Parasitology and other -أهم الأسئلة اللي جات بالهيئة

هذا الموقع لتدريب لـ Prometric Laboratory مقارب لاختبارات الهيئه نوعا ما  http://www.labce.com/start.aspx ======================== Parasitology - parasite in blood :- 1.Trypanosoma . 2.Malaria . 3.Leishmania . 4.Toxoplasmosis . - parasite in blood :- 1.Trypanosoma :-. - trypanosome habitat blood . - Intermediate = the bite tse tse flay . - infection stage = stum by trypanosome . - Diagnostic by = trypanosome in blood . - trypanosome move by flagella . - trypanosome type :- 1. trypanosome cruzi : cause chagas disease . 2. trypanosome gambienes : cause sleeping sickness . 3. trypanosome rhodesienes : cause sleeping sickness .  2.Malaria :- - Malaria habitat blood . - Intermediate = female mosquito . - infection stage = sporozoites . - in malaria RBC are lysis . - malaria detection by Thick blood film . - type of malaria :- 1. plasmodium vivax = cause Enlarges RBC . 2. plasmodium falciparum = cause malignant malaria . is most abundant prevalence.  3. plasmodium malariae . 4. plasmodium ovale.  3.Leishmania :- - Leishmania is intercellular parasite . - Leishmania cause tow disease :- Visceral Leishmania and cutaenous Leishmania . - transmits by = sand flay . - infection stage = larva . - use stain fields stain and gimsa stain . - Leishmania tropica cause oriental sore disease.  - Leishmania donovani { Visceral Leishmania } cause kala-azar and black fever . 4.Toxoplasmosis :-  - diagnosis by = serology test . - intermedia host = human . - man may acquire from cats . * - Toxoplasma gondii :- - non motile protozoa . - this organism multiply intracellular parasite.  - can cause fetal cerebral infection . - the definitive host is animal.  - human is not definitive host . - parasite in urine :- 1. schistosoma haematobium :- - habitat pelvic plexus . - infection stage = cercaria . - Diagnostic stage = egg in urine . - mode of infection = cercaria penetrates skin . - cause Egyption haematuria . 2.Trichomonas vaginalis :- - habitat = vagina , urethra , prostate . - infection stage = trophozoite . - diagnosis by = trophozoite in vagina , prostatic secretion , and urine . - can be detected in vaginal and urethral discharge . - protozoa in sexual reproduction .  - parasite in stool :- 1. schistosoma masoni :- - habitat = Mesernteric plexus . - infection stage = cerecaria . - mode of infection = cercaria penetrates skin . - diagnostic stage = Egg in Faeces . 2. Taenia saginta :- - habitat = small intestine . - infection stage = cysticercus bovies . - mode of infection = ingestion undercooked beef .  - diagnostic stage = Egg in Faeces . 3. Giardia lamblia :- - habitat = duodenum . - infection stage = cyst . - diagnostic stage = trophozopte and cyst in faeces . 4. hymenolepis nana { dworf worm } :- - habitat = small intestine . - infection stage = cysticercoid . - mode of infection = ingestion of egg or inseet .  - diagnostic stage = Egg in Faeces . 5. Entamoeba histplytica :- - habitat = large intestine . - infection stage = mature cyst . - mode of infection = ingestion of mature cyst . - diagnostic stage = trophozopte and cyst in faeces . 6. Enterobius vermicularis :- - habitat = large intestine . - infection stage = Embrgonated egg . - Diagnostic stage = Egg on perianal region. 7. Ascaris lumbricoides :- - habitat = small intestine . - infection stage = Embrgonated egg or larva  - mode of infection = swallowing water or vegetables .  - diagnostic stage = fertilized Egg in Faeces. 8.Diphylobthrium latum :- - habitat = small intestine . - infection stage = plerocercoid larva in fish muscle .  - mode of infection = ingestion of undercooked fish .  - diagnostic stage = Egg in Faeces . 8. fasciola :- - habitat = bile duct of man . - infection stage = encysted metacercaria on grass or in water .  - mode of infection = ingestion of raw vegetation or water .  - diagnostic stage = Egg in Faeces . 9. Heterophyes heterophyes :- - habitat = small intestine . - infection stage = encysted metacercaria in fish muscle .  - mode of infection = ingestion undercooked fish .  - diagnostic stage = Egg in Faeces . 10.Trichuris trichiura :-  - habitat = large intestine { caecum } . - infection stage = Embryonated egg .  - mode of infection = swallowing water or vegetables .  - diagnostic stage = Egg in Faeces . 10. Hookworms :- - habitat = small intestine . - infection stage = filariform larva .  - mode of infection = when the filaiform larva penetrates his intact skin or mucous membrane of the mouth .  - diagnostic stage = Egg in Faeces . 11. strongyloids stercoralis :- - habitat = small intestine . - infection stage = Embryonated egg .  - mode of infection = when the filaiform larva penetrates his intact skin or mucous membrane of the mouth . - diagnostic stage = Rhabdpitiform larva in Faeces . أهم الأسئلة اللي جات بالهيئة  2010 1. . chagas disease caused by ? Trypanosome cruzi .  2. . malaria diagnosis by ? Thick blood film . 3. taenia saginate diagnosis by ?  Egg in stool . 4. Ascaris lumbricoides infection stage ? Embeyonated egg . 5. Rice water stool can cused by ? Vibrreo cholera . 6. lactobacilli isolated in ? Stool . 7. yellow brown barrel-shapped egg , coloeless produce plug polar is ? Trichuris trichiura 8. parasite cause cerevral malaria ? plasmodium falciparum . 9. infection stage of ancytlostoma ? Larva  10. transmitte through sexual intercourse ? Trichomonas vaginalis . 12. human scabies diagnose by ? skin scraping of lesion . 13 - Cause Kala- azar: a- leishmania tropica b- leishmania braziliense c- leishmania donovani d- leishmania mexicana 14- cause oriental sore: a- plasmodium ovale b- leishmania tropica c- leishmania donovani d- trypanosoma rhodesiense 15- infective stage of S.mansoni  A- embrynoated egg B- larva C- cercaia D- oocyst 16- The cause of sleeping sickness: a- trypanosoma gambiense b- trypanosoma cruzi c- trypanosoma rhodesiense d- (a) & (c) Blood of microfilaria infection diagnostic with: - Intracellular parasite - Not find in the flam photometer: Photo - Presence one from this substance in urine detect abnormal condition - Use for clean slide - Meaning of calcitionin - Pyrimdin base - One of the above not present in Diabetic Mellitus coma - In a blood group the Ab in serum is - Most sever (serious) malaria infection caused by: - Alkline phosphates is the important enzme to detect function in: - Steilization by the oven is best accomplished at: - What practical cardilipin is applicable in laboratory work: - Amaylase value is high in the following disease: - Miligram >>> 10^-3 g - Rbcs male normal value is: - Anti-coagulante is better for blood agar: - One is not found (involve) in colormetric: - The smallest molecular weight Ig is: - Function of pili of bacteria: - Hb A is consisting of: - Direct ant-antibody test used to detect: - Detection of malaria parasite with persent at RBCs: - A child diagnose show scarlet fever the cause is : - Increase of hemolytic jaundice one is not likely to be found: - One is not true about acid: Turn limus paper to blue - One is not true about alkaline: Turn limus paper to red - Iodine stain entamobae cyst used to detect (diagnose): Nuclei - Most common method (technique) used to detect hormone amound in the laboratory: - Leukocyte responsible for cellular immunity: - One stage prothrombin time used to detect (diagnose) disorders in: - Leukocyte responsible for response to parasite & allergic infection: [HEMATOLOGY 1- Vitamin K antagonist : a- warfarin b- Heparin c- Protein C d- Antithrombin III 2- One of the intrinsic pathway a- factor XI b- factor XIII c- factor I d- factor VII 3- Para hemophilia is the deficiency of a- factor VIII b- factor IX c- factor V d- factor VII 4- Eosinophilia is seen in : a- food sensitivity b- Drug sensitivity c- Atopic dermatitis d- all of the above 5- Multiple myeloma is a neoplastic proliferation of: a- lymphocytes b- Granulocytes c- Plasma cells d- Monocytes 6- Test for intrinsic pathway: a- bleeding time b- Thrombin time c- Prothrombin time  d- Partial thromboplastin time PTT 7- Paul-Bunnel test is done to diagnose: a- multiple myeloma b- Hodgkin’s disease c- Infectious mononucleosis d- all of the above 8- increased platelet count is : a- thrombocytopenia b- thrombopoietin c- thrombocytosis d- all of the above 9- Decreased platelet count is: a- thrombocytopenia b- Thrombopoietin c- Thrombocytosis d- all of the above 10- All these are causes of thrombocytopenia except: a- cytotoxic drugs b- Aplastic anemia c- Hemorrhage d- Radiotherapy 11- Prothrombin time is done to test: a- Intrinsic pathway only b- Extrinsic pathway only c- Extrinsic and common pathways d- Intrinsic and common pathways 12- Normal bleeding time by Duke’s method: a- 2-7 minutes b- 2-7 seconds c- 2-4 minutes d- 2-4 seconds 13- Normal partial thromboplastin time (PPT) is : a- 3-4 minutes b- 30-45 seconds c- 12-15 seconds d- 12-15 minutes 14- Hemophilia A is the deficiency of : a- factor V b- factor VIII c- factor IX d- all of the above 15-the most common form of leukemia in children is: a- acute lymphoblastic leukemia b- Chronic lymphocytic leukemia c- Acute myeloid leukemia d- Chronic myeloid leukemia 16- Bence-Jones protein is present in cases