Hematology Review
True or false: The type of plasma proteins present affect the sedimentation rate of the red blood cells.
True
True or false: Tubes from completed ESR tests must be discarded into biohazard sharps containers.
True
True or false: Vibration of the counter where the sed rate is performed will falsely increase the result.
True
True or false: White blood cells should be observed in an area of the smear where red cells are just touching.
True
A leukocyte containing granules
granulocyte
A commonly performed test that provides the clinician with an estimate of the patient's red cell volume & the blood's oxygen-carrying capacity is the ____________.
hematocrit
The major functional component of red blood cells
hemoglobin
The process of blood cell formation
hemopoiesis
Undifferentiated bone marrow cell that gives rise to blood cells
hemopoietic stem cell
Anemia & microcytosis in some people from Southeast Asia
hgb E
Opaque or milky appearance of plasma in a spun hematocrit
high blood fat level
Always pass an affected gene to offspring
homozygous
Pregnant females
increased ESR
Increased total WBC & lymphocytes, increased "atypical lymphs"
infectious mononucleosis
Increased ESR
inflammation
The reaction of tissue to injury is called ____________.
inflammation
Microcytic cells
iron deficiency
An acute or chronic disease involving unrestrained growth of leukocytes
leukemia
Involving unrestrained growth of leukocytes
leukemia
The largest of the normal blood components
leukocytes
Folic acid deficiency
macrocytes
Red cells having a larger than normal cell size are called __________.
macrocytic
Inadequate mixing of the blood can be a source of error
manual reticulocyte count
Cannot form rouleaux
sickle cells
Wash time too short
smear too blue
Drop of blood too large
smear too thick or long
Cell nuclei
stains blue or purple
Inherited hemoglobin disorders with decrease production of normal Hgbs
thalassemias
Drop of blood too small
thin, short smear
Mutations in genes that code for globin proteins
variant forms of hemoglobin
Blood vessel that carries blood from the tissues to the heart
vein
Macrocytic cells
vitamin B12 deficiency
Number of reticulocytes divided by the number of red cells counted
% reticulocytes
Conversion factor for converting hematocrit from percentage to SI units
0.01
Hematocrit value below normal
32%
True or false: The reference value for the adult reticulocyte count is 0.5 to 1.5%
True
The form of hemoglobin that is called "adult" hemoglobin" is Hgb _____________.
A1
Many hemoglobin meters or analyzers
CLIA-waived
True or false: After centrifugation, the hematocrit is read by measuring from the bottom of the red cell column to the top of the buffy coat.
False
True or false: Automated methods for performing the ESR have not yet been developed.
False
True or false: Control solutions are not available for use with the ESR test.
False
True or false: Deficiency of vitamin B12 is one cause of microcytosis.
False
True or false: Folic acid deficiency is one cause of reticulocytosis.
False
True or false: In the packed cell column after centrifugation of blood, the leukocytes are at the bottom of the column.
False
True or false: Monocytes are derived from megakaryocytes.
False
True or false: Normal RBCs are 6-8 µm in diameter & have a round purple nucleus
False
True or false: One ESR method is Quick's ESR.
False
True or false: The ESR is a specific diagnostic test for certain diseases.
False
True or false: The basophil is named because it has blue (basophilic) cytoplasm.
False
True or false: The cells should be counted while observing the smear in an area where the cells are overlapping.
False
True or false: The hematocrit result can be used to estimate the iron content of red blood cells.
False
True or false: The reference hematocrit value for newborns is lower than that for adults.
False
True or false: The stained network of DNA in the cytoplasm of reticulocytes is called a reticulum.
False
True or false: The term poikilocytosis is used when RBCs have varied sizes.
False
True or false: When New Methylene Blue is used to stain reticulocytes, the proportion of blood to stain is two parts blood to one part stain.
False
True or false: When the centrifugation of the microhematocrit sample is complete, the centrifuge lid should be opened & the rotor brought to a stop by placing the hands on it.
