Chapter 19 - The Blood

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1

1) Plasma is closest in composition to

A) urine.

B) isotonic saline solution.

C) sterile water.

D) CSF.

E) interstitial fluid.

E) interstitial fluid.

2

The percent fraction of formed elements relative to whole blood is the

A) viscosity.

B) specific gravity.

C) packed volume.

D) hematocrit.

E) differential cell count.

D) hematocrit.

3

Which of the following is a function of the blood?

A) transport of nutrients and wastes

B) transport of body heat

C) transport of gases

D) defense against toxins and pathogens

E) All of the answers are correct.

E) All of the answers are correct.

4

Which of the following statements about blood is false?

A) Blood contains buffers that control pH.

B) The normal pH of blood is 6.8 to 7.0.

C) Blood is more viscous than water.

D) Blood is about 55 percent plasma.

E) Cells in blood comprise the formed elements.

B) The normal pH of blood is 6.8 to 7.0 (the normal pH is 7.35 to 7.45)

5

Formed elements make up about what percentage of blood?

A) 55 percent

B) 30 percent

C) 60 percent

D) 45 percent

E) 20 percent

D) 45 percent

6

The combination of plasma and formed elements is called

A) serum.

B) lymph.

C) whole blood.

D) extracellular fluid.

E) packed blood.

C) whole blood.

7

Whole blood for testing in a clinical laboratory is usually collected from

A) the heart.

B) a superficial artery.

C) a superficial vein.

D) a capillary.

E) an arteriole

C) a superficial vein.

8

When checking the efficiency of gas exchange, it may be necessary to draw a blood sample from

A) the heart.

B) the lungs.

C) an artery.

D) a vein.

E) capillaries.

C) an artery.

9

Consider the following results from a blood lab test. Which value is most likely abnormal?

A) RBCs—5.2 million/µl

B) platelets—280,000/µl

C) leukocytes—8600/µl

D) hemoglobin—10.7 g/100 ml

E) hematocrit—44 percent

D) hemoglobin—10.7 g/100 ml (normal hemoglobin is 14-18 in males, 12-16 in females)

10

Each of the following is a characteristic of whole blood, except a

A) temperature of approximately 38 degrees Celsius.

B) viscosity about the same as water.

C) pH of 7.4.

D) built-in system for clotting.

E) red color from hemoglobin.

B) viscosity about the same as water (five times as viscous as water)

11

Which of the following is/are NOT (a) formed element(s)?

  1. Erythrocytes
  2. Leukocytes
  3. Plasma
  4. Platelets

Plasma

12

Where are most plasma proteins produced?

  1. Spleen
  2. Liver
  3. Kidney
  4. Lung

Liver

13

Which category of plasma proteins includes the antibodies?

  1. fibrinogen
  2. globulins
  3. albumin
  4. hormones

Globulins

14

Why is there a difference in the hematocrit between males and females?

  1. Males have more blood than females.
  2. Androgens stimulate red blood cell production and estrogens do not.
  3. Males have more bone mass than females and thus more red bone marrow.
  4. Males have a faster metabolic rate and need more oxygen.

Androgens stimulate red blood cell production and estrogens do not.

15

The formed elements of the blood consist of __________.

  1. antibodies, metalloproteins, and lipoproteins
  2. electrolytes, nutrients, and organic wastes
  3. albumins, globulins, and fibrinogen
  4. red and white blood cells and platelets

red and white blood cells and platelets

16

What would be the effect on your body if for some reason your liver was damaged and stopped producing albumins?

  1. Tissue swelling
  2. Slow clotting time
  3. Decreased resistance to infection
  4. Inability to transport iron in the blood

A. Tissue swelling (albumin is a protein made by the liver that keeps fluid from leaking out of blood vessels, nourishes tissues, and transports hormones, vitamins, drugs, and substances like calcium throughout the body)

17

Proportionately, what is the largest component of the plasma, other than water?

  1. Electrolytes
  2. Wastes
  3. Nutrients
  4. Proteins

Proteins

18

Which of the following is the LEAST abundant type of plasma proteins?

  1. Fibrinogen
  2. Albumins
  3. Globulins
  4. Hormones

Hormones

19

How much blood does an adult male normally have?

  1. 4-5 liters
  2. 2-3 liters
  3. 5-6 liters
  4. 3-4 liters

5-6 liters

20

Which type of plasma protein serves as a carrier for hormones T3 and T4?

  1. Albumins
  2. Apolipoproteins
  3. Antibodies
  4. Fibrinogens

Albumins

21

Which component makes up the biggest proportion of the formed elements?

  1. Water
  2. Erythrocytes
  3. Thrombocytes
  4. Leucocytes

Erythrocytes

22

Which of the following statements about blood is FALSE?

  1. Blood is slightly acidic, with a pH of 6.5.
  2. Blood defends against toxins and pathogens.
  3. Blood is used to transport respiratory gases.
  4. Blood helps stabilize body temperature.

Blood is slightly acidic, with a pH of 6.5. (blood is alkaline with a pH between 7.35 and 7.45)

23

What are the major components of the cardiovascular system?

  1. Lymph, plasma, and hemoglobin
  2. Blood, heart, and blood vessels
  3. Veins, arteries, and capillaries
  4. Red blood cells, white blood cells, and platelets

Blood, heart, and blood vessels

24

Which type of protein is responsible for transporting triglycerides in the blood?

  1. Steroid-binding proteins
  2. Metalloproteins
  3. Hormone-binding proteins
  4. Apolipoproteins

Apolipoproteins

25

Which of the following is NOT a good reason why venipuncture is a common technique for obtaining a blood sample?

  1. Blood pressure is lower in veins.
  2. Veins are easier to locate and access.
  3. Blood does not clot as easily coming from veins as it does from arteries.
  4. Veins are thinner-walled than arteries.

Blood does not clot as easily coming from veins as it does from arteries.

26

What is hematocrit?

  1. The number of leukocytes in whole blood.
  2. The number of erythrocytes in whole blood.
  3. The percentage of leukocytes in whole blood.
  4. The percentage of formed elements in whole blood.

The percentage of formed elements in whole blood.

27

What portion of a person’s body weight does the blood represent?

  1. 4%
  2. 10%
  3. 3%
  4. 7%

7%

28

What kind of tissue is blood?

  1. Loose connective tissue
  2. Fibrous connective tissue
  3. Fluid connective tissue
  4. Epithelial tissue

Fluid connective tissue

29

Which of the following is NOT a function of the blood?

  1. All of the listed responses are correct.
  2. Transportation of gases, nutrients, hormones, and wastes
  3. Regulation of pH and ion composition of interstitial fluids
  4. Defend against pathogens

All of the listed responses are correct.

30

In addition to water and proteins, what else make up plasma?

  1. None of the listed responses are correct.
  2. Erythrocytes, leukocytes, and platelets
  3. Albumins, globulins, and fibrinogen
  4. Electrolytes, nutrients, and organic wastes

Electrolytes, nutrients, and organic wastes

31

How is it that liver disorders can alter the composition and the functional properties of blood?

  1. The proteins synthesized by the liver are filtered out of the blood by the kidneys.
  2. The liver serves as a filter of plasma proteins and pathogens.
  3. The liver synthesizes immunoglobulins and protein hormones.
  4. The liver is the primary source of plasma proteins.

The liver is the primary source of plasma proteins.

32

Which of the following is NOT a component of plasma?

  1. dissolved proteins
  2. organic wastes
  3. antibodies
  4. elastic fibers

elastic fibers

33

Which of the plasma proteins functions in blood clotting?

  1. Albumin
  2. Globulins
  3. Antibodies
  4. Fibrinogen

Fibrinogen

34

What is serum?

  1. Plasma with the proteins removed
  2. Plasma without electrolytes
  3. Plasma with the clotting factors removed
  4. Plasma with only immunoglobulins present

Plasma with the clotting factors removed

35

Which plasma protein would you expect to be elevated if you were suffering from strep throat?

  1. Transport globulins
  2. Fibrinogen
  3. Immunoglobulins
  4. Albumins

Immunoglobulins

36

The total volume of blood in the body of a 76-kg man is approximately ________ liters.

