NCA Hematology
The following results are obtained on a bone-marrow differential: Myeloblasts: 1, promyelocytes: 5, myelocytes: 10, bands: 9, segs: 4, eos: 1, baso: 0, lymphs: 7, monos: 2, plasmacytes: 1, normoblasts: 60 What is the myeloid: erythroid ratio? A. 0.5:1 B. 0.7:1 C. 2:1 D. 3:1
A. 0.5:1
A new set of controls for prothrombin time has a mean of 12.2 sec with a SD of 0.4 sec. Which of the following control results would NOT be acceptable? A. 11.1 sec B. 11.5 sec C. 12.3 sec D. 12.6 sec
A. 11.1 sec
A patient's hemoglobin level is 12.3 g/dL. The erthrocytes appear normochromic on the Wright-stained smear. The HCT value that correlates with these data is A. 0.34 L/L B. 0.37 L/L C. 0.40 L/L D. 0.43 L/L
B. 0.37 L/L
A miller disc is uded to perform retic counts. After counting 500 RBCs in square B, a total of 40 retics are seen in square A. How should the retic count be reported? (A = 1/9B) A. 0.1% B. 0.9% C. 4.4% D. 8.0%
B. 0.9% (40/(500x9))x100
Given the following results on a male patient, calculate the retic production index (RPI) RBC: 2.8 Hb: 9.0 Hct: 29% Uncorrected Retic count: 3% A. 0.1 B. 1.0 C. 1.9 D. 3.0
B. 1.0 RPI = (retic % x patient Hct/normal Hct)/maturation time in PB with Hct of 29%, maturation time is 2 (3.0x0.29/0.45)/2
The leukocyte count for a patient is 28 x 10^9/L. The differential shows 58 orthochromic normoblasts and 10 polychromatophilic normoblasts per 100 WBCs. The leukocyte count is closest to A. 2.8 B. 16.7 C. 17.7 D. 28.0
B. 16.7 (100/10+58)x28
Blood collected for anticoagulation testing should be collected in A. 3.5% sodium citrate with a 9:1 blood to anticoagulant ratio B. 3.2% sodium citrate with a 9:1 blood to anticoagulant ratio C. 4.0% sodium citrate with an 8:1 blood to anticoagulant ratio D. 3.8% sodium citrate with a 10:1 blood to anticoagulant ratio
B. 3.2% sodium citrate with a 9:1 blood to anticoagulant ratio
Coagulation studies are ordered on a patient with a hematocrit of 65%. What volume of sodium citrate should be used to collect a volume of 5 mL blood/anticoagulant solution? A. 16 mL B. 32 mL C. 50 mL D. 60 mL
B. 32 mL (1.85x10^-3)(100-65)x5
Using an undiluted CSF specimen, 150 WBCs are counted in the four large corner squares on one side of the hemocytometer. What is the total WBC count per mm^3? A. 38 B. 375 C. 750 D. 3750
B. 375 area is 4 mm^2 and depth is 0.1 mm 150/(4x0.1)
153 nucleated RBCs are reported on a 100 cell diff. The uncorrected WBC count is 11.9 x 10^9/L. The corrected WBC count is A. 3.6 B. 4.7 C. 5.2 D. 8.0
B. 4.7 WBC = (100/100+153) x 11.9
Given the following data, calculate the manual WBC count/ uL Dilution: 1:20 Depth: 0.1 mm Area counted: 4mm^2 Total # counted: 120 cells A. 600 B. 6000 C. 60000 D. 600000
B. 6000 (120x20)/0.4
A patient is admitted to the hospital with a WBC of 250. One parameter that may be falsely elevated by this WBC count is the A. Hb B. MCV C. platelet count D. retic count
A. Hb
A falsely elevated HCT is obtained on a defective centrifuge. Which of the following values will NOT be affected? A. MCH B. MCV C. MCHC D. all of the above
A. MCH does not use HCT in calculation, used Hb and RBC
What effect would the use of a buffer with a pH of 6 have on a Wright-stained smear A. RBC would be too pink B. WBC would be well differentiated C. RBC would be too blue D. RBC would lyse
A. RBC would be too pink normal range is 6.4-6.7
An unexpectedly small anticoagulant response to heparin therapy may be caused by decreased levels of A. antithrombin B. platelet factor 4 C. factor XIII D. thromboxane
A. antithrombin
Which of the following procedures is NOT necessary to confirm the majority of iron related anemias? A. bone marrow evaluation B. ferritin C. RBC indices, including RDW D. serum iron and total iron-binding capacity
A. bone marrow evaluation
In selecting material for smear of bone-marrow cell morphology, the CLS should select A. gray particles floating in blood and fat droplets B. the last material aspirated C. material free of fat D. clotted specimens
A. gray particles floating in blood and fat droplets
A patient has an RBC count of 2.70, a Hb of 5.5, and a hematocrit of 19%. What erythrocyte morphology would you expect to see on the peripheral blood smear? A. microcytic, hypochromic B. macrocytic, hypochromic C. normocytic, hyperchromic D. normocytic, normochromic
