MediaLab Hematology Practice Questions Part 2
All of the following are usually increased in alpha thalassemia EXCEPT? A) Iron binding capacity B) Percent iron saturation C) Lactate dehydrogenase D) Bilirubin
Iron binding capacity
Which of the following is NOT a cause of death in patients with hereditary hemochromatosis (HH)? A) Autoimmune disease B) Hepatocellular carcinoma C) Cirrhosis D) Cardiomyopathy
Autoimmune disease
What would be the logical first step to obtain correct values when the following results were obtained on an electronic particle counter in hematology for an alcoholic patient? WBC 6,500/cu. mm MCV 90.1 fL RBC 4,550,000/cu. mm MCH 39.6 pg HGB 18.0 g/dL MCHC 43.4% HCT 41.5% A) Perform a microhematocrit B) Check and correct for lipemia C) Dilute the blood D) Replace the lysing agent
Check and correct for lipemia
How is the Mean Cell Volume calculated? A) (Hemoglobin / Red blood cells) X 10 B) (Hemoglobin / Red blood cells) X 100 C) (Hematocrit %/ Red blood cells) X 10 D) (Hematocrit % X Hemoglobin) X 100
(Hematocrit %/ Red blood cells) X 10
No platelet aggregation response to ristocetin occurs in both Von Willebrand Disease and in Bernard Soulier Syndrome. In VWD, it is a cofactor for Von Willebrand Factor and as a result of deficiency of VWF, ristocetin becomes deficient as well. What is deficient in Bernard Soulier Syndrome to cause no response to ristocetin? A) GP IIb/IIIa B) TPa C) GP Ib/IX/V D) P2Y1
GP Ib/IX/V
Which of these conditions could result in a microcytic anemia? A) Iron deficiency B) Vitamin B12 deficiency C) Spherocytosis D) Folate deficiency
Iron deficiency
If a patient has three inactive alpha-globin genes, which of the four alpha (a) thalassemia classifications would they have? A) Alpha thalassemia trait B) Hydrops fetalis C) Hb H disease D) Silent carrier
Hb H disease
Cells, as shown in this iron-stained bone marrow preparation, are found in each of the following conditions EXCEPT: A) Alcohol abuse B) Chloramphenicol therapy C) Iron deficiency anemia D) Thalassemia
Iron deficiency anemia
The average bone marrow cellularity in a normal adult (50 years old) is: A) 30 B) 50 C) 65 D) 70
50
Which of the following gene translocations is associated with Acute Promyelocytic Leukemia (APL)? A) t(8;21) B) t(15;17) C) t(9;11) D) t(6;9)
t(15;17)
Which of the following formulas will provide the value that reflects the average cell volume in a blood sample? A) Hemoglobin (g/dL) x 10/RBC count (10^12/L) B) Hematocrit (%) x 10/RBC count (10^12/L) C) Hemoglobin (g/dL) x 100/Hematocrit (%) D) Hemoglobin x 3
Hematocrit (%) x 10/RBC count (10^12/L)
A quick mathematical check which can be applied to verify that the hemoglobin and hematocrit values on a complete blood count correspond with each other would be: A) Hematocrit X 3 = hemoglobin B) Hemoglobin X 3 = hematocrit C) Hemoglobin / hematocrit = 3 D) Hemoglobin + hematocrit = 3
Hemoglobin X 3 = hematocrit
A dilution commonly used for a routine sperm count is: A) 1:2 B) 1:20 C) 1:200 D) 1:400
1:20
What may cause the following mixing studies results? Initial aPTT = 133 seconds 1:1 Mix aPTT pre-incubation = 33 seconds 1:1 Mix aPTT post-incubation = 124 seconds A) Factor IX deficiency B) Factor XI deficiency C) A slow acting coagulation inhibitor D) Factor VII deficiency
A slow acting coagulation inhibitor
Which group of conditions increases the risk of HbS polymerization? A) Acid pH, dehydration, decreased level of 2,3-DPG B) Alkaline pH, dehydration, increased level of 2,3-DPG C) Acid pH, dehydration, increased level of 2,3-DPG D) Alkaline pH, dehydration, decreased level of 2,3-DPG
Acid pH, dehydration, increased level of 2,3-DPG
A 41-year-old male arrived at the clinic with complaints of fatigue, malaise, and overall discomfort. Upon testing, the patient's CBC results were notably abnormal with 30% blasts present along with anemia and thrombocytopenia. Bone marrow and cytochemical staining were subsequently performed. The cytochemical stains noted negative reactions to Myeloperoxidase and Sudan Black B but a positive reaction to alpha-naphthyl acetate. Which of the following conditions is most likely seen? A) Acute Erythroleukemia B) Acute Monocytic Leukemia C) Acute Promyelocytic Leukemia D) Acute Lymphocytic Leukemia
Acute Monocytic Leukemia
