Hematology
Of the following, the disease most closely associated with cytoplasmic granule fusion is: a. Chédiak-Higashi syndrome b. Pelger-Huet anomaly c. May-Hegglin anomaly d. Alder-Reilly anomaly
a. Chédiak-Higashi syndrome
Of the following, the disease most closely associated with glucocerebrosidase deficiency is: a. Gaucher's disease b. Chédiak-Higashi syndrome c. Pelger-Huet anomaly d. May-Hegglin anomaly
a. Gaucher's disease
A 40-year-old man had an erythrocyte count of 2.5 x l06/uL, hematocrit of 22%, and a reticulocyte count of 2.0%. Which of the following statements best describes his condition? a. The absolute reticulocyte count is 50 x 103/uL, indicating that the bone marrow is not adequately compensating for the anemia. b. The reticulocyte count is greatly increased, indicating an adequate bone marrow response for this anemia. c. The absolute reticulocyte count is 500 x l03/uL, indicating that the bone marrow is adequately compensating for the anemia. d. The reticulocyte count is slightly increased, indicating an adequate response to the slight anemia.
a. The absolute reticulocyte count is 50 x 103/uL, indicating that the bone marrow is not adequately compensating for the anemia.
Plasma from a patient with lupus coagulation inhibitor can show: a. a prolonged APTT and normal PT b. may exhibit bleeding tendencies c. no change with platelet neutralization d. complete correction when incubated with normal plasma
a. a prolonged APTT and normal PT
Prothrombin is: a. a protein formed by the liver in the presence of vitamin K b. an enzyme that converts fibrinogen into fibrin threads c. the end product of the reaction between fibrinogen and thrombin d. a protein released by platelets during coagulation
a. a protein formed by the liver in the presence of vitamin K
Platelet satellitosis is usually due to: a. abnormal proteins b. inadequate mixing of blood and anticoagulant c. hemorrhage d. poorly made wedge smear
a. abnormal proteins
A 54-year-old man was admitted with pulmonary embolism and given streptokinase. Which of the following would be most useful in monitoring this therapy? a. activated partial thromboplastin time b. bleeding time c. prothrombin time d. thrombin time
a. activated partial thromboplastin time
Most childhood leukemias are: a. acute lymphocytic b. acute monocytic c. chronic myelocytic d. chronic lymphocytic
a. acute lymphocytic
Specific (secondary) granules of the neutrophilic granulocyte: a. appear first at the myelocyte stage b. contain lysosomal enzymes c. are formed on the mitochondria d. are derived from azurophil (primary) granules
a. appear first at the myelocyte stage
Which of the following measures platelet function? a. bleeding time b. prothrombin time c. thrombin time d. partial thromboplastin time
a. bleeding time
Which of the following platelet responses is most likely associated with classic von Willebrand's disease? a. decreased platelet aggregation to ristocetin b. normal platelet aggregation to ristocetin c. absent aggregation to epinephrine, ADP, and collagen d. decreased amount of ADP in platelets
a. decreased platelet aggregation to ristocetin
In polycythemia vera, the hemoglobin, hematocrit, red blood cell count, and red cell mass are: a. elevated b. normal c. decreased
a. elevated
A patient with thalassemia minor characteristically has a(n): a. elevated A2 hemoglobin b. low fetal hemoglobin c. high serum iron d. normal red cell fragility
a. elevated A2 hemoglobin
What completes the circuit between the stationary and the moving electrodes in the fibrometer? a. fibrin strand b. cam sensing device c. third electrode d. turbidity of reaction
a. fibrin strand
If a clot incubated at 37°C dissolves within 24 hours, which of the following should be suspected? a. fibrinolysins b. low fibrinogen level c. Factor VIII deficiency d. thrombocytopenia
a. fibrinolysins
Which of the following is characteristic of Bernard-Soulier syndrome? a. giant platelets b. normal bleeding time c. abnormal aggregation with ADP d. increased platelet count