of: a- chronic myeloid myeloma b-acute myeloid myeloma c- Hodgkin’s lymphoma d- multiple myeloma 17- Reed-Sternberg cells are found in cases of : a- acute lymphoblastic leukemia b- Non Hodgkin’s lymphoma c- Hodgkin’s lymphoma d- Multiple myeloma 18- Normal platelet count is : a- 150,000 to 450,000/min3 b- 400,000 to 800,000/min3 c- 4,000 to 11,000 /min3 d- 50,000 to 100,000/min3 19- Antithrombin III inhibits: a- factor Va b- factor VIIIa c- factor Xa d- all of the above 20- Heparin potentiate the action of : a- protein C b- protein S c- antithrombin III d- warfarin 21- Factor II of blood clotting is: a- Christmas factor b- Fibrinogen c- Prothrombin d- Thromboplastin 22- One of fibrinogen group is : I V VIII XIII a- II b- V c- VII d- IX 23- Fibrinogen is converted to soluble fibrin by: a- prothrombin b- Thromboplastin c- Thrombin d- all of the above 24- Thrombopoitin control the formation of: a- red blood cells b- White blood cells c- platelets d- non of the above 25- Normal prothrombin time (PT) is: a- 30-45 seconds b- 30-45 minutes c- 12-15 seconds d- 12-15 minutes 26- Parasitic disease is associated with: a- monocytosis - bacteria b- Lymphocytosis - virus c- Basophilia - sensitive d- Eosinophilia 27- Philadelphia chromosome is diagnostic for: a- acute lymphoblastic leukemia b- Acute myeloid leukemia c- Chronic lymphocytic leukemia d- chronic myeloid leukemia 28- Normal fibrinogen level: a- 150-400 gm% b- 150-400 mg % c- 15-40 mg % d- 15-40 gm % 29-infectious mononucleosis is caused by: a- echo virus b- coxsaki virus c- Epstein Barr virus EBV d- Cytomegalo virus 30- Atypical lymphocytosis is seen in cases of: a- Hodgkin’s lymphoma b- Multiple myeloma c- Infectious mononucleosis d- Chronic lymphocytic leukemia 31-monospot test is done to diagnose: a- Acute myeloid leukemia b- Acute lymphoblastic leukemia c- Infectious mononucleosis d- Infectious lymphocytosis 32- The test which depend on blood platelets & capillary fragility is: a- prothrombin time b- Thrombin time c- Bleeding time d- Clotting time 33- Fibrin is broken to fibrin degradation products by the action of: a- Prothrombin b- Thrombin c- Plasminogen d- Plasmin 33- Fibrin is broken to fibrin degradation products by the action of: a- Prothrombin b- Thrombin c- Plasminogen d- Plasmin 34- Acute myeloid leukemia is characterized by: a- low neutrophil alkaline phosphatase b- Myeloblast with Auer rods c- Neutrophil with Pleger-Huet anomaly d- all of the above 35- Plasminogen is converted to plasmin by : a- Heparin b-Histamine c- Urokinase d- Serotonin 36- Increase D-dimers and fibrin degradation products are seen in cases of: a- Hemophilia A b- Vitamin K deficiency c- Diffuse intravascular coagulation d- Von Willebrand disease 37- Activated protein C degrades: a- factor IXa b- Factor VIIIa c- Factor Xa d- Factor Xia 38- Heparin is found in a- Neutrophil b- Basophil c- Acidophil d- all of the above 39- In hemophilia A the test which will be prolonged is a- PT b- PTT c- Bleeding time d- all of the above 40- Bleeding due to overdose of heparin is managed by giving: a- Vit K b- Vit C c- Vit A d- Protamin sulphate 41- Streptokinase and staphylokinase convert: a- Prothrombin to thrombin b- Fibrinogen to fibrin c- Soluble fibrin to insoluble fibrin d- Plasminogen to plasmin 42- Test for platelet function: a- Clot retraction b- Platelet aggregation c- Platelet adhesion d- all of the above 43- Prolonged PT occurs in cases of deficiency of: a- Factor III b- Factor IV c- Factor V d- all of the above 44- normal thrombin time (TT): a- 30-45 sec b- 2-4 min c- 3-9 min d- 10-20 sec 45- cause of vitamin K deficiency: a- Obstructive jaundice b- Prolonged use of antibiotics c- Inadequate intake d- all of the above 46- Cause of Hyper- Coagulable state: a- Aplastic anemia b- Cytotxic drugs c- Polcythemia d- Radiotherapy 47-Physiological cause of neutrophilia: a- New born b- Radiotherapy c- Cytotoxic drugs d- Prolonged use of antibiotics 48- Leucocytosis characterized by the presence of immature cells and high neutrophil alkaline phosphatase: a- chronic myeloid leukemia b- Acute myeloid leukemia c- Leukaemid reaction d- non of the above 49- Normal coagulation time (CT): a- 3-9 min b- 3-9 sec c- 30-40 sec d- 30-40 min 50- The test which measures the clotting time of citrated plasma accelerated by the addition of a clotting factor activator (kaolin) , phospholipids and calcium: a- coagulation time b- Prothrombin time c- Partial thromboplastin time d- Thrombin time 51- The test which measures the clotting time of citrated plasma to which thromboplastin and calcium has been added: a- thrombin time b- Prothrombin time c- Coagulation time d- Partial thromboplastin time 52- The test which is widely used as a control and follow up test to control anticoagulant treatment: a- APTT b- PTT c- PT d- TT 53- A disease characterized by progressive neoplastic proliferation of immature white cell precursor: a- acute leukemia b- Chronic leukemia c- Lymphoma d- Multiple myeloma 54- The absolute lymphocyte count may be up to 300,000 or more between 70 and 90 % of white cells in the blood film appear as small lymphocytes . THE CASE IS: a- Acute myeloid leukemia b- Acute lymphoblastic leukemia c- Chronic myeloid leukemia d- Chronic lymphocytic leukemia 55- Variation in red cells size: a- Poikilcytosis b- Anisocytosis c- Reticulocytosis d- Leukocytosis 56- Dark red cells with no area of central pallor: a- Stomatocyte b- Spherocyte c- Acathocyte d- Schistocyte 57- Microcytic hypochromic anemia a- hereditary spherocytosis b- Sickle cell anemia c- Iron deficiency anemia d- Vit B12 deficiency anemia 58- Target cells are seen in cases of: a- folic acid deficiency b- Iron deficiency anemia c- Vit B12 deficiency anemia d- Thalassemia 59- Red cells with elongated area of central pallor: a- spherocyte b- Schistocyte c- Stomatocyte d- Elliptocutes 60- ……………….. Symmetric, short , sharp projection from the red cells and seen   in iron deficiency anemia: a- echinocyte b- Acanthocyte c- Elliptocyte d- Ovalocyte 61- ……………… is a condition in which the absorption of vit B12 is greatly impaired due to failure or marked reduction of intrinsic factor secretion: a- fauvism b- fanconi’s anemia c-sickle cell anemia d- thalassemia e- pernicious anemia 62- Hyperchromic cells are seen in: a- iron deficiency anemia b- Thalassemia c- Hereditary spherocytosis d- Sickle cell anemia 63- A prolonged low rate of bleeding results in: a- normochromic anemia b- Hypochromic anemia c- Hyperchromic anemia d- non of the above 64- Schilling test is done in diagnosis of: a- iron deficiency anemia b- Pernicious anemia c- Aplastic anemia d- folic acid deficiency 65- Defective synthesis of either alpha or beta chains of normal hemoglobin cause: a- sickle cell anemia b- Aplastic anemia c- Pernicious anemia d- Thalassemia 66- Neutrophils represent…………… of circulating leukocyte: a- 2-8 % b- 0-1 % c- 50-70 % d- 2-4 % 67- …………. are non nucleated, biconcave shaped cells: a- platelet b- Leukocyte c- Erythrocyte d- Macrophages 68- …………….. represent 50-70 % of total leukocytes a- lymphocytes b- Neutrophils c- Monocytes d- Eosinophilis 69- …………… have a characteristic biffed nucleus and their cytoplasm is filled with large refractile granules that stain red in blood smear a- neutrophils b- Eosinophilis c- Basophiles d- Lymphocytes 70- The cell which is responsible for antibody production is: a- moncytes b- T-lymphocytes c- B-lymphocytes = plasma cell d- Neutrophils 71- …… is a curved cell with sharp ends seen in haemoglobinopathies (HBS) a- sickle cell b- Spherocyte c- Ovalocyte d- Stomatocyte 72- All of the following is correct about sickle cell anemia except: a- leg ulcers b- Gall stones c- Enlargement of spleen d- Attacks of pain 73- ……….. is a single, large, rounded , dark , purple remnant of nucleus a- Heinz body b- Howeel-Jolly body c- Pappenheimer body d- Cabot ring 74- Agranulocyte: a- neutrophil b- Lymphocyte c- Basophile d- Eosinophil 75- Pica ( craving to eat unusual substance such as clay or ice) is one of the symptoms of: a- G6PD deficiency b- Thalassemia c- Megaloblastic anemia d- Iron deficiency anemia 76- In …………….. there’s a decreased or absent hemosiderin in bone marrow a- sideroblastic anemia b- Iron deficiency anemia c- Megaloblastic anemia d- Hemolytic anemia 77- Chloramphenicol may cause …………. anemia in long term therapy a- iron deficiency b- Vit B12 deficiency c- folic acid deficiency d- Aplastic anemia 78- ………. is the fluid (with anticoagulant) component of blood , it contains salt & organic compounds: a- plasma b- Serum c- Hemoglobin d- Billirubin 79- Poikilocytosis is: a- variation in red cell size b- Variation in red cell color c- Variation in red cell shape d- non of the above 80- Red cell fragments: a- echinocyte b- Elliptocyte c- Schistocyte d- Stomatocyte 81- It is a defect of red cell member a- Thalassemia b- Sickle cell anemia c- Hereditary spherocytosis d- Megaloblastic anemia 82- All of the following is correct regarding spherocytosis except: a- normocytic normochromic anemia b- Decreased reticulocyte count c- Raised plasma bilirubin d- Increased osmotic fragility 83- Heinz bodies are seen in cases of a- hereditary spherocytosis b- Hereditary elliplocytosis c- G6PD deficiency d- sickle cell anemia 84- ……………… is caused by substitution of amino acid (valine) instead of glutamic acid at position No.