Lab Ce Heme part 1

How is the Mean Cell Volume calculated? (Hemoglobin / Red blood cells) X 10( Hemoglobin / Red blood cells) X 100 (Hematocrit %/ Red blood cells) X 10 (Hematocrit % X Hemoglobin) X 100

(Hematocrit %/ Red blood cells) X 10

How many large hemacytometer squares contain a total volume of 1 µL (microliter) of fluid? 5 10 15 18

10 Volume = # of squares counted x 0.1µL (chamber depth) # of squares counted = volume/0.1 or volume x 10 If the volume is 1, the number of squares counted is 10.

The photomicrograph is a representative field from a peripheral blood smear. Which of the following MCV values correlates best with the peripheral blood picture? 68 fL 82 fL 105 fL 149 fL

105 fL

What is the normal ratio of erythroid to myeloid cells found in the normal bone marrow? 1:1 - 2:1 1:5 1:3 1:10

1:3 1.5 : 1 - 3 : 1

What should be added to the cytocentrifuge chamber when preparing slides on serous fluids to aid in the adhesion of cells to the slide and preserve cellular morphology? Hyaluronidase 22% Albumin 10% acetic acid Sterile saline

22% Albumin

Classification of acute leukemia in the United States relies on two main systems, the FAB (French American British) and the WHO (World Health Organization) classifications. In order to diagnose acute leukemia, the FAB system requires ______% of non-erythroid blasts to be present in the bone marrow/peripheral blood, while the WHO system requires the presence of ________% non-erythroid blasts. 40%, 20% 30%, 20% 20%, 30% 20%, 40%

30%, 20%

A sample of cerebrospinal fluid is diluted 1:100; the standard 9 squares of a hemocytometer were counted on each side for a total of 18 large squares. Side 1- 186 cells counted Side 2- 184 cells counted total cells = 370 What is the cell count per microliter? 1.03 x 104 2.06 x 104 4.62 x 104 9.25 x 104

4.62 x 104 370 x 100 / 18 x 0.1 or 185 x 100 / 9 x 0.1

The normal size of an erythrocyte is: 2 to 4 microns 4 to 6 microns 7 to 8 microns 10 to 12 microns

7 to 8 microns

When performing a manual white blood cell count, 236 cells were counted on side number one of the hemacytometer, 224 cells on side number two. A 1/20 dilution of 1% HC1 was used, and the area counted on each side was 4 sq. mm. Twenty-five nucleated red blood cells in the differential were observed per 100 white blood cells. What is the CORRECT WBC/µL? 8,500 9,200 9,575 12,425

9,200 (# of Cells Counted X Dilution Factor X Depth Factor) / (# of Square Millimeters Counted)) = WBC per mm3 230 cells x 20 x 10 / 4 = 11,500 Corrected WBC count calculation = uncorrected WBC count x 100 / # of NRBCs +100 11,500 x 100 / 25 + 100 = 9,200

Which of the following leukemias can be excluded as a possible diagnosis if Auer rods are seen in blasts on the peripheral blood smear? Acute myelomonocytic leukemia Acute lymphoblastic leukemia Acute myeloid leukemia without maturation Acute promyelocytic leukemia

Acute lymphoblastic leukemia

In which disorder may a mild anemia be present even with an increased red blood cell (RBC) count and normal adult hemoglobin electrophoresis? Alpha thalassemia silent carrier Alpha thalassemia minor Alpha thalassemia intermedia Alpha thalassemia major

Alpha thalassemia minor

What term can be used to describe the abnormal variation in the size of the red blood cells seen in this image? Acanthocytosis Polychromasia Anisocytosis Poikilocytosis

Anisocytosis

Acquired hemophilia A (not classic hemophilia A) may result from which of the following conditions? Anti-factor VIII inhibitor Factor VIII deficiency Warfarin therapy Thrombosis complications

Anti-factor VIII inhibitor

In most cases of Fanconi anemia, which of the following types of anemia develops? Aplastic Microcytic Hemolytic Drug-induced

Aplastic

Exposure to all of the following chemicals may cause hemolytic anemia, EXCEPT? Heavy metals Lead Naphthalene Ascorbic acid

Ascorbic acid

It has already been established that the gated cell population is lymphocytic in nature. CD19 and CD20 cell surface antigens both appear on what type of lymphocytes? B cells T-helper cells Cytotoxic T cells NK cells

B cells

Which of the following processes does NOT occur during primary hemostasis? A. Physical decrease in the size of damaged vessel (vasoconstriction). B. Fibrin strands added to the newly formed clot. C. Blood flow rerouted around the damaged vessel. D. Platelets adhere to exposed collagen at the site of the breach.

