OSA KROK 2 ALL HEMATOLOGY QUESTIONS

( explained topic by topic based )

ERYTHROCYTES
LEUCOCYTES
THROMBOCYTES
DIAGNOSTICS
TREATMENT
 Haematology: Erythrocytes
2018 Q 1. A 35-year-old man complains of rapidly increasing fatigue, palpitations, "visual snow", dizziness. He has a
history of peptic ulcer of the stomach. Objectively the skin is pale. Vesicular respiration is observed in the lungs.
2019
Systolic murmur is detected over the cardiac apex, heart rate is 100/min. BP is 100/70mmHg. The epigastrium is
slightly tender on palpation. Blood test: erythrocytes - 3.2x10*12/L, Hb - 100 g/L, Colour index - 0.94. What type of
anemia is the most likely present in this case?
“KROK year 2018 and 2019”

A. Sideroblastic anemia
B. Posthemorrhagic anemia
C. Iron deficiency anemia
D. Hemolytic anemia
E. Hypoplastic anemia
Post -

Hemorrhagic Anemia : ulcers in Anamnesis or

prolonged
Menstruation Traumas .

2005 2. A 52 y.o. woman complains of weakness, painful itching after washing and bathing, sensation of heaviness in
the head. On examination: hyperemia of skin of face, neck, extremities. АP:180/100mmHg. Spleen is 4 cm below
the rib arch edge. What is the most probable diagnosis?

A. Systemic sclerodermia
B. Allergic dermatitis
C. Dermatomyositis
D. Essential hypertension
E. Erythremia → painful
Always go For Erythema when you see

itching after washing and

bathing in Krok .

2017 3. A 14-year-old girl came to a general practitioner with complaints of weakness, loss of appetite, headache, rapid
fatigability. Her last menstruation was profuse and lasted for 14 days after previous delay of 2 months. Objectively:
2019
the skin is pale, heart rate is 90/min., BP is 110/70 mm Hg, Hb is 88 g/l. Rectal examination: the uterus and its
appendages are without changes, no discharge from the genital tracts. What complication occurred in the patient?

A. Gastritis
B. Dysmenorrhea
C. Somatoform autonomic dysfunction of hypotonic type
D. Migraine
E. Posthemorrhagic anemia
Post -

Hemorrhagic Anemia : ulcers in Anamnesis or

prolonged
Menstruation Traumas .

2016 4. A woman complains of muscle weakness and general fatigue, dyspnea, vertigo, brittleness of her hair and nails, an
urge to eat chalk. Anamnesis states uterine fibroid. Common blood analysis: erythrocytes - 2,8 T/l, Hb- 80 g/l, color
index - 0,78, anisocytosis, poikilocythemia, serum iron - 10 mcmol/l. What diagnosis is most likely?

A. B12-deficient anemia
B. Aplastic anemia
C. Hypoplastic anemia
D. Iron-deficiency anemia
E. Autoimmune hemolytic anemia

Iron
Deficient Anemia :
Microcytes ,
Sideropenie ,
Decreased c. I

( normal O -
85 -
l .
05 )
2013 5. A patient complains of fatigue, lack of appetite, pain and burning sensation in the tongue, numbness of the distal
limbs, diarrhea. Objectively: pale skin with lemon-yellow tint, face puffiness, brown pigmentation in the form of a
2015
"butterfly", bright red areas on the tongue. The liver is 3 cm below the costal margin, soft. Blood count: RBCs -
1,5x10*12/l, colour index - 1,2, WBCs - 3,8x10*9/l, thrombocytes - 180x10*9/l, eosinophiles - 0%, stab neutrophiles -
1%, segmented neutrophiles - 58%, lymphocytes - 38% monocytes - 3%, RBC macrocytosis. ESR - 28 mm/h.What
diagnosis are these presentations typical for?

A. Chronic adrenal failure

B. B12-deficiency anemia
C. Aplastic anemia
D. Iron deficiency anemia
E. Acute erythromyelosis
Biz -

Deficiency Anemia : * Me
gab blasts , Maeweytes ,

Colour Index more than normal ( normal O 85-

-
l -
05 )

2014 6. A 25-year-old female patient complains of marked weakness, sleepiness, blackouts, dizziness, taste disorder.
2015 The patient has a history of menorrhagia. Objectively: the patient has marked weakness, pale skin, cracks in the
corners of her mouth, peeling nails, systolic apical murmur. Blood test results: RBC - 3,4x10*12/l, Hb- 70 g/l,
colour index - 0,75, platelets - 140x10*9/l, WBC- 6,2x10*9/l. What is the most likely diagnosis?

A. Acute posthemorrhagic anemia

B. Acute leukemia
C. Chronic posthemorrhagic anemia → duration mentioned
D. B12-deficiency anemia
Although no was cracks mouth
my happen in chronic

E. Werlhof’s disease

Post -

Hemorrhagic Anemia : ulcers in Anamnesis or

prolonged
Menstruation Traumas .

2015 7. A 20-year-old patient was delivered to a surgical unit complaining of an incised wound on his right forearm that
has been bleeding for 1,5 days. Suffers from general weakness, vertigo, cold sweat, opplotentes. Skin and visible
mucous membranes are pale. Heart rate is 110/min, BP is 100/70 mm Hg. Blood test: Hb is 100 g/l, erythrocytes
2,5x10*12/l. What is the cause for the patient’s general condition?

A. Acute trombophlebitis
B. Posthemorrhagic anemia
C. Wound infection
D. Aplastic anemia
E. Concomitant disease
Post -

Hemorrhagic Anemia : ulcers in Anamnesis or

prolonged
Menstruation Traumas .

8. A 22-year-old woman on a reduced diet, vegetarian, attended a hospital with complaints of distorted smell and
2011
taste perception and lesions in the angles of her mouth. Objectively: sclera is distinctly blue. Diagnosis: iron-
20 12
deficiency anemia. What clinical syndrome is expressed primarily?
2015
A. Myelodysplasic
B. Sideropenic
C. Hemorrhagic
D. Anemic
E. Hemolytic
Iron
Deficient Anemia :
Microcytes ,
Sideropenie ,
Decreased c. I

( normal O -
85 -
l .
05 )
2010 9. A patient who works as a nightman was diagnosed with of chronic arsenious intoxication. What form of anemia is
characteristic for this disease?

A. Aplastic anemia
B. Iron deficiency anemia
C. Hemolytic anemia
D. Hyper sideric anemia
E. Normochromic anemia
Due
Hemolytic Anemia :
Miewspherocytoosis ,
to Some
Poisonings .

2011 10. A 42-year-old patient complains of back pain, darkened urine, general weakness, dizziness that occurred
after treating a cold with aspirin and ampicillin. Objectively: the patient is pale, with subicteric sclerae. HR: 98
bpm. Liver: +2 cm, spleen: +3 cm. In blood: RBCs: 2,6x10*12/l, Hb: 60g/l, CI: 0,9, WBCs: 9,4x10*9/l, basophils:
0,5%, eosinophils: 3%, stab neutrophils: 6% segmented neutrophils: 58%, lymphocytes: 25%, monocytes: 7%,
ESR: 38mm/hour, reticulocytes: 24%. Total bilirubin: 38milli mole/l. What complication occurred in the patient?

A. Toxic hepatitis
B. Cholelithiasis
C. Acquired hemolytic anemia
D. Agranulocytosis
E. Paroxysmal nocturnal hemoglobinuria
Due
Hemolytic Anemia :
Miewspherocytoosis ,
to Some
Poisonings .

