Pretend you are a teacher preparing a quiz for the text I will provide. 
            Each quiz question should follow the format below. 
            Ensure that you carefully recheck the questions and answers for accuracy. 
            The output should be a ready-to-use list of dictionaries for the Python eval function:

            [

                    "question": "WRITE THE QUESTION HERE",
                    "options": ["A) OPTION_1", "B) OPTION_2", "C) OPTION_3", "D) OPTION_4"],
                    "answer": INDEX_OF_CORRECT_ANSWER_IN_OPTIONS_LIST,
                    "explanation": "EXPLAIN WHY THE ANSWER IS CORRECT"

            ]

            Text:
            aly
Spleen may enlarge due to autoimmune diseases
infections, extramedullary hematopoeisis,
portal hypertension.
Hepatosplenomegaly;  in liver diseases, Infiltrative
diseases (amyloidosis).
Hepatosplenomegaly+lymphadenopathy;
in lymphoprolefrative diseases (leukemia & lymphoma).
Splenomegaly causes discomfort/pain on left upper
abdomen, pressure on stomach causes early satiety,
splenic infarction causes severe pain radiating to left
shoulder & back (sickle cell diseases).
Examination of the spleen
Bleeding
Normal bleeding occurs during surgery&trauma.
Pathological bleeding due to structural defective
vessel rupture,any defect in homeostasis causes
vessel wall breach. or due to platelets deficiency 
or dysfunction, or coagulation factors disorders.
Careful clinical evaluation is  key for diagnosis 
of bleeding disorders & consider the following:
Bleeding – Clinical assessment
1.Site of bleeding: bleeding into joints, muscles,
intracranial likely defective coagulation factors.
Epistaxis,prolonged bleeding from small tiny
cut, GIT bleeding, menorrhagia, due to abnormal 
low platelets count& function. recurrent bleeding 
at single site indicate local structural defect.
2.Duration of history: to assess whether the 
disorder is congenital or acquired.
Bleeding – Clinical assessment
3.Precipitating causes: spontaneous bleed indicates
more severe defect than induced by trauma.
4.Surgery: history of operations, dental extraction,
circumcision are stressful test of haemostatic
system. immediate postsurgical bleeding suggest 
defective platelets plug formation, while delayed
bleeding indicates coagulation defect, if bleeding 
persistent from single site indicates surgical 
bleeding rather than bleeding disorder.
Bleeding – Clinical assessment
5.Family history:+ve FH indicates inherited defect
but –ve FH does not exclude it.
6.Drugs:use of anticoagulants,fibrinolytics must
be elicited. interaction of warfarine with drugs or
drugs induced thrombocytopenia should be 
elicited. herbals may induce bleeding.
Bleeding – Clinical findings
Skin lesions; petichiae & purpura means skin
bleeding ,is  induced by low platletes count or
dysfunction. palpable purpura indicates vasculitis.
Ecchymosis or bruising  of skin means extensive bleeding
deep in skin layers, starts dark in color then yellow
& fade as Hb degraded. retroperitoneal bleeding
presents at flanks or periumbilical hematoma.
Telangiectasia of lips, tongue points to HHT.
Joints examined for hemoarthrosis, look for signs
of liver & renal diseases, malignancy, CTD.
Purpura/petichiae in 
thrombocytopenia
Swollen joint in haemophilia
Investigations of Blood diseases
1.Full blood counts: number of circulating cells,
Hct, RBC indices,size of cell(MCV),amount of Hb
in RBC(MCH),differentiation of WBC(neutrophile
Lymphocyte,monocyte,eosinophile,basophile).
2.Blood film morphology: under microscopy to
assess abnormal RBC content ,abnormal WBC&
immature cells (leukemia), malaria parasite 
inside RBC.
Investigations of B

            Quiz: