Hematology Midterm Review

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How many total genes does a person possess for the production of alpha chains?

Four

A hemoglobin molecule is composed of?

Four heme molecules and four globin chains

Neutrophils and monocytes and direct descendants of a common progenitor known as?

GMP

What platelet organelle sequesters ionic calcium and binds a series of enzymes of the eicosanoid pathway?

GP IIb/IIIa

Which of the following is an example of a transmembrane or integral membrane protein?

Glycophorin A

Receptors found on the platelets are called?

Glycoproteins

The glycocalyx is composed of membrane?

Glycoproteins and glycolipids

The organelle involved in packaging and trafficking of cellular products is?

Golgi apparatus

Biological hazards include all but one of the following?

Hair

Hematopoietic stem cells produce all lineages of blood cells in sufficient quantities over the lifetime of an individual because they?

Have the ability of self-renewal by asymmetric division

Which of the following erythrocytes inclusions can be visualized with supravital stain but cannot be deleted on a Wright's-stain blood smear?

Heinz Bodies

Which red blood cell inclusions originate as a result of denatured hemoglobin?

Heinz Bodies

Why is the mature erythrocyte unable to synthesize proteins or lipids?

It has no nucleus

What is the fate of transferrin receptor when it has completed its role in the delivery of iron into the cell?

It is recycled to the plasma membrane, where it can bind to ligand again

Erythropoietin is produced by the?

Kidneys

When tissues become hypoxic, which of the following organs is stimulated to release erythropoietin?

Kidneys

The megakaryocyte progenitor that undergoes endomitosis is?

LD-CFU-Meg

When a hemolytic event occurs, which of the following enzymes is increased?

LDH

Which of the following is considered personal protective equipment?

Laboratory coats

Functions of the cell membrane include all of the following except?

Lipid production and oxidation

When a coagulated blood sample is separated by centrifugation, the liquid component separated from the cells. This "serum" is the?

Liquid component with no clotting factors in it

During the 2nd trimester of fetal development, the primary site of blood cell production is the?

Liver

Which organs are involved in extramedullary hematopoiesis?

Liver and Spleen

Intramedullary Hematopoiesis in adults occur in all these sites except?

Liver and spleen

The key organs involved in extramedullary hematopoiesis include the?

Liver and spleen

What single feature of normal RBCs is most responsible for limiting their life span?

Loss of the nucleus

The _________ is one of the most stable parameters in a CBC?

MCV

Kupffer cells found in the liver are?

Macrophages

Kupffer cells, found in the liver are?

Macrophages

A laboratory get multiple complaints regarding the length of time it take hematology results to get to the emergency department. What would be an appropriate response?

Make this a quality assurance project

A peripheral blood smear stained with Prussion Blue demonstrates siderocytes. On a Wright stained smear, what would be expected?

Pappenheimer Bodies

What mechanism is responsible for the destruction of the majority of normal senescent erythrocytes?

Phagocytosis by splenic macrophages

What platelet membrane phospholipid flips from the inner surface to the plasma surface on activation and serves as the assembly point for coagulation factors?

Phosphatidylserine

Which splenic process removes inclusions from circulating red blood cells?

Pitting

Which of the following behaviors is a violation of standard precautions?

Placing beverages on the laboratory work area

RBC membrane cholesterol is replenished from the?

Plasma

Which of the following is the final stage of B cell maturation after activation by antigen?

Plasma cell

In the quaternary structure of hemoglobin, the globin chains associate into?

Two alpha beta dimers

Following are several of the many steps in the process from absorption and transport of iron to incorporation into heme. Place them in proper order. i. Transferrin picks up ferric iron ii. Iron is transferred to the mitochondria iii. DMT1 transports ferrous iron into enterocyte iv. Ferroportin transports iron from enterocyte to plasma v. The transferrin receptor transports iron into the cell

iii, iv, i, v, ii

Mean cell volume (MCV) is calculated using the following formula:

(Hct / RBC) X 10

What is the percent transferrin saturation for a patient with total serum iron of 63ug/dL and TIBC of 420ug/dL?

