HEMA EXAM

•1. which of these is a normal Hgb level for an adult woman •10 g/dL •15 g/dL •20 g/dL •25 g/dL

•1.B

•1. What does the blood differential test measure •The number of all cells •The number of red blood cells •The percentage of each type of white blood cells •The volume percentage of red blood cells

•1.C

•118. why is hereditary hemochromatosis (HH) thought to be underdiagnosed? [hema] •Its early symptoms are nonspecific and vague, and generally do not get serious until later in life •It is an extremely rare disease •It appears shortly after birth, but then symptoms rapidly subside •It is a mild disorder and has no severe implication for one's health

•118. A

•12. A 7 mL EDTA tube was received in the laboratory containing approximately 2 mL of whole blood. If performed on this sample, which of the following manual laboratory test values might be in error? •Hemoglobin of 10.5 gm/dL •Retic count of 3% •Sed rate of 22 mm/br •WBC count of 10,500/mm3

•12. C

•13. Capillary blood composition most closely resembles •Arterial blood •Lymph fluid •Tissue fluid •Venous blood

•13.A

•135. methods of identifying many of the major Hgb variant such as HbA, HbF, HbS, etc. Include all the following EXCEPT: [hema] •Sodium metabisulfite solubility test •High performance liquid chromatography (HPLC) •Citrate agar electrophoresis •Alkaline electrophoresis

•135. A

•139. the small club-shaped, 'drumstick' nuclear appendage attached to one lobe of a neutrophil (marked by the blue arrow in the image) may be found in: [hema-PICTURE] •Normal male •Homozygous hemophilia A male •Normal female •Turner's syndrome

•139. C

•13. what is a deficiency of Hgb or rbcs called •Anemia •Hemoglobin •Hemophilia •Leukemia

•13A

•14. A bone marrow differential performed on a patient showed 30% blasts. Flow cytometry studies demonstrated the blasts to be pos. For CD10, CD19, CD22, and neg for CD13 and CD33. which of the following diseases is most compatible with these findings •ALL •AML •CML •CLL

•14. A

•14. what color is lipemic plasma •Brownish-yellow •Clear red •Milky •Straw-colored

•14.C

•14. Which serum protein fraction is most likely to be decreased in nephritic syndrome •Albumin •Alpha 2 globulin •Beta globulin •Gamma globulin

•14.D

•141. which one of the following Ag markers is best associated with stem cells? [hema] •CD3 •CD10 •CD18 •CD34

•141. D

•19. identify the nucleated blood cells: [hema-PICTURE] •Lymphocyte •Neutrophil •Basophil •Monocyte

•19. C

•3. serum specimens that are milky white are termed •Hemolyzed •Icteric •Lipemic •Opaque

•3.C

•33. Which of these features of G6PD deficiency are typically present on a wright giemsa stained peripheral blood smear •Cabot rings •Microcytosis •Bite cells •Heinz bodies

•33.C

•33.what is the name for the series of reaction that stop blood flow after a cut •Coagulation •Erythropoiesis •Hemostasis •Homeostasis

•33.C

•34. normal range of wbcs in blood is between ___ per microliter •120-180 •4,000-11,000 •13,000-19,000 •50,000-90,000

•34.B

•34. A 65-y/o male with metastatic pancreatic carcinoma shows elevated PT and aPTT, platelet count 15 x 103/uL (15 x 109/L) and elevated D-dimer. On a blood smear you would see. •Howell-jolly bodies •Macro-ovalocytes •Schistocytes •Target cells

•34.C

•35. A ___ clot is formed during the process of hemostasis •Fibrin •Fibrinogen •Prothrombin •thrombin

•35.A

•36. what is the major form of hemoglobin in adults •HbA •HbF •HbH •HbS

•36.A

•4. Which test measures the oxygen-carrying capacity of RBCs •CBC •ESR •Hct •Hgb

•4.D

•64. two CSF speciemens were sent to the labe with the following results: [hema/ urine] •Tube 1 = 11,200 rbc/uL; Tube 2= 300 rbc/ul •An infection •A recent subarachnoid hemorrhage •A traumatic tap •An old intracranial bleeding episode

•64. C

•65. fifity percent blasts are found on a psmear. The cells are large (3-5x size of lymphocyte) with a nucleus that contains fine homogeneous chromatin and two to three nucleli. There is moderate blue-grey cytoplasm with auer rods. What leukemia is most likely? [hema] •Acute myelogenous leukemia (AML) •Hairy cell leukemia (HCL) •Acute lymphoblastic leukemia (ALL) •Chronic lymphocytic leukemia (CLL)

