93 Million Miles nd Module 8 - 2 Bimonthly

Just keep swimming. Just keep swimming. Just keep swimming, swimming, swimming. What do we do? We swim, swim Finding Nemo Note to self: Use this for evaluation only. Do not rely on this alone. Double check the answers. Enjoy! 1. The number of pyrole rings in th porphyrin nucleus: d. Four- porphyrins are cyclic compounds formed by a. One b. two c. three d. four the linkage of FOUR pyrole rings through methyne bridges. 2. The iron porphyrin of haemoglobin synthesized in the living cells: a. Heme portion of hgb that consists of porphyrin ring a. Heme b. cytochromes c. myoglobin d. catalases structure into w/c iron is precisely suspended. -other choices are proteins that contain heme 3. Which of the following porphyrins has 2 vinyl side chains? b. Protoporphyrins-refer to harpers pg 272, fg 31-4 a. Coproporhyrins b. protoporphyrins c. uroporphyrin d. myoporphyrins 4. The more abundant and more important among the porphyrins: b. Type III-more abundant and important a. Type I b. type II c. type III d. type IV because it includes heme -only type I and III are found in nature 5. A porphyrin with a completely symmetric arrangement of the substituents: a. Type I a. Type I b. type II c. type III d. type IV 6. The precursor of heme derived from the citric acid cycle: b. Succinyl-CoA-derived from the citric acid a. Glycine b.succinyl-CoA c. pyridoxal phosphate d. amino beta cycle in the mitochondria ketoadipic acid 7. The rate-controlling enzyme in porphyrin biosynthesis in mammalian liver: d. ALA synthase a. Pyridoxal phosphatase b.ALA dehydratase c.protoporphyrinogen oxidase d. ALA synthase 8. The actual intermediates in the biosynthesis of protoporphyrin and of heme: a. a. Porphyrinogens b. porphobilinogens c.coprobilinogens d. urobilinogens 9. The final step in heme synthesis involves the incorporation of ferrous iron into: a/c a.protoporphyrin b. uroporphyrin c.coproporphyrin d. porphyrinogen 10. Synthesis of ALA occurs in this part of the cell: c a.golgi apparatus b. peroxisomes c. mitochondria d. endoplasmic reticulum 11. The metabolic end product of heme catabolism in the a. reticuloendothelial cell excreted in plasma is: a. Bilirubin b. Urobilinc. Biliverdin D. urobilinogen 12. The only porphyria inherited in a recessive mode: B a.porphyria cutanea tarda b. congenital erythopoietic porphyria c. acute intermittent porphyria d. hereditary coproporphyria 13. In protoporphyria, the deficient enzyme is: D a. Coproporphyrinogen oxidase b. ALA dehydratase c. Protoporphyrinogen oxidse d. ferrochelatase 14. The closer the reaction is to heme in the synthetic pathway, the more C prominent the symptom of ___ in porphyria a. Abdominal pain b. anemia c. photosensitivity d. neuropsychiatric symptoms 15. Patients with porphyria exhibiting photosensitivity may benefit from c administration of: a.large amounts of carbohydrates b. Hematin c. beta carotene d. alpha tocopherol 16. A patient complete obstruction of the common bile duct will have A elevated levels of: a. Urine bilirubin b. urine urobilinogen c. fecal urobilinogen d. serum indirect bilirubin 17. Van den Bergh accidentally discovered direct acting bilirubin when he b was applying Ehrlichs test to: a. Urine b. bile c. serum d. tissues 18. Direct bilirubin will be elevated in the serum in cases of : a a.obstructive jaundice b. neonatal physiologic jaundice c. carbon tetrachloride poisoning d. haemolytic anemia 19. Yellowish discoloration of the skin due to abnormal accumulation of B bilirubin a.icterus b.jaundice c. hyperbilirubinemia d. choluria 20. A cause of prehapatic jaundice d a. Amanita mushroom poisoning b. Obstructive stone in the common bile duct c. Liver cirrhosis d. Haemolytic anemia 21. Encephalopathy due to deposition of bilirubin in the basal ganglia of B the brain a. Rotor syndrome b. kernicterus c. jaundice d. choluria 22. Haemolytic transfusion reaction results in which type of jaundice A a..prehepatic b.hepatic c. posthepatic d.toxic 23. In neonatal physiologic jaundice: b a. Hyperbilirubinemia is the conjugated type b. Bilirubin UGT activity is reduced c. Exposing the infant to blue light facilitates conjugation of bile d. Administering Phenobarbital worsens the hyperbilirubinemia due to its toxic effect on the liver 24. The enzyme which catalyzes the formation of the gluronides of bilirubin: a a. UDP-glucuronyl transferase b. ALA synthase c. Coproporphyrinogen oxidase d. ferrochelatase 25. the normal brown color of feces results from the presence of: C a. urobilinogen b. biliverdin c. stercobilin d. urobilin

