Hematology Exams 1-10

Clinically, symptoms occur more rapidly with a folate dietary deficiency than with a B12 deficiency. After only 3-weeks of folate dietary deficiency, which of the following abnormal laboratory values will be found? A. Decreased urinary FIGLU B. Low serum folate C. Hypersegmentation of neutrophils D. Anemia and a low RBC folate

B. Low serum folate

The absence of circulating NRBCs and the absence of a reticulocytosis in association with asevere anemia would indicate: A. A survival type disorder B. Marrow failure C. Chronic splenomegaly D. Ineffective erythropoiesis

B. Marrow failure

Laboratory characteristics that would distinguish a HbS/betao Thalassemia from HbSS disease are: A. Positive sickle-test results B. Microcytosis and elevated RDW C. HbA2 less than 4.5% D. Poikilocytosis

B. Microcytosis and elevated RDW

What are the typical hematologic findings associated with an anemia due to endocrinedysfunction? A. Marked anisocytosis and poikilocytosis, and dysfunctional leukocytes B. Mild normocytic/normochromic anemia C. Target cells, macrocytes, and acanthocytes D. Anemia with abnormal platelets, and coagulopathy

B. Mild normocytic/normochromic anemia

Abnormal erythroid precursors of AML-M6 stain positive with which of the following cytochemical stains? A. alpha-Naphthyl esterase B. PAS C. Specific esterase D. Sudan black

B. PAS

Because hemoglobin is a "zwitter" iron, when you place it in an acid electrophoresis medium, the molecule will be: A. Negatively charged B. Positively charged C. A stabilized dimer D. In the oxidized, ferric form

B. Positively charged

A 20-year-old black man had peripheral blood changes suggesting a globin-chain disorder. The quantitative HbA2 was not detectable, the HbA level was 94%, but the HbF level was 6%. These findings would be most consistent with: A. HbS disease B. beta-Thalassemia minor C. delta/beta-Thalassemia minor D. alpha-Thalassemia minor

C. delta/beta-Thalassemia minor

The PAS stain is often most useful to help identify which of the following? A. Leukmoid reaction B. Cytoplasmic inclusions C. Myeloid leukemias D. Lymphocytic leukemia

D. Lymphocytic leukemia

Based on FAB classification, which of the following bone marrow blast percentages will be consistent with RAEB? A. 5 - 20% B. > 30% C. 20 - 30% D. < 5%

A. 5 - 20%

Massive splenomegaly is the most obvious in which of the following leukemias? A. RAEBIT B. Aplastic Anemia C. MMM D. CML

C. MMM

A lymphocytosis with complicating factors of lymphadenopathy, hypogammaglobulinemia, and AIH would most likely be associated with which of the following diseases? A. ALL-L3 B. CLL C. Pertussis D. Multiple myeloma

B. CLL

All of the following are laboratory characteristics of lead poisoning EXCEPT: A. WBC toxic granulation B. Decreased serum iron C. Increased urinary Coproporphyrin D. Basophilic stippling

B. Decreased serum iron

A microcytic/hypochromic anemia that demonstrates 4+ target cells and the majority of the hemoglobin electrophoreses banding in the A2 band, would most likely be which of the following disorders? A. HGB-CC disease B. HPHF C. Homozygous betao thalassemia D. HGB-C/beta-thalassemia

. HGB-C/beta-thalassemia

A bone marrow from an anemic patient that demonstrates a marked erythroid hypoplasia butnormal numbers of other cell lines is most consistent with a diagnosis of: A. Pure red cell aplasia B. Myelophthisic anemia C. Fanconis anemia D. Aplastic anemia

. Pure red cell aplasia

An autosomal recessive deficiency of uroporphyrinogen-III cosynthetase that presents with severe skin photosensitivity, splenomegaly, hemolysis, and excessive urinary excretion of Coproporphyrin-I and Uroporphyrinogen-I, describes which of the following disorders? A. Congenital erythropoietic porphyria B. Acute intermittent porphyria C. Sideroblastic anemia D. Erythrohepatic porphyria

