Blood Physio & Immuno Physio

The following can be found in patients with Liver Cirrhosis:

Carbon dioxide from the tissues is transported with the help of this enzyme:

Thymidine phosphorylase

Carbonic anhydrase

Dihydropyrimidine dehydrogenase

Gamma glutamyl transferase

Problems with RBC maturation can arise from:

*To prevent ethroblastosis fetalis during the second pregnancy, anti-RH immunoglobulin is given during the first pregnancy. The logic behind this intervention is:

The immunoglobulins attack maternal T-cells so that theses T-cells cannot mount an immune response

Maternal B cells immediately differentiate to plasma cells upon exposure to the injected immunoglobulin

Fetal red cells are coated with protective immunoglobulins resting phagocytosis

Fetal red cells are destroyed immediately by the immunoglobulins limiting maternal exposure and immune response

A patient with liver failure would have:

The most potent driver of erythropoiesis is:

A. Hypoxemia

B. Physical activity

C. Dehydration

D. Hormonal stress

In periods of Iron deficiency, more of this molecule can be found in the bile:

Hemosiderin

Apotransferrin

Ferritin

Apoferritin

Exposure of blood to subendothelial collagen will primarily trigger which coagulation pathway:

Intrinsic

Extrinsic

Classical

Alternative

The following are know pro coagulants, EXCEPT:

Thrombin

Fibrin

Protein C and S

Plasminogen-activator inhibitors

Carbonic Anhydrase is involved primarily in the transport of this gas:

Oxygen

Carbon dioxide

Nitrogen

Carbon Monoxide

The RBC will readily give away its stored oxygen:

Immersing erythrocytes in hypertonic solution produces:

Crenated RBCs

Ghost RBCs

Hypochromic RBCs

None of the above

The serum oncotic pressure is:

The force that pushes water extravascularly

Increased in the background of liver disease

Decreased by alpha and beta globulins

Maintained by albumin

In the adult, the primary site of erythropoiesis is in the:

Bone marrow of appendicular bones

Bone marrow of axial skeleton

Liver parenchyma

Thymus

The blood type AB is considered as the universal recipient because it:

Has both A and B antigens

Lacks Galactosamine in the H antigen

Does not have antibodies against A and B antigens

Is immediately sensitized by transfused A or B antigens

True of the vasoconstriction phase of hemostasis:

A. A myogenic response takes place upon vessel injury

B. Pain triggers a neural refles that promotes vasoconstriction

C. Platelet myosin and actin are the main players

D. All of the above

E. A & B only

The extrinsic pathway of blood coagulation:

A. Can be clinically assessed through the Prothrombin Time

B. Is activated by Tissue Factor

C. Produces weak fibrin crosslinks compared to that of the Intrinsic pathway

D. All of the above

E. A & B only

True statements about platelets:

A. Platelets attach to the Von Willebrand molecule exposed by endothelial damage via GP IIB-IIIA receptors

B. Platelets attach to other platelets via GP IB and fibrinogen

C. Platelets activate nearby platelets via Platelet Activating Factor (PAF)

D. A and B only

Oxygen will have increased affinity to hemoglobin in which of the following setting/s?

Patients who had undergone total gastrectomy can develop megaloblastic anemia. This is because: Total gastrectomy is a surgical procedure which involves the removal of the entire organ.

A. There is impaired absorption of iron

B. Folic acid production is decreased

C. There is loss of intrinsic factor

D. There is an increase in Vitamin B12 absorption

Hemochromatosis will occur in:

A. Pregnant patients receiving mega doses of iron

B. Suicidal individual ingesting large amounts of iron supplements

C. Thalassemia patients having multiple transfusions

D. All of the above

E. A & B only

In hemoglobin level determination, the intensity of the green color reflects:

A. The amount of hemoglobin in the sample

B. The percentage of red cells in the sample

C. both

D. None of the above

Which of the following is expected to have the highest hematocrit level?

