hematology 1 final exam

What is the total volume of one side of a hemocytometer if the ruled area is 3 3 mm and the depth is 0.1 mm? a. 0.3 mm3 b. 0.9 mm3 c. 1.0 mm3 d. 9 mm3

0.9 mm^3

For which patient is a hemoglobin of 10.5 g/dL normal? a. newborn b. 2-year-old child c. adult female d. adult male

2 year old child

If an adult male has a HCT of 30% and a retic count of 3%, what would the corrected reticulocyte count be? a. 1.0% b. 2.0% c. 3.0% d. 4.0%

2.0%

How many circulating platelets are produced from a single megakaryocyte? Question options: 200 - 400 2000 to 4000 6000 - 8000 10,000 - 12,000

2000 to 4000

How many lobes of the nucleus does a hypersegmented neutrophil have?

6-12 lobes

A tech performs a reticulocyte count and observes 63 reticulocytes among 1000 erythrocytes on a smear. What is the reported count? a. 0.63%, which is a decreased value b. 6.3%, which is within the reference range c. 6.3%, which is an increased value d. 63%, which is an increased value

6.3% which is an increased value

Ten nucleated red cells are found in a blood smear when differentiating 100 white cells. What is the corrected white blood count if the automated cell counter printed a count of 10.0 109/L? a. 0.91 X 109/L b. 9.1 X 109/L c. 91 X 109/L d. 10 nucleated red cells (NRBCs) are not enough to require a correction

9.1 x 10 ^9/L

Select the best test to distinguish immune hemolytic anemia from nonimmune hemolytic anemia. Question options: Direct antiglobulin test (DAT) Bilirubin Haptoglobin Reticulocyte count

DAT

Which of the following can distinguish immune hemolytic anemia from Hereditary Spherocytosis in a patient with spherocytes? Question options: Osmotic fragility Reticulocyte count Presence of polychromasia DAT

DAT

Folate and Vitamin B12 work together in the production of: Question options: proteins phospholipids RNA DNA

DNA

Megaloblastic anemias are caused by a defect in the synthesis of: Question options: DNA RNA Erythropoietin Heme

DNA

Which is the most common erythrocyte enzyme deficiency? Question options: pyruvate kinase hexokinase glucose phosphate isomerase glucose-6-phosphate dehydrogenase

G6PD

All of the following have been linked to excess erythrocyte destruction except: Question options: Drugs IgM autoimmune antibodies IgE alloantibodies IgG alloantibodies

IgE alloantibodies

Which of the following is true regarding the mechanism of warm-reactive autoimmune hemolytic anemia (WAHA)? Question options: IgG autoantibodies cause intravascular hemolysis IgG autoantibodies cause extravascular hemolysis IgM alloantibodies cause complement activation IgM autoantibodies cause immune complex formation

IgG autoantibodies cause extravascular hemolysis

A patient has crescent- or banana-shaped malarial gametocytes. Which of the following is probably true regarding the type of malaria and its clinical course? Question options: P. malariae, which is benign and needs no treatment P. ovale which is found mostly in southern United States and is usually fatal P. falciparum, which is the most clinically serious P. vivax, which is the most clinically serious

P. falciparum which is the most clinicslly serious

What substance is stained blue in a retic stain?

RNA

What test estimates the rate of erythrocyte production by the bone marrow? a. RBC b. HCT c. RPI d. Bone marrow biopsy

RPI

A patient with a deficiency of VWF protease ADAMSTS-13 would be at risk to develop which condition? Question options: TTP HUS IDA hereditary spherocytosis

TTP

Plasma exchange is used as a primary treatment in which of the following? Question options: HUS TTP DIC AMA

TTP

In what maturation stage does DNA synthesis occur? a. Rubricyte b. Reticulocyte c. Erythrocyte

a

Select the metabolic pathway that regulates oxygen delivery to tissues: a. Rapoport-Luebering Pathway b. Embden-Meyerhof Pathway c. Methemoglobin Reductase Pathway d. Hexose Monophosphate Pathway

a

The calculated indices on Mary Jones from Question 17 are: MCV (fL) MCH (pg) MCHC (g/dL) a. 93 50 53 b. 105 29 37 c. 93 22 28 d. 105 34 35

a

The first key rate limiting step of heme synthesis is Question options: a. glycine and Succinyl-CoA to form delta ALA b. protoporphyrin and heme c. uroporphyrin and porphobilinogen d. protoporphyrin X and iron

a

The immature cell located near the center is: Question options: a. Metarubricyte (Orthochromic normoblast) b. Mature erythrocyte c. Rubriblast (Normoblast) d. Prorubricyte (Basophilic normoblast)

a

When compared to mature erythrocytes, reticulocytes: a. are larger and bluer on Wright stain from remnant RNA. b. are larger and bluer on Wright stain from remnant DNA. c. still have chromosomes in the cytoplasm. d. have Heinz bodies.