A. Congenital erythropoietic porphyria

A patient is suspected of having a hemoglobinopathy. His blood smear demonstrated NRBCs, polychromasia, anisocytosis, and 4+ target cells. His osmotic fragility suggested a dual RBC population. Sickle screening tests were negative. A hemoglobin electrophoresis is performed at a pH of 8.4. What location (ie., band) on the gel tracing would you suspect the primary band will be found? A. HGB-A2 B. HGB-F C. HGB-A D. HGB-S

A. HGB-A2

The hemoglobinopathy found most commonly in people of Asian-Indian race is: A. HGB-D disease B. HGB-E disease C. HGB-C disease D. HGB-O disease

A. HGB-D disease

An anemia that at birth demonstrates 40% HGB-A, 30% HGB-Barts, and 40% HGB-F would best be diagnosed as: A. Hemoglobin-H disease B. Hemoglobin Constant Spring C. Hydrops Fetalis D. Hemoglobin-Simpson

A. Hemoglobin-H disease

This slide was taken from a patient with a WBC count of 19,000/cmm. A manual slide differential was performed because of the high WBC count and a region-2 code on the histogram. The majority of WBCs on this patient's blood smear are like the WBC(s) in this slide. A clinical exam revealed enlarged lymph nodes in the neck area. Lab work revealed a mild hemolytic anemia caused by an autoimmune anti-i, low platelet count, and a LAP of 5. Besides the WBC(s) seen on this slide, there was 10% bands and 4% metamyelocytes identified on her differential. The most likely diagnosis of this patient is: A. Infectious Mononucleosis B. CML C. AMML D. Infectious lymphocytosis

A. Infectious Mononucleosis

The blood film picture below was taken from a jaundiced 9-year-old white male with stunted growth. His spleen was enlarged significantly. The boy's significant blood work results are also shown below. What is the correct diagnosis for this boy?A. Homozygous beta+-thalassemia B. Heterozygous beta+-thalassemia C. HGB-Constant Spring D. Homozygous betao-thalassemia

A. Homozygous beta+-thalassemia

Ablast that tests positive for TdT and cytoplasmic IgM would be: A. A pre-B-lymphocyte B. An immunoblast C. A T4-Lymphocyte D. Positive for CD33

A. A pre-B-lymphocyte

A hematological workup with the findings of more than 20% immature or mature monocytes in the marrow, and with greater than 20% myeloblasts and granulocytic precursors in the bone marrow, would most likely be: A. AML-M4 B. Di Gugliemo Syndrome C. AML-M2 D. The recovery stages of a chronic infection

A. AML-M4

This Case Study includes the next 2 questions. A 50-year-old Caucasian woman was admitted for evaluation of a painful, swollen right lower extremity and marked leukocytosis. Physical examination data included distended abdomen and marked splenomegaly. The entire right lower extremity was markedly swollen with tense edema and the leg was warm and tender to palpitation. There was no lymphadenopathy. Admission laboratory data included below. Bone marrow biopsy and aspiration were obtained with some difficulty often coming up "dry". Sheets of abnormal cells resembling large primitive monocytoid cells with abundant light blue cytoplasm filed the marrow. Erythroid and normal myeloid elements were greatly decreased. Serum muramidase levels were markedly increased. Based on the previous description and laboratory results below, into what FAB classification would this patient's leukemia most likely fall? A. AML-M5b B. AML-M5a C. AML-M4 D. AML-M7

A. AML-M5b

Which features help to distinguish secondary polycythemia and relative erythrocytosis from polycythemia vera? A. Absence of splenomegaly; normal leukocyte, platelet, and LAP levels B. Presence of splenomegaly; increased leukocyte, platelet, and LAP levels C. Presence of both splenomegaly and hepatomegaly; increased leukocytes and platelets; decreased LAP score D. Presence of hepatomegaly; decreased leukocytes, platelet, and LAP levels

A. Absence of splenomegaly; normal leukocyte, platelet, and LAP levels

Epstein-Barr virus (EBV) has been indicated as the etiologic agent in: A. Burketts lymphoma B. Infectious lymphocytosis C. Toxoplasmosis D. Chronic lymphocytic leukemia

