Heme 2 Study Guide 6
15-month-old malnourished child is brought to the clinic for a routine examination. Her CBC results are as follows: WBC 9.5 x 109/L (9.5 x 103/(xL); RBC 2.70 X 1012/L (2.70 X 10% iL); hemoglobin 67 g/L (6.7 g/dL); hematocrit0.25 L/L (25%); MCV 73.5 fl_; MCHC 26.8 g/dL; reticulocyte 0.2%; ROW 19%. Abnormal RBC morphology present included pencil forms and target cells. What is the toddler's absolute reticulocyte count? - 0.05X10^9/L - 0.5X10^9/L - 5X10^9/L - 50X10^9/L
-5*10^9/L (Retic % x RBC (x 10^12)) / 100
23- year-old female who delivered a healthy newborn 1 hour ago develops postoperative bleeding
...
In the osmotic fragility test, hemolysis normally begins at_____________ NaCl and ends at________NaCl. - 0.50%; 0.35% - 0.45%; 0.30% - 0.65%; 0.20% - 0.30%; 0.45%
0.45%; 0.30%
Use the following information to answer questions A 32-year-old African-American traveling to Africa on business had been healthy until he began taking primaquine for prevention of malaria. He went to his physician because he felt faint and his urine was black. His CBC results are as follows: WBC 6.5 X 109/L; RBC 1.67 X 1012/L; HGB 50 g/L; HCT 0.15 L/L; MCV 89.8 fL; MCHC 33.38 g/dL; platelet count 175 X 109/L; reticulocyte 25.0% 1. The most likely cause of this hemolytic episode is: - G6PD deficiency - Hereditary spherocytosis - Sickle cell disease - Pyruvate kinase deficiency 2. The defect in this disorder is caused by an - Amino acid substitution - Intrinsic red blood cell membrane defect - Enzyme deficiency in the hexosemonophosphate shunt - Enzyme deficiency in theEmbden-Meyerhof pathway 3. Inclusions that form when the patient is oxidatively challenged are composed of: - RNA - Denatured hemoglobin - DNA - Iron
1. G6PD deficiency 2. Enzyme deficiency in the hexosemonophosphate shunt 3. Denatured hemoglobin
A 45 year old black male presents with the following lab results. The patient's physician orders a PT and APTT. When the specimen is collected, how much of the patient's whole blood should be added to 0.5 mL of sodium citrate? - 4.5 - 7.1 - 3.4 - 9.0
7.1 mL The ratio of blood to anticoagulant should be 9:1
An abnormal urea solubility test may indicate: - A quantitative platelet defect - A qualitative platelet defect - A deficiency of factor XIII - Hemophilia A
A deficiency of factor XIII
Abetalipoproteinemia is characterized by mild anemia and numerous ____on the blood smear - Acanthocytes - Elliptocytes - Echinocytes - Stomatocytes
Acanthocytes (Abetalipoproteinemia, or hereditary acanthocytosis, is a rare autosomal recessive disorder of lipid metabolism. An absence of serum beta lipoprotein, a transport protein, causes abnormal plasma lipids. The numerous acanthocytes (spur cells) are the result of an alteration in the lipid content of the red cell membrane. The anemia is mild, but this disorder is associated with progressive neurologic disease.)
High levels of terminal deoxynucleotidyl transferase (TdT) are found in: - Acute lymphoblastic - Lymphocytic leukemia (ALL) - Hairy cells - Myeloblasts - Monoblasts - Lymphoblasts.
Acute lymphoblastic / lymphocytic leukemia (ALL) Lymphoblasts
Auer rods may be seen in all of the following EXCEPT: - Acute myelomonocytic leukemia (M4) - Acute lymphoblastic leukemia (ALL) - Acute myeloid leukemia without maturation (M1) - Acute promyelocytic leukemia (M3)
Acute lymphoblastic leukemia (ALL) (Auer rods are not seen characteristically in lymphoblasts. They may be seen in myeloblasts, promyelocytes, and monoblasts.)
Which type of acute myeloid leukemia is called the true monocytic leukemia and follows an acute or subacute course characterized by monoblasts, promonocytes, and Monocytes? - Acute myeloid leukemia, minimally differentiated - Acute myeloid leukemia without maturation - Acute myelomonocytic leukemia - Acute monocytic leukemia
Acute monocytic leukemia (M5) (Acute monocytic leukemia has an incidence of between 1%-8% of all acute leukemias. It has a distinctive clinical manifestation of monocytic involvement resulting in skin and gum hyperplasia. The WBC count is markedly elevated, and prognosis is poor.)
Mucopolysaccharidosis associated with large, dark staining, coarse cytoplasmic granules in leukocytes is consistent with: - May-Hegglin anomaly - Alder-Reilly anomaly - Chédiak-Higashi disease - Pelger-Huët anomaly - None of the above
Alder-Reilly anomaly
Patients with afibrinogenemia usually present with an abnormal - TT - PT - APTT - Reptilase time - Blood timing - Thrombin - All of the above
All of the above
Hemoglobin F corresponds to which of the following globin chains? - Alpha2, beta2 - Alpha2, gamma2 - Zeta2, epsilon2 - Alpha2, delta2
Alpha2, gamma2
The hemoglobin A2 quantification using anion exchange chromatography will be valid in - Hemoglobin C disease. - Hemoglobin E trait. - Hemoglobin O trait - Beta-thalassemia minor
Beta-thalassemia minor
Ingestion of aspirin will adversely affect the
Bleeding time (Aspirin inhibits platelets aggregation and secretion in response to ADP, epinephrine, and low concentrations of collagen. It inhibits prostaglandin synthesis by inactivation of cycloxygenase thereby inhibiting endoperoxide and thomboxane-A2. Bleeding time will be increased)
To establish a standard curve for reading hemoglobin concentration - A commercial control material is used. - A wavelength of 640 nm is employed - Certified standards are used. - A patient blood sample of known hemoglobin concentration is used.
Certified standards are used.
An autosomal recessive disorder that manifests itself with large lysosomal inclusions in all types of leukocytes, recurrent infections, and albinism is: - Chediak-Higashi - Pelger-Huët - May-Hegglin - Alder-Reilly
Chediak-Higashi
A 53 year old female with lupus presents with an elevated BUN and creatinine and is anemic. The most likely cause of the anemia is - Iron deficiency - Renal insufficiency, auto-hemolysis - Decreased EPO - Aplastic anemia
Decreased erythropoietin
Which of the following is associated with a "shift to the left" in the oxygen dissociation curve of hemoglobin? - decreased pH and elevated temperatured - decreased oxygen affinity - decreased oxygen release - presence of 2,3-bisphosphoglycerate (2,3-BPG)
Decreased oxygen release
A 15-month-old malnourished child is brought to the clinic for a routine examination. Her CBC results are as follows: WBC 9.5 x 109/L (9.5 x 103/(xL); RBC 2.70 X 1012/L (2.70 X 10% iL); hemoglobin 67 g/L (6.7 g/dL); hematocrit0.25 L/L (25%); MCV 73.5 fl_; MCHC 26.8 g/dL; reticulocyte 0.2%; ROW 19%. Abnormal RBC morphology present included pencil forms and target cells. The earliest indicator of this disease state is - Decreased folic acid - Decreased serum iron - Decreased serum ferritin - Increased bilirubin
Decreased serum ferritin
What red cell morphologic abnormality is described by the term "poikilocytosis''? - Variations in size - Deviations from normal shape - Presence of inclusions - Alterations in hemoglobin concentration
Deviations from normal shape
Ninety percent of the ATP or glucose required by RBCs is provided by the: - Leubering- rapoport pathway - Hexose monophosphate shunt - Methemoglobin reductase pathway - Emben- meyerhof pathway
Emben- meyerhof pathway
What is the key diagnostic test for Hodgkin lymphoma? - Magnetic resonance image (MRI) of the chest. - A computed tomography (CT) scan of the cervical area. - An erythrocyte sedimentation rate (ESR). - A biopsy of the cervical lymph nodes - Bone marrow biopsy
Excisional lymph node biopsy /A biopsy of the cervical lymph nodes
Dacryocytes (teardrop cells) are associated with: - Mechanical RBC destruction - Medullary Hematopoiesis - Intrinsic RBC membrane defects - Extramedullary Hematopoiesis
