BOC Hematology

What condition might have symptoms of lethargy, glossitis, and muscle dysfunction?

Fe deficiency anemia

Name a disease not associated with a dysfunction of PMNs.

Gaucher's disease

An alpha thalassemia patient is diagnosed as having three of four genes deleted which code for alpha hemoglobin chains. Which type of hemoglobin is abnormal and would be found in such a patient?

Hb H

Normal adult HbG composition?

HbA >90% HbA2 <3,5% HbF <1-2%

Formulas for MCHC and HgB concentration?

HgB (g/dL) x100/Hct (%)

Hbg% in sickle cell patient:

HgB A=60% HgB S=38% HgB A2=2% HgB F=0@

Nitric oxide is associated with the prevention of vaso-occlusion by decreasing cellular adherence to endothelium. Which amino acid in decreased in patients with sickle cell disease and is needed as a substrate to produce nitric oxide?

L-arginine

What info can you provide from the RBC indices if an instrument is down?

MCHC only

What test results might be consistent for a patient with the following findings: macrocytosis, anemia, leukopenia, and thrombocytopenia?

MCV 115 fL Hgb 7.5 g/dL WBC 2.5x10 3/uL Platelets 75,000/uL

Calculate data set: RBC count: 5,22 x 10 12/L HbG: 17.5 g/dL Hct: 53%

MCV=102fL MCH=34 pg MCHC=33g/dL

After several incidneces of deep vein thrombosis, a patient is assessed for hypercoagulability. What would an appropriate panel for hypercoaglability screening?

PT, aPTT, LA screeing, APC, d-dimer screening

What lab test is used to monitor oral anticoagulant therapy?

PT/INR

A defect in which factor causes impaired platelet adhesion and aggregation?

Von Willebrand factor

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

WBCs

Screening test used to assess functionality of both intrinsic and extrinsic and common pathways?

aPTT

What lab result is characteristic for a patient with Von Willebrand disease?

abnormal platelet aggregation response to ristocetin

Following stain rxns were resulted on a suspected case of leaukemia: Myeloperoxidase: + Sudan Black B: + Chloroacetate Esterase: + Nonspecific Esterase: -

acute myelocytic leukemia

Alder-Reilly inclusions may be found in which cell types?

all types of mature white blood cells

Acquired hemophilia A may be the result of what?

anti-factor VIII inhibitor

In most cases of Fanconi anemia, what type of anemia develops?

aplastic

What is not a cause of an abnormal TT?

aspirin

Toxic granulation is seen most frequently in?

bacterial infections

What describes a beta thalassemia genotype b+/b?

beta thalassemia minor

Pelger-Huet anomaly is characterized by what?

bilobed or round nuclei in neutrophils(hypersegmented)

A low platelet count, along with a low WBC count and RBC count is caused by:

bone marrow hypoplasia

A small child has albino characteristics, photophobia, frequent pyogenic infections, and blood smear show giant dark granules in the monocytes and granulocytes. Probable diagnosis?

chediak-hegashi syndrome

Which of the following smear techniques has the advantage of providing the best WBC distribution when performed correctly?

coverslip technique

Alpha thalassemia:

decrease in rate of production of alpha chains due to a partial or total deletion of genetic code

What set of results is indicative of stage 3 iron deficiency?

decreased ferritin increased sTfR increased TIBC

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

defective glycoprotein ib/IX

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

delta-beta thalassemia major

HgB=6.7 Hct= 20% Platelets=355 x 10 9 RBC=3.0 x 10 12 WBC=8.75 x 10 9

dietary iron deficiency

Which coag pathway is factor VII part of?

extrinsic

What factor may be deficient if both the PT and aPTT are prolonged?

factor II

Hemophilia B or Christmas disease is the result of a hereditary deficiency in which coagulation factor?

factor IX

What assay is commonly used to confirm the diagnosis of activated protein C resistance?

factor V Leiden Mutation Assay

What factor requires vitamin K for synthesis in liver?

factor VII

Which of the following factors doesn't affect the result of the aPTT assay?

factor VII

What condition shows increased PT with a normal aPTT?

factor VII deficiency

What does warfarin not inhibit?

factor XI

The fibrin clot begins to form when fibrinogen is cleaved resulting in a fibrin monomer, fibrinopeptideb A, B fragments. The fibirn monmers spontaneously polymerize due to H bonding, and then are covalently linked to fibrin polymers by which factors?

factor XIII

What is the most responsible for increasing the ESR?

fibrinogen

Which test is not abnormal with Stuart-Prower Factor deficiency?

fibrinogen

D-dimer is useful in detecting which aspect of homeostasis?

fibrinolysis

What is associated with macrosytic anemia?

fish tapeworm

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

flow cytometry

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?

