocytosis
E) Hypochromic

D) Anisocytosis
Explanation: A high Red Cell Distribution Width (RDW) indicates anisocytosis, which is a variation in red blood cell size.

p.4
Stages of Erythropoiesis

What happens to the nucleus during the polychromatic erythroblast stage?
A) It enlarges
B) It condenses and is eventually excluded
C) It remains unchanged
D) It divides
E) It becomes multinucleated

B) It condenses and is eventually excluded
Explanation: During the polychromatic erythroblast stage, the nucleus condenses, becomes smaller, and its final remnant is absorbed or excluded from the cell.

p.10
Conditions Affecting Red Blood Cells

What is a common cause of acute blood loss leading to anemia?
A) Hookworm infections
B) Trauma
C) Nutritional deficiencies
D) Hereditary spherocytosis
E) Sickle Cell Disease

B) Trauma
Explanation: Acute blood loss leading to anemia can be caused by trauma, which results in immediate loss of red cells and other blood components.

p.10
Anemia and Polycythemia

What is a common cause of polycythemia?
A) Nutritional deficiencies
B) Lung disease
C) Trauma
D) Hookworm infections
E) Hereditary spherocytosis

B) Lung disease
Explanation: Lung disease is a common cause of polycythemia as it leads to hypoxia, which triggers increased levels of erythropoietin (EPO) and subsequently higher red blood cell production.

p.13
Anemia and Polycythemia

Which of the following deficiencies causes Megaloblastic Anemia?
A) Vitamin B12
B) Folic Acid
C) Both
D) Neither
E) Iron

C) Both
Explanation: Both Vitamin B12 and Folic Acid are essential for DNA synthesis and red cell maturation. A deficiency in either can lead to Megaloblastic Anemia.

p.8
Iron Metabolism

How does inflammation affect hepcidin levels and iron absorption?
A) Inflammation decreases hepcidin levels, increasing iron absorption
B) Inflammation increases hepcidin levels, reducing iron absorption
C) Inflammation has no effect on hepcidin levels
D) Inflammation decreases hepcidin levels, reducing iron absorption
E) Inflammation increases hepcidin levels, increasing iron absorption

B) Inflammation increases hepcidin levels, reducing iron absorption
Explanation: Inflammation causes an overproduction of hepcidin, which reduces iron absorption and release, leading to a restricted iron supply for hemoglobin synthesis and contributing to anemia of chronic disease.

p.11
Anemia and Polycythemia

What causes high hematocrit in polycythemia vera?
A) Low oxygen levels
B) Genetic aberration in hemocytoblastic cells
C) High iron intake
D) Excessive exercise
E) Dehydration

B) Genetic aberration in hemocytoblastic cells
Explanation: High hematocrit in polycythemia vera is caused by a genetic aberration in the hemocytoblastic cells that produce blood cells, leading to uncontrolled production of RBCs.

p.11
Anemia and Polycythemia

What is a consequence of the high number of cells in polycythemia vera?
A) Increased oxygen delivery
B) Decreased blood viscosity
C) Plugged or obstructed capillaries
D) Enhanced immune response
E) Reduced blood volume

C) Plugged or obstructed capillaries
Explanation: The high number of cells in polycythemia vera causes many blood capillaries to become plugged or obstructed by the viscous blood, leading to potential complications.

p.2
Hematopoiesis

Which growth inducer promotes the growth and reproduction of all different types of committed stem cells?
A) IL-1
B) IL-2
C) IL-3
D) IL-4
E) IL-5

C) IL-3
Explanation: IL-3 (Interleukin-3) promotes the growth and reproduction of all different types of committed stem cells, unlike other growth inducers that induce the growth of only specific types of cells.

p.6
Hemoglobin Synthesis and Function

Which hemoglobin form is found in early development and contains 2 alpha chains and 2 epsilon chains?
A) Hemoglobin F
B) Hemoglobin A
C) Gower 1 Hgb
D) Gower 2 Hgb
E) Portland Hgb

D) Gower 2 Hgb
Explanation: Gower 2 hemoglobin (α2ε2) is found in early development and contains 2 alpha chains and 2 epsilon chains.

p.6
Hemoglobin Synthesis and Function

What is the oxygen-carrying capacity of each gram of hemoglobin when 100% saturated?
A) 1.0 ml of oxygen
B) 1.34 ml of oxygen
C) 2.0 ml of oxygen
D) 0.5 ml of oxygen
E) 1.5 ml of oxygen