A) 10

B) 6 to 8

C) 5.3

D) 4.4

E) 3.8

C) 5.3 (adult males has about 5-6 liters)

37

The most abundant component of plasma is

A) ions.

B) proteins.

C) water.

D) gases.

E) nutrients.

water

38

A person who has a low blood volume is said to be

A) hypovolemic.

B) hypervolemic.

C) normovolemic.

D) isovolemic.

E) antivolemic.

A) hypovolemic.

39

The chief difference between plasma and interstitial fluid involves the concentration of

A) water.

B) electrolytes.

C) nitrogen wastes.

D) proteins.

E) glucose.

D) proteins.

40

A typical adult hematocrit is

A) 85.

B) 75.

C) 65.

D) 45.

E) 25.

D) 45.

41

Which of the following is not one of the formed elements of blood?

A) RBCs

B) platelets

C) antibodies

D) lymphocytes

E) basophils

C) antibodies

42

Plasma composes about ________ percent of whole blood and water composes ________ percent of the plasma volume.

A) 55; 92

B) 92; 7

C) 92; 55

D) 45; 55

E) 50; 50

A) 55; 92

43

A hematocrit provides information on

A) blood type.

B) clotting factors.

C) formed elements abundance.

D) plasma composition.

E) sedimentation rate.

C) formed elements abundance.

44

You are caring for an adult patient who weighs 48 kg. What would her approximate blood volume be?

A) 6.6 L

B) 6.0 L

C) 5.6 L

D) 4.8 L

E) 3.8 L

E) 3.8 L (7% of body weight)

45

Thyroid-binding globulin is an example of which kind of plasma protein?

A) metalloprotein

B) steroid-binding

C) hormone-binding

D) apolipoprotein

E) transport albumin

C) hormone-binding

46

Transferrin is an example of which kind of plasma protein?

A) metalloprotein

B) steroid-binding protein

C) hormone-binding protein

D) apolipoprotein

E) transport albumin

A) metalloprotein (carries metal ion)

47

Which plasma protein transports fatty acids and some hormones?

A) translipin

B) steroid-binding protein

C) hormone-binding protein

D) albumin

E) gamma globulin

D) albumin

48

Which organ secretes most of the plasma proteins?

A) pancreas

B) heart

C) kidney

D) brain

E) liver

E) liver

49

The most abundant proteins in blood plasma are

albumins.

50

Plasma proteins essential in body defense are the

A) albumins.

B) fibrinogens.

C) immunoglobulins.

D) metalloproteins.

E) lipoproteins.

C) immunoglobulins.

51

A plasma protein essential for blood coagulation is

A) albumin alpha.

B) fibrinogen.

C) immunoglobulin

D) metalloprotein

E) lipoprotein

B) fibrinogen.

52

All the circulating red blood cells in an adult originate in the

A) heart.

B) thymus.

C) spleen.

D) red bone marrow.

E) lymph tissue.

D) red bone marrow.

53

Red blood cell production is regulated by the hormone

A) thymosin.

B) angiotensin.

C) erythropoietin.

D) M-CSF.

E) renin.

C) erythropoietin.

54

Which of the following statements concerning red blood cells is false?

A) Red cells are biconcave discs.

B) Red cells lack mitochondria.

C) Red cells are about 18 µm in diameter.

D) Red cells are specialized for carrying oxygen.

E) Red cells can form stacks called rouleaux.

C) Red cells are about 18 µm in diameter (has a diameter of 7.8µm)

55

Which of these proteins functions to store or transport iron?

A) hemoglobin

B) ferritin

C) hemosiderin

D) transferrin

E) ferritin, hemosiderin, and transferrin

E) ferritin, hemosiderin, and transferrin

56

The disease sickle cell anemia is an example of what can happen if

A) the diet is deficient in iron.

B) there is insufficient heme in the hemoglobin.

C) a gene for adult hemoglobin is abnormal.

D) red blood cells bind too much oxygen.

E) hemolysis is prevented by a mutated gene.

C) a gene for adult hemoglobin is abnormal.

57

When a person who lives at sea level vacations in the Rocky Mountains, you would expect

A) a drop in atmospheric oxygen levels.

B) the release of erythropoietin.

C) a rise in hematocrit.

D) an increase in red blood cell production.

E) All of the answers are correct.

E) All of the answers are correct.

58

Surgical removal of the stomach could cause

A) hemophilia.

B) pernicious anemia.

C) thrombocytopenia.

D) leukocytosis.

E) jaundice.

B) pernicious anemia (pernicious anemia is the decrease in red blood cells when the body can't absorb enough vitamin B-12; a special protein, called intrinsic factor (IF), helps your intestines absorb vitamin B12, and this protein is released by cells in the stomach. When the stomach does not make enough intrinsic factor, the intestine cannot properly absorb vitamin B12)

59

Mary is tested for the amount of hemoglobin in her blood. The test results indicate that her hemoglobin level is 16 g/dL of blood. This value indicates that

A) she is suffering from anemia.

B) she has fewer red blood cells than normal.

C) her hematocrit is probably lower than normal.

D) she may be suffering from a form of leukemia.

E) her hemoglobin level is normal.

E) her hemoglobin level is normal (normal for males is 14-18g/dL, females 12-16g/dL)

60

An obstruction in blood flow to the kidneys would ultimately result in

A) pernicious anemia.

B) renal anemia.

C) increased erythropoiesis.

D) decreased erythropoiesis.

E) increased sensitivity to vitamin K.

C) increased erythropoiesis (erythropoietin, also called erythropoiesis-stimulating hormone is formed by the kidneys and liver. EPO appears in the plasma when peripheral tissues, especially the kidneys, are exposed to low oxygen concentrations)

61

The level of erythropoietin in the blood would rise due to all of the following except

A) anemia.

B) high altitude.

C) as a consequence of hemorrhage.

D) periods of fasting.

E) when blood flow to the kidneys is disrupted.

D) periods of fasting.

62

The average life span of a red blood cell is

A) 24 hours.

B) 1 month.

C) 4 months.

D) about 1 year.

E) many years.

C) 4 months (120 days)

63

The function of red blood cells is to

A) carry oxygen from the cells to the lungs.

B) carry carbon dioxide from the lungs to the body's cells.

C) carry nutrients from the digestive system to the body's cells.

D) defend the body against infectious organisms.

E) carry oxygen to the cells and then carry away carbon dioxide.

E) carry oxygen to the cells and then carry away carbon dioxide.

64

Eileen is a strict vegan and therefore eats no animal products. She develops an anemia that her doctor thinks is caused by a nutritional deficiency. Which of the following is the likeliest candidate?

A) aplastic anemia

B) vitamin B12 deficiency

C) lack of intrinsic factor

D) vitamin K deficiency

E) vitamin B6 deficiency

B) vitamin B12 deficiency (pernicious anemia)

65

In adults, the only site of red blood cell production, and the primary site of white blood cell formation, is the

A) liver.

B) spleen.

C) thymus.

D) red bone marrow.

E) yellow bone marrow.

D) red bone marrow.

66

Each heme ring in hemoglobin encloses an atom of

A) magnesium.

B) calcium.

C) iron.

D) sodium.

E) copper.

C) iron.

67

Excess iron is stored in the liver and spleen as

A) transferrin.

B) hemosiderin.

C) ferritin.

D) hemoglobin.

E) hemosiderin and ferritin.

E) hemosiderin and ferritin.

68

In which of the following situations would you expect the blood level of bilirubin to be elevated?

A) during coagulation

B) an alcoholic with a damaged liver

C) iron-deficient diet

D) low hematocrit

E) low blood volume

B) an alcoholic with a damaged liver (bilirubin is transported to the liver for excretion in bile)

69

If bile ducts are blocked,

A) more bilirubin appears in the plasma.

B) bilirubin appears in the saliva.

C) more hemolysis takes place.

D) more red blood cells are produced.

E) more white blood cells are produced.

A) more bilirubin appears in the plasma (diffusion into peripheral tissues)

70

More than 95 percent of the protein in a red blood cell is

A) albumin.

