Hematology - Physiology
114. Which statement best describes the relationship between dietary iron and iron absorption in a healthy individual? A. Only a small percentage of dietary iron is absorbed and used. B. All dietary iron is needed for hemoglobin synthesis and therefore absorbed. C. Most people need to take dietary iron supplements to meet their needs for iron. D. All dietary iron is absorbed and excess is stored.
A
56. Which of the following cells are of lymphoid lineage? A. Plasma cell B. Macrophage C. Eosinophil D. Megakaryocyte
A
82. All of the following are considered to be important protein regulators of iron metabolism, EXCEPT? A. Hemosiderin B. Hepcidin C. Transferrin receptor D. Ferroportin
A
84. What is the cause of iron overload in hereditary hemochromatosis? A. Absorption of excessive amounts of iron in the small intestine B. Ingestion of excessive amounts of iron from diet or supplements C. Inability of the body to excrete normal amounts of dietary iron D. Failure of developing red blood cells to incorporate iron into protoporphyrin IX
A
99. Which of the following leukocytes is most directly associated with antibody production? A. B-Cell B. T-Cell C. Neutrophil D. NK Cell
A
101. Where is the main site of action for monocytes after diapedesis? A. Peripheral blood B. Body tissues C. Bone marrow D. Digestive tract
B
106. Basophils' primary role involves: A. Phagocytosis B. Allergic reactions C. Long term immunity D. Fighting parasitic infections
B
109. All of the cells listed below function as a phagocyte, EXCEPT? A. Neutrophil B. Eosinophil C. Monocyte D. Macrophage
B
2. The bone marrow begins producing cells in the _____________ month of fetal life. A. First B. Fourth C. Sixth D. Eighth
B
3. In which organ or tissue do T-lymphocytes mature? A. Bone marrow B. Thymus C. Lymph nodes D. Spleen
B
36. Which of the following stages of neutrophilic granulocyte cellular development is at the second stage from the least mature stage? A. Band neutrophil B. Promyelocyte C. Metamyelocyte D. Myeloblast
B
38. The radioactive method used to measure red cell survival uses which of the following isotopes? A. I125 B. 51Cr C. P31 D. 14C
B
48. What are Howell-Jolly bodies composed of? A. Hemoglobin B. DNA C. Iron D. RNA
B
52. From the white blood cell values listed below, which is within the normal reference ranges? A. 3,700/mm3 B. 4,000/mm3 C. 5,500/mm3 D. 15,000/mm3
C
77. What is the main function of erythrocytes? A. To fight off infection. B. To assist in the coagulation process. C. To transport oxygen from the lungs to the tissues and carbon dioxide from the tissue to the lungs to be expelled. D. To transport nutrients, hormones, nitrogenous waste, and electrolytes among other substances.
C
80. What is the approximate percentage of individuals in the US who are heterozygous for HFE mutations for hereditary hemochromatosis? A. 0.05% to 0.10% B. 1% to 2% C. 10% to 12% D. 20% to 25%
C
10. The bone marrow begins to produce blood cells in the ________ month of gestation. A. First B. Second C. Fourth D. Seventh
D
102. What are function(s) of the platelet? A. Clotting and plug formation B. Maintain vascular integrity C. Release serotonin D. Clotting, plug formation, release of serotonin, and repair of the injured tissues.