11. Mother of a 10-month-old baby reports significant pallor, poor appetite, enlarged abdomen in the baby. As a
2014 neonate, the child underwent treatment in the in-patient hospital for jaundice and anemia. Objectively: the skin is
pale and jaundiced, teeth are absent, abdomen is enlarged, spleen is palpable. Blood test results: Hb- 90 g/l, RBC-
3, 0·1012/l, color index - 0,9, microspherocytosis, reticulocytosis up to 20%, serum bilirubin - 37 mmol/l,
unconjugated bilirubin - 28 mmol/l. What type of anemia has occurred in the patient?

A. B12-deficiency anemia
B. Iron-deficiency anemia
C. Protein-deficiency anemia
D. Hemolytic anemia
E. Hereditary elliptocytosis
Due
Hemolytic Anemia :
Miewspherocytoosis ,
to Some
Poisonings .

12. A 63-year-old female complains of general weakness, a feeling of heaviness, compression in the epigastrium,
2014 postprandial fullness, nausea, belching after meals. These symptoms have been observed for about 15
years. Objectively: body temperature is 36,4*C, respiratory rate: 20/min, Ps: 88/min, blood pressure: 115/75mmHg.
Skin and mucous membranes are pale. Blood test results: RBC: 2,0x10*12/l, Hb: 100g/l. Tests revealed parietal cell
antibodies. What is the most likely reason for the development of anemia in this patient?

A. Disruption of hemoglobin synthesis

B. Production of antibodies to intrinsic factor
C. Disruption of erythropoietin synthesis
D. Impaired iron absorption
E. Increased loss of iron

NB Parietal cells antibodies

Pernicious Anemia ( B12) due to Autoimmune A
gastritis
2012 13. A 42-year-old female lives in the basement, is unemployed, undernourished. She complains of having
general weakness, hair loss, brittle nails for six months, likes to eat chalk. Objectively: the patient is emaciated, pale,
has dry skin. Peripheral lymph nodes are not enlarged. Liver is +1,5 cm. In blood: RBCs: 1,8x10*12/l, Hb: 62g/l,
colour index: 0,78, reticulocytes: 0,5%, ESR: 18mm/h. Leukogram exhibits no pathology. What is a provisional
diagnosis?

A. Chronic hepatitis
B. B12-deficiency anaemia
C. Acquired haemolytic anaemia
D. Nutritional iron deficiency anaemia
E. Congenital haemolytic anaemia
Iron
Deficient Anemia :
Microcytes ,
Sideropenie ,
Decreased c. I

( normal O -
85 -
l .
05 )

2008
14. A 5 month old boy was born prematurely, he didn’t suffer from any disease at the infant age and later
on. Examination at an outpatient’s hospital revealed paleness of skin, sleepiness. Blood count: Hb: 95g/l,
2009 erythrocytes: 3,5x10*12/l, reticulocytes: 90/00, colour index: 0,7, osmotic stability of erythrocytes: 0,44-0,33%,
serum iron: 4,9 micromole/l. What is the most probable cause of anemia?

A. Iron deficit
B. B12-deficit
C. Hemogenesis immaturity
D. Infectious process
E. Erythrocyte hemolysis
Sider pence Decreased
Iron
Deficient Anemia :
Microcytes , ,
c. t

( normal O -
85 -
l .
05 )

2008 15. A 28 year old woman had the second labour and born a girl with manifestations of anemia and progressing
jaundice. The child’s weight was 3 400 g, the length was 52 cm. The woman’s blood group is B (III) Rh−, the father’s
blood group is A (III) Rh+, the child’s blood group is B (III) Rh+. What is the cause of anemia?

A. Antigen B incompatibility
B. Antigen A incompatibility
C. Rhesus incompatibility
D. Antigen AB incompatibility
E. Intrauterine infection

2008 16. A 50 year old patient has been admitted to the clinics with atrophic gastritis. Blood count:
erythrocytes: 3,8x10*12/l, Hb: 68g/l, c.i.: 1, macroanisocytosis, poikilocytosis. There is megaloblastic type of
haemopoesis. A number of leukocytes, reticulocytes and thrombocytes is reduced. Which pathology is suspected?

A. Iron deficiency anemia

B. B12-deficiency anemia
C. Hemolytic anemia
D. Post-hemorrhagic anemia
E. Thalassaemia
Biz -

Deficiency Anemia :
Mega
* b blasts
, Maeweytes ,

Colour Index more than normal (

normal O 85 -
-
l -
05 )
 17. Medical examination of a 43 y.o. man revealed objectively pailness of skin and mucous membranes, smoothness
2007
of lingual papillas, transverse striation of nails, fissures in the mouth corners, tachycardia. Hemoglobin content
amounts 90 g/l; there are anisocytosis, poikilocytosis. The most probable causative agent of this condition is
deficiency of the following microelement:

A. Copper
B. Iron
C. Zinc
D. Magnesium
E. Selenium
NB :
Deficiency
Brittle nails
of
iron leads to
mieweylie Anemia Symptoms
.
include :

,
taehgehardia ,
smooth
tongue pallor etc .

18. A 14 y.o. girl complains of profuse bloody discharges from genital tracts during 10 days after suppresion of
2005
menses for 1,5 month. Similiar bleedings recur since 12 years on the background of disordered menstrual cycle. On
2007
rectal examination: no pathology of the internal genitalia. In blood: Нb: 70g/L, RBC:2,3x10*12/L, Ht:20. What is the
most probable diagnosis?

A. Werlholf’s disease
B. Polycyst ovarian syndrome
C. Hormonoproductive ovary tumor
D. Juvenile bleeding, posthemorrhagic anemia
E. Non complete spontaneous abortion
Post -

Hemorrhagic Anemia : deers in Anamnesis or

prolonged
Menstruation Traumas .

19. A 42 y.o. patient complains of weakness, heartbeat, nasal hemorrhages, cutaneous hemorrhages. His
2007
condition has been worsening progressively for a month. Objectively: grave condition, the extremities and body
skin has spotted and petechial hemorrhages, lymph nodes are not palpable, Ps:116/min, liver is +2 cm enlarged,
spleen is not palpable. Blood has evident pancytopenia. What disease should you think about first of all?

A. Acute leukosis
B. Hypoplastic anemia
C. Werlhof’s disease
D. Hemorrhagic vasculitis
E. Acute agranulocytosis

Hypoplastic Anemia :
Panay to peoria
 HEMATOLOGY : LEUCOCYTES
2009 1. A 32-year-old welder complains of weakness and fever. His illness initially presented as tonsillitis one
20 1 6 month earlier. On examination temperature 38.9°C, respirations - 24/min., pulse - 100/min., blood
2017 pressure - 100/70mmHg, hemorrhages on the legs, enlargement of the lymph nodes. Complete blood
2018 count shows Hb - 70g/L, RBC - 2.2x10*12/L, WBC - 3.0x10*9/L with 32% of blasts, 1% of eosinophils, 3%
of bands, 36%, of segments, 20% of lymphocyte and 8% of monocytes, ESR - 47mm/hour. What is the
cause of anemia in this case?

A. Chronic hemolytic anemia

B. Chronic lympholeukemia
C. Aplastic anemia
D. B2-deficient anemia
E. Acute leukemia
Acute Leukemia : Increased number
of
Blast cells, Amer Rods ,

Peri oxidase staining .

2013 2. A 25-year-old patient has been admitted to the hospital with the following problems: weakness, sweating,
2016 itching, weight loss, enlarged submandibular, cervical, axillary, inguinal lymph nodes. Objectively: hepatomegaly.
Lymph node biopsy revealed giant Berezovsky-Reed-Sternberg cells, polymorphocellular granuloma composed of
2017
lymphocytes, reticular cells, neutrophils, eosinophils, fibrous tissue, plasma cells. What is the most likely diagnosis?

