MediaLab Hematology Practice Questions Part 2

All of the following are usually increased in alpha thalassemia EXCEPT? A) Iron binding capacity B) Percent iron saturation C) Lactate dehydrogenase D) Bilirubin

Iron binding capacity

Which of the following is NOT a cause of death in patients with hereditary hemochromatosis (HH)? A) Autoimmune disease B) Hepatocellular carcinoma C) Cirrhosis D) Cardiomyopathy

Autoimmune disease

What would be the logical first step to obtain correct values when the following results were obtained on an electronic particle counter in hematology for an alcoholic patient? WBC 6,500/cu. mm MCV 90.1 fL RBC 4,550,000/cu. mm MCH 39.6 pg HGB 18.0 g/dL MCHC 43.4% HCT 41.5% A) Perform a microhematocrit B) Check and correct for lipemia C) Dilute the blood D) Replace the lysing agent

Check and correct for lipemia

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

(Hematocrit %/ Red blood cells) X 10

No platelet aggregation response to ristocetin occurs in both Von Willebrand Disease and in Bernard Soulier Syndrome. In VWD, it is a cofactor for Von Willebrand Factor and as a result of deficiency of VWF, ristocetin becomes deficient as well. What is deficient in Bernard Soulier Syndrome to cause no response to ristocetin? A) GP IIb/IIIa B) TPa C) GP Ib/IX/V D) P2Y1

GP Ib/IX/V

Which of these conditions could result in a microcytic anemia? A) Iron deficiency B) Vitamin B12 deficiency C) Spherocytosis D) Folate deficiency

Iron deficiency

If a patient has three inactive alpha-globin genes, which of the four alpha (a) thalassemia classifications would they have? A) Alpha thalassemia trait B) Hydrops fetalis C) Hb H disease D) Silent carrier

Hb H disease

Cells, as shown in this iron-stained bone marrow preparation, are found in each of the following conditions EXCEPT: A) Alcohol abuse B) Chloramphenicol therapy C) Iron deficiency anemia D) Thalassemia

Iron deficiency anemia

The average bone marrow cellularity in a normal adult (50 years old) is: A) 30 B) 50 C) 65 D) 70

50

Which of the following gene translocations is associated with Acute Promyelocytic Leukemia (APL)? A) t(8;21) B) t(15;17) C) t(9;11) D) t(6;9)

t(15;17)

Which of the following formulas will provide the value that reflects the average cell volume in a blood sample? A) Hemoglobin (g/dL) x 10/RBC count (10^12/L) B) Hematocrit (%) x 10/RBC count (10^12/L) C) Hemoglobin (g/dL) x 100/Hematocrit (%) D) Hemoglobin x 3

Hematocrit (%) x 10/RBC count (10^12/L)

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

Hemoglobin X 3 = hematocrit

A dilution commonly used for a routine sperm count is: A) 1:2 B) 1:20 C) 1:200 D) 1:400

1:20

What may cause the following mixing studies results? Initial aPTT = 133 seconds 1:1 Mix aPTT pre-incubation = 33 seconds 1:1 Mix aPTT post-incubation = 124 seconds A) Factor IX deficiency B) Factor XI deficiency C) A slow acting coagulation inhibitor D) Factor VII deficiency

A slow acting coagulation inhibitor

Which group of conditions increases the risk of HbS polymerization? A) Acid pH, dehydration, decreased level of 2,3-DPG B) Alkaline pH, dehydration, increased level of 2,3-DPG C) Acid pH, dehydration, increased level of 2,3-DPG D) Alkaline pH, dehydration, decreased level of 2,3-DPG

Acid pH, dehydration, increased level of 2,3-DPG

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 positive 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

Acute Monocytic Leukemia

Alder-Reilly inclusions may be found in which cell type(s)? A) Neutrophils only B) Granulocytes only C) All types of mature white blood cells D) Erythrocytes

All types of mature white blood cells

Using an automated cell counter analyzer, an increased Red Cell Distribution Width (RDW) should correlate with which of the following? A) Leukocytosis B) Anisocytosis C) Spherocytosis D) Macrocytosis