A. microcytic, hypochromic MCV= 19x10/2.70 = 70.3 MCHC = 5.5/19 x100 = 28.9
In the performance of platelet aggregometry on patient samples, the instrument should be set to 100% transmittance using A. patient platelet poor plasma B. patient platelet rich plasma C. control platelet poor plasma D. control platelet rich plasma
A. patient platelet poor plasma
Which of the following will result in a falsey decreased SedRate? A. presence of codocytes B. inflammatory reaction C. marked anemia D. slight tilting of the tube
A. presence of codocytes Target cells impair the rouleaux that needs to happen for proper testing to occur
Which of the following conditions can cause a prolonged thrombin clotting time? A. prothrombin deficiency B. coumadin therapy C. antithrombin deficiency D. hypofibrinogenemia
A. prothrombin deficiency
What erythrocyte morphology would be expected on the peripheral blood smear of a 50-year-old alcoholic with advanced cirrhosis? A. pseudomacrocytosis, acanthocytes, codocytes B. anisocytosis, micropherocytes, schistocytes C. macrocytosis, schistocytes, dacrocytes D. microcytosis, polychromasia, echinocytes
A. pseudomacrocytosis, acanthocytes, codocytes
As the supervisory clinical lab scientist, you are asked to review a Wright-stained peripheral blood smear that shows clumping of leukocytes and platelets. Which of the following is the most probable cause for these morphologic changes? A. smear was made from 1 hr old heparinized blood B. smear was made from 1 hr old EDTA blood C. excessive pressure was applied when making the smear from blood in the tip of a venipuncture needle D. smear was made using fresh capillary blood
A. smear was made from 1 hr old heparinized blood
The traditional diluent of choice for quantifying spermatozoa in seminal fluid contains A. sodium bicarbonate and formalin B. methylene blue C dilute acetic acid D. normal saline
A. sodium bicarbonate and formalin
When reviewing a peripheral blood smear, the CLS notes many macrocytes. The MCV has been reported as 85fL. This apparent discrepancy may indicate A. the smear was made from the wrong sample B. the smear should be closely checked for spherocytes C. the patient may have a hemolytic anemia D. cold agglutinins may be present
A. the smear was made from the wrong sample
Which of the following conditions would introduce a source of error into a manual WBC count A. uneven distribution of leukocytes in the counting chamber B. immediate count of cells C. a sample with an extremely low WBC count D. using a 2% (vol/vol) solution of acetic acid as the diluting fluid
A. uneven distribution of leukocytes in the counting chamber
An EDTA-anticoagulated tube is received in the lab only particaly filled, causing excessive concentration of EDTA. Since the patient was undergoing an MRI and would not be available to provide another specimen for an hour, the physician requested that the lab perform any test that would be reliable. Which of the following procedures would be accurate on this sample? A. platelet count B. Hb C. peripheral blood smear D. spun Hct
B. Hb
A Hb electrophoresis pattern on cellulose acetate at pH 8.6 demonstrates a band in the S region. Which of the following is the best test to confirm the identity of this hemoglobin? A. alkali denaturation B. Hb electrophoresis on citrate agar. pH 6.0 C. Hb solubility D. heat stability
B. Hb electrophoresis on citrate agar. pH 6.0 alkali denaturation is for differentiation of Hb F and Hb A which do not migrate in the S region
Which of the following red-cell inclusions can be detected with a supravital preparation that used new methylene-blue N as the dye reagent but are not visible with Romanowsky stain A. Howell-Jolly bodies B. Heinz bodies C. Malarial trophozites D. Pappenheimer bodies
B. Heinz bodies
Which of the following is appropriate in preparing an EDTA-anticoagulated specimen for analysis when it was been standing in a rack and not on a mechanical rotator? A. shake vigorously by hand B. Invert gently at least 60 times C. mix for a minimum of 2 min using a vortex mixer D. invert 4-6 times
B. Invert gently at least 60 times
which of the following contain RNA and are usually identified by staining with brilliant cresyl blue of new methylene blue? A. Auer rods B. Retics C. Pappenheimer bodies D. Howell-Jolly bodies
B. Retics
