Hematology Exam Simulator Questions

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The nucleus of a small lymphocyte is about the same size as a: A) Normal erythrocyte B) Monocyte C) large platelet D) band neutrophil

A) Normal erythrocyte

What should be added to the cytocentrifuge chamber when preparing slides on serous fluid to aid in adhesion of cells to the slide and preserve cellular morphology? A) hylauronidase B) 22% Albumin C) 10% acetic acid D) sterile saline

B) 22% albumin helps preserve cellular morphology and improves adhesion to the slide

A defect in which of the following factors causes impaired platelet adhesion and aggregation? A) Stuart-Prower factor B) Von Willebrand Factor C) Hageman Factor D) Fletcher factor

B) Von Willebrand Factor

Dohle bodies

Round-oval pale grayish-blue inclusions that are found in the periphery of the cytoplasm of neutrophils, accompanies toxic granulation

Polychromasia

increased reticulocyte count

CD5 antigen is normally found on which of the following lymphocyte populations?

mature T cells

What is the precursor of the platelet which is commonly found in the bone marrow?

megakaryocytes

Corrected WBC count formula

uncorrected WBC count x (100/NRBCs +100)

Auer rods - diagnosis?

AML

Chediak-Higashi syndrome

AR - Giant granules in neutrophils, infections, oculocutaneous albinism - Caused by defect in microtubule polymerization associated with albino characteristics, photophobia, and frequent infections

An abnormality in which assays would be most likely to be associated with thrombotic tendency?

AT III Protein C Protein S

A peripheral blood smear with many myeloid cells was presented for morphology review. Toxic granulation and vacuoles in the neutrophil most likely represent which of the following conditions? A) septicemia B) viral infection C) tuberculosis D) active allergies

A) septicemia

The diameter of a normal RBC is similar in size to the nucleus of a ________? A) small lymphocyte B) normal platelet C) segmented neutrophil D) monocyte

A) small lymphocyte

Which of the following is currently considered to be a good test for screening persons for hereditary hemochromatosis (HH) due to its sensitivity and specificity for iron overload? A) transferrin saturation B) liver biopsy C) phlebotomy D) serum iron alone

A) transferrin saturation

The light blue-gray inclusions observed in the cytoplasm of many of the bands and segmented neutrophils of a burn patient are MOST likely? A) auer rods B) dohle bodies C) toxic granules D) may-hegglin bodies

B) dohle bodies - are associated with the peripheral smear of burn patients, severe infections, and cancer as a result of toxic drugs used on the patient

All of the cells listed below function as a phagocyte, EXCEPT: A) neutrophil B) eosinophil C) monocyte D) macrophage

B) eosinophil

Charcot-Leyden crystals in stool may be associated with an immune response and are thought to be breakdown products of: A) neutrophils B) eosinophils C) monocytes D) lymphocytes

B) eosinophils

Which coagulation pathways is factor VII part of? A) intrinsic B) extrinsic C) common D) intrinsic and extrinsic

B) extrinsic

Which of the following processes does NOT occur during primary hemostasis? A) physical decrease in the size of damaged vessels (vasoconstriction) B) fibrin strands added to the newly formed clot C) blood flow rerouted around the damaged vessel D) platelet adhere to exposed collagen at the site of the breach

B) fibrin strands added to the newly formed clot

What is the most common early abnormality observed in the lymph nodes of AIDs patients?

reactive lymphadenopathy

What best describes the absolute value of leukocyte differential counts?

relative percent of each cell type multiplied by the total white count

Basophilic stippling

relatively evenly distributed fine or coarse granules throughout the red cell

What are methods used in diagnosis and classification of acute leukemias?

immunophenotyping cytochemical analysis cytogenetics

Platelet characteristics

produced in the bone marrow by megakaryocytes possess an inherent sticky property that aids in adhesion and aggregation have a normal lifespan of 9-12 days

A specimen drawn from an indwelling catheter that was contaminated by heparin would be indicated by:

prolonged aPTT and normal reptilase time test

What is the main function of the hexose monophosphate shunt in the RBCs?

provide NADPH and reduced glutathione to prevent oxidation of hemoglobin

A patient's coagulation mixing study results are shown below after an initially prolonged aPTT result. Initial aPTT - 63 sec (21-34 sec) Immediate aPTT mixing study - 26 sec Incubated aPTT mixing study - 65 sec A) corrected, factor deficiency B) corrected coagulation inhibitor C) not corrected factor deficiency D) not corrected coagulation inhibitor

D) not corrected coagulation inhibitor

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

D) pernicious anemia

In an adult, the hematopoiesis occurs in which of the following listed sites? A) liver B) spleen C) pancreas D) proximal ends of long bones

D) proximal ends of long bones

What is a corrective action that can be used to obtain a valid platelet count from a patient specimen that exhibits platelet satellitism on the manual differentials? A) redraw the patient specimen in another EDTA collection tube and wait 20 minutes before sampling B) refrigerate the patient sample for 30 minutes prior to sampling C) invert the EDTA tube several times prior to sampling D) recollect the blood specimen in a blue top tube containing sodium citrate

D) recollect the blood specimen in a blue top tube containing sodium citrate

Coarse basophilic stippling is usually seen in patients who have which of the following conditions? A) lead poisoning B) bacterial infection C) leukemia D) lymphocytosis

A) lead poisoning

What MINIMUM level of a particular factor will cause the aPTT test to become prolonged? A) less than 40% B) less than 50% C) less than 60% D) less than 70%

A) less than 40%

In which of the following cells are Auer rods most likely to be seen? A) myeloblast B) lymphoblast C) erythroblast D) megakaryocytes

A) myeloblast

What is the typical regimen for long-term maintenance therapy of individuals with hereditary hemochromatosis (HH)? A) removal of 2 to 6 units of blood yearly B) dietary restriction of iron intake only C) treatment with desferrioxamine D) removal of one unit of blood once per week

A) removal of 2 to 6 units of blood yearly

Which of the following cells is characterized by a thin rim of cytoplasm around the nucleus? A) small lymphocyte B) large lymphocyte C) monocyte D) segmented neutrophil

A) small lymphocyte

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

B) body tissues

The reticulocyte count is used to assess which of the following? A) increase blood loss B) microcytic anemia C) macrocytic anemia D) RBC production by the bone marrow

D) RBC production of the bone marrow

The gene loci for the alpha globin chains are adjacent to the locus for which other globin chain? A) Beta B) Delta C) Epsilon D) Zeta

D) Zeta

Depanocytes

sickle cells are half moon shaped cells with pointy ends

What is the total magnification produced when using a 10X ocular lens and a 40X objective lens on a bright field microscope? A) 4000x B) 800x C) 400x D) cannot be determine without additional information