a

Which of the following causes a shift to the right on the oxygen dissociation curve? a. high levels of H+ in the body b. alkalosis c. hypothermia d. decreased levels of 2,3-biphosphoglycerate (2,3-BPG)

a

Which of the following correctly describes a normal mature erythrocyte? Question options: a. 7- to 8-micron biconcave disk that lives 120 days b. 7- to 8-micron spheroid that lives 120 days c. 12- to 15-micron spheroid that lives 120 days d. 12- to 15-micron biconcave disk that lives 120 days

a

Which of the following red cell indices support macrocytic normochromic red cell morphology? MCV (fL) MCH (pg) MCHC (g/dL) a. 120 36 35 b. 68 22 28 c. 90 30 34 d. 75 30 34

a

Which of the following patients is at the greatest risk for developing anemia of chronic inflammation? Question options: a middle-aged woman with Type 2 diabetes mellitus a teenager with asthma a middle-aged man with rheumatoid arthritis a recent retiree with hypertension

a middle aged man with RA

Which of the following patients would be considered anemic with a hemoglobin value of 14.5 g/dL? Question options: a newborn girl an adult man an adult woman a 10 year old boy

a newborn girl

Which anemia will you see with this picture? Question options: hemolytic anemia megaloblastic anemia acquired sideroblastic anemia iron deficiency anemia

acquired sideroblastic anemia

Neutrophilia and the presence of immature cells in the peripheral blood (left shift) are most often found in patients with: Question options: an autoimmune disorder acute bacterial infection hemolytic anemia acute viral infection

acute bacterial infection

What is the mechanism for the anemia in chronic inflammation? Question options: Acute phase reactants (lactoferritin) and cytokines impair iron mobilization and erythropoiesis Inflammation and infections slow heme development Cytokines prevent iron incorporation into protoporphyrin Bone marrow iron stores are depleted by acute phase reactants

acute phase reactants (lactoferritin) and cytokines inpair iron mobalization and erythropoiesis

Which of the following might be observed on a peripheral smear in cases of cold autoimmune hemolytic anemia? Question options: helmet cells macrocytes spherocytes agglutination

agglutination

The neutrophils in chronic granulomatous disease are incapable of producing: Superoxide Hypochlorite Hydrogen peroxide All of the above A and C only

all of the above

Lack of accessible iron is the mechanism for iron deficiency and which of the following? Question options: Hemochromatosis Hemosiderosis Lead poisoning Anemia of chronic disease

anemia of chronic disease

The red cell histogram is wider than normal. Which of the following is true? Question options: The RDW is decreased Most cells are larger than normal The coefficient of variation was calculated incorrectly Anisocytosis is present

anisocytosis is present

An elevated reticulocyte count rules out which of the following? Question options: Acute blood loss Aplastic crisis Acute hemolysis Patient being treated for folic acid deficiency

aplastic crisis

When is obtaining a bone marrow core biopsy mandatory? Question options: anemia is suspected aspirate is a dry tap leukemia is suspected megakaryocyte disorders are suspected.

aspirate is a dry tap

As most blood cells mature, which of the following is characteristic? Question options: a. cell diameter increases b. nucleus to cytoplasm ratio (N:C) decreases c. nuclear chromatin becomes less condensed d. basophilia of the cytoplasm increases

b

Fetal hemoglobin (Hgb F) consists of _____ chains Question options: a. two alpha and two beta b. two alpha and two gamma c. two alpha and two delta d. two beta and two gamma

b

Maintaining glutathione levels is the function of which metabolic pathway? Question options: a. Embden-Meyerhoff Pathway b. Hexose Monophosphate Pathway c. Methemoglobin Reductase Pathway d. Rapoport-Leubering Pathway

b

The size of the nucleus generally ______ as a cell matures Question options: a. increases b. decreases c. stays the same

b

What important function does glutathione perform? Question options: a. maintains iron in the hemoglobin molecule in the ferrous state b. prevents oxidative injury to the red cell c. facilitates delivery of oxygen to the tissues d. acts as a receptor for splenic macrophages

b

Which of the following red cell indices support microcytic hypochromic red cell morphology? MCV (fL) MCH (pg) MCHC (g/dL) a. 120 36 35 b. 68 22 28 c. 90 30 34 d. 75 30 34

b

Which of the following would result in the best intestinal iron absorption? a. Eating of vegetable nonheme iron b. Eating pot roast with carrots, potatoes and drinking lemonade c. Taking an iron supplement with orange juice on an empty stomach d. Eating flounder with baked potato, applesauce and drinking sweet tea

b

Toxic granulation, Döhle bodies, and vacuolization in neutrophils are often found together in: a. May-Hegglin anomaly. b. bacterial infection. c. Chédiak-Higashi syndrome. d. Alder-Reilly anomaly.

bacterial infection

Which of the following neutrophils is capable of chemotaxis? Question options: stem cell progenitor cell myelocyte band

band

Which of the following red cell inclusions is/are often found in lead poisoning? Question options: Howell-Jolly bodies Basophilic stippling Heinz bodies Cabot rings

basophilic stippling

Intravascular hemolysis in MAHA would be associated with which of the following parameters? Question options: Bilirubin decreased; haptoglobin decreased Bilirubn decreased; haptoglobin increased Bilirubin increased; haptoglobin decreased Bilirubin increased; haptoglobin increased

bilirubin increased, haptoglobin decreased

The acceptable hemoglobin control value range is 13 + 0.4g/dL. The control is assayed Question options: neither accurate nor precise precise but not accurate both accurate and precise accurate but not precise

both accurate and precise

Extramedullary hematopoiesis occurs: Question options: a. Normally b. In children c. If the bone marrow is damaged d. In older adults

c

Maximum oxygen saturation of a hemoglobin molecule is when it has: Question options: a. one molecule of oxygen bound to it b. two molecules of oxygen bound to it c. four molecules of oxygen bound to it d. eight molecules of oxygen bound to it

c

On a standard reticulocyte preparation with new methylene blue, there are 100 cells counted with blue-stained granulofilamentous material. (1000 rbcs counted) The red blood count is 3.22 1012/L and the hematocrit is 30%. Calculate the reticulocyte count as a percent. a. .1% b. 1% c. 10% d. 100%