Alder-Reilly inclusions may be found in which cell type(s)? A) Neutrophils only B) Granulocytes only C) All types of mature white blood cells D) Erythrocytes
All types of mature white blood cells
Using an automated cell counter analyzer, an increased Red Cell Distribution Width (RDW) should correlate with which of the following? A) Leukocytosis B) Anisocytosis C) Spherocytosis D) Macrocytosis
Anisocytosis
Acquired hemophilia A (not classic hemophilia A) may result from which of the following conditions? A) Anti-factor VIII inhibitor B) Factor VIII deficiency C) Warfarin therapy D) Thrombosis complications
Anti-factor VIII inhibitor
The causative agent of infectious mononucleosis attaches to a receptor on which of the following cells? A) T helper cell B) B lymphocyte C) T suppressor cell D) NK cell
B lymphocyte
What is the name of the structure that is indicated by the arrow in the image from a Wright-Giemsa stained smear? A) Döhle body B) Auer rod C) Barr body D) Toxic granulation
Barr body
Newborns who will develop Hemoglobin H disease may demonstrate up to 30% of which type of hemoglobin? A) Bart's B) Fetal C) Lepore D) Sickle
Bart's
A young child is brought in for a clinic visit for bleeding and bruising tendencies. Coagulation screening tests revealed normal PT and APTT levels. The CBC was overall normal with the exception of a low platelet count and giant platelets. Platelet aggregation studies were then ordered with normal responses to all agents except ristocetin which had no response. Which of the following is the disease that correlates with these findings? A) May-Hegglin Anomaly B) Glanzmann Thrombasthenia C) Hemophilia A D) Bernard Soulier Syndrome
Bernard Soulier Syndrome
Cooley's anemia is another name for which form of beta-thalassemia? A) Delta-beta thalassemia B) Beta thalassemia major C) Beta thalassemia intermedia D) Beta thalassemia minor
Beta thalassemia major
Skeletal deformations are most commonly present in which of the following beta thalassemias? A) Beta thalassemia minor B) Beta thalassemia intermedia C) Beta thalassemia major D) All of the beta thalassemias equally
Beta thalassemia major
Which beta thalassemia shows no anemia and may not be detected using hemoglobin electrophoresis? A) Beta thalassemia minima B) Beta thalassemia minor C) Beta thalassemia intermedia D) Beta thalassemia major
Beta thalassemia minima
A patient has an increased RBC count with a decreased Hb and normal Hct. The MCV is microcytic, and the RDW is within normal limits. Many codocytes are present on the peripheral smear. Serum iron is 165 µg/dL (normal = 60 -150 µg/dL), and the TIBC is 230 µg/dL (normal = 250 - 400 µg/dL). Consider the findings on alkaline hemoglobin electrophoresis, which show an increased level of hemoglobin A2 of 5% (normal values are less than 3.5%). What is this patient's most likely diagnosis? A) Beta thalassemia silent carrier B) Beta thalassemia minor C) Beta thalassemia intermedia D) Beta thalassemia major
Beta thalassemia minor
The hematology analyzer reported an elevated white blood cell count and flagged for manual review due to the suspected presence of immature cells. What is the arrowed cell's identity, and what name is given to its inclusion? A) Lymphoma cell with ingested bacteria B) Promyelocyte with overlying platelet C) Blast with Auer rod D) Blast with a Döhle body
Blast with Auer rod
Which of the following can cause an automated platelet count to appear to be lower than it actually is? A) Platelet satellitism B) Platelet clumping C) Both platelet satellitism and platelet clumping D) Neither platelet satellitism and platelet clumping
Both platelet satellitism and platelet clumping
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-
CD2+ CD3- CD11b+ CD16+
A population of small lymphocytes is gated for further evaluation in the flow cytometry laboratory. The scatterplot for one of the evaluations is shown on the right. How would you interpret this scatterplot? A) Cells in the gated population are predominantly expressing CD5, but not expressing CD20. B) Cells in the gated population are predominantly expressing CD20, but not CD5. C) Cells in the gated population are co-expressing CD5 and CD20. D) Cells in the gated population are expressing neither CD5 nor CD20.