D
11. The following polypeptide chains are found in normal adult hemoglobin A: A. Alpha and gamma B. Alpha and delta C. Beta and delta D. Alpha and beta
D
111. What is the main function of the hexose monophosphate shunt in red blood cells (RBC's)? A. Regulate the level of 2,3-DPG B. Protect hemoglobin from oxidation via NADH C. Provide ATP D. Provide NADPH and reduced glutathione to prevent oxidation of hemoglobin
D
28. Which of the following hemoglobins is replaced by hemoglobin H (HbH) after birth in individuals with HbH disease? A. Constant Spring B. A2 C. Lepore D. Bart's
D
98. Which of these blood levels will decrease during intravascular hemolysis? A. Serum (plasma) LDH B. Serum (plasma) bilirubin C. Reticulocytes D. Haptoglobin
D
1. Which of the following globin genes are found on Chromosome 11? A. Beta, gamma, epsilon B. Beta, epsilon, alpha C. Gamma, epsilon, zeta D. Alpha, zeta
A
100. After briefly circulating in the peripheral blood, which of the following cells becomes a tissue macrophage (or histiocyte) whose main function is phagocytosis? A. Monocyte B. Basophil C. Neutrophil D. Plasma cell
A
103. Which of the following statements about monocyte function is INCORRECT? A. Monocytes are white blood cells that are actively phagocytic in the peripheral blood. B. Monocytes are white blood cells that are actively phagocytic in the body tissues. C. Monocytes are white blood cells that can continue to develop into macrophages. D. Monocytes are white blood cells that play an important role in inflammatory diseases
A
107. The mediator cell type that binds to IgE antibodies is the: A. Basophil B. Eosinophil C. Polymorphonuclear neutrophil (PMN) D. Macrophage
A
108. What is the main function of leukocytes? A. To fight off infection. B. To assist in the coagulation process. C. To transport oxygen from the lungs to the tissues and carbon dioxide from the tissue to the lungs to be expelled. D. To transport nutrients, hormones, nitrogenous waste, and electrolytes among other substances.
A
110. The granules that basophils contain are composed of: A. Histamine B. Serotonin C. Myeloperoxidase D. Alkaline phosphatase
A
22. Which of the following statement is INCORRECT regarding the bone marrow biopsy specimen? A. Bone marrow cellularity can be accurately determined B. Cellular morphologic detail can be determined. C. Bone marrow architecture can be examined D. Prussian blue staining could be used to evaluate iron stores, and diagnosis of anemia.
B
44. Which of the following represent other hemoglobin gene loci that occur on the same chromosome as the beta chain loci? A. Alpha and delta B. Delta and gamma C. Gamma and zeta D. Zeta and epsilon
B
67. Which of the following causes schistocyte formation in disseminated intravascular coagulation (DIC)? A. Degranulation of promyelocytes B. Excessive fever in patients with DIC C. Microthrombi disposition in small vessels D. Excessive platelet size
C
73. Eosinophilia is commonly found in which of the following disorder? A. Pernicious anemia B. Liver disease C. Parasitic infections D. Infectious mononucleosis
C
76. Which of the following lymphoid cells have the capability of spontaneous cytotoxicity of various target cells? A. Cytotoxic T cells (TC) B. Helper T cells (TH) C. Natural killer cells (NK) D. B cells
C
68. Which of the following is LEAST likely to stimulate the production of reactive lymphocytes? A. Staphylococcus aureus B. Cytomegalovirus (CMV) C. Epstein-Barr virus D. Toxoplasma gondii
A
78. The MOST accurate observation about osmotic pressure is that it is: A. Proportional to concentration of solute particles B. Equal to number of solvent molecules times a factor C. Measurable by how much it raises the freezing point of water D. Directly proportional to the inverse log of solvent molecules
A
74. Basophils' primary role involves: A. Phagocytosis B. Initiation of allergic inflammation C. Long term immunity D. Antibody production
B
8. The average bone marrow cellularity in a normal adult (50 years old) is: A. 30 B. 50 C. 65 D. 70
B
49. Which white blood cell is found in the largest numbers in the peripheral blood of a normal adult? A. Lymphocyte B. Monocyte C. Basophil D. Segmented neutrophil
D
5. Regarding hemoglobin synthesis, which of the following constitutes the alpha globin chain coding? A. Two gene loci; one each on chromosome 11. B. Four gene loci; two each on chromosome 11. C. Two gene loci; one each on chromosome 16. D. Four gene loci; two each on chromosome 16.
D
50. To produce hemoglobin S (HbS), glutamic acid that is normally present in the sixth position on the beta globin chain is substituted with which of the following? A. Cystine B. Guanine C. Thyamine D. Valine
D
72. The primary purpose of neutrophil granules is to: A. Facilitate nuclear maturation. B. Help distinguish neutrophils from lymphocytes. C. Prepare cells for removal from circulation. D. Provide microbicidal action.
