1) Clinical signs in acute blood loss for a volume lost up to 1000-1500 ml are : 




a) tachycardia

b) palpitation

c) shock

d) fatigue

e) absent

2) The most common type of anemia in general medical practice is : 




a) hemolytic anemia

b) megaloblastic anemia

c) sick cell disease

d) anemia due to iron deficiency

e) aplastic anemia

3) Diagnosis of anemia due to iron deficiency includes : 




a) low MCV and MCHC

b) low TIBC ( total iron binding capacity ) 




c) macrophage iron is absent or severly reduced in the marrow

d) low serum ferritin levels

e) low free erythrocyte protoporphyrin

4) Parenteral iron therapy is indicated in some of the following situations : 




a) acute blood loss

b) the patient is unable to tolerate oral iron compounds

c) anemia of chronic disease

d) the patient has also a disorder of the gastrointestinal tract ( eg. Ulcerative colitis ) 



e) megaloblastic anemia
5) Characteristic for megaloblastic anemia is : 



a) MCV > 100..^3

b) Low reticulocyte count

c) Hypersegmented neutrophils

d) Markedly elevated serum LDH activity

e) Leucopenia

6) Pernicious anemia is associated with : 




a) gastric atrophy and achlorhydria

b) blood loss

c) twofold increase in the incidence of gastric cancer

d) immune destruction of the acid and pepsin secreting cells of the stomach

e) low MCV and MCHC

7) Laboratory findings in hemolytic anemias include : 




a) increased conjugated serum bilirubin level

b) reticulocytosis

c) decreased haptoglobin level

d) hemosiderinuria

e) increased hemopexin levels

8) Therapy of autoimmune hemolytic anemias with warm reactive antibodies consists of : 




a) keeping the patient warm

b) high-dose intravenous immunoglobulins over short periods

c) glucocorticoids

d) splenectomy that cannot be controlled by steroid therapy

e) transfusion of fresh frozen plasma

9) Oclusive episodes in sickle cell anemia lead finally to chronic organ damage such as : 



a) nephritic syndrome

b) gallstones

c) pulmonary fibrosis

d) leg ulcers

e) cerebral hemorrhage

10) Acquired aplastic anemia may be due to : 




a) cytomegalovirus

b) iron deficiency

c) therapy with chloramphenicol

d) exposure to benzene and related compounds

e) hepatitis C virus

11) In the differential diagnosis between iron deficiency anemia versus anemia of chronic disease
which of the following are in favor of the latter : 



a) low serum total iron-binding capacity

b) low serum ferritin level

c) decreased stroage iron

d) elevated serum ferritin levels

e) increased storage iron

12) Thrombocytosis may be encountered in some of the following situations : 




a) pernicious anemia

b) acute posthemorrhagic anemia

c) chronic inflammatory diseases

d) chronic myelogenous leukemia ( chronic phase ) 




e) acute myelogenous leukemia
13) Thrombocytopenia may be caused by : 



a) hemorrhage

b) hemolysis

c) vitamin B12 deficiency

d) iron deficiency

e) disseminated intravascular coagulation ( DIC )

14) Therapy of Thrombotic Thrombocytopenic Purpura ( TTP, Hemolytic- Uremic Syndrome )

consists of : 



a) blood transfusion

b) intravenous immunoglobulins

c) plasma exchange

d) platelet transfusions

e) immune suppression

15) Acute disseminated intravascular coagulation ( DIC ) arises in some clinical circumstances
like : 



a) acute promyelocytic leukemia

b) infection

c) shock from any cause

d) Hodgkin´s disease

e) heavy chain disease

16) The appropriate level of anticoagulation independent of laboratory reagents for chronic oral
anticoagulants is obtained using : 



a) APTT

b) bleeding time

c) PT

d) INR

e) D-dimer level
17) Adverse prognostic factors which influence outcome of therapy in AML are : 



a) increased age at diagnosis

b) AML that develops after MDS




c) Leukocyte count >30.000

d) presence of cytogenetic abnormalities like : 5q-, 7q-

e) blass cell count > 15.000

18) The most common laboratory findings in acute leukemia are : 




a) anemia

b) thrombocytopenia

c) hypocellular bone marrow

d) hyperuricemia

e) neutropenia

19) Leukemia cells in ALL are :

a) TdT positive

b) PAS negative

c) myloperoxidase negative

d) nonspecific esterase positive

e) all of the above

20) The most powerful prognostic tool available in ALL is : 




a) leukocyte count

b) age

c) immunephenotype

d) pattern of bone marrow infiltration

e) determination of the karyotype

21) Positive diagnosis in CML is made on the bassis of some of the following : 



a) thrombocytopenia

b) anemia

c) granulocytosis with immaturity of the cells

d) basophilia

e) presence of the Ph chromosome

22) Differential diagnosis of CML must be made with : 




a) leukemoid reactions

b) megaloblastic anemia

c) polycythemia Vera

d) Idiopathic myelofibrosis

e) primary throbcytemia

23) Patients with Polycythemia Vera may present : 




a) pruritus after bathing

b) thrombotic events

c) neurologic complaints : vertigo, diplopia

d) lymphadenopathy

e) bleeding and bruising

24) Therapy of the early ( plethoric) phase of Polycythemia Vera includes : 