A. Lymphogranulomatosis
B. Lymphoreticulosarcoma
C. Macofollicular reticulosis
D. Cancer metastases to lymph nodes
E. Lymph node tuberculosis

Lymphogranu tomato sis : Reed -

Sternberg cells

3. A 3-year-old child has been delivered to a hospital with complaints of pain in the legs, fever, loss of appetite.
2017
Objectively: pale skin and mucosa, hemorrhagic rash. Lymph nodes are enlarged, painless, dense and elastic,
2019 not matted together. Bones, joints, and abdomen are painful. The liver and spleen are enlarged. Hemogram:
Hb-88 g/l, color index – 1,3, platelets – 80×10*9/l, leukocytes – 25,8×10*9/l, lymphoblasts – 70%, ESR-52 mm/
hour.Make the provisional diagnosis:

A. Infectious mononucleosis
B. Hemorrhagic vasculitis (Henoch-Schonlein purpura)
C. Thrombocytopenic purpura
D. Acute rheumatic fever
E. Acute leukemia
Acute Leukemia : Increased number
of
Blast cells
,
Amer Rods ,
Peri oxidase staining .

4. Against the background of angina a patient has developed pain in tubular bones. Examination revealed
20 12
generalized enlargement of lymph nodes, hepatolienal syndrome, sternalgia. In blood: RBCs - 3,6x10*12/l, Hb- 87
2013
g/l, thrombocytes - 45x10*9/l, WBCs - 13x10*9/l, blasts - 87%, stab neutrophiles - 1%, segmented neutrophiles - 7%,
2015 lymphocytes - 5%, ESR - 55 mm/h. What is the most likely diagnosis?

A. Chronic lymphocytic leukemia

B. Erythremia
C. Acute leukemia
D. Chronic myeloid leukemia
E. Multiple myeloma
Acute Leukemia : Increased number
of
Blast cells
,
Amer Rods ,
Peri oxidase staining .
 5. A 34-year-old patient complains of profuse sweating at night, skin itching, weight loss (9 kg within the last 3
20 12
months). Examination revealed malnutrition, skin pallor. Palpation of neck and inguinal areas revealed dense elastic
2013 lymph nodes of about 1 cm in diameter, non-mobile, non-adhering to skin. What is the most probable diagnosis?
2015
A. Burkitt’s lymphoma
B. Cancer metastases
C. Chronic lymphadenitis
D. Lymphosarcoma
E. Lymphogranulomatosis

HIBS :
sweating
and
at
night ,
skin
itching enlargement
,
of
nodes
spleen , neck
inguinal revealing
areas elastic lymph
are
typical for
lymphogramslomatosis .

2009 6. A 63-year-old man complains of unmotivated weakness and pressing and bursting sensation in the left subcostal
area. According to him, these signs have been present for a year already. Previously he was healthy. He took part in
2015
containment measures during the accident at the Chernobyl Nuclear Power Plant. Objectively: the skin is pale,
peripheral lymph nodes are not enlarged, the liver is +3 cm, the spleen is +10 cm. Complete blood count:
erythrocytes -3.1x10*12/L, Hb- 100 g/L, leukocytes- 46x10*L, blasts -2%, promyelocytes- 10%, myelocytes - 18%,
band neutrophils - 27%, segmented neutrophils- 10%, lymphocytes- 12%, eosinophils - 6%, basocytes - 3%,
monocytes - 2%, erythrocyte sedimentation rate - 20mm/hour. What is the most likely diagnosis?

A. Hepatic cirrhosis
B. Chronic lymphocytic leukemia
C. Acute leukemia
D. Chronic myoleukemia
E. Hemolytic anemia
Chronic
Myeloeytie Leukemia : Pro
my ebay tes , My e
Wey tes

2019 7. A 58-year-old man complains of weakness and tumor-like formations that appeared on the anterior surface of
his neck and in the inguinal region. Palpation detects soft painless mobile cervical and inguinal lymph nodes
upto 2 cm in diameter. The liver protrudes by 2cm from the edge of the costal margin, the lower splenic pole is
at the umbilical level. In blood: erythrocytes: 3.5x10*12/L, Hb: 88 g/L, leukocytes: 86x10*9/L, band
neutrophils: 1%, segmented neutrophils: 10%, lymphocytes: 85%, eosinophils: 2%, basocytes: 0%, monocytes:
2%, erythrocyte sedimentation rate : 15 mm/hour, Gumprecht shadows. What is the most likely diagnosis?

A. Lymphogranulomatosis
B. Lymphocytic leukemoid reaction
C. Chronic lymphocytic leukemia
D. Acute leukemia
E. Chronic myeloleukemia
Chronic Lymphoblastic Leukemia :
smudge cells ,
Gum precht Shadows ,

Botkin cells .

2009 8. A 38-year-old patient complains about inertness, subfebrile temperature, enlargement of lymph nodes, nasal
20 LO
haemorrhages, ostealgia. Objectively: the patient’s skin and mucous membranes are pale, palpation revealed
enlarged painless lymph nodes; sternalgia; liver was enlarged by 2 cm, spleen - by 5cm, painless. In blood:
20 l l
erythrocytes: 2,7x10*12/l, Hb: 84 g/l, leukocytes: 58x10*9/l, eosinophils: 1%, stab neutrophils: 2%, segmented
neutrophils: 12%,lymphocytes: 83%, lymphoblasts: 2%,smudge cells; ESR: 57 mm/h. What is the most likely
diagnosis?

A. Lymphogranulomatosis
B. Chronic lymphatic leukemia
C. Acute lymphatic leukemia
D. Acute myeloleukemia
E. Chronic myeloleukemia
 Chronic Lymphoblastic Leukemia :
smudge cells , Gumpreeht Shadows
,

Botkin cells .

2012 9. A patient is 14 years old. Cytochemical study of punctate revealed 40% of blasts, there was negative reaction to
peroxidase and with Sudan black, positive reaction to glycogen. Specify the form of acute leukemia:

A. Undifferentiated
B. Promyelocytic
C. Monoblastic
D. Myeloblastic
E. Lymphoblastic
Acute Lymphoblastic Leukemia : Increased number
of
Blast cells
,

+
Lymphoblasts , t ve
Glycogen .

10. A 63 year old patient complained about pain in the lumbar area. He underwent a course of
2009
physiological treatment on account of radiculitis but this led to no improvement of his condition. R-graphy of spinal
column and pelvic bones revealed osteoporosis and serious bone defects. Blood analysis revealed moderate
normochromic anaemia, urine analysis revealed proteinuria. Whole blood protein made up 10,7 g/l. What disease
should be suspected?

A. Urolithiasis
B. Acute radiculitis
C. Myelomatosis
D. Metastases in bones
E. Systemic osteoporosis
Nye tomatosis : Bence Jones protein ,
Proteinuria

2007 11. A 54 year old woman complains of increasing fatigue and easy bruising of 3 weeks’ duration. Physical
2008 findings included pale, scattered ecchymoses and petechiae and mild hepatosplenomegaly. Blood count:
RBC: 2,5x10*12/l; Hb: 73 g/l; Ht: 20%; PLT: 23x10*9/l; and WBC: 162x10*9/l with 82% blasts, that
contained Auric rods; peroxidase stain was positive. What is the most probable diagnosis?

A. Acute leukemia
B. Chronic leukemia
C. Thrombocytopenia
D. Hemolytic anemia
E. Megaloblastic anemia

Acute Leukemia : Increased number

of
Blast cells
,
Amer Rods ,
Peri oxidase staining .