c

On a standard reticulocyte preparation with new methylene blue, there are 100 cells counted with blue-stained granulofilamentous material. The red blood count is 3.22 1012/L and the hematocrit is 30%. Calculate the corrected reticulocyte count. a. 1.5% b. 3.0% c. 6.7% d. 15.0%

c

Premature release of erythrocytes in the circulation due to increased erythropoietin stimulation results in Question options: a. anisochromia b. poikilocytosis c. stress reticulocytes d. smaller than normal reticulocytes

c

Regular review of blood specimen collection quality is an example of: Question options: a. Analytical quality assurance b. External quality assurance c. Pre-analytical quality assurance d. Post-analytical quality assurance

c

This cell is 8-12 um in size with chromatin tightly condensed in a pyknotic state. Question options: a. rubriblast b. rubricyte c. metarubricyte d. mature erythrocyte

c

What important function does 2,3-biphosphoglycerate (2,3-BPG) perform? a. maintains iron in the hemoglobin molecule in the ferrous state b. prevents oxidative injury to the red cell c. facilitates the delivery of oxygen to tissue d. aids in the exchange of membrane lipids with lipids in plasma

c

What is the absolute neutrophil count for a patient with a WBC of 1.0 X 109/L with 60neutrophils? a. 60 X 109/L b. 6 X 109/L c. 0.6 X 109/L d. 0.16 X 109/L

c

What is the most common RBC enzyme deficiency? Question options: a. ALA synthase b. glyceraldehyde-3-phosphate dehydrogenase c. glucose-6-phosphate dehydrogenase d. glutathione reductase

c

What is the primary mechanism for the anemia associated with kidney disease? a. hemolysis b. inadequate iron stores c. inadequate synthesis of erythropoietin d. inadequate synthesis of interleukins

c

What test estimates the rate of erythrocyte production by the bone marrow? a. Red cell count b. Hematocrit c. Reticulocyte count d. Bone marrow biopsy

c

Which of the following is true of red cell precursors as they mature? a. Nuclear to cytoplasmic ratio goes up b. Cytoplasm becomes less eosinophilic c. Cytoplasm becomes less basophilic d. Nucleoli become more prominent

c

Which of the following maturation sequences of the erythrocyte is correct? a. rubriblast, rubricyte, metarybricyte ,erythrocyte, prorubricyte, reticulocyte b. pronormoblast, orthochromic normoblast, polychromic normoblast, polychromatic erythrocyte, basophilic normoblast, erythrocyte c. rubriblast, prorubricyte, rubricyte, metarubricyte, reticulocyte, erythrocyte d. pronormoblast, polychromic normoblast, orthochromic normoblast, basophilic normoblast, polychromic normoblast, erythrocyte

c

The test that is most useful in differentiating Fanconi anemia from other causes of pancytopenia is: Question options: bone marrow biopsy Acidified serum mobilization assay chromosome breakage analysis flow cytometry of CD55 and CD59 cells

chromosome breakage analysis

in men and postmenopausal women whose diets are adequate, iron deficiency anemia is commonly caused by: Question options: increased need due to aging chronic gastrointestinal bleeding hookworm infections impaired iron absorption by the intestinal mucosa

chronic gastrointestinal bleeding

Which of the following organisms does not cause damage of the erythrocyte because of an intraerythrocytic life cycle? Question options: Plasmodium falciparum Babesia microti Bartonella bacilliformis Clostridium perfringens

clostridium perfringens

Which anemia will you see with this picture? Question options: Anemia caused by a malarial parasite Warm IgG AIHA Cold IgM AIHA Hereditary spherocytosis

cold IgM AIHA

What directs the mitosis and maturation action of progenitor cells in the bone marrow? Question options: erythropoietin the amount of circulating stem cells colony stimulating factor cytokines the number of mature cells in the peripheral circulation

colony stimulating factor cytokines

A preserved whole blood specimen from a manufacturer provides the mean values for several values in a complete blood count. What is this specimen called? Question options: Standard Calibrator Blank Control

control

What bone marrow sample is best to determine fat-to-cell ratio, overall cellularity, and searching for malignant cells? Question options: aspirate smears wet mount preparations spicule preparations core biopsy

core biopsy

A WBC count control has a mean value of 6000/uL and an SD of 300/uL. What is the 68.3% confidence interval Question options: a. 3000 - 9000/uL b. 5400 - 6600/uL c. 5500 - 6500/uL d. 5700 - 6300/uL

d

Heme is composed of iron and: a. Polypeptide chains b. Oxygen c. Methemoglobin d. Protoporphyrin lX

d

Most normal aged RBCs are destroyed by which means? a. Intravascular hemolysis b. Rupture by complement c. Phagocytosis by peripheral macrophages d. Phagocytosis by splenic macrophages

d

The process of formation and development of blood cells is called: Question options: a. Hematoma b. Hematomesis c. Hematology d. Hematopoiesis

d

What cell is 12-18 um in diameter, has two nucleoli, the chromatin is fine and homogenous and the cytoplasm is dark blue? Question options: a. Basophilic normoblast b. Orthochromic normoblast c. Polychromatic normoblast d. Pronormoblast

d

What is the main site for iron storage in the bone marrow? a. rubriblasts b. transferrin molecules c. sideroblasts d. macrophages

d

What stimulates production of erythropoietin? a. decreased red cell number in the bone marrow b. increased peripheral red cell number c. decreased iron stores d. decreased oxygen level in tissue

d

Which of the following has a pyknotic nucleus? a. pronormoblast b. basophilic normoblast c. polychromatophilic normoblast d. orthochromic normoblast

d

The immature cell seen here is a: Question options: a. Reticulocyte b. Prorubricyte (Basophilic normoblast) c. Metarubricyte (Orthochromic normoblast) d. Rubriblast (normoblast)

d.

