Hematology MLT Cert practice

The large blue staining cells represented in the photomicrographs comprise 50% of the total white blood cell count. Which of the following conditions is this peripheral blood picture most consistent with?

infectious mononucleosis

all of the following are associated with hereditary spherocytosis, except

intravascular hemolysis

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

it will return to a normal biconcave shape

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

Hb H

Which of the following inclusions, marked by the arrow, is seen on this smear made with a supravital stain?

Heinz bodies

A known case of hemolytic disease of the newborn (HDN) is presented in the image on the right. Many different cellular morphologies are present. Apart from the obvious anisocytosis (microcytes and macrocytes), which additional red blood cell morphologies are worth reporting?

Nucleated red blood cells, spherocytes, polychromatophilic cells, Howell-Jolly bodies

what is the predominant abnormal RBC shape seen in this illustration

acanthocyte

What is the composition of basophilic stippling?

aggregation of ribosomes

What term can be used to describe the abnormal variation in the size of the red blood cells seen in this image

anisocytosis

What is the precursor of the platelet which is, in most cases, only found in the bone marrow?

megakaryocyte

In which of the following conditions are Cabot rings most likely to be observed on a Wright-stained peripheral blood smear?

megaloblastic anemia

the presence of an increased number of hypersegmented neutrophils in the peripheral blood, as shown in this image, is an indication of which of the following conditions?

megaloblastic anemia

phagocytosis is a function of which of the following types of cells?

monocytes

Identify the predominant nucleated cell in this cerebrospinal fluid cytospin differential.

nRBCs

How many 1 mm x 1 mm squares is the Neubauer hemacytometer counting grid composed of?

nine per side

Which of the following is a clinical symptom that is associated with thrombocytopenia?

peticiae

Which of the following tests would be most affected by microclots in an EDTA tube drawn for a CBC?

platelet count

A peripheral blood smear with many myeloid cells was presented for morphology review (see image on the right). Toxic granulation and vacuoles in the neutrophil most likely represent which of the following conditions?

septicemia

In flow cytometry, the granularity of a cell is indicated by which of the following?

side scatter

methylene blue stain works by:

staining cellular components that have an acidic pH such as ribosomes, DNA, and RNA

All of the following would be situations where you would typically find an increase in eosinophils, EXCEPT?

Viral infections

Which of the following is considered to be the stain of choice for evaluation of a peripheral blood smear to include red cell morphology as well as a white cell differential count?

Wright

The appropriate magnification for a manual RBC cell count using a hemocytometer is which of the following?

40X (Dry)

How many large hemacytometer squares contain a total volume of 1 µL (microliter) of fluid?

10

What is the corrected white blood cell count if the WBC is 14,460, and there were 47 nucleated red blood cells per 100 white blood cells noted on the differential count?

9837

What is one of the main characteristics of secondary granules in the neutrophilic granulocyte cytoplasm?

Appear first at the myelocyte stage

What are the abnormal red blood cells (RBCs) indicated by the arrows that may be suggestive of an individual possessing the Rh null phenotype?

stomatocytes

which of the following statements about macrocytes is true

the cells are typically larger than a resting lymphocytes

What is the identity of the white blood cell inclusions present in this image?

toxic granulation

this image is of a peripheral blood smear from a patient with what condition

toxic granulation caused by bacterial infection

What cellular characteristic of red blood cells is described by the term poikilocytosis?

variability in shape

increased numbers of the cells indicated by the arrows can be associated with which of these conditions?

viral meningitis

Which laboratory procedure may be used to assist in differentiating chronic myelocytic leukemia (CML) from a leukemoid reaction?

LAP stain

The photomicrograph is a representative field from a peripheral blood smear. Which of the following MCV values correlates best with the peripheral blood picture?

105 fL

Auer rods are most commonly present in which of the following conditions?