Mountain dweller

Sea level dweller

Patients with renal failure

Thalassemia patient

The Rh negative person:

Will naturally have anti-Rh immunoglobulin

Can receive Rh+ donor blood liberally

Has the D antigen on its red cells

Can donate freely to an Rh+ person

If agglutination is observed in the yellow anti-serum but not in the blue anti serum, the blood type is:

Type A

Type B

Type AB

Type O

Vitamin K supplementation can prevent bleeding tendencies in:

True of clot retraction:

This is brought about by actin and myosin content of platelets

Plasmin dissolves the clot during this event

New blood vessels are formed during this process

All of the above

The Fibrin-Stabilizing Factor:

Hemophilia is a disease characterized by:

The subendothelial collagen:

Triggers the intrinsic coagulation cascade

Prevents platelet aggregation

Promotes clot retraction

All of the above

Margination of Neutrophils is made possible by:

Expression of Intracellular Adhesion Molecules (ICAMs)

Attachment to vWF

Linking GPIIb-IIIa molecule

Interacton with Lipopolysaccharide (LPS)

True of adaptive immunity:

Immunity present even with no prior exposure

Physical barriers are main components

Involves the production of specific immunoglobulins

Phagocytosis of bacteria is an example

The process by which phagocytosis is facilitated by a third party molecule is called:

Trans-phagocytosis

Opsonization

Invagination

Desensitization

The first cellular defense when bacteria are able to survive past the physical barriers is the:

Resident Macrophage

Circulating Neutrophils

Blood Monocytes

NK cells

Humoral Immunity refers to:

Physical Barriers

Differentiation of T lymphocytes

Chemical barriers

Production of specific antibodies

After Phagocytosis of the offending agent, the activated macrophages releases:

TNF

IL-1

Monocyte-Colony Stimulating Factor

All of the above

Antibodies exert their protective effects through:

The secondary immune system is characterized by:

Predominance of IgM Abs

Less potent Abs volume

More specific immunoglobulins produced

Delayed antibody production

True of immune tolerance:

Results from exposure of lymphocytes to self antigens

Failure of tolerance results in autoimmune dses

A type of CD8+ T cell plays a role

All of the above

The Reticuloendothelial System (RES) is composed of:

Blood monocytes, tissue macrophages, and spleen

Lymph nodes, pancreas, and circulating neutrophils

Spleen, basophils, and granulocytes

Lymph nodes, lymphocytes, and plasma cells

Phagocytosis is facilitated by the presence of the following molecule/s on the bacterial cell wall:

Specialized macrophages in the liver are called:

Von Kupffer cells

Langerhan's cells

Histiocytes

Alveolar macrophages

The function of this phagocytic cell is to eliminate parasites (such a Trichinella worm):

Neutrophil

Basophil

Monocyte

Eosinophil

True of allergic reactions:

Mast cells degranulate when antigens/allergens bind to surface IgE

IgE molecules attach themselves to the surface of mast cells

B cells produce specific IgE molecules upon allergen contact

All of the above

The first two

The Granzyme:

Induces apoptosis of target cell

Punctures holes in the cel membrane of target cells

Resides in lysosomes that digest phagocytosed material

All of the above

Event/s during preprocessing:

Patients who had total gastrectomy can develop megaloblastic anemia. This is because:

There is impaired absorption of iron

Folic acid production is decreased

There is loss of the Intrinsic Factor

There is increased vitamin B12 absorption

The RBCs of patients with Iron Deficiency Anemia will appear as:

Macrocytic with target lesions

Microcytic and hypochromic

Spherical and hyperchromic

Crenated and microcytic

Macrophage activation:

Occurs after the macrophage ingest bacteria

Is the central event in the inflammatory process

Colony stimulating factors are released after macrophage activation

All of the above

The first two

Hemochromatosis will occur in:

Pregnant patients receiving mega doses of iron

Suicidal individual ingesting large amounts of iron supplements

Thalassemia patients having multiple tranfusions

All of the above

The following prevent unnecessary and unwanted clotting inside damaged vessels, EXCEPT:

Smooth vascular walls

Surface glycocalyx

Thrombomodulin

Fibrin Stabilizing Factor

Suppresor T cells:

Play a part in immune tolerance

Are activated by T-helper cells

Also carry the CD8 surface marker

All of the above

Memory cells:

Bear information about the offending agent

B cells that do not differentiate into plasma cells

Rest in lymphoid tissue or circulate in the blood

All of the above

The first two

True of immune response:

IgG type of antibodies are produced during the primary immune response

Antibody production during the primary immune response is more potent compared to the secondary immune response

More specific immunoglobulins are produced during the primary response

Memory cells facilitate and hastens the immune response during the second encounter with the antigen

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