a. giant platelets
Acute disseminated intravascular coagulation is characterized by: a. hypofibrinogenemia b. thrombocytosis c. negative D-dimer d. shortened thrombin time
a. hypofibrinogenemia
When using an electronic cell counter, which of the following results can occur in the presence of a cold agglutinin? a. increased MCV and decreased RBC b. increased MCV and normal RBC c. decreased MCV and increased MCHC d. decreased MCV and RBC
a. increased MCV and decreased RBC
Biochemical abnormalities characteristic of polycythemia vera include: a. increased serum B12 binding capacity b. hypouricemia c. hypohistaminemia d. decreased leukocyte alkaline phosphatase activity
a. increased serum B12 binding capacity
The Philadelphia chromosome is formed by a translocation between the: a. long arm of chromosome 22 and long arm of chromosome 9 b. long arm of chromosome 21 and long arm of chromosome 9 c. long arm of chromosome 21 and long arm of chromosome 6 d. long arm of chromosome 22 and long arm of chromosome 6
a. long arm of chromosome 22 and long arm of chromosome 9
Which of the following cells is the largest cell in the bone marrow: a. megakayocyte b. histiocyte c. osteoblast d. mast cell
a. megakayocyte
Which of the following is associated with Chédiak-Higashi syndrome? a. membrane defect of lysosomes b. Döhle bodies and giant platelets c. two-lobed neutrophils d. mucopolysaccharidosis
a. membrane defect of lysosomes
Which of the following is a characteristic of Factor XII deficiency? a. negative bleeding history b. normal clotting times c. decreased risk of thrombosis d. epistaxis
a. negative bleeding history
Which of the following are found in association with megaloblastic anemia? a. neutropenia and thrombocytopenia b. decreased LD activity c. increased erythrocyte folate levels d. decreased plasma bilirubin levels
a. neutropenia and thrombocytopenia
The most appropriate screening test for hereditary spherocytosis is: a. osmotic fragility b. sucrose hemolysis c. heat instability test d. Kleihauer-Betke
a. osmotic fragility
Peripheral blood smears from patients with untreated pernicious anemia are characterized by: a. pancytopenia and macrocytosis b. pancytopenia and leukocytosis c. leukocytosis and ovalocytosis d. pancytopenia and microcytosis
a. pancytopenia and macrocytosis
Decreased to normal erythropoietin production is most likely to be associated with: a. polycythemia vera b. polycythemia, secondary to hypoxia c. relative polycythemia associated with dehydration d. polycythemia associated with renal disease
a. polycythemia vera
Aspirin affects platelet function by interfering with platelets' metabolism of: a. prostaglandins b. lipids c. carbohydrates d. nucleic acids
a. prostaglandins
Elevation of the lymphocyte percentage above 47% is termed: a. relative lymphocytosis b. absolute lymphocytosis c. leukocytosis d. absolute neutrophilic leukocytosis
a. relative lymphocytosis
Supravital staining is important for reticulocytes since the cells must be living in order to stain the: a. remaining RNA in the cell b. iron before it precipitates c. cell membrane before it dries out d. denatured hemoglobin in the cell
a. remaining RNA in the cell
A phase-platelet count was performed and the total platelet count was 356,000/uL. Ten fields on the stained blood smear were examined for platelets and the results per field were: 16, 18, 15, 20, 19, 17, 19, 18, 20, 16 The next step would be to: a. report the phase-platelet count since it correlated well with the slide b. repeat the phase-platelet count on a re-collected specimen and check for clumping c. check 10 additional fields on the blood smear d. repeat the platelet count using a different method
a. report the phase-platelet count since it correlated well with the slide
Higher levels of employee motivation occur when supervisor: a. sets goals to be accomplished b. provides all the details of the task c. constantly monitors progress d. immediately corrects every error
