HEME QUIZ#2

Coverslip smears from a bone marrow fragment called a spicule

What type of preparation is preferred for bone marrow aspirates?

Aspirate is a dry tap

For which of the following is obtaining a bone marrow core biopsy mandatory?

between 13.6 and 14.0 g/dL

A clinical laboratory scientist performs 30 replicate hemoglobin determinations on a single blood sample. When statistics are used to determine the precision of the method, the mean is 13.8 g/dL and 1 SD is 0.1 g/dL. This means that 95.5% of the results on this specimen lie:

Acute myelomonocytic leukemia

A patient has a very high white blood cell count with many blasts in the blood and bone marrow. Esterase stains using both napthol AS-D chloroacetate and α-napthyl acetate esterase as substrates are both positive. What condition is likely?

Severe bacterial infection

A patient has a white blood cell count of 35 x 10^9 /L with a left shift. The leukocyte alkaline phosphatase stain is 220 (normal range 22-100). Which of the following is most likely?

Enzymes, Lipids, Glycogen

Cytochemical procedure stain what cellular elements?

Megakaryocytes

Low power (x10) is used to count and evaluate which of the following?

Wright

What stain is most commonly used for bone marrow aspirates?

Acute myeloid leukemia from acute lymphoblasitc leukemia

Sudan black is used to distinguish which types of leukemia?

Hairy cells

Tartrate-resistant acid phosphatase is strongly positive in which of the following cells?

Inaccurate

A patient specimen is analyzed on an instrument known to be in control from percious assays performed on a calibrated instrument and gives a hemoglobin result of 13.2 g/dL. Two hours later it is evaluated on another instrument that is being evaluated for purchase by the laboratory. The result is 11.8 g/dL. This result, when compared with the first, is:

Precision

A patient's white blood cells (WBCs) are counted on an automated cell counter 10 times. The mean white cell count is 8000/mL, and the standard deviation (SD) is 300. What is the coefficient of variation (CV)? What does the CV calculated above describe about the white cell counts?

3.8%

A patient's white blood cells (WBCs) are counted on an automated cell counter 10 times. The mean white count is 8000/mL, and the standard deviation (SD) is 300. What is the coefficent of variation (CV)?

Calibrator

A purchased hemoglobin standard is used to adjust a hemoglobinometer. This standard is being used as a:

Rerun the control and if acceptable continue with patients

One of two controls that have been evaluated over the last 28 days gives a result on day 29 between 2 and 3 SDs of the mean; the other control is within 2 SDs of its mean. What is the correct procedure to follow?

Counting the differential

The best use for bone marrow aspirate smears is:

Shift

The control values for both controls for the prothombin test were ranging between the mean and ±1 SD for the first 19 days of use. Starting on day 20, the values for both were consistently between +1 and +2 SDs. This is an example of a:

Abnormal, more red cell precursors than normal

The myeloid-to-erythroid (M:E) ratio of a bone marrow is 1:1. Select the correct interpretation.

Distal ends of the long bones

The sites of active red marrow differ for adults and young children. Which one site is active in children but not in adults?

Core biopsy

What bone marrow sample is best to determine fat-to-cell ratio and overall cellularity, as well as for searching for malignant cells?

Malignant lymphoblasts

What cells may demonstrate a coarse block pattern of activity with the PAS stain?

Posterior iliac crest

What is the most common site for bone marrow aspiration in an adult?

Are ranges of values for an analyte in normal healthy people

Which of the following is true regarding reference ranges?

Unexpected pancytopenia

Which of the following would be a valid indication for performing a bone marrow aspiration?

Auer rods

Which of the following would stain most strongly for myeloeroxidase?