Clinical Laboratory Hematology, 3rd Edition Test Bank by McKenzie Ph.D. CLS (NCA), Shirlyn B., Lynne Williams

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Chapter 2: Cellular Homeostasis

Multiple-Choice Questions

Level I

1. Protein synthesis occurs predominantly in the:
   1. Cell membrane
   2. Nucleus
   3. Lysosome
   4. Cytosol

Correct answer: D

(Objective 1)

1. The plasma membrane of blood cells is characterized by which of the following?
   1. Carbohydrate components (glycolipids, glycoproteins) embedded in the lipid bilayer
   2. The asymmetric distribution of the phospholipids
   3. The hydrophilic ends of the phospholipids directed toward the inside of the lipid bilayer
   4. The absence of peripheral proteins

Correct answer: B

(Objective 2)

1. Which phospholipids are found predominantly in the outer layer of the lipid bilayer?
   1. Phosphatidylethanolamine and phosphatidylserine
   2. Phosphatidylethanolamine and phosphatidylcholine
   3. Phosphatidylserine and sphingomyelin
   4. Phosphatidylcholine and sphingomyelin

Correct answer: D

(Objective 2)

1. In which phase of the cell cycle is a cell quiescent?
   1. The G1 phase
   2. The G0 phase
   3. The R phase
   4. The S phase

Correct answer: B

(Objective 3)

1. The point in the cell cycle after which cell division is complete but before the next round of DNA synthesis is:
   1. The G2 phase
   2. The G0 phase
   3. The G1 phase
   4. The R phase

Correct answer: C

(Objective 3)

1. In order to maintain ________, terminally differentiated blood cells must undergo _________.
   1. Cell cycle division; necrosis
   2. Tumor suppression; apoptosis
   3. Homeostasis; apoptosis
   4. Cell regeneration; necrosis

Correct answer: C

(Objective 5)

1. All of the following are initiators of apoptosis except:
   1. BCL-2
   2. Caspases
   3. TNF-alpha
   4. Fas Ligand

Correct answer: A

(Objective 6)

1. Apoptosis plays a role in human development in all of the following except:
   1. Removal of interdigital webs of the hands and feet
   2. Formation of the blood vessels and the gastrointestinal tract
   3. Differentiation (divergence) of mast cells and basophils
   4. Selection of appropriate T and B lymphocyte clones

Correct answer: C

(Objective 5)

1. Which of the following is a mechanism of apoptosis in hematopoiesis?
   1. Expansion of B cell clonal populations in response to infection
   2. Elimination of PMNs and eosinophils after an inflammatory response
   3. Production of RBCs in response to anemia
   4. Progression of acute leukemias

Correct answer: B

(Objective 7)

1. Which cytoplasmic organelle’s function is lipid synthesis?

1. Smooth endoplasmic reticulum
2. Golgi apparatus
3. Mitochondria
4. Ribosomes

Correct answer:  A

(Objective 1)

11. Which phospholipids are predominantly found in the inner layer of the lipid bilayer?
12. Phosphatidylethanolamine and phosphatidylcholine
13. Phosphatidylethanolamine and phosphatidylserine
14. Phosphatidylserine and sphingomyelin
15. Phosphatidylcholine and sphingomyelin

Correct answer:  B

(Objective 2)

12. In which phase of mitosis do the chromosomes align on opposite poles of the cell?
13. Prophase
14. Metaphase
15. Anaphase and telophase
16. Interphase

Correct answer:  C

(Objective 3)

13. The (R) restriction point occurs during what phase in the cell cycle?
14. S
15. G₂
16. G₁
17. M

Correct answer:  C

(Objective 4)

14. If an organism fails to regulate apoptosis, resulting in excessive apoptosis, which of the following processes might result?
15. Neurodegenerative disorder
16. Autoimmune disorder
17. Lymphoma
18. Carcinoma

Correct answer:  A

(Objective 5)