C) 400x

The appropriate magnification for a manual RBC cell count using a hemocytometer is which of the following? A) 10X B) 100X (oil) C) 40X dry D) 4x

C) 40X dry

What is the CORRECT blood to anticoagulant ratio in blue top (sodium citrate) tubes used for coagulation tests? A) 4:1 B) 5:1 C) 9:1 D) 10:1

C) 9:1

EDTA and Sodium citrate combine with _____________ to inhibit coagulation in blood samples. A) Potassium B) Calcium C) Magnesium D) Sodium

B) Calcium

Which of the following leukemias can be excluded as a possible diagnosis if Auer Rods are seen in blasts on the peripheral blood smear? A) Acute myelomonocytic leukemia B) acute lymphoblastic leukemia C) acute myeloid leukemia without maturation D) acute promyelocytic leukemia

B) acute lymphoblastic leukemia

Traditional coagulation assays are based almost solely on this technique: A) chromogenic assays B) clot-based assays C) RIA assays D) ELISA assays

B) clot-based assays

MCHC calculation

(HgB x 100)/ Hct %

MCH calculation

(Hgb x 10)/RBC

INR calculation

(PT patient/PT normal) raised to the ISI

RDW calculation

(SD of RBC volume x 100)/mean MCV

Calculate Absolute cell count

(total count)(% of cells counted)

Beta thalassemia intermedia

- develops later in life - little or no need for transfusions - patients vary in clinical symptoms based on genetic inheritance patterns

Beta thalassemia intermedia

1. Normal HbF 2. No transfusion dependence

What is the approximate percentage of individuals in the US who are heterozygous for HFE mutations for hereditary hemochromatosis?

10-12%

What is the ratio of patient plasma to pooled normal plasma (PNP) that is usually used in the performance of a mixing study?

1:1

What is the normal ratio of erythroid to myeloid cells found in normal bone marrow?

1:3

What factors does warfarin inhibit?

2, 7, 9, 10

What should be added to the cytocentrifuge chamber when preparing slides on serous fluid to aid in adhesion of cells to the slide and preserve cellular morphology?

22% Albumin

Normal Myeloid-to-erythroid (M:E) ratio

2:1 - 4:1

The laboratorian completed the mixing study ordered for John Doe. The results are as follows: Initial aPTT result - 167 sec Initial 1:1 Mix with normal pooled plasma - 158 secs Incubated 1:1 Mix with normal pooled plasma - 150 secs Which of the choices below would most likely explain the results for this patient? A) factor VIII deficiency B) Immediate-actin coagulation inhibitor C) time/temperature-dependent coagulation inhibitor D) Factor VII deficiency

B) Immediate-actin coagulation inhibitor

What is the normal cellularity of of iliac crest bone marrow biopsy in a 50 year old male?

50%

factors in extrinsic pathway

7

Which of the following conditions would be associated with an increased osmotic fragility test result? A) hereditary spherocytosis B) iron deficiency anemia C) sickle cell anemia D) thalassemia

A) hereditary spherocytosis

Which coagulation pathway is initiated when collage is expose, and involves the substances high-molecular-weight kininogen (HK) prekallikrein (PK), and factor XII? A) intrinsic B) extrinsic C) common D) fibrinolysis

A) intrinsic

All of the following are usually increased in alpha thalassemia EXCEPT? A) iron binding capacity B) percent iron saturation C) lactate dehydrongenase D) bilirubin

A) iron binding capacity - because iron may remain in excess as inadequate amounts of hemoglobin are being formed

What morphologically abnormal red blood cell is associated with "hyperchromia"? A) spherocyte B) macrocytes C) microcytes D) target cell

A) spherocytes - only truly "hyperchromic" red blood cell

What leukemia is most common in children?

ALL

What hemoglobin is replaced by hemoglobin H after birth in individual with HbH disease?

bart's hemoglobin

What type of granulocytes has water soluble granules which may fade during the rinsing phase of the staining process using the Wright's stain?

basophils

Hemoglobin H bodies are tetrameters of what globin chain?

beta globin

What describes a beta thalassemia genotype B+/B?

beta thalassemia minor

Target cells appear in what conditions?

beta thalassemia minor beta thalassemia intermedia beta thalassemia major

erythroleukemia

bizarre red blood cell morphology, etrhyroid hyperplasia in bone marrow, a variant of acute myelogenous leukemia with anemia

What condition is associated with EBV?

burkitt's lymphoma

Hereditary Hemochromatosis

caused by a missense mutation in the HFE gene impairs hepcidin regulation of ferroportin activity

What drug/drug class is MOST COMMON cause of drug-induced immune hemolytic anemia?

cephalosporins

Myelopthisic Anemia

characterized by the bone marrow being invaded by fibrotic, granulomatous, or neoplastic cells

Acute Immune Thrombocytopenic Purpura is MOST OFTEN associated with which population?

children 2-6 years of age

A normal hemoglobin molecules is comprised of what?

four heme and four globin chains

The bone marrow begins producing cells in the _______ month of fetal life?

fourth

toxic granulation

general measure of the degree of inflammation

Essential thrombocythemia

myeloproliferative disorder characterized by increase in abnormal platelets increased in number and functionally abnormal

Dohle bodies are found in what type of blood cell?

neutrophil highly associated with severe infection, burns, and cancer (due to toxic drugs)

Elliptocyte

oval red blood cells

Increased number of lymphocytes is associated with bacterial or viral meningitis?

viral meningitis

In reference to semen analysis microscopic examination, differentiation and enumeration of "round cells" which are often present in semen count are referred as:

white blood cells

What is the most commonly used stain in hematology?

wright stain

pappenheimer bodies in erythrocytes can be detected using what stains?

wright stain prussian blue stain

Are monocytes phagocytic?

yes

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

you don't have to run a PT or aPTT on the new mix before incubating

What condition/situation is associated with the peripheral blood picture? A) hereditary spherocytosis B) lead poisoning C) transfusion dimorphism D) folic acid deficiency

C) transfusion dimorphism

Complaints of pain from a patient with sickle cell disease are most likely associated with which of the following conditions/events? A) hemolytic anemia B) infection C) vaso-occlusive crisis D) aplastic crisis

C) vaso-occlusive

Which form of hemoglobin cannot be measured using the cyanmethemoglobin method? A) sulfhemoglobin B) carboxyhemoglobin C) oxyhemoglobin D) hemoglobin

A) sulfhemoglobin

If a sodium citrate sample drawn for coagulation is noted to be filled an inch below the fill line (blank line), then the specimen is considered: A) unacceptable for coagulation studies B) acceptable for coagulation studies C) acceptable if the tube can be filled with additional blood D) acceptable if only the PT test is to be performed