Which two plasma coagulation factors are the least stable in vitro? A. VII and IX B. V and VIII C. XI and XIII D. I and III
B. V and VIII
An increase in metamyelocytes. myelocytes, and promyelocytes in the peripheral blood can be referred to as A. Pelger-Huet anomaly B. a shift to the left C. agranulocytosis D. leukocytosis
B. a shift to the left
The formation of D-dimer is the by-product of the effect of plasmin on A. fibrin degradation products B. cross-linked fibrin C. fibrinogen D. plasminogen
B. cross-linked fibrin
The internationally accepted method of hemoglobin measurement requires the conversion of hemoglobin to A. carboxyhemoglobin B. cyanmethemoglobin C. oxyhemoglobin D. sulfhemoglobin
B. cyanmethemoglobin
What reagent is added to conventional aggregometry to test platelets for release, as well as aggregation? A. ATP B. firefly luciferase C. ristocetin D. ADP
B. firefly luciferase
A properly calibrated and controlled instrument that uses the principle of electronic impedance produces repeated (x3) values on a blood sample: RBC: 4.01, Hct: 32%, Hb: 12.0, MCV: 80fL, MCH: 32, MCHC: 37.5 The most likely explanation for these results is A. iron-deficiency anemia B. hereditary spherocytosis C. high titer of cold agglutinins D. high retic count
B. hereditary spherocytosis
Plasma is diluted in a fibrinogen-activity determination to decrease the A. amount of thrombin necessary B. influence of inhibitors C. amount of calcium needed D. effect of deficiencies in other coagulation factors
B. influence of inhibitors
When performing a manual differential on a Wright-stained blood smear, the CLS noted purplish black precipitate over the slide. One cause of this precipitate is A. precipitation of paraproteins from the patient's blood B. insufficient rinsing of the stain and buffer mixture C. insufficient aging of the Wright's stain before use D. failure to remove stain from the back of the slide
B. insufficient rinsing of the stain and buffer mixture
The most common generalized hemostatic disorder is A. vitamin K defiiency B. liver disease C. hemophilia D. von Willebrand's disease
B. liver disease
An upward trend was observed over a six day period in a quality control plot for a prothrombin time procedure performed on a photo-optical instrument. This observation indicates a A. decrease in standard deviation values and thus a change in the reference range for the procedure B. loss of precision C. decreased coefficient of variation D. loss of accuracy but not precision
B. loss of precision
A patient has a normal PT and a prolonged APTT. To distinguish whether the prolongation of the APTT is caused by a factor deficiency or an inhibitor, the CLS should first A. mix 1 part patient plasma and 1 part normal plasma and repeat both the PT and APTT B. mix 1 part patient plasma and 1 part normal plasma and only repeat the APTT C. perform a factor X assay; if prolonged, a factor X deficiency is indicated D. perform a plasma thrombin time test
B. mix 1 part patient plasma and 1 part normal plasma and only repeat the APTT
An EDTA specimen from a known sickle-cell anemia patient is received fro a microhematocrit and hemoglobin determination using the cyanmethemoglobin principle. Values obtained are hemoglobin of 10.7 and a hematocrit of 22%. The CLS should A. centrifuge the hemoglobin and read the supernatant as the test sample B. mix the hemoglobin dilution 1:2 with distilled water, then read and multiply the results by 2 C. repeat the hematocrit using heparinized hematocrit tubes D. repeat the procedure and, if similar results are obtained, report them immediately
B. mix the hemoglobin dilution 1:2 with distilled water, then read and multiply the results by 2
In the performance of coagulation tests, the abnormal control yields unacceptable results for both the PT and APTT. The normal control is within acceptable limits for both procedures. What is the appropriate action for the CLS? A. perform preventive maintenance on the instrument before retesting the controls B. repeat the abnormal control on a new bottle of control material before proceeding with the analysis C. continue with the procedure and report out only those patient results that are in normal range D. continue with the procedure and report out only those patient results that are in the abnormal range.
