HSC 317 chapter 1 test
Which of the following test is commonly used to screen for the presence of hereditary hemochromatosis in adults?
% transferrin saturation
Which of the following fluid to serum protein ratios would be indicative of an transusdate?
0.4
If a "white blood cell square" on a hemocytometer slide is 1 mm on each slide and the chamber is 0.1 mm deep. What volume of fluid would you count if you counted 4 squares
0.4 mm3
Which of the following fluid to serum lactate dehyrogenase (LD) ratios would be indicative of an exudate?
0.7
If a normal M:E ratio in the bone marrow is 1.5:1-3.5:1, which of the following M:E ratios reflects the ratio typically associated with acute myelogenous leukemia?
10:1
Which of the following represents the reference range for hemoglobin in adult females?
12.0-16.0 g/dL
Which of the following white cell differential results is consistent with the diagnosis of parasitic infection?
14% eosinophils
Which of the following represents the reference range for hemoglobin in adult males?
14.0-18.0 g/dL
Acute lymphoblastic leukemia is characteristically seen in this age group:
2-5 years
Normal sperm concentration should be:
20-160 million/mL
When red blood cells are present in the spinal fluid, what diluting fluid is commonly used to perform the white cell count?
3% acetic acid
According to the WHO criteria, a semen specimen must contain ____ of normal forms to be considered fertile.
30%
Which of the following hemoglobin configurations is characteristic of hemoglobin H?
4 beta chains
A female patient who has no known hematologic diseases has a hemoglobin value of 13.5 g/dL. Approximately what would you expect her hematocrit value to be?
41%
What is the typical relative lymphocyte percentage for a 1-year old child?
50-70%
Which of the following white cell differential results is consistent with the diagnosis of infectious mononucleosis?
65% lymphocytes
Once released from the bone marrow, a platelet has a life span of approximately:
7-10 days
Which of the following white cell differential results is consistent with the diagnosis of appendicitis?
70% neutrophils, 15% bands
Which of the following white cell differential results is consistent with the diagnosis of bacterial meningitis?
80% neutrophils
A patient has the following results: Red cell count = 4.2 x 1012/L Hemoglobin = 13.1g/dL Hematocrit = 38% What is the patient's mean corpuscular volume
90 fL
In addition to a severely hypoplastic bone marrow, which of the following test results would also support the diagnosis of aplastic anemia?
<20,000/microliter platelets
In addition to a severely hypoplastic bone marrow, which of the following test results would also support the diagnosis of aplastic anemia?
<500/ microliter granulocytes
Which of the following hemoglobin values is typical a of patient with polycythemia vera?
>18.0
According to the WHO (World Health Organization) classification system, what bone marrow blast count is diagnostic for acute leukemia?
>20%
Which of the following platelet counts is typical of essential thrombocythemia (ET)?
>600
Which of the following statements regarding the L/S ratio is TRUE?
A ratio of 2:1 or greater usually indicates adequate pulmonary surfactant to prevent respiratory distress syndrome (RDS)
Myelodysplasia is characterized by:
A. Hyperplasia in the bone marrow and cytopenias in the peripheral blood.
The role of vitamin B12 in red cell development is:
A. To convert methyltetrahydrofolate(MTHF) to tetrahydrofolate (THF)
When hemoglobin is electrophoresed at pH 8.6, hemoglobin A1, A2, F and S move at different rates. List these hemoglobins from fastest to slowest.
A1, F, S and A2
When hemoglobin is electrophoresed at an alkaline pH (8.6) Which order will the following hemoglobins move (from fastest to slowest)?
A1, F, S, C
The Actived Protein C (APC) Ratio is a test that is used to screen for:
APC resistance (factor V Leiden)
If a patient has a factor VII deficiency which of the following tests would produce prolonged result?
APTT
The coagulation test that is typically used to monitor the effect of heparin therapy is the:
APTT
Antibodies associated with cold agglutinin syndrome usually have:
Anti-I specificity
In the diagnosis and treatment of lymphoproliferative disorders the term staging refers to:
B. Estimation of disease extent and distribution in the body
A 57-year-old male was diagnosed with chronic myelogenous leukemia four years ago. He was treated with interferon-a and responed well. His latest CBC showed 35% myeloblasts in the peripheral blood. (His previous CBC had no blasts.) A bone marrow was performed and 42% myeloblasts were found. The results of these findings indicate that the patient may have entered this stage of the disease:
BLAST CRISIS
A patient is suspected of having paroxysmal nocturnal hemoglobinuria. The physician wants to do a flow cytometry test to confirm the diagnosis. What 2 cell markers should you test the cell for?
CD55 and CD59
An 25 year-old patient presents with fever, lethargy and lymphadenopathy. Her white blood count was 14 x 109/L. 68% of those white blood cells were reactive (variant) lymphocytes. Her heterophil antibody test for infectious mononucleosis was negative as was her EBV (Epstein-Barr virus) IgM test.
CMV cytomegalovirus infection
A 49-year-old male nonsmoker is being evaluated because of fatigue and unexplained weight loss. A CBC was performed with the following results: WBC = 185 x 109/L Hgb = 9.5 g/dL Hct = 29% Platelets = 430 x 109/L Differential Myeloblasts = 1% Promyelocytes = 3% Myelocytes = 11% Metamyelocytes =16% Band Neutrophils = 25% Segmented Neutrophils = 32% Eosinophils = 6% Basophils = 3% Lymphocytes = 2% Monocytes = 1%
Chronic myelogenous leukemia
The FDP test detects which of the following products of fibrin degradation?
D and E fragment
A 17-year-old was being evaluated for heavy menstrual bleeding. A complete blood count CBC, prothrombin time (PT) and activated partial thrombplastin time (APTT) were performed and the following results were obtained: White blood count = 2.4 x 109/L Platelet count = 80 x 109/L hemoglobin = 13.0 g/dL Differential neutrophils = 16% bands = 2% monocytes = 4% lymphocytes = 8% promyelocytes = 70% Many schistocytes were noted on her blood smear PT was found to be 15.5 seconds (control 11.0) APTT was 59 seconds (control 33.0 seconds) Based on the results of the CBC and coagulation studies, what is the most likely reason for this patient's bleeding symptoms?
DIC
Hereditary spherocytosis is believed to be caused by:
Deficiencies or defects of the membrane protein spectrin
Although it's no longer widely used, the Schilling test was performed on a patients with a vitamin B12 deficiency in order to:
Differentiate a dietary deficiency of vitamin B12 from pernicious anemia
The microorganism most commonly identified as the cause of hemolytic uremic syndrome (HUS) is:
E. coli O157:H7
Which anticoagulant is preferred for preparation of slides for manual differential cell counts?
EDTA
Which of the following laboratory results is consistent with the diagnosis of disseminated intravascular coagulation?
FDP = 80 micrograms/mL (<10 micrograms/mL )
The substrate for factor XIa is:
Factor IX
Thrombosis occurs in patients with the Factor V Leiden mutation because:
Factor V is not inactivated
A chromosomal analysis of bone marrow was performed and the results came back with the following: 46,XX,t(15;17)(q22;q21)
Female with a translocation between the long arm of chromosome 15 region 2, band 2 and the long arm of 17 region 2, band 1
The steps in chromosome identification are listed below. Put them in the correct order. A. Arrest growth during metaphase B. Stain C. Place cells on glass slides D. Treat with hyptonic solution, then fixative E. Photograph F. Analyze with mircosope G. Grow cells in tissue culture
G, A, D, C, B, F, E
Which of the following inherited hemolytic anemias exhibits X-linked inheritance?f
G6PD deficienccy
"Bite cells" are usually seen in patients with:
G6PD deficiency
What enzyme deficiency results in the formation of Heinz bodies?
G6PD deficiency
Which abnormal hemoglobin consists of 4 gamma globin chains?