A) unacceptable for coagulation studies

What does the red cell distribution width (RDW) indicate on the peripheral blood smear? A) variability of RBC volume B) poikilocytosis C) macrocytosis D) microcytosis

A) variability of RBC volume

A yellow coloration found in fresh cerebrospinal fluid supernatant is termed: A) xanthochromia B) hemolysis C) jaundice D) hyperlipidemia

A) xanthochromia

How many large hemacytometer squares contain a total volume of 1uL of fluid? A) 5 B) 10 C) 15 D) 18

B) 10

Which of the following tests may be used to confirm screening test results for a lupus anticoagulant (or antiphospholipid antibody)? A) activated partial thromboplastin time B) prothrombin time C) factor assays D) Russel Viper Venom Test

Russell Viper Venom Test - used to confirm the presence of lupus anticoagulant

What is May-Hegglin anomaly?

an inherited condition that causes large Dohle-like inclusion bodies primarily in neutrophils. Platelets are affected making them abnormally large and sometimes bizarre shapes. About half of the cases will be asymptomatic while those with decreased platelet counts may experience bleeding.

What is lymphocytosis?

increase in the number of lymphocytes in the blood

What causes basophilic stippling?

lead poisoning, some anemias, and thalassemia

What are Howell-Jolly bodies?

nuclear remnants of the RBCs which are generally removed by a functional spleen; therefore, presence in a peripheral smear suggests functional asplenia in sickle cell pts

Which of the following may result in a platelet count of 230.0 x10^9/L with a bleeding time of 15 minutes. A) defective platelet function B) decreased platelet production C) increased platelet production D) increased platelet destruction

A) defective platelet function

The presence of erythrocytes with altered morphology (see photo): A) excessive burns B) babesiosis C) sickle cell disease D) type I VwD

A) excessive burns

What is the anticoagulant most commonly used for routine coagulation testing? A) EDTA B) Lithium Heparin C) Sodium Citrate D) Sodium Heparin

C) Sodium Citrate

Which of the following processes can lead to the formation of microclots in a patient specimen that is colelcted in a tube containing EDTA anticoagulant? A) failing to invert the tube after specimen collection B) filling the tube as full as the vacuum in the tube allows C) inverting the tube 5-10 times after specimen collection D) using the EDTA tube for an automated platelet count

A) failing to invert the tube after specimen collection

The predominant cell seen in CSF from a twelve-year-old female exhibiting fever, lethargy, and a stiff neck. The WBC count on the sample was 2,000/microliter. The finding most likely indicates: A) normal cytocentrifuged smear B) viral meningitis C) bacterial meningitis D) Alzheimer's disease

B) viral meningitis

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

D) Alpha thalassemia

Which of the following is NOT considered necessary for making a diagnosis of hereditary hemochromatosis (HH)? A) laboratory evidence of iron overload B) genetic mutations associated with HH C) clinical signs and symptoms consistent with HH D) a positive family history

D) a positive family history

All of the following activities are associated with platelets EXCEPT: A) aggregation B) adhesion C) lysis D) release of granules

C) lysis

What mutation is most commonly found in hereditary hemochromatosis?

C282Y

An adult patient presents with a temperature of 103F. A CBC is ordered and the whole blood cell (WBC) count is 15 x 10^9 (reference interval = 4-11) with 10% band neutrophils and 2% metamyelocytes. What can be concluded at this point with these clinical and laboratory results? A) this is most likely a parasitic infection B) this is most likely normal for this patient C) this is most likely a bacterial infection or inflammatory response D) this is most likely a viral infection

C) this is mostly a bacterial infection or inflammatory response

A 27 year-old man with Down syndrome has the following CBC results which are MOST suggestive of what condition? WBC: 27 x10^3 HGB: 8.5 g/dl HCT: 25% PLT: 30x10^9 Differential Blood Smear Results: 8% segmented neutrophil 25% lymphocytes 67% TdT-positive blasts A) acute myelogenous leukemia B) myeloproliferative disorder C) leukemoid reaction D) acute lymphocytic leukemia

D) acute lymphocytc leukemia

Which of the following is a genetic platelet disorder characterized by giant platelets, abnormal screening tests for platelet function and moderate to severe thrombocytopenia? A) Glanzmann's thrombasthenia B) Gray platelet syndrome C) delta storage pool disease D) bernard-soulier syndrome

D) bernard-soulier syndrome

All of the following are associated with Hgb C disease, EXCEPT? A) Hgb C crystal B) target cells C) lysine substituted for glutamic acid at the sixth position of the beta chain D) fast mobility of Hgb C at pH 8.6

D) fast mobility of Hgb C at pH 8.6

What principle(s) of flow cytometry is employed when performing immunophenotyping? A) diffraction grating B) impedence C) diffraction grating and impedance D) fluorescent antibody tagging and light scatter

D) fluorescent antibody tagging and light scatter

Erythropoietin is mainly produced in: A) bone marrow B) bones C) lymphocytes D) kidneys

D) kidneys

ependymal cells

produce cerebrospinal fluid in CNS lines the arachnoid space (central nervous system)

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

B) precipitation of hemoglobin

Which of the following characteristics can be seen in the microcytes present in some hemolytic disorders? A) diameter 7.5 um B) spherocytosis C) MCV 90 fL D) hypochromasia

B) spherocytosis

Pluripotential stem cells are capable of producing which of the following? A) only T-lymphocyte and B-lymphocyte subsets B) erythropoietin, thrombopoietin, and leukopoietin C) lymphoid and myeloid stem cells D) daughter cells from only a single cell line

C) lymphoid and myeloid stem cells

In which organ or tissue do T-lymphocytes mature? A) bone marrow B) thymus C) lymph nodes D) spleen

B) thymus

polycythemia vera

general increase in red blood cells myeloproliferative neoplasms erythrocytosis

Cell that stain positive with acid phosphatase, and are NOT inhibited with tartate are characteristically seen in?

hairy cell leukemia

Exposure to what chemicals can cause hemolytic anemia?

heavy metals lead naphthalene

MCV calculation

hematocrit x 10 / # of red blood cells in sample

What are causes of death in patients with hereditary hemochromatosis (HH)?

hepatocellular carcinoma cirrhosis cardiomyopathy

What condition is associated with an increased osmotic fragility test result?

hereditary spherocytosis

What cellular inclusions are composed of DNA?

howell jolly bodies

Neutrophil granules contain

hydrolytic enzymes or defensins lysozymes myeloperoxidase lactoferrin

myelocyte

immature cell that comes from a myeloblast in the red marrow and develops into either a neutrophil, eosinophil, or basophil