B. Fibrin strands added to the newly formed clot.

Which of the following set of results would be consistent for a patient with the following findings: macrocytosis, anemia, leukopenia, and thrombocytopenia? A. MCV 115 fL; Hgb 9.5 g/dL; WBC 6.5 x 103/µL; Platelets 75,000/µL B. MCV 115 fL; Hgb 7.5 g/dL; WBC 2.5 x 103/µL; Platelets 75,000/µL C. MCV 75 fL; Hgb 7.5 g/dL; WBC 2.5 x 103/µL; Platelets 75,000/µL D. MCV 75 fL; Hgb 9.5 g/dL; WBC 6.5 x 103/µL; Platelets 175,000/µL

B. MCV 115 fL; Hgb 7.5 g/dL; WBC 2.5 x 103/µL; Platelets 75,000/µL

Which of the following statements are true for the hematopoietic cords? A. Hematopoietic cells develop at random locations in the marrow cells B. Reticular cells (adventitial cells) provide support for developing hematopoietic cells within the hematopoietic cords C. Lymphocytes are not seen in normal marrow D. Fat cells content of bone marrow decrease with aging

B. Reticular cells (adventitial cells) provide support for developing hematopoietic cells within the hematopoietic cords

Which of the following is the immediate precursor of the mature neutrophil? Promyelocyte Band Myelocyte Metamyelocyte

Band

What is the name of the structure that is indicated by the arrow in the image from a Wright-Giemsa stained smear? Döhle body Auer rod Barr body Toxic granulation

Barr body

Which of the following hemoglobins is replaced by hemoglobin H (HbH) after birth in individuals with HbH disease? Constant Spring A2 Lepore Bart's

Bart's

Which of the following is a genetic platelet disorder characterized by giant platelets, abnormal screening tests for platelet function and moderate to severe thrombocytopenia? Glanzmann's thrombasthenia Gray platelet syndrome Delta storage pool disease Bernard-Soulier syndrome

Bernard-Soulier syndrome

Which of the following coagulation test results would be prolonged in a deficiency of Factor X? PT only aPTT only Both PT and aPTT Neither PT nor aPTT

Both PT and aPTT

Which of the following can cause an automated platelet count to appear to be lower than it actually is? Platelet satellitism Platelet clumping Both platelet satellitism and platelet clumping Neither platelet satellitism and platelet clumping

Both platelet satellitism and platelet clumping

Which group of conditions increases the risk of HbS polymerization? A. Acid pH, dehydration, decreased level of 2,3-DPG B. Alkaline pH, dehydration, increased level of 2,3-DPG C. Acid pH, dehydration, increased level of 2,3-DPG D. Alkaline pH, dehydration, decreased level of 2,3-DPG

C. Acid pH, dehydration, increased level of 2,3-DPG

An increased reticulocyte count MAY be found in all of the following conditions, EXCEPT? A. Hemolytic anemias B. Following acute hemorrhage C. Aplastic anemia D. Satisfactory response to therapy for pernicious anemia

C. Aplastic anemia

Which disease/condition can be indicated by the morphology displayed in the white blood cell to the right? Chediak-Higashi syndrome Pelger-Huet anomaly Dohle bodies Toxic granulation

Chediak-Higashi syndrome

Which one of the following is a true statement about Lupus Anticoagulant (LA)? A. LA is a specific inhibitor found mainly in patients with the autoimmune disease, Systemic Lupus Erythematosus (SLE), D. LA is common in hemophiliacs C. LA prolongs coagulation leading to bleeding problems in patients. D. LA is an immunoglobulin.

D. LA is an immunoglobulin.

Identify the arrowed cells in the image to the right from the Wright-Giemsa stained blood smear slide. Eosinophilic Myelocyte Promyelocyte Plasma Cell Megakaryocyte

Eosinophilic Myelocyte

Which of the following terms specifically refers to the production of red blood cells? Thrombopoiesis Leukopoiesis Erythropoiesis Hematopoiesis

Erythropoiesis

Hemophilia B or Christmas disease is the result of a hereditary deficiency in which coagulation factor? Factor X Factor VIII Factor XI Factor IX

Factor IX

A patient with a history of frequent mild bleeding episodes has the following results: Normal PTProlonged aPTT corrected by normal plasma during mixing studies Which of the following could be a possible cause of the initial aPTT prolongation? Factor VII deficiency Factor IX deficiency Factor X deficiency A circulating inhibitor is present

Factor IX deficiency A deficiency of factor IX would cause an abnormal initial aPTT because the aPTT detects coagulation proteins of the intrinsic and common pathways, and factor IX is a coagulation factor in the intrinsic system. It would be corrected in a mixing study because the normal plasma that is added would contain the missing factor IX.

Which of the following factors require Vitamin K for their synthesis in the liver? Factor XIII Factor VII Factor VIII Factor I

Factor VII Factor VII is a member of the Prothrombin group, which includes Factors II, VII, IX, X, Protein C & Protein S. This group requires vitamin K for synthesis.