Hb Bart's
Which of the following hemoglobins migrates to the same position as Hb A2 at pH 8.4?
Hb C
which two abnormal hemoglobins move at the same rate as Hb A2 when electrophoreses at an alkaline pH
Hb C and Hb E
Which of the following hemoglobins migrates to the same position as Hb S at pH 8.4?
Hb D
A patient of Asian decent was seen by her physician with symptoms of anemia. Her CBC showed a low hemoglobin, low MCV and low MCHC. The patient's serum iron, TIBC and ferritin were all normal. What abnormal hemglobin could produce these results?
Hb E
Which of the following hemoglobins migrates to the same position as Hb A2 at pH 8.4?
Hb E
What two abnormal hemoglobins move at the same rate as Hb S when electrophoresed at an alkaline pH?
Hb G and Hb D
Which of the following hemoglobins migrates to the same position as Hb S at pH 8.4? (Choose all that apply)
Hb G, Hb D
What red cell inclusion may be seen in the peripheral blood smear of a patient post-splenectomy?
Howell-jolly bodies
Which red cell inclusion is most commonly seen in megaloblastic anemia?
Howell-jolly bodies
The antibody class most commonly associated cold immune hemolytic anemia is:
IgM
A patient had a prolonged APTT and a normal PT. Which factor deficiency(ies) should you suspect?
It could be either XII, XI, IX or VIII
A 48-year-old white male patient was seen by his physician for symptoms of anemia. His white blood count was 104 x 109/L. His differential showed many immature granulocytes including myeloblasts, promyelocytes, myelocytes and metamyelocytes. A bone marrow aspiration and biopsy was performed. These slides revealed a hypercellular marrow (90% cellularity) with a large number of myeloid precursors in the sample. The ME ratio for the specimen was estimated at 20:1.
It is high, the cellularity of normal marrow is about 50%
Which is the reference method for determining fetal lung maturity?
L/S ratio
A 47-year-old male patient had a complete blood count (CBC), prothrombin time (PT) and activated partial thromboplastin time (aPTT) ordered. The tech noticed that the patient's plasma was milky-white (lipemic) when he took the PT/aPTT tube out of the centrifuge. What effect is any would this have on the CBC result?
Lipemia will falsely elevate the patient's hemoglobin
A chromosomal analysis of bone marrow was performed and the results came back with the following: 46,XY,t(8;21)(q22;q22)
Male with a translocation between the long arm of chromosome 8 region 2, band 2 and the long arm of 21 region 2, band 2
Which of the following statements regarding "Spur cell anemia" is TRUE?
Many acanthocytes and echinocytes are formed in the peripheral blood due to lipid imbalance.
A bone marrow exam performed on a female patient suffering from abnormal bleeding showed a hypercellular marrow with replacement or the normal architecture with immature myeloid cells. The marrow differential showed 23% myeloblasts containing Auer rods and 47% promyelocytes. If cytochemical stains were performed on the bone marrow which of the following results would you expect to see?
Myeloperoxidase Sudan black B and Chloracetate esterase = positive; non-specific esterase = negative
What effect does a PK (pyruvate kinase) deficiency have on a red blood cell?
PK deficiency results in a lack of ATP which effects membrane permeability
The coagulation test that is typically used to monitor the effect of coumadin (warfarin) therapy is the:
PT
Which of the following group of test results would you expect to see in a patient with von Willebrands disease?
Prolonged bleeding time, normal platelet count and abnormal aggregation with ristocetin
Which of the following group of test results would you expect to see in a patient with Glanzmann thrombasthenia?
Prolonged bleeding time; normal platelet count and no aggregation with ADP, epinephrine or collagen.
In which WHO classification of myelodysplasia is a Prussian blue stain needed to confirm the diagnosis?
REFRACTORY anemia with ringed sideroblasts
If cerebrospinal fluid can not be processed immediately, how should the tubes be stored?
Refrigerate hematology tubes; freeze chemistry tubes; hold microbiology tubes at room temperature
Most of the antibodies detected in warm autoimmune hemolytic anemias are directed toward:
Rh antigens
Which molecular method requires the use of reverse transcriptase to make complementary DNA?
RtPCR
The causes of exudates include:
TB
Routine urinalysis (UA) was performed on a patient diagnosed with Hodgkin lymphoma. All the UA results were all normal with the exception of protein. The protein dipstick test was negative but a sulfosalicytic acid (SSA) test requested by the physician was positive 3+. What is a likely explanation for these results?
The SAA test was detecting Bence-Jones protein, which was not detected by the dipstick
A complete blood count (CBC) was ordered on a patient. The white blood count was high enough to require a manual differential. While performing the differential the technologist noticed the most of the red cells were agglutinated. What effect would this have on the patient's CBC results?
The patient's mean corpuscular volume (MCV) would be falsely elevated
A physician ordered a hemoglobin test on a newborn (1 day old) female infant. The value the lab reported was 12.3 g/dL. How should this result be interpreted?
This result is abnormally low for a newborn female
Waldenstrom's macroglobulinemia is characterized by:
Waldenstrom's macroglobulinemia is characterized by:
pernicious anemia is caused by:
a lack of intrinsic factor
A patient had a prolonged APTT. A mixing study was performed. In part 1, the mixture of normal plasma and patient plasma produced a corrected result. In part 2 the mixture of normal plasma and patient plasma incubated 2 hours at 37o C produced a corrected result. What is the most likely explanation of these test results?
a sigle factor
total WBC 3.9 x 109/L Segmented neutrophils 85% Lymphocytes 8% Monocytes 6% Eosinophils 1%
absolute lymphocyotpenia
What type of abnormal red blood cell morphology is associated with abetalipoproteinemia?
acanthocytes
A patient has a factor VIII deficiency. Which of the following test would be prolonged?
activated partial thromboplastin time (aptt) only
A 4-month old Asian-American female was seen by her family physician because of a 2 week history of unexplained high fevers and scattered black and blue spots on her trunk and extremities. Neither parent smokes or works with carcinogenic chemicals. There is also no family history of malignancies. Physical exam revealed a well-developed and well-nourished infant who was pale, and bruised. She had a fever (39.5oC), and was irritable. Her liver and spleen were enlarged. The following hematological studies were performed: Hgb = 9.0 g/dL Hct = 28% RBC 3.1 x 1012/L WBC = 30.0 x 109/L PLT = 25.0 x 109/L Reticulocyte count = 0.6% Differential Segmented neutrophils = 10% Monocytes = 2% Blasts = 88% When the peripheral blood was stained with myeloperoxidase, Sudan black B and non-specific esterase stains the blasts were negative. Based on the patient age and the staining characteristics of the blasts, what type of leukemia does this patient most likely have?
acute lymphoblastic leukemia
A 5-year-old boy has a peripheral white blood cell count of 231 x 109/L. A Wright's stained blood smear shows 50% blasts many of which contain Auer rods. Which classification of leukemia can be ruled out?
acute lymphoblastic leukemia (ALL)
The malignant cells found in Burkitt lymphoma are very similar in appearance to those seen in:
acute lymphoblastic leukemia L-3
Cytochemical stains were performed on a bone marrow sample. The following results were observed for the blast cells present: = positive (45%) SBB = positive (45%) NSE = positive (50%) Tdt = negative Which form of AML is most likely present?
acute myelomonocytic leukemia (AMML)
Which type of protein is primarily responsible for increasing the sedimentation rate in inflammatory conditions?
acute phase reactants
The process by which platelets join to other tissues is called:
adherence
Which red blood cell morphology is commonly observed in cold autoimmune hemolytic anemia?
agglutination
The process by which platelets join to other platelets is called:
aggregation
hemoglobin is typically electrophoreses at ______ pH
alkaline
Symptoms of myelodysplasia may include:
all of above
Which of the following statements about platelets in myelodysplastic syndrome (MDS) is TRUE?