What morphologically abnormal red blood cell is associated with hyperchromia?

spherocytes

Acanthocytes

spur cells

What is the predominant abnormal erythrocyte morphology associated with idiopathic myelofibrosis?

tear drop cells

How long should therapy continue for patient with hereditary hemochromatosis (HH)?

therapy should be continue throughout the lifetime

Laboratory Findings of Hemolytic Uremic Syndrome

thrombocytopenia increased serum bilirubin decreased haptoglobin

Decreased platelet production can be caused by a lack of or decreased amount of what?

thrombopoietin

Aspirin ingestion prevents the synthesis of this signaling molecule in the platelet?

thromboxane A2

What organ or tissue do T-lymphocytes mature?

thymus

multinucleated histiocyte

tissue macrophages

What bone marrow processing procedure is best suited for a patient who had a dry tap?

touch preparation

Smudge cell

Created by the mechanical spreading of blood during the creation of the smear CLL

What RBC indice is measured in femtoliters?

MCV

Warfarin (Coumadin) is monitored by what test?

PT/INR

alpha globin chain loci

chromosome 16

How long are healthy neutrophils expected to reside in the peripheral blood of an adult?

7-8 hours

Factors of intrinsic pathway

8, 9, 11, 12

The ratio of whole blood to anticoagulant is very important in the PT assay; at which hematocrit level should the standard anticoagulant volume be adjusted?

>55%

A 1:20 dilution is made for a manual WBC count. The four corner squares on both sides of a hemocytometer are counted. A TOTAL of 100 cells are counted (eight total squares). What is the white blood cell count in terms of a liter? A) 2.5 x 10^9 B) 25 x 10^9 C) 2500/L D) 25000/L

A) 2.5 x 10^9

Which of the following markers is associated with normal mature B cell expression? A) CD19 B) CD8 C) CD14 D) C42

A) CD19

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

A) Factor VII

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

A) Hb Bart's

Which of the following inclusions are composed of DNA? A) Howell-Jolly Bodies B) Heinz Bodies C) Pappenheimer Bodies D) Dohle Bodies

A) Howell-Jolly Bodies

Nitric oxide is associated with the prevention of vaso-occlusion by decreasing cellular adherence to endothelium. Which amino acid is decreased in patients with sickle cell disease and is needed as a substrate to produce nitric oxide? A) L-arginine B) L-glutamine C) L-lysine D) L-tyrosine

A) L-arginine substrate needed to produce nitric oxide

Which of the following is LEAST likely to stimulate the production of reactive lymphocytes? A) Staphylococcus aureus B) cytomegalovirus (CMV) C) Epstein-Barr virus D) Toxoplasma gondii

A) Staphylococcus aureus

Which of the following statements best describes a normal mature erythrocyte? A) a biconcave disc, 6-8um in diameter, that stains pinkish-orange (salmon) in color B) a biconcave disc, 7um in diameter, with a salmon-colored cytoplasm and condensed nucleus C) a biconcave disc, 6-8um in diameter, containing ribosomes and mitochondria D) a biconcave disc, 7um in diameter, responsible for transporting myoglobin

A) a biconcave disc, 6-8um in diameter, that stains pinkish-orange (salmon) in color

What is one of the main characteristics of secondary granules in the neutrophilic granulocyte cytoplasm? A) appear first at the myelocyte stage B) dissolve in mature granulocytes C) are formed on the mitochondria D) are derived from azurophil (primary) granules

A) appear first at the myelocyte stage

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

A) beta thalassemia minima - shows no anemia and may not be detected using hemoglobin electrophoresis; silent carrier state of beta thalassemia involves one minor beta chain deletion or mutation

During data analysis in flow cytometry, how are cells gated? A) by placing a gate around cells with the same light-scattering B) by placing a gate around cells with different light-scattering C) by placing a gate around cells with different fluorescent properties D) by placing a gate around cells that have no fluorescence

A) by placing a gate around cells with the same light-scattering

Which ethnic group has the highest incidence of hereditary hemochromatosis in the United States? A) caucasians B) african americans C) asians D) hispanics

A) caucasians

When using a flow cytometer, forward scatter measures which of the following parameters? A) cell size B) clonality C) cytoplasmic complexity (granularity) D) fluorescence

A) cell size

CSF lymphocytosis is associated with all of the following EXCEPT: A) cerebral abscess B) viral meningitis C) chronic fungal meningitis D) chronic tuberculous meningitis

A) cerebral abscess

For which of these conditions or procedures there may be an increased number of megakaryocytes in the bone marrow, but a decreased number of circulating platelets? A) folic acid deficiency B) aplastic anemia C) radiation therapy D) Wiskott-Aldrich syndrome

A) folic acid deficiency

Which of the following disorders or diseases is associated with coarse basophilic stippling? A) lead poisoning B) bacterial infection C) leukemia D) lymphocytosis

A) lead poisoning

In which of the following conditions are Cabot Rings most likely to be observed on a Wright-Stained peripheral blood smear? A) megaloblastic anemia B) moderate iron deficiency anemia C) sickle cell trait D) plasma cell myeloma

A) megaloblastic anemia

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

A) monocyte

How many 1mm x 1mm square is the Neubauer hemacytometer counting grid composed of? A) nine per side B) ten per side C) twenty-two between both sides D) thirty between both sides

A) nine per side

The diagnostic value of the reticulocyte count in the evaluation of anemia is that it determines the: A) response and ability of the bone marrow to compensate for anemia B) nutritional status of the patient C) real cause of the anemia D) true red blood cell count

A) response and ability of the bone marrow to compensate for anemia

Which of the following sets of results is indicative of stage 3 iron deficiency (iron deficiency anemia)? A) decreased ferritin, normal soluble transferrin receptor (sTfR), slightly increased total iron-binding capacity (TIBC) B) decreased ferritin, increased sTfR, increased TIBC) C) decreased ferritin, increased sTfR, decreased TIBC D) increased ferritin, normal sTfR, increased TIBC

B) decreased ferritin, increased sTfR, increased TIBC)

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

B) >95% HbA, <3.5% HbA2, <1-2%HbF

Hemoglobin H (HbH) bodies are tetramers of which globin chain? A) Alpha B) Beta C) Delta D) Gamma

B) Beta seen in alpha thalassemia intermedia or Hemoglobin H disease

A deficiency in which of the following coagulation factors will produce an abnormal prothrombin time (PT) test result, but will not affect the activated partial thromboplastin time (APTT) test results? A) Factor X B) Factor VII C) Factor V D) Factor II

