Biochemistry Long Quiz 3

1. The matrix of blood is known as:

a. Plasma c. RBC & WBC
b. Serum d. WBC & platelet

2. The percentage of formed elements in the blood is

a. 45% c. 55%
b. 50% d. 65%

3. During blood coagulation, thromboplastin is released by

a. Red blood cell c. white blood cell
b. Blood plasma d. clumped platelets and damage tissues

4. Which of the following cations is required for the conversion of prothrombin into active thombin by
thromboplastin?
a. Calcium c. potassium
b. Ferrous d. sodium

5. Which statement is true or white blood cells?

a. Produced n thymus c. comes from the megakaryocytes
b. Non nucleated d. can squeeze through blood capillaries

6. The production of red blood cells in the bone marrow is regulated by

a. Renin c. erythropoietin
b. Epinephrine d. thrombopoietin

7. Which of the following white blood cell is capable of phagocytosis?

a. Basophils c. monocytes
b. Eosinophil d. lymphocytes

8. What would happen to RBCs if the heme group were removed from hemoglobin?
a. RBCs would not be able to bind oxygen
b. RBCs would not be able to reproduce
c. White blood cells would not be able to reproduced
d. Blood clot formation would be inhibited

9. Which of the following statement is not correct?

a. RBCs contain high level of superoxide dismutase
b. A and B substance are formed the addition of fucose and N-acetyl glucosamine respectively to H
substance
c. Platelets generate ATP exclusively via glycolysis
d. Mature red blood cells are devoid of internal organelles

10. A patient recently exposed to aniline displays bluish discoloration of their skin and mucous membranes. Which
of the following is the plausible diagnosis?
a. Methemglobinemia c. iron deficiency anemia
b. Sickle cell anemia d. megaloblastic anemia

11. Which of the following statement is NOT correct?

 a. Interleukins are key mediators of leukocyte production
b. Lymphocytes produce protective antibodies
c. Monocyte can be found in tissues throughout the body
d. Histamine is synthesize by the deamination of the amino acid histidine

12. Which of the following statement is NOT correct?

a. The high surface area of biconcave RBCs facilitate gas exchange
b. In order to pass through narrow capillaries, RBCs must be squeeze into a compact, spherical shape
c. The diameter of RBCS exceeds that of many peripheral capillaries
d. Protein 4.1 helps link the RBC cytoskeleton to proteins in the cell’s plasma membrane

13. An autoimmune disorder which has a genetic mutation that impairs the ability of platelets to adhere?
a. Thrombocytopenia c. hemolytic uremic syndrome
b. Immune thrombocytopenic purpura d. von Willebrand disease

14. A bleeding disorder which has a genetic mutation that impairs the ability of platelets to adhere?
a. Thrombocytopenia c. hemolytic uremic syndrome
b. Immune thrombocytopenic purpura d. von Willebrand disease

15. A transmembrane protein that facilitates the exchange of bicarbonate and chloride ions by erythrocytes
a. Spectrin c. band 4.1
b. Ankyrin d. actin

16. What intimal cell synthesizes and stores VWF?

a. Smooth muscle cell c. fibroblast
b. Endothelial cell d. platelet

17. What coagulation plasma protein should be assayed when platelets fail to aggregate properly?
a. Factor VIII c. thrombin
b. Fibrinogen d. VWF

18. What role does Vitamin K play for the prothrombin group factors?
a. Provides a surface on which the proteolytic reactions of the factors occur
b. Protects them from inappropriate activation by compounds such as thrombin
c. Accelerates the binding of the serine proteases and their cofactors
d. Carboxylate the factors to allow calcium binding

19. Which of the following conditons causes a prolonged thrombin time?

a. Prothrombin deficiency c. Hypofibrinogenemia
b. Antihrombin deficiency d. Warfarin therapy

20. What serine protease forms a complex with factor VIIa and what is the substrate of this complex?
a. Factor VIIa, factor X c. Factor Xa, prothrombin
b. Factor Va, prothrombin d. Factor IXa, factor X

21. If a patient has anatomic soft tissue bleeding and poor wound healing but the PT, PTT, thrombin time, platelet
count, and platelet functional assay results are normal, a deficiency of what factor could exist?
a. Fibrinogen c. factor XII
b. Prothrombin d. factor XIII
22. IT is used in conjunction with the activated partial thromboplastin time (aPTT) which measures
a. Intrinsic pathway c. common pathway
b. Extrinsic pathway d. none of the above

23. In fibrinolysis, a fibrin clot is broken down. What is the enzyme the cuts the fibrin mesh leading to the
production of circulating fragments?
a. Protease c. plasminogen
b. Cytokine d. plasmin

24. What plasma protein is essential to platelet adhesion?

a. von Willebrand factor c. fibrinogen
b. factor VIII d. P-selectin

25. What growth factor that is produced in the kidney & induces growth & differentiation of committed
megakaryocyte progenitors?
a. IL-3 c. IL-11
b. IL-6 d. TPO

26. What platelet membrane receptor binds fibrinogen & supports platelet aggregation?
a. GP Ib/IX/V c. GP IaVIIa
b. GP IIb/IIIa d. P2Y1

27. Which of the following first coagulation cascade complex that cleaves IX & X?
a. IXa c. Xa
b. VIIIa d. VIIa

28. In the formation of A antigen, the immunidominant sugar responsible for A specificity is?
a. Fucose c. Fructose
b. N-acetylgalactosamine d. Galactose