D
81. Which of the following statements is TRUE regarding lymphocyte cytoplasmic granules? A. Lymohocytes never contain granules in the cytoplasm. B. Lymphocytes contain fine primary or non-specific granules in the cytoplasm. C. Lymphocytes contain large secondary or specific granules in the cytoplasm. D. Lymphocytes may contain a few azurophilic granules in the cytoplasm
D
89. Which of the following represents the best match of cell type with function? A. Eosinophils - humoral immunity B. Neutrophils - mediate inflammatory responses C. T lymphocytes - cell mediated immunity D. Monocytes - protect against parasitic infections
C
91. How long are healthy neutrophils expected to reside in the peripheral blood of an adult? A. 3 days B. 1 day C. 7-8 hours D. 12-14 hours
C
96. Which of the following is a mechanism known to cause platelet satellitosis (satellitism)? A. An antibody directed against factor VIII B. An antibody directed against von Willebrand factor (vWF) C. An antibody directed against the platelet membrane D. An antibody directed against fibrinogen
C
86. All of the following characteristics describe T lymphocytes EXCEPT? A. CD4 & CD 8 positive B. Production of surface immunoglobulins C. Production of cytokines and chemokines D. Recruitment of inflammatory cells to site of inflammation or infection
B
92. T lymphocytes are characterized by all of the following functions EXCEPT which? A. Secrete cytokines B. Synthesize antibody C. Comprise majority of cells in blood lymphocyte pool D. Help regulate immune response
B
93. Which potent inhibitor of platelet aggregation is released by endothelial cells? A. Epinephrine B. Prostacyclin C. Ristocetin D. Thromboxane A2
B
94. What is the main function of thrombocytes? A. To fight off infection. B. To assist in the coagulation process. C. To transport oxygen from the lungs to the tissues and carbon dioxide from the tissues to the lungs to be expelled. D. To transport nutrients, hormones, nitrogenous waste, and electrolytes among other substances.
B
95. What is the primary function of hemoglobin? A. Bind with free iron stores B. Carry oxygen to tissues C. Carry carbon dioxide to tissues D. Carry oxygen to lungs
B
18. An assessment of the myeloid to erythroid (M:E) ratio is part of every bone marrow evaluation. Which of the following does not apply to the M:E ratio? A. The erythroid total used in calculating the M:E ratio is the sum of all the nucleated red cell precursors. B. The myeloid total used in calculating the M:E ratio is the sum of all non-RBC cell types found in the marrow. C. White blood cells used in the myeloid tally/total used to calculate the M:E ratio include neutrophil precursors as well as eosinophil precursors and basophil precursors. D. The M:E should always be interpreted in context with the overall bone marrow cellularity.
B
71. All of the following methods can be used to transport carbon dioxide to the lungs EXCEPT: A. Blood plasma B. Attached to neutrophils C. Bound to hemoglobin in the RBC D. In solution within the RBC
B
83. Which of the following is characteristic of Alder-Reilly anomaly? A. Giant, dysfunctional lysosomal cytoplasmic granules B. Döhle body-like inclusions composed of precipitated myosin heavy chains C. Large, darkly staining cytoplasmic granules composed of partially digested mucopolysaccharides D. Decreased nuclear segmentation and coarse chromatin in leukocytes
C
87. Agranulocytes include the following types of white blood cells (leukocytes): A. Monocytes and neutrophils B. Monocytes and eosinophils C. Lymphocytes and monocytes D. Lymphocytes and neutrophils
C
104. Eosinophils are increased in all of the following conditions EXCEPT? A. Parasitic infections B. Allergic reactions C. Viral infections D. Inflammatory reactions
C
105. What is the lower reference limit for progressive motility of spermatozoa when performing a semen analysis? A. 12% B. 22% C. 32% D. 40%
C
113. Each of the following has been shown to induce platelet aggregation EXCEPT? A. Epinephrine B. ADP C. Aspirin D. Collagen
C
12. Which of the following is responsible for the humoral immune response: A. Neutrophils B. Basophils C. B lymphocytes D. Monocytes
C
16. All of the following are sites of active hematopoiesis in the adult EXCEPT: A. Skull B. Ribs C. Liver D. Pelvis
C
14. Aspirin ingestion prevents the synthesis of this signaling molecule in the platelet? A. Thromboxane A2 B. Calcium C. Collagen D. ADP
A
66. A yellow coloration found in fresh cerebrospinal fluid supernatant is termed: A. Xanthochromia B. Hemolysis C. Jaundice D. Hyperlipidemia
A
70. Which of the following phenotypes is most indicative of a natural killer (NK) cell? A. CD2+ CD3+ CD5+ CD7+ B. CD2+ CD3- CD11b+ CD16+ C. CD11b+ CD16+ CD33+ CD56- D. CD19+ CD20+ CD22+ CD57-
B
85. All of the following activities are associated with platelets EXCEPT: A. Aggregation B. Adhesion C. Lysis D. Release of granules
C
15. What would you predict is the effect on iron absorption if erythopoietic activity is increased over a prolonged period of time? A. It would increase. B. It would decrease. C. It would remain the same. D. It is impossible to predict.