15%

When hand washing after a patient contact, the soap application process should last at least?

20 seconds

Calculate the mean cell hemoglobin concentration (MCHC) using the following values: Hgb: 15g/dL Hct: 47 mL/dL RBC: 4.50X10^6 uL (4.50X10^12/L)

31.9%

A patients hemoglobin is 12.3 g/dL. On the peripheral smear, the red cells appear normochromic and normocytic. The hematocrit value that correlates with these data is?

37%

When viewing a slide with the 50 X objective lens, the total magnification being used is?

500 X

The life span of a platelet is?

7 to 10 days

Which correctly describes a normal mature erythrocyte?

A 7-to-8-um biconcave disc that lives 120 days

Which of the following RBC pathways is responsible for providing 90% of the cellular ATP for red cell metabolism?

Embden-Meyerhof pathway

Which is true concerning 2,3-BPG?

Enhances O2 release from hemoglobin

Which one of the following features distinguishes a monocyte from a lymphocyte?

Abundant gray-blue cytoplasm

Autoagglutination of red cells at room temperature can cause which of the following abnormal tests results?

All of the above

Safety training is part of new employees training in health care and includes?

All of the choices

Which of the following is involved in the study of hematology and used to determine sickness and health?

All of the choices

A key rate-limiting step in heme synthesis in suppression of?

Aminolevulinate synthase

Standards and calibrators differ from control materials because

An exact amount of analyte is present in a standard or calibrator

Variation in red cell size observed on the peripheral smear is described as?

Anisocytosis

Physiologic programmed cell death is termed?

Apoptosis

White clots?

Are largely composed of platelets and von Willebrand factor

When compared with mature erythrocytes, reticulocytes?

Are larger and bluer on Wright stain from remnant ribonucleic acid (RNA)

Which is true regarding reference ranges?

Are ranges of values for an analyte in normal healthy people

A key morphological feature of the uncleared red blood cell stages is?

Baseball round nucleus

Normal red blood cell life span depends on all of the following except?

Baseball round nucleus

What type of erythrocyte inclusion are present?

Basophilic Stippling

Standard precautions involve?

Behavior that prevents direct contact with bodily fluids or contaminated surfaces

The nature of the interaction between 2,3-BPG and hemoglobin is that 2,3-BPG?

Binds to amino acids of the globin chain, contributing to a conformational change that inhibits oxygen from binding to heme

What types of samples are used primarily in the clinical laboratory?

Blood and bodily fluids

Hematology is the study of?

Blood cells

The primary lymphoid organs are the?

Bone marrow and thymus

Mature blood cells leave the bone marrow and enter the circulation via the?

Bone marrow sinuses

Mature red blood cells leave the bone marrow and enter the circulation via the?

Bone marrow sinuses

Microparticles?

Bud off of platelets after their exposure to strong agonists

Upon centrifugation of a blood specimen, the layer between the red blood cells and plasma is called the?

Buffy coat

Which CD marker is specific for monocytes?

CD14

The CD markers for HSC includes?

CD34+

Which of the following CD markers is more appropriately associated with the T cell?

CD4, CD8

Which of the following is an erythroid progenitor?

CFU-E

Carbon monoxide poisoning results from ___________ intake?

Carboxyhemoglobin

The glycolipids of the RBC membrane?

Carry RBC antigens

Which parts on the microscope is used for focusing?

Coarse and fine adjustment

Resemble a target with bulls eye in the center

Codocytes

Delta checks are used in the hematology laboratory to?

Compare past patient results with the current result

Which one of the following morphologic changes occurs during normal blood cell maturation?

Condensation of nuclear chromatin

Which chemical substances are responsible for differentiation and replication of the pluripotent stem cell?

Cytokines

Which of the following helps maintain RBC shape?

Cytoskeletal proteins

What pathway anerobically generates energy in the form of ATP?

Embden - Meyerhof pathway

What membrane-associated protein in enterocytes transports iron from the intestinal lumen into the enterocyte?

DMT1

The nucleus is composed largely of?