26. which of the following plasma porteins transports the free bilirubin to the liver a.albumin b. ceruloplasmin c.globulin d. transferring 27. physiologic hyperbilirubinemia is classified as what type? a. Conjugated, retention b. Conjugated, regurgitation c. Unconjugated, retention d. Unconjugated, regurgitation 28. In haemolytic jaundice, the bile pigment that is greatly elevated in plasma is: a. Bilirubin b. biliverdin c. urobilin d. bilirubin monoglucuronide 29. Which of the following is characterized by sever congenital jaundice due to inherited absence of UG transferase: a.dubin-Johnson syndrome b. gilberts disease c. rotors syndrome d. Crigler-Najjar syndrome 30. Choleric jaundice occurs only in regurgitation hyperbilirubinemia, which is characterized by: a. Unconjugated bilirubin in the brain b. Conjugated bilirubin in the basal ganglia c. Unconjugated bilirubin in the urine d. Conjugated bilirubin in the urine 31. Which of the following may result to kernicterus? a. Haemolytic anemia with normal liver function b. Toxic hyperbilirubinemia c. Neonatal physiologic jaundice d. Chronic idiopathic jaundice 32. The process by which bilirubin is removed from its transport protein and taken up by the hepatocytes a. Primary active b. Facilitated c. Secondary active d. Carrier-mediated 33. The process by which secretion of the conjugated bilirubin into the bile is made possible a. Active b. diffusion c. facilitated d. carrier-mediated 34. Which of the following cytosolic proteins maintain the solubility of bilirubin in the hepatocytes? a. Protein Y, transferrin b. Erythropoietin, cytochrome P450 c. Protein Y, ligandin d. Protein Y, protein S 35. The enzyme responsible for the conjugation of bilirubin is found in which of the following cytoplasmic organelle? a. Mitrochondria b. Endoplasmic reticulum c. Golgi apparatus d. Peroxisomes 36. following the action of beta glucuronidase in the intestines the bilirubin pigment is converted to urobilinogen by the process of: a. oxidation b. dehydrogenation c. reconjugation d.reduction 37. which of the following is true of bilirubin metabolism? a. reduction of bilirubin forms biliverdin b. enzyme heme oxygenase is substrate inducible c. bilirubin synthesis form heme requires 1 molecule of NADPH d. kuppfer cells convert bilirubin to polar form 38. the daily formation of bilirubin in human adults in mg is approximately: a. 250-350 b. 150-200 c. 500-600 d. 1000 39. A bacterial enzyme which catalyzes bilirubin catabolism in the large intestine: A. Dismutase b. beta glucuronidase c. porphobilinogen d. urobilinogen synthase 40. The substrate used for UDPGTase during bilirubin conjugation: a.PRPP b. Glucose c. UDP glucuronic acid d. biliverdin IX 41. Between which of the following pyrole rings is the methenyl bridge reduced by biliverdin reductase to produce bilirubin from biliverdin a. I,II b. II,III c. III,IV d. IV,V 42. The chemical form of iron, which constitutes hemin: a. Fe++ b. Fe+++ c. Fe+ d. Fe++ and Fe+++ 43. The presence of this substance facilitates the reduction of hemin to heme A. NAD b. Fe+++ c. CO d. NADPH 44. The precursor substance of bilirubin which is produced from the splitting of the tetrapyrrole ring: a. Hemin b. bilirubin monoglucoride c. biliverdin d. bilirubin diglucuronide 45. Carbon monoxide produced upon release of Fe+++ during heme degradation is derived from oxygen and splitting of which of the following? a. Alpha carbon between rings I and II b. Beta carbon between II and III c. Gamma carbon between rings III and IV d. Delta carbon between rings I and IV 46. The presence of this drug can induce the activity of bilirubin-UGT a.acetaminophen b. NSAIDS c. diazepam d. phenobarbital 47. The combination of increased urobilinogen and absence of urine

