AAB MT Hematology Review

Which of the fingers should be used for dermal puncture to obtain capillary blood specimens?

#4 Ring finger or #3 Middle finger

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? A. B cells B. T helper cells C. Cytotoxic T cells D. NK cells

A. B cells

Which of the following categories includes mature neutrophils, eosinophils, and basophils? A. Granulocytes B. Hematopoietic stem cells C. Lymphoid cells D. Mononuclear cells

A. Granulocytes

B lymphocytes and T lymphocytes are derived from: A. Hematopoietic stem cells B. Macrophages or monocytes C. Mucosa-associated lymph tissue (MALT) D. Granulocytes

A. Hematopoietic stem cells

Coarse basophilic stippling is usually seen in patients who have which of the following conditions? A. Lead poisoning B. Bacterial infection C. Leukemia D. Lymphocytosis

A. Lead poisoning

In which of the following cells are Auer rods most likely to be seen? A. Myeloblast B. Lymphoblast C. Erythroblast D. Megakaryocyte

A. Myeloblast

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? A. Hyaluronidase B. 22% Albumin C. 10% acetic acid D. Sterile saline

B. 22% albumin The addition of albumin helps preserve cellular morphology and improves adhesion to the slide.

The causative agent of infectious mononucleosis attaches to a receptor on which of the following cells? A. T helper cell B. B lymph cell C. T suppressor cell D. NK cell

B. B lymph cell Epstein-Barr virus, the causative agent of infectious mononucleosis, attaches to a receptor on B lymphocytes. IM is characterized by lymphocytosis with many reactive lymphocytes (usually >20%).

Which of the following is the immediate precursor of the mature neutrophil? A. Promyelocyte B. Band C. Myelocyte D. Metamyelocyte

B. Band

Traditional coagulation assays are based almost solely on this technique: A. Chromogenic assays B. Clot-based assays C. RIA assays D. ELISA assays

B. Clot-based assays

The anemia seen in anemia of chronic dz/infx is characterized by low serum Fe levels. Which of the following contributes to the low serum Fe levels seen in persons with anemia of chronic dz? A. Decreased EPO B. Hepcidin C. Decreased dietary intake D. Decreased ferritin levels

B. Hepcidin Decreased serum Fe levels seen in anemia of chronic dz are due to increased hepcidin, which is responsible for blocking the release of Fe from macrophages. Hepcidin is produced in response to inflammatory cytokines.

A known sickle cell trait patient has Hgb electrophoresis performed. Which of the following Hgb percentage sets would most closely match this patient's diagnostic state? A. Hgb A = 90%, Hgb S = 8%, Hgb A2 = 2%, Hgb F = 0% B. Hgb A = 60%, Hgb S = 38%, Hgb A2 = 2%, Hgb F = 0% C. Hgb A = 40%, Hgb S = 58%, Hgb A2 = 2%, Hgb F = 0% D. Hgb A = 25%, Hgb S = 70%, Hgb A2 = 2%, Hgb F = 3%

B. Hgb A = 60%, Hgb S = 38%, Hgb A2 = 2%, Hgb F = 0% Patients with sickle cell trait commonly have Hgb A between 40-60%, Hgb S between 20-40%, and Hgb A2 between 2-3%.

Ristocetin is used in certain von Willebrand Factor (vWF) functional assays. The reason it is used is because: A. Ristocetin can prevent bacterial contamination of the specimen B. Ristocetin can break down the vWF multimers into monomers and then be assayed C. Ristocetin enhances binding of vWF to platelet GPIba D. Ristocetin prevents interference by other coagulation factors

C. Ristocetin enhances binding of vWF to PLT GPIba

Bence-Jones proteinuria is associated with all of the following conditions EXCEPT: A. Macroglobulinemia B. Pernicious anemia C. MM D. Amyloidosis

B. Pernicious anemia

All of the following methods are used in the diagnosis and classification of acute leukemia, EXCEPT? A. Immunophenotyping B. Reticulocyte count C. Cytochemical analysis D. Cytogenetics

B. Reticulocyte count Reticulocyte counts are a measure of immature erythrocytes which can be present in many forms of hematologic disorders. While this procedure can be useful in monitoring a leukemic patient's status, it is not useful in the diagnosis of acute leukemia.

Which of the following describes normal lymphocyte characteristics? A. Four-lobed purple nucleus, pink cytoplasm, small purple granules B. Round-oval nucleus comprising 90% of cell with a blue cytoplasm C. Two-lobed nucleus with prominent orange/red granules in cytoplasm D. Horseshoe-shaped nucleus with fine, gray ground-glass cytoplasm

B. Round-oval nucleus comprising 90% of cell with a blue cytoplasm

In all of the following conditions, the red blood cell morphology marked by the blue arrows (teardrop cells) is a typical finding, EXCEPT? A. Myelofibrosis B. Uremia C. Myelophthisic anemia D. Thalassemia

B. Uremia Echinocytes (burr cells) are associated with uremia

Which of the following tests is used to monitor therapy with unfractionated heparin? A. PT B. aPTT C. Fibrinogen assay D. PLT function assay

B. aPTT

Diseases associated with a dysfunction of polymorphonuclear neutrophils (PMNs) include all of the following with the exception of: A. Chediak Higashi Syndrome B. Chronic Granulomatous Dz C. Gaucher's Dz D. Myeloperoxidase Deficiency