Extramedullary Hematopoiesis
A prolonged thrombin time may be seen in a patient with a deficiency of factor - I - II - V - VII
Factor I
A patient whose abnormal PT (and APTT) is not corrected with either aged serum or adsorbed plasma reagent has a deficiency of - Factor II - Factor III - Factor V - Factor XII
Factor II
An elevated PT and normal APTT is consistent with deficiency of factor: - Factor VI - Factor XII - Factor XII - Factor VII
Factor VII
A patient has a normal PT and an abnormal APTT, which is corrected with adsorbed plasma reagent but not aged serum. The patient has a deficiency of factor: - Factor II - Factor III - Factor V - Factor VIII
Factor VIII
a deficiency of which factor is associated with an asymptomatic presentation? - I - II - XII - XIII
Factor XII
Congenital pancytopenia (aplastic anemia) is found in: - thalassaemia - haemolytic anaemia - pernicious anemia - fanconi's anemia
Fanconi's anemia
Which of the following conditions show similar CBC and blood smear findings? - Beta-thalassemia major and minor - Folic acid and vitamin B12 deficiencies - Acute and chronic blood loss - Sickle cell disease and trait
Folic acid and vitamin B12 deficiencies
A 71 year old black female presents with a history of taking an oral anticoagulant for the past several months. Her prothrombin time is 63 s. Which of the following treatments would allow for the quickest correction of the prothrombin time? - Discontinue the oral anticoagulants - Fresh frozen plasma transfusion - Vitamin k injection - INR
Fresh frozen plasma transfusion
The myeloproliferative disorders include all the following except: - Polycythemia Vera - CML - Gaucher's Disease - Thrombocythemia
Gaucher's Disease/ Glanzmann thrombasthenia
A positive tartrate resistant acid phosphatase (TRAP) stain may aid in diagnosing - ALL - CLL - Hairy cell leukemia - Kaposi's syndrome
Hairy cell leukemia
The globin chains alpha2beta2 correspond to hemoglobin: - A - A2 - F - Gower 1
Hemoglobin A
When valine is substituted for glutamic acid in the sixth position of the beta globin chain, the hemoglobin is known as hemoglobin: - Hemoglobin S - CD36 - Hemoglobin C - Hemoglobin SC
Hemoglobin S
Which of the following statements about sickle cell syndrome is FALSE? (Pick 2) - Patients with chronic sickle cell disease have chronic hemolytic anemia - Sickled red blood cells have longer life spans that normal red blood cells. - Sickle hemoglobin has a flawed chemical structure that results in erythrocyte deformity when oxygen levels are low. - Splenomegaly is a common problem of sickle cell disease - Hemoglobin S is more soluble in dithionite than is normal hemoglobin
Hemoglobin S is more soluble in dithionite than is normal hemoglobin Patients with sickle cell anemia live as long as anyone else.
Codocytes (target cells) and drepanocytes (sickle cells) are seen on the peripheral blood smear of a 6-month old black male. The next step would be to perform a(n):
Hemoglobin electrophoresis
A 62 year old black male presents with schizocytes (schistocytes), thrombocytopenia, acute renal failure, and enlarged kidneys. The most likely diagnosis is: - HUS - TTP (thrombotic thrombocytopenic purpura) - DIC - Hemolytic uremic syndrome
Hemolytic uremic syndrome
Heinz bodies may be found when there is a defect in the: - Kreb's cycle - Leubering- Rapoport pathway - Hexose monophosphate shunt - Embden- meyerhof pathway
Hexose monophosphate shunt
Spherocytes will cause the osmotic fragility test to be - Decreased osmotic fragility - Increased osmotic fragility - Normal - Fragile
Increased osmotic fragility
Which of the following blood findings does NOT correlate with the presence of ringed sideroblasts in the bone marrow? - Pappenheimer bodies - Basophilic stippling - Increased total iron-binding capacity - Increased percent transferrin saturation
Increased total iron binding capacity
A patient's plasma produces an elevated PT and APTT and does not produce a normal PTand APTT when mixed with normal plasma. The most likely cause is: - Procedural error. - Prekallikrein deficiency. - Inhibitor to phospholipids - Von Willebrand's disease.