Cells in the gated population are co-expressing CD5 and CD20.
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
CFU-S
A manual white blood cell count was performed by the hematology technologist. The cell counts for both sides were 99 and 164, respectively. All nine large squares were counted on each side. The dilution for this kit was pre-measured at 1:100. What should the technologist report as the white cell count? A) 14.61 x 10^9/L B) 1.46 x 10^9/L C) 4.61 x 10^9/L D) Cannot report
Cannot report
Blood serum contains each of the following substances except: A) Water B) Sugars C) Coagulation proteins D) Electrolytes
Coagulation proteins
This image is from a patient with alpha thalassemia. Though not diagnostic for this condition, what morphology is present which would lead you to consider a quantitative disorder of hemoglobin synthesis? A) Basophilic stippling B) Codocytes C) Ovalocytes D) Schistocytes
Codocytes
This photo shows the bone marrow aspirate of a patient with a history of fatigue and petechiae. The CBC from the peripheral blood would confirm: A) Decreased RBCs, platelets, and WBCs B) Decreased RBCs C) Decreased WBCs D) Decreased platelets
Decreased RBCs, platelets, and WBCs
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
Delta and gamma
Which of the following methods for long-term diabetic monitoring is recommended for patients with sickle cell anemia? A) Fructosamine B) Hemoglobin A1c (HbA1c) C) Both methods are acceptable. D) Neither method is acceptable.
Fructosamine
Which of the following types of anemia can be described as an inherited bone marrow failure syndrome with patients developing dystrophic nails and white patches in the mouth? A) Fanconi anemia B) Dyskeratosis congenita C) Chronic aquired pure red cell aplasia D) Diamond-Blackfan anemia
Dyskeratosis congenita
What are the expected lab results in the condition known as "Afibrinogenemia"? A) Elevated PT, elevated aPTT, elevated thrombin time (TT) and elevated reptilase time B) Elevated PT, elevated aPTT, elevated thrombin time (TT) and normal reptilase time C) Elevated PT, elevated aPTT, normal thrombin time (TT) and normal reptilase time D) Normal PT, elevated aPTT, normal thrombin time (TT) and elevated reptilase time
Elevated PT, elevated aPTT, elevated thrombin time (TT) and elevated reptilase time
Which of the following cellular function is correctly matched to the cell type? A) Eosinophil: Involved in some parasitic infection response B) RBC: Involved in immune response; especially viral C) Lymphocytes: Involved in hemostasis D) Platelet: Involved in bacterial infection response
Eosinophil: Involved in some parasitic infection response
Which hormone is produced by the kidney and influences erythrocyte production? A) Growth hormone B) Erythropoietin C) Interleukin 3 D) ALA synthetase
Erythropoietin
The prothrombin time test will detect deficiencies in which pathways? A) Extrinsic and intrinsic pathways B) Extrinsic and common pathways C) Intrinsic pathway and common pathways D) Intrinsic pathway only
Extrinsic and common pathways
Which of the following coagulation pathways includes Factor VII? A) Common pathway B) Extrinsic pathway C) Intrinsic pathway D) Fibrinolysis
Extrinsic pathway
Hemophilia B or Christmas disease is the result of a hereditary deficiency in which coagulation factor? A) Factor X B) Factor VIII C) Factor XI D) Factor IX
Factor IX
Which of the following factors is Vitamin K-dependent? A) Factor I B) Factor VIII C) Factor IX D) Factor XI