False
Makes up 95-98% of adult hemoglobin
Hgb A1
Produced during gestation
Hgb F
True or false: The neutrophilic band cell is shaped like a curved sausage.
True
True or false: The presence of sickle cells in the blood will cause a decreased sed rate.
True
True or false: Bacterial infections cause an increased percentage of neutrophils & band cells.
True
True or false: Eosinophils are usually increased in allergic reactions.
True
True or false: Newborns have high reticulocyte counts that decrease to adult levels by 2 weeks of age.
True
True or false: Spun hematocrits should be run in duplicate & the results averaged
True
True or false: Successful treatment of anemia should result in an increase in reticulocytes.
True
True or false: The Sediplast ESR reference ranges differ for males & females, but the ZSR reference range is the same for all ages & genders.
True
True or false: The ZSR test requires correlation of the test result with the patient's hematocrit.
True
True or false: The area of the smear to be examined is called the, "feathered" edge.
True
True or false: The lymphocyte is the smallest WBC.
True
True or false: The microhematocrit can be determined using capillary blood or anticoagulated venous blood.
True
True or false: The neutrophil is the most numerous leukocyte in normal adult blood.
True
A common blood cell stain
Wright's stain
Which of the following is true for hemoglobin analysis? a. The specific gravity method estimates Hb level b. The reference range for adult females is 12-17 g/dL c. The Hb level is unaffected by RBC count d. It does not require use of Standard Precautions
a. The specific gravity method estimates Hb level
Which of the following is true of RBCs? a. They are biconcave disks b. In the peripheral blood, they have a nucleus c. They are about 2-3 µm in diameter d. Mature cells take up the basophilic stain
a. They are biconcave disks
Which of the following statements about the WBC differential count is NOT correct? a. Viral infections usually cause increased lymphocytes & increased total WBCs b. Neutrophils & bands can be increased in bacterial infections c. Infectious mono causes increased total WBCs d. Parasitic infections cause an increase in eosinophils
a. Viral infections usually cause increased lymphocytes & increased total WBCs
Which of the following is (are) true concerning the effect of technical factors on the ESR? a. A tilted tube causes a falsely increased rate b. Reading the test at less than 1 hour causes a falsely increased rate c. Room temperature greater than 25 degrees causes a falsely decreased rate d. All off the above (a-c) are true
a. a tilted tube causes a falsely increased rate
In the WBC differential count: a. an average of 7-20 platelets/oil immersion field is considered normal b. a one-month-old infant will have 45-50% neutrophils c. 45-50% neutrophils is normal for an adult d. 7-13% bands is normal for an adult
a. an average of 7-20 platelets/oil immersion field is considered normal
Concerning the reticulocyte count reference value: a. in a healthy adult, approximately 1% of the RBCs will stain as reticulocytes b. reticulocyte counts above 2% in an adult are above the reference range c. newborns have low retic counts that increase to adult levels by 2 weeks of age d. none of the above is true
a. in a healthy adult, approximately 1% of the RBCs will stain as reticulocytes
Which is true of hemoglobin analysis? a. It is an indirect measure of oxygen-carrying capacity b. It measures the red cell volume c. It is always determined from an anticoagulated venous bloods ample d. No stable standard is available
a. it is an indirect measure of oxygen-carrying capacity
All of the following are true of blood EXCEPT: a. it makes up 10-15% of the total body weight b. adult blood volume is approximately five liters c. it is composed of formed elements suspended in a fluid called plasma d. about 50-60% of blood volume is plasma
a. it makes up 10-15% of the total body weight
Which is NOT correct regarding the reticulocyte count procedure? a. It must be performed within 2hours of blood collection b. Immature RBCs continue to mature as blood stands c. A definite counting pattern must be followed d. A delay in staining may cause a false decrease in the reticulocyte count
a. it must be performed within 2hours of blood collection
