BASIC TISSUE DR.

LAVERS
NATIONAL BOARDS PART I

BLOOD CLOTTING

BLOOD CLOTTING
J78-20. A deficiency in vitamin K would affect blood clotting
chiefly by
*1. decreasing prothrombin production.
2. preventing the contraction of the clot.
3. preventing the reaction of thrombin with fibrinogen.
4. preventing the conversion of fibrinogen to fibrin.
5. preventing the conversation of prothrombin to thrombin.
J78-97. Which of the following is NOT required for the normal
blood clotting response?
1. Ca++
*2. Plasmin
3. Thrombin
4. Vitamin K
5. Phospholipid
6. Proteolysis
A/D79-2. The vitamin that promotes the synthesis of
prothrombin by the liver is
1. carotene
2. vitamin C *3. vitamin K
4. folic acid 5. vitamin B12
M81-73. Which of the following ion is involved in blood
clotting?
1. iron 2. sodium *3. calcium 4. potassium
82D-94. Which of the following agents is NOT likely to be
found in plasma?
*1. Thrombin
2. Fibrinogen
3. Prothrombin
4. Calcium ion 5. Ascorbic acid
D96-134. A derivative of vitamin K is the coenzyme for which
of the following?
A. Production of menadiol B. Esterification of retinol
C. Hydrolysis of peptide bonds
D. Cross-linking of fibrinogen
*E. Carboxylation of glutamate side chains
D98-113. Which of the following represents the normal
substrate of thrombin?
A. Fibrin B. Thrombospondin
C. Prothrombin
D. Thromboplastin
*E. Fibrinogen
GAS TRANSPORT
J78-10. Some degree of alkalosis occurs temporarily as a result
of
1. ingestion of ammonium chloride.
*2. prolonged deep breathing. 3. severe muscular effort.
4. excessive smoking.
5. high fluid intake.
J78-30. The membrane of the human erythrocyte can be
correctly described as
1. directly catalyzing the reaction:
H2CO3 CO2 + H20
2. being composed of hemoglobin and other soluble
proteins necessary for gaseous respiratory exchange.
*3. containing lipoproteins and specific blood group
substances.
4. having a high histone content.
5. being a site of de novo hemoglobin synthesis.

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J78-38. The bicarbonate buffer system of the blood is very

efficient because
1. bicarbonate is rapidly excreted by the kidneys.
2. bicarbonate is able to be stored in the tissue.
3. carbon dioxide is able to combine with hemoglobin.
4. carbon dioxide forms a stable combination with base.
*5. carbon dioxide is rapidly eliminated through the lungs.
J78-42. The physiologic importance of hemoglobin lies in its
ability to combine
1. irreversibly with oxygen and CO2.
2. reversibly with oxygen at the ferric heme prosthetic
group.
3. irreversibly with oxygen at the ferrous heme prosthetic
group.
*4. reversibly with oxygen at the ferrous heme prosthetic
group.
5. None of the above
J78-71. Carbon dioxide is transported in four different chemical
forms. Which of the following is the principle mode of
transport?
1. Dissolved carbon dioxide 2. Carbamino compounds
*3. Bicarbonate ions
4. Carbonic acid
A/D79-17. Carbonic anhydrase in the kidney tubular cells is
known to be associated with the reabsorption of
1. urea 2. chloride *3. bicarbonate ion
4. carbohydrate
A/D79-18. Toxic effects of carbon monoxide are best explained
by the fact that carbon monoxide
1. depresses the rate of respiration
2. prevents dissociation of oxyhemoglobin
*3. competes with O2 for hemoglobin binding sites
4. poisons oxidative catalysts of the tissue cells
5. combines irreversibly with hemoglobin forming
methemoglobin
A/D79-45. During exercise, muscle tissue accumulates lactic
acid. As a results, erythrocytes passing through capillaries
in the muscle
1. release more CO2.
2. absorb more O2.
3. release more O2.
4. both 1 and 3 above
*5. both 2 and 3 above
A/D79-65. The buffer system most important in maintaining the
physiological pH of plasma is
1. protein/proteinate. 2. acetic acid/acetate.
*3. carbonic acid/bicarbonate.
4. phosphoric acid/phosphate.
5. hydroxybutyric acid/hydroxybutyrate.

