SECTION A

INSTRUCTIONS: For each stem question write True (T) or False (F) against each answer
(a to e) provided.

1. The following cells found in the peripheral blood are granulated:

a. Monocytes
b. Red blood cells
c. Basophils
d. Neutrophils
e. Platelets

2. The following growth factors contribute to the growth and development of platelets in the
bone marrow:
a. IL-3
b. IL-6
c. Thrombopoietin
d. GM-CSF
e. IL-4

3. Thrombopoietin is produced in the following organs of the body:

a. Spleen
b. Pancreas
c. Liver
d. Kidneys
e. Salivary glands

4. The following are not functions of Thrombopoietin:

a. Promotes apoptosis of platelets
b. Suppresses proliferation of other cells derived from the CFU-GEMM
c. Decreases rate of maturation of megakaryocytes
d. Increases the number of megakaryocytes
e. Increases the rate of maturation of megakaryocytes

5. Platelets are derived from:

a. The cell membrane of megakaryoblasts
b. The cytoplasm of megakaryoblasts
c. The cytoskeleton of megakaryocytes
d. The nucleus of megakaryocytes
e. The cytoplasm of megakaryocytes
6. A megakaryocyte during its lifetime can produce approximately:
a. 2000 platelets
b. 1000 platelets
c. 6000 platelets
d. 3000 platelets
e. 4000 platelets

7. A healthy adult male has about ……………………… x 109/L platelets in circulation:

a. 100-250
b. 200-450
c. 150-400
d. 300-600
e. 50-150

8. Approximately how many platelets would be found in the spleen of an adult female with
a platelet count of 200 x 109/L?
a. 50 x 109/L
b. 100 x 109/L
c. 300 x 109/L
d. 150 x 109/L
e. 250 x 109/L

9. Platelet numbers may be found to be increased in the following conditions/situations

EXCEPT:
a. During running
b. Pregnancy
c. During jogging
d. Essential Thrombocythaemia
e. During sleep at night

10. The following are not true about the dense tubular system of a mature platelet:
a. It is in close contact with the organelle zone
b. It is derived from the smooth endoplasmic reticulum of mature megakaryocytes
c. It is the site for the sequestration of calcium
d. It is the site of production of Thromboxane A2
e. It is the site of production of serotonin
11. The delta granules of platelets contain the following:
a. Fibrinogen
b. Thromboglobulin
c. Von Willebrand factor
d. Clotting factor V
e. Calcium

12. The order of maturation in the production of granulocytes is as follows:

a. promyelocyte→myelocyte→ metamyelocyte→stab cell→granulocyte
b. myeloblast→myelocyte→stab cell→metamyelocyte→granulocyte
c. myeloblast→myelocyte→metamyelocyte→stab cell→granulocyte
d. myelocyte→myeoblast→promyelocyte→stab cell→metamyelocyte
e. promyelocyte→myelocyte→metamyelocyte→band cell→granulocyte

13. Which of the following cytokines or haemopoietic growth factors act in synergy with
other growth factors to cause myeloblasts to differentiate into specific myeloid
leukocytes?
a. IL-6
b. IL-5
c. G-CSF
d. GM-CSF
e. IL-3

14. Basophil granules contain the following EXCEPT:

a. Chondroitin
b. Histamine
c. Heparin
d. IL-6
e. IL-4

15. Basophilia may be seen in the following conditions:

a. Chicken pox
b. Varicella virus infection
c. Myxedema
d. Hypothyroidism
e. Chronic lymphocytic leukaemia
16. The following cells are forms of macrophages EXCEPT:
a. Osteoclasts
b. Langerhans cells
c. Kupffer cells
d. Histiocytes
e. Osteoblasts

17. Monocytes play a role in all the following processes EXCEPT:

a. Regulation of body calcium
b. Antigen presentation
c. Phagocytosis
d. Chemokine production
e. Dampening the effects of inflammation

18. The following are types of granules found in neutrophils:

a. Primary granules
b. Specific granules
c. Gelatinase granules
d. Azurophilic granules
e. Secondary granules