d.

A b

c c

b D

d C

bilirubin is suggestive of: a. Hepatitis b. obstructive jaundice c. haemolytic jaundice d. hepatic jaundice 48. Which of the following conditions causing jaundice result from a basic defect in bilirubin conjugation a. Neonatal jaundice, dubin-johnson syndrome, gilberts syndrome b. Crigler-najjar I, dubin-johnson syndrome, gilberts disease c. . crigler-najjar II, neonatal jaundice, rotors disease d. Toxic jaundice, crigler-najjar, gilberts disease. 49. Which of these associations between blood components and functions is correct? a. Erythrocytes-phagocytosis b. Platelets- blood coagulation c. Lymphocytes-transport oxygen d. Neutrophils-antibody production 50. Which blood cell type is expected to increase in allergic reaction? a. Neutrophils b. lymphocytes c. eosinophils d. monocytes 51. Polycythemia vera is characterized by an absolute increase in: a. Erythrocytes b. leukocytes c. plasma proteins d. platelets 52. Neutrophile tend to migrate to the area of infection. This is due to the activity of which of the following interleukins? a. IL 2 b. IL 4 c. IL 6 d. IL 8 53. Which of the following factors stimulates maturation of magakaryocytes and influences production of platelets a. Erythropoietin b. thrombopoietin c. IL 1 d. IL 11 54. Which of these lab tests is most helpful in the morphologic typing of anemias? a. Hgb determination b. Hct determination c.Red cell count d. red cell indicec determinatiion 55. Which of the following cells is/are normally seen in the peripheral blood smear? a. RBC, WBC, Plt, plasma cells, macrophages b. RBC, WBC, Plt, plasma cells c. RBC, WBC, Plt d. RBC and WBC 56. The first step in heme biosynthesis is the binding of Succinyl-CoA with: a. Serine b. cysteine c. proline d. glycine 57. The globin portion of haemoglobin A is composed of: a. 2 alpha and 2 beta chains b. 2 alpha and 2 gamma chains c. 2 alpha and 2 delta chains d. 2 beta and 2 gamma chains 58. The addition of Fe++ to protoporphyrin to form heme occurs in the: a. Nucleus b. cytoplasm c. mitochondria d. golgi apparatus 59. Which of the following would indicate that the thymocyte is a mature thymocycte? a. Presence of either CD 4/8 b. Absence of CD 1 and CD 2 c. Presence of TCR 2 d. Presence of CD 71 and CD 38 60. Among the CD markers of a lymphocyte are the following CD markers CD 38, 10, and 72. This lymphocyte is most probably a/an: a. Early thymocyte b. Intermediate thymocyte c. Pre-B cell d. Pro-B cell 61. A protein which functions as a specific antibody is called: a. Immunogen b. antigen c. immunoglobulin d.hapten 62. Which of the following cells is directly involved in production of specific antibodies? a. T effector cell b. T memory cells c. Plasma cells d. B memory cells 63. Which of the following is true of the red bone marrow? a. Collagen type I and III are found in the matrix b. Reticular cells line marrow sinusoids c. Marrow bed is supported by a thick layer of reticular fibers d. Adipocytes equal the number of reticular cells 64. Which of the following cells produce only mature blood cells? a. Unipotential progenitor b. Precursor c. Stem d. Bipotential progenitor 65. In which of the following cells in the erythropoeitic series is the nucleus extruded? a. Proerythroblast b. Basophilic erythroblast c. Polychromatophilic erythroblast d. Orthrochromatophilic erythroblast 66. The cell in granulopoiesis which demonstrates moderate azurophilic granules with initial secretion of specific granules in the golgi zone a. Myeloblast b. Promyelocyte c. Myelocyte d. metamyelocyte