Which of the following factors does not affect the result of the aPTT assay? Factor X Factor IX Factor VIII Factor VII

Factor VII Factor VII is in the extrinsic pathway. Deficiencies of Factor VII would prolong the PT.

Warfarin (coumarin-type anticoagulant) inhibits all the following coagulation factors except: Factor II Factor IX Factor VII Factor XI

Factor XI Warfarin (coumarin-type oral anticoagulant) only inhibits vitamin K dependent factors, Factors II, VII, IX, and X, and proteins C, S, and Z.

he following factors are measured by either the PT or aPTT, EXCEPT: Factor VIII Factor IX Factor V Factor XIII

Factor XIII Factor XIII is not measured in the PT or aPTT tests, as this is the clot stabilizing factor and acts once the clot is already formed. To test for Factor XIII deficiency, the 5M urea solution test can be performed (and can be followed by a mixing study)

The fibrin clot begins to form when fibrinogen is cleaved resulting in a fibrin monomer, fibrinopeptide A, and fibrinopeptide B fragments. The fibrin monmers sponaneously polymerize due to hydrogen bonding, and then are covalently linked into fibrin polymers by which factor? Plasmin Factor XIII Factor V Thrombin

Factor XIII Factor XIII, or fibrin stabilizing factor, is responsible for polymerizing the cross-linked fibrin strands to form a stable fibrin clot. Factor XIII is activated by thrombin and calcium ions. Thrombin is the key enzyme which initially cleaves the fribrinogen into the fibrin monomers, and helps to activate Factor XIII.

Sudan III will confirm the presence of: Parasites Sperm Mucus Fat

Fat Sudan III is used to identify the presence of lipids or fats in laboratory samples

Which of the following assays is more sensitive and specific for the diagnosis of Paroxysmal Nocturnal Hemoglobinuria (PNH)? Sucrose hemolysis test Ham test Flow cytometry for GPI-anchored proteins Schilling test

Flow cytometry for GPI-anchored proteins

Which of the following combination of globin chains comprise Hemoglobin H? Two alpha, two beta Two alpha, two gamma Four beta chains Four alpha chains

Four beta chains

The bone marrow begins producing cells in the _____________ month of fetal life. First Fourth to Fifth Sixth Eighth

Fourth to Fifth

No platelet aggregation response to ristocetin occurs in both Von Willebrand Disease and in Bernard Soulier Syndrome. In VWD, it is a cofactor for Von Willebrand Factor and as a result of deficiency of VWF, ristocetin becomes deficient as well. What is deficient in Bernard Soulier Syndrome to cause no response to ristocetin? GP IIb/IIIa TPa GP Ib/IX/V P2Y1

GP Ib/IX/V

Which of the following characteristics are found within May Hegglin Anomaly? Giant platelets Hyposegmented neutrophils Toxic granulation Dohle bodies

Giant platelets

Which white blood cell population would have the MOST side scatter when analyzed using flow cytometry? Monocytes Lymphocytes Granulocytes Erythrocytes

Granulocytes

In examining a Wright's stained blood smear of a patient who has had a splenectomy, one would most likely also find: Heinz bodies Howell-Jolly bodies Auer rods Dohle bodies

Howell-Jolly bodies

Which of the following inclusions may be observed on a Wright-stained peripheral blood smear if a patient has had a splenectomy? Reticulocytes Basophilic stippling Howell-Jolly bodies Schistocytes

Howell-Jolly bodies

Spherocytes are associated with which of the following conditions? Hereditary stomatocytosis Immune hemolytic anemia Thalassemia Iron deficiency

Immune hemolytic anemia

All of the following are associated with hereditary spherocytosis, EXCEPT? Increased osmotic fragility An MCHC greater than 37% Intravascular hemolysis Extravascular hemolysis

Intravascular hemolysis

All of the following are usually increased in alpha thalassemia EXCEPT? Iron binding capacity Percent iron saturation Lactate dehydrogenase Bilirubin

Iron binding capacity TIBC is normal or decreased in alpha thalassemia

Which of these conditions could result in a microcytic anemia? Iron deficiency Vitamin B12 deficiency Spherocytosis Folate deficiency

Iron deficiency

All of the following are causes of hemolytic anemia, EXCEPT? Thermal injury Iron deficiency anemia Brown recluse spider bite Plasmodium infection

Iron deficiency anemia

Bone marrow examination may be used to aid in the diagnosis of which of the following? Iron deficiency anemia Leukemia Infectious mononucleosis Plasma cell neoplasms

Leukemia

Which of the following is the most common condition associated with a nonmegaloblastic macrocytic anemia? Liver disease Aplastic anemia Chronic blood loss Folic Acid deficiency