Inhibitor to phospholipids
Which of the following statements about megaloblastic anemia is true? - Oral folate therapy reverses theneurologic symptoms of PA. - Intra muscular injections of vitamin B12 will reverse the neurologic symptoms of PA. - Methotrexate (chemotherapeuticagent) is a vitamin B antagonist. - Folate deficiency takes years to develop
Intramuscular injections of vitamin B12 will reverse the neurologic symptoms of PA
Hemoglobinemia, hemoglobinuria, and decreased haptoglobin are evidence of what kind of hemolysis (catabolism)? - Intravascular hemolysis - Extravascular hemolysis - Beta hemolysis - Alpha hemolysis
Intravascular hemolysis
Use the following information to answer questions 89 - 91. A 15 month old malnourished child is brought to the clinic for a routine examination. Her CBC results are as follows: WBC 9.5 X 109/L; RBC 2.7 X 1012/L; HGB 67 g/L; HCT 0.25 L/L; MCV 73.5 fL; MCHC 26.8 g/dL; retic count 0.2%; RDW 19%. Abnormal RBC morphology present included pencil forms and target cells. What is the toddler's most probable diagnosis? - Folic acid deficiency - Hereditary spherocytosis - Iron deficiency - Erythroblastosis fetalis
Iron deficiency
Which of the following characteristics would be LEAST likely to distinguish reactive lymphs from monocytes? - Sharp indentation of the cytoplasmic margin by adjacent red blood cells - Presence of large azurophilic granules - Irregular, indented nuclear shape - Abundant, deeply basophilic cytoplasm
Irregular indented nuclear shape
An elevated LAP score is usually: - Leukemoid reaction - CML
Leukemoid reaction
A 54 year old white male presents with fatigue and lymphadenopathy. Chronic lymphocytic leukemia is suspected. Which of the following is not normally helpful in making a more definitive diagnosis?
Leukocyte alkaline phosphatase (LAP stain)
The red cells observed on a peripheral blood smear show extreme anisocytosis with an equal number of macrocytes and microcytes. Which of the following values correlate with this finding? - MCV 108.0 fL, RDW 14.0% - MCV 90.0 fL, RDW 25.0% - MCV 75.0 fL, RDW 16.0% - MCV 88.0 fL, RDW 12.0%
MCV 90.0 fL, RDW 25.0%
The two parameters used to calculate the hematocrit are the - MCV and RBC count - HGB and RBC count - MCV and HGB count - MCV and platelet count
MCV and RBC count
RBC agglutination will cause falsely elevated: - MCV - RBC - HCT - SPIRITS
MCV- Mean Cell Volume
The Na+ K+ cation pump is an important mechanism in keeping the red blood cell intact. Its function is to maintain a high level of - Intracellular Na+ - Intracellular K+ - Plasma Na+ - Plasma K+
Maintain a high level of intracellular K+
Intrinsic factor and vitamin B12 are given to a patient with a low Schilling test. If the Schilling test remains abnormal, the most likely diagnosis is: - Anemia - Excess of vitamin B12 - Malabsorption of vitamin B12
Malabsorption of vitamin B12
The inclusions in which of the following disorders may be confused with Dohle bodies? - Pelger-Huët - May-Hegglin - Alder-Reilly - Howell-jolly bodies.