•65. A

•67. all of the following CD markers are present on a normal mature T cell, except? [hema] •CD20 •CD7 •CD3 •CD5

•67. A

•12. The routine hematology test that includes hemoglobin, hematocrit, red blood count, and white blood count determinations is the: •CBC •CDC •CPK •CRP

•12.A

•12. results of an erythrocyte sedimentation rate test are reported in •mm^3 •mm/h •mmol/L •ng/dL

•12.B

•121. a sample of CSF is diluted 1:100; the standard 9 sq of a hemocytometer were counted on each side for a total of 18 large squares. [hema/urine] •Side 1: 186 cells ct •Side 2: 184 cells ct •Total cells: 370 •What is the cell count per microliter (ul) •1.03x10^4 •2.06x10^4 •4.62x10^4 •9.25x10^4

•121. B

•123. The following are a part of the body cellular immune system, EXCEPT? [hema/immune] •Macrophages •Mast cells •Neutrophils •Thrombocytes

•123. D

•13. The image on the right is a representative field from a peripheral blood smear. What would you expect to see on the automated blood count? (hema-PICTURE) •MCV within normal limits, RDW within normal limits •MCV decreased, RDW decreased •MCV increased, RDW increased •MCV increased, RDW within normal limits

•13. C

•13. Peripheral blood smear stained with Prussian blue demonstrates siderocytes. On a wright stained smear, what would be expected? •Basophlic stippling •Howell jolly bodies •Heinz bodies •Pappenheimer bodies

•13. D

•15. which of the following conditions will show an increased prothrombin time (PT) with a normal activated thromboplastin time (aPTT)? [hema] •Factor IX defieincy •Factor VII deficiency •Factor VIII deficiency •Factor X deficiency

•15. B

•15. The hematocrit test is also known as the: •Erythrocyte sedimentation rate (ESR) test •Mean corpuscular hemoglobin conc. (MCHC) test •Packed-cell volume test •Red blood cell count

•15.C

•15. which microscope objective is used for stained blood cell counts •40x •50x •70x •100x oil immersion

•15.D

•152. in pts who have developed heparin-induced thrombocytopenia with thrombosis (HIT), which of the following should be used to prevent ischemic stroke? [hema] •Unfractionated heparin •Direct thrombin inhibitors •Oral anticoagulant •Vit K

•152. B

•153. what is the cause of iron overload in hereditary hemochromatosis? [chem/hema] •Absorption of excessive amounts of iron in the small intestine •Ingestion of excessive amounts of iron from diet or supplements •Inability of the body to excrete normal amounts of dietary iron •Failure of developing RBCs to incorporate iron into protoporphyrin IX

•153. A

•154. flow cytometry is a useful tool In the study of all the following disorders, EXCEPT? [hema/immuno] •HIV •Leukemia •Viral hepatitis •lymphoma

•154. C

•155. identify the nucleated blood cell. [hema-PICTURE] •Lymphocyte •Band neutrophil •Monocyte •Eosinophil

•155. C

•16. Which alpha thalassemia shows no anemia or evidence of disease, although a slight decrease in the MCV and MCHC may be seen? (hema) •Alpha thalassemia silent carrier •Alpha thalassemia minor •Alpha thalassemia intermedia (hemoglobin H disease) •Alpha thalassemia major (hydrops fetalis)

•16. A

•16. which abnormal morphologic term describes this slide? [hema- PICTURE] •Alder-reilly neutrophil •Auer rods •Dohle bodies, bacteria, toxic granulation •Toxic granulation

•16. C

•16. While separating serum you notice that it is icteric. This means: •It contains excess bilirubin •It is red-pink •The patient has a clotting disorder •There are fat particles present

•16.A

•16. which wbc has granules that stain orange •Eosinophil •Mature neutrophil •Monocyte •Small lymphocyte

•16.A

•162. which of the following analytes will be fasely decreased due to hemolysis? [hema] •Potassium, magnesium, Hgb •Potassium, magnesium, iron, total protein •Hct, RBC ct, potassium •Hgb, Hct, RBC ct

•162. D

•167. nitric oxide is associated with the prevention of vaso-occulusion by decreasing cellular adherence to endothelium. Which amino acid is decreased in pts with sickle cell disease and is needed as a substrate to produce nitric oxide? [hema] •L-arginine •L-glutamine •L-lysine •L-tyrosine

•167. A

•17. When setting up erythrocyte sedimentation rates, you must take care to ensure: •A fasting specimen is used •The ESR tubes are vertical •The sample is completely thawed •The water bath is exactly 37 Celsius

