Hematology LabCE

Which of the following is the recommended method for preparing a cerebrospinal fluid (CSF) sample for a differential count? A. Cytocentrifugation B. Concentration of cells by traditional cetrifugation C. manual smear methods D. use of hemocytometer

A

Which of the following represents the WBC count reference range for adults? A. 4.4-11.0 x 10^9/L B. 0.5-1.5% C. 150-450x10^9/L D. 140-200mg/dL

A

Which of the following statements characterize a reticulocyte? A. reticulum visible with a supravital stain, such as new methylene blue. B. reticulum visible with wright stain C. contains some organelles used for hemoglobin production D. pyknotic nucleus still present in the cell

A

Which of these conditions could result in a microcytic anemia? A. iron deficiency B. vitamin B12 deficiency C. Spherocytosis D. Folate deficiency

A

Which statement best describes the relationship between dietary iron and iron absorption in a healthy individual? A. Only a small percentage of dietary iron is absorbed and used B. All dietary iron is needed for hemoglobin synthesis and therefore absorbed. C. Most people need to take dietary iron supplements to meet their needs for iron D. All dietary iron is absorbed and excess is stored

A

Which of the following stages of neutrophilic granulocyte cellular development is at the second stage from the last mature stage? A. Band neutrophil B. Promyelocyte C. Metamyelocyte D. Myeloblast

B

Which of the following types of anemia can be described as an inherited bone marrow failure syndrome with patients developing dystrophic nails and white patches in the mouth? A. Fanconi anemia B. Dyskeratosis congenita C. Chronic acquired pure cell aplasia D. Diamond-Blackfan anemia

B

twenty microliters (20uL) of blood are diluted with 1.98mL of diluent. Both sides of the hemocytometer are charged with the diluent sample and the entire ruled area of the center square is counted on both sides. a total of 356 platelets are counted ( combined total of the two large squares ). what is the platelet count per liter? A. 100 x 10^9/L B. 178 x 10^9/L C. 356 x 10^9/L D. 712 x 10 ^9/L

B

The D-dimer is useful in detecting activity in which aspect of hemostasis? A. primary hemostasis B. Secondary hemostasis C. Fibrinolysis D. Quaternary hemostasis

C

Effusion fluids are classified as transudates or exudates. According to Light's criteria, all of the following is applicable to an exudate EXCEPT: A. Pleural fluid/serum protein ratio >0.5 B. Pleural fluid/serum lactate dehydrogenase (LDH) ratio >0.6 C.pleural fluid lactate dehydrogenase (LDH) <2/3 the normal upper limit for serum D. Serum- ascites albumin gradient (SAGG) <1.1g/dL

C

Eosinophilia is commonly found in which of the following disorder? A. pernicious anemia B. liver disease C. parasitic infections D. infectious mononucleosis

C

How is the mean cell volume calculated? A. (Hemoglobin / red blood cells) x 10 B. ( hemoglobin / red blood cells) x 100 C. (Hematocrit % / red blood cells) x 10 D. (Hematocrit % x hemoglobin) x 100

C

The absence of which clotting factor causes NO bleeding tendency? A. antihemophiliac factor (VIII) B. plasma thromboplastin component (IX) C. hageman factor (XII) D. plasma thromboplastin antecedent (XI)

C

"a rare congenital red cell aplasia" without leukopenia or thrombocytopenia" best describes which of the following disorders? A. diamond-blackfan syndrome (DBA) B. fanconi anemia C. myelophthisic anemia D. dyskertosis congenita

A

A yellow coloration found in each cerebrospinal fluid supernatant is termed: A. Xanthochromia B. Hemolysis C. Jaundice D. Hyperlipidemia

A

Abnormal platelet function seen in patients with Bernard-Soulier Syndrome is caused by which of the following platelet components? A. Defective glycoprotein In/IX B. Dense granule deficiency C. a-granule deficiency D. Defective glycoprotein IIb/IIIa

A

Which of these factors may be deficient if both the PT and aPTT are prolonged? A. Factor II B. Factor VII C. Factor VIII D. Factor XI

A

Abnormal thrombin times can be caused by all of the following EXCEPT: A. Low platelet count B.high heparin levels C. Low fibrinogen levels D. High fibrin-degradation products