B) porphyrin.

C) hemoglobin.

D) immunoglobulin.

E) fibrinogen.

C) hemoglobin.

71

The function of hemoglobin is to

A) carry dissolved blood gases.

B) carry bicarbonate ion.

C) aid in the process of blood clotting.

D) produce antibodies.

E) stimulate erythropoiesis.

A) carry dissolved blood gases.

72

________ is a condition in which the oxygen-carrying capacity of the blood is reduced.

A) Polycythemia

B) Leukemia

C) Anemia

D) Leukopenia

E) Thrombocytopenia

C) Anemia

73

Pernicious anemia caused by a lack of intrinsic factor is specifically treated by

A) oral doses of iron.

B) injections of iron.

C) oral doses of vitamin B12.

D) injections of vitamin B12.

E) blood transfusion.

D) injections of vitamin B12.

74

Which of the following would you expect to see in increased numbers in a peripheral blood sample after donating a unit of blood?

A) fibrocytes

B) platelets

C) reticulocytes

D) lymphocytes

E) neutrophils

C) reticulocytes (immature RBC)

75

A red blood cell that contains excessive amounts of hemoglobin would be called

A) hyperchromic.

B) normochromic.

C) hypochromic.

D) normocytic.

E) macrocytic.

A) hyperchromic.

76

A bruise appears as a greenish spot in the skin because

A) hemoglobin has leaked from the blood into the injury and hemoglobin has a green color.

B) the heme group in the hemoglobin has broken down into biliverdin.

C) bilirubin from iron recycling has built-up in the bruise.

D) red blood cells are green when they leave circulation.

E) dead white blood cells accumulate at the site of injury.

B) the heme group in the hemoglobin has broken down into biliverdin (biliverdin is green)

77

Aged and damaged erythrocytes are broken down by macrophages in the

A) spleen.

B) liver.

C) bone marrow.

D) digestive tract.

E) spleen, liver, and bone marrow.

E) spleen, liver, and bone marrow.

78

The waste product bilirubin is produced from

A) globin chains of hemoglobin.

B) heme molecules plus iron.

C) heme molecules lacking iron.

D) iron found in hemoglobin molecules.

E) abnormal proteins found in red blood cells.

C) heme molecules lacking iron.

79

Most of the iron that is removed from degraded hemoglobin is

A) excreted by the kidneys.

B) excreted by the liver.

C) excreted by the intestines.

D) recycled to the red bone marrow.

E) stored in yellow bone marrow.

D) recycled to the red bone marrow.

80

In adults, red bone marrow is located in the

A) sternum and ribs.

B) proximal epiphyses of long bones.

C) iliac crest.

D) body of vertebrae.

E) All of the answers are correct.

E) All of the answers are correct (found in flat bones)

81

The process of red blood cell production is called

A) erythrocytosis.

B) erythropenia.

C) hemocytosis.

D) erythropoiesis.

E) hematopenia.

D) erythropoiesis.

82

The developmental stage at which erythrocytes enter the circulation is as

A) hemocytoblasts.

B) reticulocytes.

C) band forms.

D) myeloid cells.

E) proerythrocytes.

B) reticulocytes.

83

________ are immature erythrocytes that are present in the circulation.

A) Erythroblasts

B) Normoblasts

C) Myeloblasts

D) Band cells

E) Reticulocytes

E) Reticulocytes

84

Erythropoiesis is stimulated when

A) oxygen levels in the blood increase.

B) carbon dioxide levels in the blood decrease.

C) blood flow to the kidney declines.

D) coagulation begins.

E) blood pressure increases.

C) blood flow to the kidney declines.

85

Each hemoglobin molecule contains

A) four alpha chains.

B) one alpha and one beta chain.

C) four iron atoms.

D) one heme group.

E) a molecule of oxygen and a molecule of carbon dioxide.

C) four iron atoms (2 alpha chains and 2 beta chains each holding a heme molecule; each heme unit holds 1 iron ion)

86

The yellow color that is visible in the eyes and skin in jaundice results from

A) excessive amounts of bilirubin in the plasma.

B) extensive breakdown of RBCs.

C) destruction of hemoglobin.

D) the recycling of hemoglobin.

E) All of the answers are correct.

E) All of the answers are correct.

87

Which of the following blood count values would be a sign of anemia?

A) 10,000 WBC

B) 3.5 million RBC

C) 400,000 platelets

D) 5.5 million RBC

E) A and D taken together

B) 3.5 million RBC (normal levels in males 4.5-6.3 million RBCs/cubic milliliter, females 4.2-5.5 million RBCs/cubic milliliter; typical WBC is 5,000-10,000 WBCs/cubic milliliter)

88

Soon after donating 0.5 liters of blood, one would expect

A) an increased reticulocyte count.

B) an increased platelet count.

C) an increased erythrocyte count.

D) an increased neutrophil count.

E) increased levels of clotting factors.

A) an increased reticulocyte count.

89

Bill wants to determine his blood type, so he takes a few drops of blood from a puncture wound in his finger and mixes it with various antisera. His blood cells agglutinate when mixed with the anti-A sera but not with the anti-B or anti-D sera. What does this mean?

A) Bill could receive type B-negative blood in a transfusion.

B) Bill could donate blood to an individual with type O blood.

C) Bill is Rh positive.

D) Bill's plasma contains B antibodies.

E) Bill's red blood cells contain the O surface antigen.

D) Bill's plasma contains B antibodies.

90

A person's blood type is determined by the

A) size of the RBCs.

B) volume of the RBCs.

C) chemical character of the hemoglobin.

D) presence of specific glycoproteins on the cell membrane.

E) shape of the RBCs.

D) presence of specific glycoproteins on the cell membrane.

91

People with type AB blood are considered the "universal recipient" for transfusions because

A) their blood cells lack A and B antigens.

B) their blood lacks A or B agglutinins.

C) their blood is plentiful in A and B agglutinins.

D) they usually have very strong immune systems.

E) they are usually Rh negative.

B) their blood lacks A or B agglutinins.

92

Blood type is identified primarily by

A) the Kahn blood group.

B) the HB blood system.

C) the Rh blood group.

D) both the ABO and Rh blood groups.

E) the ABO blood group.

D) both the ABO and Rh blood groups.

93

Type AB blood has which of the following characteristics?

A) RBCs have the Rh positive antigens and the anti-D plasma antibodies.

B) RBCs have no surface antigens and both anti-A and anti-B antibodies in the plasma.

C) RBCs have both the A & B surface antigens and no ABO plasma antibodies.

D) RBCs have the A and the B surface antigens and the plasma has anti-A and anti-B antibodies.

E) RBCs have the A antigen and the plasma has the anti-B antibody.

C) RBCs have both the A & B surface antigens and no ABO plasma antibodies.

94

Anti-D antibodies are present in the blood of

A) all individuals with type AB blood.

B) Rh negative individuals who have been exposed to the D surface antigen.

C) all Rh positive individuals.

D) Rh positive individuals who have been exposed to the D surface antigen.

E) all Rh negative individuals.

B) Rh negative individuals who have been exposed to the D surface antigen.

95

Antigens of the surface of red blood cells are also called ________ and antibodies in the blood plasma are also called ________.

A) agglutinins; agglutinogens

B) agglutinogens; agglutinins

C) T-cells; B-cells

D) erythrogens; antibiotics

E) serum; plasma

B) agglutinogens; agglutinins

96

Which of the following combinations may result in the hemolytic disease of the newborn?

A) mother Rh positive, baby Rh negative

B) mother Rh negative, baby Rh negative

C) mother Rh negative, baby Rh positive

D) mother type A+, baby type O+

E) None of the answers is correct.

C) mother Rh negative, baby Rh positive (mother is always rH negative in this disease)

97

The process of lymphopoiesis occurs mainly in the

A) spleen.

B) kidneys.

C) lymph nodes.

D) red bone marrow.

E) thymus.

D) red bone marrow.

98

Granulocytes form in

A) the intestines.

B) the spleen.

C) the thymus.

D) red bone marrow.

E) yellow bone marrow.