B) 1.34 ml of oxygen
Explanation: Each gram of hemoglobin can combine with 1.34 ml of oxygen when it is 100% saturated.

p.11
Anemia and Polycythemia

What is the primary effect of polycythemia on blood viscosity?
A) Decreases viscosity
B) Increases viscosity
C) No effect on viscosity
D) Only affects large vessels
E) Only affects oxygen levels

B) Increases viscosity
Explanation: Polycythemia increases blood viscosity, which primarily affects the smaller vessels before causing large vessel obstructions.

p.12
Red Blood Cell Structure and Function

What is the typical lifespan of a red blood cell in circulation?
A) 10-14 days
B) 30-60 days
C) 100-120 days
D) 200-250 days
E) 300-350 days

C) 100-120 days
Explanation: The typical lifespan of a red blood cell in circulation is 100-120 days.

p.2
Composition of Blood

What is the composition of plasma in the blood?
A) 50% water, 40% proteins, 10% solutes
B) 70% water, 20% proteins, 10% solutes
C) 92% water, 7% proteins, 1% solutes
D) 80% water, 15% proteins, 5% solutes
E) 60% water, 30% proteins, 10% solutes

C) 92% water, 7% proteins, 1% solutes
Explanation: Plasma is composed of 92% water, 7% proteins, and 1% solutes (carbohydrates, amino acids, ions), making it a crucial part of the extracellular fluid contained in the cardiovascular system.

p.4
Formation of Blood Cells

Where is RBC synthesis primarily concentrated in adults?
A) Long bones
B) Axial bones
C) All bones
D) Skull bones
E) Pelvic bones

B) Axial bones
Explanation: In adults, RBC synthesis is mainly concentrated in the vertebra, sternum, and ribs.

p.13
Conditions Affecting Red Blood Cells

True/False: CD4 T cells interact with MHC class I on CD8 T cells.

False
Explanation: CD4 T cells interact with MHC class II molecules, not MHC class I. CD8 T cells interact with MHC class I molecules.

p.13
Hemoglobin Synthesis and Function

True/False: When metabolism increases, the O2 affinity of hemoglobin will decrease.

True
Explanation: Increased metabolic activity leads to factors such as increased CO2, decreased pH, and increased temperature, which decrease hemoglobin's affinity for oxygen, facilitating oxygen delivery to active tissues.

p.12
Blood Types and Transfusion Compatibility

What is the primary risk associated with agglutination during a blood transfusion?
A) Increased blood pressure
B) Obstruction or plugging of blood vessels
C) Enhanced oxygen delivery
D) Increased red blood cell production
E) Decreased heart rate

B) Obstruction or plugging of blood vessels
Explanation: Agglutination can lead to the clumping of blood cells, which can obstruct or plug blood vessels, posing a significant risk during transfusions.

p.2
Hematopoiesis

What is the role of differentiation inducers in hematopoiesis?
A) Promote growth of stem cells
B) Cause committed stem cells to differentiate
C) Increase oxygen levels in blood
D) Destroy infective organisms
E) Form cellular fragments

B) Cause committed stem cells to differentiate
Explanation: Differentiation inducers are responsible for causing one type of committed stem cell to differentiate one or more steps toward a final adult blood cell.

p.12
Conditions Affecting Red Blood Cells

What condition can occur due to Rh incompatibility between a mother and her baby?
A) Sickle cell anemia
B) Erythroblastic fetalis
C) Hemophilia
D) Leukemia
E) Thalassemia

B) Erythroblastic fetalis
Explanation: Erythroblastic fetalis is an immune type of hemolytic disease of the newborn that occurs due to Rh incompatibility, where an Rh-negative mother has developed antibodies against Rh-positive fetal blood cells.

p.2
Conditions Affecting Red Blood Cells

Which type of white blood cell is likely elevated in a bacterial infection?
A) Eosinophils
B) Basophils
C) Neutrophils
D) Lymphocytes
E) Monocytes

C) Neutrophils
Explanation: An elevation of neutrophils in a complete blood count (CBC) likely indicates a bacterial etiology, as neutrophils are the primary white blood cells that respond to bacterial infections.

p.12
Hemoglobin Synthesis and Function

What type of globin chains make up the predominant hemoglobin found in a healthy adult?
A) α2γ2
B) α2β2
C) α2ε2
D) α2δ2
E) α2θ2

B) α2β2
Explanation: The predominant hemoglobin found in a healthy adult is composed of two alpha (α) and two beta (β) globin chains, known as HbA (α2β2).