#6 in the beta chain of hemoglobin a- Hb-A b- Hb-A2 c- Hb –F d- Hb –S sickle cell 85- Atrophy of the spleen is seen in cases of: a- Thalassemia b- Sickle cell anemia c- G6PD deficiency d- Hereditary elliplocytosis 86- iron deficiency lead to : a- normocytic normochromic anemia b- microcytic hypochromic anemia c- macrocytic anemia d- hemolytic anemia 87- Neurological symptoms are seen in cases of: a- iron deficiency anemia b- folic acid deficiency c- Vit B12 deficiency d- all of the above 88- Megaloplastic hematopoiesis is seen in cases of: a- iron deficiency anemia b- folic acid deficiency c- Vit B12 deficiency d- Vit C deficiency 89- Fanconi’s anemia is a type of : a - vit B12 deficiency b- aplastic anemia c- Thalassemia d- folic acid deficiency anemia 90- the most abundant leukocyte in a normal blood smear of adult is : a- lymphocyte b- Monocyte c- Eosinophil d- Neutrophil 91- The first line of defense against parasites: a- neutrophils b- Basophile c- Eosinophil d- Lymphocyte 92- …………….. play a role in immediate and delayed hypersensitivity: a- monocyte b- Lymphocyte c- Eosinophil d- Basophile 93- The largest leukocyte is : a- neutrophils b- Lymphocyte c- Monocyte d- Basophile 94- Cell which participate in cell mediated immunity: a- monocyte b- B- lymphocyte c- T- lymphocyte d- neutrophils 95- ……… promotes blood clotting and help to prevent blood loss from damaged blood vessels: a- platelets b- WBCs c- RBCs d- all of the above 96-antibody induced hemolytic disease in new born that is caused by blood group incompatibility between mother and fetus: a- hemolytic uremic syndrome b- Erythroblastosis fetalis c- Hereditary spherocytosis d- Thromboloc thrombocytopenic purpurea 97- Young red blood cell with cytoplasmic RNA: a- spherocyte b- Reticulocyte c- Stomatocyte d- elliptocyte 98- Normal adult hemoglobin tetramer is: a- 2 alpha : 2 gama b- 2 alpha : 2 beta c- 2 alpha : 2 delta d- 2 beta : 2 gama 99- …………… represent 2-4 % of total leukocyte: a- neutrophils b- Basophile c- Eosinophil d- Monocyte 100- ………… are small cytoplasmic fragment derived from megakaryocytic: a- RBCs b- WBCs c- Platelet d- non of the above 101 - ………….. is the reduction in the amount of circulating hemoglobin , red blood cells or both: a- polycythemia b- Anemia c- Hemophilia d- Leucopenia 102- Thalassemia is : a- microcytic anemia b- Macrocytic anemia c- Normocytic anemia d- non of the above 103- Vit B12 deficiency lead to : a- hemolytic anemia b- Microcytic anemia c- Normocytic anemia d- Megaloblastic anemia 104- Lymphocyte represent ………….. of total leukocyte: a- 20-40 % b- 50-70 % c- 2-8 % d- 1-5 % 105- Plumer- Vinson syndrome may be seen in cases of: a- iron deficiency anemia b- Vit B12 deficiency anemia c- Aplastic anemia d- folic acid deficiency anemia 106- peripheral, pale inclusions that push out the cell membrane and composed of hemoglobin: a- cabot ring b- Pappenheimer body c- Howell-Jolly body d- Heinz body 107- it’s an acute hemolytic anemia occurring after the ingestion of broad bean in individual with deficiency of G6PD : a-thalassemia b- Favism c- Fanconi’s anemia d- Cooley’s anemia 108-………………. is a multiple small , peripheral grape like purple clusters of iron: a- cabot ring b- Heinz body c- Howell-Jolly body d- Pappenheimer body 109- the blood smear gives the physician information concerning: a- morphology of RBCs and platelet b- Presence of abnormal inclusion c- Presence of immature cells d- all of the above 110- hypersplenism is one of the causes of : a- iron deficiency anemia b- Hemolytic anemia c- Aplastic anemia d- Megaloblastic anemia 111- Increased reticulocytes count is seen in cases of: a- hereditary spherocytosis b- G6PD deficiency c- Sickle cell anemia d- all of the above 112- The antibody which can pass the placenta: a- Ig M b- Ig G c- Ig D d- Ig E 113- ……… is an autoimmune disease in which there is an immune destruction of the acid and pepsin secreating cells of the stomach: a- fanconi’s anemia b- cooley’s anemia c-pernicious anemia d- non of the above 114- All of these are laboratory features of aplastic anemia except: a- pancytopenia b-markedly hypocellular marrow c- Increased reticulocyte count d- Markedly increase in serum erythropoietin 115- Secondary granules of neutrophils contain: a- elastase b- Myeloperoxidase c- Lysozyme d- Histamine 116- Monocytes represent ………………. of total leukocyte: a- 0-1 % b- 2-4 % c- 2-8 % d- 20-4 % 117- the reagent used for leukocyte count is : a- citric acid b- Acetic acid c- Hydrochloric acid d- Sulphoric acid BACTERIOLOGY 118- All are Prokaryotic cells except: a- Fungi b- Bacteria c - Chlamydia d- Mycoplasma 119- Viruses: a- Contain only DNA or RNA b - They Contain ribosome c- Did not affected by antibiotics d- a+c 120- All of these are essential structure except: a- Nuclear body b- Spores c- Cell wall d- Plasma Membrane 121- ________ is giving the shape to the bacteria a.- Cytoplasmic Membrane b- Capsule c- Cell Wall d- All of the above 122- One of its functions is selective permeability a- Cell wall b- Plasma membrane c- Capsule d- Spores 123- They are responsible for Haemagglutination Phenomenon a- Flagella b- Fimbria c- Capsule d- Cell wall 124- Clostridium Tetani is: a- Atrichous bacteria b- Mono-trichous bacteria c- Amphi-trichous bacteria d- Peri-trichous bacteria 125- Short curved or straight rods, motile by single polar flagellum a- spirochaeta b- Vibrio c- Escherichia d- Lactobacillus 126- Small gram negative cocci, occur in pairs a- staphylococcus b- streptococcus c- neisseria d- non of the above 127- Transfer of genetic information from one bacterium to another by bacteriophages is: a. Transformation b. Tansduction c. Conjugation d. Mutation 128- Salmonella are: a- Obligatory Aerobic bacteria b.- Obligatory Anaerobic bacteria c- Facultative Anaerobic bacteria d- Micro-aerophilic bacteria 129- According to pH, vibrio cholera is a- Osmophilic bacteria b- Basophilic bacteria c- Acidophilic bacteria d- Neutrophilic bacteria 130- Staphylococci are: a- Atrichous bacteria b- Mono-trichous bacteria c- Amphi-trichous bacteria d- Peri-trichous bacteria 131- During replication of DNA, copying errors may occur and this is called a- Conjugation b- Transduction c- Transformation d- Mutation 132- Obligatory Anaerobic bacteria a- grow only in presence of oxygen b- grow only in absence of oxygen c- grow either in presence or absence of oxygen d- grow in presence of oxygen traces and 5 – 10% CO2 133- Neutrophilic bacteria grow well at a- pH 8.5 – 9.0 b- pH 7.2 – 7.4 c- pH 5.0 – 5.5 d- pH 2.5 – 3.0 134- The rate of cell death increase and bacterial growth stopped, this is a- Adaptation phase b- Exponential phase . c- Stationary phase. d- Decline Phase 135- Beta-hemolytic a- Cause complete hemolysis of RBC’s b- Cause chemical change of Hemoglobin in RBC’s c- Do not cause hemolysis d- None of them 146- Mesophilic bacteria grow at: a- 37°C b- 14°C c- 60°C d- 120°C 137- Circulation of Bacteria and its toxins in blood a- Pyaemia b- Toxemia c.- Bacteremia - without toxins d- Septicemia 138- Disinfections that applied on living or injured tissues: a- Sterilization b- Antiseptic c- Sanitation d- Decontamination 139- Hot air oven is used for sterilization of a- Glass b- Rubber Gloves c.- Plastic Syringes d- Catheters 140- Disinfectant for superficial fungal infection a- Phenol b- Potassium permanganate c- Chlorine d- Hypochlorite compounds 141- Rifampin a- inhibit cell wall synthesis b- inhibit protein synthesis c- inhibit folic acid pathway d- inhibit mRNA synthesis 142- Transacetylase inactivate a- aminoglycosides b- chloramphenicol c- penicillin d- cephalosporins 143- The color of gram positive bacteria is a- Yellow b- Black. c- Pink d- Violet 144- Selective media for fungi a- blood agar b- Mac Conkey agar c- Nutrient agar d- Sabourand’s dextrose agar 145- Histoplasma is a : a- Systemic mycosis b- Sub – Cutaneous mycosis c- Cutaneous mycosis d- Superficial mycosis 146- All are asexual spores produced by mould except a- Conidio – spores b- Sporangio – spores c- Endospores d- Arthro – spores 147- They reproduce only by Asexual reproduction a- Blastomycosis b- Deutromycosis c- Ascomycetes d- Zygomycetes 148- The functions of cell wall is all of the following except: a- Giving the shape to the bacteria b- Carrying somatic antigen c-Selective permeability& transport of solutes = plasma membrane d- Protect the bacteria from plasmolysis 149- Atrichous Bacteria are: a- Bacteria contain one flagellum b- Bacteria contain 2 flagella c- Bacteria without flagella d- Bacteria with a tuft of flagella 150-__________ are essential for host cell attachment: a- Flagella b- Fimbria c- Spores d- Capsules 151- Irregular clusters of spherical cells: a- Streptococcus b- Staphylococcus c- Lactobacillus d- Escherichia 152- Clostridium Botulinum is: a- Obligatory Aerobic Bacteria b- Facultative Anaerobic Bacteria c- Obligatory Anaerobic Bacteria d- Micro- aerophilic Bacteria 153- Basophilic Bacteria grow well at: a- pH 8.5 – 9.0 b- pH 7.2 – 7.4 c- pH 5.0 – 5.5 d- None