folic acid deficiency

What is the term that describes the process by which fibrin strands are broken down and the removed form an established clot?

fribrinolysis

Patient with a history of mucocutaneous bleeding: PT 12 sec APTT 26 sec BT 18 min ADP abnormal Thrombin abnormal Collagen abonormal Ristocetin normal

glanzmann thromasthenia

What is not an important protein regulator of Fe metabolism?

hemosiderin

What contribute to low serum iron levels seen in persons with anemia of chronic disease?

hepcidin

The autohemolysis test is most useful in the diagnosis of?

hereditary spherocytosis

What genetic description will not contain Bart's hemoglobin at birth?

heterozyhous alpha thalassemia-2

What lab test isn't used to distinguish CML from PV?

hypercellular bone marrow

Which test result will be normal in a patient with dysvibrinogenemia?

immunologic fribrinogen level

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 is plasma sample

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

induces increased production of HbF

What condition could result in microsytic anemia?

iron deficiency

The first time a cell containing HbSS is deoxygenated, it forms a sickle cell. Upon reoxygenation, what is true of the sickle cell?

it will return to a normal biconcave shape

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

it would increase

If a patient's WBC is 50,000/mm3, what test should be ordered to determine if this is a leukemoid rxn or a chronic myelocytic leukemia?

leukocyte alkaline phosphatase stain

Platelets don't aid coagulation by?

lower bp by releasing heparin

Which of the following is considered one of the most common coagulation inhibitors?

lupus anticoagulant

RBC morphology characteristic of megaloblastic anemia?

macrocytic

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

megaloblastic anemia

To determine if an elevated aPTT is caused by a factor deficiency or a factor inhibitor when the PT is normal, the 1st step would be?

mix one part patient plasma and one part normal pooled plasma and repeat the aPTT

Esterase stains are used to help differentiate what from what?

monoblast from myeloblast

After briefly circulating in the peripheral blood, what cell becomes a tissue macrophage whose main function is phagocytosis?

monocyte

RAEB is classified under which category?

myelodysplastic syndromes

How many 1mmx1mm is the Neubauer hemacytometer counting grid composed of?

nine per side

You are running QC for HA1C by HPLC. The high control was 2.5 SD above the mean. The low control was 2.2 SD below the mean. Should you continue to run patient samples?

no, QC values indicate a violation of the R4S rule and should be rejected

How are Barr bodies usually classified?

non-pathogenical

The nucleus of a small lymphocyte is about the same size as a:

normal erythrocyte

What cell is found in numerous numbers in primary myelofibrosis?

nucleated RBCs

What is associated with thrombocytopenia?

petechiae

What procedure utilizes luekaphereisis to collect the buffy coat from whole blood?

photopheresis

What cell is found in plasma cell leukemia?

plasma cell

3-year old has recurring conjunctivitis along with woody growths on mucous membranes. Which deficiency is this?

plasminogen

A patient has a history of repeated spontaneous abortion. Coagulation studies reveal an elevated APTT, normal PT, normal platelet function, and normal thrombin time. Schistocytes were seen on the peripheral blood smear. Which test should be performed to determine if the patient has lupus anticoagulant?

platelet neutralization test

What is the best method for examination of synovial crystals?

polarized light

Which potent inhibitor of platelet aggregation is released by endothelial cells?

prostacyclin

What cell is found in infectious mononucleosis?

reactive/variant lymph

Ristocetin is used in certain vWF functional assays. Reason is:

restocetin enhances binding of vWF to platelet GPlba

Difference between megaloblasitc and nonmegaloblastic anemia in RBC morphology:

round macrocytes in nonmegaloblastic anemia

Anemia formed due to the inability to incorporate in into the protoporphyrin ring?

sideroblastic anemia

What test is not included in many of the major HgB variants?

sodium metabisulfate solubility test

What abnormal RBC is associated with hyperchromia?

spherocyte

What chemical test is useful for the diagnosis of hairy cell leukemia?

tartrate-resistant acid phosphatase test

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

thromboxane A2

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

vacuoles

12-year old girl exhibited a fever, lethargy, and a stiff neck. WBC count was 2000/microliter.

viral meningitis

What is the genotype associated with alpha thalassemia minor?

-a/-a

A semen sample for analysis should generally be received at the testing site within what period of time?

1 hr

Normal M/E ratio for adults when assessing bone marrow aspirate smear?

2.5:1

Ref range for Hct for adult male?

40-52%

The appropriate magnification for a manual RBC cell count using a hemocytometer is what?

40X (dry)

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

50%

Newborns who will develop Hb H disease may demonstrate up to 30% of what type of Hb?

Bart's

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

Bart's

Which subset of effector lymphocytes is predominantly responsible for regulation of antibody production?

TH2