all of above
What abnormal red cell morphology is associated with myelodysplasia?
all of above, oval macrocytes, basophilic stippling, Howell-jolly bodies,
Which of the following symptoms are associated with hemophilia A?
all of above: hemarthrosis, deep muscle bleeding, intracranial bleeding
The WHO classification of acute myelogenous leukemia utilizes which of the following?
all of the above
Which of the following statements concerning chromosomal identification is TRUE?
all of the above
flow cytommetry can be used to
all of the above
Disseminated intravascular coagulation (DIC) is most commonly associated with which WHO classifications of acute myeloid leukemia?
aml withr t(15;17)(q22;q12) and AMoL
Which test best correlates with the severity of hemolytic disease of the newborn (HDN)?
amniotic fluid bilirubin
Which molcular technique is being used to detect the mutation that causes factor V Leiden?
amplification
Persons with a deficiency of protein C are at increased risk of thrombosis because of:
an inability to inactivate F-Va and F-VIIIa
An 89-year-ol woman was transferred to the hospital from a nursing home facility for treatment of a chronic urinary tract infection. The patient presented with the following laboratory data: Test Result WBC 10.0 x 109/L RBC 3.1 x 1012/L Hgb 7.2 g/dL Hct 24% MCV 78 fL MCHC 31% Serum iron 29 mcg/dL (50-180 mcg/dL) TIBC 160 mcg/dL (250-450 mcg/dL) Serum ferritin 100 mcg/mL (12-200 mcg/mL)
anemia of chronic disease
In which type of microcytic anemia would an elevated erythrocyte sedimentation rate typically be observed?
anemia of chronic disease
Any number of chromosomes that is not a multiple of the haploid number (23 in humans) is referred to as:
aneuploidy
Which of the following sites is sometimes used to collect bone marrow from children under the age of 2 but NEVER used to collect samples from adults?
anteromedial tibia
Antibodies associated with paroxysmal cold hemoglobinuria usually have:
anti-P specificity
Which of the following is detected during immunophenotyping by flow cytometry?
antigens using detection antibodies
Which of the following dietary substances can cause a false-negative fecal occult blood test?
ascorbic acid
Which of the following types of bone marrow specimens is BEST for evaluating the morphology of hematopoietic precursor cells?
aspirate
Ingestion of which of the following can cause a false positive fecal occult blood test?
aspirin, broccoli, cauliflower, canalone or bananas
In which form of drug induced autoimmune hemolytic anemia (DIAIHA) is the eluate of the patients cells reactive with all antibody screen cells and panel cells?
autoantibody type
Which of the following conditions may produce spherocytes on the peripheral blood smear?
autoimmune hemolytic anemia
The precursor of the plasma cell is the:
b lymphocytes
Leukemic blasts displaying surface immunoglobulin (SIg) are characteristic of:
b-cell all
Which of the following intracellular parasites is transmitted by ticks in costal northeastern United States causes infection and is associated with mild-moderate hemolytic anemia?
babes microti
A college student was found unresponsive in his bed. His roommate called the paramedics. The physician in the emergency room found the student had a temperature of 105°C and signs of neck rigidity. The physician collected 3 mL of cerebrospinal fluid and sent them to the laboratory for analysis. The following results were found. Cerebrospinal Fluid Results Test Result Reference Interval Appearance White, Cloudy Clear Glucose 12 mg/dL 60-70% of plasma glucose Protein 148 mg/dL 15-45 mg/dL Leukocytes 7,000/mL 0-5 cells/mL Neutrophils 92% 0-6% Lymphocytes 8% 40-80%
bacterial meningitis
When performing chromosome analysis, individual chromosomes are identified by:
banding pattern
This febrile, hemolytic anemia seen in Columbia, Ecuador and Peru, is caused by a coccobacillus transmitted by sand flies:
bartonella bacilliformis
Cells used for chromosome analysis must:
be mitotically active
Which chemical is most often implicated in the development of aplastic anemia?
benzene
Which two conditions can cause the stool to have a pale yellow, white or gray appearance?
bile-duct obstruction or barium sulfate ingestion
A significant rise in the OD of amniotic fluid at 450 nm indicates the presence of what substance?
bilirbuin
Amniotic fluid is evaluated using a Liley graph and change in absorbance at 450 nm. What is being evaluated, and why?
bilirubin, which increases in HDN
Which of the following types of bone marrow specimens is BEST for preserving the architecture of the bone marrow?
biopsy
What abnormal red cell morphology(ies) is/are associated with G-6-PD deficiency on a Wright stained blood smear?
bite cells
A peritoneal fluid with a high level of creatinine would indicate:
bladder perforation
The purpose of performing a creatinine test on peritoneal fluid is to aid in the diagnosis of:
bladder perforation
Which of the following is NOT one of the typical symptoms of a platelet disorder?
bleeding into the joint
A blood pressure cuff is used to maintain constant pressure during the procedure. 1-2 standardized incisions are made on the forearm. The time it takes for the incision(s) to stop bleeding is recorded. This is the principle of what test?
bleeding time
Which of the following tests is often ordered by physicians to measure platelet function?
bleeding time
A child is born suspected of having Down Syndrome. What type of sample would be most appropriate for cytogenetic analysis?
blood
Which of the following signs is common in the presentation of childhood leukemia?
bone and joint pain
Which of the following tests can not be performed on amniotic fluid if meconium is present in the specimen?
both B and C: L/s ratio, foam stability
The anemia associated with chonic lymphocytic leukemia may be caused by:
both bone marrow infiltration and auto-antibodies
If a patient is diagnosed as having myelomonocytic leukemia (AMML), which of the following cytochemical stain(s) would you expect to yield positive results?
both myeloperoxidase and non-specific esterase
A patient has a factor X deficiency. Which of the following test would be prolonged?
both the PT and APTT
Which of the following tests would be abnormal in a patient with a vitamin K deficiency?
both the Pt and APTT
What stain is specific for Heinz bodies?
brilliant green
Hereditary pyropoikilocytosis (HP) is a red cell membrane defect characterized by:
budding and fragmented red cells
Which type of synovial fluid crystals are associated with pseudogout?
calcium pryophosphate
Which of the following cluster designations is called the "pan B cell" marker?
cd19
Elevation of the lymphocyte count above 4.8 x 109/L is termed:
ce lymphocytosis
semen analysis is performed to evaluate the following:
check post-vasectomy status, investigation of infertility, forensic analysis
A patient came into the laboratory for presurgical blood tests including a CBC, PT and APPT. The patient appeared healthy but the technologist had a difficult time collecting the blood samples so she used a syringe then transferred the blood to evacuated tubes. When the CBC was performed all parameters were normal except the platelet count, which was 33 x 109/L. What step should the technologist take next?
check smear for platelet clumping or platelet sattelitism
Hemolytic uremic syndrome (HUS) is most often seen in which age group?
children 6 months to 10 years
Which antibiotic is most often implicated in the development of aplastic anemia?
chloramphenicol
Which of the following is most likely to have a decreased M:E ratio?
chronic blood loss
A 63-year-old female nonsmoker is being evaluated because of weakness and fatigue. A CBC was performed with the following results: WBC = 22.2 x 109/L Hgb = 7.9 g/dL Hct = 24% Platelets = 496 x 109/L Differential Myelocytes = 4% Metamyelocytes = 5% Band Neutrophils = 8% Segmented Neutrophils = 54% Eosinophils = 5% Basophils = 1% Lymphocytes = 16% Monocytes = 7% 13 nucleated red blood cells and many dacryocytes observed. What is the most likely diagosis for this patient?
chronic idiopathic myelofibrosis
Autoimmune hemolytic anemia and hypergammaglobulemia are both secondary conditions associated with which type of leukemia?
