Hematology Clinical Exam
Which organ(s) is/are the primary site(s) for hematopoiesis in the fetus? Liver Spleen Bone Marrow
All of the above (Liver, Spleen, Bone Marrow)
Which granulocytic cell has large, abundant purple-black granules?
Basophil
At what stage of differentiation will cells become committed to one cell line?
Colony-forming unit (CFU)
Which of the following is not a crucial area of RBC survival and function?
Intravascular hemolysis
Which cell classification is described by the following: second most abundant cell in the blood of a normal adult, usually small and round; sky-blue to intensely blue cytoplasm; and nucleus with clumped dark purple chromatin?
Lymphocyte
Which granulocyte has a kidney-bean shaped nucleus with a clumped chromatin pattern and small secondary granules with a few primary granules?
Metamyelocyte
What is the proper cell sequence for the monocytic-phagocytic system (MPS)?
Monoblast promonocyte monocyte macrophage
Which listing represents the proper cell sequence of granulocytoiesis?
Myeloblast promyelocyte myelocyte metamyelocyte band neutrophil
Which listing represents the proper cell sequence of erythropoiesis?
Rubriblast prorubricyte rubricyte metarubricyte reticulocyte erythrocyte
What is the best description of a metarubricyte?
Solid, blue-black degenerated nucleus with nonlinear clumped chromatin pattern no nucleoli pink cytoplasm
Which of the following laboratory results would not be a usual diagnostic criterion for a patient with anemia? a. Decreased hemoglobin level b. Decreased hematocrit level c. Decreased platelet level d. Decreased RBC level
c. Decreased platelet level
What are the characteristics of Niemann-Pick cells? a. Atypical lymphocytes with large vacuoles b. Cytoplasm filled with lipid droplets, inconspicuous nucleus c. Vacuolated histiocytes or foam cells d. Lymphocytes with Alder-Reilly bodies
b. Cytoplasm filled with lipid droplets, inconspicuous nucleus
How is aplastic anemia best defined? a. A condition in which bone marrow production of red blood cells, white blood cells, and platelets has failed b. A condition in which a severe: anemia is seen c. A condition where platelet numbers are decreased d. A condition where there are reversible increases in bone marrow elements
a. A condition in which bone marrow production of red blood cells, white blood cells, and platelets has failed
The WBC is 50 x 10(9)/L with 80% blasts, 15% segs, and 5% lymphs. The bone marrow reveals sheets of immature cells. Cytochemical studies of these cells show that they are peroxidase-positive (20%) and the nonspecific esterase is negative. What is the diagnosis? a. AML, M1 type b. AML, M2 type c. AML, M4 type d. AML, M5 type
a. AML, M1 type
Each of the following favors a diagnosis of chronic myelogenous leukemia (CML) rather than a leukemoid reaction EXCEPT: a. Absence of eosinophils and basophils in the peripheral blood b. Low LAP score with myeloblasts through segs in the peripheral blood c. Philadelphia chromosome d. Enlarged spleen
a. Absence of eosinophils and basophils in the peripheral blood (Except)
Which statement best describes paroxymal nocturnal hemoglobinuria (PNH)? a. Acquired hemolytic anemia associated with cellular membrane abnormalities b. Congenital hemolytic anemia associated with the inflammatory response c. Acquired or congenital hemolytic anemia associated with enzyme deficiencies d. Hemolytic anemia of unknown origin associated with autoantibodies
a. Acquired hemolytic anemia associated with cellular membrane abnormalities
What is the process in which the immune system produces antibodies to foreign red cell antigens introduced into their circulation through transfusion, pregnancy, or organ transplantation? a. Alloimmune hemolytic anemia b. Autoimmune hemolytic anemia c. Drug-induced immune hemolytic anemia d. None of the above
a. Alloimmune hemolytic anemia
What is a characteristic finding in lead poisoning? a. Basophilic stippling b. Target cells c. Sideroblasts d. Spherocytes
a. Basophilic stippling
Directional migration toward a gradient stimulated by a chemoattractant is referred to as: a. Chemotaxis b. Random mobility c. Opsonization d. Chemokinesis
a. Chemotaxis
What is the diagnostic value of the reticulocyte count in the evaluation of anemias? a. Determines response and potential of the bone marrow b. Determines compensation mechanism c. Determines the corrected RBC count after calculation d. Determines the potential sampling error for RBC count
a. Determines response and potential of the bone marrow
What condition is defined by a platelet count >600 x 10(9)/L, megakaryocytic hyperplasia, absence of Philadelphia chromosome: and hemoglobin ≥ 13 g/dl (or normal red cell mass)? a. Essential thrombocytosis b. May-Hegglin anomaly c. Acute myelogenous leukemia d. Polycythemia vera
a. Essential thrombocytosis
How is laboratory diagnosis made for malarial infection? a. Examination of peripheral blood smear b. Recovery of the organism c. Measuring hepatic enzymes d. Skin testing
a. Examination of peripheral blood smear
Which response represents the most complete and correct listing of the most common clinical signs of anemia? a. Fatigue, weakness, gastrointestinal symptoms, dyspnea, pallor b. Uticaria, hypertension, inflammation. Nausea c. Nausea, hypertension, temperature elevation, melena d. Rapid pulse, inflammation, temperature elevation, dehydration
a. Fatigue weakness gastrointestinal symptoms dyspnea pallor
The morphological characteristic(s) associated with Chediak-Higashi syndrome is/are: a. Giant lysosomal granules b. Hypersegmented agranular neutrophils with vacuolization c. Prominent dark-staining granules and pyknotic nuclei d. Pale blue inclusions in cytoplasm of neutrophils and giant platelets