May-hegglin
A hemoglobin molecule in which iron is in the ferric (Fe 3+) state is called - deoxyhemoglobin - oxyhemoglobin - methemoglobin - hemegoblin
Methemoglobin
A 63 year old white male presents a chief complaint of bone pain. The peripheral blood smear reveals rouleaux. Which of the following is not expected to be seen considering the preliminary diagnosis? - Lymphocytes - Monocytes - Granulocytes - Neutrophils
Monocytes
Sodium fluoride may be added to the naphthyl ASD acetate esterase stain reaction. The fluoride is added to inhibit a positive reaction with: - Megakaryocytes - Monocytes - Erythrocytes - Granulocytes
Monocytes
Which type of anemia is usually present in a patient with acute leukemia? - microcytic, hyperchromic - microcytic, hypochromic - normocytic, normochromic - normocytic, hypochromic
Normocytic, normochromic
An EDTA blood sample run on an automated impedance cell counter has generated a warning flag at the upper region of the platelet histogram illustrated below. Which of the following would NOT be a cause of this warning flag? - Nucleated RBCs - Microcytic RBCs - EDTA-dependent platelet agglutinins - Giant platelets
Nucleated RBCs (Impedance counters measure RBCs and platelets using the same dilution. To differentiate the two, sizing thresholds are used. Particles between 2 and 20 fL are counted as platelets, and particles larger than 35 fL are counted as RBCs. Small RBCs, clumped platelets, and giant platelets fall in the overlap area between platelets and RBCs, generating a warning flag. Nucleated RBCs are larger than normal RBCs and are not mistaken for platelets.)
Which of the following procedures would heparin be a recommended anticoagulant? - Platelet count - Coagulation tests - Smear-based red cell morphology - Osmotic fragility
Osmotic fragility
The Donath Landsteiner antibody is associated with: - March hemoglobinuria - Microangiopathic hemolytic anemia - Paroxysmal nocturnal hemoglobinuria - Paroxysmal cold hemoglobinuria - Alloimmune hemolytic anemia
Paroxysmal Cold Hemoglobinuria (PCH)
The following results were obtained on a 10 - year old black female with a recent history of viral pneumonia. Laboratory Tests Normal Range Patient Hemoglobin 135 - 180 decreased DAT Negative positive Antibody screen Negative positive Antibody panel Negative positive The most likely diagnosis is - Paroxysmal nocturnal hemoglobinuria (PNH) - Paroxysmal Cold Hemoglobinuria (PCH)
Paroxysmal Cold Hemoglobinuria (PCH)
A patient has a positive acidified serum lysis (Ham's) test and decreased acetylcholinesterase. The likely diagnosis is - Neonatal erythrocyte - PCH - PNH - HEMPAS
Paroxysmal nocturnal hemoglobinuria (PNH)
The diagnosis of Erythroleukemia is aided by a positive: - myeloperoxidase - Sudan black B - non-specific esterase - Periodic acid-Schiff
Periodic acid-schiff (PAS)
Interpret the following laboratory data from a 53-year old white male. Laboratory tests Normal range Patient Anti-IF Negative positive Schilling test > 8 low The most likely diagnosis is:
Pernicious anemia has anti-IF (associated with vitamin D)
If one or more of the normal enzymatic steps in heme synthesis is defective, the resultant metabolic disorder is called a: - Porphyria - Porphyra - Lead poisoning - Guillain-Barré syndrome
Porphyria
Interpret the following laboratory data. — we are assuming the answer based off the test being done not the results, because we see ringed sideroblasts in there Laboratory Tests Patient Chromosomal abnormality SF3B1 mutation????? The most likely diagnosis is:
RARS (refractory anemia with ringed sideroblasts ) ??