chronic lymphocytic leukema
A 48-year-old white male patient saw his physician complaining of loss of appetite, decreased energy and increasing fatigue. Results of a physical exam showed he had a normal temperature, heart rate and blood pressure. He was slightly pale and his spleen was enlarged. His blood work was as follows: WBC = 104 x 109/L Hgb = 13.0 g/dL HCT = 34% MCV = 89 fL Platelets = 412 x 109/L Differential Blast forms = 1% Promyelocytes = 3% Myelocytes = 6% Metamyelocytes = 17% Band neutrophils = 16% Segmented neutrophils = 19% Eosinophils = 2% Basophils = 7% Lymphocytes = 21% Monocytes = 8% A leukocyte alkaline phosphatase stain performed on the blood specimen produced a score of 3. What is the most likely diagnosis?
chronic myelogenous leukemia
An LAP stain was performed on a patient with a with a cell count of 38 x 109/L. The LAP result was 7. Which diagnosis best fits these LAP results?
chronic myelogenous leukemia
Which myeloproliferative disorder is associated with the presence of the Philadelphia chromosome?
chronic myelogenous leukemia
In which type of leukemia are the malignant cell tartrate-resistant acid phosphatase positive?
chronic myelogneous leukemia
In which WHO classification of myelodysplasia is leukocytosis a common finding?
chronic myelomonocytic leukemia
Which of the following test results is consistent with a diagnosis of bacterial meningitis?
cincreased lactate
In which of the following types of hemolytic anemia, are red cells lysed due to microorganism toxins?
clostridium perfringes septicemia
Which red cell inclusion is particularly characteristic in lead poisoning?
coarse basophilic stippling
Mass screening of adults for occult blood in the stool is performed primarily to detect:
colorectal cancer
What laboratory method is typically used to quantitate hemoglobin A2?
column chromatography
A four-year-old boy was diagnosed with leukemia. Immunotyping of the bone marrow cells revealed that they were TdT+, HLA-DR+, CD19+, CD10+, CD20, cIg and SIg.
common ALL
Leukemic blasts marking with CALLA (CD10) markers but no cytoplasmic immunoglobulin (cIg) are characteristic of:
common all
Hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) is:
complement dependent
Aspirin prevents platelet aggregation by inhibiting the action of which enzyme?
cyclo-oxygenase
Measurement of the presence of fecal enzymes such as tryspin, chymotrypsin or elastase I may be used in the diagnosis of:
cystic fibrosis
A distinctive red cell morphology seen in patients with chronic idiopathic myelofibrosis with myeloid metaplasia is:
dacryocytes (tear drop cells)
What is meconium?
dark-green mucus containing stool formed by the fetus
In secondary erythrocytosis the M:E ratio is usually:
decreased
When a leukocyte alkaline phosphatase (LAP) stain is performed on a patient with chronic myelogenous leukemia, the LAP score will likely be:
decreased
Thalassemias are characterized by:
decreased production of globin chain
Anemia of chronic disease is characterized by:
decreased serum iron
A patient who was diagnosed with having rheumatoid arthritis also has a mild microcytic, hypochromic anemia. Anemia of chronic disease is suspected. Iron studies were requested. Which of the following results would be expected in this case?
decreased serum iron, decreased TIBC and increased serum ferritin
Heinz bodies are composed of what?
denatured hemoglobin
Erythrocytes hemolyze in G-6-PD deficiencies because:
denatured hemoglobin accumulates and precipitates in the cells
apt test
differentiation of fetal and maternal blood
split and neutral fasts
differentiation of steatorrhea caused by malabsorption or maldigestion
fecal pH
disaccharide deficeincy
fecal reducing substances (flintiest)
disaccharide deficiency (ex lactose intolerance)
2. An area of blue cytoplasm caused by endoplasmic RNA
dohle bodies
Which of the following describes normal semen viscosity?
droplets with a thin thread when released from a pipette
When collecting blood or bone marrow specimens for flow cytometry counting procedures, the anticoagulant recommended is:
edta
In which of the following types of hemolytic anemia, are red cells lysed due to invasion by an intracellular bacteria?
ehrlichiosis
What type of specimen is required to perform cytogenetic testing to detect abnormalities in leukemia?
either bone marrow or blood
In infectious mononucleosis, lymphocytes tend to be:
enlarged and indented by surrounding cells
Which of the following statements concerning Hodgkin's disease is TRUE?
enlargement of the lymph nodes is a common first sign
Immunophenotyping was performed and the cells were positive for CD71 and glycophorin A. What is the most likely classification of these cells?
erythroblasts
A 33-year-old female patient is being evaluated because of frequent nose bleeds and easy bruising. The patient says she had none of these symptoms when she was younger. A CBC was performed with the following results: WBC = 12.7 x 109/L Hgb = 10.2 g/dL Hct = 31% Platelets = 1,270 x 109/L Differential = normal
essential thrombocythemia
The purpose of staining a bone marrow biopsy with Prussian blue stain is to:
evaluate the iron stores
Streptokinase is said to be an ________________ activator of plasmin.
exogenous
Which of the following is NOT a cause of aplastic anemia?
exposure to cold temperatures
In G-6-PD deficiency, what situations can trigger these hemolytic episodes?
exposure to oxidative drugs
Tissue plasminogen activator (TPA) is said to be an ________________ activator of plasmin.
extrinsic
The prothrombin time can detect deficiencies in the:
extrinsic or common pathway
It is not important to know the time at which the specimen was collected.
false
Specimens should be collected after a period of sexual abstinence of 2-3 weeks
false
Specimens should be kept on ice if they are transported from another location to the laboratory.
false
is acceptable to collect a semen specimen in a latex condom purchased at a pharmacy or drug store.
false
specimens for chemical testing should not be centrifuged or filtered
false
specimens for cryogenetic testing should be frozen
false
specimens for fetal lung maturity testing should be kept at 37C
false
antacid use
false negative
ascorbic acid (vitamin C) use
false negative
aspirin use
false positive
ingestion of bananas, pear , plums
false positive
ingestion of broccoli, turnips, horseradish or cauliflower
false postieve
A bone marrow is performed on a child with severe congenital abnormalities and severe anemia. The results of the biopsy demonstrate marked hypoplasia of all cell lines. These findings are most consistent with:
fanconi's anemia
ingestion of red or rare cooked meat or fish
fasle positive
What vegetable is known to trigger hemolysis in some individuals with G-6-PD deficiency?
fava beans
L/S ratio
fetal lung maturity
foam stability tst
fetal lung maturity
lamellar bodies
fetal lung maturity
phosphatidyl glycerol
fetal lung maturity
d-dimer is formed by lysis of
fibrin
Before analyzing tissues such as lymph nodes, the technologist must prepare a:
filtered suspension of eclls
Secondary (specific) granules of the eosinophil:
first appear at the myelocyte stage of maturation
Which molecular technique uses labeled probes that hybridize with complimentary DNA in a tissue sample?
fish
What conditions can cause a person to develop megaloblastic anemia?
fish tape worm
Which of the following statement regarding the processing of amniotic fluid is TRUE?
fluid for chromosome study should be stored at 37 C
A patient presents with macrocytic anemia. Serum folate, red cell folate and serum B12 tests are performed. Those results follow: Serum folate = 1.0 ng/mL (> 2.5 ng/mL) Red cell folate = 50 ng/mL (160-700 ng/mL) Serum B12 = 650 pg/mL (247-800 ng/mL)
folate deficiency
Increases in urinary formiminoglutamic acid (FIGLU) are associated with:
folic acid deficiency
The two most common forms of non-Hodgkin lymphoma seen in adults are:
follicle center and large b cell
Which form of protein S is biologically active as a cofactor for protein C?
free protein S
In an alleged rape, which two tests could be used to prove that fluid is actually semen? Check both.