Factor IX
The most specific test to detect both presence of Factor V Leiden, also known as activated protein C resistance (APC) and predict risk of thrombosis is: A) Activated Protein C Resistance (APC) clot-based assay B) Factor V Mutation Assay C) ELISA assay for Factor V D) Antithrombin antigen assay
Factor V Mutation Assay
Which coagulation factor is found ONLY in the extrinsic pathway? A) Factor VII B) Factor VIII C) Factor IX D) Factor X
Factor VII
Warfarin (coumarin-type anticoagulant) inhibits all the following coagulation factors except: A) Factor II B) Factor IX C) Factor VII D) Factor XI
Factor XI
Platelet satellitism is most likely to cause which of the following erroneous results? A) Falsely increased WBC count B) Falsely decreased RBC count C) Falsely decreased platelet count D) Falsely decreased hemoglobin level
Falsely decreased platelet count
All of the following tests will be abnormal in a patient with Stuart-Prower Factor deficiency EXCEPT? A) Prothrombin Time (PT) B) Activated Partial Thromboplastin Time (APTT) C) Russel Viper Venom Test (dRVVT) D) Fibrinogen
Fibrinogen
A laboratory test which can detect the specific decrease in the platelet surface membrane receptor glycoprotein Ib and thus lead to a diagnosis of Bernard Soulier Syndrome (BSS) is: A) Platelet count B) Ristocetin induced platelet aggregation studies C) Flow cytometry D) ELISA
Flow cytometry
Which of the following morphologic characteristics is associated with the Chédiak-Higashi syndrome? A) Pale blue cytoplasmic inclusions in neutrophils B) Giant lysosomal granules in granulocytes C) Neutrophils with many small granules and vacuoles D) Nuclear hypo-segmentation of neutrophils
Giant lysosomal granules in granulocytes
In serum protein electrophoresis all of the following proteins reside in the band closest to the anodal end EXCEPT: A) Retinol-binding protein (RBP) B) Transthyretin C) Albumin D) Haptoglobin
Haptoglobin
Which abnormal hemoglobin may be formed in alpha thalassemia? A) Hb Bart's B) Hb Lepore C) Hb E D) Hb S
Hb Bart's
The anemia seen in anemia of chronic disease (also known as anemia of chronic infection) is characterized by low serum iron levels. Which of the following contributes to the low serum iron levels seen in persons with anemia of chronic disease? A) Decreased erythropoietin B) Hepcidin C) Decreased dietary intake D) Decreased ferritin levels
Hepcidin
The autohemolysis test is MOST useful in the diagnosis of which condition? A) Pyruvate kinase (PK) deficiency B) G6PD deficiency C) Sickle cell anemia D) Hereditary spherocytosis
Hereditary spherocytosis
Remnants of erythrocyte nuclei, nuclear fragments, or aggregates of chromosomes are called: A) Heinz bodies B) Howell-Jolly bodies C) Basophilic stippling D) Pappenheimer bodies
Howell-Jolly bodies
Single erythrocyte inclusions which are large, round, smooth, and purplish-blue staining are most likely: A) Howell-Jolly bodies B) Heinz bodies C) Basophilic stippling D) Cabot rings
Howell-Jolly bodies
Which of the following inclusions may be observed on a Wright-stained peripheral blood smear if a patient has had a splenectomy? A) Reticulocytes B) Basophilic stippling C) Howell-Jolly bodies D) Schistocytes
Howell-Jolly bodies
How does hydroxyurea aid in the treatment of sickle cell disease? A) Acts as an analgesic in pain management. B) Prevents sickle cells from clumping together. C) Induces increased production of HbF. D) Reduces the number of sickle cells that form.
Induces increased production of HbF.