2005 12. A man, aged 68, complains of tiredness, sweating, enlargement of cervical, submaxillary and axillary lymph
2006 nodes. Blood test: WBC: 35x10*9/L, lymphocytes: 60%, Botkin and Gumprecht bodies, level of haemoglobin and
quantity of thrombocytes is normal. Myelogram showed 40% of lymphocytes. What is the most probable diagnosis?

A. Tuberculous lymphadenitis
B. Acute leucosis
C. Thrombocytopenia
D. Chronic lympholeucosis
E. Chronic myeloleucosis

Chronic Lymphoblastic Leukemia :

smudge cells , Gumpreeht Shadows ,

Botkin cells .
2006 13. An 18 y.o. patient was admitted to the hematologic department with complaints of headache, general weakness,
poor appetite, body temperature rise up to 390, neck swelling. Objectively: skin and mucous membranes are
extremely pale, lymph nodes on the both sides of neck are up to 1 cm large, painless. Liver is enlarged +1 cm,
painless, spleen +0,5 cm, t0- 380. Blood count: Нb- 98g/L, RBC- 2, 9 ∗ 1012/L, leukocytes - 32 ∗ 109/L,
stab neutrophils - 0%, segmental leukocytes- 28%, monocytes - 2%, lymphocytes - 39%, blasts - 31%, reticulocytes -
31%, thrombocytes - 120∗109/L, ESR- 36 mm/h. What form of leukosis does the patient have?

A. Acute myeloblastic leukosis

B. Acute lymphoblastic leucosis
C. Undifferentiated leukosis
D. Chronic lympholeucosis
E. Chronic myeloleucosis
Acute Lymphoblastic Leukemia : Increased number
of
Blast cells
,

+
Lymphoblasts , t ve
Glycogen .

2007 14. A 65 y.o. man who has problems withurination as a result of benign prostate gland adenoma dveloped
fever and chill, hypotension, sinus tachycardia. Skin is warm and dry. Clinical blood analysis revealed absolute
granulocytopenia. These hemodynamic changes are most likely to be caused by:

A. Endotoxemia with activation of complement system

B. Secondary reflex vasodilatation as a result of lowered cardiac output
C. Secondary circulation insufficiency with retained systolic function as a result of peripheral vasoconstriction
D. Reflex vagus stimulation with lowered cardiac output
E. Secondary endothelial changes as a result of bacterial lesion

2007 15. A 27 y.o. patient has been having for almost a year fatigue, hyperhidrosis, heaviness in the left hypochondrium,
especially after meals. Objectively: spleen and liver enlargement. In blood: erythrocytes: 3,2x10*12/l, Hb: 100 g/l,
colour index: 0,87, leukocutes: 100x10*9/l, basophils: 7%, eosinophils: 5%, myelocytes: 15%, juveniles: 16%, stab
neutrophils: 10%, segmentonuclear leukocytes: 45%, lymphocytes: 2%, monocytes: 0%, reticulocytes:
0,3%, thrombocytes: 400x10*9/l, ESR: 25mm/h. What is the most probable diagnosis?

A. Chronic lympholeukosis
B. Acute leukosis
C. Erythremia
D. Chronic myeloleukosis
E. Hepatocirrhosis

Chronic
Myelocytie Leukemia : Pro
my ebay tes , Myeweytes
2005 16. A 58 y.o. male patient is examined by a physician and suffers from general weakness, fatigue, mild pain in the
left subcostal area, sometimes frequent painful urination. Moderate splenomegaly has been revealed. Blood test:
neutrophilic leukocytosis with the progress to myelocyte; basophil: 2%; eosinophils: 5%. There is a urate crystales in
urine, erythrocyte: 2-3 in the field of vision. What is the preliminary diagnosis?

A. Leukemoid reaction
B. Urolithiasis
C. Lymphogranulomatosis
D. Chronic myeloleukosis
E. Hepatocirrhosis
Chronic
Myelocytie Leukemia : Pro
my ebay tes , Myeweytes
 HEMATOLOGY : THROMBOCYTES
2017 1. A 28-year-old woman complains of skin hemorrhages after minor traumas and spontaneous appearance of
hemorrhages on the front of her torso and extremities. On examination: the skin is variegated (old and new
2018
hemorrhages), bleeding gums. Blood platelets - 20×10*9/L; in the bone marrow there is increased number of
megakaryocytes and no platelet production. Treatment with steroid hormones was effective. What is the likely
diagnosis?

A. Rendu-Osler-Weber disease (Hereditary hemorrhagic telangiectasia)

B. Hemophilia
C. Idiopathic thrombocytopenic purpura
D. Disseminated intravascular coagulation
E. Frostbite of the IV degree

Idiopathic Amm
boy tie purpura haterHug 's disease : Decreased platelet Count

2017 2. A 38-year-old patient has been delivered by an ambulance to a surgical department with complaints of
2018 general weakness, indisposition, black stool. On examination the patient is pale, there are dotted
2019
hemorrhages on the skin of his torso and extremities. On digital investigation there are black feces on the
glove. Blood test: Hb- 108 g/L, thrombocytopenia. Anamnesis states that similar condition was observed 1
year ago. Make the diagnosis:

A. Thrombocytopenic purpura
B. Rectal tumor
C. Nonspecific ulcerative colitis
D. Hemophilia
E. Bleeding from an ulcer

2019 3. A 23-year-old man complains of severe pain in his left knee joint. Objectively the left knee joint is enlarged
with hyperemic skin, painful on palpation. Complete blood count: erythrocytes – 3.8. 101/L, HD-122 L
leukocytes – 74-10P/L. platelets – 183 10 IL Erythrocyte sedimentation rate – 10 mm/hour. Bleeding time
(Duke method) – 4 min., Lee White coagulation time. 24 min. Partial thromboplastin time (activated) – 89
seconds Rheumatoid factor – negative. What is the most likely diagnosis?

A. Rheumatoid arthritis
B. Werlhof disease (immune thrombocytopenia)
C. Hemorrhagic vasculitis (Henoch-Schonlein purpura), articular form
D. Thrombocytopathy
E. Hemophilia, hemarthrosis
:( He moarthrosis is
NB
specific for Haemophilia)
* T
appt ( activated partial prothrombin time )
*
delayed clothing time * (
Articular joints bleeding pain
Note Rheumatoid factor
negative here
is

2017 4. On the 3rd day of life a newborn, who had suffered birth asphyxia, developed hemorrhage from
the umbilical wound. Laboratory analysis reveals hypocoagulation, thrombocytopenia, and
hypothrombinemia. What is the cause of such clinical developments?
A. Thrombocytopenic purpura
B. Umbilical vessel trauma
C. Hemorrhagic disease of newborn
D. Congenital angiopathy
E. Disseminated intravascular coagulation
Disseminated intravascular
coagulation :

and
*
Hypo coagulation , thrombocytopenia hypo thrombi anemia
2008 5. A 7 y.o. boy suddenly felt pain in his right knee, it became edematic. The day before he took part in a
cross-country race. Family anamnesis has no data about hemophilia and bleeding sickness. Objectively:
body temperature is 37, 50. The knee is painful, hot to the touch, edematic with local tissue tension over
it. Blood count: Нb- 123 g/L, leukocytes - 5, 6 ∗ 109/L, thrombocytes -354∗109/L, prothrombin time - 12
seconds (normally 10-15 seconds), partly activated thromboplastin time - 72 seconds (normally 35-45
seconds). Hemorrhage time is normal, VIII:C factor is 5% of norm. What is the most probable diagnosis?