BASIC TISSUE DR. LAVERS

NATIONAL BOARDS PART I

BLOOD CLOTTING

M81-8. The consequence of appreciable conversion of

hemoglobin to methemoglobin is
1. a significant increase in carbon dioxide combining power
2. a significant decrease in carbon dioxide combining
power
3. no effect on the ability of blood to pick up oxygen
4. a noticeable increase in the ability of blood to pick up
oxygen
*5. a noticeable decrease in the ability of blood to transport
oxygen
M81-34. The normal blood bicarbonate-carbonic acid ratio is
20:1. A patient with a 10:1 ratio is in
1. compensated alkalosis.
2. compensated acidosis.
3. uncompensated alkalosis.
*4. uncompensated acidosis.
5. none of the above. This patients ratio is within normal
limits.
M81-36. Iron-porphyrin protein structures are components of
1. myoglobin.
2. B vitamins.
3. hemoglobin.
*4. cytochromes. 5. pyridine dinucleotides
M81-40. The physiological importance of hemoglobin lies in its
ability to combine
1. irreversibly with oxygen and CO2.
2. reversibly with oxygen at the ferric heme prosthetic
group.
3. irreversibly with oxygen at the ferrous heme prosthetic
group.
*4. reversibly with oxygen at the ferrous heme prosthetic
group.
5. None of the above.
M81-42. Blood leaving the lungs is saturated with O2 to the
extent of approximately
1. 5 per cent.
2. 25 per cent. 3. 50 per cent.
4. 75 per cent.
*5. 98 per cent.
M81-43. CO2 is transported in the blood predominantly in the
form of
1. carbonic acid.
2. carbaminohemoglobin.
*3. bicarbonate in plasma.
4. bicarbonate in erythrocytes.
5. CO2 physically dissolved in plasma.
M81-66. In severe degenerative disease of the liver, such as
advanced alcoholic cirrhosis, a marked deficiency of which
of the following factors essential to blood coagulating
mechanisms is likely?
(a) prothromboplastin (b) prothrombin
(c ) thrombin (d) vitamin K (e) fibrinogen
1. a and e 2. b and c *3. b and e 4. c and d

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82D-18. During respiration, carbon dioxide and oxygen are
exchanged at the junction of blood and alveolar spaces and
the junction of blood and tissue. The actual diffusion of the
gases is primarily controlled by the
1. atmospheric pressue.
2. elasticity of blood capillaries.
3. bicarbonate content of the blood.
4. hemoglobin content of erythrocytes.
*5. differentials in partial pressures of the gases.
82D-22. The function of vitamin K is involved directly with
*1. synthesis of prothrombin.
2. activation of the Stuart factor.
3. regulation of calcium in the blood.
4. conversion of fibrinogen to fibrin.
5. transcriptional control for fibrinogen synthesis.
82D-67. The greatest concentration of carbonic anhydrase is
found
1. in plasma.
2. in platelets.
3. in leukocytes.
*4. in erythrocytes.
5. equally distributed between plasma and erythrocytes.
D85-40. Carbon monoxide decreases the amount of
1. bicarbonate in the blood plasma.
2. carbonic anhydrase available in the lungs.
*3. oxygen that can be transported by hemoglobin.
4.alveolar surface available for gaseous exchange.
5. carbon dioxide that can be transported by the blood.
D87-45. Carbonic anhydrase in erythrocytes increases
1. rate of dissociation of H2CO3.
2. rate of formation of oxyhemoglobin.
3. permeability of erythrocytes to HCO3.
4. formation of carbamino compounds with hemoglobin.
D87-61. Normal hemoglobin concentration is about 15 gm./dl.
Blood and normal arterial oxygen content is about 20 ml.
O2/dl. Blood. AN anemic individual breathing room air with
a hemoglobin concentration of 10 gm./dl. Blood is expected
to have
1. normal arterial oxygen tension and normal arterial
oxygen content.
2. reduced arterial oxygen tension and normal arterial
oxygen content.
*3. normal arterial oxygen tension and reduced arterial
oxygen content.
4. reduced arterial oxygen tension and reduced arterial
oxygen content.
D87-62. The hemoglobin dissociation curve is shifted to the
right by
1. a decreased in temperature.
2. an increase in arterial PCO2.
3. an increase in arterial hydrogen ion concentration.
4. both 1 and 3 above.
*5. both 2 and 3 above.

BASIC TISSUE DR. LAVERS

NATIONAL BOARDS PART I

BLOOD CLOTTING

J89-30. In sickle cell aneamia, a variation in an amino acid of

hemoglobin is detected. This substitution of valine for
glutamic acid
1. results in no change in solubility.
2. results in no change in isoelectric pH.
*3. is a result of a change in DNA coding.
4. has no noticeable effect on the O2 transport behavior of
the erythrocyte.
J89-70. the affinity of hemoglobin for oxygen diminishes as
which of the following is decreased?
*1. pH
2. PCO2
3. Temperature
4. Hydrogen ion concentration.
5. 2,3-diphosphoglyceric acid (DPG)
D96-198. MOST of the CO2 in blood is combined as
A . H2CO3.
*B. HCO3 . C. CH3COOH.
D. carbonic acid. E. carbaminohemoglobin.
D98-148. In respiratory acidosis, arterial CO2 content and pH
become abnormal. Which of the following BEST
describes their respective changes?
CO2
pH
A. Increases
Increases
*B. Increases
Decreases
C. Decreases
Increases
D. Decreases
Decreases
D98-174. Hyperventilation alters the acid-base balance of
arterial blood by
A. increasing CO2 and increasing pH.
B. increasing CO2 and decreasing pH.
C. decreasing CO2 and decreasing pH.
*D. decreasing CO2 and increasing pH.
D98-188. The rate of diffusion across the alveolar wall is
inversely proportional to which of the following?
A. The surface area for gaseous exchange
B. The thickness of the alveolar wall
*C. The difference in the partial pressures of the gas
D. The solubility of the gas.
D98-197. Absense of which of the following blood enzymes
drastically reduces blood CO2 carrying capacity?
*A. Carbonic anhydrase
B. Alkaline phosphatase
C. Pyruvate carboxykinase
D. Histidine decarboxylase
E. Serum glutamic-oxaloacetate transaminase

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