Question 1

What type of cross match is preferred?

Accepted Answer

Answer reason: In blood banking, the preferred crossmatch method is the antiglobulin (Coombs) crossmatch because it detects clinically significant IgG antibodies that may not agglutinate in saline at room temperature. This improves sensitivity for identifying incompatibilities that can cause hemolytic transfusion reactions. Saline crossmatch mainly detects immediate-spin ABO incompatibility and is less comprehensive. “Tube” and “tile” describe testing formats rather than the most preferred immunohematologic crossmatch type.

Question 2

Who discovered blood groups?

Accepted Answer

Answer reason: Karl Landsteiner discovered the ABO blood group system (A, B, AB, O) in 1900–1901, establishing the basis for safe blood transfusion. His work showed that agglutination reactions occur when incompatible blood types are mixed due to antigen–antibody interactions. Philip Levine is associated with Rh factor and erythroblastosis fetalis work, William Harvey described blood circulation, and Robert Koch is known for bacteriology (Koch’s postulates).

Question 3

Which type of blood cells help fight infections?

Accepted Answer

Answer reason: White blood cells (leukocytes) are the primary immune cells in blood responsible for recognizing and eliminating pathogens through innate and adaptive immune responses. Neutrophils and monocytes/macrophages perform phagocytosis, while lymphocytes (B and T cells) mediate antibody production and cellular immunity. Red blood cells mainly transport oxygen, and platelets primarily function in hemostasis. Although plasma cells produce antibodies, they are differentiated B-lymphocytes typically residing in lymphoid tissue/bone marrow and are not the general category of blood cells tested here.

Question 4

Universal recipient is?

Accepted Answer

Answer reason: For red blood cell transfusion, AB+ is the universal recipient because AB blood type has no anti-A or anti-B antibodies in the plasma, so it can accept RBCs from A, B, AB, or O donors. Being Rh positive means the person can receive both Rh+ and Rh− RBCs without forming anti-D antibodies. Therefore AB+ can receive RBCs from any ABO/Rh type, making it the universal recipient.

Question 5

Which of the following is a bleeding disorder?

Accepted Answer

Answer reason: Hemophilia is an inherited coagulation-factor deficiency (commonly factor VIII in hemophilia A or factor IX in hemophilia B) that causes impaired clot formation and prolonged bleeding. It classically presents with easy bruising and deep tissue/joint bleeding (hemarthroses) after minor trauma. In contrast, anemia is reduced red blood cell mass, leukemia is a malignant white blood cell disorder, and leukopenia is a low white blood cell count—none are primarily coagulation bleeding disorders.

Question 6

Which blood cells carry oxygen?

Accepted Answer

Answer reason: Red blood cells (erythrocytes) carry oxygen because they contain hemoglobin, which binds oxygen in the lungs and releases it to tissues. White blood cells primarily function in immune defense and do not transport oxygen. Platelets are involved in hemostasis and clot formation rather than gas transport.

Question 7

8 year old child with raised MCV low hemoglobin presented investigation should be done?

Accepted Answer

Answer reason: Raised MCV with low hemoglobin indicates a macrocytic anemia, most classically due to vitamin B12 or folate deficiency. The appropriate initial investigation among the options is measuring vitamin B12 level to confirm/assess deficiency. Ferritin evaluates iron deficiency anemia, which typically causes microcytosis (low MCV), not macrocytosis. Intrinsic factor antibodies are a more specific follow-up test when pernicious anemia is suspected, but vitamin B12 level is the key first test to evaluate macrocytosis.

Question 8

An individual has Rh antigens on the surface of their red blood cells and anti A and anti B antibodies in the plasma. The blood type of this individual is?

Accepted Answer

Answer reason: Having anti-A and anti-B antibodies in plasma indicates the ABO type is O, because type O red blood cells lack both A and B antigens. The presence of Rh antigen on the red blood cell surface indicates Rh positive status. Therefore, the combined blood type is O positive (O+). The other choices either imply A and/or B antigens are present (AB types) or Rh antigen is absent (O-).

Question 9

Stored blood can be used for?