C A c/b

D A

c A

67.

which cell in the maturation of the monocytes undergo division twice? a. Monoblast b. promonocyte c. monocyte d. macrophage 68. Which of the following best describes the natural killer cells? a. Presence of specific granules b. Absence of t and b cell markers c. Carries membrane TCRs d. Requires antigen pre-stimulation 69. The azurophilic granules in cytoplasm of WBC are this kind of organelles: a. Peroxisomes b. Golgi complex c. Lysosomes d. Ribosomes 70. Which type of leukocyte is the only one which returns to the blood from the tissues after diapedesis? a. Monocyte b. Lymphocyte c. Segmenters d. eosinophils 71. Metachromatically-staining granules, irregularly shaped nucleus, few specific granules describe which of the following? a. Basophil b. Eosinophil c. Neutrophil d. platelets 72. which of the following is the major site of lymphopoiesis? a. Thymus b. Spleen c. Lymph nodes d. appendix 73. the most abundant component of blood plasma a. proteins b. water c. inorganic subtances d. organic substance 74. which of the following is true of erythrocytes? a. Anucleated and biconvex discs b. Surface antigens on its plasma membrane c. Has a 1:2 ratio with WBC in terms of number d. Abundant cytoplasmic granules 75. Which formed elements help initiate an immune response and defend the body against pathogen? a. Segmenters b. Monocyte c. Platelets d. eosinophils 76. leukocytes are divided into two classes based on the presence or absence of visible organelles called: a. mitochondria b. polymorphic nuclei c. specific granules d. ribosomes 77. which granulocyte phagocytizes allergens and chemically attacks parasitic worms? a. Basophil b. Neutrophil c. Eosinophil d. platelets 78. which two type of cells release histamine and heparin? a. Neutrophils and platelets b. Basophils and lymphocytes c. Monocytes and macrophages d. Mast cells and basophils 79. Immature erythrocytes that still have nuclei and are actively synthesizing haemoglobin: a. Normoblasts b. Reticulocytes c. Pronormoblasts d. Progenitor cells 80. All blood cells arise from these stem cells: a. Precursor b. Pluripotential c. Progenitor d. Blast 81. Colony stimulating factors that influence the maturation and division of WBC include which of the following: a. Multi-CSF and G-CSF b. GM-CSF and M-CSF c. Thrombopoeitin and erythropoietin d. Stem cell factors 82. The cells that produce the smallest formed elements; a. Erythroblasts b. Megakaryocytes c. Myeloblast d. thromboblast 83. the principal hemopoietic organ up to the sixth month of embryonic life a. yolk sac b. spleen

B B

B.

Basis of blood typing

a/b

c.

