Hematology Fall Quizzes Baby
All of the following are physiologic adaptations the body makes when there is a slow drop in the number of red cells except: A -erythropoietin level increases B-oxygen dissociation curve shifts to left C-cardiac output increases D-respiratory rate increases
B-oxygen dissociation curve shifts to left
Myelodysplastic syndromes (MDSs) sometimes share similar peripheral and bone marrow cellularity with all of the following except: A. Vitamin B12 deficiency B. Aplastic anemia C. Acute leukemia D. Folate deficiency
B. Aplastic anemia
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.
B. Bacterial infection.
All of the following will be invalid when lipemia is present in a blood sample except: Question 21 options: A. Mean cell hemoglobin concentration (MCHC) B. Mean cell volume (MCV) C. Mean cell hemoglobin (MCH) D. Hemoglobin
B. Mean cell volume (MCV)
Proper specimen collection and patient satisfaction are components of: A. Quality control B. Quality assurance C. Reliability D. Precision
B. Quality assurance
The Philadelphia chromosome: A. Is a equal, balanced reciprocal translocation between chromosomes 7 and 19. B. Results in a chimeric gene (bcr/abl). C. Is diagnostic for Polycythemia Vera (PV). D. Manifests as tyrosine kinase that blocks cell maturation.
B. Results in a chimeric gene (bcr/abl).
Correct ID of inclusions in RBCs provide useful clinical information. They often help suggest the possible etiology of an anemia and thus further appropriate testing. Which inclusion goes with the composition listed :denatured hemoglobin A-basophilic stippling B-Pappenheimer body C-Heinz body D-Howell-Jolly body
C-Heinz body
On what does the World Health Organization (WHO) base its classification of the myelodysplastic syndromes (MDSs)? A. Cell morphology B. Molecular analysis C. Cytogenetics D All of the above.
D All of the above.
Correct ID of inclusions in RBCs provide useful clinical information. They often help suggest the possible etiology of an anemia and thus further appropriate testing. Which inclusion goes with the composition listed: DNA A-basophilic stippling B-Pappenheimer body C-Heinz body D-Howell-Jolly body
D-Howell-Jolly body
A patient has an increased red cell count, hemoglobin, and hematocrit. Which of the following features points to secondary polycythemia over Polycythemia Vera (PV)? A. Increase white count B. Increase red cell mass C. Bone marrow erythroid hyperplasia D. Decreased arterial O2 saturation
D. Decreased arterial O2 saturation
What abnormal findings are associated with May-Hegglin anomaly? A. Toxic granulation and vacuoles B. Fused primary and secondary granules C. Hypersegmented neutrophils D. Döhle body-like cytoplasmic inclusions and thrombocytopenia
D. Döhle body-like cytoplasmic inclusions and thrombocytopenia
A medical lab scientist sees unusual darkly stained cytoplasmic inclusions in leukocytes that she has not seen before. She should: A. Ignore them as they are probably not significant. B. Report that the patient has an Alder-Reilly anomaly. C. Report toxic granulation without further investigation. D. Have a supervisor or pathologist review the cells.
D. Have a supervisor or pathologist review the cells.
What is the greatest limitation of automated cell counters? Question 16 options: A. Poor precision B. Speed C. Unavailability of quality control materials D. Inherent specimen problems leading to occasional spurious results.
D. Inherent specimen problems leading to occasional spurious results.
What is the major drawback to chemotherapy? A. It makes the patient feel very bad. B. The high cost of the drugs and long hospital stays. C. It requires extensive laboratory monitoring. D. It suppresses the bone marrow.