B. repeat the abnormal control on a new bottle of control material before proceeding with the analysis
A patient who underwent a bone-marrow transplant had daily leukocyte counts performed. Lab policy required that counts below 2.0 be performed manually. Since the transplant patients usually have decreased count, the lab scientist prepared a standard WBC Unopette result in a 1:20 dilution. 84 leukocytes were counted in the entire area on both sides of the Neubauer hemocytometer. How should the count be reported? A. 0.4 B. 0.8 C. 0.9 D. 1.9
C. 0.9 (84/(18x0.1))x20 = 933 cells/mm^3 = 0.9 x 10^9/L
A Hb value of 12.5 best correlates with a Hct value of A. 25.3% B. 33.5% C. 37.5% D. 42.8%
C. 37.5%
A patient has a WBC count of 70.0, immature grans, and dacrocytes on the peripheral blood smear. On the diff, 10 cells are seen that have a single nucleus, marked cytoplasmic granularity, and cytoplasmic blebs. What is the most likely identification of these cells? A. Myelocytes B. Lymphoblasts C. Micromegakaryocytes D. plasma cells
C. Micromegakaryocytes
The coagulation factor that is decreased in hemophilia A is factor A. IX B. X C. VIII D. VII
C. VIII
The coagulation factor deficiency that can display both an abnormal PT and APTT is factor A. VII B. IX C. X D. XI
C. X
DIC may display which of the following coagulation problems A. activation of the extrinsic system and a prolonged bleeding time B. activation of the intrinsic system and a decreased factor VIII C. activation of both the intrinsic and extrinsic systems and a consumption of platelets D. a prolonged bleeding time and a reduction of factor VIII
C. activation of both the intrinsic and extrinsic systems and a consumption of platelets
False-positive results may occur in the screening solubility test for hemoglobin S due to A. decreased plasma proteins B. hypolipidemia C. adding more blood to the reagent than called for by test procedure D. a hemoglobin value <7.0 g/dL
C. adding more blood to the reagent than called for by test procedure
Unfractionated heparin must have which one of the following coagulation inhibitors present in normal amounts in order for it to properly anticoagulate a patient? A. Protein C B. Protein S C. antithrombin III D. alpha-2 antiplasmin
C. antithrombin III
The presence of microorganisms, increased protein, and a high leukocyte count in CSF will cause the CSF to appear A. bloody B. oily C. cloudy or turbid D. clear and colorless
C. cloudy or turbid
Only 2.0 mL of blood is collected in a vacuum tube containing powdered EDTA that is designed for a 7.0 mL draw. Which of the following test results can be expected if this specimen is used? A. falsely lowered RBC count B. falsely elevated Hb C. erroneously decreased microhematocrit D. ESR of expected value
C. erroneously decreased microhematocrit
A positive sickle-cell screening using the protein-solubility method means that A. the patient has a genotype of hemoglobin SS B. the patient has a genotype of AS C. hemoglobins D, Barts, or S may be present D. hemoglobin S or C is definitely present
C. hemoglobins D, Barts, or S may be present
A patient has an abnormal thrombin time and a normal reptilase time. Which of the following can produce this result? A. afibrinogenemia B. elevated fibrin degradation products C. heparin D. coumadin
C. heparin
Below are hematologic anticoagulants and corresponding characteristics of each. Select the one anticoagulant that does NOT match its characteristic A. Dipotassium EDTA - prevents platelet clumping B. sodium citrate - used for routine coag C. heparin - suitable for blood smears D. double oxalate - produces morphologic artifacts
C. heparin - suitable for blood smears
A student consistently makes peripheral blood smears that are too thin. You instruct the student to try A. using a smaller drop of blood B. using only capillary blood C. increasing the angle of the spreader slide D. applying more pressure on the spreader slide
C. increasing the angle of the spreader slide
While performing a WBC diff count on a capillary blood smear, no platelets were observed. What action should be taken? A. Report the finding to your supervisor immediately B. request a venous sample for an absolute platelet count C. look at the edge of the smear for platelet clumping D. report out the absence of platelets
C. look at the edge of the smear for platelet clumping
On a cytocentrifuge preparation of pleural fluid, cells are noted that are round with centrally located nuclei giving the cells a "fried egg" appearance. Some have multiple nuclei. These cells should be identified as A. reactive lymphs B. hairy cells C. mesothelial cells D. tumor cells