•17.B

•17. what is ammonium oxalate used to count •Immature rbcs •Plts •Reticulocytes •Wbcs

•17.B

•173. the bone marrow becomes the main site of hematopoiesis in the __ month of gestation. [hema] •First •Second •Fourth •Seventh

•173. D

•179. identify the cell indicated by arrow. [hema-PICTURE] •Basophil •Eosinophil •Monocyte •Segmented neutrophil

•179. D

•18. The nucleus of a small lymphocyte is about the same size as a: (hema) •Normal erythrocyte •Monocyte •Large platelet •Band neutrophil

•18. A

•18. 23y/o woman presents with fatigue/ weakness/ heart palpitations. The results of a serum iron test are as follows •Serum iron conc.: 28 mcg/dL (ref: 60-170) •Total iron-binding cap: 789 mcg/dL (ref: 240-450) •Based on these results, which type of anemia does the pt most likely have? •Hemolytic anemia •Iron deficiency anemia •Sickle cell anemia •Vitamin deficiency anemia

•18.B

•18. When blood is thoroughly mixed with glass beads, it is called ___ blood. •Clotted •Defibrinated •Serosanguinous •Whole

•18.B

•181. which of the following lab results is characteristics for a pt with Von Willebrand disease? [hema] •Decreased bleeding time •Normal FVIII lvls •Normal plt function tests •Abnormal plt aggregation repsone to ristocetin

•181. D

•182. all of the following are associated with RBC macrocytosis, EXCEPT? [hema] •Alcoholism •Hypothyroidism •B12 deficiency •Thalassemia

•182. D

•185. in which disorder may a mild anemia be present even with an increased RBC ct and normal adult Hgb electrophoresis? [hema] •Alpha thalassemia silent carrier •Alpha thalassemia minor •Alpha thalassemia intermedia •Alpha thalassemia major

•185. B

•187. during data analysis in flow cytometry, how are cells gated? [hema-PICTURE] •By placing a gate around cells with the same light-scattering •By placing a gate around cells with different light scattering •By placing a gate around cells with different fluorescent properties •By placing gate around cells that have no fluorescence

•187. A

•188. a variety of additives are used in blood collection tubes. Which of the following additives prevents clotting by inhibiting thrombin and thromboplastin? [hema/spec-col] •EDTA •Gel •Lithium or sodium heparin •Sodium fluoride

•188. C

•189. which of the following is a common clinical symptom that is directly related to thrombocytopenia? [hema] •Shortness of breath •Joint pain •Petechiae •Fever

•189. C

•19. What is the ESR? •How quickly red blood cells settle in whole blood •The conc. Of C-reactive protein in a blood sample •The proportion of blood made up of cells •The ratio of erythrocytes to leukocytes

•19.A

•19. what is the reference range for serum albumin •35-50 g/L •50-65 g/L •65-80 g/L •80-95 g/L

•19.A

•2. prolonged bleeding time and giant platelets best describe •Bernard- Soulier syndrome •Glanzmann thrombasthenia •Von Willebrand disease •Wiskott-Aldrich syndrome

•2. A

•3. which of the following would one suspect in afibrinogenemia •Bleeding time abnormal, repilase time abnormal, thrombin time abnormal •Bleeding time normal, reptilase time abnormal, thrombin time abnormal •Bleeding time abnormal, reptilase time normal, thrombin time abnormal •Bleeding time normal, reptilase time normal, thrombin time normal

•3. A

•3. How would the following results on a 72 year old adult female be interpreted •Hemoglobin - 6g/dL •MCV - 114 fl •MCH - 39 pg •MCHC - 34 g/L •RDW- 15.0% •Reticulocyte count - 1.2% •Serum B12 - 55 pg/mL (N=200-100 pg/mL) •Serum folate - 7 ng/mL (N=2-10 ng/mL) •Anti-IF (intrinsic factor) anbtibodies - positive •Schilling test- part 1- 5% excretion (N > 7%), part 2 (with IF) - 10% excretion •Oval macrocytes on wright stain •Folate deficiency •Liver disease •Pernicious anemia •Reticulocytosis

•3. C

•3. What is the term for separated serum that is dark yellow to amber in color •Crenated •Icteric •Jaundiced •Lipemic

•3.B

•30. What is the nucleated blood cell that is indicated by the arrow? (hema) •Segmented neutrophil •Band neutrophil •Eosinophils •Basophils

•30. B

•30. Giant platelets on a blood smear may indicate •Bernard-solulier syndrome •Ehler- danlos syndrome •Glanzamann throbasthemia •Von Willebrand disease