of the above 154- Cells are divided at high & constant rate: a- Decline Phase b- Stationary Phase c- Log Exponential Phase d- Adaptation Phase 155- The dominant bacterial species in dental plaque are: a- Coagulase Negative Staphylococci b- Lactobacillus c- Bacteroides d- Streptococcus Sanguis 156- The spread of Pyogenic Bacteria in blood stream to different organs & produce multiple abscess is: a- Septicemia b- Bacteremia c-Toxemia d- Pyaemia 157- Inhibit the growth of micro organisms a- Bacteriostatic b- Bactericidal c- Fungicidal d- Germicidal 158- To sterilize fluid damaged by heat: a- Gaseous Sterilization b- Heat Sterilization c- Filtration d- Ionizing Radiation 159- For water disinfection we use: a- Hydrogen peroxide b- Formaldehyde c- Chlorine d- Hypochlorite compounds 160- Mechanism of action of penicillin: a- Block peptidoglycan synthesis b- Inhibit peptidyglycan cross – linking c- inhibit folic acid pathway d- inhibit protein synthesis 161- Sulfonamides: a- inhibit cell wall synthesis b- inhibit protein synthesis c- inhibit DNA synthesis d- inhibit folic acid pathway 162- Acetylase inactivates: a- B – Lactam antibiotics b- Aminoglycosides c- Cloramphenicol d- All of the above 163- Ringworm disease is caused by a- Zygomycetes b- Ascomycetes c- Blastomycosis d- None of the above 164- For wet – mount technique we add: a- NaoH b- K oH c- H2 O2 d- All of the above 165- They are transmitted by arthropods a- Chlamydia b- Spirochetes c- Mycoplasma d- All of the above 166- In the past they were listed as large viruses a- Richettsia b- Mycoplasma c- Chlamydia d- None of the above 167- Bacteria multiply by: a- Replication cycle b- Simple binary fission c- Sexual reproduction d- All of the above 168- It protects bacteria from antibiotics a- Capsule b- Cell membrane c- Flagella d- Fimbria 169- Vibro cholera is: a- Mono –trichous bacteria b- Atrichous bacteria c- Lopho-trichous bacteria d- Peri-trichous bacteria 170- Short rods, motile by peritrichous flagella a- Spirochaeta b- Lactobacillus c- Escherichia coli d- Vibrio 171- To take up soluble DNA fragments derived from other, closely related species is: a. Mutation b. Transformation c. Transduction d. Conjugation 172- Tuberculosis are a- micro-airophilic b- Facultative anaerobic c- Obligatory anaerobic d- Obligatory aerobic 173- According to pH, Lactobacillus is a- Neutrophlic bacteria b- Acidophilic bacteria c- Basophilic bacteria d- None of the above 174- Bacteria without cell Wall a- Chlamydia b- Rickettsia c- Mycoplasma d.- Spirochetes 175- Brucella Melitensis is a- Obligatory aerobic bacteria b- Obligatory anaerobic bacteria c- Facultative anaerobic bacteria d- Micro-aerophilic bacteria 176- Pseudomonas aeroginosa is a- Peri-trichous bacteria b- Lopho-trichous bacteria c- Amphi-trichous bacteria d- Monotrichous bacteria 177- Genetic information of bacteria is carried on a- Messenger RNA b- Transfer RN|A c- Tran****** RNA d- Double – Stranded DNA 178- Thermophilic bacteria grow at a- 60 – 80 °C b- 0 - 20°C c-. 37°C d- 100 - 120°C 179- Acidophilic bacteria grow at a- pH 7.2 – 7.4 b- pH 5.0 – 5.5 c- pH 8.5 – 9.0 d- None of the above 180- Mycoplasma is a- Neutrophilic bacteria b- Acidophilic bacteria c- Basophilic bacteria d- All of the above 181- It is the adaptation of bacteria to the fresh medium a- Lag phase b- Decline phase c- Logarithmic Phase d- Stationary phase 182- Bacteria which do not cause hemolysis is a- Beta-Hemolytic b- Alpha-Hemolytic c- Gama Hemolytic d- None of the above 183- Normal flora of Lower intestine are all of the following except: a- Staphylococci b- Diphtheroids c- Shigella d- Lactobacillus 184- Opportunistic pathogens are all of the following except: a- Cause a disease when the host defense are suppressed. b- Are normal flora of healthy body c- Are greatly harmful d- Do not invade the body or tissue. 185- For disinfection of mattresses : a- Hot air oven b- Autoclave c- Ethylene Oxide d- Hydrogen Peroxide 186- Pyschrophilic bacteria grow at: a- 10٠°C b- 6٠°C c- 14°C d- 37°C 187- Bacteria which contain chlorophyll a- Heterotrophic bacteria b- Autotrophic bacteria c- Photosynthetic bacteria d- All of the above 188- Tricophyton is one of a- Yeast b- Moulds c- Dermatophyte d- Dimorphic Fungi 189- Plastomyces is one of a- Dermatophytes b- Dimorphic Fungi c- Yeast d- Moulds 190- Color of gram negative bacteria is a- Violet b- Green c- Red d- Black 191- Acid Fast Bacteria a- Salmonella b- Shigella c- M. Tuberculosis d- E – Coli 192- Spherical or avoid cells occurring in chains a- Staphylococci b- Streptococci c- Lactobacillus d- Spiro chaeta 193- ……………… carries the genetic information a- the envelope b- the capsid c- the nucleic acid d- the prion 194- …………………… may be seen under light microscope a- rota virus b- influenza virus c- herps virus d- pox virus 195- viruses may be: a- monomorphic b- pleomorphic c- dimorphic d- all of the above 196- viral capside is formed of: a- protein b- glycogen c- lipoprotein bilayer d- glycoprotein 197- class III in Baltimor classification is: a- double stranded DNA viruses b- single stranded DNA viruses c- double stranded RNA viruses d- single stranded RNA viruses 198- Hierarchial virus classification system use the following characters except: a- nature of nucleic acid b- capside symmetry c- diameter of viron & capside d- virus molecular weight 199- in viral replication which is true: a- penetration is the 1st step b- assembly is the last step c- relaease is the last step d- all of the above 200- viron: a- may be extracellular phase of virus b- may be intracellular phase of virus c- can grow and replicate d- means “ virus – like “ 201- pleomorphic viruses means : a- virus which have constant shape b- virus that may appear in 2 forms c- virus that have not a constant morphology d- virus that have spherical shape 202- vapor of gold is used in : a- shadow casting technique b- negative staining technique c- positive staining technique d- non of the above 203- direct diagnosis of virus : a- ELISA Antibody b- CFT c- IFT d- PCR virus 204- all of the following are required in cell culture except: a- neutral PH b- presence of buffer salts c- presence of antibiotics d- incubation at 20 C (( 30-37 C)) 205- all of the following are diagnostic molecular biological technique except: a- PCR b- ELISA c- nucleic acid hyperdization d- DNA finger printing 206- PCR require all of the following except: a- extracted DNA template b- 2 specific primers c- reation buffer d- RNA polymerase 207- bacteriophage is : a- virus that can be killed by antibiotic b- virus that act like a bacteria c- bacteria that act like a virus d- virus that infect bacteria 208- all of the following viruses are transmitted by blood except: a- HIV b- HBV c- HCV d- herps virus 209-all of the following are RNA viruses except: a- corona viridase b- reoviridase c- picorona viridase d- pox viridase 210- penetration of naked virus is by : a- fusion b- endocytosis c- translocation d- all of the above 211- amniotic cavity inoculation is one type of virus culture in: a- tissue wall b- lab animals c- embryonated egg d- non of the above 212- …………….. is an invitro method amplification of a short sequence of target DNA a- PCR b- hyberdization c- finger printing d- all of the above 213- nucleic acid hyberdization means: a- probe anneling or binding with it’s complementary segment of NA b- fragmentation of nucleic acid c- amplification of nucleic acid d- non of the above 214- DNA hyberdization is performed by: a- primers b- DNA labeled probe c- restriction endonuclease d- non of the above 215-PCR starts with : a- annealing b- denaturation of DNA c-extension of primers d- non of the above 216- ……………….. is a piece of DNA fragment of a particular gene that can bind specially with it’s complementary piece of DNA: a- codon b- probe c- LCR d- code 217- how many primers are used in PCR : a- non b- one c- two d- three 304-Lowenstein-Jensen media is used for the isolation for: a- neisseria gonorrhea b- mycobacterium tuberculosis c- haemophilus influenza d- staphylococcus aureus 305- Hekton-Enteric agar is the selective media for: a- salmonella b- streptococcus c- staphylococcus d- all of the above 306- the selective media for isolation of fungi is: a- S-S agar b- XLD agar c- sabouraud glucose agar d- Hekton-Enteric agar 307- gram positive rods with Chinese letter appearance: a- mycobacterium tuberculosis b- corynebacteria diphtheria c- clostridium tetani d- staphylococcus pneumonia 308- E lek test is done to diagnose : a- streptococcus b- staphylococcus aureus c- clostridium tetani d- corynebacteria diphtheria 309- all are lactose fermenter except: a- E-COLI b- proteus c- klebsiella d- enterobacter 310- produce pale colonies on MacConkey’s agar and have tendency to swarm on blood agar: a- salmonella b- shigella c- klebsiella d- proteus 311- lactose frementer gram negative bacilli with mucoid growth: a- salmonella b- shigella c- klebsiella d- proteus 312-non lactose fermenter gram negative bacilli produce H2S : a- salmonella b- shigella c- klebsiella d- proteus 313- Widal test is done for diagnosis of : a- salmonella b- shigella c- E-coli d- klebsiella 314- the causative agent of enteric fever: a- salmonella b- shigella c- klebsiella d- proteus 315- the most common cause of urinary tract infection : a- E-coli b- salmonella c- shigella d- streptococcus 316- an important cause of diarrhea in infant: a- staphylococcus b- E-coli c- salmonella d- shigella 317- the most common causative agent for peptic ulcer : a- campylobacter b- H-pylori c- V-cholera d- all of the above 318- TCBS is the selective media for isolation of: a- H-pylori b- V-cholera c- E-coli d- H influenza 319- gram negative bacilli strict aerobes grows on simple media producing a characteristic greenish pigment: a- campylobacter b- pseudomonas c- pasterulla d- bordetella 320- the bacteria which cause scarlet fever: a- staphylococcus b- streptococcus c- salmonella d- shigella 321- antistreptolysin O titer (ASO) is done for the diagnosis of: a- group A streptococcus b- group B streptococcus c- staphylococcus aureus d- staphylococcus albus 323- Loffler’s serum is used for isolation of: a- anthrax b- clostridium c- diphtheria d- T.B 324- gas gangrene is caused by: a- clostridium tetani b- clostridium botulinum c- clostridium welchii d- non of the above (( clostridium perfinges )) 325- Bacillary dysentery is caused by: a- salmonella b- shigella c- cholera d- all of the above 326- the cause of plague: a- Y-enterocolitica b- Y-pestis c- Y pseudotuberculsois d- non of the above 327- treponema palladium is the cause of : a- T.B b- gonorrhea c- syphilis d- AIDS 328- the venereal disease research laboratory test (VDRL) is done for diagnosis of: a- T.B b- gonorrhea c- syphilis d- AIDS 329- Trachoma is caused by: a- mycoplasma b- chlamydiae c-richettsia d- mycobacteria 391- M-tuberculsis bacilli stain with : a- gram stain b- Zheil Nelson stain c- Gimesa stain d- all of the above 392- AIDS is transmitted through : a- food b- blood c- semen d- (b) & (c) 393- bacteria which cause syphilis: a- Neisseria gonorrhea b- Viencent angina c- Treponema palladium d- Yersinia pestis 394- to diagnose syphilis: a- RPR b- VDRL c- Wasserman d- all of the above 395- streptococci secret: a- streptolysin O b- streptolysin S c- streptokinase d- all of the above 396- disease caused by streptococci: a- scarlet fever b- purperal sepsis c- rheumatic fever d- all of the above 397- staphylococci secrets: a- coagulase enzyme b- fibrinolysin c- hyaluronidase d- all of the above 398- gram positive bacilli: a- Klebsilla b- Salmonella c- Proteus d- C-diphtheria 399- meningeococcal meningitis is transmitted by : a- food b- droplet c- touch d- all of the above 400- dark field microscopy is used to diagnose : a- T.B. b- syphilis c- gonorrhea d- AIDS 401- it cause food poisining with flacid paralysis: a- clostridium tetani b- clostridium welchii c- clostridium botulinium d- all of the above 402- the infective stage of plasmodium vivax : a-merozoites b- sporozoites c- schizont d- trophozoite 403- Pirenella conica snail is the intermediate host of: a- schistosoma haematobium b- fasciola hiptica c- heterphyes heterophyes d- diphyllobothrium latum 404- Bulinus truncates snail is the intermediate host of : a- fasciola hepatica b- fasciola gigantica c- schistosoma haematobium d- schistosoma mansonii 405- to isolate meningiococci we have to culture the sample on: a- Bordet Gengou b- modified Thayer martin media c- Lowenstein Jensen media d- all of the above 406- to isolate fungi : a- Brain-Heart infusion media b- tissue culture c- Lowenstein –Jensen media d- chocolate agar 407- to isolate H- influenza: a- blood agar b- chocolate agar c- mac Conkey media d- all of the above 408- the bacteria which cause pseudomembrainous conjunctivitis : a- N.gonorrhea b- C. diphtheria c- staphylococcus d- Chlamydia 409- the best sample to diagnose meningitis : a- blood b- sputum c- CSF d- urine 410- used to stain Chlamydia a- gram stain b- giemsa stain c- wright stain d- all of the above 411-……….. is used as transport medium for sample in which cholera is suspected a- Cary-Blair media b- Stuart media c- Alkaline peptone water d- glycerol 412- the color of XLD medium: a- green b- red c- yellow d- blue 413- CIN medium is used to isolate: a- E.coli b- Vibrio cholera c- yersinia d- salmonella 414- to make wet mount preparation: a- 10 % KOH b- 10 % Na OH c- 10 % Na CO3 d- 10% Na Cl 415- we do wet mount preparation for vaginal smear To diagnose: a- T.vaginalis b- N.gonorrhea c- streptococci d- staphylococci 416- to isolate viruses: a- Loeffler media b- tissue culture c- Bordet –Gengou media d- Brain- Heart infusion 417- to diagnose whooping cough : a- Bordet –Gengou media b- Lowenstein –Jensen media c- modified Thayer martin media d- New York city agar 418- to diagnose systemic infection we do : a- urine culture b- CSF culture c- blood culture d- sputum culture 419- we give no growth for blood culture after: a- 1 week b- 8 weeks c- 6 weeks d- 3 weeks 420- to dissolve mucous in sputum sample : a- 10% NaOH b- 30 % NaOH c- 10 % KOH d- 10% NaCl 421- mutualism means: a- one partener benefits , other unaffected b- both partner benefit c- one partner benefit , other damaged d- living together 422- Commensalisms means: a- living together b- one partner benefit , other damaged c- both partner benefit d- one partner benefits , other unaffected 423- Balantidium coli moves by: a- flagella b- cilia d- pseudopod d- all of the above 424- Mouth inhabitant: a- Trichomonas hominis b- Trichomonas tenax c- Trichomonas vaginalis d- giardia lamblia 425- Transmitted by sexual intercourse: a- toxoplasma b- giardia lamblia c- Trichomonas vaginalis d- all of the above 465- citrate utilization test is done to assist identification of: a- gram +ve bacteria b- gram –ve bacteria c- entrobacteria d- enterococcus 466- the Kovac's reagent used in the following biochemical tests: a- catalase b- coagulase c- indole d- methyl red 467- positive results for H2S production appear as …. Colour: a- black c- yellow c- red d- green 468-………. Give positive coagulase test: a- streptococci b- staphylococcus aureus c- staphylococcus saprophyticus d- Escherichia coli 469- methyl red test is performed with: a- Erlich reagent b- Kovac's reagent c- Voges proskaur d- non of the above 470- ………… give positive result with urease test: a- salmonella b- shigella c- Y. enterocolitica d- all of the above 471-…………. test is used to differentiate between bacteroides & brucella: a- indole b- methyl red c- H2S production d- nitrate reduction 472- DNAase test is positive with: a- streptococcus pneumonia b- E.coli c- staphylococcus aureus d- staphylococcus epidermis 473- ………… solution used in the gram stain technique acts as a mordant: a- crystal violet b- safranine c- iodine d- alcohol 474- the counter stain in Ziehl- Neelson stain is : a- malachite green b- methylene blue c- iodine d- (a) & (b) 475- bile solubility test is positive with : a- streptococcus viridans b- streptococcus pneumonia c- streptococcus agalectiae d- streptococcus pyrogenes 1- Vitamin K antagonist : a- warfarin b- Heparin c- Protein C d- Antithrombin III 2- One of the intrinsic pathway a- factor XI b- factor XIII c- factor I d- factor VII 3- Para hemophilia is the deficiency of a- factor VIII b- factor IX c- factor V d- factor VII 4- Eosinophilia is seen in : a- food sensitivity b- Drug sensitivity c- Atopic dermatitis d- all of the above 5- Multiple myeloma is a neoplastic proliferation of: a- lymphocytes b- Granulocytes c- Plasma cells d- Monocytes 6- Test for intrinsic pathway: a- bleeding time b- Thrombin time c- Prothrombin time d- Partial thromboplastin time PTT 7- Paul-Bunnel test is done to diagnose: a- multiple myeloma b- Hodgkin’s disease c- Infectious mononucleosis d- all of the above 8- increased platelet count is : a- thrombocytopenia b- thrombopoietin c- thrombocytosis d- all of the above 9- Decreased platelet count is: a- thrombocytopenia b- Thrombopoietin c- Thrombocytosis d- all of the above 10- All these are causes of thrombocytopenia except: a- cytotoxic drugs b- Aplastic anemia c- Hemorrhage d- Radiotherapy 11- Prothrombin time is done to test: a- Intrinsic pathway only b- Extrinsic pathway only c- Extrinsic and common pathways d- Intrinsic and common pathways 12- Normal bleeding time by Duke’s method: a- 2-7 minutes b- 2-7 seconds c- 2-4 minutes d- 2-4 seconds 13- Normal partial thromboplastin time (PPT) is : a- 3-4 minutes b- 30-45 seconds c- 12-15 seconds d- 12-15 minutes 14- Hemophilia A is the deficiency of : a- factor V b- factor VIII c- factor IX d- all of the above 15-the most common form of leukemia in children is: a- acute lymphoblastic leukemia b- Chronic lymphocytic leukemia c- Acute myeloid leukemia d- Chronic myeloid leukemia 16- Bence-Jones protein is present in cases of: a- chronic myeloid myeloma b-acute myeloid myeloma c- Hodgkin’s lymphoma d- multiple myeloma 17- Reed-Sternberg cells are found in cases of : a- acute lymphoblastic leukemia b- Non Hodgkin’s lymphoma c- Hodgkin’s lymphoma d- Multiple myeloma 18- Normal platelet count is : a- 150,000 to 450,000/min3 b- 400,000 to 800,000/min3 c- 4,000 to 11,000 /min3 d- 50,000 to 100,000/min3 19- Antithrombin III inhibits: a- factor Va b- factor VIIIa c- factor Xa d- all of the above 20- Heparin potentiate the action of : a- protein C