A. Burketts lymphoma

This case study includes the next 5 questions. A 70-year-old man was seen by his physician for fatigue and abdominal pain on his left side. He had always been in good health and was accustomed to walking several miles a day, but for the last six months he had been feeling bad. He related to his doctor that up to this time he had not been overly concerned because, "after all, he was getting older". Physical examination revealed that he was a well-developed, slightly pale patient who presented with splenomegaly and three enlarged lymph nodes in his neck area. His CBC showed a WBC count of 29,900/mm3, a HGB of 8.5, MCV of 93.0, and a platelet count of 200,000/mm3. The picture below is a picture of his peripheral blood at the time of presentation. Immunoflorescent studies showed that the majority of his cells were positive for mainly CD5 and CD22. Based on his medical history and lab results, answer the following questions. Given the patient's age, his case history, lab data, what is the most likely diagnosis? A. CLL B. Lymphoma C. ALL D. Waldenstrom's

A. CLL

A leukmoid reaction could possibly result from all of the following disorders or conditions, EXCEPT: A. Chronic Granulocytic leukemia B. Severe hemolysis C. Lead poisoning D. Chronic bacterial infection

A. Chronic Granulocytic leukemia

In the development of IDA, serum ferritin levels are seen to start decreasing in which clinical stage? A. Iron deficient metabolic stage B. Iron deficiency anemia stage C. Iron depletion stage D. Iron deficient erythropoiesis stage

A. Iron deficient metabolic stage

This case study includes the next 2 questions. A 58-year-old male presents with a WBC count of 9,500/mm3 and 80% lymphocytes on his blood smear differential. Many of these lymphs were reported to be unusual with indistinct cellular membranes. He is also anemic, and his platelet count is 127,000/mm3. Physical examination revealed a grossly enlarged spleen. He was referred to an oncologist. The oncologist ordered an immunophenotypic workup. His cytoflow results shown below. Based on his medical history and lab results, what is the best possible diagnosis? A. Leukemic Reticuloendotheliosis (HCL) B. ALL-L2 C. Prolymphocytic leukemia D. CLL

A. Leukemic Reticuloendotheliosis (HCL)

This case study covers the next four questions. A 70-year-old male presented a long history of rheumatoid arthritis and anemia of nearly nine years duration. In the past year he noted easy bruising and developed spontaneous compression fractures of the vertebral bodies of the spine. Below are his hematological results. Close to the histogram small mononuclear cell population area, the majority of cells represented between 75 - 150 fL causing the R2 flag, are: A. Monocytes B. Blasts C. Atypical lymphs D. Large platelets

A. Monocytes

Monocytosis is: A. Present during recovery from an acute infection B. Found in cases of splenomegaly C. Associated with the early phases of an acute infection D. An expected feature of infectious mononucleosis

A. Present during recovery from an acute infection

Which of the following characteristics is common to Hereditary Spherocytosis, Hereditary Eliptocytosis, Hereditary Stomatocytosis, and Paroxysmal Nocturnal Hemoglobinuria (PNH)? A. Red cell membrane defects B. Autosomal dominate inheritance C. Positive direct antiglobulin test D. MCV of less than 80fl

A. Red cell membrane defects

Which of the following disorders demonstrates the characteristics of dysgranulopoiesis, dyserythropoiesis, a low retic count, ovalocytes, occasional blasts in the peripheral blood, and a 10% risk to develop into AML? A. Refractory anemia B. RAEB C. Polycythemia vera D. Thrombocythemia

A. Refractory anemia

Sickle cell disease (HbSS): A. Results from an abnormal hemoglobin that migrates on a Hgb electrophoresis, at pH 8.4, faster than HbA2 but slower than HbF or HbA B. Is most commonly found in people of Italian decent C. Results from a genetic deletion of beta-chains D. Is a beta-chain hemoglobinopathy in which a valine amino acid is genetically replaced by a glutamate amino acid

A. Results from an abnormal hemoglobin that migrates on a Hgb electrophoresis, at pH 8.4, faster than HbA2 but slower than HbF or HbA

Mycosis Fungoides is a(an): A. T-cell lymphoma B. Immunoblastic large cell lymphoma C. Fungal infection under the subdermal layers of skin D. EBV-caused lymphoma

A. T-cell lymphoma

Alcoholics commonly develop a macrocytic anemia due to: A. Increased blood cholesterol levels B. Folate deficiency C. Development of autoantibodies against intrinsic factor D. Intestinal malabsorption of B12