DNA

What is the composition of Howell-Jolly bodies?

DNA

Erythrocytes are elongated at one end to make a tear drop shape

Dacryocytes

Hypochromia is used to define?

Decrease in hemoglobin content of the red blood cells

Macrophages aid in adaptive immunity by?

Degrading antigen and presenting it to lymphocytes

Spleen functions include all except?

Detoxification

Spleen functions includes all except?

Detoxification

When referring to the microscope the tube length is the?

Distance from the eyepiece to the objective

All of the following are characteristics of the red blood cell in stages of development except?

Distinct granulation is in the cytoplasm

Erythrocytes are elongated with pointed ends

Drepanocytes

Basophils and mast cells have high-affinity surface receptors for which immunoglobulin?

E

What growth factor is produced in the kidneys and is used to treat anemia associated with kidney disease?

EPO

Erythrocytes with regularly distributed projections around the cell membrane

Echinocytes

Which of the following cells are important in immune regulation, allergic inflammation, and destruction of tissue invading helminths?

Eosinophils and basophils

Which of the following cells critical to iron trafficking in the body does NOT possess ferroportin?

Erythroblasts

Developing erythroblasts in the bone marrow affect the supply of body iron, both absorption and recycling, by secreting which of the following hormones?

Erythroferrone

A hormone released from the kidney that is unique for erythrocyte regeneration is?

Erythropoietin

The hormone responsible for red blood cell development in the bone marrow is?

Erythropoietin

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 bodys responses is?

Extramedullary hematopoiesis in the liver and spleen

The predominant hemoglobin found in healthy newborn is?

F

Which one of the following cytokines is required very early in the differentiation of a hematopoietic stem cell?

FLT3 ligand

Progenitor cells are capable of self renewal?

False

True or False? A normal distribution curve will have 99.7% of the measured value fall with in 2SD

False

True or False? The higher the N:C ratio is, the more mature the cell?

False

What is the majority metabolically available storage form of iron in the body?

Ferritin

Iron is transported out of macrophages, hepatocytes, and enterocytes by what membrane protein?

Ferroportin

A 7.0 ml ethylenediaminetetraacetic acid (EDTA) tube is received in the laboratory containing only 2.0 ml blood. If the laboratory is using manual techniques which of the following tests will most likely be erroneous?

Hematocrit

The process of formation and development of blood cells is termed?

Hematopoiesis

What bone marrow cells can differentiate into all of the blood cells

Hematopoietic stem cells (HSCs)

What bone marrow cells can differentiate into all of the blood cells?

Hematopoietic stem cells (HSCs)

The basic components of the hemoglobin molecule include?

Heme, globin chains, and 2,3-DPG

Which of the following is a description of the structure of oxidized hemoglobin?

Hemoglobin with iron in the ferric state (methemoglobin) and not able to carry oxygen

Which of the following indications can distinguish intravascular from extravascular lysis?

Hemoglobinuria

The transfer of iron from the enterocyte into the plasma is REGULATED by?

Hepcidin

Which of the following hemoglobins is an embryonic hemoglobin?

Hgb Gower

Of the following formulas, which formula indicates the correction check between hemoglobin and hematocrit?

Hgb X 3 = Hct

What red cell inclusion may be seen in the peripheral blood smear of a post-splenectomy patient?

Howell-Jolly Bodies

The best source of active bone marrow from a 20 year old would be?

Iliac crest

Which of the following sites is the most preferable for bone marrow aspiration and biopsy in adults?

Iliac crest

Lymphocyte concentrations in peripheral blood are greatest during what age interval?

Immediately after birth

RBC membrane phospholipids are arranged?

In two layers whose composition is asymmetric

What is the primary mechanism for the anemia associated with kidney disease?

Inadequate synthesis of erythropoietin

Reticulated platelets can be enumerated in peripheral blood to detect?

Increased platelet production in response to need

Name one condition that may shift the OD curve to the left?

Inheriting a high oxygen affinity hemoglobin

Which of the following conditions produces micro cystic red blood cells?