What is the primary function of segs? Question options: make antibodies defend body from foreign organisms kill parasites phagocytize bacteria

defend body from foreign organisms

One purpose of the DAT is to: Question options: detect RBCs coated with immunoglobulin in vivo detect antibodies attached to macrophages neutralize serum complement detect IgM antibodies

detect RBCs coated with immunoglobin in vivo

The sites of active red marrow differ for adults and young children. Which site is active in a 4 y.o. child but not in an adult? Question options: proximal ends of the long bones skull pelvis distal ends of the long bones

distal end of the long bones

What abnormal findings are found in May-Hegglin anomaly? a. toxic granulation and vacuoles b. fused primary and secondary granules c. hypersegmented neutrophils and twinning d. Döhle bodylike cytoplasmic inclusions and thrombocytopenia

dohle body like cytoplasmic inclusions and thrombocytopenia

Which of the following groups has the highest risk for pernicious anemia? Question options: malnourished infants growing children elderly patients pregnant women

elderly patients

Counting the number and size of electrical interferences created by blood cells as they pass through a small aperature is a description of which of the following principles? Question options: electronic impedence optical scatter conductivity laminar flow

electrical impedence

Counting the number and size of electrical interferences created by blood cells as they pass through a small aperture is a description of which of the following principles? Electronic impedance Optical scatter Conductivity Laminar flow

electronic impedance

One of the major criteria that distinguishes DIC from other causes of microangiopathic hemolytic anemia is: Question options: elevated liver enzymes thrombocytopenia decreased hemoglobin elevated coagulation tests

elevated coagulation tests

Which of the following disorders is not characterized by the presence of schistocytes? Question options: exercise--induced hemoglobinuria prosthetic heart valve third-degree burns over 20% of the body microangiopathic hemolytic anemia

exercise induced hemoglobinuria

A mild intravascular hemolytic anemia resulting from forceful repeated impact of the feet on hard surfaces is called: Question options: Traumatic cardiac hemolytic anemia Exercise induced hemoglobinuria Bartonellosis Carrion disease

exercise induced hemolytic anemia

When a patient has severe anemia and the bone marrow is unable to effectively produce red blood cells to meet the increased demand, one of the body's responses is: Question options: extramedullary hematopoiesis in the liver and spleen increased apoptosis of erythroid progenitor cells decreased production of erythropoietin by the kidney increase proportion of yellow marrow in the long bones

extramedullary hematopoiesis in the liver and spleen

Sideroblastic anemias result from: Question options: sequestration of iron in hepatocytes failure to incorporate heme into apohemoglobin failure to incorporate iron into protoporphyrin IX sequestration of iron in myeloblasts in bone marrow

failure to incorporate iron into protoporphyrin IX

Erythrocytes found in the peripheral blood are eukaryotic cells because they contain a nucleus that contains DNA. Question options: True False

false

Heterochromatin is the active chromatin that can be used to produce cellular products and stains darker than euchromatin. Question options: True False

false

Renal disease can cause anemia due to overproduction of eryhthropoietin (EPO). Question options: True False

false

Anemia most commonly present with which set of symptoms? Question options: fatigue and shortness of breath abdominal pain chills and fever fatigue and coughing

fatigue and shortness of breath

The clinical consequences of pancytopenia include: Question options: pallor and thrombosis kidney failure and fever fatigue, infection & bleeding weakness, hemolysis & infection

fatigue, infection and bleeding

What is most common way to diagnose malaria? Question options: Usually rely on clinical symptoms Serologic tests Finding the organisms in the bone marrow Finding the organisms on the blood smear

finding the organisms on the blood smear

The methanol in Wright stain Question options: establishes the alkaline pH needed for staining. fixes the cells. establishes the acid pH needed for staining. serves as a solvent for the dyes.

fixes the cells

Which of the following is typically a macrocytic anemia? Question options: Thalassemia Iron deficiency Folate deficiency Aplastic

folate deficiency

What are the abnormal cytoplasmic inclusions in Chédiak-Higashi? a. nuclear fragments that prevent cell division b. ribosomal material that looks like Döhle bodies c. fused granules that inhibit bactericidal functions d. mucopolysaccharide lipids that disrupt cell function

fused granules that inhibit bactericidal functions

Patients with B12 deficiency commonly experience symptoms related to: Question options: Gastrointestinal and neurologic systems Liver and lymph node enlargement Skeletal and muscle problems Kidney and bladder infections

gastrointestinal and neurologic systems

Which of the following lysosomal storage diseases is characterized by storage of glucocerebroside? Alder-Reilly anomaly Gaucher disease Niemann-Pick disease Pelger-Huet anomaly

gaucher disease

Harmful peroxides in the RBC are neutralized by which of the following? Question options: ATP production Heinz bodies bilirubin glutathione

glutathione

A medical laboratory technician sees unusual darkly stained cytoplasmic inclusions in leukocytes that she has not seen before. She should: a. ignore them—they probably are not significant. b. report that the patient has Alder-Reilly anomaly. c. report toxic granulation if the patient is known to have an infection. d. have a supervisor or pathologist look at the cells.