D) red bone marrow (granulocyte is a WBC which has abundant stained granules - neutrophil, eosinophil, and basophil)

99

Agglutinogens are contained on the __________, whereas the agglutinins are found in the __________.

  1. plasma; cell membrane of the RBC
  2. cell membrane of the RBC; plasma
  3. mitochondria; nucleus of the RBC
  4. nucleus of the RBC; mitochondria

B. cell membrane of the RBC; plasma

100

Where are red blood cells produced in an adult?

  1. Lungs
  2. Liver
  3. Red bone marrow
  4. Yellow bone marrow

Red bone marrow

101

If a person has type A, Rh surface antigens on the blood cells, and anti-B antibodies in the plasma, what is that person’s blood type?

  1. A-negative
  2. B-positive
  3. B-negative
  4. A-positive

A-positive

102

During RBC recycling, each heme unit is stripped of its iron and converted to __________.

  1. urobilin
  2. ferritin
  3. biliverdin
  4. transferrin

Biliverdin

103

Circulating mature RBCs lack __________.

  1. All of the listed responses are correct.
  2. mitochondria
  3. nuclei
  4. ribosomes

All of the listed responses are correct.

104

What type of chemical are the antigens found on our blood cells?

  1. Proteins only
  2. Steroids
  3. Glycoproteins and glycolipids
  4. Carbohydrates

Glycoproteins and glycolipids

105

What is the primary site of erythropoiesis in an adult?

  1. Kidney
  2. Heart
  3. Liver
  4. Bone marrow

Bone marrow

106

Reticulocytes are nucleated immature cells that develop into mature __________.

  1. erythrocytes
  2. lymphocytes
  3. platelets
  4. leukocytes

erythrocytes

107

Which of the following is NOT a benefit to the unusual shape of the red blood cell?

  1. Greater hemoglobin carrying capacity
  2. They are flexible.
  3. Increased surface-to-volume ratio
  4. Red blood cells can stack up on each other.

Greater hemoglobin carrying capacity

108

Jessica has just moved from Orlando, Florida, to Denver, Colorado. What condition is she now experiencing that is stimulating the production of erythropoietin and, consequently, more red blood cells?

  1. A change in diet, from deep-fried comfort foods to healthy, organic meals
  2. Hypoxia caused by an increase in her elevation above sea level
  3. A decrease in the number of existing white blood cells
  4. Increased oxygen concentration in the atmospheric air

Hypoxia caused by an increase in her elevation above sea level

109

What is the specific term for the production of red blood cells?

  1. Erythropoiesis
  2. Hemopoiesis
  3. Leukopoiesis
  4. Thrombopoiesis

Erythropoiesis

110

Which blood type can safely be transfused into a person with type O blood?

  1. Type A
  2. Type B
  3. Type O
  4. Type AB

Type O (type O is often called the universal donor. This means that they can give their blood to anyone, but they can only receive blood from another O person)

111

Signs of iron-deficiency anemia include __________.

  1. increase in hematocrit, hemoglobin, and O2-carrying capacity
  2. increase in hematocrit, decrease in hemoglobin, and decrease in O2-carrying capacity
  3. decrease in hematocrit, hemoglobin content, and O2-carrying capacity
  4. decrease in hematocrit and hemoglobin and increase in O2-carrying capacity

C. decrease in hematocrit, hemoglobin content, and O2-carrying capacity

112

A patient developed an obstruction in his renal arteries that restricted blood flow to his kidneys. What would happen to the formed elements?

  1. Leukocyte numbers would increase.
  2. Circulating thrombocyte numbers would decrease.
  3. Hematocrit would increase.
  4. Red blood cell numbers would decrease.

Hematocrit would increase.

113

Erythropoietin appears in the plasma when peripheral tissues, especially the kidneys, are exposed to __________.

  1. low oxygen concentrations
  2. temperature extremes
  3. excessive amounts of radiation
  4. high urine volumes

low oxygen concentrations

114

What type of blood is considered to be the “universal donor”?

  1. Type O negative
  2. Type AB positive
  3. Type B negative
  4. Type A negative

Type O negative

115

Which of the following is NOT a surface antigen that is used in determining blood type?

  1. C
  2. A
  3. B
  4. Rh

C

116

What is jaundice?

  1. An infection in the liver
  2. A decrease in the level of bilirubin in the blood
  3. An increase in the recycling of red blood cells
  4. A yellowing of the skin and eyes

A yellowing of the skin and eyes

117

If agglutinogen B meets with agglutinin anti-A, what is the result?

  1. No agglutination occurs.
  2. A cross-reaction occurs.
  3. The patient dies.
  4. The patient becomes comatose.

No agglutination occurs

118

Which part of hemoglobin binds oxygen?

  1. Heme
  2. Alpha chain
  3. Transferrin
  4. Beta chain

Heme

119

Protein synthesis in a mature RBC occurs primarily __________.

  1. in ribosomes
  2. nowhere; mature red blood cells cannot synthesize proteins
  3. in mitochondria
  4. in the nucleus

nowhere; mature red blood cells cannot synthesize proteins

120

What type of blood would cause a cross-reaction when given to a person with type A-positive blood?

  1. O-negative
  2. O-positive
  3. A-positive
  4. B-positive

B-positive

121

In which pregnancy are an Rh-positive mom and an Rh-positive child at risk of developing erythroblastosis fetalis?

  1. No pregnancy
  2. First pregnancy
  3. All pregnancies
  4. Second or later pregnancies

No pregnancy

122

Red blood cells have a limited lifespan and then it is phagocytized by macrophages in the liver spleen and red bone marrow. What happens to the iron ions that were in the heme group?

  1. The iron is excreted by the kidneys as urobilins in the urine.
  2. The iron will be either stored in the liver or transported back to the red bone marrow to be incorporated into new hemoglobin.
  3. The iron becomes part of bile and is excreted into the digestive tract.
  4. The iron is converted into biliverdin.

The iron will be either stored in the liver or transported back to the red bone marrow to be incorporated into new hemoglobin.

123

All of the following are true of neutrophils except that they are

A) granular leukocytes.

B) phagocytic.

C) also known as polymorphonuclear leukocytes.

D) important in coagulation.

E) active in fighting bacterial infections.

D) important in coagulation.

124

The most numerous white blood cells in peripheral circulation are the

A) neutrophils.

B) eosinophils.

C) basophils.

D) lymphocytes.

E) monocytes.

A) neutrophils (Never Let Monkeys Eat Bananas)

125

White blood cells that release histamine at the site of an injury are

A) neutrophils.

B) eosinophils.

C) basophils.

D) lymphocytes.

E) monocytes.

C) basophils.

126

________ are large phagocytic white cells that spend most of their time outside the blood as fixed and free phagocytic cells.

A) Neutrophils

B) Eosinophils

C) Basophils

D) Lymphocytes

E) Monocytes

E) Monocytes

127

Which of the following descriptions best matches the term colony stimulating factor?

A) adheres to collagen beneath endothelium

B) helper cells are one type

C) hormone that regulates white blood cell formation

D) kills bacteria using hydrogen peroxide

E) often elevated in allergic individuals

C) hormone that regulates white blood cell formation

128

White blood cells that are increased in allergic individuals are the

A) neutrophils.

B) eosinophils.

C) platelets.

D) lymphocytes.

E) monocytes.

B) eosinophils.

129

A hormone that stimulates production of granulocytes and monocytes is

A) M-CSF.

B) G-CSF.

C) GM-CSF.

D) multi-CSF.

E) thymosin.

C) GM-CSF (the designation for each factor indicates its target - granulocyte monocyte-colony-stimulating factor)

130

A genetically engineered hormone that stimulates the production of neutrophils is

A) M-CSF.

B) G-CSF (Neupogen).

C) GM-CSF.

D) multi-CSF.

E) thymosin.

B) G-CSF (Neupogen).

131

The most numerous WBCs in a differential count of a healthy individual are

A) neutrophils.

B) basophils.

C) lymphocytes.

D) monocytes.

E) leukocytes.

A) neutrophils.

132

Which of the following is not true of neutrophils?