•30.A

•30. polycythemia makes the blood •Appear blue •More acidic •Thicker •Thinner

•30.C

•31. which ion is essential for blood clotting •Calcium •Iodine •Potassium •sodium

•31.A

•31. Moderate to marked target cells are found on a blood smear. Which of the following can most likely be eliminated •Hemoglobin C disease •Hemoglobin E disease •Hereditary sphercytosis •Liver disease

•31.C

•32. Rouleaux formation on a blood smear means the blood cells •Are flatter than normal •Form stacks, like stack of coins •Have pointy projections •Stick together in three-dimensional clumps

•32.B

•32. what is the sequence of hemostasis •Coagulation, vascular spasm, plt plug formation •Plt plug formation, coagulation, vascular spasm •Vascular spasm, coagulation, plt plug formation •Vascular spasm, plt plug formation, coagulation

•32.D

•35. Which protein binds to free hemoglobin •Cryoglobulin •Erythropoietin •Haptoglobin •Methemoglobin

•35.C

•36. You are performing an occult blood test on a patients emesis. What color will the sample turn if the test is positive for occult blood. •Blue •Green •Red •Yellow

•36.A

•37. What is the main type of hemoglobin in fetuses and newborn babies •Hemoglobin A •Hemoglobin A2 •Hemoglobin F •Hemoglobin S

•37.C

•37. lab tech notes an abnormally high level of rbcs in the blood sample. This health condition is called: •Leukocytosis •Leukopenia •Polycythemia •Sickle cell anemia

•37.C

•38. which of the following coag test results would be prolonged in a defiecinecy of factor X? [hema] •PT only •aPTT only •Both PT/aPTT •Neither Pt/aPTT

•38. C

•38. Deficiencies of folic acid and which other vitamin can cause megaloblastic anemia •Vitamin A •Vitamin B12 •Vitamin D •Vitamin C

•38.B

•38. what is the normal pH of blood •4.4 •5.4 •6.4 •7.4

•38.D

•39. bilirubin is a product of the metabolism of •Bile •Hemoglobin •Urobilin •urobilinogen

•39.B

•39. Which hemoglobin has the structure alpha2/delta 2 •Hemoglobin E •Hemoglobin A1 •Hemoglobin A2 •Hemoglobin F

•39.C

•4. beta thalassemia major is also known as: [hema] •Cooley's anemia •Sickle cell anemia •Milk anemia •Pernicious anemia

•4. A

•4. which of the following results from decreased synthesis of globin chains? •Beta-thalassemis •Hemoglobin C disease •Hemoglobin Lepore syndrome •Sickle cell disease

•4. A

•4. A 22 y/o female was seen in the emergency room with evidence of bleeding following a spider bite. Laboratory results show •Blood smear: schitocytes •Platelet count: 50,000/mm3 •PT: 20 secs •APTT: 60 secs •D-Dimer: pos •The most likely diagnosis is •Allergic reaction •Primary fibrinolysis •Secondary fibrinolysis •Vitamin K deficiency

•4. C

•4. Calculate the mean corpuscular hemoglobin content (MCHC) when hgb = 15 g/dL (150 g/L), RBC count = 4.50 x 10^6/uL (4.50x10^12/L) amd hct= 47% (0.47). (hema) •34.7 g/dL •10.4 g/dL •31.9 g/dL •33.9 g/dL

•4. C

•4. icteric serum contains high amounts of •Bacteria •Bilirubin •Hemolyzed red blood cells •protein

•4.B

•40. hemophilia A is associated with a deficiency of which of the following? [hema] •Factor 9 •Factor 8 •Factor 10 •Factor 5

•40. B

•40. a 1:4 dilution is made for a manual wbc count. Five square on both sides of a hemocytometer are counted (ten squares in total). A total of 100 cell are counted. What is the wbc conc. •4x10^5 cells/uL •5x10^5 cells/uL •6x10^5 cells/uL •8x10^5 cells/uL

•40.B

•40. A lab tech analyses a patient blood sample in an automated glass counter and obtains the following results: •Uncorrected white blood count = 30,000/uL •Number of nucleated red blood cells per 100 white bloods = 100 •From this information, what is the corrected white blood cell count? •500/uL •10,000/uL •15,000/uL •18,000/uL

•40.C

•41. identify the predominant nucleated cell in this cerebrospinal fluid cytospin differential? [hema/urine-PICUTRE] •Nucleated red blood cells (nRBCs) •Neutrophils •Metamyelocyte •Tumor cells

•41. A

•46. which one of the following drugs/ drugs classes is the most common cause of drug-induced immune hemolytic anemia? [hema] •Levodopa •Quinidine •Cephalosporins •Levofloxacin