Anisocytosis

Acquired hemophilia A (not classic hemophilia A) may result from which of the following conditions? A) Anti-factor VIII inhibitor B) Factor VIII deficiency C) Warfarin therapy D) Thrombosis complications

Anti-factor VIII inhibitor

The causative agent of infectious mononucleosis attaches to a receptor on which of the following cells? A) T helper cell B) B lymphocyte C) T suppressor cell D) NK cell

B lymphocyte

What is the name of the structure that is indicated by the arrow in the image from a Wright-Giemsa stained smear? A) Döhle body B) Auer rod C) Barr body D) Toxic granulation

Barr body

Newborns who will develop Hemoglobin H disease may demonstrate up to 30% of which type of hemoglobin? A) Bart's B) Fetal C) Lepore D) Sickle

Bart's

A young child is brought in for a clinic visit for bleeding and bruising tendencies. Coagulation screening tests revealed normal PT and APTT levels. The CBC was overall normal with the exception of a low platelet count and giant platelets. Platelet aggregation studies were then ordered with normal responses to all agents except ristocetin which had no response. Which of the following is the disease that correlates with these findings? A) May-Hegglin Anomaly B) Glanzmann Thrombasthenia C) Hemophilia A D) Bernard Soulier Syndrome

Bernard Soulier Syndrome

Cooley's anemia is another name for which form of beta-thalassemia? A) Delta-beta thalassemia B) Beta thalassemia major C) Beta thalassemia intermedia D) Beta thalassemia minor

Beta thalassemia major

Skeletal deformations are most commonly present in which of the following beta thalassemias? A) Beta thalassemia minor B) Beta thalassemia intermedia C) Beta thalassemia major D) All of the beta thalassemias equally

Beta thalassemia major

Which beta thalassemia shows no anemia and may not be detected using hemoglobin electrophoresis? A) Beta thalassemia minima B) Beta thalassemia minor C) Beta thalassemia intermedia D) Beta thalassemia major

Beta thalassemia minima

A patient has an increased RBC count with a decreased Hb and normal Hct. The MCV is microcytic, and the RDW is within normal limits. Many codocytes are present on the peripheral smear. Serum iron is 165 µg/dL (normal = 60 -150 µg/dL), and the TIBC is 230 µg/dL (normal = 250 - 400 µg/dL). Consider the findings on alkaline hemoglobin electrophoresis, which show an increased level of hemoglobin A2 of 5% (normal values are less than 3.5%). What is this patient's most likely diagnosis? A) Beta thalassemia silent carrier B) Beta thalassemia minor C) Beta thalassemia intermedia D) Beta thalassemia major

Beta thalassemia minor

The hematology analyzer reported an elevated white blood cell count and flagged for manual review due to the suspected presence of immature cells. What is the arrowed cell's identity, and what name is given to its inclusion? A) Lymphoma cell with ingested bacteria B) Promyelocyte with overlying platelet C) Blast with Auer rod D) Blast with a Döhle body

Blast with Auer rod

Which of the following can cause an automated platelet count to appear to be lower than it actually is? A) Platelet satellitism B) Platelet clumping C) Both platelet satellitism and platelet clumping D) Neither platelet satellitism and platelet clumping

Both platelet satellitism and platelet clumping

Which of the following phenotypes is most indicative of a natural killer (NK) cell? A) CD2+ CD3+ CD5+ CD7+ B) CD2+ CD3- CD11b+ CD16+ C) CD11b+ CD16+ CD33+ CD56- D) CD19+ CD20+ CD22+ CD57-

CD2+ CD3- CD11b+ CD16+

A population of small lymphocytes is gated for further evaluation in the flow cytometry laboratory. The scatterplot for one of the evaluations is shown on the right. How would you interpret this scatterplot? A) Cells in the gated population are predominantly expressing CD5, but not expressing CD20. B) Cells in the gated population are predominantly expressing CD20, but not CD5. C) Cells in the gated population are co-expressing CD5 and CD20. D) Cells in the gated population are expressing neither CD5 nor CD20.

Cells in the gated population are co-expressing CD5 and CD20.