A) less abundant than lymphocytes

B) can make hydrogen peroxide

C) can exit capillaries

D) can destroy bacteria

E) attracted to complement-coated bacteria

A) less abundant than lymphocytes

133

Which of these descriptions best matches the term B lymphocytes?

A) adhere to collagen beneath endothelium

B) helper cells are one type

C) develop into plasma cells

D) kill bacteria using hydrogen peroxide

E) often elevated in allergic individuals

C) develop into plasma cells

134

Which of the following is true of basophils?

A) constitute about 1 percent of WBCs

B) granules contain heparin

C) granules contain histamine

D) attract other defense cells

E) All of the answers are correct.

E) All of the answers are correct.

135

Which of these descriptions best matches the term T lymphocytes?

A) adhere to collagen beneath endothelium

B) are involved in cell mediated immunity

C) produce antibodies in response to antigens

D) kill bacteria using hydrogen peroxide

E) often elevated in allergic individuals

B) are involved in cell mediated immunity

136

An infected wound contains typically contains

A) dead neutrophils.

B) cellular debris.

C) tissue fluids.

D) pus.

E) All of the answers are correct.

E) All of the answers are correct.

137

Which of the following is not true of monocytes?

A) about same size as basophils

B) enter tissues and wander

C) become macrophages

D) are long-lived

E) can phagocytize bacteria

A) about same size as basophils

138

Eosinophils function in

A) destroying antibody-labeled antigens.

B) blood coagulation.

C) production of surface antigens for red blood cells.

D) antibody production.

E) production of heparin.

A) destroying antibody-labeled antigens.

139

During a bacterial infection you would expect to see increased numbers of

A) neutrophils.

B) eosinophils.

C) basophils.

D) reticulocytes.

E) thrombocytes.

A) neutrophils.

140

The blood cells involved in specific immunity are the

A) neutrophils.

B) monocytes.

C) basophils.

D) erythrocytes.

E) lymphocytes.

E) lymphocytes.

141

Non-specific immunity, such as phagocytosis, is a function of which blood cells?

A) basophils and eosinophils

B) neutrophils, eosinophils, and monocytes

C) lymphocytes and monocytes

D) platelets

E) lymphocytes

B) neutrophils, eosinophils, and monocytes

142

Which of the following is true of eosinophils?

A) Granules stain with eosin dyes.

B) Allergic patients have many.

C) They have bilobed nucleus.

D) They constitute about 2 to 4 percent of WBCs.

E) All of the answers are correct.

E) All of the answers are correct.

143

A patient has an infected puncture wound to her foot. Which type of white blood cell would you expect to be elevated in a differential white cell count?

A) neutrophils

B) eosinophils

C) basophils

D) lymphocytes

E) monocytes

A) neutrophils

144

The number of eosinophils increases dramatically during __________.

  1. tissue degeneration or cellular deterioration
  2. an allergic reaction or a parasitic infection
  3. an injury to a tissue or a bacterial infection
  4. Only one of the listed responses is correct.
  5. I don't know yet

an allergic reaction or a parasitic infection

145

In the process of Hemostasis, what triggers the Extrinsic Pathway of the coagulation phase?

  1. Activated Factor X
  2. Activated Factor XII
  3. Platelet Factor or PF-3
  4. Factor III or Tissue Factor or TF

Factor III or Tissue Factor or TF

146

What does the term thrombocytopoiesis mean?

  1. Excess platelet numbers
  2. Blood clotting
  3. Platelet production
  4. Platelet destruction

Platelet production

147

Clot destruction involves a process that begins with __________.

  1. activation of Ca2+ to produce the tissue plasmin
  2. activation of the proenzyme fibrinogen, which initiates the production of fibrin
  3. activation of prothrombin, which initiates the production of thrombin
  4. activation of the proenzyme plasminogen, which initiates the production of plasmin

D. activation of the proenzyme plasminogen, which initiates the production of plasmin

148

Megakaryocytes are specialized cells of the bone marrow that are responsible for __________.

  1. production of scar tissue in an injured area
  2. specific immune responses
  3. engulfing invading bacteria
  4. formation of platelets

D. formation of platelets

149

In which phase of hemostasis does local contraction of an injured blood vessel occur?

  1. Coagulation phase
  2. Fibrinolysis
  3. Vascular phase
  4. Platelet phase

C. Vascular phase

150

An abnormally low platelet count is called __________.

  1. thrombocytosis
  2. thrombocytopenia
  3. leukopenia
  4. anemia

A. thrombocytopenia (anemia is low RBC or hemoglobin count)

151

What is the term for the characteristic of white blood cells in which they are attracted to a specific chemical stimulus?

  1. Polymorphism
  2. Phagocytosis
  3. Positive chemotaxis
  4. Leukopenia

C. Positive chemotaxis

152

Which of the following affect almost every aspect of the clotting process?

  1. Potassium ions and vitamin B12
  2. Sodium ions and vitamin D
  3. Calcium ions and vitamin K
  4. Calcium ions and vitamin C

C. calcium ions and vitamin K (all 3 pathways require calcium ions and vitamin K must be present for the liver to synthesize 4 of the clotting factors)

153

Which type of white blood cell includes the B and T cells, which are responsible for humoral and cell-mediated immunity?

  1. Neutrophil
  2. Monocyte
  3. Lymphocyte
  4. Basophil

Lymphocyte

154

What are the “patrol agents” in the blood that defend the body against toxins and pathogens?

  1. Hormones and enzymes
  2. Albumins and globulins
  3. Red blood cells and platelets
  4. White blood cells and antibodies

white blood cells and antibodies

155

Platelets are formed from large cells called __________.

  1. neutrophils
  2. macrophages
  3. megakaryocytes
  4. natural killer cells

megakaryocytes

156

Which type of granular leukocyte can engulf up to two dozen bacteria and also produces a respiratory burst that creates harsh chemical agents such as hydrogen peroxide?

  1. Basophil
  2. Neutrophil
  3. Lymphocyte
  4. Eosinophil

B. neutrophil

157

Which type of white blood cell circulates in the blood for about 24 hours before entering the tissues and differentiating into a macrophage?

  1. Lymphocyte
  2. Neutrophil
  3. Monocyte
  4. Basophil

Monocyte

158

Which of the following is NOT a function of platelets?

  1. They patch damaged vessels.
  2. They initiate blood clotting.
  3. They reduce the size of a break in a vessel.
  4. They release chemicals to destroy bacteria.

They release chemicals to destroy bacteria.

159

How do basophils respond to an injury?

  1. They perform cell-mediated immunity.
  2. They phagocytize bacteria.
  3. They release histamine and heparin.
  4. They produce antibodies.

They release histamine and heparin.

160

A person who was faithfully avoiding eating any fats could have problems with blood clotting. Why would blood clotting be affected?

  1. They would be deficient in Ca2+.
  2. They could not make the chemicals in platelets.
  3. They would be deficient in vitamin K.
  4. They could not produce platelets.

C. They would be deficient in vitamin K (absorbed with dietary lipids)

161

Which of the following types of white blood cells are involved in fighting off parasitic infections, such as flukes and roundworms?

  1. Eosinophils
  2. Neutrophils
  3. Lymphocytes
  4. Basophils

Eosinophils

162

Which blood cell is responsible for carrying out immune surveillance?

  1. Natural killer cells
  2. T-cells
  3. Macrophages
  4. B-cells

Natural killer cells

163

Even if blood is carefully collected into a tube that has not been treated with an anticoagulant, it will clot. Which part of hemostasis is triggered by the activation of clotting factor XII?

  1. The intrinsic pathway
  2. The extrinsic pathway
  3. The platelet phase
  4. The formation of thrombin

A. The intrinsic pathway

164

What type of white blood cell would you find in the greatest numbers in an infected cut?

  1. Basophil
  2. Lymphocyte
  3. Monocyte
  4. Neutrophil

Neutrophil

165

Which of the following is a notable feature of leukemia?

  1. Yellowing of the eyes and skin
  2. Excessive numbers of white blood cells
  3. Absence of certain blood-clotting factors
  4. Crescent-shaped erythrocytes

Excessive numbers of white blood cells

166

In which phase of hemostasis is fibrin deposited, creating a solid blood clot?