a. sets goals to be accomplished
A red blood cell about 5 um in diameter that stains bright red and shows no central pallor is a: a. spherocyte b. leptocyte c. microcyte d. macrocyte
a. spherocyte
What is the MCHC if the hematocrit is 20%, the RBC is 2.4 x 106/uL, and the hemoglobin is 5 g/dL? a. 21% b. 25% c. 30% d. 34%
b. 25%
The atypical lymphocyte seen in the peripheral smear of patients with infectious mononucleosis is reacting to which of the following? a. T lymphocytes b. B lymphocytes c. monocytes d. mast cells
b. B lymphocytes
Which of the following is associated with May-Hegglin anomaly? a. membrane defect of lysosomes b. Döhle bodies and giant platelets c. chronic myelogenous leukemia d. mucopolysaccharidosis
b. Döhle bodies and giant platelets
A patient has a history of mild hemorrhagic episodes. Laboratory results include a prolonged prothrombin time and activated partial thromboplastin time. The abnormal prothrombin time was corrected by normal and adsorbed plasma, but not aged serum. Which of the following coagulation factors is deficient? a. prothrombin b. Factor V c. Factor X d. Factor VII
b. Factor V
Which of the following factor deficiencies is associated with either no bleeding or only a minor bleeding tendency, even after trauma or surgery? a. Factor X b. Factor XII c. Factor XIII d. Factor V
b. Factor XII
Of the following, the disease most closely associated with granulocyte hyposegmentation is: Hematology 227 a. May-Hegglin anomaly b. Pelger-Huet anomaly c. Chédiak-Higashi syndrome d. Gaucher's disease
b. Pelger-Huet anomaly
Which of the following is a true statement about acute idiopathic thrombocytopenic purpura (ITP)? a. It is found primarily in adults. b. Spontaneous remission usually occurs within several weeks. c. Women are more commonly affected. d. Peripheral destruction of platelets is decreased.
b. Spontaneous remission usually occurs within several weeks.
Which of the following coagulation factors is considered to be labile? a. II b. V c. VII d. X
b. V
Evidence indicates that the genetic defect in thalassemia usually results in: a. the production of abnormal globin chains b. a quantitative deficiency in RNA resulting in decreased globin chain production c. a structural change in the heme portion of the hemoglobin d. an abnormality in the alpha or beta chain binding or affinity
b. a quantitative deficiency in RNA resulting in decreased globin chain production
A 20-year-old woman with sickle cell anemia whose usual hemoglobin concentration is 8 g/dL develops fever, increased weakness, and malaise. The hemoglobin concentration is 4 g/dL and the reticulocyte count is 0.1%. The most likely explanation for this clinical picture is: a. increased hemolysis due to hypersplenism b. aplastic crisis c. thrombotic crisis d. occult blood loss
b. aplastic crisis
The most frequent type of acute lymphocytic leukemia (ALL) is: a. T-cell childhood b. common childhood c. B-cell childhood d. undifferentiated childhood
b. common childhood
The following results were obtained on an electronic particle counter: -WBC: 6.5x103/uL -RBC: 4.55 x 106/uL -Hgb: 18.0 g/dL -Hct: 41.5% -MCV: 90.1 fL -MCH: 39.6 pg -MCHC: 43.4% The first step in obtaining valid results is to: a. perform a microhematocrit b. correct the hemoglobin for lipemia c. dilute the blood d. replace the lysing agent
b. correct the hemoglobin for lipemia
If a blood smear is dried too slowly, the red blood cells are often; a. clumped b. crenated c. lysed d. destroyed
b. crenated
Which of the following sets of laboratory findings is consistent with hemolytic anemia? a. normal or slightly increased erythrocyte survival; normal osmotic fragility b. decreased erythrocyte survival; increased catabolism of heme c. decreased serum lactate dehydrogenase activity; normal catabolism of heme d. normal concentration of haptoglobin; marked hemoglobinuria
b. decreased erythrocyte survival; increased catabolism of heme