Iron deficiency

In which condition can you see elliptocytes?

Iron deficiency anemia

Which of the following statements regarding 2,3-DPG is correct?

It controls hemoglobin affinity for oxygen

Which of the following determines the timing of egress of RBCs from the bone marrow?

Maturing normoblasts slowly lose receptors for adhesive molecules that bind them to stromal cells

The average of a group of data points is defined as the?

Mean

Who is ultimately responsible for determining specimen integrity before analysis?

Medical Laboratory Professional

What is responsible for erythrocyte deformability and maintaining cell shape?

Membrane protein

The stage in neutrophilic development in which the nucleus is indented in a kidney bean shape and the cytoplasm has secondary granules that are lavender in color is the?

Metamyelocyte

When the iron in the hemoglobin molecule is in the ferric (Fe3+) state, hemoglobin is termed?

Methemoglobin

Hemoglobin iron may become oxidized to Fe3+ by several pathologic mechanisms. What protein of the Embden-Meyerhof pathway reduces iron to Fe2+?

Methemoglobin reductase pathway

The shape of a cell is maintained by which of the following?

Microtubules

The energy source for cells is the?

Mitochondrion

Which of the following cell types is capable of differentiating into osteoclasts, macrophages, or dendritic cells?

Monocyte

In which stage of neutrophilic maturation are specific secondary granules first seen?

Myelocyte

What hexose-monophosphate shunt products participate in the detoxification of peroxides?

NADPH and reduced glutathione

Which one of the following is a function of neutrophils?

Nonspecific destruction of foreign organisms

What abnormality IF any present in this slide?

Normochromic normocytic (normal)

A correction is necessary for the WBC counts when Nucleated RBC's are seen on the peripheral blood smear because?

Nucleated RBC's are counted as leukocytes

The "control center" of the cell is the?

Nucleus

The marinating pool of neutrophils is located?

On the blood vessel walls

What is the most useful corrective action for the microscope when fine details cannot be visualized in immature cells?

Open up the diaphragm for maximum light

Which of the following cells is in the last nucleated stage of erythrocytic maturation? (using CAP terminology)

Orthochromic normoblast

Which of the following is the most mature normoblast?

Orthochromic normoblast

Which RBC process does not require energy?

Oxygen transportation

Which one of the following values is a critical value?

Platelet count of 10,000

What erythroid precursor can be described as follows: The cell is of medium size compared with other normoblasts, with an N:C ratio of nearly 1:1. The nuclear chromatin is condensed and chunky throughout the nucleus. No nucleoli are seen. The cytoplasm is gray-blue.

Polychromatic normoblast

Which of the following electrolytes maintains its highest concentration within the red blood cell cytoplasm as opposed to circulating in the plasma?

Potassium

Proper mixing of samples and timely delivery of samples to the laboratory are both examples of?

Preanalytic variables

A lab technologist identified a cell on peripheral cell smear- It has approximately a 20 um diameter, basophilic cytoplasm, a large purple to blue nucleus with nucleoli and an N:C ratio of 8:1. The cell is?

Pro or oblast - Rubriblast

How does the bone marrow respond to anemic stress?

Production is expanded, and red blood cells are released to the circulation prematurely

Erythropoietin can increase the production of RBCs by?

Promoting early release of reticulocytes from bone marrow

At which normoblastic stage does globin production begin?

Pronormoblast

Choose the correct order of Normoblastic maturation from least mature to most mature?

Pronormoblast, Basophilic normoblast, Polychromatic normoblast, Orthochromatic normoblast, Reticulocyte, Erythrocyte

Which of the following is not considered a Analytical variable?

Proper anticoagulant used

Which of the following is not considered a postanalytical variable?

Proper anticoagulant used

What is the name of the eicosanoid metabolite produced from endothelial cells that suppresses platelet activity?

Prostacyclin

Error analysis standard protocols, and turnaround time are all part of the?

Quality assurance system

Error analysis, standard protocols, and turnaround time all are part of the?

Quality assurance system

The CBC parameter that gives insight into the amount on anisocytosis present in a specimen is?