have a supervisor or pathologist look at the cells

Transfusion-related hemochromatosis is seen in patients who: Question options: Had an adverse reaction to a blood transfusion Received the wrong type of blood Have lifelong repeated red cell transfusions Received a transfusion from a relative

have lifelong repeated red cell transfusions

Hematopoietic stem cells produce all lineages of blood cells in sufficient quantities over the lifetime of an individual because they: Question options: are present in large numbers throughout the body are unipotent have a low mitotic potential in response to growth factor have the ability of self-renewal by asymmetric division

have the ability of self renewal by asymmetric division

A patient's red cells show globular fragmentation, budding, and microspherocytes. To what have the red cells probably been exposed? Question options: Heat Chemicals Oxidant drugs Bartonellosis

heat

Packed cell volume is another way to express: Question options: mean corpuscular volume anisocytosis erythrocyte sedimentation rate hematocrit

hematocrit

Which of the following is determined by light transmission between 525 and 555 nm on automated counting instrumentation? Reticulocytes Hemoglobin MCV MCH

hemoglobin

Which of the following is reduced as an adaptation to long-term anemia? Question options: respiratory rate hemoglobin's affinity to oxygen heart rate cardiac output/stroke volume

hemoglobins affinity to oxygen

Renal failure is a prominent feature of Question options: hemolytic uremic syndrome. thrombotic thrombocytopenic purpura. Plasmodium malariae infection. march hemoglobinuria.

hemolytic uremic syndrome

Which of the following is a typical finding in PNH? Question options: Hemosiderin in urine sediment Normal levels of decay accelerating factor (CD55) Hemolysis when blood is alkaline Elevated white cells and platelets

hemosiderin in the urine sediment

The term used to describe stopping bleeding, which involves coagulation, is: Question options: hemostasis hemorrhage hematology prothrombin time

hemostasis

RBC membrane disorders associated with known skeletal protein mutations includes all of the following EXCEPT: Question options: hereditary spherocytosis herediatary elliptocytosis hereditary overhydrated stomatocytosis hereditary pyropoikilocytosis

hereditary overhydrated stomatocytosis

What RBC membrane disorder has RBCs that are thermally unstable and fragment when heated to 45C? Question options: hereditary spherocytosis hereditary elliptocytosis hereditary pyropoikilocytosis hereditary ovalocytosis

hereditary pyropoikilocytosis

Identify the inclusion designated by the arrow. Question options: Heinz body Howell-Jolly body Pappenheimer body somewhat sexy body

howell jolly body

Which of the following CBC findings is most suggestive of a megaloblastic anemia? Question options: MCV of 104 fL hypersegmentation of neutrophils RDW of 16% hemoglobin of 9.1 g/dL

hypersegmentation of neuts

All of the following are examples of microangiopathic hemolytic anemias (MAHA) except: Question options: Thrombotic thrombocytopenia purpura (TTP) Hemolytic uremic syndrome (HUS) Disseminated intravascular hemolysis (DIC) Immune thrombocytopenia purpura (ITP)

immune throbocytopenia purpura (ITP)

During anemia of chronic inflammation, hepcidin levels will: Question options: increase and increase iron absorption from the intestinal cells increase and decrease iron absorption from the intestinal cells decrease and increase iron absorption from the intestinal cells decrease and decrease iron absorption from the intestinal cells

increase and decrease iron absorption from the intestinal cells

Which of the following is a typical finding in Hereditary Spherocytosis? Question options: Increased MCHC Normal retic Reduced fragility of red cells Normal spectrin

increased MCHC

Which of the following findings is consistent with a diagnosis of megaloblastic anemia? Question options: hyposegmentation of neutrophils increased mean cell volume increase in reticulocytes decreased serum LD levels

increased mean cell volume

Which of the following is NOT consistent with myelophthisic anemia? Question options: increased reticulocyte count decreased reticulocyte count extramedullary hematopoiesis dacrocytes on peripheral blood smear

increased retic count

Which group of patients is most likely to develop iron deficiency from increased need? Question options: Young men Infants and young children Post-menopausal women Middle-aged men

infants and young children

A college student seeks medical care for extreme fatigue and swollen lymph nodes in the neck. The white blood cell (WBC) count is 11.3 X 109/L. The differential shows a relative and absolute lymphocytosis. Many of the lymphocytes are larger than normal with a basophilic cytoplasm indented by the red blood cells (RBCs). The nuclei are less clumped than normal and some have nucleoli. The rest of the complete blood count (CBC) is normal. What is the most likely diagnosis? a. infectious lymphocytosis b. infectious mononucleosis c. lymphoma d. lymphocytic leukemia

infectious mononucleosis

How does lead exposure and the other porphyrias cause anemia? Question options: Cause destruction of red cells Chelate iron from the body Impair iron absorption Interfere with heme production

interfere with heme production

What destroys the red cells in paroxysmal nocturnal hemoglobinuria (PNH)? Question options: Intravascular macrophages Intravascular antibodies Intravascular complement Extravascular splenic macrophages

intravascular complement

Which of the following is a microcytic anemia? Question options: B12 deficiency Sickle cell anemia Iron deficiency Hereditary spherocytosis

iron deficiency anemia

Which of the following is not associated with macrocytic red cells? Question options: Liver disease Iron deficiency anemia Megaloblastic anemia Myelodysplastic syndrome

iron deficiency anemia

What is most likely if a 10-month-old child fed only cow's milk has the following results: Serum iron: decreased, TIBC: increased, Ferritin: decreased Question options: Lead poisoning Chronic disease Iron deficiency from increased need and inadequate diet Iron deficiency from chronic blood loss

iron deficiency from increased need and inadequate intake

A bone marrow aspirate shows many blue granules with the Prussian blue stain. What could this mean for the patient? Question options: iron deficiency excessive immature cells iron overload increased basophilic stippling

iron overload

The Donath-Landsteiner antibody Question options: binds to the red cell membrane at 37° C. is found in serum and causes lysis of donor RBCs, which have first been incubated at 4° C and then warmed to 37° C. has specificity for Ii blood group antigens. is associated with lymphoma.