Which of the following will not cause erroneous results when using a phase optical system for enumerating platelets? a. incipient clotting b. decreased hematocrit c. Howell-Jolly bodies d. leukocyte cytoplasmic fragments
b. decreased hematocrit
The hypoproliferative red cell population in the bone marrow of uremic patients is caused by: a. infiltration of bone marrow by toxic waste products b. decreased levels of circulating erythropoietin c. defective globin synthesis d. overcrowding of bone marrow space by increased myeloid precursors
b. decreased levels of circulating erythropoietin
The M:E ratio in acute granulocytic leukemia is usually: a. normal b. high c. low d. variable
b. high
The M:E ratio in chronic granulocytic leukemia is usually: a. normal b. high c. low d. variable
b. high
A patient has pancytopenia, decreased total serum iron, and decreased serum iron-binding capacity, and shows a homogeneous fluorescence pattern with a high titer on a fluorescent antinuclear antibody test. This is suggestive of: a. polycythemia vera b. lupus erythematosus c. iron deficiency anemia d. hemoglobin SC disease
b. lupus erythematosus
In an uncomplicated case of infectious mononucleosis, which of the following cells are affected? a. erythrocytes b. lymphocytes c. monocytes d. thrombocytes
b. lymphocytes
The cell series most readily identified by a positive Sudan black B is: a. erythrocytic b. myelocytic c. plasmocytic d. lymphocytic
b. myelocytic
The first step in the determination of functional antithrombin III (AT III) is to: a. neutralize plasma antithrombin b. neutralize thrombin with test plasma c. incubate plasma with anti-AT III d. precipitate AT III with plasma
b. neutralize thrombin with test plasma
The granules of Alder-Reilly anomaly will stain positively with: a. Sudan black B b. periodic acid-Schiff c. myeloperoxidase d. naphthol-AS-D chloroacetate esterase
b. periodic acid-Schiff
Which of the following cell types is characteristic of Pelger-Huet anomaly? a. band form b. pince-nez form c. normal neutrophil d. myelocyte
b. pince-nez form
Which of the following types of polycythemia is most often associated with emphysema? a. polycythemia vera b. polycythemia, secondary to hypoxia c. relative polycythemia associated with dehydration d. polycythemia associated with renal disease
b. polycythemia, secondary to hypoxia
The main function of the hexose monophosphate shunt in the erythrocyte is to: a. regulate the level of 2, 3-DPG b. provide reduced glutathione to prevent oxidation of hemoglobin c. prevent the reduction of heme iron d. provide energy for membrane maintenance
b. provide reduced glutathione to prevent oxidation of hemoglobin
Which of the following characteristics are common to hereditary spherocytosis, hereditary elliptocytosis, hereditary stomatocytosis, and paroxysmal nocturnal hemoglobinuria? a. autosomal dominant inheritance b. red cell membrane defects c. positive direct antiglobulin test d. measured platelet count
b. red cell membrane defects
A citrated blood specimen for coagulation studies is to be collected from a polycythemic patient. The anticoagulant should be: a. the standard volume b. reduced in volume c. changed to EDTA d. changed to oxalate
b. reduced in volume
A phase-platelet count is performed using a red cell pipet. 155 platelets are counted on one side of the hemacytometer in the red cell counting area, and 145 are counted on the other side in the same area. After making the appropriate calculations, the next step would be to: a. repeat the procedure, using a 1:20 dilution in a white cell pipet b. report the calculated value c. collect a new specimen d. repeat the procedure, using a 1:200 dilution in the red cell pipet
b. report the calculated value
Polychromatic red cells when stained with a supravital stain are called: a. siderocytes b. reticulocytes c. schistocytes d. spherocytes
b. reticulocytes
An automated platelet count is 15 x 103/uL. The technologist should: a. phone result to physician immediately b. review peripheral smear c. report count d. repeat collection
b. review peripheral smear