Level II

1. The sections of a gene that contain the coding sequences for the final protein product are:
   1. Exons
   2. Introns
   3. UTRs
   4. Nucleosomes

Correct answer:  A

(Objective 1)

1. Which of the following influence the stability of the mRNA and the efficiency of translation?
   1. Introns
   2. Untranslated regions
   3. Single-nucleotide polymorphisms
   4. Exons

Correct answer: B

(Objective 1)

1. To be considered a true polymorphism, a SNP must occur with a frequency of:
   1. >1%
   2. >5%
   3. >10%
   4. >25%

Correct answer: A

(Objective 1)

1. Structurally abnormal proteins can be eliminated from the body by tagging them with _________ and sending them to the __________.
   1. Caspase; apoptosis pathway
   2. Ubiquitin; proteosome
   3. Cyclins; necrosis pathway
   4. CDKs; apoptosis pathway

Correct answer: B

(Objective 2)

1. Which cyclin component is predominant in the G1 phase of the cell cycle?
   1. Cyclin A
   2. Cyclin B1
   3. Cyclin E
   4. Cyclin D

Correct answer: D

(Objective 3)

1. What protein is responsible for activating phosphorylation of all kinases involved in the cell cycle?
   1. Cdk
   2. CAK
   3. Cyclin
   4. Cdk inhibitor

Correct answer: B

(Objective 4)

1. Predict the effect of p16 on the cell cycle of dividing cells.
   1. Increases cell cycle progression
   2. Decreases cell cycle progression
   3. Causes no change in the cell cycle progression
   4. Initiates apoptosis

Correct answer: B

(Objective 4)

1. At which checkpoint would detection of unreplicated DNA strands occur?
   1.  G1 checkpoint
   2. G2/M checkpoint
   3. S phase checkpoint
   4. Metaphase checkpoint

Correct answer: B

(Objective 5)

1. Which regulatory protein is present in all stages of the cell cycle but has varying degrees of phosphorylation (activation) from phase to phase?
   1. p53
   2. Rb protein
   3. p21
   4. Cyclin D

Correct answer: B

(Objective 6)

1. Initiation of apoptosis occurs primarily with:
   1. Activation of p53
   2. Cleavage of appropriate caspases at timely intervals
   3. Stimulus from an inflammatory response
   4. Activation of BCL-2

Correct answer: B

(Objective 8)

1. Exposure to radiation would lead to activation of which caspase pathway?
   1. Extrinsic pathway
   2. Intrinsic pathway
   3. Common pathway
   4. None of the above

Correct answer: B

(Objective 9)

1. Predict the effect that the Bax:Bcl-2 complex will have on the apoptotic pathway.
   1. The pathway is activated by Bax: Bcl-2.
   2. The pathway is inhibited by Bax: Bcl-2.
   3. The pathway is not affected by Bax: Bcl-2.
   4. The pathway is activated and then is inhibited by Bax:Bcl-2.

Correct answer: B

(Objective 11)

1. Which of the following are apoptosis activators?
   1. BCL-2
   2. Mcl-1
   3. Bcl-X_L
   4. Bak

Correct answer: D

(Objective 10)

1. Malignancies can result from which of the following?
   1. Accelerated apoptosis
   2. Inhibited apoptosis
   3. Normal occurrence of apoptosis
   4. None of the above

Correct answer: B

(Objective 12)

1. Clearance of cytotoxic T cells after an immune response results from:
   1. Accelerated apoptosis
   2. Inhibited apoptosis
   3. Normal occurrence of apoptosis
   4. None of the above

Correct answer: A

(Objective 12)

1. All of the following are potential proto-oncogenes except:
   1. Proteins that function as growth factor receptors
   2. Proteins that bind DNA
   3. Growth factors
   4. Proteins that neutralize growth factor receptors

Correct answer: D

(Objective 7)

17. UTRs constitute which segments of mRNA?
18. Exons
19. Introns
20. 3’ and 5’ ends
21. Heteronuclear RNA

Correct answer:  C

(Objective 1)