  1. Fibrinolysis
  2. Coagulation phase
  3. Platelet phase
  4. Vascular phase

Coagulation phase

167

Which of the following statements is FALSE concerning T cells and B cells?

  1. B and T cells are involved in a specific immune response.
  2. T cells complete their maturation process in the thymus.
  3. B cells differentiate into T cells and produce antibodies against foreign antigens.
  4. B cells and T cells are both types of lymphocytes.

B cells differentiate into T cells and produce antibodies against foreign antigens.

168

Plasma makes up approximately what percentage of whole blood?

  1. 65 percent
  2. 55 percent
  3. 45 percent
  4. 38 percent

55 percent

169

Which of the following is a function of the blood?

  1. defense against toxins and pathogens
  2. transport of body heat
  3. transport of gases transport of nutrients and wastes
  4. All of the answers are correct.

All of the answers are correct

170

The plasma protein involved in blood clotting is

  1. transferrin.
  2. hemoglobin.
  3. antibodies.
  4. fibrinogen.
  5. albumin.

fibrinogen.

171

________ is a condition in which the oxygen-carrying capacity of the blood is reduced.

  1. Leukemia
  2. Anemia
  3. Leukopenia
  4. Polycythemia
  5. Thrombocytopenia

Anemia

172

A person with a type A positive blood can safely receive blood from all of these donors EXCEPT __________.

  1. O positive
  2. A negative
  3. B positive
  4. A positive

B positive

173

People with type O blood are considered "universal donors" for transfusions because __________.

  1. their blood lacks A and B agglutinins (antibodies)
  2. their blood is plentiful in A and B agglutinins
  3. their red blood cells lack A and B surface antigens
  4. they usually have very strong red blood cells

C. their red blood cells lack A and B surface antigens

174

If a patient has thrombocytopenia, the best therapy is infusion of __________.

  1. purified platelets
  2. plasma
  3. whole blood
  4. packed RBCs

A. purified platelets

175

The function of platelets is to assist in the

  1. removal of worn out red blood cells.
  2. destruction of bacteria.
  3. immune response during an infection.
  4. transport of blood gases such as oxygen.
  5. process called hemostasis.

process called hemostasis.

176

Which of these phases is NOT part of hemostasis?

  1. erythropoiesis phase
  2. coagulation phase
  3. platelet phase
  4. vascular phase

erythropoiesis phase

177

The common pathway in coagulation ends with __________.

conversion of soluble fibrinogen to insoluble fibrin

178

The enzyme that dissolves fibrin is named __________.

  1. Plasminogen
  2. Antithrombin
  3. Heparin
  4. Plasmin
  5. Prothrombin activator

D. Plasmin

179

Most of the protein factors that are required for clotting are synthesized by

  1. megakaryocytes.
  2. the spleen.
  3. platelets.
  4. the liver.
  5. the kidneys.

the liver.

180

How would removal of calcium ions from a blood sample affect coagulation?

  1. More blood cells would be produced.
  2. Coagulation would be prevented.
  3. There would be no important effect because magnesium can substitute for calcium.
  4. The coagulation pathway would be more sensitive to activation.
  5. Coagulation would occur only in Rh positive individuals.

B. Coagulation would be prevented (needed in both extrinsic and intrinsic pathways)

181

A fibrin network that contains trapped blood cells and platelets is called a(n)

  1. rouleaux.
  2. platelet plug.
  3. lysin.
  4. blood clot.
  5. agglutinin.

D. blood clot (platelet plug does not contain fibrin)

182

Serum can't coagulate because the __________ has been removed.

  1. immunoglobulin
  2. albumin
  3. protein C
  4. fibrinogen

fibrinogen

183

__________ stimulates production of red blood cells.

  1. renin
  2. calcitriol
  3. erythropoietin
  4. thymosin

erythropoietin

184

The largest white blood cell in circulation is the __________.

  1. lymphocyte
  2. eosinophil
  3. neutrophil
  4. monocyte

monocyte

185

Megakaryocytes are the source of __________.

  1. platelets
  2. most WBCs
  3. neutrophils
  4. RBCs

platelets

186

The complex process that leads to the formation of fibrin from fibrinogen is called __________.

  1. coagulation
  2. fibrinogenesis
  3. platelet adhesion
  4. syneresis

A. coagulation

187

Except for the amount of __________, plasma and interstitial fluid differ little in composition.

protein

188

Red blood cells carry __________ to the lungs and __________ to the tissues.

carbon dioxide; oxygen

189

A triglyceride + globulin complex is termed a(n) __________.

lipoprotein

190

Which of the following does NOT describe the cause of hemolytic disease of the newborn (HDN)?

  1. Fetal red blood cell exposure causes an autoimmune response in the mother.
  2. The mother is exposed to Rh-positive fetal red blood cells.
  3. Anti-Rh antibodies cross the placenta and destroy fetal red blood cells.
  4. The mother produces antibodies against the fetal red blood cells.

A. Fetal red blood cell exposure causes an autoimmune response in the mother.

191

In which of the following scenarios is HDN likely to develop without medical treatment?

  1. An Rh mother gives birth to her first child, who is Rh, and then becomes pregnant with her second child, who is Rh.
  2. An Rh mother gives birth to her first child, who is Rh, and to her second child, who is Rh+, and then becomes pregnant with her third child, who is Rh+.
  3. An Rh mother gives birth to her first child, who is Rh, and then becomes pregnant with her second child, who is Rh+.
  4. An Rh mother gives birth to her first child, who is Rh, and to her second child, who is Rh+, and then becomes pregnant with her third child, who is Rh.
  5. An Rh+ mother gives birth to her first child, who is Rh+, and then becomes pregnant with her second child, who is Rh.
  6. An Rh mother gives birth to her first child, who is Rh+, and then becomes pregnant with her second child, who is Rh+.

B. An Rh mother gives birth to her first child, who is Rh, and to her second child, who is Rh+, and then becomes pregnant with her third child, who is Rh+.

192

How does RhoGAM prevent HDN?

  1. RhoGAM prevents the mother’s immune system from actively producing antibodies against fetal Rh antigens by destroying fetal red blood cells that cross the placenta during delivery.
  2. RhoGAM prevents fetal red blood cells from crossing the placenta and being exposed to the mother’s immune system.
  3. RhoGAM allows the mother’s immune system to be sensitized to the fetal red blood cells.
  4. RhoGAM prevents general antibody production in the mother so that she is less likely to develop anti-Rh antibodies.

A. RhoGAM prevents the mother’s immune system from actively producing antibodies against fetal Rh antigens by destroying fetal red blood cells that cross the placenta during delivery.

193

The antibodies that attack antigens on foreign RBCs are called __________.

aggluntinins

194

Suzie was sewing when she accidentally punctured her finger with the needle. Several days later, it is filled with pus. Which statement provides an explanation of how the WBCs were able to populate that wound?

  1. WBCs can migrate out of the blood stream.
  2. WBCs move through tissues using amoebic motion.
  3. WBCs are positively attracted to specific chemical stimuli.
  4. WBCs demonstrate all of the listed properties, allowing them to locate the wound.

D. WBCs demonstrate all of the listed properties, allowing them to locate the wound.

195

Once platelets arrive at the site of injury, they secrete chemicals to promote the clotting process. Hemophiliacs lack clotting factor VIII or IX. Which of the following would be the most likely hypothesis to best describe the underlying problem with their condition?

  1. In hemophilia, the lack of clotting factors VIII and IX results in the disruption of fibrin production through the extrinsic pathway.
  2. Lack of clotting factors VIII and IX results in a deficiency in factor X production. Thus, this deficit in the intrinsic pathway leads to compromised blood clotting.
  3. In hemophilia, platelets cannot aggregate. As a consequence, no PF-3 is produced to activate proenzymes and initiate the intrinsic pathway.
  4. Lack of calcium compromises the production of factor X, which disrupts the ability of the common pathway to initiate clotting through the conversion of fibrinogen to fibrin.

B. Lack of clotting factors VIII and IX results in a deficiency in factor X production. Thus, this deficit in the intrinsic pathway leads to compromised blood clotting.