is found in serum and causes lysis of donor RBCs, which have first been incubated at 4* C then warmed to 37* C

Target cells are found primarily in: Question options: Hemolytic anemia Liver disease and hemoglobinopathies Microangiopathic hemolytic anemias (MAHA) Renal disease and TTP

liver disease and hemoglobinopathies

The peripheral blood smear of a 6-month pregnant woman showed the presence of schistocytes. Platelet count was <60 X 10^9/L, and her hemoglobin was 7.5 g/dL. She has no history of chronic disease. What laboratory test(s) might aid in diagnosing the underlying cause? Question options: haptoglobin reticulocyte count liver enzymes coagulation studies

liver enzymes

Which of the following results is/are typical in stage 3 iron deficiency anemia? Question options: Elevated reticulocyte percentage Thrombocytopenia Macrocytic red cells Low MCV, MCH, and MCHC

low MCV, MCH, MCHC

Which leukocyte population has cells that are produced outside of the bone marrow? Question options: neutrophils lymphocytes macrophages basophils

lymphs

Describe the morphologic appearance of the red cells given the following results: RBC: 1.89 1012/L, HGB: 7.5 g/dL, HCT: 21.0 %, MCV: 111, RDW: 18.5 Question options: Macrocytic with anisocytosis Normochromic, normocytic with anisocytosis Hypochromic, microcytic with little anisocytosis Macrocytic with most cells the same size

macrocytosis with anisocytosis

The most consistent finding in peripheral blood smears in severe aplastic anemia are: Question options: hairy cells, monocytopenia & neutropenia macrocytosis, thrombocytopenia & neutropenia blasts, immature granulocyes & thrombocytopenia polychromasis, NRBCs and hypersegmented neutrophils

macrocytosis, thrombocytopenia and neutropenia

Monocytes residing in tissues are: Question options: Mast cells T cells Plasma cells Macrophages

macrophages

What causes the destruction of red cells in hereditary spherocytosis (HS) is caused by? Question options: Complement Antibodies Peripheral monocytes Macrophages of the spleen

macrophages of the spleen

All of the following will be invalid when lipemia is present in a blood sample except: a. mean cell hemoglobin concentration (MCHC). b. mean cell volume (MCV). c. mean cell hemoglobin (MCH). d. Hemoglobin

mean cell volume

Which of the following is the best source of dietary vitamin B12? Question options: Fruit Green vegetables Meat Legumes

meat

Which of the following anemias is an example of disordered (asynchrony) hematopoiesis? Question options: Aplastic Megaloblastic Infiltration of bone marrow with abnormal or malignant cells Hemolytic

megaloblastic

Identify the anemia. Question options: Iron deficiency anemia megaloblastic anemia hemolytic anemia

megaloblastic anemia

Which of the following statements is correct? Question options: Macrocytic anemia is pernicious anemia. Macrocytic anemias are megaloblastic. Megaloblastic anemia is pernicious anemia. Megaloblastic anemia is macrocytic.

megaloblastic anemia is macrocytic

what cell is this

metamyelocyte

What is the pathogenesis of MAHA? Question options: Microthrombi and fibrin formed on damaged endothelial cells trap and break red cells Erythrocytes are destroyed by heat or chemicals In an attempt to remove abnormal inclusions, the spleen sequesters red cells Antibodies are formed that activate complement destroying the red cell membrane

microthrombi and fibrin formed on damaged endothelial cells trap and break red cells

Which of the following is a good use of the erythrocyte sedimentation rate (ESR)? a. monitor patients with rheumatoid arthritis b. diagnose acute appendicitis c. diagnose multiple myeloma d. monitor patients with osteoarthritis

monitor patients with RA

Which of the following cell types is capable of differentiating into osteoclasts, macrophages or dendritic cells? Question options: neutrophils leukocytes monocytes eosinophils

monocytes

Secondary cold-reactive autoimmune hemolytic anemia is found most often in patients with: Question options: Hemolytic disease of the newborn caused by anti-A or anti-D Acute and chronic myeloid leukemias Mycoplasma pneumoniae or infectious mononucleosis Hereditary spherocytosis or hereditary elliptocytosis

mycoplasma pneumoniae or infection mononucleosis

A cell having a round nucleus with delicate chromatin, prominent nucleoli, and scant basophilic cytoplasm with no to few azurophilic granules: Question options: myeloblast. myelocyte. metamyelocyte. band.

myeloblast

what cell is this

myeloblast

The correct maturation sequence for granulocytes starting with youngest. Question options: promyelocyte, myeloblast, metamyelocyte, myelocyte, segmented myeloblast, promyelocyte, myelocyte, metamyelocyte, band, segmented segmented, band, metamyelocyte, myelocyte, promyelocyte, myeloblast CFU-GEMM, promyelocyte, metamyelocyte, myelocyte, segmented

myeloblast, promyelocyte, myelocyte, meta, band, seg

The last cell in the granulocyte maturation sequence able to undergo mitosis: Question options :myeloblast promyelocyte myelocyte band

myelocyte

What is the earliest stage where a neutrophil can be distinguished from an eosinophil? Question options: CFU-GEMM myeloblast promyelocyte myelocyte

myelocyte

what cell is this

myelocyte

Normal bone marrow cells being replaced with abnormal or malignant cells is called: Question options: Diamond-Blackfan Type II CDA Pure red cell aplasia Myelophthisic anemia

myelophthisic anemia

What reagent is used in the Reticulocyte stain?