•46. C

•48. twenty microliters (20uL) of blood are diluted with 1.98 mL of diluent. Both side of the hemocytometer are charged with the diluted sample and the entire ruled area of the center square is counted on both sides. A total of 356 plts are counted (combined total of the two large squares). What is the plt ct per liter? [hema] •100x10^9/L •178x10^9/L •356x10^9/L •712x10^9/L

•48. B

•49. what would you predict is the effect on iron absorption of erythropoietic activity is increased over a prolonged period? [hema] •It would increase •It would decrease •It would remain the same •It is impossible to predict

•49. A

•5. Which of the following is an immune mediated condition characterized by platelet count and is found primarly in children •Idiopathic thrombocytopenia purpura •Thrombotic thrombocytopenia purpura •May- Hegglin •Wiscott-Aldrich

•5. A

•5. the normal M:E ratio for an adult is •1:1:5 •3:1 •5:1 •9:1

•5. B

•5. Which test counts the number of immature red blood cells in a blood sample? •Differential •Osmotic fragility test •Red blood cell count •Reticulocyte count

•5.D

•5. a 36y/o woman has a rbc count of 7.8x10^12 /L. what is the term for this cell count •Anemia •Leukocytosis •Leukopenia •Polycythemia

•5.D

•52. peritoneal fluid sample via lavage on a pt who complained fever and abdominal pain following auto accident. How should the analyzed sample in image be reported? [hema/otherfluids-PICTURE] •Lymphocytes •Eosinophils and parasites •Mesothelial cells •Neutrophils and bacteria

•52. D

•54. the image on the right is a representative field from a pblood smear. What characteristics would describe the red cell distrubtion curve that you would expect to see? [hema-PICTURE] •Histogram with two peaks •Histogram with a shift to the left •Histogram that is wider than normal •Histogram with a shift to the right

•54. B

•55. after orders to follow up an abnormal coagulation screening test, the lab completes a mixing study with the following results: [hema] •Initial aPTT: 98 secs •Initial 1:1 mix w/ normal pooled palsma: 28 secs •Incubated 1:1 mix with normal pooled plasma: 30 secs •Which of the choices below would most likely explain the results for this pt? •Immediate acting coag inhibitor •Time/temp dependent coag inhibitor •Factor 8 deficiency •Factor 7 deficiency

•55. C

•55. which of the following represents the best match of cell type with function? [hema] •Eosinophils- humoral immunity •Neutrophils- mediate inflammatory responses •T lymphocytes- cell mediated immunity •Monocytes- protect against parasitic infection

•55. C

•56. plasma exchange is the current treatment for all of these conditions, EXCEPT: [bloodbank/hema] •Warm autoimmune hemolytic anemia (WAIHA) •Diarrhea-associated hemlytic uremic syndrome (HUS) •Thromotic thrombocytopenic purpura (TTP) •Pernicious anemia

•56. D

•58. what is a typical regiment for long-term maintenance therapy of pts w/ hereditary hemochromatosis (HH)? [hema] •Removal of 2-6 units of blood yearly •Dietary restrictions on iron intake only •Treatment with desferrioxamine •Removal of one unit of blood once per week

•58. A

•59. a representative congenital neutrophil functional disorder is: [hema/immune] •Chediak-Higashi syndrome •Gauchers disease •Niemann-Pick disease •Systemic inflammatory response syndrome (SIRS)

•59. A

•59. CSF specimens are usually collected by lumbar puncture and placed in umbered tubes starting with the first tube collected. If four tubes are collected, which tube would be used for a cell count and differential? [hema/urine(other fluids)] •Tube 1 •Tube 2 •Tube 3 •Tube 4

•59. C

•6. a patient with a neg dithionite solubility test has a band in the A region and a band in the S region on cellulose acetate hemoglobin electrophoresis at pH 8.6. On citrate agar there is only a band in the A region. Which of the following is compatible with these results? •Hb AS •Hb AE •Hb AD •Hb ACHarlem

•6. C

•6. the normal adult range for plt count is ____ per nanoliter of blood •150-450 •250-550 •350-650 •450-750

•6.A

•6. A 42-year-old woman has a leukocyte count of 18.4 x 10^9/L. What is the term for this type of cell count •Anemia •Leukemia •Leukocytosis •Leukopenia

•6.C

•61. von Willebrand factor (vWF) multimer analyses of pts plasma can be performed by: [hema] •Ristocetin induced plt aggregation tests (RIPA) •ELISA Ag assays •SDS agarose gel electrophoresis •Latex agglutination tests