B) Factor VII

Which of the following factors require Vitamin K for their synthesis in the liver? A) Factor XIII B) Factor VII C) Factor VIII D) Factor I

B) Factor VII

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

B) Factor XIII

Which of the following set of results would be consistent . for a patient with the following findings: macrocytosis, anemia, leukopenia, and thrombocytopenia? A) MCV 115fL; Hgb 9.5 g/dL; WBC 6.5x10^3; Platelet 75000/uL B) MCV 115fL; Hgb 7.5 g/dL; WBC 2.5x10^3; Platelet 75000/uL C) MCV 75fL; Hgb 7.5 g/dL; WBC 2.5x10^3; Platelet 75000/uL D) MCV 75fL; Hgb 9.5 g/dL; WBC 6.5x10^3; Platelet 175000/uL

B) MCV 115fL; Hgb 7.5 g/dL; WBC 2.5x10^3; Platelet 75000/uL

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

B) anisocytosis

All of the following methods can be used to transport carbon dioxide to the lungs EXCEPT: A) blood plasma B) attached to neutrophils C) bound to hemoglobin in the RBC D) in solution within the RBC

B) attached to neutrophils

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

B) basophilic stippling

The erythrocyte inclusions which are thin, red-purple staining strands, usually found in figure-eight shapes are called: A) basophilic stippling B) cabot rings C) pappenheimer bodies D) heinz bodies

B) cabot rings

A monoclonal B-cell population (Kappa or Lambda predominant) with expression of CD19, CD20, CD23, and co-expression of CD5 is consistent with which of the following? A) A normal B cell B) chronic lymphocytic leukemia C) mantle cell lymphoma D) A mature T cell

B) chronic lymphocytic leukemia

A 68 year old woman presents with pressure under the lower left ribs from a swollen spleen, but s not complaining of any other symptoms. her laboratory data showed the following: Hgb - 13.5g/dl Hct - 40% Platelets - 240x10^9 WBC - 46x10^9 Differential - 45% Neutrophils, 2% lymphocytes, 6% Eosinophils, 2% Basophils, 35% myelocytes, 10% metamyelocytes LAP Score - 11 What is the potential diagnosis? A) Leukemoid reaction B) chronic myelogenous leukemia C) acute myelogenous leukemia D) polycythemia vera

B) chronic myelogenous leukemia

A 36-year-old woman visits her physician after experiencing fevers, night sweats, and overall fatigue over the past 3 months. Upon physical examination she displays lymphadenopathy. When a lymph node biopsy is performed, Reed-Sternberg cells, bands of fibrosis, and various-sized lymphocytes are noted. Which of the following conditions is the most likely diagnosis? A) mantle cell lymphoma B) hodgkin lymphoma C) follicular cell lymphoma D) burkitt lymphoma

B) hodgkin lymphoma

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

B) howell-jolly bodies

All of the following are causes of hemolytic anemia EXCEPT? A) thermal injury B) iron deficiency anemia C) brown recluse spider bite D) plasmodium infection

B) iron deficiency anemia

The analysis of a differential blood smear and laboratory results produced the following results: WBC: 47000/uL Hgb: 10.9 g/dL Hct: 34% Differential: 4% monocytes 20% lymphocytes 4% myelocytes 2% promyelocytes 15% metamyelocytes 25% segmented neutrophils 30% bands Leukocyte Alkaline Phosphatase (LAP) - increased What is the MOST likely disease/condition associated with these results? A) myelofibrosis B) leukemoid reaction C) chronic myelogenous leukemia D) acute myelogenous leukemia

B) leukemoid reaction - presents with increased white blood cell counts due to a physiologic response to stress or infection. LAP score is high in leukemoid reactions but NOT CML

What does the M:E ratio in a bone marrow evaluation represent? A) monocytes to erythrocytes B) myeloid cells to erythroid cells C) myelocytes to erythrocytes D) megakaryocytes to erythrocytes

B) myeloid cells to erythroid cells

By utilizing a Prussian Blue stain, which of the following red blood cell inclusions would be identifiable if present? A) cabot rings B) pappenheimer (siderotic) bodies C) howell jolly bodies D) malarial parasites

B) pappenheimer (siderotic) bodies

Mott Cell What is the condition in which these cells are associated? A) Chronic lymphocytic leukemia B) plasma cell myeloma C) Chediak-Higashi anomaly D) severe pyogenic infection

B) plasma cell myeloma

An assessment of the myeloid to erythroid (M:E) ratio is part of every bone marrow evaluation. Which of the following does not apply to the M:E ratio? A) the erythroid total used tin calculating the M:E ratio is the sum of all of the nucleated red cell precursors B) the myeloid total used in calculating the M:E ratio is the sum of all non-RBC cell types found in the marrow C) white blood cells used in the myeloid tally/total used to calculate the M:E ratio include neutrophil precursors D) the M:E should always be interpreted in context with the overall bone marrow cellularity

B) the myeloid total used in calculating the M:E ratio is the sum of all non-RBC cell types found in the marrow normal ratio 2:1 - 4:1

Xanthochromic CSF means that the color of the CSF can be any of the following EXCEPT: A) pale orange B) pale pink C) yellow D) blue

D) blue

What is the approximate percentage of individuals in the US who are heterozygous for HFE mutations for hereditary hemochromatosis? A) 0.05% to 0.10% B) 1% to 2% C) 10% to 12% D) 20% to 25%

C) 10% to 12%

An abnormality of which of the following assays would be LEAST likely to be associated with thrombotic tendency? A) AT III B) Protein C C) APTT D) Protein S

C) APTT - used to evaluate the intrinsic pathway and the common pathway of the coagulation cascade, reflects the activity of prekallikrein, HMWK, and factors XII, XI, IX, VIII, X, V, II and I Deficiencies of protein C. protein S, and AT III all cause hypercoagulability

Which of the following statements regarding coagulation disorders is correct? A) Hemophilia A and B are usually acquired disorders B) Damage to the kidneys can cause hemostatic dysfunction as the kidneys are the primary site for clotting factor production C) Clotting Factor II, VII, IX, and X are vitamin K-dependent D) Factor IX deficiency is the most common inherited coagulation factor deficiency

C) Clotting Factor II, VII, IX, and X are vitamin K-dependent

A woman in labor is bleeding, has a very high fever, and is in danger of losing the fetus. Laboratory results include a platelet count of 15x10^9, ( normal platelet count of 150-450), prolonged PT and aPTT, decreased fibrinogen, and increased D-dimer. Her automated blood count flagged for blood smear review, and the cells (schistocytes) were seen on her peripheral smear along with a decrease in the number of platelets present. What condition is suggested by these results? A) Thrombotic thrombocytopenic purpura (TTP) B) hemolytic uremic syndrome (HUS) C) disseminated intravascular coagulation (DIC) D) glanzmann thrombasthenia