C. Gaucher's disease

A 55-year-old white male had the following lab data: RBC 3.7 X 1012/L Serum iron 220 µg/dL (N: 60-80 µg/dL) TIBC 300 µg/dL (N: 260-400 µg/dL) Hct 32% Serum Ferritin 2,800 ng/mL (N: 10-200 ng/mL) WBC 5.8 x 109/L MCV 86 fL MCH 26 pg MCHC 32% Prussian Blue stain of bone marrow aspirate indicates markedly elevated iron stores. These laboratory results are MOST consistent with which of the following conditions? A. Sideroblastic anemia B. Anemia of chronic dz C. Hemochromatosis D. Megaloblastic anemia

C. Hemochromatosis Characteristic findings are elevations in serum iron and ferritin. Positive Prussian Blue stain of the bone marrow indicates elevated iron (hemosiderin) stores.

Which laboratory procedure may be used to assist in differentiating CML from a leukemoid reaction? A. Absolute PLT count B. Prussian Blue stain C. LAP stain D. Peroxidase Stain

C. LAP stain

The site most frequently used to collect bone marrow samples from adults is: A. Sternum B. Anterior iliac crest C. Posterior iliac crest D. Tibia

C. Posterior iliac crest

The clot-based assay that is most specific for measuring fibrinogen function is the: A. PT B. aPTT C. Thrombin Time D. Immunoassay for fibrinogen

C. Thrombin time

Obstruction of a blood vessel caused by a stationary blood clot is called: A. Phlebitis B. Embolism C. Thrombosis D. Aneurysm

C. Thrombosis

CSF specimens are usually collected by lumbar puncture and placed in numbered tubes. If 4 tubes are collected, which tube would be used for a cell count and differential? A. 1 B. 2 C. 3 D. 4

C. Tube 3 Tube 1 goes to chemistry/serology. Tube 2 goes to micro for stain/culture. Tube 4 is reserved for specialized testing.

Which Hgb is replaced by HgbH after birth in individuals with HbH dz? A. Constant spring B. A2 C. Lepore D. Bart's

D. Bart's

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? A. 14.61 x10^9/L B. 1.46 x10^9/L C. 4.61 x10^9/L D. Cannot report

D. Cannot report When comparing the white cell counts from one side of the hemacytometer to the other, there is not good duplication. Cell counts from opposite sides of the hemacytometer (within the same patient sample) that are >10% of one another are considered discrepant and should not be used to calculate reportable results.

Which is the MOST accurate definition for an orthochromic normoblast or nucleated red blood cell (NRBC)? A. Cell with irregular lobulated/puckered shape containing residual RNA and mitochondria in the cytoplasm B. Cell with a high nuclear:cytoplasmic ratio with a lacy, fine linear chromatin pattern C. Cell with deeply basophilic cytoplasm, a perinuclear halo and a wheel spoke chromatin pattern D. Cell with a low nuclear-to-cytoplasmic ratio with pink cytoplasm and a heavily condensed chromatin pattern

D. Cell with a low nuclear-to-cytoplasmic ratio with pink cytoplasm and a heavily condensed chromatin pattern

All of the following are associated with Hgb C disease, EXCEPT? A. Hgb C Crystals B. Target Cells C. Lysine substituted for glutamic acid at the sixth position of the beta chain D. Fast mobility of Hgb C at pH 8.6

D. Fast mobility of Hgb C at pH 8.6 Hemoglobin C has a high positive charge and therefore has slow mobility on electrophoresis using alkaline gel. Hemoglobin C migrates with hemoglobin A2 and hemoglobin E on cellulose acetate electrophoresis at pH 8.6

Which of these blood levels will decrease during intravascular hemolysis? A. Serum/plasma LDH B. Serum/plasma bilirubin C. Reticulocytes D. Haptoglobin

D. Haptoglobin Haptoglobin is an alpha2-globulin that binds to free hemoglobin intravascularly. Increased intravascular destruction of red blood cells will result in a decrease in the haptoglobin level.

A medical laboratory scientist working in Hematology was performing Myeloperoxidase staining on a suspected AML case. They found positive reactions of the segmented neutrophils. What would be the next step? A. Report result, patient is confirmed for AML B. Report result and perform Sudan Black B and Esterase stains to further confirm AML C. Inaccurate result, Myeloperoxdase stain confirms ALL not AML D. Inaccurate result, only blast cells are to be examined for reaction

D. Inaccurate result, only blast cells are to be examined for reaction

Which one of the following statements about iron deficiency anemia (IDA) is false? A. It's the most common cause of anemia B. Described as hypochromic, microcytic anemia with increased RDW C. The majority of total body iron is present as hemoglobin iron D. On average, 25% to 35% of ingested iron is absorbed each day

D. On average, 25% to 35% of ingested iron is absorbed each day On average, only 5% to 10% of ingested iron is absorbed each day.

Howell-Jolly Bodies consist of:

DNA

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

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

Iron deficiency anemia will have what indices/parameters on blood smear?

Microcytic, hypochromic

What WBC inclusions are seen in both Wright's stain smears and Prussian Blue stained smears?

Pappenheimer bodies