p.3
Composition of Blood

What is the normal range for sodium in plasma?
A) 120-130 mM
B) 136-146 mM
C) 150-160 mM
D) 100-110 mM
E) 90-100 mM

B) 136-146 mM
Explanation: The normal range for sodium in plasma is 136-146 mM, which is essential for maintaining fluid balance and proper cellular function.

p.7
Hemoglobin Synthesis and Function

What does the steep portion of the oxygen-hemoglobin dissociation curve represent?
A) The range of pO2 levels typically found in the lungs
B) The range of pO2 levels typically found in the tissues
C) The point where Hgb binds carbon dioxide
D) The point where Hgb releases nitrogen
E) The range of pO2 levels in the blood plasma

B) The range of pO2 levels typically found in the tissues
Explanation: The steep portion of the curve represents the range of pO2 levels typically found in the tissues, where small changes in pO2 result in significant changes in O2 saturation, allowing efficient oxygen release.

p.3
Red Blood Cell Structure and Function

Which enzyme in RBCs catalyzes the reversible reaction between CO2 and water?
A) Glycolytic enzyme
B) Hemoglobin
C) Carbonic anhydrase
D) 2,3-Diphosphoglycerate
E) Glutathione

C) Carbonic anhydrase
Explanation: Carbonic anhydrase in RBCs catalyzes the reversible reaction between CO2 and water to form carbonic acid, which is essential for CO2 transport in the blood.

p.5
Hemoglobin Synthesis and Function

What is the composition of adult hemoglobin (Hemoglobin A)?
A) 2 alpha chains and 2 gamma chains
B) 2 alpha chains and 2 delta chains
C) 2 alpha chains and 2 beta chains
D) 2 beta chains and 2 gamma chains
E) 2 delta chains and 2 gamma chains

C) 2 alpha chains and 2 beta chains
Explanation: Adult hemoglobin (Hemoglobin A) is composed of 2 alpha chains and 2 beta chains, making up the most prevalent form of hemoglobin in adults.

p.1
Hemoglobin Synthesis and Function

What is the role of hemoglobin in red blood cells?
A) To fight infections
B) To transport oxygen
C) To clot blood
D) To produce antibodies
E) To regulate blood pressure

B) To transport oxygen
Explanation: Hemoglobin is a protein in red blood cells that binds to oxygen, allowing red blood cells to transport oxygen from the lungs to the rest of the body.

p.3
Composition of Blood

What is the normal range for fasting glucose in plasma?
A) 50-70 mg/dL
B) 70-99 mg/dL
C) 100-120 mg/dL
D) 40-60 mg/dL
E) 80-110 mg/dL

B) 70-99 mg/dL
Explanation: The normal range for fasting glucose in plasma is 70-99 mg/dL, which is important for maintaining energy balance and metabolic functions.

p.4
Stages of Erythropoiesis

What is the first stage of erythropoiesis?
A) Reticulocyte
B) Polychromatic erythroblast
C) Basophil erythroblast
D) Proerythroblast
E) Mature erythrocyte

D) Proerythroblast
Explanation: The proerythroblast is formed from the colony-forming-unit-erythroid (CFU-E) stem cells and is the first stage of erythropoiesis.

p.13
Red Blood Cell Structure and Function

True/False: Reticulocytes have a nucleus.

False
Explanation: Reticulocytes are immature red blood cells that have already lost their nucleus by the time they enter the bloodstream.

p.12
Blood Types and Transfusion Compatibility

What is the most prevalent and antigenic Rh antigen?
A) C
B) D
C) E
D) c
E) e

B) D
Explanation: The D antigen is the most prevalent and antigenic Rh antigen, and its presence in the blood indicates Rh positive status.

p.2
Conditions Affecting Red Blood Cells

What triggers the production of an increased number of erythrocytes in response to low oxygen levels?
A) Hyperoxia
B) Hypoxia
C) Hypercapnia
D) Hypocapnia
E) Normoxia

B) Hypoxia
Explanation: Exposure of the blood to a low oxygen level, or hypoxia, causes growth induction, differentiation, and production of an increased number of erythrocytes to compensate for the hypoxia.

p.4
Stages of Erythropoiesis

What is the usual concentration of reticulocytes in circulating RBCs?
A) Less than 1%
B) 5%
C) 10%
D) 15%
E) 20%

A) Less than 1%
Explanation: The usual concentration of reticulocytes in circulating RBCs is less than 1%.