RDW

The following is unique to both B and T lymphocytes and occurs during their early development?

Rearrangement of antigen receptor genes

Which of the following forms of hemoglobin molecule has the lowest affinity for oxygen?

Tense

Which of these assays is the best test to assess the bone marrows response to anemic stress?

Reticulocyte count

The site of protein synthesis is the?

Ribosomes

RBC membranes block passage of most large molecules, such as proteins, but allow passage of small molecules such as the cations Na+, K+, and CA2+. What is the term for this membrane property?

Semipermeable

Which of the following molecules is stored in platelet dense granules?

Serotonin

Abnormalities in the horizontal and vertical linkages of the transmembrane and cytoskeletal RBC membrane proteins may be seen as?

Shape changes

Using the normal hemoglobin-oxygen dissociation curve, predict the position of the curve when there is a decrease in pH?

Shifted to the right of normal with decreased oxygen affinity

For a patient with screening iron study values that are equivocal for iron deficiency, which of the following tests would be most helpful in determining whether iron deficiency is present or not?

Soluble transferrin receptor

The proper definition of a standard is?

Solutions with a known amount of the analyte

The red blood cell protein that is responsible for deformability and flexibility of the red blood cell is?

Spectrin

Which red cell protein is responsible for deformability and flexibility of the red cell?

Spectrin

Erythrocytes with no central pallor and smaller than normal shape?

Spherocytes

Which organ is the site of sequestrations of platelets?

Spleen

Extravascular hemolysis occurs when?

Splenic macrophages ingest senescent RBCs

The primary function of erythropoietin is to?

Stimulate red blood cell production and maturation

Hypoxia stimulates RBC production by?

Stimulating EPO production by the kidney

The bone marrow, erythroid precursors are located?

Surrounding macrophages in erythroid islands

Which subpopulation of T cells alters the cell membrane?

T cytotoxic

Which one of the following cells is a product of the common lymphoid progenitor?

T lymphocyte

Which red blood cell morphology may form as a result of excess cholesterol taken on the red blood cell membrane?

Target cells

The M:E ratio describes?

The amount of myeloid elements in relation to erythrocyte elements in the marrow

Type II myeloblasts are characterized by?

The presence of fewer than 20 primary granules per cell

Upon activation, platelets secrete their alpha-granule contents via?

The surface connected canalicular system

The growth factor that is produced in the kidney and induces growth and differentiation of committed megakaryocyte progenitors is?

Thrombopoietin

Which one of the following organs is responsible for the maturation of T lymphocytes and regulation of their expression of CD4 and CD8?

Thymus

One of the primary glands in an infant responsible for lymphocyte origination is the?

Thymus gland

Iron is transported in plasma via?

Transferrin

The total iron-binding capacity (TIBC) of the serum is an indirect measure of which iron-related protein?

Transferrin

Which of the following plays a role in iron sensing so as to adjust iron absorption and recycling?

Transferrin receptor 2

Red pulp is composed of RBCs platelets and phagocytic cells

True

True or False? Accuracy is a measurement of the true value of an analyte

True

True or False? Red pulp is composed of RBCs platelets and phagocytic cells

True

True or False? Standard deviation is a measurement of precision

True

What plasma protein is essential for platelet adhesion?

VWF

Which of the following is the definition of a reference interval?

Values established for a particular analyte, given a method, instrument, or patient population

A delta check is a historical reference on samples run in the laboratories. Once a sample fails a delta check, the most obvious corrective action is to?

Verify the identification of the patient sample

All of the following represents an example of a safety violation in the laboratory except?

Wearing closed toe shoes

The morphology of blood cells is important to evaluate?

When a profiling instrument result is abnormal

How are the globin chain genes arranged?

With alpha genes and beta genes on separate chromosomes, including two alpha genes on one chromosome and one beta gene on a different chromosome

Fetal hemoglobin consists of which of the following chains?

a2, y2

Normal adult Hb A contains which polypeptide chains?

alpha and beta

The spleen harbors __________ of the circulatory platelet mass

one-third


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