Platelet clumps and satellitism are seen on a smear from blood collected in EDTA. The best course of action is to:
Recollect blood in a sodium citrate tube and multiply by 1.1
A patient's bone marrow shows 27% blasts with Auer rods, and he has peripheral pancytopenia. The most likely diagnosis is: - Refractory anemia with excess blasts - Refractory anemia with excess blasts in transformation - Refractory anemia - Refractory anemia with ringed sideroblasts
Refractory anemia with excess blasts in transformation
A 50-year-old female was admitted to a hospital for hip replacement surgery. The preoperative tests were performed and the results showed an Hgb of 13.5 g/dL; Hct = 42%; PT = 12 sec; APTT = 36 sec. The patient was bleeding during surgery and the postoperative test results revealed an Hgb = 5.0 g/dL; Hct = 16%; PT = 8 sec; andAPTT = 25 sec. What steps should be taken before releasing these results? - No follow-up steps are needed; report the results as obtained - Report Hgb and Hct results, adjust the anticoagulant volume, and redraw a new sample for PT and APTT - Call the nurse and ask if the patient is receiving heparin - Because the patient is severely anemic, multiply the PT and APTT results by two and report the results
Report Hgb and Hct results, adjust the anticoagulant volume, and redraw a new sample for PT and APTT
In myeloid cells, the stain that selectively identifies phospholipid in the membranes of both primary and secondary granules is: - PAS - Myeloperoxidase - Sudan Black B stain - Terminal deoxynucleotidyl transferase (TdT)
Sudan black b
The hemoglobin pigment that cannot be quantitated by the cyanmethemoglobin method is - Sulfhemoglobin - Carboxyhemoglobin - Oxyhemoglobin - Hemoglobin
Sulfhemoglobin
The presence of CD 2, CD5, CD7 and the absence of CD 10 (CALLA) are associated with - B lymphocytes - T lymphocytes - Myeloid cells - Monocytic cells
T lymphocytes
Which of the following reactions are often positive in ALL but are negative in AML - Terminal deoxynucleotidyl transferase and PAS - Chloroacetate esterase and nonspecific esterase - Sudan Black B and peroxidase - New methylene blue and acid phosphatase
Terminal deoxynucleotidyl transferase (TdT) and PAS
The most sensitive test for heparin therapy and DIC is the - Thrombin time - Bleeding time - PT - APTT
Thrombin time (D-dimer if there)
Which of the following is consistent with leukemoid reaction? - Toxic granulation, vacuoles, and Dohle bodies - Toxic granulation, vacuoles, and eosinophilia - Philadelphia chromosome
Toxic granulation, vacuoles, and Dohle bodies (High LAP, toxic granulation, dole bodies, no Philadelphia chromosome)
A patient with a congenital deficiency of antithrombrin III, protein C, or protein S may exhibit: - Job's Syndrome - Venous Thrombosis - Polycythemia vera - Aplastic anemia
Venous Thrombosis Vitamin K deficiency or Thrombosis disorders (primary thrombosis, prothrombotic state, venous thrombosis, pulmonary embolism)
Decreased aggregation with ristocetin is often found in patients with - Hemophilia A - Hemophilia B - Bernard soilier syndrome - Von Willenbrands disease
Von Willebrands disease
A newborn infant is diagnosed with hemolytic disease of the newborn. Which of the following will probably have to be re-calculated to produce a correct result? - WBC - RBC - HCT - NRBC
WBC?