19. With H & E staining, basophil granules stain:

a. Dark brown
b. Purple red
c. Dark purple
d. Blue
e. Deep blue

20. The following substances are common to basophils and platelets:

a. Heparin
b. Histamine
c. Serotonin
d. 5-hydroxytryptophan
e. Thromboxane A2
21. The following are natural inhibitors of platelet function:
a. Nitric oxide
b. Prostacyclin
c. Nitrous oxide
d. 5-hydroxytryptophan
e. Serotonin
22. The International Organization for Standardization has established a standard which
relates various needle diameters to specific gauges. The following needle diameter: gauge
pairs are correct:
a. 19G = 1.1 mm
b. 23G = 0.6 mm
c. 17G = 1.6 mm
d. 19G = 1.1 cm
e. 25G = 0.4 cm

23. All the following are needed to set a phlebotomy tray EXCEPT:
a. Scissors
b. Scapel
c. 0.8% chlorhexidine swab
d. Puncture resistant biohazard container
e. 0.5% Bleach

24. Regarding blood storage for transfusion purposes, any of the following anticoagulants
can be used:
a. Alsever’s solution
b. Acid citrate dextrose
c. Citrate phosphate dextrose
d. Citrate phosphate dextrose adenine
e. Ringer’s lactate

25. Before one uses a specimen tube for sample collection, one must check the following
details from the tube:
a. Type of specimen tube
b. Volume of blood required
c. Storage temperature of blood
d. Expiry date of tube
e. Weight of the tube.

26. A needle can be inserted at any of these angles during venipuncture:

a. 250
b. 350
c. 150
d. 170
e. 290
27. The tourniquet can be left tied on the arm for any of these periods of time without
compromising test results:
a. 10 seconds
b. 200 seconds
c. 100 seconds
d. 50 seconds
e. 120 seconds

28. During waste disposal following venipuncture, one has to place both the needle and
syringe in:
a. The sluice room
b. The dustbin
c. A puncture resistant container
d. A biohazard bag
e. A sharps’ container

29. Sequestrene as an anticoagulant can be used in combination with other anticoagulants

such as:
a. Alsevier’s fluid
b. Heparin
c. Fluoride oxalate
d. Sodium fluoride
e. CPD

30. For the purposes of the Erythrocyte Sedimentation Rate estimation, the Trisodium citrate
: Blood ratio of:
a. 4:1 is used
b. 8:2 is used
c. 1:9 is used
d. 1:4 is used
e. 2:18 is used

31. Venipuncture should not be attempted on a/an

a. Site of haematoma
b. Site of Scarring
c. Infected arm
d. Arm receiving an infusion
e. Arm that is dislocated
32. The following anticoagulants are employed for haematological tests:
a. EDTA-Fluoride
b. K3-EDTA
c. K2-EDTA
d. Li2-EDTA
e. Lithium Heparin

33. When blood begins to lyse after two to three days of storage, the following parameters
are not affected:
a. The red cell count
b. The packed cell volume
c. The mean cell haemoglobin
d. The mean cell haemoglobin concentration
e. The haemoglobin phenotype

34. When plasma or serum is frozen, it can be allowed to thaw and refrozen up to …………
times before it loses its integrity.
a. Three
b. Two
c. Four
d. Five
e. Six

35. Excessive shaking of blood when collected into a specimen tube may cause the following
a. Cell disintegration
b. Cell enlargement
c. Partial coagulation
d. Lysis of cells
e. Autolysis

36. When taking a blood sample from a finger, it is undesirable to take the sample from the:
a. Thumb
b. Index finger
c. Ring finger
d. Third finger
e. Pinky
37. The following are true about human blood:
a. It comprises 7% to 8% of the human body weight
b. It is weakly alkaline
c. It is about 3-5 times as viscous as water
d. About 35% of blood is made up of plasma
e. The blood cells comprise about 30% of blood volume

38. Normal peripheral blood comprises 3 types of cells, namely:

a. Erythrocytes, white cells and thrombocytes
b. Red cells, white cells and thrombocytes
c. Red cells, platelets and white cells
d. Leukocytes, platelets and white cells
e. Lymphocytes, red cells and platelets

39. Which of the following white blood cells is capable of phagocytosis?

a. Basophil
b. Eosinophil
c. Lymphocyte
d. Neutrophil
e. Monocyte

40. The following pairs are correct with respect to transport of substances in the blood:
a. Haem – albumin
b. Iron – ferritin
c. Folic acid – globulin
d. Haptoglobin – extracellular haemoglobin
e. Copper – caeruloplasmin

41. Plasma cells are produced from:

a. The myelocyte lineage
b. Megakaryocytes
c. T-lymphocytes
d. Natural killer cells
e. T-helper cells
42. Monocytes:
a. Have large bluish cytoplasm
b. Have a nucleus with a cleft
c. Are large white cells with a kidney-shaped nucleus
d. Form about 2 % of circulating white cells
e. Have nuclei measuring 16 -22 µl in diameter

43. The following information about platelets is correct:

a. They are more numerous than white cells in the blood
b. Their synthesis is controlled by the hormone thrombopoietin which is chiefly/mainly
produced by the kidneys
c. They have nuclei which have been broken down to form granules
d. Their most immediate precursor cell is the megakaryocyte
e. They play a primary role in arresting bleeding.

44. The following statements are true about blood:

a. It is about 4.5 – 5.5 times as viscous as water
b. It comprises 70ml per kilogram of the body’s weight
c. It has an average density of 1060 kg/cm3
d. It has a pH that is partially alkaline
e. It is about 1.2 – 3.1 times as viscous as urine

45. The following are products of haemopoiesis EXCEPT:

a. Basophils
b. Monocytes
c. B lymphocytes
d. T lymphocytes
e. Thrombocytes

46. The following red blood cell precursors are nucleated EXCEPT:
a. Burst forming unit erythroid
b. Colony forming unit erythroid
c. Orthochromic normoblast
d. Polychromatic normoblast
e. Pronormoblast
47. The following stages of red cells can be found in the bone marrow EXCEPT:
a. Reticulocyte
b. Colony forming unit erythroid
c. Orthochromic normoblast
d. Polychromatic normoblast
e. Pronormoblast

48. Erythropoietin acts on the following red cell precursors EXCEPT:

a. Burst forming unit erythroid
b. Colony forming unit erythroid
c. Orthochromic normoblast
d. Polychromatic normoblast
e. Pronormoblast

49. The Hexose monophosphate shunt produces the following:

a. Reduced glutathione
b. Ribulose-5-phosphate
c. NADH
d. ATP
e. Glucose-6-phosphate dehydrogenase

50. The ATP produced by glycolysis in the red cell is used for the maintenance of:
a. RBC shape
b. RBC flexibility
c. RBC rigidity
d. RBC shape and flexibility only
e. RBC volume

51. The following cells are multipotent progenitor cells:

a. CFU-E
b. CFU-E0
c. GM-CSF
d. BFU-EMeg
e. CFU-GEMM
 52. The haematocrit of a healthy adult female is in the range of:
a. 36-48 L/L
b. 36-48%
c. 28-46%
d. 0.36-0.48%
e. 0.40-0.52%

SECTION B
Choose the best answer by circling one of the options (a to e) provided

53. In which of these conditions/situations can Granulocyte colony stimulating factor

(G-CSF) not be clinically applied:
a. Recovery from neutropenia
b. Granulocyte recovery in the case of post-chemotherapy
c. Granulocyte recovery in the case of post-chemotherapy and radiotherapy
d. To improve marrow function in myelodysplasia
e. Monocytopenia

54. …………………acts alone and or in synergy with other cytokines on haematopoietic

stem cells, the common myeloid progenitor cells and myeloblasts driving both
differentiation and maturation of myeloid leukocytes.
a. IL-3
b. IL-6
c. G-CSF
d. GM-CSF
e. SCF

55. Neutrophils play crucial roles in:

a. Immunity
b. The development of mammary glands
c. Wound healing
d. The regulation of inflammation
e. Allergic reactions

56. Eosinophilia is not seen in this condition:

a. Parasitic infection
b. Hypersensitivity
c. Connective tissue disorders
d. Neoplasia
e. Gastritis
57. The following growth factors influence monopoiesis EXCEPT:
a. IL-6
b. IL-3
c. G-CSF
d. GM-CSF
e. SCF

58. After blood is collected into an anticoagulant tube, it is usually stable for up to
…………….. hours when stored at room temperature.
a. 10
b. 3
c. 7
d. 9
e. 8

59. After ………………. of storage of blood at room temperature, the red blood cells begin
to …………………
a. 3 hours, shrink
b. 8 hours, swell
c. 10 hours, lyse
d. 3 hours, swell
e. 9 hours, shrink

60. When blood is stored at 40C, changes to blood cell counts and morphology is delayed up
to …………………...
a. 12 hours
b. 2 weeks
c. 3 days
d. 1 day
e. 48 hours

61. Reticulocyte counts begin to fall when blood is stored at room temperature for more than:
a. 1 hour
b. 6 hours
c. 2 hours
d. 3 hours
e. 5 hours
62. It is true that changes that occur in blood when stored at 40C are significantly reduced for
up to 24 hours. It is however, recommended that the full blood count be carried out
within……………
a. 12 hours
b. 1 hour
c. 2 hours
d. 30 minutes
e. 3 hours