fructose levels, microscopic exam for sperm
A patient was determined to have a vitamin B12 deficiency. Which of the following tests could the physician use to determine if the patient's deficiency is caused by pernicious anemia?
gastric fluid analysis
Which of the following results correlates with the diagnosis of inflammatory disease?
glucose = 25 mg/dL
When Ryes syndrome is suspected, what test might be ordered on the spinal fluid?
glutamine
Which of the following properties of the cell analyzed by flow cytometry is related to angle 90o (side) light scatter?
granularity
The diagnostic criteria for aplastic anemia includes which of the following?
granulocyte count <0/5 x 10^9/L
In addition to increased erythrocytes, what other cell populations are often increased in patients with polycythemia vera?
granulocytes and platelets
Which of the following substances is considered the best for fecal occult blood testing?
guiac
Patients with beta-thalassemia major who are frequently transfused are at risk for developing:
hematochromatosis
When evaluating the cellularity of a bone marrow sample, what ratio is being evaluated?
hematopoietic cells to fat
delat A450 determination (bilirubin scan)
hemolytic disease of the new rn
In this hemolytic anemia, bacterial toxins are believed to trigger the formation of thrombi in renal microvasculature leading to red cell fragmentation
hemolytic uremic syndrome HUS
Test Patient Result Reference Range Bleeding time 5.0 min 2.0-8.0 min. PT 11.2 sec 10.0-12.9 sec APTT 97.4 sec 26.0-36.0 sec TT 12.3 sec. 10.0-15.0 sec FVIII assay 95% 55-145% FIX assay 12% 60-140%
hemophilia B
Mixture Result Part 1 normal plasma + patient plasma no correction Part 2 phospholipide + patient plasma no correction
heparin contamination of the specimen
The osmotic fragility test is used to support the diagnosis of
hereditary spherocytosis
Which of the following hemolytic anemias is caused by defective membrane permeability?
hereditary stomatocytosis
In which of the following pathways, is the enzyme G-6-PD found?
hexose monophosphate shunt
The substance that causes synovial fluid to be highly viscous is:
hyaluronate
A physician performs a bone marrow biopsy and aspirate on a 65-year-old male. The cellularity is estimated to be 80% and the M:E ratio is 0.5 to 1. What is the correct description of this marrow?
hyper cellular with a decreased M:E ratio
Any number of chromosomes that is greater than normal (46 in humans) is called:
hyperploidy
A patient has a mean corpuscular hemoglobin concentration (MCHC) of 30%, what word could be used to describe these cells?
hypo chromic
Abnormal red cell morphologies associated with iron deficiency anemia are:
hypochromia, microcytes, target cells and ellipotcytes
Calculation of the CSF IgG index is helpful in determining:
if IgG is being produced in the central nervous system
Measurement of CSF glutamine is helpful in determining:
if the patient has Reyes syndrome
Which of the following immunoglobulins is increased in Waldenstrom's macroglobulinemia?
igM
The term shift to the left refers to:
immature granulocytes on a blood smear
In which form of drug induced autoimmune hemolytic anemia (DIAIHA) is the DAT positive with polyspecific AHG and anti-C3d but not anti-IgG?
immune complex type
A 59-year-old man was diagnosed with chronic lymphocytic leukemia based on the results of a CBC and bone marrow exam. What additional testing could be performed to characterize the type of white cells associated with this disease?
immunophenotyping
In which molecular method are probes used to detect specific areas of DNA in intact cells?
in situ hybridization
In chronic myelogenous leukemia the M:E ratio is usually:
increased
When a leukocyte alkaline phosphatase (LAP) stain is performed on a patient with polycythemia vera, the LAP score will likely be:
increased
Spherocytes differ from normal red cells in all of the following EXCEPT:
increased deformability
Protein electrophoresis of serum from a patient diagnosed with multiple myeloma would typically show:
increased gammaglobulins with monoclonal spike
A hypercellular bone marrow has an M:E ratio of 10:1. This indicates:
increased granulopoiesis
Which of the following test results is consistent with a diagnosis of bacterial meningitis?
increased protein
Laboratory results seen in warm autoimmune hemolytic anemia include:
increased reticulocyte count, decreased haptoglobin, spherocytes
sperm concentration = 8 million/ mL
infertility
volume = 1 ml
infertility
fecal leukocytes
inflammation of the intestinal wall (ex bacillary dystentary)
The purpose of performing an alkaline phosphatase test on either pleural or peritoneal fluid is to aid in the diagnosis of:
intestinal perforation
The activated partial thromboplastin time (APTT) can detect deficiencies in the:
intrinsic or common pathways
The Prussian blue stain is used to detect what substance in the bone marrow?
iron
In which type of microcytic anemia is stainable bone marrow iron decreased or absent when Prussian blue stained smears are examined?
iron deficiency anemia
A Protein C deficiency can lead to thrombus formation because Protein C:
is need to inactivate FBa and FVIIIa
Which characteristic describes antithrombin (AT)?
it Is enhanced by heparin
Which of the following statement regarding hemophilia A is TRUE?
it accounts for about 80-85% of all access of inherited hemophilia A
All of the following statement regarding Heparin are true EXCEPT:
it can be given orally
A 59 year old man was diagnosed as having macrocytic anemia. Megaloblastic anemia was ruled out based on the results of a serum B12 and folate tests. The physician referred the patient to a hematologist who ordered a bone marrow exam, including a Prussian blue stain of the marrow.
it detects iron and is used to observe ringed sideroblasts
What is a Heinz body?
it is a red cell inclusion body formed from oxidized hemoglobin
Which of the following is TRUE of paroxysmal nocturnal hemoglobinuria (PNH)?
it is an acquired hemolytic anemia
Which of the following statements regarding Burkitt's lymphoma it TRUE?
it is associated with Epstein Barr virus
Which of the following is most TRUE of glucose-6-phosphate dehydrogenase (G6PD) deficiency?
it is inherited as a sex-linked trait
Which of the following statements about Bence-Jones protein is TRUE?
it is made of light chains of immunoglobulin moelcuels
If a patient has a factor V deficiency which of the following tests would produce prolonged result?
it is used to standardize PT results
A 62 year old woman visited her physician with complaints of fatigue, weakness and light-headedness. Her physician performed a spun hematocrit in his office, it was 18.5%. He drew more blood and sent it to the hospital laboratory for analysis. The results of the CBC were as follows: WBC = 6.3 x 109/L Hgb = 6.2 g/dL Hct = 18.7% MCV = 112 fL RDW = 18 PLT = 87 x 109/L The differential was normal except for 5% metamyelocytes, hypersegmentation of neutrophils, oval macrocytes, Pappenheimer bodies and Howell-Jolly bodies. A serum B12 and folate were performed and both were found to be within the reference range. what is significance of serum b12 and folate?
it rules out megaloblastic anemia as possible diagnosis
What is the effect of platelet clumping on a platelet count?
it will falsely decrease the count
If a quantitative d-dimer test is performed on a patient with acute disseminated intravascular coagulation (DIC), what would the result most likely be?
it would be elevated
If a prothrombin time (PT) is performed on a patient with acute disseminated intravascular coagulation (DIC), what would the result most likely be?
it would be prolonged
Which statement concerning protein C is TRUE?
its activity is enhanced by protein S
which statement regarding lead poisoning is true?
lead interferes with the heme synthesis pathway
The substrate is hydrolyzed by an enzyme found in secondary granules of neutrophils producing a colored precipitate. This describes the principle of the:
leukocyte alkaline phosphatase stain
segmented neutrophils 65% band neutrophils 17% metamyelocytes 5% eosinophils 1% monocytes 2% lymphocytes 11% Dohle bodies Present toxic granulation Present
leukomoid reaction due to a bacterial infection
Flow cytometry is based on the principle of:
light scatter
What type of specimen would be appropriate for cytogenetic analysis of suspected lymphoma?