C. mesothelial cells
The following information is obtained from an electronic cell counter MCV: 75 fL (80-100) RDW: 20% (11-14) Based on the above parameters, what RBC morphology would be expected on the peripheral blood smear? A. normocytic cells that vary little in size B. microcytic cells that vary little in size C. microcytic cells with significant variation in size D. macrocytic cells with significant variation in size
C. microcytic cells with significant variation in size
The leukocyte count for an adult patient is 18.0 x10^9/L. The differential shows PMNs: 56% Bands: 5% Lymphs: 25% Monos: 10% Eos: 3% Baso: 1% The above data reveal an absolute increase in A. PMNs and bands B. lymphs and monos C. monos and PMNs D. Eos and Basos
C. monos and PMNs
A cytospin smear of CSF from an adult contains a few lymphs, monos, and ependymal cells. These findings indicate that the patient has A. meningeal melanoma B. bacterial meningitis C. normal cytology in CSF D. a traumatic brain injury
C. normal cytology in CSF
The following erythrocyte indices are obtained for a specimen: MCV: 88fL MCH 30 pg MCHC: 34 g/dL These erythrocytes on a Wright-stained smear should appear A. hypochromic, microcytic B. normochromic, microcytic C. normochromic, normocytic D. hypochromic, normocytic
C. normochromic, normocytic
A specimen is being tested from a patient with severe jaundice. The prothrombin time perfored on an electro-optical instrument is 7.4 sec. The clinical lab tech should A. request a new sample, drawn preferably as a microsample B. dilute the sample 1:2 and rerun the sample multiplying the result by two C. perform the test on an electromechanical instrument D. put a patient blank prior to the patient sample in the electro-optical instrument
C. perform the test on an electromechanical instrument
An 18 year old female was scheduled to have her wisdom teeth removed. Because the patient had a history of frequent nosebleeds, heavy menstrual periods, and easy bruisability, the surgeon ordered a full coagulation screen. The following results were obtained: Prothrombin time: 11.8 sec (10-12) APTT: 40 (25-35) plt count: 300 (150-450) Based on these results, what additional procedure should be performed? A. factor VII assay B. vitamin K level C. platelet-aggregation study D. thrombin clotting time
C. platelet-aggregation study
Am automated plt count performed on a venous blood specimen collected in EDTA is 40. The CLS notes platelet clumps on the Wright-stained blood smear. The CLS should A. perform a manual plt count using the same specimen B. redraw the specimen in sodium oxalate and repeat the count C. redraw the specimen in sodium citrate and repeat the count D. inform the physician that an accurate plt count cannot be obtained on the patient
C. redraw the specimen in sodium citrate and repeat the count
A peripheral blood smear contains 80% blast cells, which stain positive with sudan black B and peroxidase. This result is consistent with a diagnosis of A. ALL B. acute undifferentiated leukemia C. chronic myelocytic leukemia D. AML
D. AML
A patient's hematologic results from an electrical impedance instrument are: WBC: 2.0 RBC: 3.83 Hb: 11.5 HCT: 0.34 PLT: 60 Blood-smear evaluation for QC purposes reveals acceptable cell distribution, normocytic, normochromic RBCs; 2 leukocytes per 40x field; and 10 platelets per oil-immersion field. The next step would be A. report the results as obtained B. repeat the leukocyte count C. repeat the platelet count D. repeat the RBC count
C. repeat the platelet count 10 platelets/ field is expected to be a value >100
A specimen for dermination of APTT for monitoring heparin therapy is collected in sodium citrate at 0930 and allowed to remain at room temp in the collection center until delivery to the lab at 1430. What effect will storage have on the results? A. shortened due to increased glass activation B. prolonged due to deterioration of factor VIII C. shortened due to platelet neutralization of heparin D. not effect
C. shortened due to platelet neutralization of heparin
A falsely elevated G-6-PD assay using the fluorescent spot test may be seen in patients with A. an increased RBC count B. a change in drug dosage C. the presence of many retics D. a deficiency of pyruvate kinase
C. the presence of many retics