196

The most abundant solute (by mass) in plasma is __________.

protein

197

The most abundant protein in blood is __________.

hemoglobin

198

Which of these statements about basophils is not true?

  1. They release histamine.
  2. They promote inflammation.
  3. They are abundant.
  4. They contain cytoplasmic granules.

They are abundant.

199

Granulocyte-colony-stimulating factor (G-CSF) stimulates production of __________.

granulocytes (neutrophils, eosinophils, and basophils)

200

The agranular leukocyte (agranulocyte) that is capable of phagocytosis is the __________.

monocyte

201

An important function of thrombocytes is to transport __________.

clotting factors

202

Platelets are

A) red cells that lack a nucleus.

B) blue cells that have a nucleus.

C) large cells with a prominent, concave nucleus.

D) tiny cells with a polynucleus.

E) cytoplasmic fragments of large cells.

E) cytoplasmic fragments of large cells.

203

In case of hemorrhage, platelets are stored as a reserve in the _______.

A) the heart.

B) the kidneys.

C) the spleen.

D) the thymus gland.

E) bone marrow.

spleen

204

Which of the following descriptions best matches the function of platelets?

A) adhere to collagen beneath endothelium

B) helper cells are one type

C) produce antibodies in response to antigens

D) kill bacteria using hydrogen peroxide

E) often elevated in allergic individuals

A) adhere to collagen beneath endothelium

205

A person whose platelet count is 40,000/µl is suffering from _______.

A) thrombocytosis.

B) leukocytosis.

C) hemocytosis.

D) thrombocytopenia.

E) leukopenia.

thrombocytopenia (average platelet count is 350,000/µl)

206

________ involves a cascade of reactions leading to the conversion of fibrinogen to fibrin.

A) Vascular spasm

B) The platelet phase

C) Retraction

D) Coagulation

E) Fibrinolysis

Coagulation

207

Most of the protein factors that are required for clotting are synthesized by the _______.

A) platelets.

B) megakaryocytes.

C) the liver.

D) the kidneys.

E) the spleen.

liver

208

The extrinsic pathway of coagulation is initiated by

A) sticking of platelets to damaged tissue.

B) activation of Factor VII exposed to collagen.

C) release of tissue factor (Factor III) by damaged endothelium.

D) release of heparin from the liver.

E) conversion of prothrombin to thrombin.

C) release of tissue factor (Factor III) by damaged endothelium.

209

Tissue factor (Factor III) is a factor in the ________ pathway.

A) extrinsic

B) intrinsic

C) common

D) retraction

E) fibrinolytic

extrinsic

210

Plasma thromboplastin is a factor in the ________ pathway.

A) extrinsic

B) intrinsic

C) common

D) retraction

E) fibrinolytic

intrinsic

211

Some rat poisons contain a toxin that blocks the liver's ability to utilize vitamin K. Animals that consume this poison would die of _______.

A) anemia.

B) acidosis.

C) hemorrhage.

D) thrombocytopenia.

E) starvation.

hemorrhage

212

A moving blood clot is called a(n) _______.

A) embolus.

B) thrombus.

C) plaque.

D) procoagulant.

E) platelet plug.

embolus

213

Areas in a vessel wall where large quantities of lipid accumulate are called _______.

A) thrombi.

B) emboli.

C) plaques.

D) clots.

E) occlusions.

plaques

214

Which of the following are common sources of vitamin K?

A) green vegetables

B) organ meats

C) whole grains

D) intestinal bacteria

E) All of answers are correct.

E) All of answers are correct.

215

The conversion of fibrinogen to fibrin is catalyzed by the enzyme _______.

A) fibrinogen-converting enzyme.

B) plasmin.

C) factor VIII.

D) thrombin.

E) prothrombinase.

thrombin

216

A digestive disorder that impairs a person's ability to absorb vitamin K will result in

A) low levels of prothrombin.

B) low levels of Factor X.

C) low levels of thromboplastin.

D) prolonged bleeding.

E) All of the answers are correct.

E) All of the answers are correct.

217

After blood is _______ its components are separated for the purpose of analysis.

Fractioned

218

Jane has been taking the antibiotic chloramphenicol for a few weeks as treatment for a serious bacterial infection. There is a possibility that a future side effect of long-term antibiotic therapy could cause her to develop problems in blood cell counts. The result is _______.

A) autoimmune disease.

B) aplastic anemia.

C) drug resistance.

D) thrombocytopenia.

E) erythroblastosis.

aplastic anemia

219

You have spent 24 hours traveling from the U.S to New Zealand, on quite a few airplanes with many stops. Because of the stress, changes in time zones, and short blocks of time between planes, you find yourself tired with a headache when you arrive. You are severely dehydrated. A hematocrit value on your blood would be ________ than normal because ________.

A) lower; more red blood are being made by the bone marrow

B) higher; you have less blood plasma volume

C) lower; the bone marrow is making fewer red blood cells due to the latitude of the airplanes

D) higher; more plasma proteins are made by the liver

higher; you have less blood plasma volume

220

________ is responsible for the RBC's ability to transport oxygen and CO2.

A) Hemoglobin

B) Fibrinogen

C) Albumin

D) Transferrin

E) Ferritin

Hemoglobin

221

Which of the following statements is true regarding the ABO blood types and the Rh blood types?

A) Rh disease in the newborn occurs when the mother is Rh+ and the baby is Rh-.

B) Rh disease is worse in male offspring because it is a hereditary disease.

C) A person with O- blood type has blood cells with O antigens, but no Rh antigens.

D) Those with AB blood type can receive blood from other AB people only, no other blood type can be given.

E) An Rh- person has to be exposed to Rh+ blood in order to produce anti-Rh.

E) An Rh- person has to be exposed to Rh+ blood in order to produce anti-Rh.

222

Type A blood has ________ antibodies in the blood plasma.

A) anti-A

B) anti-D

C) anti-B

D) anti-Rh

E) anti-O

anti-B

223

The clumping of red blood cells, when the specific antibody against the antigen on the cells is added, is called _______.

A) coagulation.

B) agglutination.

C) hemostasis.

D) vascularization.

E) areolation.

agglutination

224

Jane has Type A blood; therefore, she

A) has antibodies to B agglutinogens.

B) can give blood to other people with Type A blood only.

C) can receive blood from other people with Type A blood only.

D) makes anti-A without ever having been exposed to Type A blood.

E) has B antigen on her RBCs.

A) has antibodies to B agglutinogens.

225

Hormones called ________ are involved in regulation of white blood cell populations.

A) erythropoietin

B) bilirubin

C) thrombopoietin

D) colony-stimulating factors

E) plasmin

colony-stimulating factors

226

The ________ is a procedure that is used to determine the number of each of the various types of white blood cells.

A) differential count

B) hematocrit

C) sedimentation rate

D) WBC count

E) complete cell count (CBC)

differential count

227

Fifty to seventy percent of circulating white blood cells are _______.

A) monocytes.

B) lymphocytes.

C) eosinophils.

D) basophils.

E) neutrophils.

neutrophils

228

A small white blood cell with a large round nucleus would be a _______.

A) neutrophil.

B) lymphocyte.

C) monocyte.

D) basophil.

E) eosinophil.

lymphocyte (monocyte is a large cell)

229

Which of the following statements is true about platelets?

A) Platelets live for less than two weeks.

B) The spleen is a storage organ for a large platelet population.

C) Platelets are not cells.

D) Platelets clump together at a site of injury.

E) All of the answers are correct.

E) All of the answers are correct.

230

A sign of thrombocytopenia would be

A) a drop in oxygen-carrying capacity.

B) allergic reactions.

C) bacterial infections.

D) excessive clotting.

E) bleeding.

E) bleeding (thromobocytopenia is low platelet number)

231

Plasminogen is converted to its active form by an enzyme called

A) tissue plasminogen activator.

B) papain.

C) fibrinolysin.

D) prothrombin.

E) polymerase.

A) tissue plasminogen activator.

232

Endothelial cells release ________ that stimulate smooth muscle contraction and accelerate the repair process.