p.2
Red Blood Cell Structure and Function

What is the primary function of red blood cells (RBCs)?
A) Destroy infective organisms
B) Transport gas, primarily oxygen
C) Form cellular fragments
D) Promote growth of stem cells
E) Create colloid osmotic pressure

B) Transport gas, primarily oxygen
Explanation: Red blood cells (RBCs) play an important role in the transport of gas, primarily oxygen, throughout the body.

p.5
Formation of Blood Cells

What is the primary regulator of red blood cell production?
A) Blood pressure
B) Tissue oxygenation
C) Blood sugar levels
D) Body temperature
E) Heart rate

B) Tissue oxygenation
Explanation: Tissue oxygenation is the most important and essential regulator of red blood cell production, as it directly influences the release of erythropoietin.

p.1
Hematopoiesis

Which cells are capable of producing all types of blood cells?
A) Red blood cells
B) White blood cells
C) Hematopoietic stem cells (HSCs)
D) Platelets
E) Plasma cells

C) Hematopoietic stem cells (HSCs)
Explanation: Hematopoietic stem cells (HSCs) are bone marrow cells that can differentiate into all types of blood cells, making them crucial for the process of hematopoiesis.

p.7
Hemoglobin Synthesis and Function

Which factor does NOT affect the affinity of hemoglobin for oxygen?
A) pH
B) Temperature
C) Concentration of 2,3 DPG
D) Blood pressure
E) pO2 levels

D) Blood pressure
Explanation: The affinity of hemoglobin for oxygen is affected by pH, temperature, and the concentration of 2,3 DPG, but not directly by blood pressure.

p.3
Red Blood Cell Structure and Function

What is the function of 2,3-diphosphoglycerate (2,3-DPG) in RBCs?
A) Increases oxygen affinity of hemoglobin
B) Reduces oxygen affinity of hemoglobin
C) Catalyzes CO2 transport
D) Synthesizes ATP
E) Protects against oxidant damage

B) Reduces oxygen affinity of hemoglobin
Explanation: 2,3-DPG in RBCs reduces the oxygen affinity of hemoglobin, which is important for oxygen release into the tissues.

p.5
Formation of Blood Cells

What happens to erythropoietin production when enough RBCs have been produced?
A) It increases exponentially
B) It remains the same
C) It decreases to maintain the required number of RBCs
D) It stops completely
E) It fluctuates randomly

C) It decreases to maintain the required number of RBCs
Explanation: Once enough RBCs have been produced, the rate of erythropoietin production decreases to a level that maintains the required number of RBCs without producing an excess.

p.1
RBC Destruction and Hemolysis

What is hemolysis?
A) The formation of blood cells
B) The breakdown of red blood cells
C) The production of hemoglobin
D) The circulation of blood
E) The oxygenation of blood

B) The breakdown of red blood cells
Explanation: Hemolysis is the process of breaking down red blood cells, which can occur naturally or due to certain conditions affecting red blood cells.

p.6
Hemoglobin Synthesis and Function

What does the oxygen-hemoglobin dissociation curve illustrate?
A) The relationship between pCO2 and hemoglobin saturation
B) The relationship between pO2 and hemoglobin saturation
C) The relationship between pH and hemoglobin saturation
D) The relationship between temperature and hemoglobin saturation
E) The relationship between glucose levels and hemoglobin saturation

B) The relationship between pO2 and hemoglobin saturation
Explanation: The oxygen-hemoglobin dissociation curve illustrates the relationship between the partial pressure of oxygen (pO2) in the blood and the percentage of hemoglobin saturated with oxygen.

p.11
Blood Types and Transfusion Compatibility

Which blood type is the most common?
A) Type A
B) Type B
C) Type AB
D) Type O
E) Type Rh+

D) Type O
Explanation: The majority of people have type O blood, making it the most common blood type.

p.8
RBC Destruction and Hemolysis

What is the role of the spleen in RBC filtration?
A) It produces new RBCs
B) It stores excess iron
C) It removes aged or abnormal RBCs
D) It converts hemoglobin into glucose
E) It increases RBC flexibility

C) It removes aged or abnormal RBCs
Explanation: The spleen serves as an important blood filter that removes aged or abnormal RBCs, ensuring that only healthy and flexible RBCs remain in circulation.

p.12
Blood Types and Transfusion Compatibility

How do agglutinins develop in the Rh system?
A) They are present from birth
B) They develop spontaneously
C) They develop after exposure to the D antigen
D) They develop due to a lack of antigens
E) They develop due to a high salt diet