c. liver d. red marrow 84. the appearance in the cytoplasm of variously-colored specific granules marks which of the following: a. promyelocyte b. myelocyte c. metamyelocyte d. myeloblast 85. the youngest non dividing cell of the granulocyte series: a. metamyelocyte b. myelocyte c. band neutrophil d. segmenter 86. which of the following represents two thirds of the marrow erythropoietic cells? a. Proerythroblast b. Basophilic erythroblast c. Polychromatophilic erythroblast d. Orthrochromatic erythroblast 87. Which of the following is true of erythropoiesis? a. Synthesis of RNA declines in each stage b. Heme synthesis ends in the orthrochromatiphilic erythroblast stage c. The mature RBC contains remnants of polyribosomes d. Loose and lacy cytoplasm distinguishes the basophilic erythroblast from other cells 88. In the normal marrow: a. It is possible to distinguish morphologically myeloblast from monoblast b. Megakaryocyte development occurs by nuclear division without cytoplasmic division c. Lymphopoiesis depends on antigenic stimulation d. Natural killer cells share the same progenitor cells as neutrophils 89. Which of the following is true? a. Mast cells can be ssen in the bone marrow but do not normally appear in blood b. The bursa of fabricius in birds has a counterpart in the secondary lymphoid organs in the human c. Mature erythrocytes circulate in the blood for 30 days d. Basophils outnumber eosinophils in the normal individual 90. A measure of effective erythropoiesis: a. Hgb and hct determination b. Reticulocyte count c. RBC count d. MCHC 91. Oval clusters of lymphatic cells with some extracellular matrix but no connective tissue capsule describe: a. Lymph nodes b. Lymphatic nodules c. Lymphatic sinuses d. Lymphatic cords 92. The lymphocyte most abundant in peripheral blood a. B cell b. NK cell c. T cell d. Plasma cell 93. Which of the following associations between growth factors and their activity is true? a. G-CSF-formation and metabolism of granulocytes b. GM-CSF in vitro and in vivo formation of malignant (leukemic) cells c. IL 3- formation of erythrocyte and lymphocyte series d. M-CSF-increase tumor activity and monocyte 94. A fine layer between plasma and the buffy coat in a centrifuged blood contains which if the following cells? a. Leukocytes b. Platelets c. Fat deposits d. Fragmented cells 95. The most abundant three major classes of plasma proteins are: a. Fibrin, fibrinogen, and regulatory proteins b. Albumins, globulins, and fibrinogen c. Alpha, beta and gamma globulins d. Agglutinins, agglutinogens and lipoproteins 96. Heme synthesis begins with the condensation of the amino acid glycine and succinyl CoA catalysed by the enzyme: a. Succinyl-CoA synthase b. ALA dehydratase c. Delta aminolevulenic acid synthase d. Porphobilinogen synthase 97. The synthesis of heme occurs at the : a. Cytosol and ribosomes b. Cytosol and mitochondria c. Mitochondria and ER d. Cytosol and ribosomes 98. The synthesis of normal adult haemoglobin takes place in the ribosomes of: a. Rubricytes

b. Pluripotent stem cells c. Megakaryocytes d. erythrocytes 99. the sequence of amino acids of the alpha chains of globin in haemoglobin is dictated by a gene present in: a. chromosome 11 b. chromosome 14 c. chromosome 15 d. chromosome 16 100. porphyrins are cyclic compounds which emit re flourensence when the rings are linked by: a. methyl b. methenyl c. proprionate d. acetate group 1. the porphyrins are classified on the basis of the: a. 4 pyrole rings b. Affinity for the metal ions c. Side chain substituent for the 6 H atoms d. Carbon bridges that link the pyrole rings 2. Which of the following catalyzes the rate limiting step in porphyrin biosynthesis in mammalian liver? a. ALA synthase b. ALA dehydratase c. Porphobilinogen synthase d. Uroporphobilinogen synthase 3. The first pyrole ring formed in the synthesis of porphyrin is: a. Hydroxymethylbilane b. Uroporphyrin 1 c. Porphobilinogen d. Uroporphobilinogen 1 4. Which of the following is true of heme biosynthesis? a. Heme synthase appears to be the principal rate limiting step b. Oxidation of the methyl side shain substituent forms protoporphyrin c. The final step involves the incorporation of iron into protopophyrin d. All of the above 5. which of the following is true of heme catabolism? a. Involves initial oxidation of iron in heme b. Catalysed by heme oxygenase system c. Is carried out in the microsomal fraction of RBC d. All of the above 6. Carbon monoxide is formed/released during heme catabolism. The carbon atom is derived from the: a. Reaction of CO2 and ferric iron b. Splitting of pyrole rings I and IV c. Removal of alpha methenyl bridge 7. The bilirubin formed from RES are transported to the liver bound to plasma? a. Albumin b. Globulin c. Lipoprotein d. glucuronide 8. which of the following catalyzes the additions of a polar group to bilirubin in the hepatocytes? a. Dismutase b. UDPG transferase c. Bilirubin reductase d. Biliverdin reductase 9. The rate limiting stem in porphyrin biosynthesis is: a. Catalyzed by ALA synthase b. Catalysed by ferrochelatase c. The formation of porphobilinogen d. The formation of protoporphyrin 10. The reaction wherein the metal iron is incorporated in porphyrin ring is catalysed by: a. ALA dehydratase b. Uroporphyrin oxidase c. Heme synthase d. Coproporphyrin oxidase 11. The only oxidation reaction in heme synthesis which requires an enzyme is the: a. Formation of protoporphyrin b. Formation of heme c. Formation of uroporphyrin d. Formation of coproporphyrin 12. The vitamin cofactor required by ALA synthase? a. NAD b. FAF c. Coenzyme d. Pyridoxal PO4 13. the most common form of porphyria is? a. porphyria cutanea tarda b. variegate porphyria c. protoporphyria d. congenital erythropoietic porphyria