•61. C

•62. what is the mechanism that causes megaloblastic anemia? [hema] •Defective stem cell production •Interruption of hemoglobin production •Interruption of DNA synthesis •Interruption of development of precursor cells

•62. C

•7. Which microscope objective is used first when examining a stained blood film? •10x •40x •50x •70x

•7.A

•7. 36y/o woman has a plt count of 120x10^9 /L. What is the term for this cell count •Anemia •Polycythemia •Thrombocytopenia •Thrombocytosis

•7.C

•74. what is the cell indicated by the arrow in this Prussian blue stain? [hema-PICTURE] •Ringed sideroblast •Siderocyte •Segmented neutrophils •Myelocyte

•74. A

•79. pictured are scattered ancanthocytes, enchinocytes,target cells, sphercytes, schistocytes, and Howell-jolly bodies. What condition displays all of these atypical RBCs in psmear [hema-PICTURE] •Hemolytic anemia •Postsplenectomy syndrome •Disseminated intravascular coagulation •Thalassemia minor

•79. B

•8. a patient with a markedly elevated WBC count with a left shift, toxic granulation, vacuoles, dohle bodies and an increased LAP probably has which of the following •Chronic lymphocytic leukemia •Chronic myelogenous leukemia •Leukemoid reaction •Pelger-Huet anomaly

•8. C

•8. Which of these could cause a thin blood smear? •A small drop size •Holding the spreader at a high angle •Spreading the blood too slowly •Using transfused blood

•8.A

•8. 42y/o man has a plt count of 660x10^9 /L. what is the term for this type of cell count •Anemia •Polycythemia •Thrombocytopenia •thrombocytosis

•8.D

•82. this picture represents which type of leukocyte? [hema-PICTURE] •Neutrophil •Eosinophil •Lumphocyte •Basophil

•82. B

•82. the predominant cells seen on the CSF smear (image) are indicative of: [hema/urine-PICTURE] •Normal cytocentrifuged smear •Viral meningitis •Bacterial meningitis •Fungal infection

•82. C

•83. which of the following assays is more sensitive and specific for the diagnosis of paroxysmal nocturnal hemoglobinuria (PNH)? [hema] •Sucrose hemolysis test •Ham test •Flow cytometry for GPI-anchored proteins •Schilling test

•83. C

•85. which of the following is a clinical finding of myelodysplastic syndrome with excess blasts subtype 2 (MDS-ED-2)? [hema] •5-15% ring sideroblasts •Isolated deletion of the long arm of chromosome 5 (del 5q) •10-19% blasts in the bone marrow •No cytopenia in the pblood

•85. C

•87. all of the following cells are considered granulocytes, EXCEPT? [hema] •Neutrophils •Lymphocytes •Basophils •Eosinophils

•87. B

•9. A patients lymphocytes demonstrate cytoplasmic projections and a pos. tartate-resistant acid phosphatase stain. What would the diagnosis most likely be? •Chronic lymphocytic leukemia •Acute lymphocytic leukemia •Sezary syndrome •Hairy cell leukemia

•9. D

•9. What is the international normalized ratio (INR) a measurement of? •How long it take blood to form a clot •How long it takes red blood cells to separate from plasma •The average blood glucose level over the past 3 months •The ratio of oxygen to carbon dioxide in the blood

•9.A

•9. which of these would cause a low erythrocyte sedimentation rate •Bone marrow disease •Carcinoma •Leukemia •Polycythemia

•9.D

•93. disease associated with a dysfunction of polymorphonuclear neutrophils (PMNs) include all of the following with the exception of: [hema/immune] •Chediak-higashi syndrome (CH) •Chronic granulomatous disease (CGDs) •Gauchers disease •Myeloperoxidase deficiency (MPO)

•93. C

•94. a cell ct is ordered on a CSF sample that is bloody. Which of the following procedures would improve the non-nucleated cell ct accuracy? [hema/urine] •Dilute the sample to minimize the number of rbcs in the squares being ct •Use spinal diluting fluid, a mixture of acetic acid and crystal violet •Use an automated hematolgy cell counter •Use of electrnoic cell counters

•94. A

•96. the red cells in image exhibit which of the following abnormal erythrocyte shapes: [hema-PICTURE] •Teardrop cells •Blister cells •Stomatocytes •Ovalocytes

•96. A

•97. after reviewing this cytospin form a pleural fluid identify the cells that would be appropriate to report? [hema/urine-PICUTRE] •Macrophages, neutrophils, and rbcs •Mesothelial cells, neutrophils, and rbcs •Tumore cells, neutrophils, and rbcs •Plasma cells, neutrophils, and rbcs

