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