D. It suppresses the bone marrow.
Which of the following is characteristic of Polycythemia vera? a- elevated urine erythropoietin levels b- increased oxygen affinity of hemoglobin c- teardrop poikilocytosis d- decreased or absent bone marrow iron stores
d- decreased or absent bone marrow iron stores
What percentage of red cells are destroyed and replaced daily in a normal adult? A-1% B-5% C-10% D-20%
A-1%
Correct ID of inclusions in RBCs provide useful clinical information. They often help suggest the possible etiology of an anemia and thus further appropriate testing. Which inclusion goes with the composition listed: precipitated RNA A-basophilic stippling B-Pappenheimer body C-Heinz body D-Howell-Jolly body
A-basophilic stippling
The anemia found in liver disease is: A-macrocytic nonmegaloblastic B-microcytic hypochromic C-macrocytic megaloblastic D-microcytic normochromic
A-macrocytic nonmegaloblastic
A 27-year-old woman presents with acute bleeding to the emergency department and is found to have a white cell count of 25.7 x 10ˆ9/L, hematocrit 27%, platelet count 35 x 10ˆ9/L, and an absolute neutrophil count of 0.8 x 10ˆ9/L. She has a combination or 97% blasts and abnormal promyelocytes; some of the cells contain Auer rods, on her peripheral blood smear. What form of leukemia is she most likely to have? A. Acute promyelocytic leukemia with t(15;17)(q22;q12) B. Chronic myeloid leukemia C. Acute monoblastic leukemia D. Acute myeloid leukemia with t(8;21)(q33;q22)
A. Acute promyelocytic leukemia with t(15;17)(q22;q12)
The nitroblue tetrazolium (NBT) reduction test is used to diagnose: A. Chronic granulomatous disease B. Pelger-Huët anomaly C. May-Hegglin anomaly D. Necrobiosis
A. Chronic granulomatous disease
A middle-aged man has a white cell count of 80 x 10ˆ9/L with the differential showing 90% mature-looking lymphocytes and many smudge cells. Which of the following is most his diagnosis? A. Chronic lymphocytic leukemia (CLL) B. Hairy cell leukemia C. T cell lymphoma D. Sézary syndrome
A. Chronic lymphocytic leukemia (CLL)
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? Question 12 options: A. Electronic impedance B. Optical scatter C. Conductivity D. Laminar flow
A. Electronic impedance
A patient has a platelet count of 1200 x 109/L. Many platelets are giant and have abnormal shapes. A mild anemia is present. The bone marrow shows increased megakaryocytes in clusters and iron stores appear normal. Which of the following is most likely? A. Essential thrombocythemia B. Chronic myeloid leukemia C. Thrombocytosis secondary to blood loss D. Polycythemia Vera (PV)
A. Essential thrombocythemia
A laboratory gets numerous complaints regarding the length of time it takes hematology results to get to the emergency department. What would be an appropriate response? Question 10 options: A. Make this a quality assurance project. B. Ignore the complaints. C. Explain to the emergency department why it takes so long. D. Tell the lab employees to work faster.
A. Make this a quality assurance project.
Serum protein electrophoresis on an elderly patient reveals a monoclonal protein spike. Increased plasma cells are present in the bone marrow. They are CD19 and CD20 negative, but demonstrate high density CD38 and monoclonal cytoplasmic immunoglobulin (Ig). What is the most likely diagnosis? A. Multiple myeloma B. Hodgkin lymphoma C. Burkitt lymphoma D. Chronic lymphocytic lymphoma
A. Multiple myeloma
The control values for both controls for the prothrombin test were ranging between the mean and +1 standard deviation (SD) for the first 19 days of use. Starting on day 20, the values for both were consistently between +1 and +2 SDs. This is an example of a: Question 7 options: A. Shift B. Trend C. Random error D. Predictable error
A. Shift
Which of the following is true regarding the clinical course of the myelodysplastic syndromes (MDSs)? A. The course is variable based on cell counts and type of MDS. B. Most patients survive an average of 10 years with minimal symptoms. C. It has an aggressive course with most patients succumbing to infection in less than one year. D. All cases convert to acute leukemia.
A. The course is variable based on cell counts and type of MDS.
The abnormal granules seen in Alder-Reilly anomaly could be confused for: A. Toxic granulation. B. Intracellular bacteria. C. Döhle bodies. D. Intracellular yeast.