A. Hemophilia A
B. Hemophilia B
C. Schoenlein-Henoch disease
D. Vitamin K deficiency
E. Thrombocytopenia

Haemophilia A : 8th Factor Deficiency

2019 6. Disease onset was acute. A developed general weakness, pain in the joints, and elevated
temperature. Later these signs became accompanied by itching skin rash manifested as erythematous
spots 25 mm in size. The rash gradually turned hemorrhagic. Large joints are painful and swollen: pain
attacks periodically occur in the peri-umbilical area; there are signs of intestinal hemorrhage. What is the
most likely diagnosis?

A. Scarlet fever
B. Hemorrhagic vasculitis (Henoch-Schonlein purpura)
C. Hemorrhagic meningoencephalitis
D. Streptococcal impetigo
E. Rheumatism
Henoch Schon bin / vasculitis
Normal platelet count
purpura
t
Hemorrhagic
Paint fever
:

2010 7. A 42-year-old woman complains about bruises on her both legs and prolonged menstruation; general
weakness, tinnitus cerebri. Objectively: multiple macular haemorrhages on the legs and body. The patient
presents with tachypnoe, tachycardia, systolic murmur in all auscultatory points. AP:75/50mmHg. Blood
count: RBC:1,9x10*12/l, Нb:60g/l, colour index:0,9, WBC:6,5x10*9/l, thrombocytes:20x10*9/l, ESR:12mm/
h. Duke bleeding time:12 minutes. Bone marrow analysis revealed plenty of juvenile immature forms of
megacaryocytes without signs of thrombocyte pinch-off. What is the most likely diagnosis?

A. True thrombocytopenic purpura

B. Type A haemophilia
C. Willebrand’s disease
D. Acute megacaryoblastic leukemia
E. Type B haemophilia

Idiopathic thrombolytic purpura haterHug 's disease : Decreased platelet Count

2005 8. A child was delivered severely premature. After the birth the child has RI symptoms, anasarca, fine
bubbling moist rales over the lower lobe of the right lung. Multiple skin extravasations, bloody foam from the
mouth have occured after the 2 day. On chest X-ray: atelectasis of the lower lobe of the right lung. In
blood: Hb-100 g/L, Ht- 0,45. What is the most probable diagnosis?

A. Disseminated intravascular clotting syndrome

B. Edematous-hemorrhagic syndrome
C. Pulmonary edema
D. Hyaline membrane disease
E. Congenital pneumonia
Edematous children below
NB : -

hemorrhagic syndrome affects

The
age of
2 with
respiratory Infections .
 2007 9. A 7 y.o. boy has crampy abdominal pain and a rash on the back of his legs and buttocks as well as
on the extensor surfaces of his forearms. Laboratory analysis reveals proteinuria and microhematuria.
He is most likely to be affected by:

A. Dermatomyositis
B. Polyarteritis nodosa
C. Poststreptococcal glomerulonephritis
D. Anaphylactoid purpura
E. Systemic lupus erythematosus
NB :
Anaphylactic purpura
and buttocks
* Rash at the back
of legs
and hematuria
*
proteinuria
2007 10. An 8 y.o. child presents with low- grade fever, arthritis, colicky abdominal pain, and a purpuric rash
limited to the lower extremities. laboratory studies reveal a guaiac-positive stool, a urinalysis with red blood
cell (RBC) casts and mild proteinuria, and a normal platelet count. The most likely diagnosis is:

A. Henoch-Schonlein’s vasculitis
B. Systemic lupus erythematosus (SLE)
C. Idiopathic thrombocytopenic purpura
D. Poststreptococcal glomerulonephritis
E. Rocky Mountain spotted fever
Henoch Schon bin / vasculitis
Normal platelet count
purpura
t
Hemorrhagic
Paint fever
:

2008 11. A 52 year old patient was admitted to a hospital because of high hemorrhagic diathesis of
mucous membranes, massive skin haemorrhages in form of ecchymoses and spots, nasal and
2009
stomachal haemorrhages. After clinical examinations her illness was diagnosed as thrombocytopenic
purpura. What is the most probable cause of this disease?

A. Deficit of the VIII factor of blood coagulation

B. Disturbed hemostasis
C. Generation of antithrombocytic anti- bodies
D. Inherited insufficiency of plasm factors of blood coagulation
E. Iron deficit in blood serum, bone marrow and depot
Note :* Massive skin
haemorrhage
*
thrombocytopenic purpura
2009 12. A 3 year old boy has petechial eruption. Examination revealed no other pathological changes.
Thrombocyte number is 20x10*9g/l; haemoglobin and leukocyte concentration is normal. What is the
most probable diagnosis?

A. Schonlein-Henoch disease
B. Immune thrombocytopenic purpura
C. Disseminated intravascular coagulopathy
D. Acute lymphoblastic leukemia
E. Systemic lupus erythematosus
Idiopathic thrombolytic purpura haterHug 's disease : Decreased platelet Count

2007 13. A 16 y.o. female presents with abdominal pain and purpuric spots on the skin. Laboratory
investigations reveals a normal platelet count, with haematuria and proteinuria.The most likely diagnosis:

A. Henoch-Schonlein’s vasculitis
B. Haemolytic uraemic syndrome
C. Thrombotic thrombocytopenic purpura
D. Heavy metal poisoning
E. Sub acute bacterial endocarditis
 Henoch Schon bin / vasculitis
Normal platelet count
purpura
t
Hemorrhagic
Paint fever
:

2005 14. An 18 y.o. girl complains of weakness, dizziness, loss of appetite, menorrhagia. There are many-
2006 coloured petechiae on the skin of the upper extremities. Blood test: Hb:105g/l; RBC:3,2x10*12/L; C.I.-0,95;
thromb.:20x10*9/L. The sedimentation time according to Lee White is 5; hemorrhagia duration according to
Duke is 8, "pinch and tourniquet" test is positive. What is the most probable diagnosis?

A. Hemorrhagic diathesis
B. Hemophilia
C. Idiopathic thrombocytopenic purpura
D. Marchiafava-Micheli’s disease
E. FIron deficiency anemia
Idiopathic thrombolytic purpura haterthug 's disease : Decreased platelet Count
 HEMATOLOGY : DIAGNOSTIC
& TREATMENT
Tears A 24-year-old patient visited a doctor complaining of enlargement of his submaxillary lymph
2013
nodes. Objectively: submaxillary, axillary and Inguinal lymph nodes are enlarged. Chest X-ray
20 15
shows: enlarged lymph nodes of the mediastinum. Blood test: erythrocytes - 3.4x10*12/L, Hb
-100g/L, blood colour index - 0.88, platelets - 190x10*9/L, Leucocytes - 7.5x10*9/L, eosinophils
20 Lf
- 8%, band neutrophils - 2%, segmented neutrophils - 67%, lymphocytes - 23%, ESR - 22 mm/
2018
hour. What test must be prescribed to verify the cause of lymphadenopathy?
A. Abdominal US
B. Open biopsy of the lymph nodes
C. Mediastinum tomography
D. Puncture biopsy of the lymph nodes
E. Sternal puncture

A 25-year old woman complains of fatigue, dizziness, hemorrhagic rashes on the skin. She has
2008 been presenting with these signs for a month. Blood test: erythrocytes - 1.0x10*12/L, Hb - 37g/
20 1 8
L, color index - 1.1, leukocytes - 1.2x10*9/L, platelets - 42x10*9/L. What analysis would be the
most advisable for diagnosis making in this case?
2019
A. Sternal puncture (bone marrow biopsy)
B. Splenic biopsy
C. Liver biopsy
D. Coagulation studies
E. US of the gastrointestinal tract

