Florida International University

BIO PCB 4023

Chapter 15

1)The changing color of a bruise is caused by the breakdown products of hemoglobin. Hemoglobin is broken down into        , which is a green molecule.   is a yellowish-brown molecule, again a breakdown product of hemoglobin.

1. 1. bilirubin : Biliverdin
   2. ammonia: Bile
   3. basophil : Plasma
   4. biliverdin : Bilirubin
   5. bile : Ammonia
2. What is a hematocrit measuring?
   1. the amount of oxygen that can be transported by blood
   2. the percentage of blood that is comprised of red blood cells only
   3. the percentage of blood that is comprised of red and white blood cells
   4. the amount of hemoglobin in blood
   5. the percentage of blood that is comprised of plasma
3. A normal hematocrit is approximately what value? A) 90 B) 45 C) 25 D) 10 E) 75

4. Polycythemia is best defined as a
   1. higher than normal concentration of protein in the plasma.
   2. higher than normal concentration of erythrocytes.
   3. lower than normal concentration of erythrocytes.
   4. lower than normal concentration of leukocytes.
   5. higher than normal concentration of leukocytes.
5. What is the most abundant plasma protein?
   1. carbonic anhydrase
   2. fibrinogen
   3. albumin
   4. globulins
   5. hemoglobin
6. Which statement best describes the function of albumins?
   1. They provide the nutrients needed to replicate erythrocytes.
   2. They transport lipids, playing a role in clotting and defending the body against foreign substances.
   3. They primarily affect the movement of fluid into capillaries by creating an osmotic gradient.
   4. They aid in the structural form of the erythrocyte.
   5. They are the key substance in the formation of blood clots.

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7. Which statement best describes the function of globulins?
   1. They provide the nutrients needed to replicate erythrocytes.
   2. They aid in the structural form of the erythrocyte.
   3. They are the key substance in the formation of blood clots.
   4. They primarily affect the movement of fluid into capillaries by creating an osmotic gradient.
   5. They transport lipids, playing a role in clotting and defending the body against foreign substances.
8. Which statement best describes the function of fibrinogen?
   1. It is the key substance in the formation of blood clots.
   2. It provides the nutrients needed to replicate erythrocytes.
   3. It transports lipids, playing a role in clotting and defending the body against foreign substances.
   4. It primarily affects the movement of fluid into capillaries by creating an osmotic gradient.
   5. It aids in the structural form of the erythrocyte.

9. A majority of the protein present within blood is synthesized within what organ?
   1. kidneys
   2. central nervous system
   3. skeletal muscles
   4. lungs
   5. liver
10. Which of the following statements is NOT accurate with respect to erythrocytes?
    1. They lack mitochondria.
    2. They transport oxygen and carbon dioxide.
    3. They contain large amounts of hemoglobin.
    4. They lack nuclei.
    5. They migrate into infected regions of tissue.
11. Which statement best describes the importance of the biconcave shape of erythrocytes?
    1. It allows for phagocytosis of foreign particles.
    2. It allows for the movement of erythrocytes out of the capillaries.
    3. It provides a large surface are for the exchange of gases.
    4. It makes the erythrocyte small and flexible.
    5. It conforms to the molecular shape of hemoglobin.
12. The iron-containing ring in hemoglobin is called  and it binds           .
    1. spectrin : carbon dioxide
    2. heme : carbon dioxide or oxygen
    3. globin : oxygen
    4. heme : carbon dioxide
    5. heme : oxygen

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13. What enzyme catalyzes the conversion of carbon dioxide and water to carbonic acid, and where is this enzyme located?
    1. carbonic dehydrogenase, in plasma
    2. carbonic anhydrase, in hemoglobin
    3. carbonic anhydrase, in plasma
    4. carbonic anhydrase, in erythrocytes
    5. carbonic dehydrogenase, in hemoglobin
14. Carbonic acid reversibly dissociates to form what two products, without the need of an enzyme?
    1. water and hydrogen ion
    2. bicarbonate and hydrogen ion
    3. carbon dioxide and bicarbonate
    4. water and bicarbonate
    5. water and carbon dioxide
15. Erythrocytes are synthesized in what organ and under the control of what chemical?
    1. bone marrow, under control of bilirubin
    2. bone marrow, under control of erythropoietin
    3. liver, under control of erythropoietin
    4. liver, under control of bilirubin
    5. kidney, under control of transferrin
16. What hematopoietic growth factor controls red blood cell synthesis, and what organ releases it?
    1. oxytocin, released by posterior pituitary
    2. erythropoietin, released by kidney
    3. parathyroid hormone, released by parathyroid glands

16. 4. transferrin, released by bone marrow
    5. calcitonin, released by kidney
17. What triggers erythropoietin release?
    1. increased blood carbon dioxide levels
    2. damage to a blood vessel wall and subsequent exposure of collagen
    3. decreased blood oxygen levels
    4. infection in the blood
    5. infection in the tissues
18. Lab results for your patient have just been sent from the lab and the lab tech has flagged the reticulocyte count as higher than normal. Which statement best describes why you should be concerned about a higher than normal recticulocyte count?
    1. It is a common side effect of iron-deficiency anemia.
    2. This may indicate a severe hemorrhage.
    3. It may be a result of polycythemia.
    4. This may be evidence of a myocardial infarction.
    5. This may be an indication of leukemia.