A. Toxic granulation.
Platelet clumps would most likely interfere with which other automated parameter? Question 17 options: A. White blood cell count (WBC) B. Red blood cell count (RBC) C. Hemoglobin D. Red cell indices
A. White blood cell count (WBC)
Why is Burkitt's lymphoma such an aggressive malignancy? A. Cells readily metastasize to the bone marrow. B. Cells have a high proliferative rate. C. Cells fail to mature to functional immunophenotype. D. Red cells are destroyed prematurely.
B. Cells have a high proliferative rate.
Which of the following is determined by light transmission between 525 and 555 nm? Question 13 options: A. Reticulocytes B. Hemoglobin C. MCH D. MCV
B. Hemoglobin
The best way to prevent errors in the laboratory is to ensure: Question 9 options: A. The purchasing of quality instruments from reputable vendors. B. Hiring only well-trained, conscientious workers. C. The lab has quality management. D. Make it a routine to perform external quality control procedures.
B. Hiring only well-trained, conscientious workers.
A patient presents with a white cell count of 12.6 x 10ˆ9/L, hematocrit of 28%, and platelet count of 27 x 10ˆ9/L. Examination of a Wright-stained blood smear reveals that almost all of the white cells in the peripheral blood are blasts. The patient's bone marrow slide hypercellularity, the majority of cells being blasts, and very little fat. Flow cytometry is performed on the peripheral blood cells. A large cluster of the cells demonstrate the presence of CD20 and have monoclonal kappa light chains present on their surface. This patient has a: A. Myeloid leukemia. B. Mature B cell malignancy. C. Reactive B cell hyperplasia. D. Mature T cell malignancy.
B. Mature B cell malignancy.
One of two controls that have been evaluated over the last 28 days gives a result on day 29 between 2 and 3 standard deviations (SDs) of the mean; the other control is within 2 SDs of its mean. What is the correct procedure to follow? Question 6 options: A. Ignore the result unless it happens again the next day. B. Rerun the control and if acceptable continue with patients. C. Recalibrate the instrument. D. Open new vials of controls and repeat both controls.
B. Rerun the control and if acceptable continue with patients.
Forward scatter is related to what cellular feature? Question 25 options: A. Density B. Size C. Granularity D. Complexity
B. Size
An automated hematology analyzer is used to evaluate a blood specimen. Which of the following, coming off the instrument, would require performance of a manual white cell differential as opposed to smear review? Question 18 options: A. Flagged data B. Suppression of automated differential data C. Abnormal red cell indices D. A slightly elevated platelet count
B. Suppression of automated differential data
A 15-year-old boy present complaining of sever headache; he has a white count of 76.0 x 10ˆ9/L, platelet count of 55.0 x 10ˆ9/L, and a hematocrit of 33%. When a white cell differential is performed, most of the nucleated cells are blast. They are CD2, CD4, and CD8 positive. What is the most likely diagnosis? A. Immature B cell acute lymphoid leukemia B. T cell acute lymphoid leukemia C. Acute myeloid leukemia without maturation D. Acute myeloid leukemia with maturation
B. T cell acute lymphoid leukemia
What is the concern if Pelger-Huët is not recognized? A. Without treatment, the patient will die. B. The cells could be misclassified as immature neutrophils, indicating the patient has a bacterial infection when indeed they would not. C. The patient could develop pseudo-Pelger-Huët syndrome followed by leukemia. D. The cells could be misclassified as blasts, indicating the patient has acute leukemia when indeed they would not.
B. The cells could be misclassified as immature neutrophils, indicating the patient has a bacterial infection when indeed they would not.
The precision limits of a new method are defined by: Question 11 options: A. The mean. B. The standard deviation. C. Sensitivity. D. Specificity.
B. The standard deviation.
Which of the following occurs if testing is not performed within 24 hours from specimen collection? Question 22 options: A. White blood cell count rises. B. White blood cells deteriorate and red blood cells swell. C. Hemoglobin value rises. D. Mean cell volume (MCV) decreases.