C) Disseminated intravascular coagulation

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

C) Factor VIII is deficient in hemophilia A and factor IX is deficient in hemophilia B

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

C) Hemoglobin F

In which disorder do neonates demonstrate the presence of Bart's hemoglobin that changes to beta chain tetramers in adults? A) Alpha thalassemia major B) Alpha thalassemia minor C) Hemoglobin H disease D) hydrops fetalis

C) Hemoglobin H disease

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

C) LASER is an acronym for light amplified by stimulated energy radiation

Which of the following viruses is MOST often reported as the cause of infection leading to aplastic crisis in a patient with sickle cell disease? A) Adenovirus B) Epstein-Barr Virus C) Parvovirus B19 D) Zoster-simplex virus

C) Parvovirus B19

CSF specimens are usually collected by lumbar puncture and placed in numbered tubes starting with the first tube collected. If tubes are collected, which tube would be used for a cell count and differential? A) Tube 1 B) Tube 2 C) Tube 3 D) Tube 4

C) Tube 3

Which group of conditions increases the risk of HbS polymerization? A) acid pH, dehydration, decreased levels of 2,3 DPG B) alkaline pH, dehydration, increased levels of 2,3 DPG C) acid pH, dehydration, increased levels of 2,3 DPG D) alkaline pH, dehydration, decreased levels of 2,3 DPG

C) acid pH, dehydration, increased levels of 2,3 DPG risk of HbS polymerization is enhanced in low pH

All of the following factors would cause an increase erythrocyte sedimentation rate (ESR) values EXCEPT: A) severe anemia B) abnormal protein (rouleaux) C) blood drawn into sodium citrate anticoagulant D) a slanted (not perpendicular tube)

C) blood drawn into sodium citrate anticoagulant

The hemoglobin electrophoresis patter for patient #2 shows an increase in HbF and a decrease in both HbA and HbA2. These results correlate best with which of these thalassemias? A) beta thalassemia minor B) beta thalassemia major C) delta-beta thalassemia minor D) alpha thalassemia major

C) delta-beta thalassemia minor

In the hemoglobin methodology using potassium ferricyanide the following measurable reaction occurs A) carboxyhemoglobin is formed B) iron remains in the ferrous state C) ferrous iron is oxidized to ferric iron to form methemoglobin D) acid hematin is formed

C) ferrous iron is oxidized to ferric iron to form methemoglobin

Which white blood cell population would have the MOST side scatter when analyzed using flow cytometry? A) monocytes B) lymphocytes C) granulocytes D) erythrocytes

C) granulocytes side scatter is the measurement of cell complexity (granularity)

Which of the following stains is used to differentiate a neutrophilic leukemoid reaction from chronic myelogenous leukemia (CML)? A) Sudan Black B B) periodic acid-schiff reagent C) acid phosphate with tartrate D) leukocyte alkaline phosphatase (LAP)

D) leukocyte alkaline phosphatase (LAP)

The cells found in the peripheral blood smear of a patient with the following results: Total WBC - 21.5x10^9/L Differential Count: metamyelocyte 4 band neutrophils 16 segmented neutrophils 48 monocytes 6 eosinophil 1 basophils 1 lymphocytes 24 This hematologic picture is most consistent with: A) Leukemoid reaction B) chromic myeloid leukemia C) left shift D) leukoerythroblastosis

C) left shift

Which of the following . major cellular elements does not develop solely in the bone marrow? A) monocyte B) neutrophil C) lymphocyte D) macrophages

C) lymphocyte

Which of the following cells are capable of producing antibodies? A) thrombocytes B) macrocytes C) lymphocytes D) neutrophils

C) lymphocytes

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

C) make a larger dilution

What procedure(s) would be acceptable to run on an EDTA specimen containing a small clot? A) Platelet count only B) ESR only C) no procedures will be accurate D) hemoglobin by cyanmet method

C) no procedures will be accurate

Hematocrit is: A) percentage of blood made up of serum B) concentration of serum x 100 C) percentage of blood made up of red blood cells D) concentration of red cells x 100

C) percentage of blood made up of red blood cells

What is the correct order of erythrocyte maturation in the bone marrow? A) polychromatophilic normoblast, basophilic normoblast, polychromatophilic erythrocyte, orthochromic normoblast, pronormoblast B) orthochromic normoblast, basophilic normoblast, polychromatophilic normoblast, polychromatophilic erythrocyte, pronormoblast C) pronormoblast, basophilic normoblast, polychromatophilic normoblast, orthochromic normoblast, polychromatophilic erythrocyte D) pronormoblast, basophilic normoblast, polychromatophilic erythrocyte, orthochromatic normoblast, polychromatophilic normoblast

C) pronormoblast, basophilic normoblast, polychromatophilic normoblast, orthochromic normoblast, polychromatophilic erythrocyte

In addition to the Romanowsky stain, which one of the following would be useful in the routine evaluation of a bone marrow? A) Chloroacetate esterase B) periodic acid-schiff (PAS) C) prussian blue D) sudan black B

C) prussian blue

All of the following are decreased in beta thalassemia major EXCEPT: A) mean corpuscular hemoglobin concentration (MCHC) B) mean corpuscular volume (MCV) C) red cell distribution width (RDW) D) red blood cell (RBC) count

C) red cell distribution width (RDW) - due to anisocytosis and poikilocytosis

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

C) regular use of multivitamins with iron

For which determination is the brillant cresyl lue stain used MOST often? A) malaria -ring forms B) plasma cells C) reticulocytes D) basophilic stippling

C) reticulocytes

In the flow cytometric analysis, which of the following data can be collected? A) anisocytosis due to presence of microcytes or macrocytes B) hemoglobin and hematocrit levels C) size and granularity of the cell by forward/side scatters D) presence of abnormal erythrocyte inclusions

C) size and granularity of the cell by forward/side scatters

The removal of which of these organs may be a last resort treatment for a patient whose platelet count is less than 30 x 10^9/L as a result of chronic idiopathic thrombocytopenic purpura (ITP)? A) gall bladder B) pancreas C) spleen D) a kidney

C) spleen

Which red cell morphological classification is characteristic of megaloblastic anemia? A) Normocytic B) Microcytic C) Hypochromic D) Macrocytic

D) macrocytic

Which of the following cells is the most common nucleated cells in normal adult bone marrow? A) myeloblast B) promyelocyte C) myelocyte D) metamyelocyte

D) metamyelocyte

CD markers for normal mature T cells

CD3 CD5 CD7

Low LAP score

CML

What is the BEST type of microscopy for performing manual platelet counts? A) electron B) dark-field C) light D) phase contrast