 

18. Disposal of damaged or misfolded proteins is carried out by which cell component?
19. Lysosome
20. Ubiquitin/proteosome system
21. Caspase/apoptosis system
22. Molecular chaperones

Correct answer:  B

(Objective 2)

19. Cdks must be complexed with what molecule to drive one cell to the next cell-cycle stage?
20. DNA
21. Phosphorylating enzymes
22. mRNA
23. Cyclin

Correct answer:  D

(Objective 3)

 

20. Which two proteins are critical for the effective function of the G1 checkpoint?
21. Cdk4 and Cdk6
22. Cyclin E
23. P21 and p57
24. P53 and Rb

Correct answer:  D

(Objective 3, 5)

21. What feature distinguishes necrosis from apoptosis?
22. Necrosis requires ATP.
23. Necrosis is characterized by cellular shrinkage and chromatin condensation.
24. Necrosis induces inflammation.
25. Necrosis results in nuclear fragments of 185 base pairs.

Correct answer:  C

(Objective 14)

Short-Answer Questions

1. Explain in detail how p53 and Rb can contribute to the onset of malignancy.

Answer:  Rb is the protein product of the retinoblastoma susceptibility gene, which predisposes individuals to retinoblastomas and other tumors when only one functional copy is present.  Rb is present throughout the cell cycle.  Phosphorylations vary with each cell-cycle phase.  In its hypophosphorylated (active) state, Rb has antiproliferative effects, inhibiting cell cycling.  It does this by inhibiting transcription factors required for the transcription of genes needed for cell proliferation, rendering them nonfunctional.  Hyperphosphorylation, on the other hand, neutralizes (inactivates) the Rb protein, thus promoting cell cycle division.

P53 acts as a molecular policeman; it monitors the integrity of the genome.  It can activate and inhibit gene expression depending on the target gene.  It is activated in response to DNA breakage, and slows cell-cycle division to initiate DNA repair or apoptosis.  It functions as a tumor suppressor gene, and it is the most common mutated gene in tumors.

(Objectives 6 and 7, Level II)

1. List three ways in which the caspase pathway can be activated.  Explain the role of each, and indicate which arm of the caspase pathway will be activated.

Answer:  The extrinsic pathway of apoptosis is triggered by extracellular “death” signals (TNF, Fas Ligand, and CD95).  The intrinsic pathway of apoptosis is triggered by intracellular signals in response to stress, exposure to cytotoxic agents, and radiation.

(Objective 9, Level II)

1. Describe the apoptotic pathway.

Answer:  Death receptor binding of death receptor to cell receptor → caspase recruitment → activation of initiator caspases → activation of effector caspases → cleavage of crucial cellular proteins → cell death.

 (Objective 5, Level I)

1. Explain the role of epigenetic alterations in cancer development.

Answer:  The most common epigenetic change in the development of cancer involves a methylation/demethylation of CpG dinucleotide bases. Cancer can involve demethylation of promoter regions of genes making them transcriptionally ready.  Methylation can result in transcriptional silencing of the gene and loss of function of tumor suppressor genes.  Deacetylation of key histones can result in gene silencing which may favor growth over differentiation.

 (Objective 13, Level II)

1. List the four major phospholipids found in the plasma membrane of hematopoietic cells, and explain their unique distribution.

Answer:  The four major phospholipids that are found in the plasma membrane are phosphatidylethanolamine (PE), phosphatidylserine (PS), phosphatidylcholine (PC), and sphingomyelin (SM).  Most blood cells have an asymmetric distribution of these phospholipids, with PE and PS occurring in the inner layer and PC and SM occurring in the outer layer.