lymph node
The following results were seen after staining bone marrow blasts. Myeloperoxidase = negative Sudan black B = negative Non-specific esterase = negative Terminal deoxynucleotidyl transferase = positive
lymphoblats
What type of cells would you expect to find in the pleural fluid from a patient who has tuberculosis?
lymphocytes
When a patient has viral meningitis, what type of white blood cells are typically predominant in the spinal fluid?
lymphocytes
Which of the following red cell morphologies is associated with pernicious anemia?
macrocytes, Howell-jolly bodies, elliptocytes
A patient's mean corpuscular volume is 132 fL. What word could be used to describe these cells?
macrocytic
The type of anemia seen in myelodysplastic syndromes (MDS) is ususally:
macrocytic, normchromic
Which of the following is a characteristic of spinal fluid from a cerebral hemorrhage?
macrophages containing ingested red blood cells
What is the role of the Medical Laboratory Scientist in bone marrow collection?
make direct bone marrow smears
A runner just completed a marathon over city streets and sidewalks using a new type of shoe. Afterword he complains of dark, reddish urine. The next day his urine has returned to its normal color. What is the most likely cause of his problem?
march hemoglobinura
A man has a leukocyte count of 8.7 x 109/L on Thursday. He runs a marathon on Saturday and after the race his leukocyte count is 13.4 x 109/L. The difference in the two cell counts is most likely due to:
marginating neutrophil entering circulation
Immunophenotyping was performed and the cells were positive for CD41, CD42 and CD61. What is the most likely classification of these cells?
megakaryoblats
In which stage of mitosis is chromosome morphology best observed?
metaphase
Red blood cell morphology in beta-thalassemia would most likely include:
microcytes, hypchromia, target cells, elliptocytes, stippled cells
Lack of vitamin B12 causes what type of anemia?
microcytic, normochromic
meat fibers
monitoring persons with maldigestion
Cytochemical stains were performed on a bone marrow sample. The following results were observed for the blast cells present: MPO = negative SBB = negative NSE = positive (67%) Tdt = negative
monoblasts
Immunophenotyping was performed and the cells were positive for CD11b and CD14. What is the most likely classification of these cells?
monoblasts
The following results were seen after staining bone marrow blasts. Myeloperoxidase = negative Sudan black B = negative Non-specific esterase = positive Terminal deoxynucleotidyl transferase = negative What type of blasts are present?
monoblasts
The precursor of the tissue macrophage is the:
monocyte
Non-specific esterase stains cells of what lineage?
monocytic
Persons with the Prothrombin 20210 mutation produce
more prothrombin than normal
The following results were seen after staining bone marrow blasts. Myeloperoxidase = positive (80%) Non-specific esterase = negative Terminal deoxynucleotidyl transferase = negative
myelo
The following results were seen after staining bone marrow blasts. Myeloperoxidase = positive Sudan black B = positive Non-specific esterase = negative Terminal deoxynucleotidyl transferase = negative What type of blasts are present?
myeloblasts
Sudan black B stains cells of what lineage?
myeloid
The M/E ratio is defined as a comparison of the number of:
myeloid precursors to erythroid precursors
If a patient is diagnosed as having AML with maturation, which of the following cytochemical stain(s) would you expect to yield positive results?
myeloperoxidase (MPO) only
A bone marrow exam performed on a female patient suffering from abnormal bleeding showed a hypercellular marrow with replacement or the normal architecture with immature myeloid cells. The marrow differential showed 23% myeloblasts containing Auer rods and 47% promyelocytes If cytochemical stains were performed on the bone marrow which of the following results would you expect to see? .
myeloperoxidase Sudan black B and Chloracetate esterase = positive; non-specific esterase = negative
If a patient is diagnosed with AML with t(15;127)(q22;q12), which of the following cytochemical stain(s) would you expect to yield positive results?
myeloperoxidase only (MPO)
An enzyme found in primary granules of granulocytes reacts with a substrate producing a colored precipitate. This describes the principle of the:
myeloperoxidase stain
Monosodium urate crystals are:
negative birefringent
acetylcholinesterase
neural tube defects
alpha-feto protein
neural tube defects
Phaogcytosis is a function of:
neutrophils
The predominant cell type found in the cerebrospinal fluid of patients with bacterial meningitis is:
neutrophils
Neutropenia is defined as:
neutrophils <1.5x 10^9/L
Which of the following results correlates with the diagnosis of septic joint disease?
neutrophils = 96%
Neutrophilia is defined as
neutrophils >7.0x10^9/L
If a patient is diagnosed as having acute monoblastic leukemia (AMoL), which of the following cytochemical stain(s) would you expect to yield positive results?
non-specific esterase (NSE) only
An enzyme found in monocytes reacts with either alpha-naphthyl acetate or alpha-naphthyl butyrate releasing naphthol. Naphthol then combines with a diazonium salt producing a colored precipitate. This describes the principle of the:
non-specific esterase stain
Patient diagnosed with polycythemia vera will typically have an arterial pO2 that is:
normal
An 8-year-old male patient has a hemoglobin of 11.9 g/dL. How would this value be interpreted?
normal for male or female child
Patient diagnosed with polycythemia vera will typically have an erythropoietin (EPO) level that is:
normal or decreased
The anemia associated with lymphocytic leukemia and lymphoma is usually:
normocytic, normochromic
The anemia seen in sickle cell disease is ususally:
normocytic, normochromic
the red blood cells in aplastic anemia are typically
normocytic, normochromic
An abnormal APTT caused by a pathologic inhibitor such as anti-VIII is:
not corrected with normal plasma
Which of the following is characteristic of cellular changes as megakaryoblasts mature into megakaryocytes?
nuclear division without cytoplasmic division
What fecal test is used for mass screening of adults for colorectal cancer?
occult blood
guiac test
occult blood
Hybridization means that
one nucleotide strand binds to another strand forming hydrogen bonds between the complimentary nucleotides
The part of the flow cytometer that collects the scattered laser and fluorescent light is called the:
optics
A patient is suspected of having hereditary spherocytosis. What laboratory test could you perform to help support the physician's suscipion?
osmotic fragility test
Thresholds and gating refer to:
parameters used too elected specific populations of cells for study
Presence of Anti-P antibodies is associated with:
paroxysmal cold hemoglobinuria
The sugar water test is a test traditionally used for the diagnosis of what membrane disorder?
paroxysmal nocturnal hemoglobinuria
L/S ratios were performed on three patient's amniotic fluid. All three fluids were free of blood and merconium. None of the patients are diabetic. Which patient(s)' LS ratio indicate the lungs are mature enough that the baby can be delivered without risk of respiratory distress?
patients 2 and 3
PCR is favored over rtPCR because:
pcr is less time consuming
A patient is being evaluated for possible thrombotic thrombocytopenic purpura. Her platelet count was 70 x 109/L. A platelet estimate was performed to verify the count. The tech saw 1-2 platelets per microscopic field. The platelets were not clumped, but there were many schistocytes present. What should the technologist do to get an accurate platelet count?
perform manual platelet count on this sample
A patient is suspected of having acute erythroid leukemia (AEL). Which of the following stains could be positive if the diagnosis of AEL is true?
periodic acid schiff
An acid is used to hydrolyze glycogen, mucoprotein and other large carbohydrates to aldehydes. The aldehydes react with a reagent forming a red-pink color. This describes the principle of the:
periodic acid-schiff stain
Which of the following is a common finding in aplastic anemia?
peripheral blood pancytopenia
The production of which sufactant lipid is delayed in mothers who have diabetes?
phophatidyl glycerol
The lupus anticoagulant is directed against:
phospholipid
Which of the following intracellular parasites is transmitted by mosquitos and is associated with severe hemolytic anemia known as Black-water fever?