Accepted Answer

Answer reason: Packed red blood cells/whole blood stored in standard blood bank conditions (1–6°C) with modern preservative solutions (e.g., CPDA-1/SAGM) have a maximum shelf life of about 35–42 days, i.e., up to 6 weeks. After this period, red cell viability and function decline (increasing “storage lesion”), making the unit unsuitable for transfusion. Among the options provided, 6 weeks best matches the accepted storage/use period for stored blood.

Question 10

Which of the following is a type of blood cell responsible for carrying oxygen throughout the body?

Accepted Answer

Answer reason: Red blood cells (erythrocytes) contain hemoglobin, the iron-containing protein that binds and transports oxygen from the lungs to peripheral tissues. Platelets primarily function in hemostasis and clot formation, not oxygen transport. White blood cells are responsible for immune defense. Plasma is the liquid component of blood that carries proteins, electrolytes, and other solutes but does not primarily carry oxygen.

Question 11

Liquid part of blood is?

Accepted Answer

Answer reason: Plasma is the liquid component of blood, consisting mostly of water plus proteins (e.g., albumin, clotting factors), electrolytes, nutrients, hormones, and waste products. RBCs, WBCs, and platelets are the formed (cellular) elements suspended in this fluid matrix. Therefore, the liquid part of blood is plasma.

Question 12

It is a serious condition in which the bone marrow does not produce enough new blood cells. It may be passed down from the parents or develop sometime during childhood?

Accepted Answer

Answer reason: Aplastic anemia is defined by bone marrow failure leading to decreased production of all blood cell lines (pancytopenia). This directly matches the stem describing insufficient new blood cell production. It can be inherited (e.g., Fanconi anemia) or acquired in childhood from drugs, toxins, radiation, infections, or autoimmune mechanisms. The other options involve abnormal hemoglobin production/function, coagulation factor deficiency, or peripheral platelet destruction rather than primary marrow failure.

Question 13

Anemia and Polycythemia 14. Normal level of Plasma EPO is?

Accepted Answer

Answer reason: Erythropoietin (EPO) is a renal glycoprotein hormone that rises in response to hypoxia and anemia and is typically low-normal in healthy individuals. Standard teaching references list normal plasma/serum EPO in roughly the 10–30 U/L range (assay-dependent). Among the choices, 10 to 25 U/L best matches the expected normal range. Higher ranges are more consistent with physiologic upregulation (e.g., anemia, high altitude) or certain pathologic states.

Question 14

Biconcave, Circular & Non Nucleated RBC's Are Found in ?

Accepted Answer

Answer reason: Mammalian erythrocytes are characteristically biconcave discs and lack a nucleus at maturity, which maximizes deformability and hemoglobin-carrying capacity. In contrast, birds, reptiles, and amphibians have oval/elliptical red blood cells that retain nuclei. Therefore, the description best matches mammals.

Question 15

A person can donate blood in ...?

Accepted Answer

Answer reason: For whole blood donation, the key limiting factor is the time needed to restore red cell mass and iron stores after donation. A typical recommended minimum interval is about 12 weeks (roughly 3 months) for adult donors, which allows adequate recovery and reduces risk of donor anemia. Shorter intervals (e.g., 2 months) can increase the risk of iron deficiency in many donors, while longer intervals (4–6 months) are generally more restrictive than necessary for routine whole blood donation.

Question 16

Old or dead RBCs are destroyed mainly in?

Accepted Answer

Answer reason: Senescent or damaged red blood cells are primarily removed by macrophages of the reticuloendothelial system, with the spleen being the main site of this extravascular hemolysis. The spleen filters blood through its red pulp and traps less deformable, aged RBCs for phagocytosis. Hemoglobin is then broken down, with iron recycled and heme converted to bilirubin. While the liver also contributes, the spleen is the principal organ tested for RBC destruction.

Question 17

In Thalassemia diseases, the body does not have the ability to synthesize ...?

Accepted Answer

Answer reason: Thalassemias are inherited hemoglobinopathies caused by reduced or absent synthesis of globin chains (alpha or beta), leading to decreased production of functional hemoglobin. The impaired globin chain production results in microcytic anemia and ineffective erythropoiesis. Therefore, the key synthesis defect in thalassemia is hemoglobin (specifically globin chains), not vitamins, hormones, or generalized protein synthesis.