2018 A 57-year-old woman complains of weakness, dyspnea, loss of appetite, and liquid feces. She
2019
has been suffering from this condition for 2 years. Objectively she presents with pale skin,
subicteric sclera, and bright red fissured tongue. Lymph nodes are not enlarged. Pulse - 100/
min.; BP- 105/70mmHg. Liver +3 cm, the spleen cannot be palpated. Blood test: erythrocytes -
1.2×10*12/L, Нb- 56 g/L, color index - 1.4, macrocytes, leukocytes - 2, 5 × 10*9/L, eosinophils -
1%, juvenile - 1%, metamyelocytes - 1%, band neutrophils - 8%, segmented neutrophils - 47%,
lymphocytes 38%, monocytes - 4%, reticulocytes - 0.1%, platelets - 100 × 10*9/L, ESR- 30 mm/
hour, indirect bilirubin - 26 mmol/L. What changes can be expected in the bone marrow puncture
material?
A. Prevalence of lymphoid tissue
B. Increased number of sideroblasts
C. Erythroid hyperplasia
D. Presence of blast cells
E. Prevalence of megaloblasts

2015 A 5-year-old child has body temperature risen up to febrile numbers, suffers from inertness,
2016
weakness. Examination revealed hemorrhage on the skin of limbs and torso. Enlargement of
cervical and axillary lymph nodes can be detected. The liver is 4 cm below the costal arch; the
2018
spleen is 6 cm below the costal arch. Blood test: erythrocytes - 2.3 × 10*12/L, Hb- 60 g/L,
platelets - 40 × 10*9/L, leukocytes - 32.8 × 10*9/L, eosinophiles - 1%, band neutrophiles - 1%,
segmented neutrophiles - 12%, lymphocytes - 46%, monocytes - 1%, blasts - 40%, Duke’s
bleeding time test result is 9 min. What examination is necessary to make the diagnosis?
A. Detection of hepatitis markers
B. Analysis of dynamic platelet function
C. Abdominal US
D. Lymph nodes biopsy
E. Myelogram (bone marrow biopsy)
2015
A 5-year-old child has body temperature risen up to febrile numbers, suffers from inertness,
weakness. Examination revealed hemorrhage on the skin of limbs and torso. Enlargement of
2016
cervical and axillary lymph nodes can be detected. The liver is 4 cm below the costal arch; the
2018
spleen is 6 cm below the costal arch. Blood test: erythrocytes - 2.3 × 10*12/L, Hb- 60 g/L,
platelets - 40 × 10*9/L, leukocytes - 32.8 × 10*9/L, eosinophiles - 1%, band neutrophiles - 1%,
segmented neutrophiles - 12%, lymphocytes - 46%, monocytes - 1%, blasts - 40%, Duke’s
bleeding time test result is 9 min. What examination is necessary to make the diagnosis?
A. Detection of hepatitis markers
B. Analysis of dynamic platelet function
C. Abdominal US
D. Lymph nodes biopsy
E. Myelogram (bone marrow biopsy)

2018 A 35-year-old man complains of persisting enlargement of his peripheral lymph nodes that cause
him no discomfort. The case history states that the first lymph nodes to enlarge were cervical,
supraclavicular, and axillary; new groups of lymph nodes emerged. Objectively the lymph nodes
are soft and elastic on palpation, enlarged, painless, not fixed to the surrounding tissue. What
examination method would be the most informative for early diagnostics of this disease?
A. Magnetic resonance tomography
B. Ultrasound
C. X-ray
D. Needle biopsy
E. Radioisotope scanning of the skeleton

A 58-year-old woman complains of spontaneous bruises, weakness, bleeding gums, dizziness.

2017
Objectively: the mucous membranes and skin are pale with numerous hemorrhages of various
2014 time of origin. Lymph nodes are not enlarged. Ps-100/min, BP- 110/70 mm Hg. There are no
alterations of internal organs. Blood test results: RBC-3,0×10*12/l, Hb-92 g/l, color index – 0,9,
anisocytosis, poikilocytosis, WBC-10×10*9/l, eosinophils – 2%, stab neutrophils – 12%,
segmented neutrophils – 68%, lymphocytes -11%, monocytes – 7%, ESR-12 mm/h. What
laboratory test should be performed additionally to make the diagnosis?
A. Osmotic resistance of erythrocytes
B. Fibrinogen
C. Reticulocytes
D. Clotting time
E. Platelets

A 48-year-old man complains of fatigue, excessive sweating, severe skin itching, undulant fever,
2017
enlarged cervical and supraclavicular lymph nodes. Objectively: paleness of skin and mucosa,
cervical lymph nodes are mobile, dense, elastic, walnut-sized, painless, not attached to the skin.
Complete blood count: erythrocytes – 3.0×10*12/l, Hb - 100 g/l, leukocytes –14×10*9/l,
eosinophils - 6%, basophils – 3%, band neutrophils – 11%, segmented neutrophils – 69%,
lymphocytes - 7, monocytes – 4%, platelets – 280×10*9/l, ESR- 37mm/hour. What method should
be applied to verify the diagnosis?
A. Lumbar puncture
B. Lymph node biopsy
C. Muscle biopsy
D. Sternal puncture
E. Chest X-ray
 2016 A 27-year-old woman complains of bleeding gums, nasal hemorrhages, multiple hematomas on
the skin of her limbs and on the front of her torso, extreme general fatigue. Blood test: Hb- 64 g/
l, erythrocytes - 2, 5 × 10*12/l, reticulocytes - 16%, platelets - 30 × 10*9/l, ESR- 22 mm/hour.
What approach would be most efficient for treatment of this pathology?
A. Cytostatics
B. Group B vitamins
C. Dicynone (Etamsylate)
D. Platelet concentrate transfusion
E. Splenectomy

2019 10 hours after birth a child developed jaundice, hypotonia, hyporeflexia, and moderate
hepatosplenomegaly. Feces and urine are of normal color. Úmbilical cord blood bilirubin is 51
mcmol/L due to unconjugated bilirubin levels. In venous blood: erythrocytes - 3.5x10*12/L, Hb-
140g/L, reticulocytes - 1.5%, bilirubin- 111 mcmol/L, conjugated- 11 mcmol/L, ALT- 40U/L, AST- 30
U/L. Mother's blood group is A(II) Rh(-), child's blood group is A(II) Rh(+). What laboratory test can
confirm the diagnosis?
A. Viral hepatitis markers analysis
B. Coombs test
C. Erythrocytometery
D. Measurement of erythrocyteosmotic resistance
E. Measurement of glucose 6-phosphate dehydrogenase levels in erythrocytes

2010 A 3-year-old child has been admitted to a hospital because of ostealgia and body temperature
20 12 rise up to 39*C. Objectively: the patient is in grave condition, unable to stand for ostealgia, there
is apparent intoxication, lymph nodes are enlarged up to 1,5 cm. Liver can be palpated 3 cm
below the costal margin, spleen - 2 cm below the costal margin. In blood: RBCs:3,0x10*12/l,
Hb:87g/l, colour index:0,9, thrombocytes:190x10*9/l, WBCs:3,2x10*9/l, eosinophils:1, stab-
neutrophils:1, segmented neutrophils:0, lymphocytes:87, monocytes:2, ESR:36mm/h. What
examination should be conducted in order to specify the diagnosis?
A. Lymph node puncture
B. Ultrasound
C. Sternal puncture
D. Lymph node biopsy
E. Computer tomography