new methylene blue

Regarding reticulocytes: What stain is used? What cell product is stained? On Wright stain, what term is used to describe the cell? Question options: DNA Polychromasia RNA Methylene Blue Basophilic stippling New Methylene Blue

new methylene blue rna polychromasia

A hemoglobin of 19 g/dL is normal for which of the following patients? a. newborn b. 2-year-old child c. adult female d. adult male

newborn

Foam cells in the bone marrow are associated with

niemann-pick disease

What is the typical clinical course for those with G6PD deficiency? Question options: Severe anemia from infancy onward Moderate anemia throughout adulthood No anemia until exposure to an oxidant drug causes acute hemolysis Benign because it does not cause anemia

no anemia until exposed to an oxidant drug causes acute hemolysis

The red cell morphology associated with aplastic anemia is: Question options: Normochromic, normocytic with no polychromasia Normochromic, normocytic with marked polychromasia Hypochromic, microcytic Macrocytic

normochromic, normocytic, with no polychromasia

After the removal of RBCs from the circulation, hemoglobin is broken down into: Question options: a. iron, porphyrin, and amino acids b. iron, protoporphyrin, and globin c. heme, protoporphyrin, and amino acids d. heme, hemosiderin, and globin

not b, maybe c?

Diamond-Blackfan anemia differs from Fanconi anemia in that: Question options: reticulocyte count is increased fetal hemoglobin is decreased only erythropoiesis is affected white patches appear on skin and oral mucosa; nails are dysmorphic

only erythropoiesis is affected

The principle confirmation test for a diagnosis of hereditary spherocytosis is: Question options: autohemolysis test sucrose hemolysis test thermal stability test osmotic fragility test

osmotic fragility test

Which cells, occasionally found in bone marrow biopsy specimens, are responsible for the formation of bone? Question options: osteoblasts plasma cells osteoclasts macrophages

osteoblasts

What are you seeing in this picture? Question options: Babesia sp. Plasmodium falciparum Plasmodium vivax Bartonella bacilliformis

pasmodium falciparum

In the erythropoietic porphyrias, mild anemia may be accompanied by what distinctive clinical finding? Question options: gallstones patient sunburns very easily impaired night vision restless leg syndrome

patients sunburn very easily

Nuclear hyposegmentation and denser-than-normal chromatin clumping are features of: a. Alder-Reilly anomaly. b. Chédiak-Higashi syndrome. c. May-Hegglin anomaly. d. Pelger-Huët anomaly.

pelger huet anomaly

Which of the following inherited leukocyte disorders is characterized by hyposegmented neutrophils and a mutation in the lamin B receptor? Alder-Reilly anomaly May-Hegglin anomaly Gaucher disease Pelger-Huet anomaly

pelger huet anomaly

Which anemia will you see with this picture? Question options: pernicious anemia megaloblastic anemia iron deficiency anemia hemolytic anemia

pernicious anemia

A cell is described as having an eccentric, heavily stained (condensed chromatin) nucleus with blue cytoplasm. A pale perinuclear halo is next to the nucleus (hof) representing the Golgi complex. What cell is this? Question options: myelocyte myeolblast plasma cell B lymphocyte

plasma cell

what cell is this

plasma cell

Which cells are responsible for antibody production? Question options: B lymphocytes T lymphocytes Natural Killer lymphocytes Plasma cells

plasma cells

Which of these is detectable only by examination of a peripheral blood smear? Question options: anisocytosis microcytosis hypochromia poikilocytosis

poik

What term is describes a retic when stained with Wright's stain?

polychromatophilic

What are the most common erythroid stages found in normal marrow? Question options: pronormoblasts and basophilic normoblasts pronormoblasts basophilic and polychomatophilic normoblasts polychromatophilic and orthochromic normoblasts

polychromatophilic and orthochromic normoblasts

Which site is used for both aspiration and core biopsy of the bone marrow? Question options: sternum posterior iliac crest tibia spinous process of lumbar vertebrae

posterior iliac crest

Heinz bodies are found when hemoglobin: Question options: Precipitates from exposure to oxidants Becomes less soluble Concentration is decreased Forms crystals

precipitates from exposure to oxidants

Pernicious anemia can be distinguished from folate deficiency by the: Question options: Presence of hypersegmented neutrophils MCV Bone marrow findings Presence of antibodies to intrinsic factor

presence of antibodies to intrinsic factor

Laboratory staff is requires to annually perform manual WBC counts on a set of fluids with known values. This exercise is known as: Question options: Linear regression studies Pre-analytical quality assurance Proficiency testing Assay validation

proficiency testing

The outstanding feature of this cell is the prominent primary azurophilc granulation. Average size is 14-20 um. The nuclear chromatin is more condensed than in the myeloblast, and the nucleoli are present. Which cell is it? Question options: myelocyte metamyelocyte band promyelocyte

promyelocyte

what cell is this

promyelocyte

he following is unique to both B and T lymphocytes and occurs during their early development: Question options: synthesis of immunoglobulins rearrangement of antigen receptor genes maturation in the thymus expression of surface antigens CD4 and CD8

rearrangement of antigen receptor genes

How can the correct platelet count on a patient be determined when his or her platelets repeatedly clump in an EDTA specimen, even after warming? a. Re-collect in sodium citrate tube (blue top) and multiply by 0.5. b. Re-collect in sodium citrate tube (blue top) and multiply count by 1.1. c. Report the estimated number from the smear. d. Re-collect in an EDTA tube.

recollect in sodium citrate tube (blue top) and ,ultiply by 1.1

All of the following can be determined from a peripheral blood smear except: a. red cell morphology. b. white cell estimate. c. red cell estimate. d. platelet estimate.

