Internal Medicine/ Hematology

1. Basics of Hematology.
    

1. Hematology.
   ***) The majority of hemoglobin in erythrocytes from the normal adults is termed:

1. Hemoglobin F
2. Hemoglobin A
3. Hemoglobin A2
4. Hemoglobin C
5. Hemoglobin Bart's
    
   Answer: B* Hemoglobin A
    
   ***) Platelets normally have a half life of:

1. 7 minutes
2. 7 hours
3. 7 days
4. 4 weeks
5. 3 months
    
   Answer: C* 7 days
    
   ***) In human being, normal red blood cell survival time is approximately:

1. One month
2. 80 Days
3. Three months
4. 120 days
5. Five months
    
   Answer: D* 120 days
    
   ***) All the following are true concerning lymphocytes, except:

1. Are formed in the spleen
2. Enters the circulation via lymphatics
3. Are the precursors of platelets
4. Are reduced in number by immunosuppressive therapy
5. Are more sensitive to irradiation than granulocytes
    
   Answer: C* Are the precursors of platelets
    
   ***) Phagocytosis is a primary function of:

1. Neutrophils
2. Monocytes
3. Lymphocytes
4. Eosinophiles
5. Erythrocytes
    
   Answer: A* Neutrophils
    

1. Erythrocyte Sedimentation Rate (ESR).
   ***) All of the following may cause very high ESR, except:

1. Active rheumatoid arthritis
2. Giant cell arteritis
3. Sickle cell anemia
4. Carcinomatosis
5. Multiple myeloma
    
   Answer: C* Sickle cell anemia
    

1. Common Presentations.
    

1. Skin Pigmentation Disorders.
   ***) Generalized increased pigmentation may be seen in all of the following, except:

1. Hypopituitarism
2. Chronic liver disease
3. Addison disease
4. Hemochromatosis
5. Ectopic ACTH secretion
    
   Answer: A* Hypopituitarism
    
   ***) Generalized increased pigmentation may be seen in all of the following, except:

1. Nelson's syndrome
2. Hemochromatosis
3. Chronic renal failure
4. Panhypopituitarism
5. Primary biliary cirrhosis
    
   Answer: D* Panhypopituitarism
    
   ***) All of the following are known causes of hypopigmentation except:

1. Albinism
2. Tuberous sclerosis
3. Post inflammatory
4. Addison disease
5. Vitiligo
    
   Answer: D* Addison disease
    

1. Palmar Erythema.
   ***) All of the following can cause palmar erythema, except:

1. Epilepsy
2. Alcoholism
3. Rheumatoid arthritis
4. Pregnancy
5. Polycythemia
    
   Answer: A* Epilepsy
    
   ***) All of the following can cause palmar erythema, except:

1. Rheumatoid arthritis
2. Pregnancy
3. Thyrotoxicosis
4. Multiple sclerosis
5. Liver cirrhosis
    
   Answer: D* Multiple sclerosis
    

1. Splenomegaly.
   ***) Splenomegaly is expected to be present in all of the following, except:

1. Glucose-6-phosphate dehydrogenase deficiency
2. Congenital spherocytosis
3. Hemoglobin H disease
4. Pyruvate kinase deficiency
5. Chronic immune hemolytic anemia
    