B. Folate deficiency

A hemolytic anemia that is due to a hereditary RBC membrane defect and presents with marrow hyperplasia is which of the following? A. G-6PD deficiency B. Alpha-Thalassemia C. AIHA D. Stomatocytosis

D. Stomatocytosis

A thalassemia that is due to an elongated alpha-chain with 31 extra amino acids and reduced alpha-chain production is: A. alpha+-Thalassemia B. Hemoglobin Constant Spring C. Hemoglobin Chesapeake D. Hemoglobin-H disease

B. Hemoglobin Constant Spring

A health maintenance organization (HMO) has a contract for laboratory testing services with your laboratory. The HMO has decided to screen its members for hereditary hemochromatosis. Which laboratory test will you recommend to them for this screening? A. Serum ferritin B. % transferrin saturation C. Molecular testing for mutated HFE gene D. Serum iron

B. % transferrin saturation

Normal blood cells that constitute a normal absolute circulating range of 0 to 450/mm3 and contain acid mucopolysaccharides in their granules, describes which of the following? A. Monocytes B. Neutrophil myelocytes C. Eosinophils D. Basophils

C. Eosinophils

Homozygous delta/beta-thalassemia would result in which of the following electrophoresis results? A. 0% - HGB-A, 2 - 5% - HGB-A2, 95 - 98% - HGB-F B. 0% - HGB-A, 0% - HGB-A2, 100% - HGB-F C. 5 - 15% - HGB-A, 2 - 5% - HGB-A2, 85 - 95% - HGB-F D. 50% - HGB-A, 2 - 8% - HGB-A2, 1 - 8% - HGB-F

B. 0% - HGB-A, 0% - HGB-A2, 100% - HGB-F

A 81-year-old male presented with a leukemia that demonstrated 85% blasts in the marrow. These cells stained positive with alpha-naphthyl acetate esterase and the patient was shown to have a t(9:11) abnormality. Which of the following is the correct diagnosis? A. CML in blast crisis B. AML M5a C. AML-M6 D. AML-M5b

B. AML M5a

The Acute Myeloblastic Leukemia FAB subtype associated with a etiology of predominately blasts in the blood and bone marrow, and a skip in maturation from myeloblasts to segs is: A. Acute Stem cell Leukemia B. AML-M1 C. AML-M5a D. AML-M3

B. AML-M1

An AML that presents with abnormal lymph node pathology, blasts positive for alpha-naphthyl acetate, and markedly elevated levels of serum muramidase would fit the profile for which of the following leukemias: A. AML-M6 B. AML-M5 C. AML-M3 D. AML-M4

B. AML-M5

A microcytic/hypochromic hemolytic anemia in an adult individual with moderate Heinz bodies and a hemoglobin electrophoresis demonstrating a high amount of Hb H would most likely be: A. Hydrops Fetalis B. Alpha-thalassemia C. Hb D disease D. Beta-thalassemia

B. Alpha-thalassemia

ranulocytic qualitative abnormalities such as toxic granulation, Dohle bodies, and vacuoles are indicators of which of the following conditions: A. An autoimmune neutropenia B. An increased rate of granulopoiesis C. Loeffler's syndrome D. May Hegglin anomaly

B. An increased rate of granulopoiesis

Which of the following is an anemia that presents with marrow hypoplasia? A. Anemia of acute blood loss B. Anemia of renal failure C. Pernicious anemia D. Sideroblastic anemia

B. Anemia of renal failure

Bone marrow hypoplasia may be caused by: A. Anti-RH antibodies B. Antimitotic agents (drugs) C. Chronic Hemorrhage D. Relative polycythemia

B. Antimitotic agents (drugs)

Eosinophil Chemotactic Factor of Anaphylaxis (ECF-A) is synthesized and released by: A. Neutrophils B. Basophils C. Eosinophils D. Injured tissue

B. Basophils

What is the most likely underlying predisposing cause of this patient's anemia? A. Genetic mutation B. Erythroid unipotential stem cell failure C. Exposure to pesticide and at high risk for hepatitis D. Hemolytic anemia caused by exposure to pesticide

C. Exposure to pesticide and at high risk for hepatitis

How long does it take an individual to develop a full-scale megaloblastic anemia once they eliminate folate from their diet? A. Two months B. Two weeks C. Five months D. Two years