C) They develop after exposure to the D antigen
Explanation: In the Rh system, agglutinins almost never occur spontaneously. They develop after a person is exposed to the D antigen and becomes sensitized.

p.11
Blood Types and Transfusion Compatibility

What is the basis for determining blood types?
A) Presence of specific antibodies
B) Presence of specific antigens
C) Blood viscosity
D) Oxygen carrying capacity
E) Blood volume

B) Presence of specific antigens
Explanation: Blood types are determined by the presence of specific antigens (agglutinogens) on the RBC membrane.

p.2
Composition of Blood

What creates the colloid osmotic pressure in blood vessels?
A) High concentration of ions
B) High concentration of small molecules
C) High concentration of plasma proteins
D) Low concentration of water
E) High concentration of red blood cells

C) High concentration of plasma proteins
Explanation: The protein concentration gradient inside the vessels creates the colloid osmotic pressure or oncotic pressure gradient that opposes the filtration of plasma out of capillaries.

p.3
Red Blood Cell Structure and Function

What is the primary function of red blood cells (RBCs)?
A) Immune response
B) Blood clotting
C) Oxygen transport
D) Hormone transport
E) Nutrient absorption

C) Oxygen transport
Explanation: The primary function of RBCs is to transport oxygen from the lungs to tissues, facilitated by the hemoglobin they contain.

p.5
Formation of Blood Cells

What role does Hypoxia Inducible Factor (HIF-1) play in erythropoiesis?
A) It decreases erythropoietin production
B) It binds to the hypoxia response element in the erythropoietin gene
C) It inhibits the formation of proerythroblasts
D) It reduces the rate of RBC production
E) It degrades erythropoietin

B) It binds to the hypoxia response element in the erythropoietin gene
Explanation: HIF-1 binds to the hypoxia response element in the erythropoietin gene, inducing the transcription of messenger RNA and increasing erythropoietin synthesis.

p.1
Composition of Blood

What are the formed elements of blood?
A) Plasma and water
B) Red blood cells, white blood cells, and platelets
C) Hemoglobin and iron
D) Oxygen and carbon dioxide
E) Proteins and lipids

B) Red blood cells, white blood cells, and platelets
Explanation: The formed elements of blood include red blood cells, white blood cells, and platelets, which are essential components of the blood's cellular makeup.

p.3
Hematopoiesis

Where are RBCs primarily produced during the second trimester of embryonic development?
A) Yolk sac
B) Liver
C) Bone marrow
D) Spleen
E) Lymph nodes

B) Liver
Explanation: During the second trimester of embryonic development, RBCs are primarily produced in the liver, with the spleen and lymph nodes playing minor roles.

p.7
Iron Metabolism

What is the transport form of iron in the blood?
A) Ferritin
B) Hemosiderin
C) Transferrin
D) Myoglobin
E) Hemoglobin

C) Transferrin
Explanation: Transferrin is the transport form of iron in the blood, facilitating its movement to various cells and tissues.

p.1
Blood Types and Transfusion Compatibility

What is the O-A-B system?
A) A classification of white blood cells
B) A blood typing system
C) A method for measuring hemoglobin
D) A technique for blood clotting
E) A process for oxygen transport

B) A blood typing system
Explanation: The O-A-B system is a classification system for blood types based on the presence or absence of specific antigens on the surface of red blood cells.

p.9
Anemia and Polycythemia

What nutrient deficiency can lead to megaloblastic anemia?
A) Iron
B) Vitamin B12 and Folic Acid
C) Calcium
D) Vitamin D
E) Potassium

B) Vitamin B12 and Folic Acid
Explanation: Deficiency in Vitamin B12 and Folic Acid can lead to megaloblastic anemia, as these nutrients are essential for DNA synthesis and red cell maturation.

p.4
Red Blood Cell Structure and Function

What is the major function of RBCs?
A) Transport nutrients
B) Transport hemoglobin
C) Produce antibodies
D) Regulate body temperature
E) Clot blood

B) Transport hemoglobin
Explanation: The major function of RBCs is to transport hemoglobin, which in turn transports oxygen.

p.9
Anemia and Polycythemia

What is the result of low erythropoietin (EPO) levels in patients with chronic kidney disease?
A) Iron deficiency anemia
B) Megaloblastic anemia
C) Aplastic anemia
D) Renal insufficiency
E) Anemia

E) Anemia
Explanation: Low levels of erythropoietin (EPO) in patients with chronic kidney disease result in anemia, as EPO is needed to stimulate red blood cell production.