plasmodium falciparum
A patient has a normal platelet count but a prolonged bleeding time. Which of the following tests would be helpful in determining his diagnosis?
platelet aggregation
An agonists is added to platelet rich plasma. A recording is made of the change in the light scatter of the specimen. This best describes the principle of which test?
platelet aggregometry
Which of the following laboratory results is consistent with the diagnosis of disseminated intravascular coagulation?
platelet count- 40x 10^9 (150-450_
A 54-year-old male nonsmoker is being evaluated because of headache, weakness, fatigue and unexplained weight loss. The patient has no history or pulmonary or renal disease. He has no signs of infection or inflammation. A CBC was performed with the following results: WBC = 13. x 109/L Hgb = 18.5 g/dL Hct = 57% Platelets = 520 x 109/L Differential = normal What is the most likely diagnosis for this patient?
polycythemia
How would you interpret the following results of a Donath-Landsteiner test? Patient incubated at 4ºC then 37ºC = hemolysis Control incubated at 37ºC only = no hemolysis
positive
Which of the following is NOT one of the characteristics of acute immune thrombocytopenic purpura (ITP)?
positive family history of ITP
Which of the following sites is most commonly used to collect bone marrow aspirates or biopsies from adults?
posterior iliac crest
Leukemic blasts displaying cytoplasmic immunoglobulin (cIg) but no CD10 or surface immunoglobulin (SIg) are characteristic of:
preB-all
A 2-year-old child is suspected of having leukemia. A bone marrow aspirate and biopsy revealed a cellular marrow 80% of which was replaced by small, round blast cells most with scant cytoplasm. These blasts were positively with TdT. When immunophenotyping was performed the cells were positive for CD2, CD3, CD5 and CD7 but were negative for CD10, CD19, CD20 and CD22. These cells are most likely.
precursor t cell
Mixture Result Part 1 normal plasma + patient plasma no correction Part 2 phospholipid + patient plasma corrected result
prese ce of lupus anticoagulante
Which of the following is necessary for platelet aggregation to occur?
presence of GPIIb/IIIa
A patient had a prolonged APTT. A mixing study was performed. In part 1, the mixture of normal plasma and patient plasma produced a corrected result. In part 2 the mixture of normal plasma and patient plasma incubated 2 hours at 37o C produced a prolonged result. What is the most likely explanation of these test results?f
presence of a factor inhibitor (antibody)
Which of the following could lead to errors in measuring hemoglobin using the manual cyan methemoglobin method?
presence of lipemia
which of the following is associated with sideroblastic anemia?
presence of ringed sideroblasts
All molecular test that analyze specific portions of the human genome rely on the principle that:
probes bind to their complementary target sequence through the hybridization process
What cells are predominant in the bone marrow patients with AML with the t(15;17)(q22;21) translocation commonly observed?
promyelocytes
Aspirin affects platelet funcion by interfering with the platelets metabolism of:
prostagladins (thromboxane)
Failure of a semen specimen to liquify within 2 hours could indicate a problem with the:
prostate
Seminal fluid zinc and citric acid measurements are used to evaluate the function of:
prostate
Which prosthetic device has been associated with mild hemolytic anemia?
prosthetic heart valves
the substrate for factor Xa is:
prothrombin
The reagent for this test contains tissue factor, phospholipid and calcium chloride:
prothrombin time
The coagulation factors which need vitamin K for production are:
prothrombin, VII, IX, and X
prostate gland
provide enzymes and proteins for coagulation and liquefaction
seminal vessicles
provide nutrients for sperm and fluid
At what point should a physician use the adult hemoglobin reference range rather than the pediatric reference range for interpreting hemoglobin values for a child?
pubert
A physician suspects his patient has G6PD deficiency and has ordered a spot fluorescent G6PD assay. The patient was recently hospitalized with pneumonia and has a hemoglobin of 10.5g/dL and a corrected reticulocyte count of 10.2%. What course of action should the technologist take?
recommend the physical to wait to preform the assay because reticulocytes will produce falsely high results
Which of the following tests can be used to differentiate primary polycythemia from relative polycythemia?
red blood cell mass
Which of the following parameters will be elevated when anisocytosis is present?
red cell distribution width (RDW)
Reticulocytosis usually indicates:
red cell regeneration
What is the role of reduced glutathione in maitaining the integrety of the red blood cell?
reduced glutathione prevents the build up of oxidants such as peroxides
Which of the following cells is considered the malignant cell for Hodgkin's disease?
reed-sternberg cells
A patient with symptoms of anemia was being evaluated, his peripheral blood had no blasts; his bone marrow had 3% blasts and no ringed sideroblasts. Using the WHO classification system, which form of myelodysplasia is most likely present?
refractory anemia
A patient with symptoms of anemia was being evaluated, his peripheral blood had 3% blasts; his bone marrow had 8% blasts and no ringed sideroblasts. What form of myelodysplasia is most likely present?
refractory anemia with excess blast 1
In which WHO classification of myelodysplasia does the peripheral blood contain 5-19% blasts and the bone marrow contain 10-19% blasts?
refractory anemia with excess blast 2
A patient with anemia is being evaluated for myelodysplasia. He had 7% myeloblasts in the peripheral blood, along with macro-ovalocytes. The bone marrow exam revealed 15% myeloblasts. Using the WHO classification system, which form of myelodyplasia does he have?
refractory anemia with excess blasts 2
A 62 year old woman was diagnosed as having macrocytic anemia. Her white cell count and platelet counts were normal. Megaloblastic anemia was ruled out based on the results of a serum B12 and folate tests. The physician referred the patient to a hematologist who ordered a bone marrow exam, including a Prussian blue stain of the marrow. The bone marrow was reported as 70% cellular. 3% of the non-erythroid cells were blasts. On the Prussian blue stain, 20% of the erythroid precursor cells contained 5 or more blue-green granules that encircled the nucleus. What diagnosis would you assign this patient?
refractory anemia with ringed sideroblasts
Total WBC 4.9 x 109/L Segmented neutrophils 35% Lymphocytes 57% Monocytes 5% Eosinophils 3%
relative lymphocytosis
Elevation of the neutrophil count above 70% is termed:
relative neutrophilia
What technique is used to get an accurate hemoglobin result when a patient's plasma is lipemic?
replace the patient's plasma in the specimen with saline
Hemolytic uremic syndrome is characterized by all of the following EXCEPT:
retuclocytopenia
Which platelet agonist detects platelet adhesion rather than platelet aggregation?
ristocetin
A what temperature should a blood specimen for immunophenotyping be stored?
room temp
What abnormal red blood cell morphology is associated with disseminated intravascular coagulation (DIC)?
schistocytes
Microangiopathic hemolytic anemia is characterized by:
schistocytes and nucleated red blood cells
Patients suffering from chronic anemia who receive multiple blood transfusions can over time develop this condition:
secondary hemochromatosis
A 69-year-old male patient was diagnosed with chronic lymphocytic leukemia (CLL) 3 years previously. His hemoglobin has now dropped to 5.6 g/dL. There are spherocytes and nucleted red cells present on his blood smear. His reticulocyte count is 6.8% and his total bilirubin is 4.5 mg/dL. His direct antiglobulin test (DAT) is positive. Based on these findings, what is the most likely cause of this patient's anemia?
secondary warm auto-immune hemolytic anemia (WAIHA)
Seminal fluid fructose measurements are used to evaluate the function of:
seminal vessicles
An anemic patient has oval macrocytes and hypersegmented neutrophils in the peripheral blood. Both megaloblastic anemia and myelodyplasia are possible diagnoses. What test(s) could be used to differentiate between the two?
serum b12 and foalte
A physician wants to measure a patient's iron stores. What blood test could he order?
serum ferritin
Of the following, which is the pattern of results typically observed in iron deficiency anemia?