•97. B

•98. all of the following factors offer a protective effect, delaying symptoms in persons with hereditary hemochromatosis (HH), EXCEPT [hema] •Regular blood donation •Pregnancy •Regular use of multivitamins with iron •Menstruation

•98. C

•7. A 5 y/o African American child with hepato-splenomegaly and skeletal abnormalities has the following lab results: [hema] •WBC= 8.8*10^9/L | RBC = 4.70*10^12/L |HGB = 6.2 g/dL •40 NRBC/100 WBC •Many target cells, Marked microcytosis, hypochromasia, anisocytosis & poikilocytosis were present •Serum iron = 200 ug/dL (elevated) •Sickle solubility = neg | Hemoglobin F = elevated •What is the probable cause of these findings •Aplastic anemia •Beta-thalassemia major •Sickle cell anemia •Hemoglobin C disease

•7. B

•7. The failure of granulocytes to develop past the 'band' or two-lobed stage is characteristic of. •Bernard-Soulier syndrome •Chediak-Higashi syndrome •May-Hegglin anomaly •Pelger-Huet anomaly

•7. D

•15. multiple myeloma may be suspected if which of the following is seen on a peripheral smear •Basophilic stippling •Bizarre blast cells •Hypersegmented neutrophils •Rouleaux

15. ?

•1. the major iron storage compound is •Hemosiderin •Ferritin •Siderotic granules •Transferrin

•1. B

•1. if one performs an aPTT on a patient on high dose warfarin therapy, we would expect that the result would be: •Normal because warfarin effect the PT only •Elevated because of fibrinogen split products •Elevated because of factor VII deficiency •Elevated because of other factor deficiencies

•1. D

•10. Plasma cells evolve from which cell line •Lymphocytic •Monocytic •Myelocytic •megakaryocytic

•10. A

•10. Which of these tests would give a low result for a patient with disseminated intravascular coagulation? •D-dimer test •Partial thromboplastin time •Platelet count •Prothrombin time

•10.C

•10. which of these is not tested in clinical hematology •Plts •Rbcs •Solutes in plasma •Wbc

•10.C

•101. the cell containing the inclusions indicated by the arrows are often associated with which of the following conditions? [hema-PICTURE] •Albinism •Sepsis •Alder-reilly anomaly •Megaloblastic anemia

•101. B

•105. what may prevent the detection of lupus anticoagulant in a plasma sample if the blood used for testing is not centrifuged for a sufficient time? [hema] •Residual RBCs in the plasma sample •Increased plts in the plasma sample •Residual wbcs in the plasma sample •Centrifugation time would not affect the detection of lupus anticoagulant in a plasma sample

•105. B

•11. a manual white blood cell count using the unopette dilution system and a Neubauer hemacytometer gave an average total count of 50 cells. What is the patients white cell count? •5,000/uL •10,000/uL •5,500/uL •11,000/uL

•11. C

•11. when an anticoagulated blood sample is centrifuged, it separates into three layers. What is the middle layer called •Plasma •The buffy coat •The erythrocyte layer •The leukocyte layer

•11.B

•11. Lipemic blood refers to a condtion where: •The glucose levels are high •Glucose levels are low •Serum is blue •Serum is milky white

•11.D

•110. which of these is arranged from least mature to most mature? [hema] •Lymphoblast, lymphocyte, prolymphocyte, stem cell •Stem cell, lymphoblast, prolymphocyte lymphocyte •Stem cell, lymphoblast, lymphocyte, prolymphocyte •Lymphocyte, prolymphocyte, lymphoblast, stem cell

•110. B

•2. how would the following results on a 32 year old adult female be interpreted •Hemoglobin - 7.0 gm/dL •MCV - 64 fl •MCH - 20 pg •MCHC - 31.5 g/dL •RDW - 19.0% •Serum ferritin - 4 ng/ml (N=20-250 ng/mL) •Serum iron - 29ug/dL (N=70-200 ug/dL) •TIBC - 590 ug/dL (N=250-435 ug/dL) •% saturation - 5 •Anemia of chronic disease •Iron deficiency anemia •Thalassemia minor •Sideroblastic anemia

•2. B

•2. An automated blood cell counter uses the principle of: •Changes in cell electrical currents •Color absorption changes •Diffusion •High-frequency sound waves

•2.A

•2. why is it important to mix a blood sample before performing a cell count •To ensure all blood components are evenly distributed •To oxygenate the sample •To prevent clots •To prevent platelets from clumping together

•2.A

•20. Red cell indices include •MCCH, PLT, and HBC •MCHC, RDW, and MCH •MCI, MCO, and PCV •MPV, RBC, and RDW