14. the formation of the first pyrole ring is catalysed by: a. ALA dehydratase b. uroporphyrinogen III cosynthase c. coproporphyrinogen III synthase d. uroporphyrinogen I synthase 15. this type of porphyria is associated with deficiency of uroporphyrinogen III co synthase: a. acute intermittent porphyria b. congenital erythropoietic porphyria c. variegate porphyria d. porphyria cutanea tarda 16. the iron free porphyrin portion of heme is degraded mainly in the RE cells of all of the following except? a. liver b. spleen c. kidney d. liver 17. the van den Bergh test for bilirubin utilizes: a. blood sample b. diazotized sulfanilic acid c. methanol as medium of reaction d. all of the above 18. bilirubin is secreted into the bile by: a. osmosis b. simple diffusion c. facilitated diffusion d. active transport 19. the reduction of hemin to heme in the microsome is catalysed by heme oxygenases which requires this vitamin co factor which one? a. NADPH b. FMN c. FAD d. coenzyme A 20. the intermediate product of heme catabolism formed by the action of heme oxygenase activity is? a. bilirubin 1 b. bilirubin 2 c. biliverdin d. hydroxymethylbilane 21. the soluble enzyme biliverdin reductase reduces which part of the pyrole rings so as to produce the pigmented bilirubin IX? a. methynyl bridge of rings III and IV b. carbon of pyrole ring III c. methelene bridge of rings I and IV d. carbon of pyrole ring IV 22. when bilirubin conjugates are abnormally present in the plasma they are usually in the form of: a. bilirubin diglucuronide b. bilirubin monoglucuronide c. bilirubin unconjugated d. bile slats 23. most of the bilirubin that are excreted in the bile of mammals is in the form of: a. bilirubin diglucuronide b.bilirubinmonoglucuronide c. bilirubin unconjugated d. bile salts 24. the most probable rate limiting step in the entire process of bilirubin metabolism is the: a. bilirubin synthesis b. bilirubin transport c. bilirubin excretion into the bile d. bilirubin metabolism in intestine 25. the enzymatic removal of glucuronides, the bilirubin conjugates starts in this part of the intestine: a. ileum b. transverse colon c. rectum d. jejunum 26. following the removal of glucuronides, the bilirubin is reduced producing a colorless compound: a. uroporphyrinogen b. urobilinogen c. coproporphyrinogen d. coprobilin 27. darkening of the feces is due to which of the following: a. urobilin b. urobilinogen c. porphobilin d. urophorphyrin 28. jaundice will start to occur when serum bilirubin concentration reaches: a. 2mg/dl b. 0.2mg/dl c. 20mg/dl d. 200mg/dl 29. under pathologic conditions, when the urobilinogen is formed in excess the urobilinogen, via enterohepatic urobilinogen cyle, will be reexcreted via: a. skin

d.