AML

All of the following CD makers are present on a normal mature T cell except? CD 20 CD 7 CD 3 CD5

CD20

A 68-year-old woman presents with pressure under the lower left ribs from a swollen spleen but is not complaining of any other symptoms. Her laboratory data showed the following Hgb = 13.5 g/dL Hct = 40% Platelets = 240 x 10^9 /L WBC count = 46 x 10^9 /L Diff: 45% PMNs, 2% Lymphs, 6% Eos, 2% Baso, 35% myelocytes, 10% metamyelos LAP = 11 What is the most likely disease present based on the laboratory findings

Chronic Myelogenous Leukemia

What are Howell-Jolly bodies composed of?

DNA

What are the expected results of the laboratory markers in iron deficiency anemia?

Decreased serum iron, increased transferrin, decreased ferritin, decreased percent saturation, and increased total iron-binding capacity.

When performing controls for the morning run in coagulation, the normal control is within acceptable limits for both the PT and APTT, but the abnormal control is out of range for both procedures. Which of the following would be an appropriate action to take?

Document QC, repeat the abnormal control, troubleshoot if necessary; report patient results only when both controls are within acceptable ranges

What is the correct procedure when using a winged collection device (butterfly) to draw a light-blue top tube intended for a coagulation test if this is the first tube that will be collected in the draw?

Draw and discard a waste light-blue top tube before the tube that will be used for coagulation studies.

Which of the following will cause a falsely increased erythrocyte sedimentation rate?

ESR tube is slanted

Which coagulation pathway is factor VII part of?

Extrinsic

which of the followng factors is Vitamin K-dependent

Factor IX

which of the following conditions will show an increased prothrombin time with a normal activated thromboplastin time?

Factor VII deficiency

Hemophilia A is associated with a deficiency of which of the following?

Factor VIII

All of the following tests will be abnormal in a patient with Stuart-Prower Factor deficiency EXCEPT?

Fibrinogen

Which of the following conditions is associated with the defective erythrocytes that are indicated by the arrows in this image?

G6PD

A quick mathematical check which can be applied to verify that the hemoglobin and hematocrit values on a complete blood count correspond with each other would be:

Hemoglobin X 3 = hematocrit

A teenage boy is visiting his doctor under the suspicion of a viral illness. He has always been relatively healthy without many illness-related complaints. The doctor decides to order a laboratory workup including a complete blood count. A peripheral blood smear is reviewed. The image on the right is a representative field, with a predominance of the arrowed cells throughout the smear. Which of the following conditions would be most consistent with this patient's history and peripheral blood picture?

Hereditary elliptocytosis

what cell population is gated in this peripheral blood sample case analyzed by flow cytometry

Lymphocytes

A technologist is evaluating the red blood cell morphology on a peripheral blood smear. The image on the right is a representative field from the smear. How should the technologist describe the red blood cell morphology?

Macrocytic, normochromic

Which of the following terms could be used to describe this picture?

Lymphocytosis

All of the following methods are used to detect and differentiate white blood cells in most hematology analyzers, EXCEPT?

Lysis of white cells with subsequent conversion to cyanmethemoglobin followed by spectrophotometric determination

which of the following RBC indices is expressed in femtoliters

MCV

Which of the following set of results would be consistent for a patient with the following findings: macrocytosis, anemia, leukopenia, and thrombocytopenia?

MCV 115 fL; Hgb 7.5 g/dL; WBC 2.5 x 103/µL; Platelets 75,000/µL

Which of the marrow cells from the list below has highly granular basophilic cytoplasm but does not show nuclear lobules?

Mast cell

What is the correct order of erythrocyte maturaton in the bone marrow? (beginning from the most immature)

Pronormoblast, basophilic normoblast, polychromatophilic normoblast, orthochromic normoblast, polychromatophilic erythrocyte

When scanning a Wright's stained blood smear, which of the following would describe the optimum area to begin your blood smear analysis and differential white blood cell count?

RBCs are lying singly, barely touching, with occasional overlapping.

What would be the next step when an EDTA specimen had an automated platelet count of 61,000/mm3 and the platelets were surrounding the neutrophils on the differential?