Laser light can be described by all of the following characteristics EXCEPT: A) Intensity and concentration B) Used in flow cytometry for cell sorting and identification of cells C) LASER is an acronym for light amplified by stimulated energy radiation D) Monochromaticity
LASER is an acronym for light amplified by stimulated energy radiation
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
Large, darkly staining cytoplasmic granules composed of partially digested mucopolysaccharides
All of the following are sites of active hematopoiesis in the adult EXCEPT: A) Skull B) Ribs C) Liver D) Pelvis
Liver
A patient initially has a prolonged PT. After reviewing the patient's case and laboratory findings, the physician administers intravenous vitamin K. The repeat PT results are normal after 24 hours of vitamin K therapy. What clinical condition is MOST likely to produce these results? A) Liver disease B) Factor XI deficiency C) Fibrinogen deficiency D) vWF deficiency
Liver disease
Relative polycythemia is a mild form of polycythemia that can be the result of all of the following EXCEPT? A) Dehydration B) Hemoconcentration C) Gaisböck's syndrome D) Low thrombopoietin levels
Low thrombopoietin levels
Normal adult CSF may have 0-5 white blood cells (WBCs)/µL. Which of the following cell types account for 60-100% of these WBCs? A) Neutrophils B) Lymphocytes C) Monocytes D) Eosinophils
Lymphocytes
The peroxidase stain is useful in differentiating between which cells? A) Lymphocytic and granulocytic cells B) Monoblastic and myeloblastic cells C) Leukemoid reaction and myelocytic leukemia D) Eosinophils and neutrophils
Lymphocytic and granulocytic cells
Hemoglobin (g/100mL) x 10 / RBC count (millions/mm3) is the formula for calculating: A) MCHC B) MCV C) MCH D) RDW
MCH
Blood samples for complete blood counts are collected on morning rounds and stored in a rack in the phlebotomist's basket. When the phlebotomist delivers the samples to your workstation, the cells and plasma in the samples have separated. As a result, one of the samples has lipemic plasma. Which of the following parameters may be affected by the lipemia? A) RDW B) MCV C) MCHC D) None of the parameters would be affected.
MCHC
An automated complete blood count produced the following red blood cell parameters: Parameter: Value: Reference Interval White blood cells (WBC): 5.6 x 109/L: 4.0-10.0 x 109/L Red blood cells (RBC): 3.4 x 10^12/L: 4.2-5.9 x 10^12/L Hemoglobin: 11.1 g/dL: 12-16 g/dL Hematocrit: 31%: 37-48% MCV: 92 fL: 80-100 fL MCHC: 38 g/dL: 30-37 g/dL A specimen for a repeat complete blood count is received in the laboratory six hours later. The sample visually appears to be much lighter in color than the original sample. The technologist questions whether both samples are from the same patient. Which of the following parameter(s) is LEAST likely to change between samples, if from the same patient, and would be most useful to determine if there is a discrepancy that may be the result of a preanalytical error in sample collection? A) Hemoglobin B) Hematocrit C) MCV D) White blood count
MCV
When comparing normal cells, the nucleus of a small lymphocyte is about the same size as a? A) Normal erythrocyte B) Small monocyte C) Large platelet D) Band neutrophil
Normal erythrocyte
A 52 year old male with a history of alcoholism is admitted to the hospital with severe abdominal pain. A CBC reveals the following results: Parameter: Value: Reference Interval White blood cells (WBC): 15.7 x109/L: 4.0-10.0 x109/L Red blood cells (RBC): 3.9 x10^12/L: 4.2-5.9 x10^12/L Hemoglobin: 14.4 g/dL: 12-16 g/dL Hematocrit: 41%: 37-48% MCV: 105 fL: 80-100 fL RDW-CV: 16.5%: 11.0-14.0% Considering the information that is provided, which of the following would be an appropriate description this patients RBC population? A) Macrocytic, heterogenous (i.e., more variable) B) Macrocytic, homogenous (i.e., not as variable) C) Normocytic, homogenous D) Microcytic, heterogenous
Macrocytic, heterogenous (i.e., more variable)
CD5 antigen is normally found on which of the following lymphocyte populations? A) Mature T cells B) Normal B cells C) Both mature T cells and normal B cells D) None of the above, CD5 is not a lymphoid marker
Mature T cells
Which of these descriptions correlates best with the red cell distribution curve shown? A) Microcytic patient after transfusion B) Normal red cell distribution C) Pronounced macrocytosis D) Marked anisocytosis
Normal red cell distribution
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
Monocyte
The pale-staining cytoplasmic bodies marked by the arrow in the image may be seen in each of the following conditions EXCEPT? A) Pregnancy B) Acute infections C) Mucopolysaccharidosis D) Burns
Mucopolysaccharidosis