   Answer: A* Glucose-6-phosphate dehydrogenase deficiency
    
   ***) Splenomegaly can occur in all of the following, except:

1. Celiac disease
2. Portal hypertension
3. Tuberculosis
4. Sarcoidosis
5. Infectious mononucleosis
    
   Answer: A* Celiac disease
    
   ***) Splenomegaly can occur in all of the following, except:

1. Celiac disease
2. Myelofibrosis
3. Kala azar
4. Typhoid fever
5. Endocarditis
    
   Answer: A* Celiac disease
    
   ***) Splenomegaly can occur in all of the following, except:

1. Thalassemia
2. Portal hypertension
3. Celiac disease
4. Early in sickle cell anemia
5. Leishmaniasis (Kala-azar)
    
   Answer: C* Celiac disease
    
   ***) Splenomegaly can occur in all of the following, except:

1. Chronic granulocytic leukemia
2. Chronic malaria
3. Amyloidosis
4. Celiac disease
5. Brucellosis
    
   Answer: D* Celiac disease
    

1. Lymphadenopathy.
   ***) Generalized lymphadenopathy is seen in all of the following, except:

1. Sarcoidosis
2. Hepatic cirrhosis
3. Lymphoma
4. HIV infection
5. Infectious mononucleosis
    
   Answer: B* Hepatic cirrhosis
    
   ***) All of the following are causes of cervical lymph node enlargement, except:

1. Infectious mononucleosis
2. Toxoplasmosis
3. Anemia
4. Tuberculosis
5. Rheumatic fever
    
   Answer: C* Anemia
    
   ***) All of the following are causes of cervical lymph node enlargement, except:

1. Multiple myeloma
2. Sarcoidosis
3. Tuberculosis
4. Chronic lymphoid leukemia
5. Phenytoin
    
   Answer: A* Multiple myeloma
    

1. Polycythemia.
   ***) All of the following may produce polycythemia, except:

1. Cushing’s syndrome
2. Primary hepatoma
3. Heavy smoking
4. Gastric carcinoma
5. High altitudes
    
   Answer: D* Gastric carcinoma
    
   ***) All of the following may produce polycythemia, except:

1. Hepatoma
2. Right to the left shunt
3. Hematoma
4. Multiple myeloma
5. Fibroma of uterus
    
   Answer: D* Multiple myeloma
    
   ***) All of the following are causes of polycythemia, except:

1. High altitude
2. Right to left shunt
3. Lymphoma
4. Massive uterine fibroma
5. Renal cell carcinoma
    
   Answer: C* Lymphoma
    

1. Thrombocytopenia.
   ***) Thrombocytopenia caused by increased platelet destruction is most closely associated with which of the following:

1. Aplastic anemia
2. Acute leukemia
3. Combination chemotherapy
4. Systemic lupus erythematosus SLE
5. Excessive ethanol uptake
    
   Answer: E* Excessive ethanol uptake
    
   ***) Causes of thrombocytopenia include all of the following, except:

1. Aplastic anemia
2. Pernicious anemia
3. Polycythemia rubra vera
4. Hypersplenism
5. Disseminated intravascular coagulation
    