serum iron decreased, TIBC increased, serum ferritin decreased
Which of the following are associated with mycosis fungoides?
sezary cells
In which condition is autosplenectomy (non-immune destruction of the spleen) most likely to occur?
sickle cell disease
Presence of Pappenheimer bodies are characteristic of which iron related condition?
sideroblastic anemia
Which of the following properties of the cell, analyzed by flow cytometry, is related to forward angle light scatter?
size
Which types of fat found in the stool requires acidification and heat before staining with Sudan III or Oil Red O stain?
soaps and fatty acids (split fats)
In which of the following population groups would alpha-thalassemia be most prevalent?
southeast asians
In which molecular method are restriction endonucleases in combination with gel electrophoresis?
southern blot
An enzyme found primarily in neutrophils reacts with naphthol AS-D chloroacetate releasing naphthol. Naphthol then combines with a diazonium salt producing a colored precipitate. This describes the principle of the:
specific esterase stain
Which of the following is a characteristic of spinal fluid from a traumatic tap?
specimen clotted
epididymis
sperm maturation
seminiferous tubules
spermatogensis
Which red blood cell morphology is commonly observed in warm autoimmune hemolytic anemia (WAIHA)?
spherocytes
Autoimmune hemolytic anemia is characterized by which of the following?
sphetocytic red cells
Which of the following is TRUE regarding the international normalized ratio (INR)?
standardize pt
All of the following are examples inflammatory (type 2) joint disorders EXCEPT:
staphylococcus aureus infection
Which of the following in NOT one of the causes of secondary polycythemia?
stem cell defect
Which of the following is NOT one of the causes of relative polycythemia?
stem cell defect
The stain reacts with lipids such as sterols, neutral fats and phospholipids. This describes the principle of the:
sudad black b stain
Which chromosomal abnormality is found in the majority of cases of chronic myelogenous leukemia?
t(9;22)
The most common form of lymphoma seen in children is:
t-cell lymphoblastic lymphoma
An acid is used to inhibit all the isoenzyme forms except 5. A substrate is added, if isoenzyme 5 is present, the substrate is hydrolyzed and a red precipitate is formed. This describes the principle of the:
tartrate resistant acid phosphatase stain
Which "stain" uses fluorescene labeled monoclonal antibodies to detect cells of lympoid origin?
terminal deoxynuclotidyl transferase
Most lymphoblasts stain positively with:
terminal doxyribonucleotidyl transferase
Which of the following statements about amniotic fluid bilirubin is TRUE?
the 410 nm peak is due to hemoglobin and the 450 peak is due to bilirbuin
A patient has hereditary spherocytosis. How would this affect his red cell indices?
the MCHC would be increased
Which is not one of the mechanisms of drug-related hemolytic anemia?
the drug itself mimics complement inducing cell lysis
A physician aspirates knee fluid that is yellow but slightly bloody. When acetic acid is added to some of the fluid a solid clot is formed. This result indicates that:
the fluid has normal synoviscoity
Infants with sickle cell disease typically do not exhibit symptoms of the disease until 6 months of age. How can this be explained?
the infant is protected by high concentrations of Hb F until then
calculation of the CSF/serum albumin index is helpful in determining:
the integrity of the blood brain barrier
Qualitative neutral and total fat stains were performed on a stool specimen. The neutral fat slide show a normal amount of fat while the split (total) fat slide shows an increased amount of fat present. These results indicate:
the patient has celiac disease
The Guiac test is based on this principle:
the pseudoperoxidase activity of hemoglobin
A seminal fluid that is yellow in color is received in the laboratory. Although the specimen had a normal count, decreased motility and viability were noted. What do these results indicate?
the specimen was probably contaminated with urine which is toxic to sperm
Which of the following is associated with antithrombin deficiency?
thrombosis
In this hemolytic anemia lack of an enzyme called ADAMTS13 is believed to allow very large von Willebrand multimers to form which in turn causes platelet thrombi to form in the microvasculature:
thrombotic thromboycytopenic purpura (TTP)
Plasma exchange using fresh frozen plasma has been shown to be an effective treatment for:
thrombotic thromocytopenic purpura
In addition to a sperm count in a fertility study, analysis of seminal fluid should include what tests?
time if liquefaction, estimation of motility and morphology
What is the purpose of performing red blood cell counts on peritoneal lavage fluid?
to detect abdominal hemorrhage
Why would a medical laboratory scientist use 3% acetic acid to dilute a blood specimen for a manual blood count?
to lyse RBCs
A tube labeled as containing amniotic fluid is received by the laboratory. A creatinine level is requested, why might creatinine be performed on this fluid?
to make sure it is amniotic fluid and not maternal urin
Amniotic fluid is almost always collected in amber colored tubes, why?
to prevent the destruction of bilirubin
A four-year-old boy was diagnosed with acute lymphoblastic leukemia. A spinal fluid was collected from and no white blood cells were observed in the fluid. Why was spinal fluid collected?
to see if malignant cells have spread to the central nervous system (CNS).
Which of the following tests is an indirect measure of transferrin?
total iron binding capacity
1. Dark staining granules related to rapid cell maturation
toxic granules
What protein transports iron in the blood stream?
transferrin
Which of the following is detected in the neutral fat test?
triglycerides
Which type of fat found in the stool stains readily (without heating) with Sudan III or Oil Red O stain?
triglycerides (neutral fats)
9. After specimens arrive in the laboratory, they should be kept at 37oC.
true
Specimens should be collected after a period of sexual abstinence of no more than 5 days.
true
The entire ejaculate should be included in the specimen.
true
The specimen container should be warm
true
The specimen containers should be made of any type of sterile plastic or glass
true
specimens for any amniotic fluid testing should be processed immediately upon receipt by lab
true
specimens for bilirubin testing must be protected from light
true
Cerebrospinal fluid is typically collected in three tubes. Which tube should be sent to microbiology for cultures?
tube 2
Cerebrospinal fluid is typically collected in three tubes. Which tube should be sent to hematology for cell counts?
tube 3
How many defective alpha-globin genes are present in a patient with alpha-thalasemia minor?
two
Hemophilia, traumatic injury and heparin overdose are all examples of causes of what type of joint disorder?
type 4- hemorrhagic
In majority of cases of aplastic anemia the cause is:
unknown (idiopathic)
Which of the following test is MOST sensitive to decreased levels of vitamin B12?
urine methylmalonic acid (MMA)
3. A bubble-like cytoplasmic inclusion caused by phagocytosis
vacuoles
Select the amino acid substitution that is responsible for sickle cell anemia:
valine is substituted for glutamic acid at the sixth position of the beta chain
fresh seminal fluid specimen with eosin-nigrosin stain to determine:
viability
Which of the following tests could one use to screen for the presence of lupus anticoagulant?
viper venom
Intrinsic factor is required for absorption of?
vitamin B12
Without vitamin supplementation, persons adhering to a strict vegetarian diet can develop:
vitamin B12 deficiency
Plasma homocysteine levels are elevated in:
vitamin b12 deficiency and folic acid deficiency
Which of the following is necessary for platelet adhesion to occur?
von willebrand factor
Turbidity of cerebrospinal fluid is most frequently caused by:
white blood cells
morphology = 55% normal forms (basic criteria)
within range
motility- 65% with strong forward motion
within range
viability = 80%
within range
viscosity = pours in droplets
within range
white blood cells = 0.1 million/mL
within range
A patient presents with paleness, fatigue and bruising. The physician orders a CBC and the white blood count is 2.6 x 109/L. Could this patient have acute myelogenous leukemia (AML)?
yes, about 50% of all cases present with normal or low total white blood cell count
Test Result Color Gray-white Volume 4.2 mL Liquefaction 40 minutes Viscosity Watery Sperm concentration 30,000,000/mL Motility 70% Morphology 70% normal Viability 60%
yes, motility is too high compared to viability