b.

b. urine c. feces d. all of the above 30. the type of hyperbilirubinemia associated with kernicterus: a. conjugated b. unconjugated c. conjugated and unconjugated bilirubin d. regurgitation 31. retention hyperbilirubinemia is due to a. overproduction b. reflux c. obstruction d. undersecretion 32. acholuric jaundice occurs only in: a. conjugated hyperbilirubinemia b. regrurgitation hyperbilirubinemia c. unconjugated hyperbilirubinemia d. conjugated and unconjugated hyperbilirubinemia 33. which of the following drug is effective in inducing bilirubin metabolism even in immature liver? a. heparin b. aspirin c. phenobarbital d. paracetamol 34. Which of the following can cause prehepatic jaundice? a. hepatitis b. hemolysis c. bile obstruction d. physiologic jaundice 35. The following are true of physiologic jaundice in newborn, except. a. transient condition b. conjugated bilirubin in plasma is high c. may be due to an immature hepatic system d. phototherapy promotes hepatic excretion ofbilirubin 36. heme biosynthesis cannot occur in mature red cells because they do not have: a. nuclei b. mitochondria c. golgi complex d. rough endoplasmic reticulum 37. which of the following characteristics of porphyria cutanea tarda? a. abdominal pain b. photosensitivity c. positive urine porphobilinogen d. deficient uroporphyrinogen 1 synthase 38. Dr. dela cruz suspected his patient is suffering from obstructive jaundice. Which of the following lab results support the doctors impression? a. unconjugated hyperbilirubinemia and absence of urin bilirubin b. urine urobilinogen, + fecal urobilin elevated indirect bilirubin c. elevated direct reacting bilirubin, - urine urobilin fecal urobilin d. none of the above 39. an autosomal recessive disorder due to compensated hemolysis associated with unconjugated hyperbilirubinemia due to defect in uptake of bilirubin by the liver: a. gilberts disease b. rotors syndrome c. Dublin-johnson syndrome d. crigler-najjar syndrome 40. which of the following characteristics of the protoporphyrin structure will differentiate it from other porphyrins? a. asymmetric orientation of the side chain in ring IV b. presence of methyl side chain substituent c. presence of propionate side chain substituent d. none of the above 41. the liquid part of blood after coagulation without a clotting factor a. serum b. plasma c. haematocrit c. supernatant 42. which of the following is/are true of plasma? a. aqueous solution and a pH of 7.3 b. liquid intercellular substance and transluscent c. a protein made in the liver and whitish in color d. it does not contains fibrinogen 43. the alpha granules contains: a. polyribosomes b. lysosomal enzymes c. enzymes with strong bacterial actions d. peroxidases 44. which of the following is true? a. all granulocytes are motile b. neutrophils can replenish their stored granules c. leukocyte is the dominant cell type in the blood d. WBC and RBC have bilobed nucleus 45. the following statements are true except a. the release of the contents of the granules of basophils is receptor-mediated b. monocytes give rise to osteoclasts

a/d

c/a

c. T and B lymphocytes form a vast majority of lymphocytes in the blood stream d. platelets are fragments of the nucleus of megakaryocyte 46. which of the following harbors mainly adipocytes and dominates in the diaphysis of adult long bones a. red bone marrow b. reticular tissue c. yellow bone marrow d. reticular cells 47. normal values of eosinophils a. 1-2% b. 3-3.9% c. 1-0.5 % d. 2-4% 48. the laboratory test that measures the total percentage of RBC in the blood sample a. HCT count b. HGb count c.MCV d. MCHC 49. the laboratory test that measures the variability of the RBC size a. reticulocyte count b. red cell distribution width c.hgb count d. MCH 50. How many liters of blood does the adult human body contain? a. 5 liters b. 5 gallons c. 10 liters d. 10 milliliters

d a