Which of the following is the proper designation for the pluripotential stem cell that is a precursor for both myeloid and lymphoid cell lines? A) CFU-S B) CFU-GEMM C) G-CSF D) CFU-GM

CFU-S

A manual white blood cell count was performed by the hematology technologist. The cell counts for both sides were 99 and 164, respectively. All nine large squares were counted on each side. The dilution for this kit was pre-measured at 1:100. What should the technologist report as the white cell count? A) 14.61 x 10^9/L B) 1.46 x 10^9/L C) 4.61 x 10^9/L D) Cannot report

Cannot report

Blood serum contains each of the following substances except: A) Water B) Sugars C) Coagulation proteins D) Electrolytes

Coagulation proteins

This image is from a patient with alpha thalassemia. Though not diagnostic for this condition, what morphology is present which would lead you to consider a quantitative disorder of hemoglobin synthesis? A) Basophilic stippling B) Codocytes C) Ovalocytes D) Schistocytes

Codocytes

This photo shows the bone marrow aspirate of a patient with a history of fatigue and petechiae. The CBC from the peripheral blood would confirm: A) Decreased RBCs, platelets, and WBCs B) Decreased RBCs C) Decreased WBCs D) Decreased platelets

Decreased RBCs, platelets, and WBCs

Which of the following represent other hemoglobin gene loci that occur on the same chromosome as the beta chain loci? A) Alpha and delta B) Delta and gamma C) Gamma and zeta D) Zeta and epsilon

Delta and gamma

Which of the following methods for long-term diabetic monitoring is recommended for patients with sickle cell anemia? A) Fructosamine B) Hemoglobin A1c (HbA1c) C) Both methods are acceptable. D) Neither method is acceptable.

Fructosamine

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 aquired pure red cell aplasia D) Diamond-Blackfan anemia

Dyskeratosis congenita

What are the expected lab results in the condition known as "Afibrinogenemia"? A) Elevated PT, elevated aPTT, elevated thrombin time (TT) and elevated reptilase time B) Elevated PT, elevated aPTT, elevated thrombin time (TT) and normal reptilase time C) Elevated PT, elevated aPTT, normal thrombin time (TT) and normal reptilase time D) Normal PT, elevated aPTT, normal thrombin time (TT) and elevated reptilase time

Elevated PT, elevated aPTT, elevated thrombin time (TT) and elevated reptilase time

Which of the following cellular function is correctly matched to the cell type? A) Eosinophil: Involved in some parasitic infection response B) RBC: Involved in immune response; especially viral C) Lymphocytes: Involved in hemostasis D) Platelet: Involved in bacterial infection response

Eosinophil: Involved in some parasitic infection response

Which hormone is produced by the kidney and influences erythrocyte production? A) Growth hormone B) Erythropoietin C) Interleukin 3 D) ALA synthetase

Erythropoietin

The prothrombin time test will detect deficiencies in which pathways? A) Extrinsic and intrinsic pathways B) Extrinsic and common pathways C) Intrinsic pathway and common pathways D) Intrinsic pathway only

Extrinsic and common pathways

Which of the following coagulation pathways includes Factor VII? A) Common pathway B) Extrinsic pathway C) Intrinsic pathway D) Fibrinolysis

Extrinsic pathway

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

Factor IX

Which of the following factors is Vitamin K-dependent? A) Factor I B) Factor VIII C) Factor IX D) Factor XI

Factor IX

The most specific test to detect both presence of Factor V Leiden, also known as activated protein C resistance (APC) and predict risk of thrombosis is: A) Activated Protein C Resistance (APC) clot-based assay B) Factor V Mutation Assay C) ELISA assay for Factor V D) Antithrombin antigen assay

Factor V Mutation Assay

Which coagulation factor is found ONLY in the extrinsic pathway? A) Factor VII B) Factor VIII C) Factor IX D) Factor X

Factor VII

Warfarin (coumarin-type anticoagulant) inhibits all the following coagulation factors except: A) Factor II B) Factor IX C) Factor VII D) Factor XI

Factor XI

Platelet satellitism is most likely to cause which of the following erroneous results? A) Falsely increased WBC count B) Falsely decreased RBC count C) Falsely decreased platelet count D) Falsely decreased hemoglobin level

