Hemopoiesis and formation of hemoglobin are central topics in hematology and pharmacotherapy for B. Pharm students. This introduction covers hematopoietic stem cells, erythropoiesis, erythropoietin regulation, iron metabolism, and the multi-step heme biosynthesis pathway (including key enzymes such as ALA synthase and ferrochelatase). Clinical and pharmacologic links include anemia classification, reticulocyte response, effects of drugs (EPO analogs, hydroxyurea, iron chelators), and porphyria mechanisms. Understanding globin gene regulation, fetal versus adult hemoglobin, and oxygen affinity modulators (2,3-BPG) is essential for rational drug therapy and lab interpretation. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. Which is the principal site of adult hemopoiesis?
- Fetal liver
- Spleen
- Red bone marrow
- Yellow bone marrow
Correct Answer: Red bone marrow
Q2. Which cell surface marker is commonly used to identify human hematopoietic stem cells?
- CD3
- CD19
- CD34
- CD45RA
Correct Answer: CD34
Q3. Which organ is the main source of erythropoietin (EPO) in adults?
- Liver
- Kidney
- Spleen
- Bone marrow stromal cells
Correct Answer: Kidney
Q4. Which of the following is the earliest committed erythroid precursor?
- Myeloblast
- CFU-GEMM
- Proerythroblast
- Megakaryoblast
Correct Answer: Proerythroblast
Q5. Where does hemoglobin synthesis occur in developing erythrocytes?
- Only in mitochondria
- Only in the nucleus
- In both mitochondria and cytoplasm
- Only in the Golgi apparatus
Correct Answer: In both mitochondria and cytoplasm
Q6. What is the rate-limiting enzyme of heme biosynthesis in erythroid cells?
- Ferrochelatase
- ALA synthase
- ALA dehydratase
- Porphobilinogen deaminase
Correct Answer: ALA synthase
Q7. Which erythroid progenitor is most directly responsive to circulating EPO?
- BFU-E (burst-forming unit-erythroid)
- CFU-E (colony-forming unit-erythroid)
- CFU-Meg
- CFU-GM
Correct Answer: CFU-E (colony-forming unit-erythroid)
Q8. What is the tetrameric composition of adult hemoglobin A (HbA)?
- α2β2
- α2γ2
- α2δ2
- β2γ2
Correct Answer: α2β2
Q9. Which hemoglobin predominates in the fetus?
- HbA
- HbA2
- HbF (α2γ2)
- HbS
Correct Answer: HbF (α2γ2)
Q10. 2,3-Bisphosphoglycerate (2,3-BPG) affects oxygen binding by:
- Increasing hemoglobin oxygen affinity
- Decreasing hemoglobin oxygen affinity
- Converting HbA to HbF
- Blocking heme synthesis
Correct Answer: Decreasing hemoglobin oxygen affinity
Q11. What is the primary intracellular iron storage protein?
- Transferrin
- Ferritin
- Ferroportin
- Hemosiderin
Correct Answer: Ferritin
Q12. Which plasma protein transports iron in the blood?
- Ferritin
- Transferrin
- Haptoglobin
- Albumin
Correct Answer: Transferrin
Q13. A deficiency of ferrochelatase leads to which disorder?
- Acute intermittent porphyria
- Porphyria cutanea tarda
- Erythropoietic protoporphyria
- Lead poisoning
Correct Answer: Erythropoietic protoporphyria
Q14. Lead toxicity primarily disrupts heme synthesis by inhibiting which enzymes?
- ALA dehydratase and ferrochelatase
- ALA synthase and ferrochelatase
- Porphobilinogen deaminase and uroporphyrinogen decarboxylase
- Hemoglobin synthase and heme oxygenase
Correct Answer: ALA dehydratase and ferrochelatase
Q15. What does an increased reticulocyte count generally indicate?
- Poor bone marrow activity
- Bone marrow response to anemia or increased erythropoiesis
- Iron overload
- Decreased erythropoietin production
Correct Answer: Bone marrow response to anemia or increased erythropoiesis
Q16. What is the average lifespan of a normal human red blood cell?