The characteristic morphologic feature in multiple myeloma is: a. cytotoxic T cells b. rouleaux formation c. spherocytosis d. macrocytosis
b. rouleaux formation
The most appropriate screening test for paroxysmal nocturnal hemoglobinuria is: a. heat instability test b. sucrose hemolysis c. osmotic fragility d. dithionite solubility
b. sucrose hemolysis
Which of the following is the formula for mean corpuscular volume (MCV)? a. (Hgb x 10)/RBC b. Hgb/Hct c. (Hct x 10)/RBC d. RBC/Hct
c. (Hct x 10)/RBC
A patient develops unexpected bleeding and the following test results were obtained: -Prolonged PT and APTT -Decreased fibrinogen -Increased fibrin split products -Decreased platelets What is the most probable cause of these results? a. familial afibrinogenemia b. primary fibrinolysis c. DIC d. liver disease
c. DIC
A 56-year-old woman was admitted to the hospital with a history of a moderate to severe bleeding tendency of several years' duration. Epistaxis and menorrhagia were reported. Prolonged APTT was corrected with fresh normal plasma, adsorbed plasma, and aged serum. Deficiency of which of the following is most likely? a. Factor XII b. Factor VIII c. Factor XI d. Factor IX
c. Factor XI
A patient has a normal prothrombin time and a prolonged activated partial thromboplastin time (APTT) using a kaolin activator. The APTT corrects to normal when the incubation time is increased. These results suggest that the patient has: a. hemophilia A (Factor VIII deficiency) b. Hageman factor (XII) deficiency c. Fletcher factor deficiency (prekallikrein) d. Factor V deficiency
c. Fletcher factor deficiency (prekallikrein)
A 15-year-old girl is taking primaquine for a parasitic infection and notices her urine is a brownish color. A CBC shows mild anemia. The laboratorian performing the reticulocyte count notices numerous irregular shaped granules near the periphery of the RBC. These cellular inclusions are most likely: a. Howell-Jolly bodies b. basophilic stippling c. Heinz bodies d. Pappenheimer bodies
c. Heinz bodies
Which one of the following statements concerning vitamin K is NOT true? a. There are two sources of vitamin K: vegetable and bacterial b. Vitamin K converts precursor molecules into functional coagulation factors c. Heparin inhibits the action of vitamin K d. Vitamin K is fat soluble
c. Heparin inhibits the action of vitamin K
The most appropriate screening test for detecting hemoglobin F is: a. osmotic fragility b. dithionite solubility c. Kleihauer-Betke d. heat instability test
c. Kleihauer-Betke
Of the following, the disease most closely associated with pale blue inclusions in granulocytes and giant platelets is: a. Gaucher's disease b. Alder-Reilly anomaly c. May-Hegglin anomaly d. Pelger-Huet anomaly
c. May-Hegglin anomaly
A platelet count done by phase microscopy is 200 x 103/uL (normal, 150-450 x 103/uL). A standardized template bleeding time on the same person is 15 minutes (normal, 4.5 ± 1.5 minutes). This indicates that: a. the Duke method should have been used for the bleeding time b. the manual platelet count is in error c. abnormal platelet function should be suspected d. the results are as expected
c. abnormal platelet function should be suspected
A leukocyte count and differential on a 40-year-old white man revealed: WBC 5.4 x 103/uL Differential Segs 20% Lymphs 58% Monos 20% Eos 2% These data represent: a. absolute lymphocytosis b. relative neutrophilia c. absolute neutropenia d. leukopenia
c. absolute neutropenia
Increased levels of TdT activity are indicative of: a. Burkitt's lymphoma b. acute granulocytic leukemia c. acute lymphocytic leukemia d. eosinophilia
c. acute lymphocytic leukemia
The bone marrow in the terminal stage of erythroleukemia is often indistinguishable from that seen in: a. myeloid metaplasia b. polycythemia vera c. acute myelocytic leukemia d. aplastic anemia
c. acute myelocytic leukemia
The peripheral blood monocyte is an intermediate stage in the formation of the: a. plasmacyte b. Turk irritation cell c. histiocyte d. hairy cell