Falsely decreased platelet count

All of the following tests will be abnormal in a patient with Stuart-Prower Factor deficiency EXCEPT? A) Prothrombin Time (PT) B) Activated Partial Thromboplastin Time (APTT) C) Russel Viper Venom Test (dRVVT) D) Fibrinogen

Fibrinogen

A laboratory test which can detect the specific decrease in the platelet surface membrane receptor glycoprotein Ib and thus lead to a diagnosis of Bernard Soulier Syndrome (BSS) is: A) Platelet count B) Ristocetin induced platelet aggregation studies C) Flow cytometry D) ELISA

Flow cytometry

Which of the following morphologic characteristics is associated with the Chédiak-Higashi syndrome? A) Pale blue cytoplasmic inclusions in neutrophils B) Giant lysosomal granules in granulocytes C) Neutrophils with many small granules and vacuoles D) Nuclear hypo-segmentation of neutrophils

Giant lysosomal granules in granulocytes

In serum protein electrophoresis all of the following proteins reside in the band closest to the anodal end EXCEPT: A) Retinol-binding protein (RBP) B) Transthyretin C) Albumin D) Haptoglobin

Haptoglobin

Which abnormal hemoglobin may be formed in alpha thalassemia? A) Hb Bart's B) Hb Lepore C) Hb E D) Hb S

Hb Bart's

The anemia seen in anemia of chronic disease (also known as anemia of chronic infection) is characterized by low serum iron levels. Which of the following contributes to the low serum iron levels seen in persons with anemia of chronic disease? A) Decreased erythropoietin B) Hepcidin C) Decreased dietary intake D) Decreased ferritin levels

Hepcidin

The autohemolysis test is MOST useful in the diagnosis of which condition? A) Pyruvate kinase (PK) deficiency B) G6PD deficiency C) Sickle cell anemia D) Hereditary spherocytosis

Hereditary spherocytosis

Remnants of erythrocyte nuclei, nuclear fragments, or aggregates of chromosomes are called: A) Heinz bodies B) Howell-Jolly bodies C) Basophilic stippling D) Pappenheimer bodies

Howell-Jolly bodies

Single erythrocyte inclusions which are large, round, smooth, and purplish-blue staining are most likely: A) Howell-Jolly bodies B) Heinz bodies C) Basophilic stippling D) Cabot rings

Howell-Jolly bodies

Which of the following inclusions may be observed on a Wright-stained peripheral blood smear if a patient has had a splenectomy? A) Reticulocytes B) Basophilic stippling C) Howell-Jolly bodies D) Schistocytes

Howell-Jolly bodies

How does hydroxyurea aid in the treatment of sickle cell disease? A) Acts as an analgesic in pain management. B) Prevents sickle cells from clumping together. C) Induces increased production of HbF. D) Reduces the number of sickle cells that form.

Induces increased production of HbF.

Laser light can be described by all of the following characteristics EXCEPT: A) Intensity and concentration B) Used in flow cytometry for cell sorting and identification of cells C) LASER is an acronym for light amplified by stimulated energy radiation D) Monochromaticity

LASER is an acronym for light amplified by stimulated energy radiation

Which of the following is characteristic of Alder-Reilly anomaly? A) Giant, dysfunctional lysosomal cytoplasmic granules B) Döhle body-like inclusions composed of precipitated myosin heavy chains C) Large, darkly staining cytoplasmic granules composed of partially digested mucopolysaccharides D) Decreased nuclear segmentation and coarse chromatin in leukocytes

Large, darkly staining cytoplasmic granules composed of partially digested mucopolysaccharides

All of the following are sites of active hematopoiesis in the adult EXCEPT: A) Skull B) Ribs C) Liver D) Pelvis

Liver

A patient initially has a prolonged PT. After reviewing the patient's case and laboratory findings, the physician administers intravenous vitamin K. The repeat PT results are normal after 24 hours of vitamin K therapy. What clinical condition is MOST likely to produce these results? A) Liver disease B) Factor XI deficiency C) Fibrinogen deficiency D) vWF deficiency

Liver disease

Relative polycythemia is a mild form of polycythemia that can be the result of all of the following EXCEPT? A) Dehydration B) Hemoconcentration C) Gaisböck's syndrome D) Low thrombopoietin levels