Which of the following is true when examining a smear containing abnormal cells? a. Personnel must following the written procedure of the facility b. The staining technique does not affect cell identification c. Each technician can use their own method of examining the smear d. If the patient is "healthy," the smear will not have abnormal cells
a. personnel must following the written procedure of the facility
In performing the reticulocyte count, which is NOT true? a. Precipitate in the stain solution will not interfere with the test b. The technician must use care not to confuse artifacts or debris with reticulum c. Cells must be examined carefully to void overlooking faintly stained, fine reticulum d. A definite counting pattern is used to avoid counting the same cells twice
a. precipitate in the stain solution will not interfere with the test
Which of the following is NOT true when making blood smears? a. Smears must be stained before they air-dry b. Smears from anticoagulated venous blood should be made within 2 hours of blood collection c. Smears should have a feathered edge d. Capillary blood is preferred over venous blood
a. smears must be stained before they air-day
Reticulocyte percentage x patient's RBC count
absolute reticulocyte count
Falsely decreases ESR
air bubbles in the tube
Smear dried too slowly
artifacts
Basket or "batch"
automatic stainer
Which of the following is not a reference range for differential count on an adult? a. 25-40% lymphocytes b. 3-9% neutrophils c. 0-7% bands d. 1-3% eosinophils
b. 3-9% neutrophils
Which of the following is INCORRECT concerning the "normal" WBC differential counts? a. Neutrophils & lymphocytes comprise 85-95% of cells b. Eosinophils make up 3-9% of the cells c. Monocytes, eosinophils, & basophils make up 5-15% of the cells d. Blood from a one-month-old infant can have 40-70% lymphocytes
b. Eosinophils make up 3-9% of the cells
All of the following are ESR methods EXCEPT: a. Sediplast b. Quick's ESR c. Westergren d. Zeta e. Wintrobe
b. Quick's ESR
Which of the following is true regarding the preparation & staining of a blood smear? a. Smears must be stained immediately b. Smears can be immersed in methanol & stained later c. Smears can be preserved by immersing in ethanol d. Wright's stain contains no preservative
b. Smears can be immersed in methanol & stained later
Which is NOT true concerning safety during the performance of the reticulocyte count? a. Cells are stained in the living state without fixative b. The cell stain mixture represents no biological hazard c. Standard Precautions must be observed d. Appropriate PPE must be worn during blood collection & staining
b. The cell stain mixture represents no biological hazard
All of the following are true of blood collected for blood smears EXCEPT: a. the preferred specimen is capillary blood b. anticoagulant must always be used in blood for blood smears c. venous blood with EDTA can be used d. capillary blood can be collected into capillary tubes
b. anticoagulant must always be used in blood for blood smears
"Thick-walled, elastic, & muscular" describes which type of blood vessel? a. capillaries b. arteries c. veins d. venules
b. arteries
An immature blood cell normally found only in the bone marrow is: a. a keratocyte b. blast cell c. codocyte d. elliptocyte e. Cabot cell
b. blast cell
The hemoglobin molecule: a. is made up of eight globin chains b. contains protein & heme c. contains four heme groups d. all of the above
b. contains protein & heme
The Westergren ESR: a. is reported as a percentage b. is reported in mm per hour c. result is obtained by diving patient Hct by mm/hr d. correct answer is not given
b. is reported in mm per hour
Which is NOT true of the reticulocyte count? a. It estimates the number of immature RBCs in the circulating blood b. It estimates the amount of hemoglobin in the average red cell c. It indirectly estimates the rate of RBC production d. It can be used to monitor the course for treatment for anemia
b. it estimates the amount of hemoglobin in the average red cell
Which of the following functions is carried out by blood? a. It delivers nutrients & CO2 to the tissues b. It regulates body temperature c. It delivers O2 to the lungs & tissues d. None of the above (a-c) e. All of the above (a-c)
b. it regulates body temperature
All of the following are true of hemoglobin EXCEPT: a. usually included in the CBC b. reference value for females is higher than males c. transports CO2 from the tissue to the lungs d. the reference value for newborns is higher than adult males