D) phase contrast

Which of the following cells is indicative of Hodgkin's disease? A) Niemann-Pick cells B) reactive lymphocytes C) flame cells D) reed-sternberg (RS) cells

D) reed-sternberg (RS) cells

Which of the following blood smear observation would support the diagnosis of Multiple Myeloma if a patient demonstrated plasma cells in his bone marrow and had an elevated serum IgG? A) Anisocytosis B) Target Cells C) Microcytic RBCs D) Rouleaux formation

D) rouleaux formation

In the process of thrombopoiesis, which is arranged from least mature to more mature? A) Thrombocyte, metamegakaryocyte, megakaryocyte, promegakarocyte, megakaryoblast, stem cell B) Stem cell, megakaryoblast, megakaryocyte, promegakaryocyte, thrombocyte, metamegakaryocyte C) megakaryocyte, promegakaryocyte, megakarocyte, thrombocyte D) stem cell, megakaryoblast, promegakaryocyte, megakaryocyte, thrombocyte

D) stem cell, megakaryoblast, promegakaryocyte, megakaryocyte, thrombocyte

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

D) thrombocytes

Hyposegmented neutrophils

Defect in chromatin synthesis (myelodysplasia) nucleus may be round, peanut shaped or bilobed

At an alkaline pH, what hemoglobins cannot be separated from hemoglobin S during hemoglobin electrophoresis?

Hb D Hb G

With the exception of beta thalassemia minima, which hemoglobin is decreased in beta thalassemia?

HbA

If a patient has three inactive alpha globin genes, which of the four alpha (a) thalassemia classifications would he/she have?

HbH disease

Russell Bodies

Multiple myeloma Mott cell - globular inclusions are immunoglobulin accumulations representing the accumulation of excessive mucopholysaccharides and globulins with endoplasmic reticulum

What can interfere with the measurement of hemoglobin?

Icteric plasma lipemia leukocytosis

A manual white blood cell count was performed by the hematology technologist. The cell count for each of two sides was 38 and 42 respectively. All nine large squares were counted on each side. The dilution fo this kit was pre-measured at 1:10. What should the technology report as the white cell count? A) 4.8 x 10^9/L B) 4.4 x 10^9/L C) 0.48 x 10^9/L D) 0.44 x 10^9/L

D) 0.44 x 10^9/L

The central pallor in a red blood cell is about __________ the diameter of the cell. A) 1/4 B) 1/2 C) 1/8 D) 1/3

D) 1/3

Which of the following sites is used most often for the CSF collection? A) ventricles B) L1-L2 C) subarachnoid D) L3-L4

D) L3-L4

If a Mycobacterium sp. infection is suspected on a bone marrow or body fluid, what stain should be used to detect these bacteria? A) Wright's stain B) new methylene blue stain C) hematoxylin and eosin (H&E) stain D) acid fast stain

D) acid fast stain acid allow the stain to penetrate the cell wall

General formula for hemocytometer

Count = [(Dilution Factor) x (Total cell count in # squares)] x volume correction factor

Anemia of Chronic Disease

EPO production inhibitied by cytokines direct cytokine inhibition of erythropoiesis shortened erythrocyte survival

What FAB designation is called the "true" monocytic leukemia and is characterized by monoblasts, promonocytes, and monocytes?

FAB M5

Hemophilia B (Christmas disease)

Factor IX deficiency

Hemophilia A

Factor VIII deficiency

What blood cell inclusions cannot be detected on a Wright's stained blood smear?

Heinz bodies

What are important protein regulators of iron metabolism?

Hepcidin Transferrin receptor Ferroportin

Pappenheimer bodies

Iron inclusions in red blood cells that appear as pale blue granules with Wright's stain

Pappenheimer bodies

Iron inclusions in red blood cells that appear as pale blue granules with Wright's stain can also been seen n Prussian Blue Stain

If a patient has a white blood count of 40,000/µL, what would be the MOST useful staining procedure to distinguish between bacterial infection and chronic myelogenous leukemia (CML)?

LAP

G6PD deficiency

Low NADPH leads to hemolytic anemia (free radicals) with bite cells and heinz bodies Fava beans, sulfonamides, primiquine, dapsone X-linked recessive

G6PD deficiency

Low NADPH leads to hemolytic anemia (free radicals) with bite cells and heinz bodies Fava beans, sulfonamides, primiquine, dapsone X-linked recessive schistocytes

What are the usual results of the MCV and RDW in alpha thalassemia?

MCV decreased RDW usually increased

Beta thalassemia major

No B-globin production Growth retardation, developmental delays Increase in Hemoglobin A2 and F Patients die in childhood without transfusions

Orthochromic Normoblast (Metarubricyte)

Stage 4-Last stage where nucleus is present Cell size: 8-12 N/C Ratio: 1:1 Cytoplasm: Pink-orange color due to hemoglobin production, Moderate amount Nucleus: Small and pyknotic (a homogenous blue-black mass with no structure), Coarse and condensed chromatin pattern, Bluish-purple Location: Mostly found in bone marrow, May migrate to peripheral blood during times of increased production

What two inclusions can sometimes be seen in segmented neutrophils?

Toxic granulation and dohle bodies

Pelger-Huet anomaly

WBC disorder in which neutrophils, eosinophils, and basophils are not segmented properly, but function normally Mimics a left shift HYPOSEGMENTATION

Are neutrophils normally the most numerous cell type found in peripheral blood of an otherwise healthy adult?

Yes - segmented neutrophils (40-80%)

What hormone is produced by the kidney and influences erythrocyte production?

erythropoietin

Beta Thalassemia

a decrease in the rate of production of beat chains due to a partial or total deletion of loci from chromosome 11 that code for the beta chain

What test is used to monitor therapy with unfractionated heparin?

aPTT

What are laboratory characteristics of patient with von willibrand disease?

abnormal platelet aggregation response to ristocetin

What conditions are associated with RBC macrocytosis?

alcoholism hypothyroidism B12 deficiency

What is the primary role of basophils?

allergic reactions

What disorder may a mild anemia be present even with an increased RBC count and normal adult hemoglobin electrophoresis?

alpha thalassemia minor

Promyelocyte

an immature, developing form of blood cell

Abetalipoproteinemia

an inherited inability to synthesize apolipoprotien B, thus lipids absorbed in the small intestine cannot be transported by chylomicrons and therefore it builds up in enterocytes.