b- protein S c- antithrombin III d- warfarin 21- Factor II of blood clotting is: a- Christmas factor b- Fibrinogen c- Prothrombin d- Thromboplastin 22- One of fibrinogen group is : I V VIII XIII a- II b- V c- VII d- IX 23- Fibrinogen is converted to soluble fibrin by: a- prothrombin b- Thromboplastin c- Thrombin d- all of the above 24- Thrombopoitin control the formation of: a- red blood cells b- White blood cells c- platelets d- non of the above 25- Normal prothrombin time (PT) is: a- 30-45 seconds b- 30-45 minutes c- 12-15 seconds d- 12-15 minutes 26- Parasitic disease is associated with: a- monocytosis - bacteria b- Lymphocytosis - virus c- Basophilia - sensitive d- Eosinophilia 27- Philadelphia chromosome is diagnostic for: a- acute lymphoblastic leukemia b- Acute myeloid leukemia c- Chronic lymphocytic leukemia d- chronic myeloid leukemia 28- Normal fibrinogen level: a- 150-400 gm% b- 150-400 mg % c- 15-40 mg % d- 15-40 gm % 29-infectious mononucleosis is caused by: a- echo virus b- coxsaki virus c- Epstein Barr virus EBV d- Cytomegalo virus 30- Atypical lymphocytosis is seen in cases of: a- Hodgkin’s lymphoma b- Multiple myeloma c- Infectious mononucleosis d- Chronic lymphocytic leukemia 31-monospot test is done to diagnose: a- Acute myeloid leukemia b- Acute lymphoblastic leukemia c- Infectious mononucleosis d- Infectious lymphocytosis 32- The test which depend on blood platelets & capillary fragility is: a- prothrombin time b- Thrombin time c- Bleeding time d- Clotting time 33- Fibrin is broken to fibrin degradation products by the action of: a- Prothrombin b- Thrombin c- Plasminogen d- Plasmin 34- Acute myeloid leukemia is characterized by: a- low neutrophil alkaline phosphatase b- Myeloblast with Auer rods c- Neutrophil with Pleger-Huet anomaly d- all of the above 35- Plasminogen is converted to plasmin by : a- Heparin b-Histamine c- Urokinase d- Serotonin 36- Increase D-dimers and fibrin degradation products are seen in cases of: a- Hemophilia A b- Vitamin K deficiency c- Diffuse intravascular coagulation d- Von Willebrand disease 37- Activated protein C degrades: a- factor IXa b- Factor VIIIa c- Factor Xa d- Factor Xia 38- Heparin is found in a- Neutrophil b- Basophil c- Acidophil d- all of the above 39- In hemophilia A the test which will be prolonged is a- PT b- PTT c- Bleeding time d- all of the above 40- Bleeding due to overdose of heparin is managed by giving: a- Vit K b- Vit C c- Vit A d- Protamin sulphate 41- Streptokinase and staphylokinase convert: a- Prothrombin to thrombin b- Fibrinogen to fibrin c- Soluble fibrin to insoluble fibrin d- Plasminogen to plasmin 42- Test for platelet function: a- Clot retraction b- Platelet aggregation c- Platelet adhesion d- all of the above 43- Prolonged PT occurs in cases of deficiency of: a- Factor III b- Factor IV c- Factor V d- all of the above 44- normal thrombin time (TT): a- 30-45 sec b- 2-4 min c- 3-9 min d- 10-20 sec 45- cause of vitamin K deficiency: a- Obstructive jaundice b- Prolonged use of antibiotics c- Inadequate intake d- all of the above 46- Cause of Hyper- Coagulable state: a- Aplastic anemia b- Cytotxic drugs c- Polcythemia d- Radiotherapy 47-Physiological cause of neutrophilia: a- New born b- Radiotherapy c- Cytotoxic drugs d- Prolonged use of antibiotics 48- Leucocytosis characterized by the presence of immature cells and high neutrophil alkaline phosphatase: a- chronic myeloid leukemia b- Acute myeloid leukemia c- Leukaemid reaction d- non of the above 49- Normal coagulation time (CT): a- 3-9 min b- 3-9 sec c- 30-40 sec d- 30-40 min 50- The test which measures the clotting time of citrated plasma accelerated by the addition of a clotting factor activator (kaolin) , phospholipids and calcium: a- coagulation time b- Prothrombin time c- Partial thromboplastin time d- Thrombin time 51- The test which measures the clotting time of citrated plasma to which thromboplastin and calcium has been added: a- thrombin time b- Prothrombin time c- Coagulation time d- Partial thromboplastin time 52- The test which is widely used as a control and follow up test to control anticoagulant treatment: a- APTT b- PTT c- PT d- TT 53- A disease characterized by progressive neoplastic proliferation of immature white cell precursor: a- acute leukemia b- Chronic leukemia c- Lymphoma d- Multiple myeloma he absolute lymphocyte count may be up to 300,000 or more between 70 and 90 % of white cells in the blood film appear as small lymphocytes . THE CASE IS: a- Acute myeloid leukemia b- Acute lymphoblastic leukemia c- Chronic myeloid leukemia d- Chronic lymphocytic leukemia 55- Variation in red cells size: a- Poikilcytosis b- Anisocytosis c- Reticulocytosis d- Leukocytosis 56- Dark red cells with no area of central pallor: a- Stomatocyte b- Spherocyte c- Acathocyte d- Schistocyte 57- Microcytic hypochromic anemia a- hereditary spherocytosis b- Sickle cell anemia c- Iron deficiency anemia d- Vit B12 deficiency anemia 58- Target cells are seen in cases of: a- folic acid deficiency b- Iron deficiency anemia c- Vit B12 deficiency anemia d- Thalassemia 59- Red cells with elongated area of central pallor: a- spherocyte b- Schistocyte c- Stomatocyte d- Elliptocutes 60- ……………….. Symmetric, short , sharp projection from the red cells and seen   in iron deficiency anemia: a- echinocyte b- Acanthocyte c- Elliptocyte d- Ovalocyte 61- ……………… is a condition in which the absorption of vit B12 is greatly impaired due to failure or marked reduction of intrinsic factor secretion: a- fauvism b- fanconi’s anemia c-sickle cell anemia d- thalassemia e- pernicious anemia 62- Hyperchromic cells are seen in: a- iron deficiency anemia b- Thalassemia c- Hereditary spherocytosis d- Sickle cell anemia 63- A prolonged low rate of bleeding results in: a- normochromic anemia b- Hypochromic anemia c- Hyperchromic anemia d- non of the above 64- Schilling test is done in diagnosis of: a- iron deficiency anemia b- Pernicious anemia c- Aplastic anemia d- folic acid deficiency 65- Defective synthesis of either alpha or beta chains of normal hemoglobin cause: a- sickle cell anemia b- Aplastic anemia c- Pernicious anemia d- Thalassemia 66- Neutrophils represent…………… of circulating leukocyte: a- 2-8 % b- 0-1 % c- 50-70 % d- 2-4 % 67- …………. are non nucleated, biconcave shaped cells: a- platelet b- Leukocyte c- Erythrocyte d- Macrophages 68- …………….. represent 50-70 % of total leukocytes a- lymphocytes b- Neutrophils c- Monocytes d- Eosinophilis 69- …………… have a characteristic biffed nucleus and their cytoplasm is filled with large refractile granules that stain red in blood smear a- neutrophils b- Eosinophilis c- Basophiles d- Lymphocytes 70- The cell which is responsible for antibody production is: a- moncytes b- T-lymphocytes c- B-lymphocytes = plasma cell d- Neutrophils 71- …… is a curved cell with sharp ends seen in haemoglobinopathies (HBS) a- sickle cell b- Spherocyte c- Ovalocyte d- Stomatocyte 72- All of the following is correct about sickle cell anemia except: a- leg ulcers b- Gall stones c- Enlargement of spleen d- Attacks of pain 73- ……….. is a single, large, rounded , dark , purple remnant of nucleus a- Heinz body b- Howeel-Jolly body c- Pappenheimer body d- Cabot ring 74- Agranulocyte: a- neutrophil b- Lymphocyte c- Basophile d- Eosinophil 75- Pica ( craving to eat unusual substance such as clay or ice) is one of the symptoms of: a- G6PD deficiency b- Thalassemia c- Megaloblastic anemia d- Iron deficiency anemia 76- In …………….. there’s a decreased or absent hemosiderin in bone marrow a- sideroblastic anemia b- Iron deficiency anemia c- Megaloblastic anemia d- Hemolytic anemia 77- Chloramphenicol may cause …………. anemia in long term therapy a- iron deficiency b- Vit B12 deficiency c- folic acid deficiency d- Aplastic anemia 78- ………. is the fluid (with anticoagulant) component of blood , it contains salt & organic compounds: a- plasma b- Serum c- Hemoglobin d- Billirubin 79- Poikilocytosis is: a- variation in red cell size b- Variation in red cell color c- Variation in red cell shape d- non of the above 80- Red cell fragments: a- echinocyte b- Elliptocyte c- Schistocyte d- Stomatocyte 81- It is a defect of red cell member a- Thalassemia b- Sickle cell anemia c- Hereditary spherocytosis d- Megaloblastic anemia 82- All of the following is correct regarding spherocytosis except: a- normocytic normochromic anemia b- Decreased reticulocyte count c- Raised plasma bilirubin d- Increased osmotic fragility 83- Heinz bodies are seen in cases of a- hereditary spherocytosis b- Hereditary elliplocytosis c- G6PD deficiency d- sickle cell anemia 84- ……………… is caused by substitution of amino acid (valine) instead of glutamic acid at position No.#6 in the beta chain of hemoglobin a- Hb-A b- Hb-A2 c- Hb –F d- Hb –S sickle cell 85- Atrophy of the spleen is seen in cases of: a- Thalassemia b- Sickle cell anemia c- G6PD deficiency d- Hereditary elliplocytosis 86- iron deficiency lead to : a- normocytic normochromic anemia b- microcytic hypochromic anemia c- macrocytic anemia d- hemolytic anemia 87- Neurological symptoms are seen in cases of: a- iron deficiency anemia b- folic acid deficiency c- Vit B12 deficiency d- all of the above