29. Proteins secreted by activated white blood cells that attract additional leukocytes to a site of infection or injury.
a. Chemotaxis
b. Diapedesis
c. Chemokines
d. Phagocytes

30. In the formation of B antigen, the immunodominant sugar responsible for B specificity is?
a. Fucose c. Fructose
b. N-acetylgalactosamine d. D-Galactose

31. In the blood, oxidation of ferrous iron is catalyzed by this multicopper ferroxidase, which is a 160 kDa a2-
globulin synthesized by the liver
a. Albumin c. immunoglobulin
b. Ceruloplasmin d. A1-antitrypsin

32. Which of the following is not a major function of blood?

a. Regulation of body temperature by the distribution of body heat
b. Controls coordination and balance
 c. Transport of metabolic waste to the kidney, lungs, skin, and intestines for removal
d. Transport of hormones and regulation of metabolism

33. A 40-year old man known alcoholic, beverage drinker, as admitted due to difficulty of breathing and abdominal
pain. On physical examination, patient’s abdomen is globular with positive fluid wave. Ultrasound showed liver
cirrhosis with moderate ascites. Which of the following laboratory results contribute to the ascites of the
patient?
a. elevated WBC count c. elevated alkaline phosphatase
b. elevated creatinine levels d. low levels of serum albumin

34. In what way haptoglobin protects the kidneys?

a. Haptoglobin protects the kidney because it is an acute phase protein which prevents inflammation
b. Haptoglobin form a precipitates that damaged the kidneys
c. Haptoglobin binds with free extracorpuscular hemoglobin to form a tight non-covalent complex which is
large enough to pass through the glomerulus
d. Haptoglobin binds with the ferric form of iron to form a complex which is large enough to pass through
the glomerulus

35. Which of the following is the B-globulin that binds free heme?
a. Haptoglobin c. ferroportin
b. Hemopexin d. hemosiderin

36. Which of the following is a cause of decreased levels of Haptoglobin?

a. Wilson’s disease c. hemolytic anemia
b. Iron deficiency anemia d. hemosiderosis

37. A 40-year old woman sought consult at the OPD department due to dizziness. Laboratory showed Hemoglobin
of 8.1 gdl and hematocrit of 27%. You are the physician on duty at the OP department. IF you are considering an
iron deficiency anemia, what laboratory test will you request to differentiate iron deficiency anemia from other
types of anemia?
a. Total iron binding capacity c. serum iron
b. Transferrin saturation d. serum ferritin

38. Hemoglobin is broken down by this enzyme converting it to biliverdin and released carbon monoxide and iron as
by-products.
a. Duodenal cytischrome B c. Heme oxygenase
b. Ferroportin d. Heme reductase

39. Inorganic dietary iron in the (Fe3+) ferric state is reduced to its ferrous form (Fe 2+) by which of the following?
a. Duodenal cytochrome b (Dcytb) c. Vitamin C
b. DMT1 d. Ferroportin

40. In humans, iron is transported through the body tightly bound to this plasma protein, which is glycoprotein,
synthesized by the liver.
a. Ferritin c. Haptoglobin
b. Ceruloplasmin d. Transferrin

41. Glycosylation of transferrin is impaired in which of the following?

a. Hemosiderosis c. Chronic alcoholism
 b. COPD d. Hemosiderosis

42. A copper-containing plasma protein synthesized by liver, which is a ferroxidase required for the oxidation of Fe 2+
to Fe3+
a. Haptoglobin c. Hemopexin
b. Ceruloplasmin d. Heme oxygenase

43. A genetic condition in which a mutation in the gene for the copper-binding P-type ATPase (ATP7B protein)
blocks the excretion of excess copper in the bile.
a. Hemolytic anemia
b. Hemosiderosis
c. Wilson’s disease
d. Hereditary hemochromatosis

44. It is a 25-amino acid peptide, synthesized in the liver which is the chief regulator of systemic iron homeostasis
a. Hepcidin c. Transferrin
b. Ceruloplasmin d. Ferritin

45. Genetic deficiency of a1-antitrypsin leads to one of the following disease:

a. Viral hepatitis c. Wilson’s disease
b. Thalassemia syndromes d. emphysema

46. A member of the thiol ester plasma protein family, comprises 8% to 10% of the total plasma protein in humans,
which neutralizes many proteases and targets certain cytokines to specific organs.
a. A2-macroglobulin c. Hepcidin
b. A1-antitrypsin d. Acute phase reactants

47. Refers to an impairment of tissue function that results from the accumulation of insoluble aggregates of proteins
between cells.
a. Emphysema c. Wilson’s disease
b. Amyloidosis d. Hemochromatosis

48. Is the plasma-borne arm of the innate immune system. This is activated by a series of proteolytic cleavage
events that transform dormant zymogens into active proteases.
a. Immunoglobulins c. Complement system
b. Cytokines d. Acute Phase Proteins

49. Main antibody in the secondary response, which opsonizes bacteria, making them easier to phagocytose.
a. IgM c. IgD
b. IgG d. IgA

50. They are responsible for the synthesis of circulating, humeral antibodies also known as Immunoglobulins.
a. T cells c. Innate immune system
b. B cells d. thymus