•20.B

•20. which anticoagulant inhibits thrombin formation •EDTA •Heparin •Potassium oxalate •Sodium citrate

•20.B

•21 what are howel-jolly bodies composed of? [hema] •Hgb •DNA •Iron •RNA

•21. B

•21. All of the following may be used when setting up an ESR except: •Wesley tubes •Westergren tubes •Wintrobe tubes •Citrated blood

•21.A

•21. which of these is higher in capillary blood than in venous blood •Calcium •Carotene •Glucose •Total protein

•21.C

•22. a BM biopsy from a 50yo pt that has an overall cellularity of 20% (80% fat/ 20% hematopoietic cells) is considered: [hema] •Normocellular •Hypocellular •Hypercellular •Monocellular

•22. B

•22. Cytomegalovirus (CMV) appears to suppress cell-mediated immune functions. Which of the following is a characteristic finding in persons infected with CMV [hema/immune] •Increase CD4+ cells; decreased CD8+ cells •Increased CD4+; increased CD8+ •Decreased CD4+; increased CD8+ •Decreased CD4+; decreased CD+

•22. C

•22. A blood film that demonstrates 'serrated' blood cells has been: •Improperly fixed •Improperly stained •Made from old blood •Submerged in a buffer of the wrong pH

•22.C

•22. the normal hematocrit range for men is •10-24% •20-34% •30-44% •40-54%

•22.D

•23. An automated hematology counter flagged the WBC count. Upon reviewing the peripheral blood smear, the technologist viewed many cells that appeared similar to those in this image. What should the tech report? [hema-PICTURE] •Lymphocytes •Lymphoblasts •Reactive/atypical lymphocytes •Plasma cells

•23. C

•23. Hemoglobin A consists of: •Five alpha chains •One alpha chain, one beta chain, and one delta chain •Three delta chains •Two alpha and two beta chains

•23.D

•23. blood is generally stored •At room temp •In water bath •Freezer •refrigerator

•23.D

•24. Which of these is the most common type of anemia •Aplastic anemia •Induced related anemia •Iron deficiency anemia •Sickle cell anemia

•24.C

•24. which of these is a normal hematocrit result for an adult •12% •22% •32% •42%

•24.D

•25. The reticulocyte count is used to assess which of the following? (hema) •Increased blood loss •Microcytic anemia •Macrocytic anemia •RBC production by the bone marrow

•25. D

•25. You dilute a blood sample with tryptan blue by 1:1. then, using hemocytometer, you count 100 cells in 5 of the large squares. What is the cell conc. •2x10^4 cells/mL •3x10^4 •4x10^5 •5x10^5

•25.C

•25. while separating serum you notice that it is cloudy. This means •It contains excess bilirubin •The PCV is high •The pt has a clotting disorder •There are fat particles present

•25.D

•26. The presence of excessive rouleaux formation on a blood smear is often accompanied by an increased: •Erythrocyte count •Hematocrit •Reticulocyte count •Sedimentation rate

•26.D

•26. anticoag therapy is monitored by performing a: •ESR •FBS •Hgb •PT

•26.D

•27. what condition would be suspected in an asymptomatic pt with greater than 20% atypical (reactive) lymphocytes on their pblood smear? [hema/immune] •Herpes simplex virus infection •Epstein-Barr virus infection •Bacterial meningitis •Acute leukemia

•27. B

•27. Which type of acute myeloid leukemia is characterized by minimal maturation of myeloid cells •FAB M1 •FAB M2 •FAB M3 •FAB M4

•27.A

•27. on which sample is the HbA1C test performed •Plasma •Serum •Urine •Whole blood

•27.D

•28. Auer rods are characteristically found in which leukemia? •Acute lymphocytic leukemia •Acute myeloid leukemia •Chronic lymphocytic leukemia •Chronic myeloid leukemia

•28. B

•28. which of these is included on a CBC •ALP •CRP •Hb •PT

•28.C

•29. The examination of a peripheral blood smear revealed 12 nucleated erythrocytes per 100 leukocytes. Which histogram observation correlates with the finding •Failure of the granulocyte population to return to baseline on the leukocyte histogram •Failure of the lymphocyte population to begin at baseline on the leukocyte histogram •Shift to the left of the erythrocyte population on the erythrocyte histogram •Shift to the right of the platelet population on the platelet histogram

•29.B

•29. what is the hematocrit •The average mass of hemoglobin per rbc •The rate at which rbc descend in a tube •The time it take for blood to clot •The vol. percentage of rbcs in blood

•29.D