Which of the following cells are considered abnormal and clinically significant on a CSF differential? A) Ependymal B) Myeloblast C) Pia arachnoid mesothelial D) Choroidal cells
Myeloblast
In which stain will auer rods have the most intense reaction? A) Sudan Black B B) Myeloperoxidase C) Chloroacetate Esterase D) Periodic Acid-Schiff
Myeloperoxidase
An automated hematology counter flagged the white blood cell count. Upon reviewing the peripheral blood smear, the technologist viewed many cells that appeared similar to those in this image. What should the technologist report? A) Lymphocytes B) Lymphoblasts C) Reactive/atypical lymphocytes D) Plasma cells
Reactive/atypical lymphocytes
A semen sample for semen analysis should generally be received at the testing site within what period of time? A) One hour B) Two hours C) Three hours D) Four hours
One hour
Which of the following is a sign of dyserythropoiesis that occurs in Myelodysplastic Syndromes? A) Oval macrocytes B) Schistocytes C) Basophilic stippling D) Sickle cells
Oval macrocytes
After several incidences of deep vein thrombosis (DVT), a patient is to be assessed for hypercoagulability. The following would be an appropriate panel for hypercoagulability screening: A) PT, aPTT. Lupus Anticoagulant (LA) screening, Activated Protein C resistance (APC) , d-dimer screening B) LA screening, APC resistance C) D-dimer screening and Fibrin Degradation Products (FDP) test D) PT, aPTT, Thrombin Time (TT), Bleeding Time, and mixing studies
PT, aPTT. Lupus Anticoagulant (LA) screening, Activated Protein C resistance (APC) , d-dimer screening
By utilizing a Prussian Blue stain, which of the following red blood cell inclusions would be identifiable if present? Note: Upper image = Wright-Giemsa stain Lower image = Prussian Blue stain A) Cabot rings B) Pappenheimer (siderotic) bodies C) Howell Jolly bodies D) Malarial parasites
Pappenheimer (siderotic) bodies
Degenerated erythrocyte cytoplasmic organelles that contain iron are called: A) Cabot rings B) Howell-Jolly bodies C) Heinz bodies D) Pappenheimer bodies
Pappenheimer bodies
Which of the following is considered a macrocytic anemia? A) Cooley's anemia B) Iron deficiency anemia C) Pernicious anemia D) Polycythemia vera
Pernicious anemia
What is another name used to designate a fully committed B-lymphocyte: A) T-lymphocyte B) Reactive lymphocyte C) Large lymphocyte D) Plasma cell
Plasma cell
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
Polychromatic normoblast
Which one of the following conditions is associated with glucose-6-phosphate dehydrogenase (G6PD) deficiency? A) Microcytic red cells B) Precipitation of hemoglobin C) Faulty heme synthesis D) Hemoglobins with low oxygen affinities
Precipitation of hemoglobin
Which of the following is responsible for inhibiting the tissue plasminogen activator? A) Antithrombin B) Tissue Factor Pathway Inhibitor C) Thrombin D) Protein C
Protein C
All of the following factors offer a protective effect, delaying symptoms in persons with hereditary hemochromatosis (HH) EXCEPT? A) Regular blood donation B) Pregnancy C) Regular use of multivitamins with iron D) Menstruation
Regular use of multivitamins with iron
Patients who undergo urologic procedures, as well as those with genitourinary tract diseases such as prostate cancer can sometimes be prone to diffuse hemorrhage. A possible cause of this could be which of the following? A) Dysfunction of platelets B) Release of urokinases C) Initiation of tissue factor released from endothelial cells D) Release of PGL (a prostacyclin ) from endothelial cells
Release of urokinases
A smear that is prepared from equal parts of new methylene blue and whole blood is used for which of the following? A) WBC differential B) Platelet estimate C) Reticulocyte count D) Manual RBC count
Reticulocyte count
All of the following methods are used in the diagnosis and classification of acute leukemia, EXCEPT? A) Immunophenotyping B) Reticulocyte count C) Cytochemical Analysis D) Cytogenetics
Reticulocyte count
What physiological factor causes sedimentation in the Erythrocyte Sedimentation Rate (ESR)? A) Elevated levels of immunoglobulins B) Increased concentrations of fibrinogen C) Rouleaux formation D) Tilted tube, varying from the vertical
Rouleaux formation
Von Willebrand Factor (vWF) multimer analyses of patient's plasma can be performed by: A) Ristocetin induced platelet aggregation tests (RIPA) B) ELISA antigen assays C) SDS agarose gel electrophoresis D) Latex agglutination tests
SDS agarose gel electrophoresis
The image is a stained smear of cerebrospinal fluid. Which of the following statements is true about the cells shown at the right? A) Their numbers are increased when the patient has leukemia. B) Their numbers are increased when the patient has multiple sclerosis. C) They line the arachnoid space. D) They are capable of engulfing red cells.