red cell estimate

An increase in which of the following indicates a shortened life span of RBCs and hemolytic anemia? Question options: hematocrit MCHC reticulocyte count RDW

retic count

A characteristic finding on a blood smear in MAHA is the presence of: Question options: schistocytes target cells elliptocytes spur cells

schistocytes

A 40 y.o. woman went to her physician complaining of headaches and dizziness. Here CBC results show a mild microcytic, hypochromic anemia with polychromasia and basophilic stippling. What other tests might aid in confirming the cause of her anemia? Question options: serum lead level reticulocyte count serum ferritin level Prussian blue staining of the bone marrow

serum lead level

The formation of schistocytes in MAHA is primarily due to: Question options: pitting by splenic macrophages defective cell membranes increased cell membrane phospholipids shearing of erythrocytes by fibrin threads

shearing of erythrocytes by fibrin threads

Which of the following is an expected finding in MAHA? Question options: Elevated platelets Shistocytes or red cell fragments Found mostly in children Extravascular hemolysis

shistocytes and red cell frags

What is the association between malaria and Sickle Cell Anemia (SCA)? Question options: Sickle gene makes people more prone to malaria Sickle gene prevents for all malaria species They are both found in Africa Sickle gene offers some protection against malaria

sickle gene offers some protection against malaria

Which anemia correlates with the findings on this slide? Question options: pernicious anemia sideroblastic anemia iron deficiency anemia hemolytic anemia

sideroblastic anemia

Which of the following is a feature of a normal segmented neutrophil? Question options: basophilic cytoplasm round nucleus with fine chromatin small salmon-pink granules prominent primary granules

small salomon pink granules

14. Which of the following could cause the microhematocrit to be falsely decreased? a. specimen contaminated with intravenous (IV) fluid b. trapped plasma from abnormally shaped red cells c. dehydration d. insufficient centrifugation

specimen contaminated with IV fluid

The characteristic erythrocyte seen in a peripheral smear in WAIHA is a(n): Question options: macrocyte spherocyte dacrocyte elliptocyte

spherocyte

Red cells acquiring a reduced surface area from losing unsupported membrane due to a deficiency of skeletal proteins describes hereditary: Question options: Spherocytosis Stomatocytosis Pyropoikilocytosis Acanthocytosis

spherocytosis

Which type of RBC can be caused by overhydration or dehydration? Question options: codocytes stomatocytes elliptocytes dacrocytes

stomatocytes

Which one of the following cells is a product of the common lymphoid progenitor? Question options: megakaryocyte granulocyte T lymphocyte erythrocyte

t lymphocyte

In the appropriate area of a well-made blood film there are 2 to 3 white cells seen per high dry field. The automated cell counter white count on the same patient is 20.6 109/L. Select the correct interpretation. a. The estimate matches the count; report the results. b. The estimate does not match the count; investigate labeling error. c. Repeat the estimate on oil immersion. d. Rerun the sample through the cell counter.

the estimate does not match the count, investigate labeling error

Why is the bone marrow (storage) pool of granulocytes so large compared with the total number found in peripheral blood? Question options: They prefer bone marrow to peripheral blood. They can be quickly released when needed to fight bacterial infections. It enhances their ability to function. It prolongs their life span in circulation.

they can be quickly released when needed to fight bacterial infections

Which of the following results is associated with HUS and TTP? Question options: increased haptoglobin thrombocytopenia reticulocytopenia decreased LD

thrombocytopenia

Which anemia will present this way on a peripheral smear? Question options: iron deficiency anemia thrombotic thrombocytopenia purpura hereditary spherocytosis paroxysmal nocturnal hemoglobinuria

thrombotic thrombocytopenia purpura

Mature mast cells are: Question options: basophils progenitor cells cytokines tissue effector cells

tissue effector cells

The abnormal granules seen in Alder-Reilly anomaly could be confused for: a. toxic granulation. b. intracellular bacteria. c. Döhle bodies. d. intracellular yeasts.

toxic granulation

Euchromatin functions as the: Question options: Transcriptionally active DNA Site of ribosome production Support structure for nucleoli Attachment for centrioles

transciptionally active DNA

Extracellular growth factors are no longer needed for a cell to move through the cell cycle once it passes the restriction point. Question options: True False

true

Which type of bilirubin is increased in the plasma during intravascular hemolytic anemias? Question options: conjugated bilirubin unconjugated bilirubin

unconjugated bilirubin

Interpret the following results (all tests performed manually) on an adult female named Mary Jones. RBC: 3.22 X 1012/L Hgb: 16.0 g/dL Hct: 30.0% a. All are normal. b. All are decreased. c. Hemoglobin is elevated and other two are normal. d. Values do not agree with the "rule of three."

values do not agree with the rule of three

Which of the following conditions would be included in the diagnosis of an anemic patient with the following values: RDW 20% and MCV 125 fL Question options: Aplastic anemia Vitamin B12 deficiency Sickle cell anemia iron deficiency anemia

vit B12 deficiency

What is the correct relationship between red cells' affinity for oxygen and red cell production? Question options: When affinity is low, more oxygen is released and the body compensates by making red cells larger When affinity is low, less oxygen is released and the body compensates by increasing erythropoietin and making more red cells When affinity is high, less oxygen is released and the body compensates by increasing erythropoietin and making more red cells When affinity is high, more oxygen is released and fewer red cells are needed

when affinity is high, less oxygen is released and the body compensates by increasing EPO and making more red cells

A patient has a clinical picture of megaloblastic anemia. The serum folate level is decreased, and the serum vitamin B12 level is within normal range. What is the expected value for methylmalonic acid? Question options: decreased within normal range increased

within normal range

What stain is most commonly used for bone marrow aspirates? Question options: Wright stain hemotoxylin & eosin (h&E) stain Prussian blue stain supravital staining

wright stain