Low thrombopoietin levels

Normal adult CSF may have 0-5 white blood cells (WBCs)/µL. Which of the following cell types account for 60-100% of these WBCs? A) Neutrophils B) Lymphocytes C) Monocytes D) Eosinophils

Lymphocytes

The peroxidase stain is useful in differentiating between which cells? A) Lymphocytic and granulocytic cells B) Monoblastic and myeloblastic cells C) Leukemoid reaction and myelocytic leukemia D) Eosinophils and neutrophils

Lymphocytic and granulocytic cells

Hemoglobin (g/100mL) x 10 / RBC count (millions/mm3) is the formula for calculating: A) MCHC B) MCV C) MCH D) RDW

MCH

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 workstation, the cells and plasma in the samples have separated. As a result, one of the samples has lipemic plasma. Which of the following parameters may be affected by the lipemia? A) RDW B) MCV C) MCHC D) None of the parameters would be affected.

MCHC

An automated complete blood count produced the following red blood cell parameters: Parameter: Value: Reference Interval White blood cells (WBC): 5.6 x 109/L: 4.0-10.0 x 109/L Red blood cells (RBC): 3.4 x 10^12/L: 4.2-5.9 x 10^12/L Hemoglobin: 11.1 g/dL: 12-16 g/dL Hematocrit: 31%: 37-48% MCV: 92 fL: 80-100 fL MCHC: 38 g/dL: 30-37 g/dL A specimen for a repeat complete blood count is received in the laboratory six hours later. The sample visually appears to be much lighter in color than the original sample. The technologist questions whether both samples are from the same patient. Which of the following parameter(s) is LEAST likely to change between samples, if from the same patient, and would be most useful to determine if there is a discrepancy that may be the result of a preanalytical error in sample collection? A) Hemoglobin B) Hematocrit C) MCV D) White blood count

MCV

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

Normal erythrocyte

A 52 year old male with a history of alcoholism is admitted to the hospital with severe abdominal pain. A CBC reveals the following results: Parameter: Value: Reference Interval White blood cells (WBC): 15.7 x109/L: 4.0-10.0 x109/L Red blood cells (RBC): 3.9 x10^12/L: 4.2-5.9 x10^12/L Hemoglobin: 14.4 g/dL: 12-16 g/dL Hematocrit: 41%: 37-48% MCV: 105 fL: 80-100 fL RDW-CV: 16.5%: 11.0-14.0% Considering the information that is provided, which of the following would be an appropriate description this patients RBC population? A) Macrocytic, heterogenous (i.e., more variable) B) Macrocytic, homogenous (i.e., not as variable) C) Normocytic, homogenous D) Microcytic, heterogenous

Macrocytic, heterogenous (i.e., more variable)

CD5 antigen is normally found on which of the following lymphocyte populations? A) Mature T cells B) Normal B cells C) Both mature T cells and normal B cells D) None of the above, CD5 is not a lymphoid marker

Mature T cells

Which of these descriptions correlates best with the red cell distribution curve shown? A) Microcytic patient after transfusion B) Normal red cell distribution C) Pronounced macrocytosis D) Marked anisocytosis

Normal red cell distribution

After briefly circulating in the peripheral blood, which of the following cells becomes a tissue macrophage (or histiocyte) whose main function is phagocytosis? A) Monocyte B) Basophil C) Neutrophil D) Plasma cell

Monocyte

The pale-staining cytoplasmic bodies marked by the arrow in the image may be seen in each of the following conditions EXCEPT? A) Pregnancy B) Acute infections C) Mucopolysaccharidosis D) Burns

Mucopolysaccharidosis

Which of the following cells are considered abnormal and clinically significant on a CSF differential? A) Ependymal B) Myeloblast C) Pia arachnoid mesothelial D) Choroidal cells

Myeloblast

In which stain will auer rods have the most intense reaction? A) Sudan Black B B) Myeloperoxidase C) Chloroacetate Esterase D) Periodic Acid-Schiff