   Answer: C* Polycythemia Rubra Vera
    
   ***) Which of the following laboratory procedure can detect thrombocytopenia:

1. Clotting time
2. Prothrombin time
3. Bleeding time
4. Partial thromboplastin time
5. Thrombin time
    
   Answer: C* Bleeding time
    

1. Pancytopenia.
   ***) All of the following can cause pancytopenia, except: Q2012

1. Leukemoid reaction
2. Aplastic anemia
3. Hypersplenism
4. Myelofibrosis
5. Megaloblastic anemia
    
   Answer: A* Leukemoid reaction
    
   ***) All of the following can cause pancytopenia, except:

1. Aplastic anemia
2. Megaloblastic anemia
3. Iron deficiency anemia
4. Hypersplenism
5. Systemic lupus erythematosus
    
   Answer: C* Iron deficiency anemia
    
   ***) All of the following are causes of pancytopenia, except:

1. Hereditary spherocytosis
2. Aplastic anemia
3. Megaloblastic anemia
4. Hypersplenism
5. Myelofibrosis
    
   Answer: A* Hereditary spherocytosis
    

1. Neutrophilia.
   ***) All of the following are causes of neutrophil leucocytosis, except:

1. Bacterial infection
2. Myocardial infarction
3. Viral infection
4. Leukemia
5. Leukemoid reaction
    
   Answer: C* Viral infection
    
   ***) Leucocytosis may occur in all of the following, except:

1. Brucellosis
2. Myocardial infarction
3. Bacterial infection
4. Burns
5. Infancy
    
   Answer: E* Infancy
    

1. Neutropenia.
   ***) All of the following are causes of neutropenia, except:

1. Viral infections
2. Felty's syndrome
3. Typhoid fever
4. Myocardial infarction
5. Congenital
    
   Answer: D* Myocardial infarction
    
   ***) Which of the following is not a recognized cause of neutropenia:

1. Multiple myeloma
2. Corticosteroids
3. Cytotoxic drugs
4. Typhoid fever
5. Felty's syndrome
    
   Answer: B* Corticosteroids
    
   ***) Neutropenia is least likely to be caused by one of the following:

1. Cytotoxic therapy
2. Bone marrow transplant
3. Radiotherapy
4. Diabetic ketoacidosis
5. Splenic enlargement
    
   Answer: D* Diabetic ketoacidosis
    

1. Eosinophilia.
   ***) Which of the following would be least likely to be associated with eosinophilia: Q2012

1. Asthma
2. Contact dermatitis
3. Parasitic infection
4. Mycobacterial infection
5. Prednisone administration
    
   Answer: E* Prednisone administration
    
   ***) Which of the following would be least likely to be associated with eosinophilia:

1. Toxoplasmosis
2. Hypoadrenocorticism
3. Loeffler's endocarditis
4. Allergic vasculitis
5. Myxedema
    
   Answer: E* Myxedema
    

1. Microcytic Anemia.
    

1. Microcytic Anemia.
   ***) Which of the following may be a cause of microcytosis:

1. Vitamin B₁₂ deficiency
2. Folic acid deficiency
3. Beta-thalassemia
4. Reticulocytosis
5. Aplastic anemia
    
   Answer: C* Beta-thalassemia
    
   ***) Which of the following would be most likely to be a cause of hypochromic microcytic anemia:

1. Thalassemia
2. Immune hemolytic anemia
3. Methotrexate therapy
4. Obstructive jaundice
5. Phenytoin therapy
    
   Answer: A* Thalassemia
    
   ***) Microcytic anemia can be caused by all of the following, except:

1. Iron deficiency
2. Anemia of chronic disease
3. Thalassemia
4. Sideroblastic anemia
5. Folate deficiency
    
   Answer: E* Folate deficiency
    
   ***) Microcytic hypochromic anemia is associated with all except:

1. Thalassemia
2. Iron deficiency anemia
3. Vitamin B₁₂ deficiency
4. Chronic infection
5. Lead poisoning
    
   Answer: C* Vitamin B₁₂ deficiency
    
   ***) Microcytic hypochromic blood picture is seen in all of the following, except:

1. Iron deficiency anemia
2. Lead poisoning
3. Thalassemia
4. Sideroblastic anemia
5. Sickle cell anemia
    
   Answer: E* Sickle cell anemia
    

1. Iron Metabolism.
   ***) All of the following increase iron absorption in the small intestine, except:

1. Increased acidity
2. When iron is complemented with lactose
3. Ascorbic acid
4. Tea drinking
5. Iron of animal source
    
   Answer: D* Tea drinking
    
   ***) All of the following about iron are true, except:

1. Ferrous iron absorbed better than ferric
2. Iron absorption takes place in the terminal ileum
3. The average daily iron intake is 10-20 mg
4. Alcohol increases iron absorption
5. Iron deficiency is the commonest anemia
    
   Answer: B* Iron absorption takes place in the terminal ileum
    

1. Iron Deficiency Anemia.
   ***) All of the following about iron deficiency anemia are true, except:

1. Is the commonest type of anemia in Jordan
2. May occur during pregnancy
3. Stomatitis may occur
4. Treatment of choice is intravenous iron
5. Causes microcytosis with hypochromia
    
   Answer: D* Treatment of choice is intravenous iron
    
   ***) In iron deficiency anemia which of the following is true:

1. Serum binding capacity is decreased
2. Marrow iron stores are normal
3. Sideroblasts in the marrow are increased
4. Serum iron concentration is decreased
5. Tear drop cells on blood film
    