The occurrence of the Philadelphia chromosome in CML is an indicator of: - a good prognosis - an unfavorable prognosis -nothing - aplastic anemia
a good prognosis
The red blood cells found in led poisoning characteristically exhibit coarse granules composed of ______ that are reported as _____________. - precipitated hemoglobin; Pappenheimer bodies - aggregated ribosomes; basophilic stippling - nuclear fragments; Pappenheimer bodies - excess iron deposits; basophilic stippling
aggregated ribosomes; basophilic stippling
What does measuring the TIBC represent? - Amount of free iron in serum - Circulating protein-bound iron - Amount of iron that transferrin can bind - Indirect measurement of iron stores
amount of iron that transferrin can bind
A 45 year old female presents with general fatigue and the following laboratory results: Laboratory Test Normal Range Patient Hemoglobin (g/L) 120 - 160 decreased Serum Iron (ug/dL) 55 - 160 decreased TIBC (ug/dL) 230 - 400 normal Transferrin saturation 20 - 50% decreased Serum ferritin 16 - 150 increased The most likely diagnosis is: - siderblastic anemia - anemia of chronic disease - iron deficiency anemia - lead poisoning
anemia of chronic disease
Hemoglobinometry is based on the direct measurement of: - hemoglobin - oxyhemoglobin - carboxyhemoglobin - cyanmethemoglobin
cyanmethemoglobin
Which of the following statements does NOT characterize erythropoietin (EPO)? - transforms the CFU-E into the earliest recognizable RBC precursor - increases the rate of red blood cell production by the bone marrow - shortens the maturation time of developing erythroid precursors - decreases stimulation of erythropoiesis when cellular hypoxia increases
decreases stimulation of erythropoiesis when cellular hypoxia increases
A 28 year old black male presents in the emergency department with severe vomiting and diarrhea. Laboratory data reveal elevated WBC, RBC, and platelet counts. The likely cause of the abnormality is: - anemia - dehydration - AML - CML
dehydration
An elevated PT, APTT, and thrombin time in a patient with DIC is caused by: - circulating inhibitor - factor V/VIII was modified - consumed factors X XII and XIII - normal thrombin time
factor V/VIII was modified consumed factors X XII and XIII Depletion of coagulation factors
During an acute intravascular hemolytic episode, which of the following would be decreased? - haptoglobin - urine hemoglobin - serum hemoglobin - urine urobilinogen.
haptoglobin
A reticulocyte count is ordered on a man with a hemolytic crisis due to G6PD deficiency. What feature may also be present? - heinz bodies - dohle bodies - howell-jolly bodies. - no bodies
heinz bodies
Metheme is transported by - hemopexin - haptoglobin - transferrin - lactoferrin
hemopexin (methemalbumin? protein that transports metheme, forms when hemopexin is consumed)
Interpret the following laboratory data. Laboratory Test Patient Heterophile antibody test positive EBV test 1:512 CMV antibody test negative Liver enzymes normal The most likely cause is: - infectious mononucleosis with liver involvement - infectious mononucleosis without liver involvement - CMV with liver involvement - CMV without liver involvement
infectious mononucleosis without liver involvement
Myeloperoxidase is not present in: - neutrophils - lymphocytes - myeloid - monocytes
lymphocytes
Impaired DNA metabolism is characteristic of - hemoglobin C disease - iron-deficiency anemia - sideroblastic anemia - megaloblastic anemia
megaloblastic anemia
Several hours after birth, an infant develops petechiae purpuric hemorrhages, and a platelet count of 21 X 109 /L. The most likely diagnosis is: - drug induced immune thrombocytopenia - thrombotic thrombocytopenia purpura - neonatal idiopathic thrombocytopenia
neonatal idiopathic thrombocytopenia
The technique used by Technicon hematology instrumentation for leukocyte differential analysis includes: - optical flow cytometry, cytochemistry and light scattering. - Individual cell volume, high frequency conductivity, and laser light - -
optical flow cytometry, cytochemistry and light scattering.
A 45-year-old Scandinavian woman with white hair appears older than her age. She complains to her physician of weakness, a tingling sensation in her lower extremities, and shortness of breath. Her CBC results are as follows: WBC 3.4 X 109/L; RBC 1.9 X 1012/L; HGB 86 g/L; HCT 0.25 L/L; MCV 132 fL; MCHC 34.4 g/dL; platelet count 100 X109/L. Cabot rings are noted on the peripheral smear. The clinical and laboratory findings are most consistent with - Liver disease - Pernicious anemia - Folic acid deficiency - Aplastic anemia
pernicious anemia
A blood specimen reveals 97% hemoglobin A, 2% hemoglobin A 2, and 1% hemoglobin F. The next step is to: - recollect the specimen - perform kleihauer- Betke stain - send out the report - quantitate hemoglobin A2 by column chromatography
send out the report
Which of the following stains is specific for phospholipids? - peroxidase - sudan black B - periodic acid-Schiff (PAS) - prussian blue
sudan black b
A screening test for paroxysmal nocturnal hemoglobinuria is the - Immunophenotyping - Sugar-water test - Acidified serum test - All of the above
sugar water test