Liver disease

Identify the nucleated blood cell: Lymphocyte Neutrophil Basophil Monocyte

Lymphocyte

Normal adult CSF may have 0-5 white blood cells (WBCs)/µL. Which of the following cell types account for 60-100% of these WBCs? Neutrophils Lymphocytes Monocytes Eosinophils

Lymphocytes

Pluripotential stem cells are capable of producing which of the following? Only T-lymphocyte and B-lymphocyte subsets Erythropoietin, thrombopoietin, and leukopoietin Lymphoid and myeloid stem cells Daughter cells from only a single cell line

Lymphoid and myeloid stem cells

When assessing a bone marrow aspirate smear of an adult, a normal M/E ratio (myeloid to erythroid cells) would be? M:E = 1:1 M:E =1:3.5 M:E = 2.5:1 M:E = 7:1

M:E = 2.5:1

The hematology laboratory is experiencing instrument downtime. The laboratory has a backup method for hemoglobin, and hematocrit testing that is being used until the instrument is repaired. The hematologist calls and asks if you can provide any of the red blood cell indices. Which of the indices, if any, can you provide for the hematologist? MCV and MCH MCH and MCHC MCH only MCHC only

MCHC only

Which of the following is NOT classified as a Myelodysplastic Syndrome? MDS with Philadelphia Chromosome (MDS-PC) MDS with Ring Sideroblasts (MDS-RS) MDS with Single Lineage Dysplasia (MDS-SLD) MDS with Excess Blasts (MDS-EB)

MDS with Philadelphia Chromosome (MDS-PC)

CD5 antigen is normally found on which of the following lymphocyte populations? Mature T cells Normal B cells Both mature T cells and normal B cells None of the above, CD5 is not a lymphoid marker

Mature T cells

In which of the following conditions would you expect to find Howell-Jolly bodies? Iron deficiency anemia Splenomegaly Diabetes Megaloblastic anemia

Megaloblastic anemia

On a Cytospin preparation from a pleural fluid specimen, 50% of the cells have the following characteristics: - uniform, regular arrangement- some cells resemble a "fried egg"- multiple nuclei- smooth nuclear outline and homogeneous chromatin- when present in clumps, there are clear spaces between the cells ("windows") How should these cells be classified? Atypical cancer cells Mesothelial cells Tumor cells Ependymal cells

Mesothelial cells

Which of the following cells is the most common nucleated cell in normal adult bone marrow? Myeloblast Promyelocyte Myelocyte Metamyelocyte

Metamyelocyte

An accumulation of this results in a heavily granulated appearance in Alder Reilly Anomaly? Sphingomyelinase Mucopolysaccharide Beta-glucocerebrosidase Myeloperoxidase

Mucopolysaccharide

Identify the cell indicated in this Wright-Giemsa stained bone marrow. Metamyelocyte Myelocyte Myeloblast Promyelocyte

Myeloblast

The two nucleated cells in this peripheral blood smear image can be identified as (left image-right image): Myelocyte - lymphocyte Monocyte- nucleated red blood cell Monocyte - lymphocyte Myelocyte - nucleated red blood cell

Myelocyte - nucleated red blood cell

What does the M:E ratio in a bone marrow evaluation represent? Monocytes to erythrocytes Myeloid cells to erythroid cells Myelocytes to erythrocytes Megakaryocytes to erythrocytes

Myeloid cells to erythroid cells

A physician obtains a peritoneal fluid sample by lavage on a patient who complained of fever and abdominal pain following an automobile accident. The fluid is analyzed in the laboratory. How should the sample shown in the image to the right be reported? Lymphocytes Eosinophils and parasites Mesothelial cells Neutrophils and bacteria

Neutrophils and bacteria

How are Barr bodies usually classified? Pathological Reactive Non-pathological Atypical

Non-pathological

All of the following would be represented in the usual classification of anemia EXCEPT: Microcytic, hypochromic Normocytic, normochromic Normocytic, hyperchromic Macrocytic

Normocytic, hyperchromic

By utilizing a Prussian Blue stain, which of the following red blood cell inclusions would be identifiable if present? Note: Upper image = Wright-Giemsa stain Lower image = Prussian Blue stain Cabot rings Pappenheimer (siderotic) bodies Howell Jolly bodies Malarial parasites

Pappenheimer (siderotic) bodies

A few dark blue staining granular inclusions located near the periphery of an erythrocyte are most likely: Pappenheimer bodies Howell-Jolly bodies Heinz bodies Basophilic stippling

Pappenheimer bodies

The red blood cell inclusions noted in the Wright stained peripheral smear to the right are called: Heinz bodies Basophilic stippling Malarial ring forms Pappenheimer bodies

Pappenheimer bodies

Eosinophilia is commonly found in which of the following disorder? Pernicious anemia Liver disease Parasitic infections Infectious mononucleosis