B. White blood cells deteriorate and red blood cells swell.
An appropriately increased reticulocyte production index (RPI) >3 is associated with:\ A-iron deficiency anemia B-macrocytic megaloblastic anemia C-hemolytic anemia D-sideroblastic anemia
C-hemolytic anemia
A 47-year-old male patient has gingival hypertrophy (red, swollen gum tissues) and a white blood cell count of 108 x 10ˆ9/L. He has a moderate anemia and is thrombocytopenic. The white cell differential consists primarily of a combination of mature monocytes, promonocytes, and CD14-positive blasts. Which of the following forms of acute myeloid leukemia (AML) is most likely? A. AML with maturation B. Acute promyelocytic leukemia with t(15;17)(q22:q12) C. Acute monoblastic leukemia D. AML with minimal maturation
C. Acute monoblastic leukemia
A patient has a normal white blood count, a moderately high platelet count, and a mild anemia. The differential shows immature granulocytes, nucleated red cells, and teardrop-shaped red cells. Which of the following is most likely? A. Polycythemia Vera (PV) B. Chronic myeloid leukemia (CML) C. Chronic idiopathic myelofibrosis (CIMF) D. Essential thrombocythemia (ET)
C. Chronic idiopathic myelofibrosis (CIMF)
A patient sample comes off an automated cell counter with a failure of the red cell "rule of three". The red count is lower than expected given the hemoglobin value. The mean cell volume (MCV), mean cell hemoglobin (MCH), and the mean cell hemoglobin concentration (MCHC) are elevated. Which of the following is the most likely reason for the failure? A. Megaloblastic anemia B. Lyse-resistant red cells C. Cold agglutinin D. lipemia
C. Cold agglutinin
The tubing that brings the lyse reagent to the hemoglobin cuvette on an automated cell counter is pinched and not delivering any reagent. All hemoglobin values are greater than 20g/dL. This represents what type of error? Question 5 options: A. Random B. Imprecision C. Constant systematic D. Proportional systematic
C. Constant systematic
The diagnosis of infectious mononucleosis is most often made by which of the following findings? A. Significant lymphocytosis with reactive lymphocytes predominating. B. Presence of mild thrombocytopenia with a significant lymphocytosis. C. Demonstration of the presence of the heterophil antibody. D. Demonstration of the presence of cytomegalovirus (CMV) antibody.
C. Demonstration of the presence of the heterophil antibody.
A laboratory comparing its results to those of other laboratories on the same specimen is an example of: Question 8 options: A. Precision monitoring B. Internal quality control C. External quality control D. Delta checks
C. External quality control
What are the abnormal cytoplasmic inclusions comprised of in Chédiak-Higashi syndrome? 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.
C. Fused granules that inhibit bactericidal functions.
Deficient enzymes that allow various lipids to accumulate in macrophages and monocytes describe: A. Chronic granulomatous disease B. Congenital C3 deficiencies C. Lipid storage cell diseases D. Familial hyperlipidemia disorders
C. Lipid storage cell diseases
Which of the following is always calculated on cell counters? Question 14 options: A. Hematocrit B. MCV C. MCHC D. Red cell counts
C. MCHC
Which of the following is true regarding the symptoms of acute leukemia? A. Lymphadenopathy is found more often in myeloid than lymphoid. B. Central nervous system involvement is the most common presenting symptom. C. Most symptoms are related to abnormal cell counts. D. Bone pain results from fractures related to calcium loss.
C. Most symptoms are related to abnormal cell counts.
Which of the following can determined from examining a peripheral blood smear? A. Sub-categorization of lymphocytes (ex. THelper, TSuppressor, etc.) B. Surface makers C. Presence and percentage of blasts D. Gene translocations
C. Presence and percentage of blasts
What is the etiology of myelodysplastic syndromes (MDSs)? A. Decreased cell apoptosis B. They are inherited disorders. C. There is proliferation of mutated myeloid cells. D. Epstein-Barr virus
C. There is proliferation of mutated myeloid cells.
What is the recommended method for establishing accuracy of automated hematology analyzers? Question 23 options: A. Use at least three levels of controls for calibration. B. Use whole blood calibration methodology. C. Use commercially prepared whole blood calibrators. D. Perform manual methods for comparison.