   Answer: D* Serum iron concentration is decreased
    
   ***) In a patient with anemia all of the following might suggest the presence of iron deficiency anemia, except:

1. Microcytosis
2. Koilonychia
3. Peripheral neuropathy
4. High iron binding capacity
5. Low serum ferritin
    
   Answer: C* Peripheral neuropathy
    
   ***) The appropriate treatment of iron deficient anemia is:

1. Just encourage red meat in the diet
2. Iron and vitamins must be supplemented
3. Elemental iron is mandatory at a dose of 4-6 mg/kg/day orally
4. Blood transfusion to supply RBSs as well as iron
5. Injectable iron
    
   Answer: C* Elemental iron is mandatory at a dose of 4-6 mg/kg/day orally
    

1. Normocytic Anemia.
    

1. Aplastic Anemia.
   ***) All of the following are causes of aplastic anemia, except:

1. Fanconi's anemia
2. Benzene
3. Insecticides
4. Viral hepatitis
5. Meningitis
    
   Answer: E* Meningitis
    
   ***) Aplastic anemia may occur following the administration of which of the following:

1. Penicillin
2. Prednisolone
3. Tetracycline
4. Chloramphenicol
5. Erythromycin
    
   Answer: D* Chloramphenicol
    

1. Hemolytic Anemia.
    

1. Hemolytic Anemia.
   ***) Hemolysis may occur in all of the following, except:

1. Hereditary spherocytosis
2. Aplastic anemia
3. Thalassemia
4. Sickle cell anemia
5. Glucose-6-phosphate deficiency
    
   Answer: B* Aplastic anemia
    
   ***) All of the following are hemolytic anemias, except:

1. Hereditary spherocytosis
2. Hereditary elliptocytosis
3. G-6-PD deficiency
4. Sickle cell anemia
5. Aplastic anemia
    
   Answer: E* Aplastic anemia
    
   ***) The presence of hemolysis is indicated by all of the following clinical manifestations, except:

1. Present or reduced serum haptoglobin
2. Increased number of reticulocytes
3. Elevated serum lactate dehydrogenase
4. Microcytic red blood cell indices
5. Shortened red blood cell survival
    
   Answer: D* Microcytic red blood cell indices
    
   ***) The hemolytic anemia is associated with the following, except:

1. Increased indirect bilirubin
2. Decreased haptoglobin
3. Increased reticulocytes count
4. Decreased free hemoglobin
5. Increased PCV
    
   Answer: D* Decreased free hemoglobin
    
   ***) The following are characteristic of hemolytic type of jaundice, except:

1. Increased serum unconjugated bilirubin
2. Bilirubin does not appear in the urine
3. Abnormal liver function tests
4. Increased urinary urobilinogen
5. Anemia
    
   Answer: C* Abnormal liver function tests
    

1. Thalassemia.
   ***) All of the following are features of thalassemia, except: Q2012

1. Bone marrow hyperplasia
2. Hair on end appearance
3. Hypochromic microcytic RBCs
4. Increased osmotic fragility
5. Splenomegaly
    
   Answer: D* Increased osmotic fragility
    
   ***) All of the following are acquired anemia, except:

1. Iron-deficiency anemia
2. Megaloblastic anemia
3. Aplastic anemia
4. Thalassemia
5. Auto-immune hemolytic anemia
    
   Answer: D* Thalassemia
    
   ***) One of the following is not true of Beta-thalassemia trait (minor):

1. Mild anemia is usually present
2. Spleen is usually palpable
3. Peripheral smear is usually abnormal
4. Mean corpuscular volume is usually low
5. Hemoglobin A2 is usually elevated
    
   Answer: B* Spleen is usually palpable
    
   ***) Beta-thalassemia (major) usually manifests at the age of:

1. Newborn period
2. 4 months
3. 8 months
4. 12 months
5. 24 months
    
   Answer: C* 8 months
    
   ***) Concerning Thalassemia major, all the following are true, except:

1. Hemolytic anemia resulting from imbalance of alpha and beta globin chains
2. Patient becomes symptomatic in the second 6 months
3. Facial deformities are present from expansion of the bone marrow
4. Splenomegaly is present after 2 years from presentation
5. Hypochromic microcytic anemia
    