C. Five months

The leukemia with the best chance of remission (greater than 90%) is: A. Acute Granulocytic Leukemia B. Hodgkin's C. Acute Lymphocytic Leukemia D. Chronic Lymphocytic Leukemia

C. Acute Lymphocytic Leukemia

Which of the following anemias could be misdiagnosed as a B12 deficiency? A. Anemia of renal disease B. Myelophthisic anemia C. Anemia of hypothyroidism D. Iron deficiency anemia

C. Anemia of hypothyroidism

What is the most probable type of anemia this young man should be diagnosed as having? A. Iron deficiency anemia B. Sideroblastic anemia C. Aplastic anemia D. Anemia of liver disease

C. Aplastic anemia

Which one of the following anemias is usually associated with a normal free erythrocyte Protoporphyrin level? A. Lead poisoning B. Sideroblastic anemia C. Aplastic anemia D. Iron deficiency anemia

C. Aplastic anemia

Characteristic (or diagnostic) laboratory features of CML include all of the following, EXCEPT: A. Absolute monocytosis B. A complete spectrum of granulocyte maturation stages on the differential with the presence of blasts, usually less than 10% C. Characteristic differential with the sum of myeloblasts and promyelocytes exceeding the sum of the other types of cells in number D. Absolute basophilia

C. Characteristic differential with the sum of myeloblasts and promyelocytes exceeding the sum of the other types of cells in number

A genetically-induced deficiency in neutrophil myeloperoxidase activity is known as: A. Neiman-Pick disease B. Jordon's anomaly C. Chronic granulomatous disease D. Di George's syndrome

C. Chronic granulomatous disease

A 40-year-old white male was admitted to the hospital for treatment of anemia, lassitude, weight loss, and loss of libido. The patient presented with the following laboratory data shown below. Examination of the bone marrow revealed erythroid hyperplasia with a shift to the left of erythroid precursors. Prussian blue staining revealed markedly elevated iron stores noted with occasional sideroblasts seen. This data is most consistent with which of the following conditions? A. Anemia of chronic disease B. Acute blood loss C. Hemochromatosis D. Iron deficiency anemia

C. Hemochromatosis

Increased levels of serum B12 can indirectly relate to a chronic granulocytosis due to: A. Increased serum folate B. Increased levels of intrinsic factor (IF) C. Increased levels of transcobalamin-II D. Increased serum transferrin

C. Increased levels of transcobalamin-II

Considering the diagnosis, what type of cell would you expect his to be? A. Null lymphs B. Early B-lymphoblasts C. Mature B-lymphs D. Mature T-lymphs

C. Mature B-lymphs

A common type of Hodgkin's, usually first discovered as enlarged mediastinal lymph nodes in young females, that demonstrates a node histological picture of lymphs, bands of collagen, histiocytes, and a few Reed-Sternberg cells, is classified as: A. Mixed-cell type B. Lymphocyte predominant C. Nodular sclerosis D. Lymphocyte depletion type

C. Nodular sclerosis

Hemolytic disorders due to a RBC membrane abnormality include the following: A. Microangiopathic hemolytic anemia B. HDN C. PNH D. Sickle cell anemia

C. PNH

The peripheral smear shows normocytic, normochromic anemia, slight polychromatophilia, and no other morphologic abnormalities. Which of the following possible diagnoses should be next pursued? A. Beta-Thalassemia B. Sickle Cell Anemia C. RBC membrane or metabolic disorder D. Chronic blood loss

C. RBC membrane or metabolic disorder

The characteristic RBC morphology triad of distinguishing features of a megaloblastic anemia include all of the following, EXCEPT: A. Macroovalocytes B. Howell-Jolly bodies C. Reticulocytosis D. Hypersegmentation

C. Reticulocytosis

The metabolic function of tetrahydrofolate is to: A. Synthesize intrinsic factor B. Synthesize methionine C. Serve as a cofactor with cobalamin in the synthesis of thymidylate D. Transfer carbon units from donors to receptors

C. Serve as a cofactor with cobalamin in the synthesis of thymidylate

Which of the following does not cause secondary absolute polycythemia? A. Emphysema B. High altitudes C. Smoking D. Chronic obstructive pulmonary disease