A
20. What is the cause of iron overload in hereditary hemochromatosis? A. Absorption of excessive amounts of iron in the small intestine B. Ingestion of excessive amounts of iron from diet or supplements C. Inability of the body to excrete normal amounts of dietary iron D. Failure of developing red blood cells to incorporate iron into protoporphyrin IX
A
21. Which of the following is the proper designation for the pluripotential stem cell that is a precursor for both myeloid and lymphoid cell lines? A. CFU-S B. CFU-GEMM C. G-CSF D. CFU-GM
A
33. In an adult, hematopoiesis occurs in which of the following listed sites? A. Liver B. Spleen C. Pancreas D. Proximal ends of long bones
D
23. A bone marrow biopsy from a 50-year-old patient that has an overall cellularity of 20% (i.e., 80% fat and 20% hematopoietic cells) is considered: A. Normocellular B. Hypocellular C. Hypercellular D. Monocellular
B
24. Which of the following statements is correct regarding bone marrow evaluation? A. Bone marrow cellularity increases with age. B. Bone marrow cellularity is highest in young children compared to adults. C. In a healthy person, the expected myeloid : erythroid ratio is less than 1 (one). D. As we age, the amount of adipose tissue (fat) decreases.
B
27. The presence of red blood cells with fine basophilic stippling and polychromatophilic red cells are associated with which of the following conditions? A. Lead poisoning B. Increased red cell production C. There are no abnormalities on this slide D. Decreased red blood cell production
B
41. Adult (normal) Hemoglobin is made up of the following composition: A. >90% HbA, 1% HbA2, 5% HbF B. >95% HbA, <3.5% HbA2, <1-2% HbF C. <90% HbA, 10% HbA2, 5% HbF D. >90% HbA, 1% HbA2, 5-10% HbF
B
54. Which of the following statements are true for the hematopoietic cords? A. Hematopoietic cells develop at random locations in the marrow cells B. Reticular cells (adventitial cells) provide support for developing hematopoietic cells within the hematopoietic cords C. Lymphocytes are not seen in normal marrow D. Fat cells content of bone marrow decrease with aging
B
57. The percentage of red blood cells in whole blood is called: A. Hemoglobin B. Hematocrit C. Hemostasis D. Hemopoiesis
B
69. A normal hemoglobin molecule is comprised of the following: A. Ferrous iron and four globin chains B. Four heme and four globin chains C. Four heme and one globin chains D. One heme and four globin chains
B
46. What is the normal cellularity of an iliac crest bone marrow biopsy in a 50-year-old male: A. 20% B. 35% C. 50% D. 65%
C
60. How long is the normal lifespan of an erythrocyte? A. 24 hours B. 10 days C. 120 days D. 200 days
C
35. Erythropoietin is mainly produced in: A. Bone marrow B. Bones C. Lymphocytes D. Kidneys
D
75. Which of the following statements is true regarding macrophages (histiocytes)? A. It is a form of lymphocyte that is capable of cell lysis. B. It is a type of monocyte that has entered the tissues via diapedesis. C. It is a cell found in tissues with numerous basophilic granules in the cytoplasm. D. It is a type of eosinophil that has immunoglobulins on the surface to recognize invading parasites.