After staining a peripheral blood smear with Wright's stain and a buffer with the correct pH, the RBCs appear pale pink and the WBC stain very weakly with little-to-no nuclear detail. One possible explanation is A. the patient is experiencing diabetic alkalosis B. the smear was stained while still wet C. there was excessive washing of the smear D. the slide was not on a flat surface, causing pooling of stain
C. there was excessive washing of the smear
A clinical laboratory tech is reviewing a smear for QC purposes. The smear is wedge-shaped with smooth edges and extends over ~60% of the surface of the slide. On low-power it is noted that granulocytes are clustered at the tail of the smear. on high magnification, the RBCs appear a buff pink. White cell nuclei appear dark blue to purple. This evaluation indicates the the smear is A. acceptable B. unacceptable b/c the smear is too long C. unacceptable b/c the white cells are clustered at the tail D. acceptable even tho the RBCs are stained lightly
C. unacceptable b/c the white cells are clustered at the tail
The rule of 3 means that the A. MCV is three times the MCH B. RBC count is three times the Hb C. HCT is three times the MCH D. HCT is three times the Hb
D. HCT is three times the Hb
In the performance of a modifed ESR, what is the recommended dilution? A. 1:2 B. 1:3 C. 1:4 D. 1:5
D. 1:5
Thawing of platelet poor plasma that has been stored at -40 degrees for coagulation studies should be performed at what temperature? A. 0-4 degrees B. 4-8 degrees C. 10-20 degrees D. 35-38 degrees
D. 35-38 degrees
A patient has a hematocrit of 15%. In order to obtain an acceptable wedge peripheral-blood smear, the clinical lab scientist should make the following adjustment A. use a hemocytometer cover glass as the spreader slide B. push the spreader slide 50% slower than usual C. permit some of the blood to get in front of the spreader slide D. Increase the angle of the spreader slide greater than 45 degrees
D. Increase the angle of the spreader slide greater than 45 degrees
The APPT is a screening test for all coagulation factors in the intrinsic pathway EXCEPT which of the following A. VIII B. IX C. XI D. XIII
D. XIII
The most frequent hereditary condition predisposing to venous thrombosis is A. dysfibrinogenemia B. protein S deficiency C. protein Z deficiency D. activated protein C resistance
D. activated protein C resistance
Which characteristic differentiates the myelocyte from other myelocytic cells? A. a kidney-bean-shaped nucleus B. presence of coarse nuclear chromatin C. presence of nucleoli D. appearance of specific granules
D. appearance of specific granules
Oral anticoagulant therapy with coumarins may do all of the following EXCEPT A. prolong the prothrombin time B. act in the peripheral blood to decrease factor activity C. prolong the APTT D. be neutralized by protamine sulfate
D. be neutralized by protamine sulfate
Specimens for leukocyte alkaline phosphatase stain will yield the most reliable results if smears are made from A. blood anticoagulated with EDTA B. blood anticoagulated with 3.2% sodium citrate C. a finger stick and stored at room temp for 24 hr D. capillary blood and stained immediately
D. capillary blood and stained immediately EDTA has an inhibitory effect on LAP stain
Which of the following would be an acceptable specimen for semen analysis? A. collected at home using an ordinary condom B. First morning specimen collected at home and transported to the lab 2 hours later C. collected in the office and maintained at 2-8 degrees until examination D. collected at the office without a condom and examined within 1 hr
D. collected at the office without a condom and examined within 1 hr
All of the following conditions may cause a prolonged thrombin time EXCEPT A. hypofibrinogenemia B. increased fibrin-degradation products C. heparin therapy D. decreased prothrombin
D. decreased prothrombin
vigorous mixing of a whole-blood specimen collected with EDTA as the anticoagulant results in a/an A. acceptable specimen for routine hematologic tests B. acceptable specimen for special tests, such as leukocytes alkaline phosphatase C. falsely elevated WBC count D. falsely decrease hct
D. falsely decrease hct
Hematologic testing on an adult patient provides the following data Hb: 7.5 HCT: 0.26 L/L WBC: 14.6 (PMNs 80%, lymphs 17%, monos 3%) These results would best correlate with A. normochromic RBCs, relative lymphocytopenia B. hypochromic RBCs, absolute lymphocytopenia C. normochromic RBCs, absolute lymphocytopenia D. hypochromic RBCs, relative lymphocytopenia
D. hypochromic RBCs, relative lymphocytopenia MCHC is 28.9 and reference range for lymphs is 1.5-4.5