2011 A 62-year-old patient complaining of enlargement of cervical, supraclavicular and axillary lymph
nodes, subfebrile temperature for the last 3 months has been admitted to a hospital. In
blood: WBCs:64x10*9/l, lymphocytes:72%. What method of study should be used to specify the
diagnosis?
A. Lymphography
B. Lymphoscintigraphy
C. X-rays
D. Thermography
E. Myelogram
2011 An 8-year-old boy suffering from haemophilia was undergoing transfusion of packed red cells.
Suddenly he felt pain behind the breastbone and in the lumbar area, dyspnea, cold sweat.
Objectively: pale skin, heart rate:100/min, AP:60/40mm Hg; oliguria, brown urine. For
the treatment of this complication the following drug should be administered:
A. Analgine
B. Lasix
C. Adrenaline
D. Aminophylline
E. Prednisolone

Lol I A 16-year-old patient who has a history of intense bleedings from minor cuts and sores needs to
20 12 have the roots of teeth extracted. Examination reveals an increase in volume of the right
knee joint, limitation of its mobility. There are no other changes. Blood analysis shows an
inclination to anaemia (Hb:120g/l). Before the dental intervention it is required to prevent the
bleeding by means of:
A. Cryoprecipitate
B. Epsilon-aminocapronic acid
C. Fibrinogen
D. Dried blood plasma
E. Calcium chloride

2011 A 27-year-old patient complains of nasal haemorrhages, multiple bruises on the anterior surface
20 12 of the trunk and extremities, sudden weakness. In blood: Hb:74g/l, reticulocytes:16%,
RBCs:2,5x10*12/l, platelets:30x10*9/l, ESR:25mm/h. What is the most effective measure for the
treatment of thrombocytopenia?
A. Cytostatics
B. Vitamin B12
C. Iron preparations
D. Hemotransfusion
E. Splenectomy

2013 An 18-year-old patient since childhood suffers from bleeding disorder after minor injuries. His
younger brother also has bleeding disorders with occasional haemarthrosis. Which laboratory
test will be informative for diagnosis verification?
A. Fibrinogen rate
B. Clotting time
C. Blood clot retraction
D. Thrombocyte count
E. Determination of prothrombin time

20 13 Blood typing resulted in positive isohemagglutination reaction with standard sera of А(II) and
В(III) groups and negative reaction with sera of 0(I) and АВ(IV) groups. What is this
result indicative of?
A. Faulty standard sera
B. The first blood group
C. The second blood group
D. The third blood group
E. The fourth blood group
20 12 Several hours before, a 28-year-old patient suddenly developed acute headache and repeated
vomiting, then lost consciousness. Objectively: focal neurological symptoms were not found.
Pronounced meningeal symptoms were revealed. AP - 120/80 mm Hg. According to clinical and
liquorological findings the patient was diagnosed with subarachnoid hemorrhage. After
administration of dehydrants the patient’s condition somewhat improved. What is the main
component of further emergency care?
A. Antiaggregants
B. Anticoagulants
C. Coagulants
D. Fibrinolytics
E. Corticosteroids

2009 A 19 year old patient was admitted to a hospital with acute destructive appendicitis. He suffers
from hemophilia of B type. What antihemophilic medications should be included in pre- and
post- operative treatment plan?
A. Native plasma
B. Cryoprecipitate
C. Fresh frozen blood
D. Fresh frozen plasma
E. Dried plasma

2005 A 19 y.o. boy was admitted to the hospital with closed abdominal trauma. In course of operation
2006 multiple ruptures of spleen and small intestine were revealed. AP is falling rapidly, it is
necessary to perform hemo-transfusion. Who can determine the patient’s blood group
20 07
and rhesus compatibility?
2008

A. A laboratory physician
B. A doctor of any speciality
C. A surgeon
D. A traumatologist
E. An anaesthesilogist

2009 A 27 year old patient suffers from haemophilia. He was admitted to the hospital with melena and
skin pallor. Objectively: Ps:110bpm, AP:100/60mmHg. In blood: Hb:80g/l, erythrocytes:2,
8x10*12/l. What medication should be administered in the first place?
A. Cryoprecipitate
B. Stored blood
C. Packed red blood cells
D. Dicinone
E. Epsilon-aminocapronic acid

2009 A 67 year old female patient complains about edemata of face and legs, pain in the lumbar area
that is getting worse at moving; great weakness, sometimes nasal haemorrhages, rise of body
temperature up to 38,4*C. Objectively: painfulness of vertebral column and ribs on palpation.
Laboratorial study revealed daily proteinuria of 4,2g, ESR:52mm/h. What changes of
laboratory indices are to be expected?
A. Haemoglobin - 165 g/l
B. Leukocytes - 15,3 g/l
C. Whole protein of blood serum - 101 g/l
D. Albumins - 65%
E. γ-globulins - 14%
2007 A 19 year old patient was admitted to a hospital with acute destructive appendicitis. He suffers
2008 from hemophilia of B type. What anti-hemophilic medications should be included in pre- and
post-operative treatment plan?
A. Fresh frozen plasma
B. Cryoprecipitate
C. Fresh frozen blood
D. Native plasma
E. Dried plasma

A 30 year old patient undergoes treatment because of Werlhof’s disease. Objectively: the
2008
patient is pale, there are petechial haemorrhages on the extension surfaces of forearms. Ps is
92 bpm, AP is 100/60mmHg. The lower edge of spleen is at a level with umbilicus. Blood
count: erythrocytes: 2,8x10*12/l, Hb:90g/l, Ht: 0,38, thrombocytes:30x10*9/l. The patient is
being prepared for splenectomy. What transfusion medium should be chosen in the first place
for the preoperational preparation?
A. Thrombocytic mass
B. Stored blood
C. Native erythrocytic mass
D. Erythrocytic suspension
E. Washed erythrocytes

2005 A 13 y.o. teenager who suffers from hemophilia A was taken to the hospital after a fight at
20 07
school. His diagnosis is right-sided hemarthros of knee joint, retroperitoneal hematoma. What
should be primarily prescribed?
A. Aminocapronic acid
B. Washed thrombocytes
C. Fresh frozen plasma
D. Placental albumin
E. Dry plasma

2019 A 45-year-old woman is registered for regular check-ups due to Werlhof disease(immune
thrombocytopenia). Complete blood count: Hb: 100 g/L, erythrocytes- 2.8x10*12g/L, platelets -
90x10*9/L, leukocytes- 8.4x10*9/L, erythrocyte sedimentation rate- 13 mm/hour. Examination
detects a single small hematoma on the anterior surface of the thigh, developed after the patient
accidentally stumbled on a table. What treatment tactics should be chosen in this case?
A. Administer thrombocytic mass, continue the treatment in the hematology unit
B. Continue the supervision by the hospital hematologist
C. Urgent hospitalization into the general care unit
D. Urgently start a hemostatic therapy, followed by a planned hospitalization into the hematology unit
E. Urgent hospitalization into the hematology unit

2006 A 25 y.o. woman complained of fatigue, hair loss and brittle nails. The examination revealed
2007 pallor of skin, Ps:94/min, BP:110/70mmHg. On blood count: Hb:90 g/L, RBC:3,5x10*12/L,
C.I.:0,7; ESR:20mm/h. Serum iron level was 8,7mcmol/L. What treatment would you initiate?
A. Ferrous sulfate orally
B. Iron dextrin injections
C. Vitamin B12 intramuscularly
D. Blood transfusion
E. Packed RBCs transfusion
20 07 A 10 y.o. boy with hemophilia has signs of acute respiratory viral infection with fever. What of the
mentioned anti- febrile medications are contraindicated to this patient?
A. Paracetamol
B. Analgin
C. Pipolphen
D. Acetylsalicylic acid
E. Panadol extra