B
13. What is the composition of the granules associated with basophilic stippling? A. Aggregates of iron B. Aggregates of hemoglobin C. Aggregates of ribosomes D. Aggregates of DNA
C
17. What is the normal ratio of erythroid to myeloid cells found in the normal bone marrow? A. 1:1 - 2:1 B. 1:5 C. 1:3 D. 1:10
C
19. All of the following are present in normal bone marrow EXCEPT? A. Siderocyte B. Sideroblast C. Ringed sideroblast D. Hemosiderin
C
29. What is the precursor of the platelet which is commonly only found in the bone marrow? A. Myeloblast B. Promegakarocyte C. Megakaryocyte D. Erythroblast
C
31. Which of the following is an expected or common laboratory finding in patients with hereditary hemochromatosis (HH)? A. Elevated hemoglobin and hematocrit B. Decreased transferrin saturation C. Presence of HFE mutation D. Decreased serum ferritin
C
40. Whole blood if composed of approximately: A. 75% formed elements and 25% plasma B. 60% formed elements and 40% plasma C. 45% formed elements and 55% plasma D. 30% formed elements and 70% plasma
C
42. Effusion fluids are classified as transudates or exudates. According to Light's criteria, all of the following is applicable to an exudate EXCEPT? A. Pleural fluid/serum protein ratio >0.5 B. Pleural fluid/serum lactate dehydrogenase (LDH) ratio >0.6 C. Pleural fluid lactate dehydrogenase (LDH) <2/3 the normal upper limit for serum D. Serum-ascites albumin gradient (SAGG) <1.1 g/dL
C
112. How does Aspirin (salicylic acid) affect platelet function? A. Inhibiting cyclooxygenase B. Activates lipids C. Inhibiting carbohydrates D. Activating nucleic acid
A
25. What is the normal myeloid to erythroid (M:E) ratio in the bone marrow? A. 2:1 - 4:1 B. 1:2 - 1:4 C. 3:1 - 5:1 D. 5:1 -10:1
A
26. Out of the choices below, which set of cells is arranged from least mature to most mature? A. Stem Cell, Rubriblast, Prorubricyte, Rubricyte, Metarubricyte, Reticulocyte, Erythrocyte B. Stem Cell, Prorubricyte, Metarubricyte, Erythrocyte, Rubriblast, Rubricyte, Reticulocyte C. Erythrocyte, Reticulocyte, Metarubricyte, Rubricyte, Prorubricyte, Rubriblast, Stem Cell D. Rubricyte, Rubriblast, Stem Cell, Prorubricyte, Erythrocyte, Reticulocyte, Metarubrictye
A
30. Which of the following statements is correct regarding the bone marrow compartments? A. The two main compartments of the bone marrow are the vascular sinuses and hematopoietic cords. B. The two main compartments of the bone marrow are the vascular sinuses and blood vessels. C. Erythropoiesis in the bone marrow occurs in all areas of the marrow. D. A unique bone marrow microenvironment is not necessary for hematopoiesis.
A
32. What is the expected life span of a normal red blood cell? A. 3-4 months B. 1-2 months C. 3-6 weeks D. 1-3 weeks
A
115. During phagocytosis by a neutrophil, the granules which fuse with the phagosome (phagocytic vacuole) can contain all of the following EXCEPT: A. Lysozyme B. Myeloperoxidase C. Lactoferrin D. Lactase
D
97. Pluripotential stem cells are capable of producing which of the following? A. Only T-lymphocyte and B-lymphocyte subsets B. Erythropoietin, thrombopoietin, and leukopoietin C. Lymphoid and myeloid stem cells D. Daughter cells from only a single cell line
C
34. What morphologically abnormal red blood cell is associated with "hyperchromia"? A. Spherocyte B. Macrocyte C. Microcyte D. Target cell
A
51. Which of the following is NOT a way hemoglobinopathies can be caused? A. Deletion of a globin chain. B. Substitution of amino acids in a globin chain. C. Deletion of an amino acid in a globin chain. D. Addition of an amino acid in a globin chain.