Parasitic infections

Which of the following disorders is characterized by a stem cell mutation due to the PIGA gene that leads to clones of cells that bind abnormally large amounts of complement? Spur cell anemia Paroxysmal nocturnal hemoglobinuria (PNH) Hereditary acanthocytosis (aka Abetalipoproteinemia) Hereditary pyropoikilocytosis

Paroxysmal nocturnal hemoglobinuria (PNH)

Which of the following conditions would produce the results listed below in an anemic patient? MCV = 115 fL MCH = 30 pg MCHC = 34 % Sickle cell anemia Aplastic anemia Iron deficiency anemia Pernicious anemia

Pernicious anemia

The thrombomodulin-thrombin complex is known to aid in the activation of which of the following? Factor VII Plasminogen Fibrin Factor XII

Plasminogen

All of the following substances can be used to induce platelet aggregation when performing platelet aggregation studies EXCEPT: Thrombin Adenosine diphosphate (ADP) Epinephrine Plasminogen

Plasminogen Thrombin, ADP, and epinephrine, as well as collagen, snake venom, and ristocetin, can all be used to induce platelet aggregation using turbidometric or other methods.

Identify the cell in this image: Myeloblast Promyelocyte Myelocyte Metamyelocyte

Promyelocyte

Identify the leukocyte seen in this illustration: Myeloblast Promyelocyte Reactive lymphocyte Metamyelocyte

Promyelocyte

The reticulocyte count is used to assess which of the following? Increased blood loss Microcytic anemia Macrocytic anemia RBC production by the bone marrow

RBC production by the bone marrow

Secondary hypercoagulable states can be caused by all of the following conditions EXCEPT: Obesity Rapid weight loss Pregnancy Postoperative states

Rapid weight loss

Which of the following cells is indicative of Hodgkin's disease? Niemann-Pick cells Reactive lymphocytes Flame cells Reed-Sternberg (RS) cells

Reed-Sternberg (RS) cells

A smear that is prepared from equal parts of new methylene blue and whole blood is used for which of the following? WBC differential Platelet estimate Reticulocyte count Manual RBC count

Reticulocyte count

Which one of the following hematological determinations is MOST reliable for evaluating bone marrow erythropoietic activity? Hemoglobin Reticulocyte count Platelet count Mean corpuscular volume

Reticulocyte count

Which white blood cell is found in the largest numbers in the peripheral blood of a normal adult? Lymphocyte Monocyte Basophil Segmented neutrophil

Segmented neutrophil

Neoplastic T lymphocytes with irregular, convoluted (cerebriform) nuclear outlines best describe which of the following? Gaucher cells Mott cells Sezary Cells Leptocytes

Sezary Cells

A WBC differential count on CSF should be performed using the following technique: Wet mount of sample from collection tube Stained smear of a cytocentrifuged specimen Directly from hemocytometer chamber count Directly from stained hemocytometer count

Stained smear of a cytocentrifuged specimen

The arrows in the image point to Heinz bodies in erythrocytes. Which of the following stains was used to confirm the presence of these inclusions? Prussian blue stain Wright-Giemsa stain Supravital stain Any of the above stains

Supravital stain

Which of the following represents the best match of cell type with function? Eosinophils - humoral immunity Neutrophils - mediate inflammatory responses T lymphocytes - cell mediated immunity Monocytes - protect against parasitic infections

T lymphocytes - cell mediated immunity

Decrease platelet production can be caused by a lack of or decreased amount of which of the following? Erythropoietin Thrombopoietin von Willebrand factor (vWF) Factor VIII

Thrombopoietin

In which organ or tissue do T-lymphocytes mature? Bone marrow Thymus Lymph nodes Spleen

Thymus

All of the following bones contain active hematopoietic bone marrow in a normal adult, EXCEPT? Pelvis Sternum Tibia Vertebrae

Tibia

Which of the following bone marrow sampling methods would be advisable if the quantity is inadequate for an aspirate smear? Touch imprint Bone marrow core biopsy Direct aspirate smear Clot section

Touch imprint

All of the following are ways hemoglobin functions EXCEPT: Transport Oxygen Transport Carbon Dioxide Transport Nitric Oxide Transport Haptoglobin

Transport Haptoglobin

What red blood cell morphology is pictured here? Normocytic, normochromic Microcytic, hypochromic Microcytic, normochromic Unable to determine

Unable to determine

In all of the following conditions, the red blood cell morphology marked by the blue arrows (teardrop and howell-jolly) is a typical finding, EXCEPT? Myelofibrosis Uremia Myelophthisic anemia Thalassemia

Uremia

Which of the following inclusions are frequently seen on the same peripheral blood smear along with toxic granulation? May-Hegglin bodies Vacuoles Auer rods Primary granules

Vacuoles

Eosinophils are increased in all of the following conditions EXCEPT? Parasitic infections Allergic reactions Viral infections Inflammatory reactions

Viral infections

A defect in which of the following factors causes impaired platelet adhesion and aggregation? Stuart-Prower factor Von Willebrand factor Hageman factor Fletcher factor

Von Willebrand factor

Which of the following genotypes cause beta thalassemia minor? ß/ß ß+/ß+ ß0/ß ß0/ß0

ß0/ß

What is the mechanism of heparin-induced thrombocytopenia (HIT)? A. Antibodies directed against platelet factor 4 (PF-4) and heparin complex. B. Administration of toxic doses of heparin that destroy platelets. C. Abrupt cessation of heparin therapy. D. Purposeful destruction of platelets by heparin administration.