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19. Pernicious anemia is associated with which of the following?
    1. damage to the bone marrow
    2. abnormal hemoglobin
    3. inadequate bilirubin levels
    4. insufficient vitamin B12
    5. bleeding
20. Old red blood cells are removed from the blood by macrophages in what organ?
    1. bone marrow
    2. kidney
    3. spleen
    4. pancreas
    5. thymus
21. Olympic athletes train in Colorado Springs, Colorado because this location is at high altitude and near the 14,000 foot Pikes Peak. Which statement best describes why this location was chosen?
    1. Oxygen levels are low and, therefore, more red blood cells are produced, giving the athletes an advantage when competing at lower altitudes.
    2. The thinner air causes it to be easier to move into and out of the lungs, which leads to higher oxygen transport.
    3. Oxygen levels are low and therefore fewer red blood cells are available, which puts more physiological stress on the body. This leads to a greater efficiency of getting oxygen to the tissues.
    4. The thin air allows for less resistance when biking or running and, therefore, the athletes can run and bike faster, which builds up their endurance for future races
    5. The concentration difference for getting air into the lungs is greater at high altitudes.
22. Some athletes, in order to gain an advantage over their competitors, participate in blood doping. This process increases the number of red blood cells in their cardiovascular systems and in turn delivers more oxygen to their metabolically active tissues. Which statement best describes how athletes' blood dope and the dangers associated with blood doping?
    1. Colony-stimulating factors are injected to increase the number of red blood cells. Too many, however, can clog arteries, causing a heart attack.
    2. Hemoglobin is injected, increasing the oxygen carrying capacity of red blood cells. However, too much hemoglobin can cause hemolysis.
    3. Erythropoietin is injected stimulating more red blood cell production. An increase in red blood cells increases the hematocrit which can increase blood pressure and weaken vessels making the chances of

stroke increase.

1. 4. Athletes receive blood transfusions to increase the number of red blood cells and by doing so increase their chances of developing aids or hepatitis C.
   5. Leukocytes are injected because they are larger than red blood cells. However, they make the body more susceptible to infection.

23. During hemoglobin metabolism, what is the yellow pigmented substance produced by the removal of the iron group called?
    1. ferritin B) transferrin C) bilirubin D) bile E) myoglobin

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24. What is the life span of an erythrocyte?
    1. 1 day
    2. 10 days
    3. 30 days
    4. 120 days
    5. They last for as long as you live.
25. Which metabolite of hemoglobin imparts the yellowish tinge found in plasma and in the condition of jaundice?
    1. ferritin
    2. biliverdin
    3. transferring
    4. bilirubin
    5. bile
26. You're looking at your patient's complete blood count (CBC) and notice that he has a normal hematocrit but low hemoglobin. What is the most likely cause for this result?
    1. aplastic anemia
    2. iron-deficiency anemia
    3. hemolytic anemia
    4. hemorrhagic anemia
    5. renal anemia
27. An elevated leukocyte count is indicative of infection. What procedure would give a physician a better guess at what type of infection?
    1. a hemoglobin A1C test
    2. a differential white blood cell count
    3. a platelet count
    4. a bleeding time test
    5. a CBC
28. Your patient has been admitted for an asthma attack. In what type of white blood cell would you expect to see an elevated count?
    1. eosinophils
    2. basophils
    3. monocytes
    4. neutrophils
    5. lymphocytes

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29. You notice on your patient's complete blood count (CBC) that she has a very low basophil count. Which statement best describes this abnormal result?
    1. Sickle cell anemia may have inhibited basophil production.
    2. This is a common side effect of rheumatoid arthritis.
    3. The basophils may have been killed by a flu virus.