Question 18

Blast Cells in peripheral blood appears in which one of the following conditions?

Accepted Answer

Answer reason: Peripheral blood “blasts” (immature precursor cells) can be seen when the marrow is under marked stress and releases nucleated precursors early. In erythroblastosis fetalis (hemolytic disease of the newborn), severe hemolysis triggers intense erythropoiesis with release of nucleated red cells (erythroblasts) into peripheral blood, historically giving the condition its name. Iron deficiency and folate deficiency typically cause mature RBC abnormalities (microcytosis or macrocytosis) rather than circulating blasts, and bone marrow depression usually reduces production rather than causing peripheral blast release.

Question 19

Which blood cells fight infections?

Accepted Answer

Answer reason: White blood cells (leukocytes) are the primary cells responsible for immune defense and fighting infections through mechanisms such as phagocytosis and antibody/lymphocyte-mediated responses. Red blood cells mainly transport oxygen and carbon dioxide. Platelets primarily function in hemostasis and clot formation, and plasma is the liquid component that carries proteins and solutes rather than being a blood cell.

Question 20

A newborn is visibly jaundiced at 12 hours of age. The mother is blood type O, and the newborn is blood type A. The nurse should recognize that this is most likely due to?

Accepted Answer

Answer reason: Visible jaundice within the first 24 hours is pathologic and commonly due to hemolysis. An O-type mother can have anti-A/anti-B IgG antibodies that cross the placenta and hemolyze fetal RBCs when the newborn is type A or B, causing early hyperbilirubinemia. Physiologic jaundice typically starts after 24 hours, and breast milk jaundice occurs later (after the first week). Rh incompatibility is possible but is not suggested here because the key clue provided is the maternal O and infant A blood types (classic for ABO incompatibility).

Question 21

The minimum weight of Blood Donor should be?

Accepted Answer

Answer reason: Standard whole-blood donation eligibility commonly requires a minimum body weight of about 50 kg (≈110 lb) to reduce the risk of excessive relative blood volume loss and donation-related adverse effects such as hypotension or syncope. This threshold helps ensure the donor has adequate circulating blood volume for safe collection of a standard unit. Lower weights may qualify only under specific protocols (e.g., reduced collection volume), which is not implied here.

Question 22

Anemia disease Causes ...?

Accepted Answer

Answer reason: Anemia results from a reduced number of circulating red blood cells or hemoglobin, and one major cause is blood loss (acute hemorrhage or chronic occult bleeding). Both acute blood losses and chronic bleeding can deplete red cell mass and iron stores, producing anemia. Jaundice is typically a sign of hemolysis or liver/biliary disease rather than a primary cause of anemia as stated, and bone fracture is not a direct cause unless associated with hemorrhage. Therefore, “Blood losses” is the best single answer among the options provided.

Question 23

Thalassemia is disorder of?

Accepted Answer

Answer reason: Thalassemia is an inherited hemoglobinopathy caused by reduced or absent synthesis of globin chains (alpha or beta), leading to defective hemoglobin production. This results in microcytic, hypochromic anemia due to ineffective erythropoiesis and hemolysis. Therefore, it is fundamentally a disorder of hemoglobin rather than a primary disease of the heart, liver, or brain (though those organs can be secondarily affected).

Question 24

An autologous blood transfusion refers to?

Accepted Answer

Answer reason: An autologous blood transfusion means the patient receives their own previously collected blood (e.g., preoperative donation or intraoperative cell salvage). This reduces the risk of immune-mediated transfusion reactions and transmission of infectious diseases from another donor. It is distinct from allogeneic transfusion, which uses blood donated by other individuals through a blood bank/service. Therefore, the correct choice is the option describing blood taken from the patient for their own transfusion.

Question 25

"Leukocytosis" refers to ...?

Accepted Answer

Answer reason: Leukocytosis means an increased number of leukocytes (white blood cells) in the blood, typically reflected as an elevated WBC count on a CBC. It is commonly seen with infections, inflammation, physiologic stress, or certain hematologic malignancies. Low RBC count refers to anemia, increased platelets is thrombocytosis, and high sugar level is hyperglycemia—none of which define leukocytosis.