C. Smoking

A patient diagnosed with Polycythemia vera two years ago, now has a normal hematocrit, decreased hemoglobin, microcytic/hypochromic RBCs, and an increased WBC count. What is the most probable cause of the current blood picture? A. Aplastic anemia B. Myelofibrosis C. Preleukemia D. Therapeutic phlebotomy

D. Therapeutic phlebotomy

A blood picture with pancytopenia, dacrocytes, hypersegmentation, increased serum iron, and marrow hyperplasia is common to: A. PNH B. Sideroblastic anemia C. beta-thalassemia D. Megaloblastic anemia

D. Megaloblastic anemia

All of the following are laboratory characteristics of an anemia associated with chronic inflammation EXCEPT: A. Decreased marrow sideroblasts B. Increased serum iron C. Normal retic count D. Microcytic/hypochromic RBCs

D. Microcytic/hypochromic RBCs

Addition of sodium fluoride to the staining solution inhibits the staining reaction in ________________in the __________________ cytochemical stain. A. Neutrophils; leukocyte alkaline phosphatase B. Lymphocytes; acid phosphatase C. Lymphocytes; Periodic acid-shift D. Monocytes; non-specific esterase

D. Monocytes; non-specific esterase

Oxygen hemoglobin saturation in Polycythemia vera is: A. Increased B. Decreased C. Unable to be measured because of increased blood viscosity D. Normal

D. Normal

Which of the following conditions increases the daily requirement for vitamin B12? A. Splenectomy B. Aplastic anemia C. Hypothyroidism D. Pregnancy

D. Pregnancy

Twenty-eight year-old Norma Blastic had been lately, feeling worse than an elephant with a nose bleed. She demonstrated all the typical symptoms of anemia. A doctor's visit resulted in a CBC being ordered to check out her possible anemia. Her results indicated a Hgb. of 8.2 g/dl, and a Hct. of 25%. Her MCV value was 120 fl. Based on these preliminary results, all of the following lab tests would easily distinguish between a condition of macrocytosis with a normoblastic marrow and a condition of macrocytosis with a megaloblastic marrow, EXCEPT: A. Serum B12 and folate B. WBC count C. Reticulocyte count D. RBC count

D. RBC count

All of the following represent typical laboratory findings in a case of late stage irondeficiency anemia, EXCEPT: A. TIBC- 600 ug/dL B. MCV- 70fL C. Marrow sideroblasts- 10% D. RBC count - 5.25 x 106 /mm3

D. RBC count - 5.25 x 106 /mm3

Hemoglobinopathies associated with methemoglobinemia include all of the following characteristics, EXCEPT: A. Do not respond to treatment with strong reducing agents B. Are not associated with RBC metabolic enzyme deficiencies C. Result in cyanosis D. Result from globin chain amino acid substitutions at surface alpha - beta contact points

D. Result from globin chain amino acid substitutions at surface alpha - beta contact points

A 65 year-old female was diagnosed to be anemic 20 years ago. At age 34 she developed jaundice after the birth of her first child. Years later she again developed jaundice after taking antibiotics for an upper-respiratory infection. Two years after that she again became jaundiced with a viral infection. She has 2 daughters who are also anemic with intermittent jaundice. Presently at age 65 she is being again evaluated for arthritis and her chronic anemia. Her most current laboratory data are shown below. Based upon the patient's medical history and the lab results, this patient is a classic case of: A. Anemia of chronic liver disease B. Aplastic Anemia C. Paroxysmal nocturnal hemoglobinuria D. Hereditary Spherocytosis

D. Hereditary Spherocytosis

Which finding is not characteristic for acute hemolytic transfusion reactions? A. Hemoglobinemia, hemoglobinuria, and hemosiderinuria B. Acute intravascular hemolysis C. Most commonly caused by ABO IgM complement-activating antibodies D. Increase in plasma haptoglobin

D. Increase in plasma haptoglobin

A reticulocyte count was not ordered. Based upon the patient's admission blood results and the diagnosis, what would you expect the reticulocyte count to be? A. Not present in the peripheral blood due to bone marrow erythropoietic failure B. Decreased below normal range C. Within normal range D. Increased above normal range