Best Wishes: Dr.Ehab Aboueladab, Tel:01007834123 Email:ehab10f@gmail.com,ehababoueladab@yahoo.com

bilirubin

ماهو ال bilirubin ? هو أحد نواتج تحلل كريات الدم الحمراء كيف ينتج ال bilirubin ? نخاع العظام bone marrow يقوم بعملية انتاج كرات الدم الحمراء فى الطحال spleen يحدث تحلل لكرات الدم الحمراء اذا تقدمت فى العمر او حدث لها damage ينتج عن هذا التحلل -----------< ال hemoglobin -----------------< الذى يتكسر الى ---------------< ال heme + globin ال globin------------------<يتحول الى amino acids ال heme ------< يتحول الى uncongugated bilirubin -------< يتحد مع ال albumin -----------, يتوجه الى ال liver فى ال liver يتحد ال uncong bilirubin + golcuronic acid ----- water soluble compound <-------- congugated bilirubi ال congugated bilirubin يتوجه الى الحويصلة الصفراوية bile duct -------------< ينزل مع ال small intestine<--------bile فى الأمعاء تقوم البكتريا بتحويل بعض من ال cong bili الى -------------------urobilinogen"redused form " , urobilin "oxidixed form " و الباقى ينزل مع ال feces فى حالة اذا كان هناك أمراض فى الكبد أو مشكلة فى الحوصلة الصفراوية --------------< يظهر ال congugated bilirubin فى الurine يعطيه لون غامق أهمية ال bilirubin : اذا كانت نسبته معقولة فهو يحمى الجسم من ال free radicals زيادة ال bilirubin : - يزداد بسبب أمراض فى الكبد أو حصوات فى المرارة  - بعض الأدوية مثل ال antispasmodics  - فى حالة الأطفال حديثى الولادة :عندهم مشكلتين : 1- الكبد مازال لا يؤدى وظيفته جيدا  2- عندهم نقص فى ال intestinal bacteria  لذلك تلاحظ أن لون ال feces عند الأطفال المولودين باهت أعراض زيادة ال bilirubin : لون الجلد و بياض العين يكون لونهم أصفر "juandice

Best Wishes: Dr.Ehab Aboueladab, Tel:01007834123 Email:ehab10f@gmail.com,ehababoueladab@yahoo.com

Urine

Urine

I. Physical properties of urine:

A. Volume:

1. Normally: 800 -2000 ml / day.

2. Polyuria is the urine excretion of more than 2000 ml/day. It is caused by:

a) Physiological polyuria as in high fluid intake (water, tea), and high protein diet (the end product of protein metabolism is urea which causes osmotic diuresis).

b) Pathological polyuria as in diabetes mellitus (glucose causes osmotic diuresis) and in diabetes insipidus due to lack of antidiuretic hormone. (Note: diabetes means increased urine volume).

c) Oliguria and anuria: Even under condition of severe water restriction, an individual usually excretes at last 500 ml urine/day. Oliguria is the excretion of less than 500 ml/ day. Anuria is the excretion of less than 125 ml / day. They may be caused by:

1) Physiological oliguria as in low fluid intake and at hot weather due to excessive sweating.

2) Pathological oliguria or anuria as in urinary obstruction (by stones or tumor), excessive vomiting and diarrhea or due to shock and hemorrhage.

B. Odor:

1. Fresh urine has an aromatic odor.

2. On standing, for any length of time, urine gets the odor of ammonia due to decomposition of urea by bacteria and release of ammonia.

3. Some diets and medicine may change urine odor.

C. Color:

1. Normally, urine is pale or amber yellow.

2. Dilute urine is pale yellow, while concentrated urine appears almost deep orange.

3. The color of urine is due to 2 pigments; urochrome and urobilin.

4. Variations of urine color may result from many metabolic products, drugs and foods.

a) Red or red brown color due to hematuria.

b) Yellow-brown or green-brown due to jaundice.

D.Aspect (appearance):

1. Normally, freshly voided urine is transparent.

2. Turbid urine may be associated with the presence of abnormal constituents e.g. pus (pyuria), red cells (hematuria), chyle (chyluria) and crystals (calcium phosphate or urate).

E. Specific gravity (urine relative mass density):

1. Specific gravity (SG), of any liquid is its density compared with the density of distilled water, which has a density of 1,000. (Liquid density / water density).

2. Normally, the specific gravity of urine collected over 24-hours ranges 1015-1025.

3. The higher the urine specific gravity, is the more the dissolved solids in urine e.g. urea, uric acid, sugar.

4. Urine specific gravity indicates the concentrating power of the kidney.

5. Variations of specific gravity:

a) Decreased in cases of dilute urine as in diabetes insipidus.

b) Increased in cases of concentrated urine as in diabetes mellitus.