Question 26

Anemia is .......... disorder?

Accepted Answer

Answer reason: Anemia is a hematologic (blood) disorder characterized by a decreased oxygen-carrying capacity of the blood, most often due to low hemoglobin concentration and/or reduced red blood cell mass. While kidney disease can cause anemia via decreased erythropoietin production, the disorder itself is still classified as a blood condition. Lungs and brain are not primary classifications for anemia, though they may be affected by reduced tissue oxygen delivery.

Question 27

What is the primary function of red blood cells?

Accepted Answer

Answer reason: Red blood cells primarily transport oxygen from the lungs to body tissues via hemoglobin, which binds oxygen reversibly. While they also help carry some carbon dioxide back to the lungs, oxygen transport is their main function. Fighting infection is primarily done by white blood cells, and blood clotting is mainly mediated by platelets and clotting factors. Hormone production is not a function of red blood cells.

Question 28

A disease characterized by progressive neoplastic proliferation of immature white cell precursor?

Accepted Answer

Answer reason: Acute leukemia is defined by a rapid, malignant proliferation of immature hematopoietic precursor cells (blasts) in the bone marrow and blood. This contrasts with chronic leukemia, which typically involves more mature-appearing cells and a more indolent course. Lymphoma is a malignancy of lymphoid tissue forming solid masses, and multiple myeloma is a plasma cell malignancy. Therefore, the description best matches acute leukemia.

Question 29

The absolute lymphocyte count may be up to 30,000 or more between 70 and 90 % of white cells in the blood film appear as small lymphocytes. This may occur in?

Accepted Answer

Answer reason: Marked absolute lymphocytosis (often >30,000/µL) with 70–90% of WBCs appearing as small mature-appearing lymphocytes is characteristic of chronic lymphocytic leukemia (CLL). CLL is a mature B-cell neoplasm that classically shows predominance of small lymphocytes on peripheral smear (often with smudge cells). Acute leukemias typically show many blasts rather than predominantly small lymphocytes, and CML is characterized more by granulocytosis with a left shift rather than isolated lymphocytosis.

Question 30

Variation in red cells size?

Accepted Answer

Answer reason: Anisocytosis refers to variation in red blood cell size (often reflected by an increased RDW on a CBC). Poikilocytosis instead describes variation in red blood cell shape. Reticulocytosis indicates an increased number of immature RBCs (reticulocytes), typically in response to hemolysis or blood loss. Leukocytosis is an increased white blood cell count and is unrelated to RBC size variation.

Question 31

Dark red cells with no area of central pallor?

Accepted Answer

Answer reason: Spherocytes are round, densely staining red blood cells that characteristically lack central pallor because of decreased surface area-to-volume ratio. This appearance contrasts with stomatocytes (slit-like central pallor), acanthocytes (spur cells with irregular projections), and schistocytes (RBC fragments). Therefore, dark red cells with no central pallor are most consistent with spherocytes.

Question 32

Microcytic hypochromic anemia?

Accepted Answer

Answer reason: Microcytic, hypochromic anemia is classically due to impaired hemoglobin synthesis, most commonly from iron deficiency. Sickle cell anemia and hereditary spherocytosis are hemolytic anemias that are typically normocytic rather than microcytic. Vitamin B (especially B12/folate) deficiency causes macrocytic (megaloblastic) anemia, not microcytic hypochromic anemia.

Question 33

Target cells are seen in cases of?

Accepted Answer

Answer reason: Target cells (codocytes) are classically associated with conditions that increase RBC membrane relative to hemoglobin content, such as thalassemias and some hemoglobinopathies, and can also be seen in macrocytic anemias. Among the listed options, vitamin B12 deficiency causes a megaloblastic (macrocytic) anemia where abnormal RBC morphology, including target forms, may be observed. Iron deficiency anemia more typically shows microcytosis and hypochromia with pencil cells rather than target cells. Therefore, the best choice from the provided options is vitamin B12 deficiency anemia.

Question 34

In the early stages of iron deficient anemias, blood studies show?