Many schistocytes are seen on a peripheral blood smear. One of the most common causes fro these cells is A. presence of an abnormal Hb B. high-titer cold agglutinins C. deficiency of spectrin D. microangiopathic anemia
D. microangiopathic anemia
A new CLS in a hematology/oncology clinic consistently reads microhematocrit-control and patient causes higher than co-workers do. Which of the following actions of the CLS could explain this discrepancy? A. Buffy coat is not being included B. time of centrifugation is too long C. speed of centrifugation is too high D. microhematocrit tubes are allowed to sit and are not read within a few minutes of centrifugation
D. microhematocrit tubes are allowed to sit and are not read within a few minutes of centrifugation
During the examination of a CSF specimen from a 45 y/o man, the clinical lab tech noted the presence of rare choroid plexus cells in a total WBC count of 6/mm^3. These results are indicative of A. malignant disease B. inflammatory disease C. degenerative disease D. normal state
D. normal state
A 12-year-old child has had a mild chronic anemia. The physician orders an osmotic fragility test, since the patient's father had a splenectomy as a teenager due to chronic hemolysis. The result is normal. Which of the following procedures would be most helpful to confirm the diagnosis of hereditary spherocytosis? A. hemoglobin electrophoresis at both alkaline and acid pH B. sucrose hemolysis test C. fluorescent spot tests for both G-6-PD and PK D. osmotic fragility with incubation of specimen at 24 hrs at 37 degrees before testing
D. osmotic fragility with incubation of specimen at 24 hrs at 37 degrees before testing
After a gentle inversion of tube #1 of a freshly collected CSF specimen, the specimen appeared slightly turbid and pale yellow. After centrifugation, the supernatant was clear and yellow. Which of the following statements is correct? A. Methemoglobin is presnt B. a tramatic tap has occurred C. Free hemoglobin is present D. pathologic bleeding occurred
D. pathologic bleeding occurred
A manual Hb determination using the using the cyanmethemoglobin reagent is performed on a known sickle-cell patient's whole blood. The blood/reagent mixture appears cloudy. The correct procedure is to A. report the results as >20g/dL B. allow the mixture to stand for at least 10 more minutes C. recollect the specimen, making sure that there is a proper ratio of anti-coagulant to whole blood D. redilute the blood/reagent mixture using a 1:2 dilution with distilled water, determine the new value, and multiply the result by 2
D. redilute the blood/reagent mixture using a 1:2 dilution with distilled water, determine the new value, and multiply the result by 2
a clinical lab tech notes that a specimen for an APTT has been stored at room temp for 5 hours prior to testing. The CLT should A. perform the APTT and report the results B. perform the APTT and report the results, noting the delay in processing C. dilute the sample 1:2 with buffered saline to correct the pH and perform the APTT D. request a redraw
D. request a redraw 4 hours is the limit
The type of bone-marrow specimen that is most valuable in estimating marrow cellularity and histologic structure is a A. thin smear of aspirated marrow B. thick smear of aspirated marrow C. touch preparation of biopsied marrow D. section preparation of biopsied marrow
D. section preparation of biopsied marrow
Samples for lab studies involving hematology, chemistry, and hemostasis require the collection of tiger-top serum separator tube, a tube containing sodium citrate, and an EDTA tube. What should be the order of draw in order to preserve the integrity of the specimen for coagulation studies? A. tiger top, sodium citrate, EDTA B. sodium citrate, EDTA, tiger top C. tiger top, EDTA, sodium citrate D. sodium citrate, tiger top, EDTA
D. sodium citrate, tiger top, EDTA
The most reliable criterion used to determine the maturity of a Wright-stained white blood cell is the A. size of the nucleus B. color of the nucleus C. nucleus-to-cytoplasm ratio D. structure of the nuclear chromatin
D. structure of the nuclear chromatin
A patient with anatomic bleeding and poor wound healing has the following hemostasis findings APTT: 31.5 (25.2-35.4) PT: 11.2 (10.5-13.1) platelet count: 195 (150-400) platelet aggregation: normal What is the logical next hemostasis test to perform? A. lupus anticoagulant screen B. test for single factor inhibitor C. test for factor XII deficiency D. test for factor XIII deficiency
D. test for factor XIII deficiency
