1 >>Which one of the following test is not done in the evaluation of thrombophilia? ?
- (A) PT and APTT
- (B) Anticardiolipin and anti-B2GPI antibiodies
- (C) Serum cholestrol
- (D) Protein C and S assay
2 >>Which one of these is not an advantage of LMWH over UFH? ?
- (A) There is a reduced risk of osteoporosis
- (B) Has a half life of 30 min so effect can be easily reversed
- (C) Dosing does not require monitoring by blood test
- (D) Does not require continuous infusion
3 >>Antiphospholipid antibody syndrome (APLA) is associated with all of the following, except: ?
- (A) Pancytopenia
- (B) Recurrent abortions
- (C) Venous thrombosis
- (D) Pulmonary hypertension
4 >>Which of the following treatment is required in pregnant women with APLA? ?
- (A) Aspirin + LMWH + Warfarin
- (B) Aspirin + LMWH + Steroid Thrombosis 19
- (C) Aspirin + LMWH
- (D) No treatment
5 >>All of the following statements are true about HUS, except: ?
- (A) Uremia
- (B) Thrombocytopenia
- (C) Positive DCT
- (D) Fibrinogen normal
6 >>D -ve HUS is due to the inherited deficiency of: ?
- (A) Factor I and H
- (B) Complement C3, C4
- (C) ADAMTS 13
- (D) Large vWF multimers
7 >>A 30 year old lady presented with pulmonary thromboembolism and is found to have APLA. She was given fondaparinux and warfarin and then maintained on warfarin. The appropriate target INR is: ?
- (A) 2
- (B) 2.5
- (C) 3
- (D) 3.5
8 >>A 30 year old lady underwent prosthetic valve replacement surgery done for rheumatic heart disease and she is started on UFH by continuous infusion plus warfarin. Six days after she developed DVT of right lower limb. Her CBC was normal preoperatively and now she has dropped her platelet count to 50,000/mm3. Her INR is 2.3 and APTT is 90 (control 35). The best therapeutic option would be: ?
- (A) IVIg followed by steroids
- (B) Fondaparinux
- (C) Stop heparin and add aspirin to warfarin
- (D) Change to low molecular weight heparin
9 >>A young patient developed unprovoked DVT for which he was started on LMWH and acitrom. LMWH should be continued: ?
- (A) For 5 days
- (B) For 5 days or until INR is between 2-3 for atleast 24 hours, whichever is longer
- (C) Until the INR is between 2-3
- (D) For 7 days
10 >>A young male developed spontaneous DVT of right lower limb and he is having a sister who had DVT 5 years back and having protein C deficiency. He was started on warfarin and the INR came to 2-3 after which he had started following at local hospital where his warfarin dose was steadily increased as his INR never went higher than 1.5 and is currently on warfarin dose of 20 mg/day. He was referred back to hospital and was evaluated and found to be having warfarin level of 2.385 mg/l (therapeutic range 0.7 – 2.3 mg/l), PIVKA is > 10 (Ref. range < 0.2). What is the most likely explanation for the subtherapeutic INR? ?
- (A) Cytochrome p450 mutation
- (B) VKORC 1 mutation
- (C) Not taking warfarin
- (D) Local hospital INR testing quality control is not good
11 >>All of the following are seen in a patient of APLA, except: ?
- (A) Pre-eclampsia
- (B) Infertility
- (C) Placental abruption
- (D) IUGR
12 >>All of the following pathogens are associated with HUS, except: ?
- (A) E. coli 0157:H7 strain
- (B) Shigella dysenteriae serotype I
- (C) Citrobacter freundii
- (D) Yersinia enterocolitica
13 >>Which of the following have decreased osmotic fragility? ?
- (A) HS
- (B) Hereditary elliptocytosis
- (C) Hereditary xerocytosis
- (D) Hereditary stomatocytosis/hydrocytosis
14 >>Typical dominant HS is most commonly caused by deficiency of: ?
- (A) Ankyrin
- (B) Band 3
- (C) Spectrin
- (D) Protein 4.2
15 >>In how many percentage of HS patients, spherocytes are seen in PS: ?
- (A) 0.4
- (B) 0.6
- (C) 0.8
- (D) 1
16 >>Increased osmotic fragility is seen in all, except: ?
- (A) IDA
- (B) HS
- (C) HE
- (D) AIHA
17 >>Which of the following is true about hereditary elliptocytosis/pyrropoikilocytosis? ?
- (A) Autosomal dominant inheritance
- (B) Caused by defect in spectrin heterodimer self association site
- (C) Can be caused by defect in protein 4.1
- (D) Degree of hemolysis correlates with the number of elliptocytes
18 >>A condition with an X-linked mode of inheritance, often associated with CGD, hemolytic anemia, characteristic red cell acanthocytosis: ?
- (A) GB syndrome
- (B) Rh null phemotype
- (C) McLeod phenotype
- (D) Gerbich negative phenotype
19 >>The characteristic red cell indices in hereditary spherocytosis are: ?
- (A) Low MCV, high MCHC, increased RDV
- (B) Low MCV, increased MCHC, decreased RDV
- (C) High MCV, increased MCHC, increased RDV
- (D) High MCV, increased MCHC, decreased RDV
20 >>Incubation increases the sensitivity of osmotic fragility test by: ?
- (A) Overhydration of the cell
- (B) Dehydration of the cell
- (C) Increasing the loss of surface area
- (D) Increasing the MCV