2007 A 60 y.o. patient cpmplains of weakness, dizziness, heaviness in the upper part of abdomen,
paresthesia of toes and fingers. Objectively: skin icteritiousness, tongue is crimson,
smooth. Hepatomegaly. In blood: Hb:90g/l, erythrocytes:2,3x10*12/l, reticulocytes:0,2%; color
index:1,2, macrocytosis; Jolly’s bodies, Cabot’s ring bodies. What medication is the most
appropriate for treatment?
A. Feroplex
B. Packed red blood cells
C. Prednisolone
D. Dyspherol
E. Vitamin 12

2005 Full term newborn has developed jaundice at 10 hours of age. Hemolytic disease of newborn due
to Rh- incompatibility was diagnosed. 2 hours later the infant has indirect serum bilirubin level
increasing up to 14 mmol/L. What is most appropriate for treatment of hyperbilirubinemia in this
infant?
A. Phototherapy
B. Exchange blood transfusion
C. Phenobarbital
D. Intestinal sorbents
E. Infusion therapy

2005 A 33 y.o. patient was admitted to the hospital with stopped recurrent peptic ulcer bleeding. On
examination he is exhausted, pale. Нb:77g/L, Нt:0,25. Due to anemia there were two attempts of
blood transfution of identical blood group ()Rh+. Both attempts were stopped because of
anaphylactic reaction. What blood transfution environment is desirable in this case?
A. Erythrocyte mass poor for leucocytes and thrombocytes
B. Erythrocyte emulsion
C. Erythrocyte mass (native)
D. Freshcitrated blood
E. Washed erythrocytes
2005 A 35 y.o. woman is suspected of aplastic anemia. The bone marrow punction has been
administered with the diagnostic purpose. What changes in the marrow punctatum are
suggested?
A. Replacement of marrow elements with fibrous tissue
B. Replacement of marrow elements with adipose tissue
C. Prevalence of megaloblasts
D. Presence of blast cells
E. Absolute lymphocytosis

2005
The physician must undertake measures for primary prophylaxis of iron deficiency anemia.
Which of the following categories of patient are subject to such primary prophylactic measures?
A. Patients after 60
B. All children
C. Patients after operation
D. Workers of industrial enterprises
E. Pregnant women

2017 A 65-year-old man was diagnosed with B12-deficient anemia and the treatment was
prescribed. A week later control blood test was performed. What would be the early indicator of
the therapy effectiveness?
A. Increased number of reticulocytes
B. Megaloblastic hematopoiesis
C. Increased erythrocyte number
D. Normoblastic hematopoiesis
E. Increased hemoglobin level
 HEMATO : MISCELLANEOUS
20 10 1. A 67-year-old female patient complains about edemata of face and legs, pain in the lumbar
area that is getting worse at moving; great weakness, sometimes nasal hemorrhages, rise of
body temperature up to 38,4*C. Objectively: painfulness of vertebral column and ribson
palpation. Laboratorial study revealed daily proteinuria of 4,2 g, ESR- 52 mm/h. What changes
of laboratory indices are to be expected?
A. Whole protein of blood serum - 101 g/l
B. Leukocytes - 15,3 g/l
C. Haemoglobin - 165 g/l
D. Albumins - 65%
E. γ-globulins - 14%

2012 2. To replace the blood loss replacement1000 ml of the same group of Rhesus-compatible
donated blood was transfused to the patient. The blood was conserved by sodium citrate. At
the end of hemo-transfusion there appeared excitement, pale skin, tachycardia, muscles
cramps in the patient. What complication should be suspected?
A. Pyrogenous reaction
B. Citrate shock
C. Allergic reaction
D. Anaphylactic shock
E. Citrate intoxication

20 12 3. A 42-year-old patient with acute haemorrhage and class III blood loss underwent blood
transfusion and got 1,8l of preserved blood and erythro mass of the same group and Rh. After the
transfusion the patient complained of unpleasant retrosternal sensations, his arterial pressure
dropped to 100/60 mmHg, there appeared convulsions. Blood serum calcium was at the rate of
1,7 milli-mole/liter. What is the mechanism of this complication development?
A. Citrate causes the development of metabolic acidosis
B. Citrate is cardiotoxic and nephrotoxic
C. Citrate binds calcium ions, hypocalcemia impairs myocardial function
D. The increased citrate rate causes convulsions
E. Citrate binds potassium causing severe hypokalemia

2008 4. A 33 year old male patient was brought to Emergency Department with the signs of
cardiovascular collapse: BP 60/30 mm Hg, Ps - 140 bpm, the skin is pale and moist, diuresis 20
ml/h, Hb - 80g/l, red blood cell count - 2, 5 · 1012/l. The reduction of blood volume averages:
A. 20-25%
B. 10-15%
C. 15-20%
D. 30-40%
E. 25-30%
2006 5. A full-term newborn child has a diagnosis Rh-factor hemolytic disease of newborn. Bilirubin
2007 rate is critical. The child’s blood group is В(III), his mother’s blood group - А(II). The child has
indication for hemotransfusion. What donor blood must be chosen?
A. Blood group В(III), Rh (-)
B. Blood group А(II), Rh (-)
C. Blood group B(III), Rh (+)
D. Blood group А(II), Rh (+)
E. Blood group О(I), Rh (-)

2005 6. A 19 y.o. boy was admitted to the hospital with closed abdominal trauma. In course of
2006 operation multiple ruptures of spleen and small intestine were revealed. AP is falling rapidly, it is
20077 necessary to perform hemo-transfusion. Who can determine the patient’s blood group
2- 008
and rhesus compatibility?
A. A laboratory physician
B. A doctor of any speciality
C. A surgeon
D. A traumatologist
E. An anaesthesilogist

2019 7. 10 hours after birth a child developed jaundice, hypotonia, hyporeflexia, and moderate
hepatosplenomegaly. Feces and urine are of normal color. Umbilical cord blood bilirubin is 51
mcmol/L due to unconjugated bilirubin levels. In venous blood: erythrocytes – 3.5 . 1012/L, Hb-
140 g/L. reticulocytes – 1.5%, bilirubin – 111 mcmol/L, conjugated – 11 mcmol/L, ALT-40 U/L, AST-
30 U/L. Mother’s blood group is A(II) Rh(-), child’s blood group is A(II) Rh(+). What laboratory test
can confirm the diagnosis?
A. Viral hepatitis markers analysis
B. Coombs test
C. Erythrocytometry
D. Measurement of erythrocyte osmotic resistance
E. Measurement of glucose 6-phosphate dehydrogenase levels in erythrocytes

2007 8. A 56 y.o. patient ill with cholecystectomy suddenly had an intense hemorrhage. She needs
blood transfusion. Her blood group is (VI )Rh−. Hemotransfusion station doesn’t dispose of this
group. What group of donors can be involved?
A. Reserve donors
B. Donors of active group
C. Relatives
D. Emergency donors
E. Donors of rare blood groups
2005 9. A 33 y.o. patient was admitted to the hospital with stopped repeated ulcerative bleeding. He was
2007 pale and exhausted. Blood count: Нb- 77g/l, Нt- 0,25. In view of anemia there were made
two attempts of blood transfusion of the same group - ()Rh+. In both cases the transfusion had to
be stopped because of development of anaphylactic reaction. What transfusion medium would be
advisable in this case?
A. Fresh citrate blood
B. Washed erythrocytes
C. Erythrocytic mass (native)
D. Erythrocytic suspension
E. Erythrocytic mass poor in leukocytes and thrombocytes

2005 10. A 35 y.o. woman is suspected of aplastic anemia. The bone marrow punction has been
administered with the diagnostic purpose. What changes in the marrow punctatum are
suggested?

A. Replacement of marrow elements with adipose tissue

B. Replacement of marrow elements with fibrous tissue
C. Prevalence of megaloblasts
D. Presence of blast cells
E. Absolute lymphocytosis