29. 4. This may be due to an acute allergic reaction.
    5. It can be an indication of a microbial infection.
30. Your patient is an elderly woman who has been treated with prednisone (a steroid) for years to treat her rheumatoid arthritis. In what type of white blood cell would you expect to see an elevated count?
    1. monocytes
    2. eosinophils
    3. neutrophils
    4. lymphocytes
    5. basophils
31. What is the most abundant class of white blood cells?
    1. eosinophils
    2. neutrophils
    3. lymphocytes
    4. monocytes
    5. basophils
32. Which of the following leukocytes has cytoplasmic granules?
    1. neutrophils only
    2. basophils only
    3. eosinophils only
    4. both basophils and eosinophils
    5. basophils, eosinophils, and neutrophils
33. Which of the following leukocytes is a phagocyte?
    1. neutrophils only
    2. basophils only
    3. monocytes only
    4. both neutrophils and basophils
    5. both neutrophils and monocytes
34. What type of leukocyte defends against parasitic infections?
    1. neutrophils
    2. basophils
    3. eosinophils
    4. monocytes
    5. erythrocytes

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35. What type of leukocyte secretes heparin?
    1. eosinophils
    2. neutrophils
    3. lymphocyte
    4. basophils
    5. monocytes
36. B cells and T cells fall under what category of leukocytes?
    1. neutrophils
    2. basophils
    3. monocytes
    4. lymphocytes
    5. eosinophils
37. What type of leukocyte differentiates into macrophages in the tissues?
    1. monocytes

37. 2. lymphocytes
    3. basophils
    4. eosinophils
    5. neutrophils
38. What type of cell is the precursor for platelets?
    1. megakaryocytes
    2. neutrophils
    3. macrophages
    4. null cells
    5. erythrocytes
39. What is the stoppage of bleeding called?
    1. erythrostasis
    2. homeostasis
    3. fibrinostasis
    4. vasculostasis
    5. hemostasis
40. Which of the following is the first step of hemostasis?
    1. formation of a blood clot
    2. formation of a fibrin clot
    3. vascular spasm
    4. secretion of histamine
    5. formation of a platelet plug

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41. Formation of a platelet plug is initiated by   binding to            .
    1. fibrin : erythrocytes
    2. ADP : platelets
    3. arachidonic acid : collagen
    4. thrombin : platelets
    5. von Willebrand factor : collagen
42. Platelets become sticky when exposed to which of the following?
    1. von Willebrand factor
    2. thrombin
    3. serotonin
    4. fibrin
    5. prostacyclin
43. Which of the following chemicals involved in the development of a platelet plug is secreted by activated platelets in response to ADP?
    1. epinephrine
    2. serotonin
    3. arachidonic acid
    4. thromboxane A2
    5. prostacyclin
44. In healthy endothelial cells, arachidonic acid is converted to                      , which       formation of blood clots.
    1. prostacyclin : inhibits
    2. thromboxane A2 : inhibits
    3. thromboxane A2 : stimulates
    4. nitric oxide : inhibits
    5. prostacyclin : stimulates

45. In activated platelets, arachidonic acid is converted to                       , which   formation of blood clots.
    1. thromboxane A2 : inhibits
    2. prostacyclin : stimulates
    3. nitric oxide : inhibits
    4. prostacyclin : inhibits
    5. thromboxane A2 : stimulates
46. What converts fibrinogen to fibrin?
    1. plasmin
    2. von Willebrand factor
    3. thrombin
    4. arachidonic acid
    5. prostacyclin

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47. What chemical dissolves blood clots?
    1. heparin
    2. protein C
    3. fibrin
    4. plasmin
    5. thromboxane A2
48. Hemophilia is a genetic clotting disorder usually characterized by the absence of what clotting factor?
    1. thrombin
    2. factor XIII
    3. von Willebrand factor
    4. factor X
    5. factor VIII
49. Low dosages of aspirin inhibit clotting by blocking the formation of which of the following?
    1. thrombin
    2. factor VIII
    3. vitamin K
    4. factor X
    5. thromboxane A2
50. High doses of aspirin can stimulate clotting by inhibiting the synthesis of
    1. tissue plasminogen activator.
    2. plasmin.
    3. protein C.
    4. thrombomodulin.
    5. prostacyclin.
51. Most coagulation factors are synthesized by what organ?
    1. bone marrow
    2. liver
    3. thymus
    4. kidney
    5. heart
52. Which statement below best describes why diabetics are two times more likely to develop cardiovascular disease than non-diabetics?
    1. Diabetes promotes bacterial infections which will eventually destroy the heart.
    2. Diabetics must take insulin and, therefore, their blood glucose levels fluctuate causing tremendous stress on all systems of their bodies.

1. 3. Diabetes leads to heart disease because of the side effects of insulin on the cardiovascular system.
   4. Diabetes leads to high cholesterol levels and, therefore, atherosclerosis.
   5. Diabetics tend to be obese and, therefore, cannot get enough aerobic exercise.