Myeloperoxidase

An automated hematology counter flagged the white blood cell count. Upon reviewing the peripheral blood smear, the technologist viewed many cells that appeared similar to those in this image. What should the technologist report? A) Lymphocytes B) Lymphoblasts C) Reactive/atypical lymphocytes D) Plasma cells

Reactive/atypical lymphocytes

A semen sample for semen analysis should generally be received at the testing site within what period of time? A) One hour B) Two hours C) Three hours D) Four hours

One hour

Which of the following is a sign of dyserythropoiesis that occurs in Myelodysplastic Syndromes? A) Oval macrocytes B) Schistocytes C) Basophilic stippling D) Sickle cells

Oval macrocytes

After several incidences of deep vein thrombosis (DVT), a patient is to be assessed for hypercoagulability. The following would be an appropriate panel for hypercoagulability screening: A) PT, aPTT. Lupus Anticoagulant (LA) screening, Activated Protein C resistance (APC) , d-dimer screening B) LA screening, APC resistance C) D-dimer screening and Fibrin Degradation Products (FDP) test D) PT, aPTT, Thrombin Time (TT), Bleeding Time, and mixing studies

PT, aPTT. Lupus Anticoagulant (LA) screening, Activated Protein C resistance (APC) , d-dimer screening

By utilizing a Prussian Blue stain, which of the following red blood cell inclusions would be identifiable if present? Note: Upper image = Wright-Giemsa stain Lower image = Prussian Blue stain A) Cabot rings B) Pappenheimer (siderotic) bodies C) Howell Jolly bodies D) Malarial parasites

Pappenheimer (siderotic) bodies

Degenerated erythrocyte cytoplasmic organelles that contain iron are called: A) Cabot rings B) Howell-Jolly bodies C) Heinz bodies D) Pappenheimer bodies

Pappenheimer bodies

Which of the following is considered a macrocytic anemia? A) Cooley's anemia B) Iron deficiency anemia C) Pernicious anemia D) Polycythemia vera

Pernicious anemia

What is another name used to designate a fully committed B-lymphocyte: A) T-lymphocyte B) Reactive lymphocyte C) Large lymphocyte D) Plasma cell

Plasma cell

In which developmental stage do red blood cells begin forming hemoglobin in amounts large enough to be visualized on a Wright-stained bone marrow aspirate smear? A) Reticulocyte B) Pronormoblast C) Basophilic normoblast D) Polychromatic normoblast

Polychromatic normoblast

Which one of the following conditions is associated with glucose-6-phosphate dehydrogenase (G6PD) deficiency? A) Microcytic red cells B) Precipitation of hemoglobin C) Faulty heme synthesis D) Hemoglobins with low oxygen affinities

Precipitation of hemoglobin

Which of the following is responsible for inhibiting the tissue plasminogen activator? A) Antithrombin B) Tissue Factor Pathway Inhibitor C) Thrombin D) Protein C

Protein C

All of the following factors 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

Regular use of multivitamins with iron

Patients who undergo urologic procedures, as well as those with genitourinary tract diseases such as prostate cancer can sometimes be prone to diffuse hemorrhage. A possible cause of this could be which of the following? A) Dysfunction of platelets B) Release of urokinases C) Initiation of tissue factor released from endothelial cells D) Release of PGL (a prostacyclin ) from endothelial cells

Release of urokinases

A smear that is prepared from equal parts of new methylene blue and whole blood is used for which of the following? A) WBC differential B) Platelet estimate C) Reticulocyte count D) Manual RBC count

Reticulocyte count

All of the following methods are used in the diagnosis and classification of acute leukemia, EXCEPT? A) Immunophenotyping B) Reticulocyte count C) Cytochemical Analysis D) Cytogenetics

Reticulocyte count

What physiological factor causes sedimentation in the Erythrocyte Sedimentation Rate (ESR)? A) Elevated levels of immunoglobulins B) Increased concentrations of fibrinogen C) Rouleaux formation D) Tilted tube, varying from the vertical

Rouleaux formation

Von Willebrand Factor (vWF) multimer analyses of patient's plasma can be performed by: A) Ristocetin induced platelet aggregation tests (RIPA) B) ELISA antigen assays C) SDS agarose gel electrophoresis D) Latex agglutination tests

SDS agarose gel electrophoresis

The image is a stained smear of cerebrospinal fluid. Which of the following statements is true about the cells shown at the right? A) Their numbers are increased when the patient has leukemia. B) Their numbers are increased when the patient has multiple sclerosis. C) They line the arachnoid space. D) They are capable of engulfing red cells.