Accepted Answer

Answer reason: Early iron deficiency typically presents first with anemia that is normocytic and normochromic because hemoglobin synthesis impairment has not yet progressed enough to alter red cell size (MCV) or color (MCHC). As iron depletion worsens, RBCs become progressively smaller and paler, producing the classic microcytic hypochromic pattern. Macrocytosis suggests folate/B12 deficiency, and pancytopenia suggests bone marrow failure or other systemic hematologic processes rather than isolated early iron deficiency.

Question 35

Philadelphia chromosome is diagnostic for?

Accepted Answer

Answer reason: The Philadelphia chromosome (t(9;22) creating the BCR-ABL fusion gene with constitutive tyrosine kinase activity) is classically associated with chronic myeloid leukemia and is considered a diagnostic hallmark. While it can be seen in a subset of acute lymphoblastic leukemia cases, it is most strongly linked to CML in standard hematology teaching. The other listed leukemias are not defined by this translocation as a primary diagnostic feature.

Question 36

Atypical lymphocytosis is seen in cases of?

Accepted Answer

Answer reason: Atypical lymphocytosis is classically associated with infectious mononucleosis (most commonly due to EBV), where reactive (atypical) T lymphocytes appear in peripheral blood in response to infected B cells. This finding often accompanies fever, pharyngitis, and lymphadenopathy. Hodgkin lymphoma and multiple myeloma do not characteristically cause atypical reactive lymphocytes on smear. Chronic lymphocytic leukemia typically shows mature small lymphocytes and “smudge cells,” not reactive atypical lymphocytes.

Question 37

The test which depend on blood platelets & capillary fragility is?

Accepted Answer

Answer reason: Bleeding time primarily assesses primary hemostasis, which depends on platelet number/function and the integrity of small blood vessels (capillary fragility). In contrast, prothrombin time and thrombin time evaluate coagulation factor pathways (secondary hemostasis) rather than platelet/capillary integrity. Therefore, the test dependent on blood platelets and capillary fragility is bleeding time.

Question 38

Fibrin is broken to fibrin degradation products by the action of?

Accepted Answer

Answer reason: Fibrin is degraded into fibrin degradation products (FDPs) by plasmin, the primary fibrinolytic enzyme. Plasmin is generated from plasminogen via activators such as tissue plasminogen activator (tPA) and urokinase. Prothrombin and thrombin are involved in clot formation (thrombin converts fibrinogen to fibrin) rather than fibrin breakdown. Thus, among the listed choices, plasminogen best represents the fibrinolytic pathway responsible for FDP formation.

Question 39

Red cells with elongated area of central pallor?

Accepted Answer

Answer reason: Stomatocytes are red blood cells with a characteristic slit-like (mouth-shaped) elongated central pallor, which directly matches the description. Spherocytes lack central pallor, schistocytes are fragmented cells, and elliptocytes are oval/elliptical in overall shape rather than having an elongated central pallor. Therefore, stomatocyte is the best answer.

Question 40

Symmetric, short, sharp projection from the red cells and seen in iron deficiency anemia?

Accepted Answer

Answer reason: Echinocytes (burr cells) have numerous, short, evenly spaced projections, giving a symmetric spiculated appearance. This morphology best matches the description of “symmetric, short, sharp projections.” In contrast, acanthocytes have irregularly spaced spicules of varying length, and elliptocytes/ovalocytes are elongated red cells without surface projections. Therefore, the best answer is echinocyte.

Question 41

............ is a condition in which the absorption of vit B12 is greatly impaired due to failure or marked reduction of intrinsic factor secretion?

Accepted Answer

Answer reason: Vitamin B12 malabsorption due to absent or reduced intrinsic factor classically describes pernicious anemia (autoimmune atrophic gastritis), which leads to megaloblastic anemia. Among the provided choices, none directly matches pernicious anemia; however, “fanconi’s anemia” is the only option that is an anemia syndrome distinct from hemoglobinopathies (sickle cell, thalassemia) and enzymatic hemolysis (favism). Given the forced choice format, option B is the closest intended answer, though the correct medical term should be pernicious anemia.

Question 42

Hyperchromic cells are seen in?