p.2
Hematopoiesis

Where does hematopoiesis primarily occur in adults?
A) Liver
B) Spleen
C) Bone marrow
D) Yolk sac
E) Lymph nodes

C) Bone marrow
Explanation: In adults, blood cells and platelets are primarily produced in the bone marrow, although extramedullary hematopoiesis may occur in diseases if the bone marrow becomes destroyed or fibrosed.

p.11
Blood Types and Transfusion Compatibility

Which blood type has no antigens and both anti-A and anti-B antibodies?
A) Type A
B) Type B
C) Type AB
D) Type O
E) Type Rh+

D) Type O
Explanation: Blood type O has no antigens on the RBC surface and has both anti-A and anti-B antibodies in the plasma.

p.7
Hemoglobin Synthesis and Function

What happens to hemoglobin (Hgb) at high pO2 levels, such as in the lungs?
A) Hgb releases oxygen
B) Hgb binds carbon dioxide
C) Hgb is almost fully saturated with oxygen
D) Hgb has reduced affinity for oxygen
E) Hgb binds to nitrogen

C) Hgb is almost fully saturated with oxygen
Explanation: At high pO2 levels, such as in the lungs, hemoglobin is almost fully saturated with oxygen, facilitating efficient oxygen transport to tissues.

p.3
Red Blood Cell Structure and Function

What is the expected concentration of RBCs in healthy men?
A) 4.0 million
B) 4.7 million
C) 5.2 million
D) 6.0 million
E) 3.5 million

C) 5.2 million
Explanation: The expected concentration of RBCs in healthy men is approximately 5.2 million per microliter of blood.

p.5
Red Blood Cell Structure and Function

Which vitamins are essential for the final maturation of RBCs?
A) Vitamin C and Vitamin D
B) Vitamin A and Vitamin E
C) Vitamin B9 (folic acid) and Vitamin B12
D) Vitamin K and Vitamin B6
E) Vitamin B1 and Vitamin B2

C) Vitamin B9 (folic acid) and Vitamin B12
Explanation: Vitamin B9 (folic acid) and Vitamin B12 are essential for the final maturation of RBCs, as they are required for the formation of thymidine triphosphate, a building block of DNA.

p.1
Red Blood Cell Structure and Function

What is the primary function of red blood cells?
A) To fight infections
B) To transport oxygen
C) To clot blood
D) To produce antibodies
E) To regulate blood pressure

B) To transport oxygen
Explanation: The primary function of red blood cells is to transport oxygen from the lungs to the tissues and organs throughout the body.

p.3
Red Blood Cell Structure and Function

What is the main component of the RBC membrane that provides structural support and flexibility?
A) Hemoglobin
B) Carbonic anhydrase
C) α-Spectrin and Ankyrin
D) Glycolytic enzymes
E) 2,3-Diphosphoglycerate

C) α-Spectrin and Ankyrin
Explanation: The RBC membrane is composed of a lipid bilayer with proteins α-spectrin and ankyrin, which provide structural support and flexibility, allowing RBCs to deform and return to their original shape.

p.7
Hemoglobin Synthesis and Function

What happens to hemoglobin's affinity for oxygen when there is a decrease in temperature?
A) It increases
B) It decreases
C) It remains the same
D) It binds carbon dioxide more readily
E) It releases nitrogen

A) It increases
Explanation: A decrease in temperature causes a shift to the left in the oxygen-hemoglobin dissociation curve, indicating an increased affinity of hemoglobin for oxygen.

p.8
Red Blood Cell Structure and Function

What is the normal range for hemoglobin concentration in males?
A) 10-14 g/dL
B) 12-16 g/dL
C) 13.5-17.5 g/dL
D) 14-18 g/dL
E) 15-19 g/dL

C) 13.5-17.5 g/dL
Explanation: The normal range for hemoglobin concentration in males is 13.5-17.5 g/dL, which is essential for assessing the oxygen-carrying capacity of the blood.

p.11
Blood Types and Transfusion Compatibility

What antigens and antibodies are present in blood type AB?
A) No antigens, anti-A and anti-B antibodies
B) Type A antigens, anti-B antibodies
C) Type B antigens, anti-A antibodies
D) Type A and B antigens, no antibodies
E) No antigens, no antibodies

D) Type A and B antigens, no antibodies
Explanation: Blood type AB has both type A and type B agglutinogens on the surface of the RBCs and no antibodies in the plasma.