b. reference value for females is higher than males
The ESR is decreased in which of the following conditions? a. rheumatic fever b. sickle cell anemia c. viral hepatitis d. multiple myeloma e. pregnancy
b. sickle cell anemia
Which is true regarding the reference values for the reticulocyte count? a. The range for adults is 0.5-1.5% with an upper limit of normal being 10% b. The reference range for newborns is 2.5-6.5% c. The reference range for newborns is 0.5-1.5% with an upper limit of normal being 3% d. The reference range for adults is 2.5-6.5 with an upper limit of 10%
b. the reference range for newborns is 2.5-6.5%
Which of the following is correct for reporting the reticulocyte count? a. The percentage is calculated by dividing the number of reticulocytes counted by 500 & multiplying by 100 b. The reticulocyte count can be corrected for anemia for correlating it to the Hct The absolute reticulocyte count is calculated by dividing the RBC count by the percentage of reticulocytes d. None of the above (a-c) is correct
b. the reticulocyte count can be corrected for anemia for correlating it to the Hct
Which is true concerning hemoglobin(s)? a. They cannot be measured on small handheld analyzers b. They are named according to the type of globin chain c. Thalassemias are caused by abnormalities in the me portion d. A1 is the major hemoglobin in infants
b. they are named according to the type of globin chain
Increased percentage of "band" cells
bacterial infections
A(n) ____ is an immature granulocyte with a nonsegmented nucelus
band, band cell
Abnormal number of basophilic red cells in the blood
basophilia
Blood cell morphology
blood cell morphology
Estimation of oxygen-carrying capacity
blood hemoglobin level
Reticulocyte stain
brilliant cresyl blue
Two-step method
buffer
Leukocytes
buffy coat
A shrunken red blood cell with scalloped or toothed margins is known as a(n) ________ ____.
crenated cell
Nuclear remnants remaining after the nucleus is lost & commonly seen in pernicious anemia are: a. basophilic stippling b. basophilia c. Howell-Jolly bodies d. erythrocyte indices
c. Howell-Jolly bodies
Which of the following is true? a. Lymphocytes often have vacuoles in their cytoplasm b. Lymphocytes are derived from a common precursor called the promyelocyte c. Lymphocytes are produced in the bone marrow & other lymphoid tissue d. Monocytes are involved in the immune response by producing antibodies
c. Lymphocytes are produce din the bone marrow & other lymphoid tissue
Which of the following is true? a. Plasma proteins affect the size of RBCs b. A slight tilt of the ESR tube has no effect on the results c. The ESR is affected y the RBC count d. Low temperatures cause the erythrocytes to settle more rapidly
c. The ESR is affected y the RBC count
All of the following are true of RBCs EXCEPT: a. Their color is due to hemoglobin b. Normal mature RBCs stain pink-tan c. The central area stains darker than the edge d. Their diameter is 6-8 µm
c. The central area stains darker than the edge
When preparing slides by the two-slide method, which is true? a. A large drop of blood makes the best smear b. The spreader slide can be used to prepare several smears c. The smear should cover 1/2 to 3/4 of the slide d. Smears with holes & ridges are acceptable
c. The smear should cover 1/2 to 3/4 of the slide
Which is true of red cells in iron deficiency anemia? a. They are normocytic b. They are macrocytic c. They are hypochromic d. They are normocytic & hypochromic e. They are hyperchromic
c. They are hypochromic
In cardiopulmonary circulation: a. blood is carried from the heart to the tissues b. blood circulates from the heart to the lungs to the tissues c. blood circulates from the heart to the lungs where O2 is picked up by the blood & CO2 is released d. blood is carried from the heart to the tissues & back to the heart, providing O2 to the tissues
c. blood circulates from the heart to the lungs where O2 is picked up by the blood & CO2 is released
Which of the following is true of the erythrocyte sedimentation rate? a. It must be set up within 2 hours of blood collection, or within 6 hours if refrigerated b. Air bubbles will cause incorrect results c. Both a & b are true d. Neither a nor b is true
c. both a & b are true