A. Antibodies directed against platelet factor 4 (PF-4) and heparin complex.

During data analysis in flow cytometry, how are cells gated? A. By placing a gate around cells with the same light-scattering. B. By placing a gate around cells with different light-scattering. C. By placing a gate around cells with different fluorescent properties. D. By placing a gate around cells that have no fluorescence.

A. By placing a gate around cells with the same light-scattering. In flow cytometry, gating is the process of isolating cells with the same light-scattering or fluorescence properties by electronically placing a gate around them. In the image below, the cell population that has bound to the red fluorochrome has been electronically gated.

All of the following statements describe a method by which platelets aid coagulation EXCEPT: A. Lower blood pressure by releasing heparin B. Catalyze coagulation by releasing Platelet Factor 3 C. Cause blood vessels to constrict by releasing serotonin D. Form a plug to stop the flow of blood

A. Lower blood pressure by releasing heparin

Which of the following may be seen in a CSF sample of a patient that has a subarachnoid (intracranial) hemorrhage (SAH)? A. Macrophages containing hemosiderin B. Uneven distribution of blood in CSF tubes collected C. Clot is present in the CSF sample D. Supernatant of CSF sample does not have xanthochromia

A. Macrophages containing hemosiderin

Patient A and patient B both had hemoglobin migrating in the S position on an alkaline hemoglobin electrophoresis. Which of the following interpretations is appropriate for the sodium metabisulfite tests shown here? A. Patient A has a positive solubility test. B. Patient B has a positive solubility test. C. Patient B has a inconclusive solubility test, the technologist should repeat the test. D. Patient A has a inconclusive solubility test, the technologist should repeat the test.

A. Patient A has a positive solubility test.

Which of the following is the cause of thrombotic thrombocytopenic purpura (TTP)? Thrombopoietin (TPO) deficiency ADAMTS13 deficiency Platelet antibodies The cause of TTP is idiopathic

ADAMTS13 deficiency

What is the predominant abnormal RBC shape seen in this illustration? Burr cell Acanthocyte Ovalocyte Schistocyte

Acanthocyte

A 41-year-old male arrived at the clinic with complaints of fatigue, malaise, and overall discomfort. Upon testing, the patient's CBC results were notably abnormal with 30% blasts present along with anemia and thrombocytopenia. Bone marrow and cytochemical staining were subsequently performed. The cytochemical stains noted negative reactions to Myeloperoxidase and Sudan Black B but a positive reaction to alpha-naphthyl acetate. Which of the following conditions is most likely seen? Acute Erythroleukemia Acute Monocytic Leukemia Acute Promyelocytic Leukemia Acute Lymphocytic Leukemia

Acute Monocytic Leukemia

A population of small lymphocytes is gated for further evaluation in the flow cytometry laboratory. The scatterplot for one of the evaluations is shown on the right. How would you interpret this scatterplot? A. Cells in the gated population are predominantly expressing CD5, but not expressing CD20. B. Cells in the gated population are predominantly expressing CD20, but not CD5. C. Cells in the gated population are co-expressing CD5 and CD20. D. Cells in the gated population are expressing neither CD5 nor CD20.

C. Cells in the gated population are co-expressing CD5 and CD20.

Which of the following is the most common method for diagnosing malaria? A. Serological testing B. Polymerase chain reaction (PCR) techniques C. Demonstration of the organism in peripheral blood D. Biochemical reactions

C. Demonstration of the organism in peripheral blood

Which of the following statements is false about von Willebrand's disease (vWD)? A. vWD can be inherited or acquired. B. vWD can involve qualitative or quantitative changes in von Willebrand's Factor (vWF). C. Functional vWF molecules usually occur as a monomers or dimers. D. Functional ELISA tests and ristocetin co-factor assays have been used to test vWF function.

C. Functional vWF molecules usually occur as a monomers or dimers.

The gel electrophoresis pattern for hemoglobin S (HbS) shows which of the following migration patterns? A. HbS migrates alone in alkaline and with HbD in acid electrophoresis. B. HbS migrates with HbD in alkaline and with HbA in acid electrophoresis. C. HbS migrates with HbD in alkaline and alone in acid electrophoresis. D. HbS migrates with HbA in alkaline and HbD in acid electrophoresis.