They line the arachnoid space.
All of the following are true of lab results of patients with Glanzmann thrombasthenia EXCEPT? A) Deficient GPIIb/IIIa B) Severe thrombocytopenia C) Increased bleeding time D) Abnormal platelet aggregation with ADP, collagen, and epinephrine
Severe thrombocytopenia
Neoplastic T lymphocytes with irregular, convoluted (cerebriform) nuclear outlines best describe which of the following? A) Gaucher cells B) Mott cells C) Sezary Cells D) Leptocytes
Sezary Cells
What is the characteristic RBC that is uniquely associated with HbSS? A) Target cell (codocyte) B) Sickle cell (drepanocyte) C) Polychromatophilic cell D) Spherocyte
Sickle cell (drepanocyte)
Which anemia is formed due to the inability to incorporate iron into the protoporphyrin ring? A) Iron Deficiency Anemia B) Sideroblastic Anemia C) Anemia of Chronic Inflammation D) Thalassemia
Sideroblastic Anemia
Which of the following would best describe what you might observe after a traumatic CSF tap? A) All tubes pale yellow B) All tubes clear C) All tubes contain equal amounts of blood D) Significantly more RBCs were found in tube #1 vs. tube #3
Significantly more RBCs were found in tube #1 vs. tube #3
A 49-year-old male with pneumonia was treated with high-dose intravenous penicillin. He became jaundiced with yellow sclera. The image on the right is typical of other fields that were observed on his peripheral blood smear. Since penicillin may, in some individuals, cause autoimmune hemolytic anemia, the clinician requested a direct antiglobulin test (DAT) be performed. The DAT was positive, indicating that antibodies to the drug were produced, which were then attached to the drug on the surface of the red cells. Hemolysis occurred due to the drug-induced antibody attachment, leaving the patient with various abnormal red blood cell morphologies. Which of the following cell types would you report for this patient? A) Acanthocytes, nucleated red blood cells, polychromatophylic red blood cells B) Burr cells, spherocytes, polychromatophylic red blood cells C) Target cells, acanthocytes, polychromatophylic red blood cells D) Spherocytes, nucleated red blood cells, polychromatophylic red blood cells
Spherocytes, nucleated red blood cells, polychromatophylic red blood cells
In which of the following conditions would one see Pappenheimer bodies on the peripheral blood smear? A) Iron deficiency anemia B) Malarial infections C) G6PD deficiency D) Splenectomies
Splenectomies
The role of the medical laboratory scientist in processing bone marrow aspirates can vary depending on laboratory and clinician protocols. Which of the following statements is true regarding the bone marrow procedures typically performed by an MLS? A) They prepare the patient for the bone marrow procedure. B) They perform the bone marrow aspiation and biopsy. C) They make and/or stain the bone marrow smear. D) They examine and interpret the bone marrow smear.
They make and/or stain the bone marrow smear.