They line the arachnoid space.

All of the following are true of lab results of patients with Glanzmann thrombasthenia EXCEPT? A) Deficient GPIIb/IIIa B) Severe thrombocytopenia C) Increased bleeding time D) Abnormal platelet aggregation with ADP, collagen, and epinephrine

Severe thrombocytopenia

Neoplastic T lymphocytes with irregular, convoluted (cerebriform) nuclear outlines best describe which of the following? A) Gaucher cells B) Mott cells C) Sezary Cells D) Leptocytes

Sezary Cells

What is the characteristic RBC that is uniquely associated with HbSS? A) Target cell (codocyte) B) Sickle cell (drepanocyte) C) Polychromatophilic cell D) Spherocyte

Sickle cell (drepanocyte)

Which anemia is formed due to the inability to incorporate iron into the protoporphyrin ring? A) Iron Deficiency Anemia B) Sideroblastic Anemia C) Anemia of Chronic Inflammation D) Thalassemia

Sideroblastic Anemia

Which of the following would best describe what you might observe after a traumatic CSF tap? A) All tubes pale yellow B) All tubes clear C) All tubes contain equal amounts of blood D) Significantly more RBCs were found in tube #1 vs. tube #3

Significantly more RBCs were found in tube #1 vs. tube #3

A 49-year-old male with pneumonia was treated with high-dose intravenous penicillin. He became jaundiced with yellow sclera. The image on the right is typical of other fields that were observed on his peripheral blood smear. Since penicillin may, in some individuals, cause autoimmune hemolytic anemia, the clinician requested a direct antiglobulin test (DAT) be performed. The DAT was positive, indicating that antibodies to the drug were produced, which were then attached to the drug on the surface of the red cells. Hemolysis occurred due to the drug-induced antibody attachment, leaving the patient with various abnormal red blood cell morphologies. Which of the following cell types would you report for this patient? A) Acanthocytes, nucleated red blood cells, polychromatophylic red blood cells B) Burr cells, spherocytes, polychromatophylic red blood cells C) Target cells, acanthocytes, polychromatophylic red blood cells D) Spherocytes, nucleated red blood cells, polychromatophylic red blood cells

Spherocytes, nucleated red blood cells, polychromatophylic red blood cells

In which of the following conditions would one see Pappenheimer bodies on the peripheral blood smear? A) Iron deficiency anemia B) Malarial infections C) G6PD deficiency D) Splenectomies

Splenectomies

The role of the medical laboratory scientist in processing bone marrow aspirates can vary depending on laboratory and clinician protocols. Which of the following statements is true regarding the bone marrow procedures typically performed by an MLS? A) They prepare the patient for the bone marrow procedure. B) They perform the bone marrow aspiation and biopsy. C) They make and/or stain the bone marrow smear. D) They examine and interpret the bone marrow smear.

They make and/or stain the bone marrow smear.

Out of the choices below, which set of cells is arranged from least mature to most mature? A) Stem Cell, Rubriblast, Prorubricyte, Rubricyte, Metarubricyte, Reticulocyte, Erythrocyte B) Stem Cell, Prorubricyte, Metarubricyte, Erythrocyte, Rubriblast, Rubricyte, Reticulocyte C) Erythrocyte, Reticulocyte, Metarubricyte, Rubricyte, Prorubricyte, Rubriblast, Stem Cell D) Rubricyte, Rubriblast, Stem Cell, Prorubricyte, Erythrocyte, Reticulocyte, Metarubrictye

Stem Cell, Rubriblast, Prorubricyte, Rubricyte, Metarubricyte, Reticulocyte, Erythrocyte

The arrows in the image point to Heinz bodies in erythrocytes. Which of the following stains was used to confirm the presence of these inclusions? A) Prussian blue stain B) Wright-Giemsa stain C) Supravital stain D) Any of the above stains

Supravital stain

Which of the following best describes a segmented neutrophil? A) Nucleus contains greater than 5 lobes. B) The nucleus contains 2-5 lobes connected by a thin filament. C) Nucleus is kidney bean shaped. D) Cytoplasm of the cell contains large primary granules.