   Answer: D* Splenomegaly is present after 2 years from presentation
    
   ***) All of the following are features of Beta-thalassemia major, except:

1. Skull X-ray show "hair on end" appearance
2. Blood film shows hypochromic and microcytic picture
3. It is usually asymptomatic
4. Hepatosplenomegaly is a feature
5. It is inherited disease
    
   Answer: C* It is usually asymptomatic
    
   ***) In the treatment of thalassemia syndromes which of the following is true:

1. Splenectomy is contraindicated in thalassemia major
2. Transfusion is unnecessary if the hemoglobin remains above 10 g/dl
3. Small iron supplements are beneficial even in the absence of iron deficiency anemia
4. The level of fetal hemoglobin is 2-5% during the first year of life
5. Immunization with pneumococcal polysaccharide vaccine is not recommended
    
   Answer: B* Transfusion is unnecessary if the hemoglobin remains above 10 g/dl
    

1. Sickle Cell Disease.
   ***) All of the following about sickle cell anemia are true, except:

1. More common in black
2. Increased incidence of salmonella osteomyelitis
3. Predisposes to auto-splenectomy
4. More susceptible to falciparum malaria
5. Sickle cell tract are usually asymptomatic
    
   Answer: D* More susceptible to falciparum malaria
    
   ***) The following features may be found in an adult with sickle cell anemia, except:

1. Aseptic necrosis of bone
2. Massive splenomegaly
3. Chronic leg ulcers
4. Hematuria
5. Impaired ability to concentrate urine
    
   Answer: B* Massive splenomegaly
    
   ***) All can be associated with Sickle Cell Anemia, except:

1. Vaso-occlusive crisis
2. Infection
3. Bleeding disease
4. Organ damage
5. Chest Syndrome
    
   Answer: C* Bleeding disease
    

1. G6PD Deficiency.
   ***) All the following are oxidant stress which can cause hemolysis in patient with Glucose-6-phosphate dehydrogenase (G6PD) deficiency, except:

1. Infection
2. Sulfa drugs
3. Vit E
4. Fava beans
5. Nitrofurantoin
    
   Answer:  C* Vit E
    
   ***) Favism is a hemolytic anemia caused by deficiency of:

1. Pyruvate kinase
2. Glucose-6-phosphate dehydrogenase
3. Al-antitrypsin
4. Alanine aminotransferase
5. Acid phosphatase
    
   Answer: B* Glucose-6-phosphate dehydrogenase
    

1. Macrocytic Anemia.
    

1. Vitamin B₁₂ Deficiency.
   ***) All of the following are features of pernicious anemia, except:

1. Usually over 30 years, with blue eyes
2. Microcytic and hypochromic anemia
3. Subacute combined degeneration of the cord can occur
4. Dementia is a feature
5. Optic atrophy can occur
    
   Answer: B* Microcytic and hypochromic anemia
    
   ***) All of the following about pernicious anemia are true, except:

1. Is a disease of elderly
2. Weight loss is a common feature
3. Subacute combined degeneration can occur
4. Gastric atrophy with achlorhydria
5. Treatment should be continued for two years
    
   Answer: E* Treatment should be continued for two years
    
   ***) All of the following are causes of macrocytic anemia, except: Q2012

1. Vit B₁₂ deficiency
2. Folate deficiency
3. Hypothyroidism
4. Hyperthyroidism
5. Chronic liver disease
    
   Answer: D* Hyperthyroidism
    
   ***) A macrocytic peripheral blood smear may be seen in any of the following, except:

1. Alcoholism
2. Hypothyroidism
3. Celiac disease
4. Folate deficiency
5. Iron deficiency
    
   Answer: E* Iron deficiency
    
   ***) All of the following are causes of macrocytic anemia, except:

1. Vit B₁₂ deficiency
2. Chronic liver disease
3. Sickle cell anemia
4. Hypothyroidism
5. Folate deficiency
    
   Answer: C* Sickle cell anemia
    
   ***) All of the following are causes of macrocytosis (large red cells), except:

1. Alcoholism
2. Hypothyroidism
3. Chronic renal failure
4. Sideroblastic anemia
5. Hemolysis
    
   Answer: D* Sideroblastic anemia
    
   ***) All about vitamin B₁₂ are true, except:

1. It is a cobalt containing substance
2. Deficiency causes large primitive red cell precursors to appear in the peripheral blood
3. It is mainly absorbed in terminal ileum
4. It is bound firmly to intrinsic factor prior to absorption
5. It presents in high amount of vegetables
    