A) platelets

B) endothelins

C) histamines

D) CSFs

E) heparins

B) endothelins (promote muscle contraction/spasm)

233

Most of the chemicals involved in the coagulation pathways are _______.

A) electrolytes.

B) lipids.

C) vitamins.

D) proteins.

E) carbohydrates.

D) proteins

234

Why do people with advanced kidney disease commonly become anemic?

(1) Damaged kidneys produce less erythropoietin and so there is less stimulation of the marrow to produce RBCs. (2) Erythropoietin is more easily lost into the urine by leaky kidneys. (3) Finally, during dialysis treatment, the patient's erythropoietin is washed away. Treatment for kidney patients today includes injections of synthetic erythropoietin.

235

________ is a condition in which the red blood cells are increased.

A) Polycythemia

B) Leukemia

C) Anemia

D) Leukopenia

E) Thrombocytopenia

A) Polycythemia

236

________ is a condition in which the platelet count is low.

A) Polycythemia

B) Leukemia

C) Anemia

D) Leukopenia

E) Thrombocytopenia

E) Thrombocytopenia

237

The phase of hemostasis that involved clotting of blood is called

A) coagulation.

B) hemolysis.

C) vascular spasm.

D) a platelet plug.

E) diapedesis.

A) coagulation.

238

Which feature of WBCs makes them particularly important in tissue injury?

A) They undergo aerobic respiration.

B) They stick to injured blood vessels.

C) They undergo a fast rate of mitosis.

D) They can squeeze out through blood vessel walls into tissues.

E) They carry loads of oxygen.

D) They can squeeze out through blood vessel walls into tissues.

239

A cross-match test is performed between donor blood and recipient blood, even though the ABO and Rh blood types match between the two because

A) there are many more surface antigens on red blood cells other than A, B and Rh.

B) all antibodies of the donor blood and the recipient blood must be identified.

C) coagulation can occur even in a small percentage of cases.

D) one has to make sure that the same agglutinogens have to be on both donor and recipients red blood cells.

E) errors are commonly made by the clinical staff regarding donor-recipient matches.

A) there are many more surface antigens on red blood cells other than A, B and Rh.

240

Plasma extenders are used to

A) maintain the normal osmotic pressure of blood.

B) carry oxygen to the tissues.

C) maintain the normal blood pH.

D) keep blood volume normal.

E) keep blood volume normal and maintain osmotic pressure.

E) keep blood volume normal and maintain osmotic pressure.

241

People who suffer from hemophilia A fail to produce a functional Factor VIII; as a result,

A) they lack a functional intrinsic pathway.

B) they lack a functional extrinsic pathway.

C) they lack a functional common pathway.

D) their coagulation times are much longer than normal.

E) their coagulation times are too quick.

A) they lack a functional intrinsic pathway.

242

A substance that activates plasminogen might be useful to

A) cause clots to form faster.

B) cause clot dissolution to proceed faster.

C) initiate clot formation.

D) mimic heparin.

E) recruit neutrophils to an infection.

B) cause clot dissolution to proceed faster.

243

The enzyme that can digest fibrin and dissolve a clot is

A) thrombin.

B) plasmin.

C) heparin.

D) fibrinase.

E) phosphokinase.

B) plasmin.

244

The process of fibrinolysis

A) activates fibrinogen.

B) draws torn edges of damaged tissue closer together.

C) dissolves clots.

D) forms emboli.

E) forms thrombi.

C) dissolves clots.

245

The intrinsic pathway of coagulation is activated by the

A) sticking of platelets to each other.

B) activation of Factor XII by platelet factors.

C) release of tissue factor (Factor III) by damaged endothelium.

D) release of heparin from the liver.

E) conversion of prothrombin to thrombin.

B) activation of Factor XII by platelet factors.

246

Blood temperature is approximately ___________, and blood pH averages ___________.

(a) 36°C, 7.0,

(b) 39°C, 7.8,

(c) 38°C, 7.4,

(d) 37°C, 7.0.

(c) 38°C, 7.4,

247

A hemoglobin molecule is composed of

(a) two protein chains,

(b) three protein chains,

(c) four protein chains and nothing else,

(d) four protein chains and four heme groups,

(e) four heme groups but no protein

(d) four protein chains and four heme groups

248

The following is a list of the phases involved in the process of hemostasis.

(1) coagulation

(2) fibrinolysis

(3) vascular spasm

(4) retraction

(5) platelet phase

The correct sequence of these phases is

(a) 5, 1, 4, 2, 3,

(b) 3, 5, 1, 4, 2,

(c) 2, 3, 5, 1, 4,

(d) 3, 5, 4, 1, 2,

(e) 4, 3, 5, 2, 1.

(b) 3, 5, 1, 4, 2,

249

Stem cells responsible for lymphopoiesis are located in

(a) the thymus and spleen,

(b) the lymph nodes,

(c) the red bone marrow,

(d) all of these structures.

(d) all of these structures (generation of lymphocytes)

250

Dehydration would

(a) cause an increase in the hematocrit,

(b) cause a decrease in the hematocrit,

(c) have no effect on the hematocrit,

(d) cause an increase in plasma volume.

(a) cause an increase in the hematocrit,

251

Erythropoietin directly stimulates RBC formation by

(a) increasing rates of mitotic divisions in erythroblasts,

(b) speeding up the maturation of red blood cells,

(c) accelerating the rate of hemoglobin synthesis,

(d) a, b, and c.

(d) a, b, and c.

252

A difference between the A, B, and O blood types and the Rh factor is

(a) Rh agglutinogens are not found on the surface of red blood cells,

(b) Rh agglutinogens do not produce a cross-reaction,

(c) individuals who are Rh – do not carry agglutinins to Rh factor unless they have been previously sensitized,

(d) Rh agglutinogens are found free in the

(c) individuals who are Rh – do not carry agglutinins to Rh factor unless they have been previously sensitized

253

What five major functions are performed by blood?

1. transport gases/nutrients/wastes/hormones

2. regulates pH

3. restricts fluid loss through damage

4. defends against toxins/pathogens

5. stabilizes body temperature

254

Name the three major types of plasma proteins and identify their functions,

Albumin - maintain osmotic pressure and transfer fatty acids

Globulins - bind to small ions/hormones and attack foreign proteins (immunoglobulin)

Fibrinogen - clotting

255

Which type of antibodies does plasma contain for each of the following blood types?

(a) type A,

(b) type B,

(c) type AB,

(d) type O.

Type A - anti B antibodies

Type B - anti A antibodies

Type AB - neither anti A and B antibodies

Type O - both A and B antibodies

256

What four characteristics of WBCs are important to their response to tissue invasion or injury?

1. emigration (between endothelial cells and capillary wall)

2. amoeboid movement

3. positive chemotaxis

4. phagocytosis

257

Which kinds of WBCs contribute to the body’s nonspecific defenses?

Neutrophils, eosinophils, basophils, and monocytes

258

Name the three types of lymphocytes and identify their functions,

T cells - cell mediated immunity (phagocytes not antibodies)

B cells - humoral immunity (extracellular, antibodies)

Natural killer cells - immune surveillance

259

What is the difference between prothrombin and thrombin?

Prothrombin is an active precursor that is converted to thrombin during coagulation. Thrombin causes clotting by converting fibrinogen to fibrin.

260

What four conditions cause the release of erythropoietin?

Anemia, decrease in blood flow to kidney, oxygen in lungs decreases, damage to respiratory surfaces of lungs

261

What contribution from the intrinsic and the extrinsic pathways is necessary for the common pathway to begin?

Activation of factor X

262

How do red blood cells differ from white blood cells in both form and function?

RBCs - biconcave discs without ribosomes, mitochondria, nucleus; contain hemoglobin and transport gases

WBCs - larger, some granulated, have nucleus; immunity

263

What is the role of blood in the stabilization and maintenance of body temperature?

Absorbing and redistributing heat

264

Relate the structure of hemoglobin to its function,

Made of 4 protein subunits each containing molecule of heme. The heme picks up and releases oxygen

265

Why is aspirin sometimes prescribed for the prevention of vascular problems?

Inhibits clotting


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