LC Hematology

A 27 year old man with down syndrome has the following CBC results which are most suggestive of which condition

Acute lymphocytic leukemia

Which of the following chemicals may cause hemolytic anemia?

All the above

Which disorder exhibits a genetic code that is incompatible with life?

Alpha Thalassemia major.

Which of the following tests would be employed in order to detect neural tube defects

Alpha fetoprotein

The impedence principle shown in this illustration is best described by the following statement.

Blood cells or other particles are counted and sized, based on changes in electrical resistance as they pass between 2 electrodes.

Which 2 of the following are associated with macrocytic anemia

Folic acid deficiency and fish tapeworm

Which of the following inclusions are composed of DNA

Howell jolly bodies

What may prevent the detection of lupus anti coagulant in a plasma sample if the blood used for testing is not centrifuge for a sufficient time.

Increased platelets in the plasma sample

In which of the following disorders would you probably observe coarse basophilic stippling on a right stained peripheral blood smear.

Lead poisoning and thalassemia.

The precursor of the platelet, which is commonly only found in the bone marrow, is.

Megakaryocyte.

When evaluating a potentially malignant effusion, select all of the following choices which would apply.

Note presence of blast or tumor clumps on report after confirmation by pathologist. Send a cytospin preparation for hematology or pathology review. Notify a clinician of suspected malignant cells, according to hospital protocol.

Which statement? Best describes the relationship between dietary iron and iron absorption in a healthy individual.

Only a small percentage of dietary iron is absorbed and used

Warfarin based oral anticoagulant therapy is commonly monitored with.

PT/INR

What is the cell indicated by the arrow in this illustration?

Plasma cell

In addition to a Romanowsky stain, which one of the following would be useful in the routine evaluation of a bone marrow.

Prussian blue

Which of these methods could be used to differentiate between howell jolly bodies and Pappenheimer bodies and what results, would be noted.

Prussian blue stain: Pappenheimer bodies stain blue but Howell Jolly bodies do not stain blue

Eosinophils are increased in all of the following conditions, except.

Viral infections

A defect in which of the following factors causes impaired platelet adhesion and aggregation

Von Willebrand factor.

When performing your mixing study, you aliquot your sample plasma and the pooled normal plasma to create your mix, you then place the sample in a water bath to incubate for 90 minutes before running your new mix sample. What is the problem with the steps involved? The procedure above.

You have not run a pt or aptt on the new mix before incubating.

Which group of conditions increases the risk of HBS polymerization?

acid Ph dehydration increased level of 23 DPG.

An abnormality of which of the following assays would be least likely to be associated with thrombotic tendency.

aptt

These test results are most consistent with which of the following types of beta thalassemia. RBC morphology- Microcytes, basophilic stippling codocytes present.

beta Thalassemia minor

Hemoglobinopathies can be caused by all of the following structural defects except

deletion of a globin chain

If one finds excessive roulleaux formation on a blood smear examination than one might also find an increased.

esr

The first time a cell containing Hb SS is deoxygenated, it forms an irreversiblly sickled cell

false

Classic automated blood cell counters are based on

impedance principle

Which coagulation pathway is initiated when collagen is exposed and involves the substances, high molecular weight kininogen, prekallikrein, and coagulation factor 12.

intrinsic pathway

Laboratory results obtained on a 47 year old patient were, as follows, which test would be most helpful in establishing a diagnosis in this case.

lap stain

All of the following statements describe a method by which platelets aid coagulation except

lowering blood pressure by releasing heparin

Blood samples for complete blood counts are collected on morning rounds and stored in a rack in the phlebotomist's basket when the phlebotomist delivers the samples to your work station, the cells and plasma in the samples have separated. One of the samples has lipemic plasma, which of the following parameters may be affected by the lipemia.

mchc

Which of the following cells is the most common nucleated cell and normal adult bone marrow

metamyelocyte

Phagocytosis is a function of which of the following types of cells

monocytes

the most immature neutrophil found in normal peripheral blood is.

neutrophil band

How would the red blood cells appear on the peripheral blood smear if the red cell indices obtained on a patient are as follows? MCV 88.5 mch30.2 mchc33.1

normochromic, normocytic

Which of the following would not be represented in the usual classification of anemia?

normocytic, hyperchromic

If present, how many howell jolly bodies are usually seen within a given erythrocyte.

one

Approximately 80 to 90 percent of the neutrophils on the peripheral blood smear of a young man are similar to those in the image this peripheral smear most likely represents which condition.

pelger-huet anomaly.

Which of the following conditions would produce these results in an anemic patient. MCV 115 MCV 30 mchc 34

pernicious anemia

A patient has a history of repeated spontaneous abortion. Coagulation studies reveal an elevated aPTT, normal pt normal platelet function and normal clotting time. schistocytes were seen on the peripheral blood smear, which tests should be performed to determine if the patient has lupus anticoagulant.

platelet neutralization test

For which determination is the brilliant cresyl blue used most often

reticulocytes

Which of the following alpha thalassemia syndromes has the genotype. -a/aa

silent carrier

A hemocytometer is generally not used for which of the following.

synovial fluid crystal count

During phagocytosis the neutrophilic granules release digestive enzymes into the vacuole to kill or destroy the phagocytized particles.

true

The cell diameter of a normal RBC is similar in size to the nucleus of a small lymphocyte.

true

Match the conditions listed below with the elements that may be seen on a stained CSF smear when this condition is present. 1.Previous subarachnoid hemorrhage. 2.Bacterial meningitis 3.Bone marrow contamination of the CSF. 4.Viral meningitis

1. hemosiderin deposits 2. neutrophilic pleocytosis 3. NRBCs 4. lymphocytic pleocytosis

How many large hemocytometer squares contain a total volume of one microliter of fluid

10

What approximate percentage of individuals in the us who are heterozygous for hfe mutations?

10 to 12 percent

If the dilution is 1 to 100 and the average platelet counts from both sides of the hemocytometer counting chamber in 2mm. is 68. What is the calculated platelet count?

68,000

What are the primary reagents used in the activated partial thromboplastin time

Activated partial thromboplastin and calcium

Select the letter representing the cell that can be seen in increased concentrations in the peripheral blood smear during immediate hypersensitivity reactions.

B. Basophil

Which of the following non hbs hemoglobins can also sickle and show a positive solubility test.

BBC harlem

Nucleated RBCs are most likely to be seen in the peripheral blood of which of these beta Thalassemia

Beta Thalassemia major

Which of the following are the beta thalassemia syndromes whose genotype is? B0/B+

Beta thalassemia intermedia and major

Which of the following CD markers is not present on a normal mature t cell.

CD 20

CSF lymphocytosis is associated with all of the following except

Cerebral abscess

A woman in labor is bleeding, has a very high fever and is in danger of losing the fetus. Laboratory results include a platelet count of 15 prolonged pt and aPTT decreased fibrinogen and increased d dimer. Her Automated blood count flaged for blood smear review and the cells indicated by the arrows were seen on her peripheral smear along with a decrease in the number of platelets present. What condition is suggested by these results?

DIC

Hypochromia can best be described as

Decrease in hemoglobin concentration in RBCs

Which of the following laboratory test results indicates that a sickle cell patient may be an aplastic crisis.

Decreased reticulocyte count

hereditary hemochromatosis thought to be under diagnosed

Early symptoms are non specific and vague, physicians and patients may lack knowledge of this disorder

What is the identification of this cellular clump found in CSF note the presence of many similar appearing nuclei without distinct lines of demarcation between cells.

Ependymal clump

In which of the following situations would a bone marrow aspirate and biopsy possibly be used as an aid for diagnosis? I

Evaluation of anemia and thrombocytopenia, evaluation of cytopenias, diagnosis of leukemia, evaluation of fever of unknown origin

Which of the following factors does not affect the results of the aPTT assay

Factor 7

Which one of these test systems can be used to evaluate the adequacy of fibrinogen in heparinized patients?

Reptilase time

Which of the following mechanisms involve a series of interrelated chemical processes that lead to the formation of durable fibrin strands.

Secondary hemostasis

what clinical characteristics, might a person with beta Thalassemia intermedia exhibit.

Some splenomegaly

Identify the large foamy cells in the joint fluid image shown to the right.

Synovial lining cells

All of the following descriptions are characteristic of monocytes except

The nuclear chromatin appears very condensed

what it is a typical finding for determining the end point for the initial or iron depletion phase of treatment for hereditary hemochromatosis.

The serum ferritin decreases to between 20 and 50ng/ml