The nucleus contains 2-5 lobes connected by a thin filament.

Which of the following statements is correct regarding the bone marrow compartments? A) The two main compartments of the bone marrow are the vascular sinuses and hematopoietic cords. B) The two main compartments of the bone marrow are the vascular sinuses and blood vessels. C) Erythropoiesis in the bone marrow occurs in all areas of the marrow. D) A unique bone marrow microenvironment is not necessary for hematopoiesis.

The two main compartments of the bone marrow are the vascular sinuses and hematopoietic cords.

Which of the following statements regarding the peripheral blood smear shown in the photomicrograph is TRUE? A) This area is acceptable for performing a manual differential B) This area is unacceptable for scanning for blast cells, parasites, fibrin strands, and platelet clumps C) This area is unacceptable for evaluating red blood cell morphology because it is too thin D) This area is acceptable for evaluating red blood cell morphology

This area is unacceptable for evaluating red blood cell morphology because it is too thin

Which of the following converts Fibrinogen into Fibrin Monomer? A) Heparin B) Calcium 2+ ions C) Tissue Factor D) Thrombin

Thrombin

All of the following would be considered a part of the body's cellular immune system EXCEPT? A) Macrophages B) Mast cells C) Neutrophils D) Thrombocytes

Thrombocytes

Aspirin ingestion prevents the synthesis of this signaling molecule in the platelet? A) Thromboxane A2 B) Calcium C) Collagen D) ADP

Thromboxane A2

In which organ or tissue do T-lymphocytes mature? A) Bone marrow B) Thymus C) Lymph nodes D) Spleen

Thymus

What condition/situation is associated with the peripheral blood picture in the image on the right? A) Hereditary spherocytosis B) Lead poisoning C) Transfusion dimorphism D) Folic acid deficiency

Transfusion dimorphism

These 3 tubes of cerebrospinal fluid (CSF) are delivered to the laboratory for analysis. The tube labeled #1 was the first tube collected. Which one of the tubes should be used by the hematology department for cell count and differential? A) Tube #1 B) Tube #2 C) Tube #3 D) Any one of the tubes can be used

Tube #3

The principle behind the diagnosis of Paroxysmal Nocturnal Hemoglobinuria (PNH) by flow cytometry is: A) Incubation of patient blood in sucrose solutions, thus promoting hemolysis of PNH blood by complement. B) Evaluating the patient's lymphocytes for CD4 and CD8 markers. C) Using a fluorescein labeled proaerolysin variant to selectively bind to GPI anchor proteins. D) Evaluating red blood cell histograms for variation in size.

Using a fluorescein labeled proaerolysin variant to selectively bind to GPI anchor proteins.

Conditions suggested by the macrocytes and the neutrophil in the photograph to the right include Folate deficiency and which other condition? A) Thalassemia B) Vitamin B12 deficiency C) Pelger-Huet anomaly D) Sickle cell anemia

Vitamin B12 deficiency

Eosinophils are increased in all of the following conditions EXCEPT? A) Parasitic infections B) Allergic reactions C) Viral infections D) Inflammatory reactions

Viral infections

An 18-year-old patient bled profusely following a tooth extraction. She had a history of sporadically increased menstrual bleeding and nose bleeds. The laboratory tests showed: Platelet count of 350 x 109/L PT of 12 seconds PTT of 125 seconds Factor VIII activity of 20% Factor IX activity levels 102% Platelet aggregation studies - normal ADP, collagen and decreased with Ristocetin. What is the most likely cause of this patients bleeding episodes? A) Von Willebrand's disease B) Hemophilia A C) Hemophilia B D) Vascular Disease

Von Willebrand's disease

Cell counts on CSF specimens should be performed within what time frame following collection of the CSF sample? A) Within one hour B) Within four hours C) Within eight hours D) Within 24 hours

Within one hour

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

Xanthochromia