A
53. B lymphocytes and T lymphocytes are derived from: A. Hematopoietic stem cells B. Macrophages or monocytes C. Mucosa-associated lymphoid tissue (MALT) D. Granulocytes
A
6. What is the platelet precursor cell found in the bone marrow? A. Megakaryocyte B. Megaloblast C. Myeloblast D. Pronormoblast
A
61. What causes the hemolysis associated with infection by malaria organisms? A. Multiplication of merozoites within erythrocytes B. Invasion of erythrocytes by sporozoites C. Host's immunologic response to damaged erythrocytes D. Toxins produced by the malarial organisms
A
79. All of the following statements describe a method by which platelets aid coagulation EXCEPT: A. Lower blood pressure by releasing heparin B. Catalyze coagulation by releasing Platelet Factor 3 C. Cause blood vessels to constrict by releasing serotonin D. Form a plug to stop the flow of blood
A
63. All of the following conditions are associated with hereditary spherocytosis, EXCEPT? A. Increased osmotic fragility B. An MCHC greater than 37% C. Intravascular hemolysis D. Extravascular hemolysis
C
65. When red blood cells hemolyze, what is the molecule released that will give the plasma its reddish appearance? A. Sodium B. Potassium C. Hemoglobin D. Glucose
C
55. All of the following bones contain active hematopoietic bone marrow in a normal adult, EXCEPT? A. Pelvis B. Sternum C. Tibia D. Vertebrae
C
39. Which of the following are terms used to describe storage pool iron? A. Hemosiderin and myoglobin B. Ferritin and hemosiderin C. Hemopectin and hemoglobin D. Apoferritin and transferrin
B
47. Which of the following major cellular elements does not develop solely in the bone marrow? A. Monocyte B. Neutrophil C. Lymphocyte D. Macrophage
C
62. What RBC morphology on a Wright-stained smear may indicate the presence of an unstable hemoglobin? A. Acanthocytes B. Codocytes C. Schistocytes D. Xerocytes
C
43. If greater than 50% lymphocytes were found on the peripheral blood smear of a 5 month old child you would suspect which of the following conditions? A. Immune deficiency syndrome B. Acute viral infection C. Normal finding D. Infectious hepatitis
C
45. What is the correct order of erythrocyte maturaton in the bone marrow? (beginning from the most immature) A. Polychromatophilic normoblast, basophilic normoblast, polychromatophilic erythrocyte, orthochromic normoblast, pronormoblast B. Orthochromic normoblast, basophilic normoblast, polychromatophilic normoblast, polychromatophilic erythrocyte, pronormoblast C. Pronormoblast, basophilic normoblast, polychromatophilic normoblast, orthochromic normoblast, polychromatophilic erythrocyte D. Pronormoblast, basophilic normoblast, polychromatophilic erythrocyte, orthochromic normoblast, polychromatophilic normoblast
C
37. In which developmental stage do red blood cells begin forming hemoglobin in amounts large enough to be visualized on a Wright-stained bone marrow aspirate smear? A. Reticulocyte B. Pronormoblast C. Basophilic normoblast D. Polychromatic normoblast
D
4. In which of the following situations would a bone marrow aspirate and biopsy be MOST LIKELY recommended to aid in diagnosis? A. Primary evaluation of a hypochromic/microcytic anemia B. Routine screening for hematologic complications C. Part of bone density screening D. Evaluation of unexplained cytopenias
D
58. The production of and development of blood cells is called: A. Hemoglobin B. Hematocrit C. Hemostasis D. Hemopoiesis
D
59. The gene loci for the alpha globin chains are adjacent to the locus for which other globin chain? A. Beta B. Delta C. Epsilon D. Zeta
D
64. Degenerated erythrocyte cytoplasmic organelles that contain iron are called: A. Cabot rings B. Howell-Jolly bodies C. Heinz bodies D. Pappenheimer bodies
D
7. Which of the following is NOT considered necessary for making a diagnosis of hereditary hemochromatosis (HH)? A. Laboratory evidence of iron overload B. Genetic mutations associated with HH C. Clinical signs and symptoms consistent with HH D. A positive family history
D
88. The granules of Basophil contain which of the following? A. Antihistamine B. IgE C. The contents of helminth digestion D. Initiators of allergic inflammation
D
9. Which of the following cells is the most common nucleated cell in normal adult bone marrow? A. Myeloblast B. Promyelocyte C. Myelocyte D. Metamyelocyte
D
90. All of the following would be considered a part of the body's cellular immune system EXCEPT? A. Macrophages B. Mast cells C. Neutrophils D. Thrombocytes
D