C. HbS migrates with HbD in alkaline and alone in acid electrophoresis.

Alpha thalassemia is defined as: A. The production of an abnormal form of hemoglobin due to the substitution of an amino acid in the alpha chain. B. The decrease in the rate of production of Hb A due to a substitution of an amino acid in the alpha chain. C. The decrease in the rate of production of alpha chains due to a partial or total deletion of the genetic code. D. The decrease in the rate of production of alpha chains due to a mutation on chromosome 11.

C. The decrease in the rate of production of alpha chains due to a partial or total deletion of the genetic code.

The role of the medical laboratory scientist in processing bone marrow aspirates can vary depending on laboratory and clinician protocols. Which of the following statements is true regarding the bone marrow procedures typically performed by an MLS? A. They prepare the patient for the bone marrow procedure. B. They perform the bone marrow aspiation and biopsy. C. They make and/or stain the bone marrow smear. D. They examine and interpret the bone marrow smear.

C. They make and/or stain the bone marrow smear. The pathologist then examines and interprets the bone marrow smear.

Which one of the following antigen markers is BEST associated with stem cells? CD3 CD10 CD18 CD34

CD34

Which of the following cell markers are useful in the diagnosis of paroxysmal nocturnal hemoglobinuria (PNH)? CD4 and CD8 CD55 and CD59 CD56 and CD57 CD14 and CD15

CD55 and CD59

A manual white blood cell count was performed by the hematology technologist. The cell counts for both sides were 99 and 164, respectively. All nine large squares were counted on each side. The dilution for this kit was pre-measured at 1:100. What should the technologist report as the white cell count? 14.61 x 109/L 1.46 x 109/L 4.61 x 109/L Cannot report

Cannot report Cell counts from opposite sides of the hemacytometer (within the same patient sample) that are greater than 10% of one another are considered discrepant and should not be used to calculate reportable results. This particular count should not be used to report patient results.

What would be the logical first step to obtain correct values when the following results were obtained on an electronic particle counter in hematology for an alcoholic patient? WBC 6,500/cu. mmMCV 90.1 fLRBC 4,550,000/cu. mmMCH 39.6 pgHGB 18.0 g/dLMCHC 43.4%HCT 41.5% Perform a microhematocrit Check and correct for lipemia Dilute the blood Replace the lysing agent

Check and correct for lipemia

A monoclonal B-cell population (Kappa or Lambda predominant) with expression of CD19, CD20, CD23, and co-expression of CD5 is consistent with which of the following? A normal B cell Chronic lymphocytic leukemia Mantle cell lymphoma A mature T cell

Chronic lymphocytic leukemia

Detecting the BCR/ABL1 mutation by molecular techniques is useful in the diagnosis of which of the following diseases/conditions? Paroxysmal Nocturnal Hemoglobinuria (PNH) Chronic myelogenous leukemia (CML) Acute Promyelocytic Leukemia (APL) Iron Deficiency Anemia (IDA)

Chronic myelogenous leukemia (CML)

This image is from a patient with alpha thalassemia. Though not diagnostic for this condition, what morphology is present which would lead you to consider a quantitative disorder of hemoglobin synthesis? Basophilic stippling Codocytes Ovalocytes Schistocytes

Codocytes Codocytes are a typical erythrocyte morphology found in most thalassemias and hemoglobinopathies.

What is the term used to describe the abnormal RBC shape seen in this illustration? Sickle cell Thorn cell Fragmented cell Crenated cell

Crenated cell Thorn cell = acanthocyte Fragmented cell = schistocytes

When performing controls for the morning run in coagulation, the normal control is within acceptable limits for both the PT and APTT, but the abnormal control is out of range for both procedures. Which of the following would be an appropriate action to take? A. Document the out of range QC and continue with the morning run while reporting out only those results that are in normal range B. Continue with the morning run and report out only those results that fall within normal range C. Document QC, then repeat controls at the end of the morning run and report if both controls are acceptable D. Document QC, repeat the abnormal control, troubleshoot if necessary; report patient results only when both controls are within acceptable ranges

D. Document QC, repeat the abnormal control, troubleshoot if necessary; report patient results only when both controls are within acceptable ranges

A specimen drawn from an indwelling catheter that was contaminated by heparin would be indicated by: A. Normal PT and aPTT results B. Prolonged PT and normal aPTT results C. Prolonged aPTT and prolonged reptilase time test D. Prolonged aPTT and normal reptilase time test

D. Prolonged aPTT and normal reptilase time test patient sample containing pre-analytical heparin contamination will show an increased aPTT (and sometimes PT as well) while showing a normal reptilase time.