c. histiocyte
A deficiency of protein C is associated with which of the following? a. prolonged activated partial thromboplastin time (APTT) b. decreased fibrinogen level (less than 100 mg/dL) c. increased risk of thrombosis d. spontaneous hemorrhage
c. increased risk of thrombosis
A term that means varying degrees of leukocytosis with a shift to the left and occasional nucleated red cells in the peripheral blood is: a. polycythemia vera b. erythroleukemia c. leukoerythroblastosis d. megaloblastoid
c. leukoerythroblastosis
Cells that produce antibodies and lymphokines are: a. erythrocytes b. granulocytes c. lymphocytes d. thrombocytes
c. lymphocytes
Which of the following is true of acute lymphoblastic leukemia (ALL)? a. occurs most commonly in children 1-2 years of age b. patient is asymptomatic c. massive accumulation of primitive lymphoid-appearing cells in bone marrow occurs d. children under 1 year of age have a good prognosis
c. massive accumulation of primitive lymphoid-appearing cells in bone marrow occurs
Precursors of tissue macrophages of the reticuloendothelial system most likely are: a. T lymphocytes b. B lymphocytes c. monocytes d. mast cells
c. monocytes
Which of the following is characteristic of platelet disorders? a. deep muscle hemorrhages b. retroperitoneal hemorrhages c. mucous membrane hemorrhages d. severely prolonged clotting times
c. mucous membrane hemorrhages
Dwarf or micromegakaryocytes may be found in the peripheral blood of patients with: a. pernicious anemia b. DIC c. myelofibrosis with myeloid metaplasia d. chronic lymphocytic leukemia
c. myelofibrosis with myeloid metaplasia
Which of the following is associated with pseudo-Pelger-Huet anomaly? a. aplastic anemia b. iron deficiency anemia c. myelogenous leukemia d. Chédiak-Higashi syndrome
c. myelogenous leukemia
Anemia secondary to uremia characteristically is: a. microcytic, hypochromic b. hemolytic c. normocytic, normochromic d. macrocytic
c. normocytic, normochromic
The anemia found in myeloproliferative disorders is usually: a. microcytic, hypochromic b. macrocytic, normochromic c. normocytic, normochromic d. microcytic, normochromic
c. normocytic, normochromic
The stain that identifies intracellular carbohydrate, glycogen, mucopolysaccharide, mucoprotein, glycoprotein, and glycolipid is: a. Sudan black B b. leukocyte alkaline phosphatase (LAP) c. periodic acid-Schiff (PAS) d. peroxidase
c. periodic acid-Schiff (PAS)
In the APTT test, the patient's plasma is mixed with: a. ADP and calcium b. tissue thromboplastin and collagen c. phospholipid and calcium d. tissue thromboplastin and calcium
c. phospholipid and calcium
The ideal capillary blood collection site on a newborn is: a. tip of the thumb b. ear lobe c. plantar surface of the heel d. the great toe
c. plantar surface of the heel
Five preoperative and control samples for APTT had prolonged times when run on an optical density coagulation instrument. The results for patients and controls were confirmed by using an alternate method of mechanical detection. Which of the following would best explain these results? a. incorrect anticoagulant used b. sample carryover c. reagent contamination d. improperly reconstituted controls
c. reagent contamination
Which of the following types of polycythemia is a severely burned patient most likely to have? a. polycythemia vera b. polycythemia, secondary to hypoxia c. relative polycythemia associated with dehydration d. polycythemia associated with renal disease
c. relative polycythemia associated with dehydration
The laboratory tests performed on a patient indicate macrocytosis, anemia, leukopenia, and thrombocytopenia. Which of the following disorders is the patient most likely to have? a. iron deficiency b. hereditary spherocytosis c. vitamin B12 deficiency d. acute hemorrhage
c. vitamin B12 deficiency
Which of the following is the formula for mean corpuscular hemoglobin (MCH)? a. Hct/(RBC x 1000) b. Hgb/Hct c. RBC/Hct d. (Hgb x 10)/RBC