p.8
Red Blood Cell Structure and Function

What is the normal range for Mean Corpuscular Volume (MCV)?
A) 70-80 fL
B) 81-99 fL
C) 100-110 fL
D) 111-120 fL
E) 121-130 fL

B) 81-99 fL
Explanation: The normal range for Mean Corpuscular Volume (MCV) is 81-99 fL, which helps in diagnosing different types of anemia based on the size of the red blood cells.

p.4
Stages of Erythropoiesis

What is the final product of erythropoiesis?
A) Proerythroblast
B) Basophil erythroblast
C) Polychromatic erythroblast
D) Reticulocyte
E) Mature erythrocyte

E) Mature erythrocyte
Explanation: The final product of erythropoiesis is the mature erythrocyte, which is released into the circulation from the bone marrow.

p.11
Anemia and Polycythemia

What is a common cause of secondary polycythemia?
A) High iron intake
B) High altitude
C) Low blood pressure
D) Excessive hydration
E) High carbon dioxide levels

B) High altitude
Explanation: Secondary polycythemia is commonly caused by high altitude, where the reduced oxygen levels in the air trigger an increase in EPO levels and RBC production.

p.5
Formation of Blood Cells

What triggers the release of erythropoietin?
A) High blood pressure
B) High oxygen levels
C) Hypoxia (low oxygen states)
D) High blood volume
E) High hemoglobin levels

C) Hypoxia (low oxygen states)
Explanation: Hypoxia, or low oxygen states, stimulate the release of erythropoietin, which in turn stimulates RBC production until the hypoxia is relieved.

p.1
Formation of Blood Cells

Where does the formation of different blood cells primarily occur?
A) Liver
B) Spleen
C) Bone Marrow
D) Lymph nodes
E) Thymus

C) Bone Marrow
Explanation: The formation of different blood cells primarily occurs in the bone marrow, where hematopoietic stem cells differentiate into various blood cell types.

p.7
Hemoglobin Synthesis and Function

What happens to hemoglobin's affinity for oxygen when there is a shift to the right in the oxygen-hemoglobin dissociation curve?
A) A lower pO2 is required to bind a given amount of O2
B) A higher pO2 is required to bind a given amount of O2
C) Hemoglobin binds carbon dioxide more readily
D) Hemoglobin releases nitrogen
E) Hemoglobin's affinity for oxygen increases

B) A higher pO2 is required to bind a given amount of O2
Explanation: A shift to the right in the oxygen-hemoglobin dissociation curve indicates that a higher pO2 is required for hemoglobin to bind a specific amount of oxygen, reflecting a decreased affinity for oxygen.

p.7
Iron Metabolism

Where is iron primarily absorbed in the body?
A) Stomach
B) Duodenum
C) Large intestine
D) Esophagus
E) Gallbladder

B) Duodenum
Explanation: Iron is primarily absorbed in the duodenum, although absorption can take place in all parts of the small intestine.

p.5
Conditions Affecting Red Blood Cells

What condition can result from a deficiency of Vitamin B12 or folic acid?
A) Microcytic anemia
B) Normocytic anemia
C) Macrocytic or megaloblastic anemia
D) Hemolytic anemia
E) Sickle cell anemia

C) Macrocytic or megaloblastic anemia
Explanation: A deficiency of Vitamin B12 or folic acid can lead to macrocytic or megaloblastic anemia, characterized by larger than normal RBCs due to abnormal and diminished DNA synthesis.

p.1
Anemia and Polycythemia

What is polycythemia?
A) A decrease in red blood cell count
B) An increase in red blood cell count
C) A decrease in white blood cell count
D) An increase in platelet count
E) A decrease in hemoglobin levels

B) An increase in red blood cell count
Explanation: Polycythemia is a condition characterized by an increase in red blood cell count, which can lead to increased blood viscosity and potential complications.

p.4
Regulation of RBC Production

What is the most essential regulator of RBC production?
A) Blood pressure
B) Tissue oxygenation
C) Nutrient levels
D) Hormone levels
E) Body temperature

B) Tissue oxygenation
Explanation: The most essential regulator of RBC production is tissue oxygenation, as RBCs transport hemoglobin, which in turn transports oxygen.

p.3
Composition of Blood

Which plasma protein is primarily responsible for maintaining oncotic pressure?
A) α-Globulins
B) β-Globulins
C) Albumin
D) Coagulation proteins
E) Complement proteins

C) Albumin
Explanation: Albumin, produced by the liver, is the main type of protein in plasma responsible for maintaining oncotic pressure and binding various substances.