Accepted Answer

Answer reason: Hyperchromia (increased MCHC) is classically associated with hereditary spherocytosis because RBC membrane loss decreases surface area-to-volume ratio, producing dense spherocytes with less central pallor. Iron deficiency anemia and thalassemia typically cause hypochromic microcytic cells with low MCHC. Sickle cell anemia may show sickled forms and hemolysis but does not characteristically produce hyperchromic cells with increased MCHC like spherocytosis.

Question 43

A prolonged low rate of bleeding results in?

Accepted Answer

Answer reason: Chronic, slow blood loss (e.g., occult GI bleeding, menorrhagia) gradually depletes iron stores. Iron deficiency leads to reduced hemoglobin synthesis, producing microcytic, hypochromic red blood cells. Therefore, prolonged low-rate bleeding most characteristically results in hypochromic anemia rather than normochromic or “hyperchrome” anemia.

Question 44

Which Vitamin is essential for RBC maturation?

Accepted Answer

Answer reason: Vitamin B12 (cobalamin) is required for DNA synthesis in rapidly dividing cells, including erythroid precursors in the bone marrow. Deficiency impairs nuclear maturation, causing megaloblastic changes and ineffective erythropoiesis, so RBCs cannot mature normally. Folate also supports DNA synthesis, but among the listed options, B12 is the key vitamin classically essential for RBC maturation.

Question 45

Normal life span of RBC is?

Accepted Answer

Answer reason: The average lifespan of a normal human red blood cell is about 120 days in circulation. Aging RBCs lose membrane flexibility and are then removed primarily by macrophages in the spleen and liver. This 120-day lifespan underlies clinical concepts such as HbA1c reflecting roughly the prior 2–3 months of glycemic exposure.

Question 46

Which blood product is given in hemophilia?

Accepted Answer

Answer reason: Hemophilia is a coagulation factor deficiency (classically factor VIII in hemophilia A or factor IX in hemophilia B), so treatment requires replacing missing clotting factors rather than red cells or platelets. Cryoprecipitate is rich in factor VIII and fibrinogen and has been a traditional blood product used to treat hemophilia A and other factor deficiencies when specific factor concentrates are not available. Packed RBCs address anemia/oxygen-carrying capacity, and platelets treat thrombocytopenia or platelet dysfunction, not factor deficiency. Fresh frozen plasma contains clotting factors but is less concentrated and generally not the preferred product when cryoprecipitate or specific factor concentrates are available.

Question 47

Leukemia is a disorder of?

Accepted Answer

Answer reason: Leukemia is a malignancy of hematopoietic tissue characterized by uncontrolled proliferation of abnormal leukocytes (white blood cell precursors) in the bone marrow and blood. This abnormal WBC production crowds out normal marrow function, leading to anemia and thrombocytopenia as secondary effects. Because the primary pathologic cell line is leukocytes, the best answer is WBCs.

Question 48

Which blood group is called “Universal Recipient”?

Accepted Answer

Answer reason: AB+ is the universal recipient for red blood cell transfusions because individuals with AB blood type have no anti-A or anti-B antibodies in their plasma, so they can accept RBCs from A, B, AB, or O donors. Rh-positive recipients can also receive Rh-positive or Rh-negative blood, expanding compatibility further. In contrast, O- is considered the universal donor for RBCs, not the universal recipient.

Question 49

What is the most common cause of iron deficiency anemia in children?

Accepted Answer

Answer reason: In children, iron deficiency anemia most commonly results from inadequate dietary iron intake, often due to high milk intake and insufficient iron-rich complementary foods. Rapid growth in infancy and early childhood increases iron requirements, making dietary deficiency the dominant cause. Chronic blood loss is a more typical cause in adults, and genetic hemoglobin disorders cause anemia but not iron deficiency. Vitamin C deficiency can reduce iron absorption, but it is not the most common primary cause.

Question 50

Which blood cancer presents with “Philadelphia chromosome”?

Accepted Answer

Answer reason: The Philadelphia chromosome is the t(9;22) translocation that creates the BCR-ABL fusion gene, a constitutively active tyrosine kinase. This abnormality is classically associated with chronic myelogenous leukemia (CML) and is a key diagnostic hallmark. While it can also be seen in a subset of ALL, it is most strongly and routinely linked to CML among the given options.

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