D. Increased above normal range

A newborn was placed in a neonatal intensive care unit because initial blood work had the following results that are shown below. The pediatrician ordered a hemoglobin electrophoresis with the following results: HGB-Barts: 35%; HGB-H: 2%; HGB-F: 3%; HGB-A: 60%. Based on these results, this infant should be diagnosed with which of the following disorders: A. Beta+-Thalassemia major B. S/beta+-Thalassemia C. Hemoglobin Constance Spring D. Alpha+-Thalassemia minor

D. Alpha+-Thalassemia minor

A l0 year old female was admitted into the hospital for observation by her pediatrician because she had vomiting, fever, and her CBC demonstrated a high WBC count of 30,000/mm3 with 90% lymphs. The lymphocytes appeared to be normal mature lymphs, and no atypical forms were seen. A bone marrow aspiration showed 75% normal lymphs. A mono test was done and proved to be negative. After 3 weeks of hospitalization the WBC count returned to normal and the child returned to normal health. The most likely diagnosis would be: A. Cytomegalovirus infection B. Waldenstrom's macroglobulinemia C. CLL D. Infectious lymphocytosis

D. Infectious lymphocytosis

If this patient's present RBC distribution and histogram were compared with her RBC histogram prior to treatment, what would be the difference in patterns, if any? A. No difference B. A normal RBC histogram and distribution C. A single peak to the right of the normal RBC distribution area D. A single peak left of the normal RBC distribution area

D. A single peak left of the normal RBC distribution area

What would be the expected blast percent in his marrow? A. 20 - 40% B. 1-2% C. 50 - 100% D. 2 - 10%

D. 2 - 10%

Anaerobic glycolysis (Embden-Meyerhof Pathway) in RBCs leads to the formation of which of the following products? A. Glutathione B. NADPH C. Glucose D. ATP

D. ATP

Which one of the following disorders would be the least likely to be considered from the previous test results? A. Paroxysmal Nocturnal hemoglobinuria (PNH) B. Microangiopathic hemolytic anemia C. Sickle Cell Anemia D. Auto-immune hemolytic anemia (AIHA)

D. Auto-immune hemolytic anemia (AIHA)

If a patient excretes less than 7.5% of a radioactively tagged crystalline B12 dose after 24 hours, both before and after administration of a dose of oral intrinsic factor, which of the following is a possible diagnosis? A. Liver disease B. Gastrectomy C. Pernicious anemia D. Celiac disease

D. Celiac disease

Neutropenia due to marrow myeloid hypoplasia can result from all of the following conditions EXCEPT: A. Aplastic anemia B. Chemotherapy C. Cyclic neutropenia D. Felty's syndrome

D. Felty's syndrome

With cellulose acetate electrophoresis, using standard barbiturate buffer (pH 8.4), the sequence of hemoglobin migration RATE, from fast-to-slow is: A. CSAHF B. HACSF C. FASCH D. HAFSC

D. HAFSC

Nonspecific hemoglobinopathies associated with unstable hemoglobins show a pattern of a hemolytic anemia due to what physiological process? A. Complement-activating IgM antibodies B. A decrease in RBC G-6-PD activity C. Aplastic crisis D. Heinz bodies

D. Heinz bodies

Situation: A patient's peripheral blood smear and bone marrow both contain about 92% blast cells. The doctor wants to specifically identify this leukemia in order to give proper treatment. Therefore, he requests a peroxidase stain. If the majority of these blast cells are found to be peroxidase negative, the patient would probably have: A. Acute myeloblastic leukemia B. Reticulum cell sarcoma C. An excellent Blue Cross/Blue Shield insurance plan D. Lymphocytic leukemia E. Plasma cell leukemia

D. Lymphocytic leukemia

If a child with lead poisoning also had a significant microcytic/hypochromic anemia, what complicating pathology(s) should be considered? A. Thalassemia B. Iron deficiency and Thalassemia C. Iron deficiency D. Thalassemia and Sideroblastic anemia

Iron deficiency and Thalassemia

The M:E ratio in Polycythemia vera is usually: A. Low B. Variable C. Normal D. High

Normal

His CBC was run with a modern Coulter impedance cell counter. What error flag would you expect on his histogram? A. RBC dimorphic population B. R4 C. R3 D. R2

R2

The general symptoms of anemia include all of the following EXCEPT: A. Increase heart rate B. Increased erythropoietin C. Venous hyperviscosity D. Pallor

Venous Hyperviscosity