What would be the next step when an EDTA specimen had an automated platelet count of 61,000/mm3 and the platelets were surrounding the neutrophils on the differential? A. Report the automated platelet count since it is more accurate than a platelet estimate B. Warm the EDTA tube and repeat the automated platelet count C. Rerun the original specimen since the platelet count and blood smear estimate do not match D. Recollect a specimen for a platelet count without using EDTA

D. Recollect a specimen for a platelet count without using EDTA

Which of the following would best describe what you might observe after a traumatic CSF tap? A. All tubes pale yellow B. All tubes clear C. All tubes contain equal amounts of blood D. Significantly more RBCs were found in tube #1 vs. tube #3

D. Significantly more RBCs were found in tube #1 vs. tube #3

All of the following statements are correct regarding polychromatophilic red blood cells EXCEPT? A. They correspond to the reticulocyte stage of red blood cell maturation. B. They stain blue-lavender/gray on Wright stain. C. They are often slightly larger than mature red blood cells and increased numbers are referred to as stress or shift reticulocytes. D. They are never seen on normal peripheral blood smears.

D. They are never seen on normal peripheral blood smears.

As an RBC ages, all of the following are true EXCEPT: A. The membrane becomes less flexible. B. The cellular hemoglobin concentration increases. C. Glycolysis and other enzyme activity decrease. D. They become less prone to phagocytosis.

D. They become less prone to phagocytosis.

The decreased serum iron levels seen in anemia of chronic disease (also referred to as anemia of chronic infection or inflammation) is caused by which of the following? Increased total iron binding capacity (TIBC) Decreased serum ferritin Increased erythropoietin Decreased iron released from macrophages

Decreased iron released from macrophages

Myelodysplastic Syndromes are characterized by cytopenias with at least one cell line decreased as well as this: Left shift Leukoerythroblastosis Dyspoiesis Leukemoid Reaction

Dyspoiesis

Cells that stain positive with acid phosphatase, and are NOT inhibited with tartrate, are characteristically seen in: Infectious mononucleosis Infectious lymphocytosis Hairy cell leukemia T-cell ALL

Hairy cell leukemia artrate resistant acid phosphatase (TRAP) is a test performed on blood cells or bone marrow to confirm a diagnosis of hairy cell leukemia. Hairy cells characteristically display red staining granulation with the TRAP stain, while other leukocytes will not. Hairy cells will also stain positive, like other types of leukocytes with regular acid phosphatase stain

Which abnormal hemoglobin may be formed in alpha thalassemia? Hb Bart's Hb Lepore Hb E Hb S

Hb Bart's

Which hemoglobin will be increased in delta-beta thalassemia? Hb A Hb A2 Hb F Hb H

Hb F It is increased to 100% in delta-beta thalassemia major.

The hemoglobin electrophoresis patterns that are shown include controls labeled AF and ASC above and below the patient results on the alkaline electrophoresis (on the left) and above the patient results on the acid electrophoresis (on the right). Note that labels AF and ASC are labeled for the controls and do not indicate the migration order. The patient was tested in duplicate, and the results are in lanes 4 and 6. The patient samples displayed in these hemoglobin electrophoresis patterns are consistent with what diagnosis? HbAS HbSC HbSD HbS/HPFH

HbAS

Which of the following blood cell inclusions cannot be detected on a Wright's stained blood smear? Pappenheimer bodies Dohle bodies Heinz bodies Howell-Jolly bodies

Heinz bodies

The percentage of red blood cells in whole blood is called: Hemoglobin Hematocrit Hemostasis Hemopoiesis

Hematocrit

When red blood cells hemolyze, what is the molecule released that will give the plasma its reddish appearance? Sodium Potassium Hemoglobin Glucose

Hemoglobin

WBC 9.6 x 109/L (4.3 - 10.8 x 109/L) Hemoglobin 9.1 g/dL (11.5 - 13.5 g/dL) HCT 28% (37 - 48%) MCV 80 fL (86 - 98 fL) RDW 13.1 (11 - 15) Platelets 90.1 x 109/L (150 - 450 x 109/L) The peripheral blood smear is represented in the image to the right. Which of the following condition(s) could be present in this patient when considering the information above and the cells indicated by the arrows on the peripheral smear? Hereditary spherocytosis Hemolytic uremic syndrome (HUS) Beta thalassemia Iron deficiency anemia

Hemolytic uremic syndrome (HUS)

Which hematologic condition could be associated with the findings shown in these images? Disseminated intravascular coagulation Hereditary spherocytosis Hereditary elliptocytosis Sickle cell anemia

Hereditary spherocytosis

Which of the following conditions would be associated with an increased osmotic fragility test result? Hereditary spherocytosis Iron deficiency anemia Sickle cell anemia Thalassemia

Hereditary spherocytosis

The buffy coat includes which of the following constituents of the blood? Red blood cells and white blood cells White blood cells and platelets Platelets and red blood cells Plasma and red blood cells

White blood cells and platelets