   Answer: E* It presents in high amount of vegetables
    

1. Folate Deficiency.
   ***) Megaloblastic anemia secondary to folate deficiency is best corrected by administering folate:

1. Intravenously 10 mg daily
2. Intramuscularly 1 gm daily
3. Orally 5 mg daily
4. Subcutaneously 100 mg monthly
5. In combination with ascorbic acid
    
   Answer: C* Orally 5 mg daily
    
   ***) Which of the following statements about megaloblastic anemia is not true:

1. Serum folic acid and vitamin B₁₂ may be normal
2. Manifestation may appear in the first year of life
3. White blood cells and platelets are normal
4. Occasionally treatment is required for life
5. In Jordan goat's milk may be a factor in its etiology
    
   Answer: A* Serum folic acid and vitamin B₁₂ may be normal
    

1. Hemostasis.
    

1. Hemostasis.
   ***) A boy bleeding a lot after circumcision may have any of the following, except:

1. Factor XIII deficiency
2. Factor XII deficiency
3. Factor XI deficiency
4. Factor X deficiency
5. Factor IX deficiency
    
   Answer: B* Factor XII deficiency
    
   ***) In vascular injury the immediate response that produce hemostasis is:

1. Platelet adherence at the injury site
2. Vasoconstriction
3. Liberation of serotonin
4. Thrombus formation
5. Platelet plug formation
    
   Answer: B* Vasoconstriction
    

1. Heparin-Induced Thrombocytopenia.
   ***) Anticoagulant effect of heparin is based on: Q2012

1. Alteration of thrombin levels
2. Potentiation of antithrombin III
3. Activation of plasmin into plasminogen
4. Inactivation of ionized calcium
5. Reduction of available factor VII
    
   Answer: B* Potentiation of antithrombin III
    
   ***) With anti-coagulant (heparin) therapy the antidote treatment of choice is: Q2012

1. Calcium gluconate
2. Protamine sulfate
3. Potassium chloride
4. Vitamin K
5. Cetrovorum factor
    
   Answer: B* Protamine sulfate
    
   ***) The most useful test in monitoring heparin therapy is:

1. Bleeding time
2. Prothrombin time
3. Platelet aggregation
4. Clot retraction
5. Partial thromboplastin time (PTT)
    
   Answer: E* Partial thromboplastin time (PTT)
    
   ***) Important uses of acetylsalicylic acid include all of the following, except:

1. Acute rheumatic fever
2. Antipyretic
3. Thrombocytopenia
4. Transient ischemic attacks
5. Mild migraine headache
    
   Answer: C* Thrombocytopenia
    
   ***) Which of the following drugs should not be given together:

1. Streptomycin and INH
2. Penicillin and gentamycin
3. Warfarin and aspirin
4. Glycosides and metformin
5. Vitamin B₁₂ and folic acid
    
   Answer: C* Warfarin and aspirin
    
   ***) Contraindications to the use of streptokinase therapy include all of the following, except:

1. Bleeding peptic ulcer
2. Infective endocarditis
3. Surgery to eye
4. Cor pulmonale
5. Severe hepatic insufficiency
    
   Answer: D* Cor pulmonale
    

1. Vitamin K Deficiency.
   ***) The most frequent and clinically important vitamin deficiency developing in patients with cholestatic liver disease is which of the following:

1. Vitamin D
2. Vitamin A
3. Vitamin B₁₂
4. Vitamin B_l
5. Vitamin K
    
   Answer: E* Vitamin K
    
   ***) Vitamin K dependent coagulation factors may include all the following, except:

1. Factor 2
2. Factor 7
3. Factor 9
4. Factor 11
5. Factor 10
    
   Answer: D* Factor 11
    

1. Disseminated Intravascular Coagulation.
   ***) All of the following can cause disseminated intravascular coagulation, except:

1. Gram negative septicemia
2. Von Willebrand's disease
3. Falciparum malaria
4. Snake bites
5. Surgery
    
   Answer: B* Von Willebrand's disease
    

1. Neoplasms.
    

1. Polycythemia Rubra Vera.
   ***) Polycythemia Rubra Vera is associated with all of the following, except:

1. Raised ESR
2. Pruritus
3. Hemorrhage
4. Hyperuricemia
5. Thrombosis
    
   Answer: A* Raised ESR
    

1. Acute Lymphoblastic Leukemia.
   ***) Concerning acute lymphocytic leukemia all of the following are true, except:

1. Most patients will have anemia
2. Most patients will have thrombocytopenia
3. Spleen is generally not enlarged
4. Leukemic lymphocytes in blood smear are present
5. Bone marrow is essential for the diagnosis
    
   Answer: C* Spleen is generally not enlarged
    

1. Lymphoma.
   ***) Which of the following tumors has a strong association with a viral infection:

1. Acute lymphoblastic leukemia
2. Acute myelogenous leukemia
3. Histiocytosis
4. Burkitt's lymphoma
5. Hodgkin's disease
    
   Answer: D* Burkitt's lymphoma
    

1. Hodgkin Lymphoma.
   ***) Concerning Hodgkin's lymphoma all of the following are correct, except:

1. It occurs in both males and females but more in males
2. It occurs in children and old ages
3. Histologically it is multi-cellular infiltration with a characteristic giant cells
4. It starts usually in extra-nodal tissues
5. Radiotherapy forms the main line of treatment in early stages
    
   Answer: D* It starts usually in extra-nodal tissues
    
   ***) All the following are histological subtype of Hodgkin's lymphoma except:

1. Lymphocyte predominant
2. Lymphocyte depleted
3. Mixed cellularity
4. Nodular sclerosis
5. Leukemic lymphocytic predominant
    
   Answer: E* Leukemic lymphocytic predominant
    

1. Multiple Myeloma.
   ***) The following are features of multiple myeloma, except: Q2012

1. Renal failure
2. Hypocalcemia
3. Lytic bone lesions
4. Anemia
5. M-band on protein electrophoresis
    
   Answer: B* Hypocalcemia
    
   ***) All of the following about multiple myeloma is correct, except:

1. It is a disease of elderly
2. Backache is a common symptom
3. Renal failure can occur
4. The ESR is usually slightly elevated
5. Bence-Jones protein is present in urine
    
   Answer: D* The ESR is usually slightly elevated
    
   ***) All of the following about multiple myeloma are true, except:

1. Backache
2. Recurrent infections
3. May cause hypercalcemia
4. Presence of Bence-Jones protein in urine
5. High alkaline phosphatase
    
   Answer: E* High alkaline phosphatase
    
   ***) The following are features of multiple myeloma, except:

1. Bone pain
2. Hypercalcemia
3. Renal failure
4. Bleeding tendency
5. Polycythemia
    
   Answer: E* Polycythemia
    

1. Blood Products and Transfusions.
    

1. Blood Products.
   ***) Plasma from group-A blood will agglutinate:

1. Only group AB blood
2. Only group B blood
3. Group B blood and group AB blood
4. Group AB blood, and group O blood
5. Group B blood and group O blood
    