C. Use commercially prepared whole blood calibrators.
Select the most appropriate action when dealing with a cold agglutinin Question 20 options: A. Report the results. B. Lyse the red cells manually and rerun. C. Warm the sample to 37 degrees Celsius and rerun. D. Replace the sample's plasma with saline and rerun.
C. Warm the sample to 37 degrees Celsius and rerun.
Two different patients both have hemoglobins in the 5.0 to 6.0 g/dL range. One has pallor, fatigue, and headaches whereas the other is experiencing life-threatening shock. Which of the following is probably the major difference between the two patients? A-the morphologic classification of anemia B-whether other cells lines (platelets or white cells) are also involved C-the patient's gender D-how quickly the anemia developed
D-how quickly the anemia developed
What test is used along with the mean cell volume (MCV) to morphologically classify anemias? A-red blood count B-hemoglobin C-hematocrit D-red cell distribution width (RDW)
D-red cell distribution width (RDW)
The following are compounds formed in the synthesis of heme: 1. Coproporphyrinogen 2.Porphobilinogen 3. Uroporphyrinogen 4. Protoporphyrinogen Which of the following responses lists these compounds in the order in which they are formed? A. 4,3,1,2 B. 1,2,4,3 C. 3,1,4,2 D. 2,3,1,4
D. 2,3,1,4
Cell dysfunction in the myelodysplastic syndromes (MDSs) may be present in: A. Red cells B. Granulocytes C. Platelets D. All of the above.
D. All of the above.
Compared to manual methods, automated reticulocyte counting improved which of the following? Question 15 options: A. Distribution error B. Statistical sampling error C. Inter-observer error D. All of the above.
D. All of the above.
Which of the following is true regarding reference ranges? Question 3 options: A. Should be derived from reference books B. Need to be determined only for adults C. Can be established by running the test procedure on 10 health people D. Are ranges of values for an analyte in normal health people
D. Are ranges of values for an analyte in normal health people
Gaucher cells and Niemann-Pick cells are found in: A. Peripheral blood B. Bone marrow only C. Spleen only D. Bone marrow and spleen
D. Bone marrow and spleen
Why are patients with multiple myeloma susceptible to infection? A. Decreased lymphocytes B. Neutropenia C. Suppressed normal immunoglobulin levels D. Both b and c.
D. Both b and c.
Neoplastic lymphocytes with non-cleaved, clumped nuclei, very basophilic cytoplasm, and prominent vacuoles describes: A. Reed-Sternberg cells B. Mantle cell lymphoma cells C. Small-cell lymphocytic lymphoma cells D. Burkitt lymphoma cells
D. Burkitt lymphoma cells
Acute myelomonocytic leukemia is positive for which of the following? A. CALLa (CD10) B. Periodic acid-Schiff (PAS) stain C. HLA-DR1a D. CD13 and CD14
D. CD13 and CD14
A purchased hemoglobin standard is used to adjust a hemoglobinometer. The standard is being used as a: Question 4 options: A. Control B. Precision check C. Delta check D. Calibrator
D. Calibrator
Hydrodynamic focusing in flow cytometry is important because it: Question 24 options: A. Directs the laser light. B. Intensifies the laser light with mirrors. C. Collects the scattered light. D. Creates a core of individually aligned cells.
D. Creates a core of individually aligned cells.
What does the coefficient of variation (CV) calculate? Question 2 options: A. Accuracy B. Reliability C. Proper calibration D. Precision
D. Precision
Mature T cells with cerebriform (brain shaped), clefted nuclei found in the skin and peripheral blood describe: A. Hairy cells B. Prolymphocytes C. Lymphoblasts D. Sézary cells
D. Sézary cells
A patient with Beta-Thalassemia characteristically has a/an: a- elevated A2 hemoglobin b- low fetal hemoglobin c- high serum iron d- normal rbc fragility
a- elevated A2 hemoglobin