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
Stem Cell, Rubriblast, Prorubricyte, Rubricyte, Metarubricyte, Reticulocyte, Erythrocyte
The arrows in the image point to Heinz bodies in erythrocytes. Which of the following stains was used to confirm the presence of these inclusions? A) Prussian blue stain B) Wright-Giemsa stain C) Supravital stain D) Any of the above stains
Supravital stain
Which of the following best describes a segmented neutrophil? A) Nucleus contains greater than 5 lobes. B) The nucleus contains 2-5 lobes connected by a thin filament. C) Nucleus is kidney bean shaped. D) Cytoplasm of the cell contains large primary granules.
The nucleus contains 2-5 lobes connected by a thin filament.
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.
The two main compartments of the bone marrow are the vascular sinuses and hematopoietic cords.
Which of the following statements regarding the peripheral blood smear shown in the photomicrograph is TRUE? A) This area is acceptable for performing a manual differential B) This area is unacceptable for scanning for blast cells, parasites, fibrin strands, and platelet clumps C) This area is unacceptable for evaluating red blood cell morphology because it is too thin D) This area is acceptable for evaluating red blood cell morphology
This area is unacceptable for evaluating red blood cell morphology because it is too thin
Which of the following converts Fibrinogen into Fibrin Monomer? A) Heparin B) Calcium 2+ ions C) Tissue Factor D) Thrombin
Thrombin
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
Thrombocytes
Aspirin ingestion prevents the synthesis of this signaling molecule in the platelet? A) Thromboxane A2 B) Calcium C) Collagen D) ADP
Thromboxane A2
In which organ or tissue do T-lymphocytes mature? A) Bone marrow B) Thymus C) Lymph nodes D) Spleen
Thymus
What condition/situation is associated with the peripheral blood picture in the image on the right? A) Hereditary spherocytosis B) Lead poisoning C) Transfusion dimorphism D) Folic acid deficiency
Transfusion dimorphism
These 3 tubes of cerebrospinal fluid (CSF) are delivered to the laboratory for analysis. The tube labeled #1 was the first tube collected. Which one of the tubes should be used by the hematology department for cell count and differential? A) Tube #1 B) Tube #2 C) Tube #3 D) Any one of the tubes can be used
Tube #3
The principle behind the diagnosis of Paroxysmal Nocturnal Hemoglobinuria (PNH) by flow cytometry is: A) Incubation of patient blood in sucrose solutions, thus promoting hemolysis of PNH blood by complement. B) Evaluating the patient's lymphocytes for CD4 and CD8 markers. C) Using a fluorescein labeled proaerolysin variant to selectively bind to GPI anchor proteins. D) Evaluating red blood cell histograms for variation in size.
Using a fluorescein labeled proaerolysin variant to selectively bind to GPI anchor proteins.
Conditions suggested by the macrocytes and the neutrophil in the photograph to the right include Folate deficiency and which other condition? A) Thalassemia B) Vitamin B12 deficiency C) Pelger-Huet anomaly D) Sickle cell anemia
Vitamin B12 deficiency
Eosinophils are increased in all of the following conditions EXCEPT? A) Parasitic infections B) Allergic reactions C) Viral infections D) Inflammatory reactions
Viral infections
An 18-year-old patient bled profusely following a tooth extraction. She had a history of sporadically increased menstrual bleeding and nose bleeds. The laboratory tests showed: Platelet count of 350 x 109/L PT of 12 seconds PTT of 125 seconds Factor VIII activity of 20% Factor IX activity levels 102% Platelet aggregation studies - normal ADP, collagen and decreased with Ristocetin. What is the most likely cause of this patients bleeding episodes? A) Von Willebrand's disease B) Hemophilia A C) Hemophilia B D) Vascular Disease
Von Willebrand's disease
Cell counts on CSF specimens should be performed within what time frame following collection of the CSF sample? A) Within one hour B) Within four hours C) Within eight hours D) Within 24 hours
Within one hour
A yellow coloration found in fresh cerebrospinal fluid supernatant is termed: A) Xanthochromia B) Hemolysis C) Jaundice D) Hyperlipidemia
Xanthochromia