(Objective 2, Level I)

 

 

Chapter 7: Granulocytes and Monocytes

Multiple-Choice Questions:

Level I

1. Which of the following terms is used to describe an absolute increase in the number of eosinophils?
   1. Neutropenia
   2. Eosinophilia
   3. Leukocytosis
   4. Lymphocytosis

Correct Answer: B

(Objective 1)

2. What characteristic that is present in promyelocytes morphologically differentiates a promyelocyte from a myeloblast?
3. Primary granules
4. Secondary granules
5. Loss of nucleoli
6. Pink cytoplasm

Correct Answer: A

(Objective 2)

 

1. The information of 20 mcM (μm) in size, round nucleus with lacey chromatin and several nucleoli, deep blue cytoplasm with large bluish-purple granules describes which stage of neutrophil maturation?
   1. Promyelocyte
   2. Metamyelocyte
   3. Band neutrophil
   4. Myelocyte

Correct Answer: A

(Objective 3)

4. A(n) __________ has purple-black granules that obscure the cytoplasm, whereas a(n) __________ contains granules that orange to red in color. (Objective 4)
5. eosinophil; neutrophil
6. monocyte; lymphocyte
7. lymphocyte; basophil
8. basophil; eosinophil

Correct Answer: D

(Objective 3)

1. Which cell line is the first line of defense against helminth infections?
   1. Neutrophil
   2. Lymphocyte
   3. Monocyte
   4. Eosinophil

Correct Answer: D

(Objective 5)

1. All of the following are included in the kill mechanism by neutrophils except:
   1. Chemoattraction of neutrophils to infectious agent.
   2. Diapedesis of neutrophils from blood into tissues.
   3. The formation of the phagolysosome by the neutrophil.
   4. The presentation of the infectious agent to a monocyte for phagocytosis.

Correct Answer: D

(Objective 6)

1. An instrument printout shows a normal WBC count with a neutrophil count of 30%. What can be concluded from this?
   1. The patient is suffering from an infection.
   2. There is a normal neutrophil concentration.
   3. The patient has a relative neutropenia.
   4. The patient is an infant.

Correct Answer: C

(Objective 7, 9)

1. An instrument printout shows a WBC count of 4.5 ´ 10⁹/L with 75% neutrophils. What is the absolute neutrophil count?
   1. 1.9 ´ 10⁹/L
   2. 3.8 ´ 10⁹/L
   3. 3.4 ´ 10⁹/L
   4. 4.5 ´ 10⁹/L

Correct Answer: C

(Objective 8)

1. All of the following can cause a leukocytosis except:
   1. Malignancy
   2. Viral infection
   3. Exposure to radiation
   4. Immune responses

Correct Answer: C

(Objective 10)

1. Which of the following is associated with an increased leukocyte concentration?

1. Birth, pregnancy, infection
2. Older adults, birth
3. Older adults, pregnancy
4. Tissue necrosis, whole body irradiation

Correct Answer:  A

(Objective 10)

11. The life span of the neutrophil is spent in three compartments. Which compartment is the primary site of host defense?
12. Bone marrow
13. Liver
14. Thymus
15. Tissues

Correct Answer:  D

(Objective 5)

12. The basophil is the least plentiful cell found in the peripheral blood. What can it indicate when it is increased in the blood?
13. Infection
14. Malignancy
15. Inflammation
16. Allergic reaction

Correct Answer:  B

(Objective 10)

1. Absolute cell count calculation adjusts for what variation(s)?

1. Total WBC count
2. Differential count
3. Total WBC and differential counts
4. Total lymphocyte counts

Correct Answer:  C

(Objective 9)

14. Routine hematological analysis was performed on a 21-year-old adult. The WBC was 8.3 × 10⁹/L. This finding represents a(n):
15. Normal leukocyte count
16. Absolute leukocytosis
17. Relative leukopenia
18. Absolute leukopenia

Correct Answer:  A

(Objective 11)

15. Hematological analysis was performed on a 10-day-old baby who appeared to have difficulty breathing and had a temperature of 101.2° The WBC was 29.8 × 10⁹/L. This finding represents a(n):
16. Normal leukocyte count
17. Absolute leukocytosis
18. Relative leukopenia
19. Absolute leukopenia

Correct Answer:  B

(Objective 11)

 

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