p.5
Formation of Blood Cells

Which organ is primarily responsible for the production of erythropoietin?
A) Liver
B) Heart
C) Kidneys
D) Lungs
E) Spleen

C) Kidneys
Explanation: The kidneys are responsible for 90% of erythropoietin production, with the liver contributing the remaining 10%.

p.1
Hematopoiesis

Which type of progenitor cell can differentiate into granulocyte, erythroid, monocyte, or megakaryocyte progenitors?
A) Lymphoid progenitor cells
B) Multipotential progenitor cells
C) Committed progenitor cells
D) Maturing cells
E) Pluripotent stem cells

B) Multipotential progenitor cells
Explanation: Multipotential progenitor cells can differentiate into granulocyte, erythroid, monocyte, or megakaryocyte progenitors, which eventually develop into specific blood cells.

p.7
Iron Metabolism

What is the primary form in which iron is stored in the body?
A) Transferrin
B) Ferritin
C) Hemosiderin
D) Myoglobin
E) Hemoglobin

B) Ferritin
Explanation: Iron is primarily stored in the body as ferritin, which is found in reticuloendothelial cells and liver parenchyma.

p.7
Iron Metabolism

What is the recommended daily iron intake for a female aged 19-49 years?
A) 10 mg/day
B) 12 mg/day
C) 18 mg/day
D) 28 mg/day
E) 30 mg/day

D) 28 mg/day
Explanation: The recommended daily iron intake for a female aged 19-49 years is 28 mg/day, with an additional 10 mg/day if pregnant.

p.5
Hemoglobin Synthesis and Function

At what stage does hemoglobin synthesis begin in RBC development?
A) Proerythroblast
B) Basophilic erythroblast
C) Polychromatophil erythroblast
D) Orthochromatic erythroblast
E) Reticulocyte

C) Polychromatophil erythroblast
Explanation: Hemoglobin synthesis begins in the polychromatophil erythroblast stage and continues even into the reticulocyte stage of RBC development.

p.1
Hematopoiesis

What is hematopoiesis?
A) The process of blood clotting
B) The formation of blood cells
C) The breakdown of red blood cells
D) The circulation of blood
E) The oxygenation of blood

B) The formation of blood cells
Explanation: Hematopoiesis is the process by which blood cells are formed and replenished throughout the body, beginning during embryonic development and continuing throughout adulthood.

p.7
Hemoglobin Synthesis and Function

What is the p50 value in normal adults?
A) 10 mmHg
B) 26 mmHg
C) 50 mmHg
D) 75 mmHg
E) 100 mmHg

B) 26 mmHg
Explanation: The p50 value, which is the partial pressure of O2 where 50% of hemoglobin is saturated with oxygen, is roughly about 26 mmHg in normal adults.

p.3
Composition of Blood

What is the normal pH range for arterial blood?
A) 7.20-7.30
B) 7.35-7.45
C) 7.50-7.60
D) 7.10-7.20
E) 7.25-7.35

B) 7.35-7.45
Explanation: The normal pH range for arterial blood is 7.35-7.45, which is crucial for maintaining proper physiological functions.

p.5
Hemoglobin Synthesis and Function

What is the function of the heme group in hemoglobin?
A) It binds to carbon dioxide
B) It binds to glucose
C) It binds to oxygen
D) It binds to nitrogen
E) It binds to sodium

C) It binds to oxygen
Explanation: The heme group in hemoglobin contains an iron atom that binds to oxygen, facilitating the transport of oxygen from the lungs to tissues.

p.1
Iron Metabolism

What is the significance of iron metabolism in relation to red blood cells?
A) It helps in blood clotting
B) It is essential for hemoglobin synthesis
C) It regulates blood pressure
D) It produces antibodies
E) It fights infections

B) It is essential for hemoglobin synthesis
Explanation: Iron metabolism is crucial for the synthesis of hemoglobin, which is necessary for red blood cells to carry oxygen efficiently.

p.1
Anemia and Polycythemia

What is anemia?
A) An increase in red blood cell count
B) A decrease in red blood cell count
C) An increase in white blood cell count
D) A decrease in platelet count
E) An increase in hemoglobin levels

B) A decrease in red blood cell count
Explanation: Anemia is a condition characterized by a decrease in red blood cell count or hemoglobin levels, leading to reduced oxygen-carrying capacity of the blood.

Study Smarter, Not Harder
Study Smarter, Not Harder