d. (Hgb x 10)/RBC
To prepare 25 mL of 3% acetic acid, how much glacial acetic acid is needed? a. 7.5 mL b. 3.0 mL c. 1.5 mL d. 0.75 mL
d. 0.75 mL
Which of the following anomalies is an autosomal dominant disorder characterized by irregularly sized inclusions in polymorphonuclear neutrophils, abnormal giant platelets, and often thrombocytopenia? a. Pelger-Huët b. Chédiak-Higashi c. Alder-Reilly d. May-Hegglin
d. May-Hegglin
Thrombocytopenia is a characteristic of: a. classic von Willebrand's disease b. hemophilia A c. Glanzmann's thrombasthenia d. May-Hegglin anomaly
d. May-Hegglin anomaly
Which of the following is associated with Glanzmann's thrombasthenia? a. normal bleeding time b. normal ADP aggregation c. abnormal initial wave ristocetin aggregation d. absence of clot retraction
d. absence of clot retraction
Hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) is: a. temperature-dependent b. complement-independent c. antibody-mediated d. caused by a red cell membrane defect
d. caused by a red cell membrane defect
Which of the following are characteristic of polycythemia vera? a. elevated urine erythropoietin levels b. increased oxygen affinity of hemoglobin c. teardrop" poikilocytosis d. decreased or absent bone marrow iron stores
d. decreased or absent bone marrow iron stores
In infectious mononucleosis, lymphocytes tend to be: a. small with little cytoplasm b. normal c. decreased in number d. enlarged and indented by surrounding structures
d. enlarged and indented by surrounding structures
Many microspherocytes and schistocytes and budding off of spherocytes can be seen on peripheral blood smears of patients with: a. hereditary spherocytosis b. disseminated intravascular coagulation (DIC) c. acquired autoimmune hemolytic anemia d. extensive bums
d. extensive bums
A 60-year-old man has a painful right knee and a slightly enlarged spleen. Hematology results include: -Hemoglobin 15 g/dL -Absolute neutrophil count 10.0 x 103/uL -Platelet count 900 x 103/uL -Uncorrected retic count 1% -Normal red cell morphology and indices -A slight increase in bands -Rare metamyeloctye and myelocyte -Giant and bizarre-shaped platelets These results are most compatible with: a. congenital spherocytosis b. rheumatoid arthritis with reactive thrombocytosis c. myelofibrosis d. idiopathic thrombocythemia
d. idiopathic thrombocythemia
Which of the following is typical of polycythemia vera? a. increased serum iron concentration b. decreased thrombocyte count c. increased erythropoietin d. increased leukocyte alkaline phosphatase activity
d. increased leukocyte alkaline phosphatase activity
Which of the following is NOT a characteristic usually associated with hairy cell leukemia? a. pancytopenia b. mononuclear cells with ruffled edges c. splenomegaly d. increased resistance to infection
d. increased resistance to infection
Heparin acts by: a. precipitating calcium b. binding calcium c. activating plasmin d. inhibiting thrombin
d. inhibiting thrombin
Which of the following is NOT a characteristic of hemoglobin H? a. it is a tetramer of beta chains b. it is relatively unstable and thermolabile c. electrophoretically, it represents a "fast" hemoglobin d. its oxygen affinity is lower than that of Hgb A
d. its oxygen affinity is lower than that of Hgb A
Which of the following is most useful in differentiating hemophilias A and B? a. pattern of inheritance b. clinical history c. activated partial thromboplastin time d. mixing studies (substitution studies)
d. mixing studies (substitution studies)
In which of the following disease states are teardrop cells and abnormal platelets most characteristically seen? a. chronic myelocytic leukemia b. multiple myeloma c. thalassemia d. myeloid metaplasia
d. myeloid metaplasia
In synovial fluid, the most characteristic finding in rheumatoid arthritis is: a. cartilage debris b. monosodium urate crystals c. hemosiderin-laden macrophages d. neutrophils with 0.5- to 1.5-um inclusions
d. neutrophils with 0.5- to 1.5-um inclusions