   Answer: C* Group B blood and group AB blood
    

1. Platelets.
   ***) The most helpful and reliable bedside platelet function is:

1. Platelet adhesiveness
2. Bleeding time
3. Clot retraction
4. Platelet size
5. Clotting time
    
   Answer: B* Bleeding time
    

1. Coagulation Factors.
   ***) To stop bleeding in hemophilic baby you have to give:

1. Fibrinogen
2. Albumin
3. Fresh frozen plasma
4. Cryoprecipitate
5. Platelet rich plasma
    
   Answer: D* Cryoprecipitate
    
   ***) The liver is the sole site of synthesis of all of the following coagulation factors, except:

1. Factor II
2. Factor V
3. Factor VII
4. Factor IX
5. Factor IV
    
   Answer: E* Factor IV
    
   ***) Stored blood is deficient in:

1. Factor 2
2. Factor 7
3. Factor 8
4. Factor 9
5. Factor 10
    
   Answer: C* Factor 8
    

1. Blood Transfusion.
   ***) All of the following are complications of blood transfusion, except: Q2012

1. Hypothermia
2. Hypocalcemia
3. Hyperkalemia
4. Thrombocytopenia
5. Thromboembolism
    
   Answer: E* Thromboembolism
    
   ***) All of the following are complications of blood transfusion, except:

1. Hypercalcemia
2. Hemolytic reactions
3. Anaphylactic reactions
4. Hepatitis C
5. HIV infection
    
   Answer: A* Hypercalcemia
    
   ***) In massive blood transfusion, all the following are complication except:

1. Acute congestive heart failure
2. Transmission of infection
3. Transfusion reaction
4. Hypercalcemia
5. Hyperkalemia
    
   Answer: D* Hypercalcemia
    
   ***) All of the following are potential risks of massive blood transfusion, except:

1. Acidosis
2. Impaired hemostasis
3. Hypokalemia
4. Citrate toxicity
5. Impaired oxygen delivery
    
   Answer: C* Hypokalemia
    
   ***) All the following are possible complications of blood transfusion except:

1. Hypercalcemia
2. Congestive cardiac failure
3. Hyperkalemia
4. Incompatibility
5. Non-cardiogenic pulmonary edema
    
   Answer: A* Hypercalcemia
    
   ***) The most fatal complication of blood transfusion is:

1. Allergic reactions
2. Anaphylactic reaction
3. Human error
4. Bacterial contamination
5. Pyrogenic reaction
    
   Answer: C* Human error
    
   ***) All the following diseases are transmitted through blood transfusion except:

1. Syphilis
2. Helicobacter Pylori
3. Malaria
4. Hepatitis B and C
5. Epstein-Bar virus
    
   Answer: B* Helicobacter Pylori
    

1. Immunosuppressive Drugs.
    

1. Steroids.
   ***) Prolonged use of corticosteroids may cause the following, except: Q2012

1. Proximal myopathy
2. Metabolic alkalosis
3. Avascular necrosis of the head femur
4. Thrombocytopenia
5. Leukocytosis
    
   Answer: D* Thrombocytopenia
    
   ***) The following complicate steroid therapy, except:

1. Hyperglycemia
2. Osteoporosis
3. Hyperkalemia
4. Skin atrophy
5. Weight gain
    
   Answer: C* Hyperkalemia
    
   ***) All of the following are side effects of steroids, except:

1. Cataract
2. Retardation of growth in children
3. Increased incidence of vascular thrombosis
4. Hyperglycemia
5. Osteoporosis
    
   Answer: C* Increased incidence of vascular thrombosis
    
   ***) All of the following are side effects of corticosteroids, except:

1. Hypertension
2. Peptic ulcer disease
3. Hyperkalemia
4. Osteoporosis
5. Acne
    
   Answer: C* Hyperkalemia
    
   ***) All of the following are side effects of long term steroid therapy, except:

1. Osteoporosis
2. Hypertension
3. Hematuria
4. Diabetes mellitus
5. Delayed healing of wounds
    
   Answer: C* Hematuria
    
   ***) Prolonged use of corticosteroids may cause the following, except:

1. Adrenocortical suppression
2. Skin malignancy
3. A papulopustular facial rash
4. Purpura
5. Cutaneous striae
    
   Answer: B* Skin malignancy
    
   ***) Corticosteroids could be used in the treatment of all the following, except:

1. Acute leukemia
2. Nephrotic syndrome
3. Sydenham's chorea
4. Rheumatoid iridocyclitis
5. Addison's disease
    
   Answer: C* Sydenham's chorea