A

All helper cells are T cells. consequently, in a normal lymphocyte population, it is reasonable to expect all CD4-positive cells also be positive for which of the following CD markers? A. CD3 B. CD20 C. CD33 D. CD41 and CD42

A

What is the normal M:E ratio in the bone marrow? A. 2:1-4:1 B. 1:2-1:4 C.3:1-5:1 D.5:1-10:1

A

What is the typical finding for determining the endpoint for the initial or iron-depletion phase of treatment for hereditary hemochromatosis(HH)? A. the serum ferritin decreases between 20 and 50 ng/mL B. the hepatic iron index returns to normal C. the transferrin saturation drops below 20% D. the serum iron falls to below 35ug/dL

A

What is the main site of action for monocytes after diapedesis? A. peripheral blood B. body tissues C. bone marrow D. digestive tract

B

Which of the following coagulation test results would be prolonged in deficiency of factor X? A. PT only B. aPTT only C. Both PT and aPTT D. neither PT nor aPTT

C

Which of the following laboratory tests is commonly used to monitor oral anticoagulant therapy? A. Activated partial thromboplastin time (aPTT) B. Thrombin time (TT) C. Prothrombin Time (PT)/INR D. Fibrinogen assay

C

Which of the following options best describes how hemophilia A differs from hemophilia B? A. The clinical presentation is drastically different. B. Hemophilia A is an inherited disorder and hemophilia B is an acquired disorder. C. Factor VIII is deficient in hemophilia A factor IX is deficient in hemophilia B. D. Hemophilia A is a disorder of secondary hemostasis and hemophilia B is a disorder of primary hemostasis.

C

Which of the following statements about macrocytes is true? A. MCV is within normal limits B. the appearance of the cell is due to exaggerated flattening C. the cells are typically larger than a resting lymphocyte D. macrocytic cells are generally hypochromic

C

Which of these coagulation factors are referred to as vitamin K dependent? Factors I,V,VIII,XIII Factors II, V, IX, XII Factors II, VII, IX, X Factors XI,XII, fletcher, Fitzgerald

C

which of the following is a mechanism known to cause platelet satellitosis (satellitism)? A. an antibody directed against factor VIII B. an antibody directed against von Williebrand factor (vWF) C. an antibody directed against the platelet membrane D. an antibody directed against fibrinogen

C

A laboratory test to determine heparin levels in a patient's plasma is: A. activated partial thromboplastin time (aPTT) B. Anti-factor Xa assay (anti-FXa) C. prothrombin time (PT) D. D-dimer assay

B

What are Howell-Jolly bodies composed of? A. hemoglobin B. DNA C. Iron D.RNA

B

All of the following would be represented in the usual classification of anemia EXCEPT: A. microcytic, hypochromic B. normocytic, normochromic C. normocytic, hyperchromic D. macrocytic

C

A 2 year old girl, who had been treated with an upper respiratory tract infection a few weeks ago, showed multiple bruises and had the following laboratory findings: Hgb: 13.5 g/dL RBC: 3.9x 10^12/L WBC: 8.0x 10^9/L Platelets: 5x 10^9/L Bone marrow M:E ratio=3:1 Megakaryocytes:increased These results are most suggestive of which condition? A. Glanzmann thrombasthenia B. Wiskott-Aldrich syndrome C. Immune (idiopathic) thrombocytopenia purpura D. Thrombotic thrombocytopenia purpura

C

A newly admitted patient has the following coagulation results: PT:12.9 seconds (N=12-14 sec) aPTT:84 seconds (N=25-35 sec) platelet count: 200x 10^9/L (N=150-450 X 10^9/L A mixing study was performed due to the abnormal aPTT test results. the mixing study demonstrated the following: aPTT was corrected by normal plasma, factor IX deficient plasma, but not by factor VIII deficient plasma. What factor assay should be performed next? A. None; a platelet disorder is indicated. B. Factor V assay C. Factor VIII assay D. Factor IX assay

C

A technologist decides to make a 1:20 dilution of cerebrospinal fluid (CSF) after briefly evaluating a portion of the sample microscopically. after making the dilution and charging the chambers, the number of cells that are observed in each of the large squares of the hemacytometer is >100. what should the technologist do to obtain the most accurate count? A. count all four corner squares B. make a smaller dilution C. make a larger dilution D. no dilution necessary

C

All of the following are decreased in beta thalassemia major, EXCEPT? A. MCHC B. MCV C. RDW D. RBC Count

C

All of the following offer a protective effect, delaying symptoms in persons with hereditary hemochromatosis (HH) EXCEPT? A. regular blood donation B. Pregnancy C. Regular use of multivitamins with iron D. menstruation

C

Anticoagulant drugs which are direct thrombin inhibitors (such as argatroban and bivalirudin) can prolong which of the following clot based assay/s? A. Ecarin clotting time only (ECT) B. Activated thromboplastin time (aPTT) only C. PT and aPTT D. PT, aPTT and Ecarin clotting time

D

Granulocytes include the following types of white blood cells (leukocytes) A. Neutrophils, basophils, and monocytes B. Neutrophils, eosinophils, and monocytes C. Eosinophils, monocytes, and lymphocytes D. Neutrophils, eosinophils, and basophils

D

Hemoglobin D (HbD) is elevated in all of the following, EXCEPT? A. hemoglobin D disease B. hemoglobin SD disease C. Hb D/beta-thalassemia D. Alpha thalassemia

D

Hemophilia B or Christmas disease is the result of a hereditary deficiency in which coagulation factor? A. Factor X B. Factor VIII C. Factor XI D. Factor IX

D

Patient presents to the ER with prolonged bleeding. PT and aPTT tests both come back prolonged. After running factor assays it was determined the patient has hemophilia B, also known as Christmas disease, a deficiency of which factor? A. Factor VII B. Factor VIII C. Factor X D. Factor IX

D

Which of the following categories includes mature neutrophils, eosinophils and basophils? A. Granulocytes B. Hematopoietic stem cells C. Lymphoid cells D. Mononuclear cells

A

Which of the following is the common name for factor II? A. Prothrombin B. Fibrinogen C. tissue factor D. proaccelerin

A

All of the following erythrocyte alterations are always associated with pathological conditions, EXCEPT: A. Rouleaux B. Basophilic stippling C. Howell jolly bodies D. Pappenheimer bodies

A

In essential thrombocytopenia, the platelets are usually: A. Increased in number and functionally abnormal B. Normal in number and functioning abnormal C. Decreased in number and functionally normal D. Decreased in number and functionally abnormal

A

Inflammation of a vein is known as: A. Phlebitis B. Embolism C. Thrombosis D. Aneurysm

A

The Philadelphia chromosome is consistently associated with which of the following blood disorders? A. Chronic myelocytic leukemia (CML) B. Chronic lymphocytic leukemia (CLL) C. Acute myelocytic leukemia (AML) D. Acute lymphocytic leukemia (ALL)

A

The life span of RBCs containing hemoglobin H is typically: A. less than 120 days B. 100-120 days C. 120-140 days D. greater than 140 days

A

What morphologically abnormal red blood is associated with hyperchromia? A. Sphereocytes B. Macrocyte C. Microcyte D. Target cell

A

When comparing normal cells, the nucleus of a small lymphocyte is about the same size as? A. normal erythrocyte B. small monocyte C. large platelet D. Band neutrophil

A

cerebrospinal fluid (CSF) specimens are usually collected by lumbar puncture and placed in numbered tubes starting with the first tube collected. If four tubes are collected , which tube would be used for a cell count and differential?

A. Tube #1 B. Tube #2 C. Tube #3 D. Tube #4 C

A patient is admitted to the emergency room with lethargy and pallor. The CBC results are as follows: RBC:4.1x10^12/L Hemoglobin: 7.9g/dL Hematocrit:29% How would you classify this anemia?

A.microcytic, hypochromic B. Normocytic, normochromic C. Macrocytic,normochromic D. Microcytic, hyperchromic A

In which myelodysplastic syndrome classification would a patient having <5% blasts and <15% ringed sideroblasts belong? A. RA B. RCMD C. AML D. RAEB

A.

An isolated crenated erythrocyte with spicules is seen on an otherwise normocytic normochromic peripheral blood smear. Which of the following statements is true?

A. Finding is indicative of possible abeta-lipoproteinemia B. Morphology suggests liklihood of disseminated intravascular coagulation. C. Morphology indicates hemoglobinopathy such as thalassemia D.finding is most likely an artifact caused by poor smear preparation D

A 41 year old male arrived at the clinic with complaints of fatigue, malaise, and overall discomfort. upon testing, the patient's CBC results were notably abnormal with 30% blasts present along with anemia and thrombocytopenia. bone marrow and cytochemical staining were subsequently performed. the cytochemical stains noted negative reactions to myeloperoxidase and sudan black B but a positve reaction to alpha- naphthyl acetate. which of the following conditions is most likely seen? A. acute erythroleukemia B. acute monocytic leukemia C. acute promyelocytic leukemia D. acute lymphocytic leukemia

B

A quick mathematical check which can be applied to verify that the hemoglobin and hematocrit values on a complete blood count correspond with each other would be: A. hematocrit x 3= hemoglobin B. hemoglobin x 3 = hematocrit C. hemoglobin / hematocrit =3 D. hemoglobin + hematocrit = 3

B

A serum ferritin above what level would be suggestive of iron overload and possibly hereditary hemochromatosis (HH) in a pre-menopausal woman? A. 100 ng/mL B. 200 ng/mL C. 300 ng/mL D. 400 ng/mL

B

A technologist performed a STAT spinal fluid count by pipetting undiluted spinal fluid in a neubauer counting chamber and counting both sides of the chamber (4 large WBC squares on each side). a total of 54 white cells were counted. how many white cells would there be per cubic millimeter? A. 3.80 B.67.5 C.13.5 D.300

B

Adult ( normal ) hemoglobin is made up of the following composition: A.>90% HbA, 1% HbA2, 5% HbF B.>95% HbA,<3.5% HbA2, <1-2%HbF C.<90% HbA, 10% HbA2 5% HbF D. >90% HbA, 1% HbA2, 5-10% HbF

B

All of the cells listed below function as a phagocyte EXCEPT: A. Neutrophil B. Eosinophil C. Monocyte D. Macrophage

B

An MCV is reported by the instrument as 82fL. The MCV is flagged with a delta check alert as the previous MCV reported on the patient 12 hours earlier was 97 fL. What is a possible cause for this discrepancy? A. Transfusion B. The specimens are not from the same patient C. Acute hemorrhage D. The second patient was hemolyzed

B

Considering the red cell distribution width (RDW) in alpha thalassemia, how would you expect the red blood cell histogram to look? A. Shifted to the right B. Shifted to the left C. Bimodal D. Normal

B

Formation of which of the following forms of poikilocytosis listed below is associated with other absence of beta-lipoproteins (abetalipoproteinemia)? A. Schistocytes B. Acanthocytes C. Drepanocytes D. Spherocytes

B

In the heterozygous state of HbS, referred to as sickle cell trait, which of the following hemoglobins appear in combination with HbS? A. HbE B. HbA C. HbC D. HbD

B

In which of the following conditions would you NOT expect to find Howell-Jolly bodies? A. sickle cell anemia B. Iron deficiency anemia C. post splenectomy D. megaloblastic anemia

B

Pernicious anemia refers to cobalamin deficiency that results from a lack of which of the following? A. Vitamin B12 B. Intrinsic Factor C. Folate D. Vitamin C

B

The condition which is highly associated with the oval-macrocytes and hypersegmented neutrophils (with 6 or more lobes): A. sideroblstic anemia B. Megaloblastic Anemia C. Iron deficiency anemia D. Malarial infection

B

The fibrin clot begins to form when fibrinogen is cleaved resulting in a fibrin monomer, fibrinopeptide A, and fibrinopeptide B fragments. The fibrin monomers spontaneously polymerize due to hydrogen bonding, and then are covalently linked into fibrin polymers by which factor? A. Plasmin B. Factor XIII C. Factor V D. Thrombin

B

The percentage of ref blood cells in whole blood is called: A. hemoglobin B. hematocrit C. hemostasis D. hemopoiesis

B

This assay would be used to help RULE OUT heparin contamination in a coagulation sample: A. Protein C assay B. Thrombin Time C. PT D. aPTT

B

What abnormal red blood cell inclusion is composed of multiple small, dark blue aggregates of ribosome (RNA) that are distinguished throughout the RBC? A. Pappenheimer bodies B. Basophilic stippling C. Heinz bodies D. Howell-Jolly bodies

B

What is the primary function of hemoglobin? A. bind with free iron stores B. carry oxygen to tissues C. carry carbon dioxide to tissues D. carry oxygen to lungs

B

What is the principle of the Kleihauer-Betke test? A. Fetal cells present in the mother's blood smear contain fetal hemoglobin (Hgb F). When treated with acid the fetal cells are sensitive and become ghost cells. B. Fetal cells present in the mother's blood smear contain fetal hemoglobin (Hgb F). When treated with acid the fetal cells are resistant and will stain pink with the counter stain. C. Maternal red blood cells contain fetal hemoglobin (Hgb F). When treated with acid the maternal cells are resistant and we stain pink with counter stain. D. Paternal cells present in the mother's blood smear are stained pink with an acid treatment.

B

What is the term that describes the process by which fibrin strands are broken down and then removed from an established clot? A. fibrinogenesis B. fibrinolysis C. hemolysis D. fibrin Polymerization

B

Which of the following are terms used to describe storage pool iron? A. Hemosoderin and myoglobin B. Ferritin and hemosoderin C. Hemopectin and hemoglobin D. Apoferritin and transferrin

B

Which of the following bone marrow processing procedures is best suited for a patient who had a dry tap? A. Direct differential smear B. touch preparations C. concentrate (buffy coat) smears D. crush smear

B

Which of the following conditions can produce a normal aPTT and a prolonged PT? A. factor IX deficiency B. factor VII deficiency C. factor VIII deficiency D. factor X deficiency

B

Which of the following disorders us characterized by a stem cell mutation due to the PIGA gene that leads to clones of cells that bind abnormally large amounts of complement? A. Spur cell anemia B. paroxysmal nocturnal hemoglobinuria C. hereditary acanthocytosis( aka abetalipoproteinemia) D. hereditary pyropoikilocytosis

B

Obstruction of a blood vessel caused by a stationary blood clot is called: A. Phlebitis B. Embolism C. Thrombosis D. Aneurysm

C

Ristocetin is used in certain von williebrand factor (vWF) functional assays. the reason this is true is because: A. ristocetin can prevent contamination of the specimen. B. ristocetin can break down the vWF multimers into monomers, and then be assayed. C. ristocetin enhances binding of vWF to platelet GPiba D. ristocetin prevents interference by other coagulation factors.

C

The following describes a clot based test to assess protein C function, as well as the results of someone's test who has a protein C deficiency. A. A partial thromboplastin time (PTT) is performed using C- depleted normal plasma, a venom activator of protein C (such as protac), and a heparin neutralizer. The clotting time would be prolonged (above reference range) in someone with a protein C deficiency. B. A PTT is performed using low phospholipid reagents along with C-enriched plasma, a venom activator of protein C (such as protac), and a heparin neutralizer. The clotting time would be prolonged (above reference range) in someone with a protein c deficiency. C. A partial thromboplastin time (PTT) is performed using C-depleted normal plasma, a venom activator of protein C (such as protac), and a heparin neutralizer. The clotting time would not be prolonged in someone with a protein C deficiency. D. A PTT is performed using low phospholipid reagents along with C- enriched plasma, a venom activator of protein C (such as protac), and a heparin neutralizer. The clotting time would not be prolonged in someone with a protein C deficiency.

C

The most striking laboratory finding of this myeloproliferative neoplasms is an absolute erythrocytosis and hemoglobin concentrations of greater that 18.5 g/dL? A. Chronic myelogenous leukemia (CML) B. Essential thrombocytopenia (ET) C. Polycythemia Vera (PV) D. Primary myelofibrosis (PMF)

C

To obtain accurate aPTT times in patients who have hemophilia and have blood drawn from implanted venous access devices, it is important to: A. run the activated thromboplastin time (aPTT) in triplicate B. compare the patients current aPTT with previous results C. treat patient plasma with heparin neutralizers and then do the aPTT D. perform the aPTT on the plasma from a green top tube, rather than a blue top.

C

Two CSF specimens were sent to the Lab with the following results: Tube #1 =11,200 rbc/uL tube #2= 300 rbc/uL the results on these CSF specimens are indicative of: A. an infection B. a recent subarachnoid hemorrhage C. a traumatic tap D. an old intracranial bleeding episode

C

Von Williebrand Factor (vWF) multimer analysis of patients plasma can be performed by: A. Ristocetin induced platelet aggregation tests (RIPA) B. ELISA antigen assays C. SDS agarose gel electrophoresis D. Latex agglutination test

C

What RBC morphology on Wright-stained may indicate the presence of an unstable hemoglobin? A. Acanthocytes B. Codocytes C. Schistocytes D. Xerocytes

C

What is the main function of erythrocytes? A. to fight off infection B. to assist in the coagulation process C. to transport oxygen from the lungs to the tissues and carbon dioxide from the tissue to the lungs to be expelled. D. to transport nutrients, hormone, nitrogenous waste and electrolytes among other substances.

C

What is the precursor of the platelet which is commonly only found in the bone marrow? A. myeloblast B. promegakarocyte C. megakaryocyte D. erythroblast

C

What is the reference limit for progressive motility of spermatozoa when performing a semen analysis? A.12% B.22% C.32% D.40%

C

Which condition is caused by the increased plasminogen activator inhibitor 1 (PAI-1) AND fibrinogen often present in metabolic syndrome? A. hyperglycemia B. proinflammatory state C. prothrombotic state D. atherogenic dyslipidemia

C

Which hemoglobin, when elevated, acts as a protection against sickling in patients with HbS? A. hemoglobin E B. hemoglobin C C. hemoglobin F D. hemoglobin D

C

Plasma exchange is the current treatment for all these conditions, EXCEPT: A. Warm autoimmune hemolytic anemia (WAIHA) B. Diarrhea-associated hemolytic uremic syndrome (HUS) C. Thrombotic thrombocytopenia purpura (TTP) D.pernicious anemia

D

Which is MOST accurate definition for an orthochromic normoblast or nucleated red blood cell? A. a cell with irregular lobulated or puckered shape containing residual RNA and mitochondria in the cytoplasm B. a cell with a high nuclear-to-cytoplasmic ratio with a lacy, fine linear chromatin pattern. C. a cell with deeply basophilic cytoplasm, a perinuclear halo and a wheel spoke chromatin pattern. D. a cell with a low nuclear-to-cytoplasimic ratio with pink cytoplasm and a heavily condensed chromatin pattern.

D

Which laboratory result is the most critical in recognizing heparin-induced thrombocytopenia (HIT)? A. Fibrinogen level B. Prothrombin time C. D-dimer D. Platelet count

D

Which of the following laboratory results is characteristic for a patient with von Williebrand disease? A. decreased bleeding time B. normal FVIII levels C. normal platelet function tests D. abnormal platelet aggregation response to ristocetin

D

Which of the following ranges is the reference range for hematocrit for an adult male? A. 14-18g/dL B. 12-16 g/dL C. 35-47% D. 40-52%

D

Which would describe hypochromia? A. Decreased size of RBCs B. Variation in the shape of RBCs C. Increased variation of size of RBCs D. Decreased hemoglobin concentration in RBCs

D

what would the following schilling test results indicate: Part I: 2% excretion of radioactive vitamin B12 (N=5-35% Part II: 8% excretion of radioactive vitamin B12 after intrinsic factor was given with vitamin B12 (N=7-10%) A. tropical sprue B. transcobalamin deficiency C. folic acid deficiency D. pernicious anemia

D

which of the following factors does not affect the result of the aPTT assay? A. Factor X B. Factor IX C. Factor VIII D. Factor VII

D

which of these methods could be used to differentiate between Howell-Jolly bodies and pappenheimer bodies and what results would be noted? A. Wright- Giemsa stain: pappenheimer bodies stain blue but howell jolly bodies do not stain blue. B. Wright-geimsa stain howell jolly bodies stain blue but pappenheimer bodies do not stain blue. C. prussian blue stain: howell jolly bodies stain blue but pappenheimer bodies do not stain blue D. prussian blue stain: pappenheimer bodies stain blue but howell jolly bodies do not stain blue.

D