a) Melphalan

b) Cyclophosphamide

c) Phlebotomy

d) Hydroxyreea

e) Aspirin
25) Poor prognostic signs in Idiopathic Myelofibrosis are : 



a) unexplained fever

b) thrombocytopenia

c) anemia

d) severe hemolysis

e) hepatomegaly

26) Major indications for splenectomy in Idiopathic Myelofibrosis are : 




a) excessive transfusions requirement

b) severe thrombocytopenia

c) painful, enlarged spleen

d) failure of glucocorticoids

e) refractory hemolysis

27) Differential diagnosis of Essential ( Primary ) Thrombocythemia is made by exlusion and the
following should be demonstrated : 



a) the patient is not iron deficient and has normal to low red cell mass when iron sufficient or iron
repleted

b) the Philadelphia chromosome is absent

c) there is no evidence for myelofibrosis

d) there is no recognizable cause for secondary thrombocytosis

e) all ov the above

28) Treatment options in Essential ( Primary ) Thrombocythemia include : 




a) Busulphan

b) Hydroxyureea

c) Interferon-a

d) Anagrelide

e) Vincristin
29) A 36 year old male patient recently diagnosed with Hodgkin´s disease with the following
findings after procedures for staging completed, has cervical lymph nodes, inguinal lymph node
enlargement, grade 1 splenomegaly, abdominal lymph node mass with a maximum diamter of 8
cm; he also complains of drenching night sweats, and a weight loss of 5 kg ( his initial weight was
80kg), bone marrow biopsy is normal. He is staged

a) 2 BX


b) 3 AX


c) 3 B


d) 4 BX


e) 3 BX





30) Diagnosis of Hodgkin´s disease is made on : 



a) the symptom complex of lymph node enlargement and mediastinal adenopathy and fever

b) fine needle lymph node aspiration

c) bone marrow biopsy

d) fever, night sweats and weight loss

e) lymph node biopsy

31) Adverse prognostic factors in non-Hodgkin´s lymphoma are : 




a) more than two extranodal sites of disease

b) elevated LDH level

c) age < 60 years

d) T-cell versus B-cell Lymphomas

e) presence of anemia at diagnosis

32) Which of the following statements is/are correct in regard to non-Hodkin´s Lymphoma : 



a) NHL are usually disseminated at diagnosis

b) Splenectomy is mandatory for staging NHL 




c) Radiotherapy is alone can cure high grade NHL



d) Stage is determinant for therapeutical strategy

e) 80-85% of NHL are of T-cell origin

33) NHL must be differentiated from : 



a) ALL

b) metastatic carcinoma

c) primary TB with hilar adenopathy

d) pseudolymphoma

e) Hodgkin´s disease

34 ) Stage C ( Binnet ) CLL is characterized by : 




a) lymphocytosis > 10.000

b) platelets < 100.000

c) > 3 sites of lymphadenopathy

d) Hb < 11g/dl

e) lymphocytes in the bone marrow > 30%

35) Which of the following statements is/are correct regarding CLL 




a) therapy is not indicated until active progression or symptoms occur

b) treatment has not been proven to prolong survival

c) patients with CLL are more likely to develop second malignancies

d) predisposition to infection is due to hypogammaglobulinemia and granulocytopenia

e) Lymphocytosis > 100.000 is an adverse prognostic factor

36) Chemotherapy in CLL includes : 




a) L-Asparaginase

b) Chromambucil

c) Hydrocyureea

d) Fludarabine

e) Cytosine- arabinoside
37) Diagnosis of Wladenstroms Macroglobulinemia is sustained by : 



a) very high ESR

b) high total serum proteins levels

c) monoclonal lgG on immuelectrophoresis

d) evidence of Bence-Jones protein in the urine

e) monoclonal lgM on immuelectrophoresis

38) In which of the following situations can a diagnosis of multiple myeloma be made : 



a) monoclonal serum lgG= 6.0 g/dl; lgA= 0.03 mg/dl

b) marrow plasmacytosis=17%, monoclonal lgA=1,6 g/dl, lgM= 0.06g/dl, lgG= 0.8 g/dl

c) marrow plasmacytosis= 56%, lytic bone lesions, monoclonal lgG=6.2 g/dl

d) marrow plasmacytosis=12%, monoclonal lgA=1,2 g/dl, lgG=0.9 g/dl, lgM=0.04 g/dl

e) marrow plasmacytosis=8%, lytic bone lesions, lgG=1g/dl

39) Which of the following statements is/are true in regard to multiple myeloma ? 



a) serum level of ß2-microglobulin correlates with myeloma cell mass

b) serum creatinine and serum uric acid are frequently elevated

c) proteinuria is uncommon due to renal impairment

d) ESR is markedly elevated

e) Lymphadenopathy is a common feature

40) Unfavorable prognostic signs in multiple myeloma are : 




a) elevated ESR

b) elevated serum beta2-microglobulin levels

c) hypercalcemia

d) thrombocytopenia

e) anemia
41) Which of the following diseases are frequently associated with spleen enlargement : 



a) immunologic thrombocytopenic purpura

b) thrombotic thrombocytopenic purpura

c) immune hemolytic anemia

d) thalassemia

e) idiopathic myelofibrosis