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53. Which white blood cell is a phagocyte that also releases toxins from its cytoplasmic granules?
    1. monocyte
    2. eosinophil
    3. neutrophil
    4. basophil
    5. lymphocyte
54. Which white blood cell is the most abundant phagocyte in the blood?
    1. eosinophil
    2. lymphocyte
    3. neutrophil
    4. monocyte
    5. basophil
55. Which white blood cell is a non-phagocytic granulocyte?
    1. basophil
    2. lymphocyte
    3. monocyte
    4. neutrophil
    5. eosinophil
56. Which white blood cell differentiates into macrophages in the tissue?
    1. basophil
    2. monocyte
    3. neutrophil
    4. lymphocyte
    5. eosinophil
57. Which type of white blood cell includes B and T cells?
    1. neutrophil
    2. eosinophil
    3. basophil
    4. lymphocyte
    5. monocyte
58. Which chemical forms the meshwork of the blood clot?
    1. thrombin
    2. thromboxane A2
    3. arachidonic acid
    4. von Willebrand factor
    5. fibrin  10
59. Which chemical formed from arachidonic acid facilitates platelet plug formation?
    1. fibrin
    2. thrombin
    3. von Willebrand factor
    4. thromboxane A2
    5. arachidonic acid
60. Thrombin plays a direct role in

60. 1. stimulating nitric oxide release.
    2. causing vasoconstriction of blood vessels.
    3. activating factor X.
    4. the production of prothrombin.
    5. the conversion of fibrinogen to fibrin.
61. Which chemical, formed from arachidonic acid, inhibits platelet plug formation?
    1. thrombin
    2. prostacyclin
    3. fibrin
    4. thromboxane A2
    5. arachidonic acid
62. What substance binds to collagen and activates platelets?
    1. thromboxane A2
    2. fibrin
    3. thrombin
    4. von Willebrand factor
    5. arachidonic acid
63. What substance inhibits both the intrinsic and extrinsic clotting pathways?
    1. thromboxane A2
    2. fibrin
    3. arachidonic acid
    4. von Willebrand factor
    5. protein C  11
64. What chemical is released from aggregated platelets and stimulates the platelets to produce thromboxane A2?
    1. prostacyclin
    2. protein C
    3. ADP
    4. arachidonic acid
    5. thromboxane A2
65. What substance is a precursor for prostacyclin?
    1. arachidonic acid
    2. thrombin
    3. von Willebrand factor
    4. fibrin
    5. thromboxane A2
66. What is plasma from which clotting factors have been removed called?
    1. platelets
    2. serum
    3. buffy white coat
    4. thrombocytes
    5. colony-stimulating factors
67. What cytosolic protein gives the membrane of erythrocytes its flexibility?
    1. fibrinogen
    2. heme group
    3. spectrin
    4. fibrin
    5. globin

68. The enzyme            catalyzes the reversible reaction whereby carbon dioxide and water are converted to

             .

68. 1. carboxypeptidase : carbonic acid
    2. prostacyclin : protein C
    3. carbonic anhydrase : carbonic acid
    4. carboxypeptidase : acidic acid
    5. hydrolase : carbonase
69. Synthesis of red blood cells is called      and occurs in the         .
    1. erythropoiesis : bone marrow
    2. erythropoiesis : kidney
    3. hemostasis : kidney
    4. erythropoiesis : spleen
    5. hemostasis : bone marrow

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70. What cell type is the last stage of erythrocyte production prior to development of a mature erythrocyte?
    1. monocyte
    2. myeloid stem cell
    3. lymphoid stem cell
    4. megakaryocyte
    5. reticulocyte
71. What is defined as a decrease in the oxygen-carrying capacity of blood?
    1. anemia
    2. polycythemia
    3. hypoxia
    4. hemolysis
    5. hematocrit
72. An increase in plasma levels of               causes a yellowish appearance of the skin and the whites of the eyes. This condition is called .
    1. bilirubin : jaundice
    2. biliverdin : jaundice
    3. bilirubin : renal anemia
    4. bilirubin : hemostasis
    5. bile : pernicious anemia
73. Which of the following white blood cells are granulocytes?
    1. neutrophils, eosinophils, and basophils
    2. monocytes, lymphocytes, and megakaryocytes
    3. monocytes, lymphocytes, and reticulocytes
    4. neutrophils, eosinophils, and monocytes
    5. monocytes, lymphocytes, and macrophages
74. Which of the following leukocytes are phagocytes?
    1. neutrophils, eosinophils, and monocytes
    2. neutrophils, eosinophils, and basophils
    3. monocytes, lymphocytes, and megakaryocytes
    4. monocytes, lymphocytes, and macrophages
    5. monocytes, lymphocytes, and reticulocytes
75. Both the intrinsic and extrinsic pathways converge on activation of what factor, which then activates prothrombin?
    1. factor IV