63. Blood appears…………………. when infected.

a. Whitish
b. Frothy
c. Turbid
d. Icteric
e. Foamy

64. Blood that appears discoloured is indicative of ……………………...

a. Decreased haemoglobin concentration
b. Jaundice
c. Infection
d. Diabetes
e. Hypertension

65. Blood to be used for estimating the concentration of haptoglobin should be centrifuged
within ………………… of collection.
a. 5 hours
b. 3 hours
c. 1 hour
d. 4 hours
e. 2 hours

66. After 12 to 18 hours of blood storage, neutrophil (s):

a. Become more phagocytic
b. Granules are released
c. Nuclear lobes become separated
d. Vacuoles disappear
e. Nuclei stain more heterogeneously than in fresh blood
67. When blood is to be collected to assess osmotic fragility of red cells
………………….will be the most ideal anticoagulant.
a. K2-EDTA
b. K3-EDTA
c. Lithium heparin
d. Sodium fluoride
e. Trisodium Citrate

68. The following cells are found in the stromal environment of the bone marrow EXCEPT:
a. Osteoclasts
b. Osteoblasts
c. Endothelial cells
d. Megakaryocytes
e. Fat cells

69. Which of the following is not a general characteristic of myeloid and lymphoid growth
factors?
a. They are lipoproteins that act at very low concentrations
b. They act hierarchically
c. They are usually produced by many cell types
d. They usually affect more than one lineage
e. They are usually active on stem/progenitor and functional end cells

70. Which of the following vitamins is not required for erythropoiesis?

a. Vitamin B1
b. Vitamin B2
c. Vitamin B3
d. Vitamin B6
e. Vitamin B12

71. The following are committed progenitor cells EXCEPT:

a. BFU-E
b. CFU-E
c. CFU-Meg:
d. CFU-GM
e. CFU-M

72. Red cell precursors derive energy molecules (ATP) mainly from the:
a. Pentose phosphate pathway
b. Hexose monophosphate shunt
 c. Tricarboxylic acid cycle
d. Embden-Meyerhoff pathway
e. Lubering-Rapoport shunt

73. During foetal life, haemopoiesis takes place at the following sites EXCEPT:
a. Yolk sac
b. Liver
c. Spleen
d. Bone marrow
e. Kidneys

74. The following are indications for treatment with recombinant erythropoietin (Epo)
EXCEPT:
a. Anaemia of chronic renal dx
b. Myelodysplastic syndrome
c. Anaemia associated with malignancy or chemotherapy.
d. Anaemia of chronic dx e.g. Rheumatoid arthritisPolycythaemia vera
e. Polycythaemia vera

75. The following factors shift the Haemoglobin-oxygen dissociation curve to the right
EXCEPT:
a. Increased hydrogen ion concentration
b. Increased carbon dioxide
c. Increased 2,3- diphosphoglycerate
d. HbS
e. Decreased hydrogen ion concentration

76. Haemoglobin bound to carbon monoxide is called:

a. Carboxyhaemoglobin
b. Carbaminohaemoglobin
c. Methaemoglobin
d. Haemoglobin carbon monoxide
e. Oxyhaemoglobin

77. Lipids make up …………… of the red cell membrane mass.

a. 40-50%
b. 60-70%
c. 30-35%
d. 20-30%
e. 20-20%
78. ………………is an integral protein found in the red cell membrane.
a. α spectrin
b. β spectrin
c. Band 3 protein
d. Actin
e. Ankyrin

79. The P50 of normal blood is …………………………………………

a. 26.6 mmHg
b. 28.8 mmHg
c. 27.7 mmHg
d. 30.6 mmHg
e. 26.9 mmHg

80. Platelet production per day can be increased ………………when there is increased
demand for platelets.
a. 10-20 times
b. 30-40 times
c. 50-60 times
d. 2-5 times
e. 6-9 times

81. What is the percentage of the haemoglobin with the α2β2 structure in normal adult
blood?
a. 96-98 %
b. 95%
c. 90%
d. 0.5-0.8%
e. 1.5-3.2%

82. The following are found in the alpha granules of platelets EXCEPT:
a. Heparin antagonist (PF4)
b. ATP
c. Platelet-derived growth factor (PDGF)
d. Thromboglobulin
e. Fibrinogen