- 30 days
- 60 days
- 120 days
- 240 days
Correct Answer: 120 days
Q17. Which transcriptional regulator mediates hypoxia-induced EPO production?
- NF-κB
- HIF-1 (hypoxia-inducible factor 1)
- STAT3
- Myc
Correct Answer: HIF-1 (hypoxia-inducible factor 1)
Q18. Which brush-border enzyme reduces dietary Fe3+ to Fe2+ to facilitate absorption?
- Hephaestin
- Duodenal cytochrome b (Dcytb)
- Ferroportin
- Transferrin
Correct Answer: Duodenal cytochrome b (Dcytb)
Q19. Microcytic anemia is characterized primarily by which laboratory finding?
- Low MCV (mean corpuscular volume)
- High MCV
- High reticulocyte count only
- Low platelet count
Correct Answer: Low MCV (mean corpuscular volume)
Q20. On which chromosome are the alpha-globin genes located?
- Chromosome 11
- Chromosome 16
- Chromosome X
- Chromosome 7
Correct Answer: Chromosome 16
Q21. Which drug is known to increase fetal hemoglobin (HbF) production and is used in sickle cell disease?
- Hydroxyurea
- Iron dextran
- Erythropoietin
- Deferoxamine
Correct Answer: Hydroxyurea
Q22. Porphyria cutanea tarda is due to deficiency of which enzyme?
- ALA synthase
- Porphobilinogen deaminase
- Uroporphyrinogen decarboxylase
- Ferrochelatase
Correct Answer: Uroporphyrinogen decarboxylase
Q23. What does MCHC measure?
- Mean corpuscular hemoglobin concentration (hemoglobin concentration in a given volume of packed RBCs)
- Total serum iron
- Bone marrow cellularity
- Absolute reticulocyte count
Correct Answer: Mean corpuscular hemoglobin concentration (hemoglobin concentration in a given volume of packed RBCs)
Q24. Where are globin polypeptide chains synthesized?
- In mitochondria on mitochondrial ribosomes
- In the cytosol on cytosolic ribosomes
- Inside the nucleus
- On the rough endoplasmic reticulum for secretion
Correct Answer: In the cytosol on cytosolic ribosomes
Q25. Which enzyme inserts iron into protoporphyrin IX to form heme?
- ALA synthase
- Ferrochelatase
- ALA dehydratase
- Porphobilinogen synthase
Correct Answer: Ferrochelatase
Q26. Thrombopoietin (TPO) primarily stimulates development of which lineage?
- Erythroid
- Megakaryocyte/platelet
- Granulocyte
- Lymphoid
Correct Answer: Megakaryocyte/platelet
Q27. CFU-GEMM progenitors give rise to which cell types?
- Only erythrocytes
- Granulocytes, erythrocytes, monocytes, and megakaryocytes
- Only lymphocytes
- Only megakaryocytes
Correct Answer: Granulocytes, erythrocytes, monocytes, and megakaryocytes
Q28. Which dietary factor enhances non-heme iron absorption?
- Tannins in tea
- Calcium
- Vitamin C (ascorbic acid)
- Phytates in grains
Correct Answer: Vitamin C (ascorbic acid)
Q29. The point mutation responsible for sickle cell disease substitutes which amino acid in the beta chain?
- Valine for glutamic acid
- Glutamic acid for valine
- Lysine for glutamic acid
- Alanine for glycine
Correct Answer: Valine for glutamic acid
Q30. Which pattern of laboratory findings is typical in hemolytic anemia?
- Decreased reticulocyte count and increased haptoglobin
- Increased reticulocyte count and decreased haptoglobin
- Normal reticulocyte count and increased haptoglobin
- Decreased reticulocyte count and decreased bilirubin
Correct Answer: Increased reticulocyte count and decreased haptoglobin
I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.
Mail- Sachin@pharmacyfreak.com