Another name for sickle cell is: a. codocyte b. elliptocyte c. drepanocyte d. keratocyte e. stomatocyte
c. drepanocyte
Which of the following is not a cause of iron deficiency anemia? a. increased demand in pregnancy b. chronic blood loss c. genetic defect in the Hb beta chains d. inadequate dietary iron
c. genetic defect in the Hb beta chains
All of the following are true of reticulocytosis EXCEPT: a. it can be a response to acute blood loss b. it can be due to chronic blood loss c. it can be caused by iron deficiency anemia d. it can result from treatment for anemia
c. it can be caused by iron deficiency anemia
All of the following are formed elements found in normal blood EXCEPT: a. RBCs (erythrocytes) b. WBCs (leukocytes) c. megakaryocytes d. platelets
c. megakaryocytes
Which of the following is true regarding identification of WBCs? a. The size can be estimated by comparing them to epithelial cells b. Abnormal cells are easy to identify c. Most normal WBCs can be easily identified d. The shape of the nuclei is not considered
c. most normal WBCs can be easily identified
Drepanocytes, codocytes, elliptocytes, & keratocytes are examples of: a. anisocytosis b. thalassemias c. poikilocytosis d. erythrocyte indices e. red cell inclusions
c. poikilocytosis
Which statement is true regarding the reticulocyte count procedure? a. RBCs are fixed before being stained b. Manual count results are more accurate than automated c. Smears are prepared from a mixture of New Methylene Blue stain & blood d. A total of 500 red cells are counted
c. smears are prepared from a mixture of New Methylene Blue stain & blood
Non-heparinzed capillary tubes
capillary blood
Heterozygous for a hemoglobin gene
carrier
Normal lymphocyte percentage greater than 50%
children
Which of the following is correct concerning quality assessment when preparing a blood smear? a. The procedure should produce minimal alteration of cell distribution & morphology b. Venous anticoagulated blood must be well mixed before making a smear c. The only anticoagulant that can be used for smears is EDTA d. All of the statements (a-c) are true
d. All of the statements (a-c) are true
Which of the following cellular features are examined to identify a cell? a. relative cell size b. nuclear characteristics c. cytoplasmic characteristics d. all of the above
d. all of the above
All of the following are related to the red blood cell indices EXCEPT: a. MCH b. the size & hemoglobin content of RBCs c. femtoliter d. drepanocyte e. hematocrit
d. drepanocyte
All of the following are true of reticulocytopenia EXCEPT: a. it can be seen in vitamin B12 deficiency b. it can be seen in folic acid deficiency c. it can be seen in aplastic anemia d. it can be seen in acute blood loss
d. it can be seen in acute blood loss
All of the following are true of RBCs with a diameter greater than 8µm EXCEPT: a. they are called macrocytes b. they are called megalocytes c. the condition can be caused by deficiency of B12 d. the condition can be caused by iron deficiency
d. the condition can be caused by iron deficiency
Sickle shape
decreased oxygen
A patient with an artificial heart valve could have damaged red cells called: a. codocytes b. sick cells c. stomatocytes d. nucleated RBCs e. keratocytes
e. keratocytes
Write's stain is a combination of ______________ & Methylene blue stains.
eosin
Blood cell that transports O2 to tissues & CO2 to the lungs
erythrocyte
Nonspecific test
erythrocyte sedimentation rate
Shape, size, structure, & color
evaluation of cell nucleus
The large bone marrow cell from which platelets are derived is called a(n) _____________.
megakaryocyte
Platelets
megakaryocytes
Packed cell volume
microhematocrit
A neutral-staining leukocyte, usually the first line of defense against infections, is called a(n) __________.
neutrophil
PMN, poly, or seg
neutrophil
Not normally in adult peripheral blood
nucleated red blood cells
The form of hemoglobin that binds & transports oxygen
oxyhemoglobin
Increased eosinophils
parasitic infections
A formed element that plays in important role in blood coagulation
platelet
7-20 per oil immersion field is normal
platelets
Somewhat pink to the naked eye properly stained smear
properly stained smear
A nucleic acid found in all living cells that is important in protein synthesis is ___________ _____.
ribonucleic acid
Use of beveled-edge, rounded corner slides
safety practice