1. Most common blood transfusion reaction is:
A) Hemolysis
B) Febrile nonhaemolytic reactions
C) Fluid overload
D) Transmission of viruses
2. Heparin induced thrombocytopenia is treated with:
A) Corticosteroid
B) Lepirudin
C) Vitamin K
D) Platelet transfusion
3. Following is not a manifestation of antiphospholipid syndrome:
A) Hrperlipedemia
B) Pulmonary hypertension
C) Recurrent abortions
D) Deep vein thrombosis
4. Mainstay of treatment of antiphospholipid syndrome is:
A) Statins
B) Warfarin
C) Ecospirin
D) Corticosteroids
5. Activity of which of the coagulation factors is reduced in Von Willebrand (VW) disease?
A) Factor VIII
B) Factor XI
C) Factor IX
D) Factor V
6. Autosplenectomy is most commonly seen in long standing:
A) Lymphoblastic leukemia
B) Hereditary spherocytosis
C) Sickle cell anemia
D) Thalassemia
7. Aplastic crisis in sickle cell anaemia is due to infection due to:
A) Salmonella Typhi
B) Pneumococci
C) Herpes virus
D) Parvovirus B19
8. Replacement of Glutamate by Valine in beta chain causes increase in concentration of:
A) Haemoglobin A
B) Haemoglobin S
C) Haemoglobin C
D) Haemoglobin E
9. Most common manifestation of sickle cell anaemia is:
A) Severe anaemia
B) Haemolytic crisis
C) Sequestration crisis
D) Repeated episodes of skeletal pain
10. What is not true about sickle cell anaemia?
A) Hypersplenism may warrent splenectomy
B) Cardiomegaly and heart failure develop with time
C) Patients have susceptibility to pneumococcal infection
D) Pulmonary hypertension develops with time
Answers:
Ans: 1- B
There are two types of blood transfusion reactions; immunologic and infectious. 7% of transfusions result in febrile nonhaemolytic reactions due to reaction between donor WBCs and Recipient antibodies. The febrile reaction can be prevented by using leucoreduction filters. The treatment is with antipyretics after acute haemolysis is ruled out.
Ans: 2-B
Lepirudin is a direct thrombin inhibitor. Heparin should be discontinued if it induces thrombocytopenia. In such cases Lepirudin is indicated.
Ans: 3-A
Antiphospholipid syndrome is an autoimmune disorder. It is associated with thrombosis in both arteries and veins. Deep vein thrombosis of lower limbs is the commonest complication. It is also associated with pulmonary hypertension due to pulmonary embolism and pregnancy related complications such as recurrent abortions and preeclampsia. It does not affect lipid profile.
Ans: 4-B
Antiphospholipid syndrome is associated with increased thrombogenicity. Prolonged anticoagulation can be achieved by warfarin. Pregnant women with the disease are treated with heparin, as warfarin can cross the placenta and is teratogenic.
Ans: 5-A
VW disease is an autosomal dominant disorder due to deficiency in coagulation factor that is required for normal platelet adhesion (bleeding pathway). VW factor serves as a plasma carrier for factor VIII c (Intrinsic clotting pathway) resulting in reduced activity of factor VIII. VW disease is associated with prolonged bleeding and clotting time and normal prothrombin time and partial thromboplastin time.
Ans: 6-C
Repeated episodes of microinfarctions due to sickled RBCs cause hyposplenism which is also known as autosplenectomy. The condition causes increased susceptibility to infection with Pneumococcus, Meningococcus and H. Influenza. Thalassemia causes splenomegaly and hypersplenism.
Ans: 7-D
Parvovirus B19 triggers aplastic crisis in sickle cell anaemia. The virus causes complete suppression of haematopoesis for 2-3 days. It has little effect in normal individuals; but in sickle cell anaemia due to shortened RBC life span, crisis results. Patients may require blood transfusion.
Ans: 8-B
Sickle cell anaemia results when glutamate of beta chain of haemoglobin A is replaced by Valine. Concentration of Haemoglobin S increases causing sickling of RBCs.
Ans: 9-D
Anaemia in sickle cell disease is moderate. Haemolytic crisis is uncommon; it causes jaundice and reduction in haemoglobin. Sequestration crisis is rare; it causes massive pooling of RBCs in spleen in children between 6 months and 3 years. Most common manifestation of sickle cell disease is recurrent episodes of skeletal pain caused due to microinfarction.
Ans: 10-A
Sickle cell anaemia is associated with hyposplenism due to repeated splenic infarctions. This results in autosplenectomy. Reduced splenic function causes impaired opsonisation and infection due to capsulated organisms such as pneumococci. Cardiomegaly, heart failure and pulmonary hypertension are common with chronic sickle cell anaemia.
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