F. Urine pH:

1.  Normally, urine pH is acidic (about 6).

2. Acidity of urine results from conversion of basic phosphate (Na₂HPO₃) into acid phosphate (NaH₂PO₃) in distal convoluted tubules of the kidney.

3. After meals, urine pH becomes less acidic. This is due to the formation of gastric HCl is associated with absorption of more bicarbonate. The later is then excreted in urine making it alkaline. This process is called alkaline tide.

4. Low urine pH (below 6): may be associated with:

a) High protein diet.

b) Metabolic and respiratory acidosis.

c) Urinary tract infection by a type of bacteria called: E.coli.

5. High urine pH (above 6): may be associated with:

a) High citrus fruits and vegetables.

b) Administration of some alkalies as sodium bicarbonate.

c) Potassium depletion, as it leads to alkalosis.

G.Deposits (sediments):

1. Normally, urine contains no visible deposits.

2. Upon centrifugation, one or more of the following deposits may appear by using microscope:

a) Pus cells which are dead leucocytes (pyuria): It indicates urinary tract infection.

b) Red cells (hematuria).

c) Epithelial cells: Squamous epithelium is normally present in female urine. They are derived while urine passing female genital tract. Columnar or transitional epithelium are derived from kidney, ureter or bladder due to a variety of causes e.g. infection.

d) Parasites and ova: e.g. bilharzial ova.

e) Casts: These are cylindrical structures formed from mucoproteins in the distal convoluted tubules. After formation, they become loose and go down the tubules into the urine. They indicate chronic glomerulonephritis.

f) Crystals: as urate, oxalate, and phosphate crystals.

II.Normal constituents of urine:

Organic materials	Inorganic materials
Urea, Ammonia, Creatinine Creatine, Uric acid, Amino acids, Proteins, Sugars Others	Sodium (Na+), Potassium (K+), Chloride (CI-) Bicarbonate (HCO3-), Phosphate, Sulfate

A. Nonprotein nitrogenous compounds

1. Urea:

a) It is end product of protein metabolism. It is the main

solute in urine.

b) Normally it ranges 20-40 g/day.

c) It is formed in the liver, and excreted by the kidney.

d) It constitutes about 85% of the total urinary nitrogen.

2. Ammonia:

 a) Normally it is about 0.7 g/day.

b) Ammonia in urine is derived from deamination of amino acids mainly glutamine:

c) Formation of ammonia by the kidney is increased in acidosis as in diabetes mellitus. In alkalosis, ammonia is almost absent in urine.

3. Creatinine and creatine:

a) Normally creatinine excretion is about 1.4 g/day, while creatine excretion ranges 0-0.2 g/day.

b) Creatinine (anhydrous creatine) is the end product of creatine metabolism.

c) Creatinine excretion depends on muscle bulk of the individual and not on diet.

4. Uric acid:

a) It is end product of purine metabolism.

 b) Normally it is about 0.5 g/day.

c) Uric acid is either derived exogenously from diet or endogenously from breakdown of tissue nucleoproteins in liver.

d) Uric acid is acidic because it contains 3 enol groups (C-OH) that can give (H⁺) ions.

e) Uric acid solution is alkaline in reaction. This is because uric acid is slightly soluble in water but highly soluble in alkalis. So, the alkaline reaction of uric acid is due to the alkali in which uric acid is dissolved and not uric acid itself.

f) Uric acid excretion is increased in leukemia, severe liver disease and gout.

g) Allanation is a substance derived from partial oxidation of uric acid in birds. Human urine contains very small amount of allanation.

5. Amino acids:

a) Normally it ranges 150-200 mg/day.

6. Other nonprotein nitrogenous compounds: excreted in urine include hippuric acid, indican, purines and coproporphyrins.

B. Proteins: proteins as such are excreted in urine In very small amounts (less than 30 mg/liter).

C.Sugars: 50 % of people excrete 2-3 mg/dl after heavy meal.

D. Other organic constituents: include ascorbic acid, ketone bodies, oxalic acid, phenols as well as some hormones, vitamins and enzymes.

E. Inorganic constituents: as Na⁺, K⁺, CI^-, HCO₃^- phosphate and sulfate.

III.Abnormal constituents of urine:

A. Sugars:

1. Glucose: Normally less than 0.1 gram glucose is excreted per day. Causes of glycosuria (excessive excretion of glucose)

2. Fructose: (fructosuria), galactose (galactosuria) and pentose (pentosuria):

3. Lactose (lactosuria): presence of lactose in urine, it may occur in mothers during pregnancy, lactation and the weaning period.

B. Proteins (proteinuria):

1. Normal urine contains very little amount of proteins (less than 30 mg/liter). These are:

a) Albumin and globulins (30 %).

b) Mucoproteins of renal origin called: Tamm Horsfall

mucoprotein (70%).

 2. Microalbuminuria is the excretion of proteins (30-200 mg/liter). It indicates early affection of kidney as in diabetes mellitus. It cannot be detected by ordinary methods and needs special techniques for its detection.

3. Proteinuria: It is the presence of protein in urine (more than 200 mg/liter). It is characteristic of all acute and chronic kidney diseases:

a) Most excreted proteins are albumin (albuminuria) due to its low molecular weight and higher plasma concentration compared with globulins.

b) Proteinuria (albuminuria) may be classified into:

1) Prerenal proteinuria: as in heart failure due to renal venous congestion.

2) Renal proteinuria: due to kidney affection (glomerular) as in glomerulonephritis, or tubular as in pyelonephritis).

3) Postrenal proteinuria: due to lower urinary tract affection as inflammation or tumor of urinary bladder.

4)  Other proteins in urine:

a) Bence Jones protein:

It is an abnormal type of globulins (light chains of immunoglobulins), present in urine of patients suffering from multiple myeloma (malignant plasma cells). It is precipitated at 50°-60°C, dissolved at 100°C and re-precipitated on cooling.

b) Hemoglobin (hemoglobinuria):

It indicates intravascular hemolysis as in malaria and hemolytic anemia.

c) Myoglobin (myoglobinuria): It indicates massive muscle damage as in burns and severe electric shock.

c. Ketone bodies (ketonuria):

1. Normally, less than 18 mg of ketone bodies are excreted per day.

2. Ketonuria is the presence of ketone bodies in the urine in abnormal concentrations.

3. Ketonuria may occur associated with ketosis in any condition where carbohydrate utilization is impaired e.g. starvation, carbohydrate poor diet and diabetes mellitus.

D. Bilirubin:

1. The presence of bilirubin in the urine occurs in obstructive jaundice and in some stages of toxic jaundice.

2. It gives the urine a dark greenish brown color.

E. Blood (hematuria):

1. It is the presence of blood or intact red cells in urine.

2. It is caused by urinary bilharziasis, glomerulonephritis, and traumatic or malignant diseases.

F. Porphyrins:

1. Normally, trace of coproporphyrins is excreted in urine per day.

2. The presence of excess amount of coproporphyrins or uroporphyrins in urine occurs in patients suffering from porphyrias.

IV. Urinary stones (calculi):

A. Over 10% of adult males suffer from urinary stones at least once in a life.

B. Urinary stones are almost always composed of substances normally excreted in the urine. These substances for unknown causes are supersaturated, precipitated and form crystals. The crystals are then bound together by a binding substance forming stone.

C. Urinary stones may be classified into:

1. Simple stone: consisted only of a single constituent.

2. Mixed stone: consisted of two or more constituents.

D. Chemical composition of urinary calculi:

The most common substances enter in stone formation are:

1. Calcium oxalate.

2. Calcium phosphate.

3. Calcium carbonate.

4. Magnesium ammonium phosphate (triple phosphate).

5. Less commonly stones are formed of:

a) Uric acid: 4-10% .

b) Cystine stone: less than 1%.

c) Xanthine stone: very rare.

E. Causes of urinary calculi:

There are many factors that may predispose to the formation of calculi:

1. Change in urine pH: as in infection of urinary tract, this makes the urine alkaline due to the action of bacteria on urea. Alkalinity causes precipitation of crystals and stone formation.

2. Disturbance in vitamins:

a) Excess vitamin D (= hypervitaminosis D): leads to the absorption of excess calcium and causes calcium stone formation.

b) Excess vitamin C (=L-Ascorbic acid): L-ascorbic acid can be converted in human to oxalate, which may lead to the formation of calcium oxalate stones.

c) Deficiency of vitamin A: leads to roughness of the lining epithelium of the urinary tract. This leads to precipitation of crystals and stone formation.

3. Disturbance in hormones: as in hyperparathyroidism. It leads to hypercalcuria and formation of calcium stones.

4. Excess excretion of uric acid: as in gout. This leads to formation of uric acid stones.

5. Excess excretion of cystine: as in cystinuria. This leads to formation of cystine stones.

6. Excess mucoproteins in urine: Mucoproteins act as the cement substance that binds the excreted salts to form stone.

Best Wishes: Dr.Ehab Aboueladab, Tel:01007834123 Email:ehab10f@gmail.com,ehababoueladab@yahoo.com