What characteristics are most often associated with alpha thalassemia intermedia?

anemia splenomegaly

What conditions cause coarse basophilic stippling?

anemias of abnormal hemoglobin synthesis thalassemia lead poisoning

Acquired Hemophilia A may be the result of what condition?

anti-factor VIII inhibitor

Howell-Jolly bodies

appear as round, smooth, almost pyknotic, dark-purple staining bodies

May-Hegglin Anomaly

autosomal dominant trait disorder where neutrophils have blue-staining inclusions that resemble Dohle bodies; thrombocytopenia is also present with giant abnormal platelets

Alder-Reilly Anomaly

autosomal recessive trait associated with disorders that prevent normal breakdown of mucopolysaccharides, characterized by presence of prominent, dark staining, coarse cytoplasmic granules

A deficiency in plasminogen activator inhibitor-1 can lead to a serious bleeding disorder due to what?

excessive and unregulated fibrinolysis

What is the function of ADAMTS13 enzyme?

cleaving ultra-large von willebrand factor to keep them out of circulation

What are the functions of platelets?

clotting plug formation release of serotonin repair of the injured tissues

Fresh Frozen Plasma should be used for what?

coagulation deficiencies

What smear technique has the advantage of providing the best WBC distribution when performed correctly?

coverslip technique

Cytomegalovirus (CMV) appears to suppress cell-mediated immune functions. What are characteristic findings in persons affected?

decreased CD4+ cells increased CD8+ cells

What lab results are consistent with hemolytic anemia?

decreased erythrocyte survival increased catabolism of heme decreased haptoglobin levels

Hypochromia

decreased hemoglobin concentration in RBCs

Sickle dex test

decreased solubility of deoxygenated HbS in solution produces visible turbidity

Abnormal platelet function seen in patient with Bernard Soulier Syndrome is caused by which of the following platelet components?

defective glycoprotein Ib/IX

What other hemoglobin gene loci occur on the same chromosome as the beta chain loci?

delta and gamma

A hemoglobin F concentration of 100% is seen in which beta thalassemia?

delta-beta thalassemia major

What coag factors are Vitamin K dependent?

factors 2, 7, 9, 10

Storage Pool Iron

ferritin and hemosiderin

What is likely to cause an abnormal thrombin time (TT)?

fibrin split products heparin dysfibrinogenemia

What is associated with macrocytic anemia?

fish tapeworm (absorbs vitamin B12)

What laboratory tests would be most helpful in determining the number of T cells in circulation?

flow cytometry

What assays are more sensitive and specific for the diagnosis of paroxysmal nocturnal hemoglobinuria (PNH)?

flow cytometry for GPI-anchored proteins

What are conditions associated with hereditary spherocytosis?

increased osmotic fragility MCHC greater than 37% extravascular hemolysis

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?

increased platelets in the plasma sample

How does hydroxyurea aid in the treatment of sickle cell disease?

induces increased production of HbF

Bacterial Meningitis

inflammation of the protective membranes covering the brain and spinal cord caused by various types of bacteria

What conditions would you NOT expect to see howell jolly bodies?

iron deficiency anemia

What would you predict is the effect of iron absorption if erythropoietic activity is increased over a prolonged period of time?

it would increase

What cells have a blue-gray cytoplasm with a "ground glass" appearance and vacuoles in the cytoplasms?

monocytes

Hepcidin function

key regulator of the entry of iron into circulation via ferroportin

Sideroblastic anemia

lead toxicity, Etoh -- iron accumulation -mitochondria dx: hct 20-30%, lead= basophilic stippling of RBCs tx: chelation therapy; transfusion

Bone marrow examination may be used to aid in the diagnosis of what condition?

leukemia

High LAP score

leukemoid reaction

What organ is associated with the production of the majority of clotting factors?

liver

What condition is most commonly associated with nonmegaloblastic macrocytic anemia?

liver disease

What lab assays are useful in diagnosing Hereditary Hemochromatosis?

liver function tests genetic studies iron studies

acute leukemia

presence of undifferentiated or immature cells, usually blast cells occurs more often in children

What cells have pale blue cytoplasm with a few azurophilic granules and an oval or indented nucleus?

lymphocytes

CD45 is present on what cells?

lymphocytes monocytes granulocytes

The peroxidase stain is useful in differentiating between which cells?

lymphocytic and granulocytic cells

What lineage are plasma cells from?

lymphoid lineage

During the "staining" process prior to flow cytometry analysis of white blood cells, how are the erythrocytes treated?

lysed

The presence of an increased number of hypersegmented neutrophils in the peripheral blood is an indication of what condition?

megaloblastic anemia

Characteristic findings in patients with iron deficiency anemia

microcytic, hypochromic red cell morphology decreased serum iron level decreased ferritin

What age group is Type I Hereditary Hemochromatosis most likely to be initially detected based on clinical symptoms?

middle age adults

neutrophilic granulocyte maturation

myeloblast promyelocyte myelocyte metamyelocyte band neutrophil

Tear Drop Cells are seen in what conditions?

myelofibrosis myelophthisic anemia thalassemia

What is the most immature neutrophil found in normal peripheral blood?

neutrophil bands

If present, how many Howell Jolly bodies are usually seen within a given erythrocyte?

one

What red cell inclusions are found in a patient with sideroblastic anemia?

pappenheimer bodies

What bones contain active hematopoietic bone marrow in a normal adult?

pelvis sternum vertebrae

Hematocrit

percentage of blood volume occupied by red blood cells

What is a clinical symptom associated with thrombocytopenia?

petechiae

What is a common clinical symptom that is directly related to thrombocytopenia?

petechiae

A white blood cell stained with Wright's stain has the following characteristics: Round eccentric nucleus with clumped chromatin pattern 1:1 nucleus to cytoplasm ratio Basophilic cytoplasm Crescent-shaped clear area next to nucleus What is the MOST likely identification of this cell?

plasma cell

Hb H inclusions

precipitate with brilliant cresyl blue

Osteoblast

resemble plasma cells

A smear that is prepared from equal parts of new methylene blue and whole blood is used for what count?

reticulocyte count

What hematological determinations is most reliable for evaluating bone marrow erythropoietic activity?

reticulocyte count

What physiological factor causes sedimentation in ESR?

rouleaux formation

How are T lymphocytes characterized?

secrete cytokines compromise majority of cells in blood lymphocyte pool help regulate immune response

What conditions is DIC associated with?

septicemia obstetric emergencies intravascular hemolysis

Spherocytes

small, spherically shaped erythrocytes immune hemolytic anemia increased osmotic fragility

What stain must be used to visualize Heinz bodies?

supravital stain

Transfusion Dimorphism

two population of red blood cells present

What inclusions are frequently seen on the same peripheral blood smear along with toxic granulation?

vacuoles


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Chapter 12 Sliding Filament Theory #3

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