Which of the following platelet responses is most likely associated with hemophilia A (Factor VIII deficiency)? a. defective ADP release; normal response to ADP b. decreased amount of ADP in platelets c. absent aggregation to epinephrine, ADP, and collagen d. normal platelet aggregation
d. normal platelet aggregation
A patient has a tumor that concentrates erythropoietin. He is most likely to have which of the following types of polycythemia? a. polycythemia vera b. polycythemia, secondary to hypoxia c. benign familial polycythemia d. polycythemia associated with renal disease
d. polycythemia associated with renal disease
All of the findings listed below may be seen in acquired hemolytic anemias of the autoimmune variety. The one considered to be the MOST characteristic is: a. increased osmotic fragility b. leukopenia and thrombocytopenia c. peripheral spherocytosis d. positive direct antiglobulin test
d. positive direct antiglobulin test
Which of the following is the most common cause of an abnormality in hemostasis? a. decreased plasma fibrinogen level b. decreased Factor VIII level c. decreased Factor IX level d. quantitative abnormality of platelets
d. quantitative abnormality of platelets
The automated platelet count on an EDTA specimen is 58 x 103/pL. The platelet estimate on the blood smear appears normal, but it was noted that the platelets were surrounding th neutrophils. The next step should be to: a. report the automated platelet count since it is more accurate than a platelet estimate b. warm the EDTA tube and repeat the automated platelet count c. rerun the original specimen since the platelet count and blood smear estimate do not match d. re-collect a specimen for a platelet count using a different anticoagulant
d. re-collect a specimen for a platelet count using a different anticoagulant
An automated platelet count indicates platelet clumping, which is confirmed by examining the smear. The technician should: a. repeat the count on the same sample b. report the automated count c. perform a manual count d. re-collect in sodium citrate
d. re-collect in sodium citrate
On setting up the electronic particle counter in the morning, one of the controls is slightly below the range for the MCV. Which of the following is indicated? a. call for service b. adjust the MCV up slightly c. shut down the instrument d. repeat the control
d. repeat the control
A patient has a high cold agglutinin titer. Automated cell counter results reveal an elevated MCV, MCH, and MCHC. Individual erythrocytes appear normal on a stained smear, but agglutinates are noted. The appropriate course of action would be to: a. perform the RBC, Hgb, and Hct determinations using manual methods b. perform the RBC determination by a manual method; use the automated results for the Hgb and Hct c. repeat the determinations using a microsample of diluted blood d. repeat the determinations using a prewarmed microsample of diluted blood
d. repeat the determinations using a prewarmed microsample of diluted blood
In von Willebrand's disease, platelets give an abnormal aggregation result in the presence of: a. adenosine diphosphate b. epinephrine c. collagen d. ristocetin
d. ristocetin
A characteristic morphologic feature in hemoglobin C disease is: a. macrocytosis b. spherocytosis c. rouleaux formation d. target cells
d. target cells
A useful chemical test for the diagnosis of hairy-cell leukemia is the: a. peroxidase test b. Sudan black B test c. periodic acid-Schiff test d. tartrate-resistant acid phosphatase test
d. tartrate-resistant acid phosphatase test
When evaluating a smear for a reticulocyte count, the technician observes that the red blood cells are overlapping throughout the entire slide. The most likely explanation is: a. grease on the slide prevented even spreading b. improper proportions of blood and stain were used c. the slide was dried too quickly d. the drop used for the slide preparation was too large
d. the drop used for the slide preparation was too large