Recollect a specimen for a platelet count without using EDTA

Which of the following descriptions best describes the term absolute value as it would relate to leukocyte differential counts

Relative % of each cell type multiplied by total white count

How would you describe the arrangement of RBCs on this slide ?

True rouleaux

The diagnostic value of the reticulocyte count in the evaluation of anemia is that it determines the:

Response and ability of the bone marrow to compensate for the anemia

which of the following disorders or diseases is associated with coarse basophilic stippling

lead poisoning

T lymphocytes are characterized by all of the following functions EXCEPT which?

Synthesize antibody

What is the predominant abnormal erythrocyte morphology associated with idiopathic myelofibrosis?

Teardrop Cells

which of the following conditions would have macrocytic red cells

liver disease and vitamin B12 deficiency

All of the following bones contain active hematopoietic bone marrow in a normal adult, EXCEPT?

Tibia

Which of the following conditions/findings is most likely associated with the peripheral blood picture in the photomicrograph?

Transfusion dimorphism

pelger-huet anomaly is characterized by which of the following

bilobed or round nuclei in neutrophis

A manual white blood cell count was performed by the hematology technologist. The cell counts for both sides were 99 and 164, respectively. All nine large squares were counted on each side. The dilution for this kit was pre-measured at 1:100. What should the technologist report as the white cell count?

cannot report

Which ethnic group has the highest incidence of hereditary hemochromatosis in the United States?

caucasians

This image represents a field of red blood cells (RBCs) stained using a supravital stain. How would these cells appear if viewed on a Wright-stained smear?

polychromatophilic RBCs

chat are the cells that are indicated by the arrows in this slide?

stomatocytes

The site most frequently used to collect bone marrow samples from adults is:

posterior iliac crest

This photo shows the bone marrow aspirate of a patient with a history of fatigue and petechiae. The CBC from the peripheral blood would confirm:

decreased RBCs platelets and WBCs

all of the following are known causes of aplastic anemia except?

enzyme deficiencies

which of the following terms could be used to describe the red blood cells in this field

hypochromic

Which hemoglobin, when elevated, acts as a protection against sickling in patients with HbS?

hemoglobin F

A 5-year-old girl was brought to the emergency department with bloody diarrhea and severe abdominal pain. A complete blood count produced these results: CBC ParameterPatient ResultReference IntervalWBC9.6 x 109/L4.3 - 10.8 x 109/LHemoglobin9.1 g/dL11.5 - 13.5 g/dLHCT28%37 - 48%MCV80 fL86 - 98 fLRDW13.111 - 15Platelets90.1 x 109/L150 - 450 x 109/L The peripheral blood smear is represented in the image to the right. Which of the following condition(s) could be present in this patient when considering the information above and the cells indicated by the arrows on the peripheral smear?

hemolytic uremic syndrome (HUS)

spherocytes are associated with which of the following conditions

immune hemolytic anemia

Calculate the red cell indices from the following set of patient data: RBC count = 5.22 x 1012/L Hemoglobin = 17.5 g/dL Hematocrit = 53%

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

A 49-year-old male with pneumonia was treated with high-dose intravenous penicillin. He became jaundiced with yellow sclera. The image on the right is typical of other fields that were observed on his peripheral blood smear. Since penicillin may, in some individuals, cause autoimmune hemolytic anemia, the clinician requested a direct antiglobulin test (DAT) be performed. The DAT was positive, indicating that antibodies to the drug were produced, which were then attached to the drug on the surface of the red cells. Hemolysis occurred due to the drug-induced antibody attachment, leaving the patient with various abnormal red blood cell morphologies. Which of the following cell types would you report for this patient?

Spherocytes, nucleated red blood cells, polychromatophylic red blood cells

which of the following would describe hypochromia?

decreased hemoglobin concentration in RBCs

which of the following options best describes how hemophilia A differs from hemophilia B

factor VIII is deficient in hemophilia A and factor IX is deficient in hemophilia B

An automated hematology counter flagged the white blood cell count. Upon reviewing the peripheral blood smear, the technologist viewed many cells that appeared similar to those in this image. What should the technologist report?

reactive/atypical lymphocytes