a. Giant lysosomal granules
Which type of thalassemia has primarily hemoglobin Bart's and shows the following clinical expressions: infants die in utero or soon after birth; severe anemia; marked hepatomegaly; and splenomegaly; and ascites? a. Homozygous alpha thalassemia b. Homozygous beta thalassemia c. Thalassemia minor d. Alpha-thalassemia trait
a. Homozygous alpha thalassemia
What is the correct sequence for iron transport? a. Ingestion, conversion to ferrous iron in stomach, reconversion to ferric state in bloodstream, transport by transferrin, incorporation into cells and tissues b. Ingestion, transport by transferrin to liver, conversion in liver to ferric state, transport in ferrous state to cells and tissues for incorporation. c. Ingestion, conversion to ferrous state in stomach, transport in bloodstream to cells and tissues, conversion to ferric state prior to incorporation into cells and tissues d. Ingestion, transport by transferrin to cells and tissues, conversion to ferrous state prior to incorporation into cells and tissues
a. Ingestion, conversion to ferrous iron in stomach, reconversion to ferric state in bloodstream, transport by transferrin, incorporation into cells and tissues
Which list represents the complete set of processes necessary for normal hemoglobin production? Iron delivery and supply, synthesis of protoporphyrins, globin synthesis
a. Iron delivery and supply synthesis of protoporphyrins globin synthesis
How would a red blood cell that has a diameter of 9 u and an MCV of 104 In (3) be classified? a. Macrocyte b. Microcyte c. Normal d. Either normal or slightly microcytic
a. Macrocyte
What causes hemolytic disease of the newborn (HDN)? a. Maternal IgG antibodies cross the placenta, formed as a result of a previous blood exposure and/or pregnancy, cross the placenta and attach to fetal cells b. Fetal IgG antibodies cross the placenta and attach to maternal red cells c. Maternal IgM antibodies, formed as a result of a previous blood exposure and/or pregnancy, cross the placenta and attach to fetal cells d. Fetal IgM antibodies attach to fetal red cells and cross the placenta to enter the mother's circulation
a. Maternal IgG antibodies cross the placenta, formed as a result of a previous blood exposure and/or pregnancy, cross the placenta and attach to fetal cells
What routine hematologic finding is indicative of thalassemia? a. Microcytic, hypochromic anemia b. Macrocytic, hypochromic anemia c. Normocytic, normochromic anemia d. Macrocytic, normochromic anemia
a. Microcytic, hypochromic anemia
Which of the following is a correct description of the sugar water test (sucrose hemolysis test)? a. PNH cells are lysed by complement-after exposure to low-ionic-strength sugar water b. PNH cells are lysed by antibody and complement after heating to 56C in sugar water solution (5%) c. Patient's serum is acidified to enhance complement binding and lysis of patient cells d. Patient's serum is heat-inactivated and treated with HCI; complement is added; patient cell lysis occurs
a. PNH cells are lysed by complement-after exposure to low-ionic-strength sugar water
What steps occur in the extravascular breakdown of senescent RBCs? a. RES cells phagocytize red cells; iron is coupled to transferrin and returned to bone marrow; globin is returned to amino acid pool; biliverdin is converted to bilirubin; bilirubin is coupled to albumin and transported to liver; bilirubin, glucoronide is converted to urobilinogen and excreted. b. RBCs breakdown in lumen of vessel; haptoglobin-hemoglobin complex goes to liver; unbound hemoglobin dimers are excreted through kidney as hemosiderin, hemoglobin or methemoglobin; haptoglobin is broken down to be excreted as urobilinogen c. RES cells phagocytize red cells; iron is coupled to transferrin and returned to bone-marrow; globin is returned to amino acid pool; haptoglobin-hemoglobin complex goes to liver; unbound hemoglobin dimers are excreted through kidney as hemosiderin, hemoglobin, or methemoglobin; haptoglobin is broken down to be excreted as urobilinogen d. RBCs breakdown in lumen of vessel; haptoglobin picks up dissociated hemoglobin; haptoglobin-hemoglobin complex goes to liver; biliverdin is converted to bilirubin; bilirubin is coupled to albumin and transported to liver; bilirubin, glucuronide is converted to urobilinogen and excreted
a. RES cells phagocytize red cells iron is coupled to transferrin and returned to bone marrow globin is returned to amino acid pool; biliverdin is converted to bilirubin bilirubin is coupled to albumin and transported to liver bilirubin, glucoronide is converted to urobilinogen and excreted.
What is the enzyme deficiency seen in Niemann-Pick disease? a. Sphingomyelinase b. Hexosaminidase A c. Beta-glucocerebrosidase d. Alpha-galactosidase
a. Sphingomyelinase
What defect is found in lipid storage diseases? a. Subcellular accumulation of unmetabolized material in lysosomes b. Cellular accumulation of metabolites in cytoplasm c. Protein accumulation in cellular mitochondria d. Abnormal sequestration of minerals and trace elements in cellular nuclear organelles
a. Subcellular accumulation of unmetabolized material in lysosomes
Which morphologies would be prominent on a smear of a patient with severe liver disease? a. Target cells, macrocytes b. Microcytes, elIiptocytes c. Schistocytes, fragmented cells d. Sickle cells, crystals
a. Target cells macrocytes
How is a monoclonal antibody produced? a. The fusion of immune B cells with a myeloma partner to produce an immortalized hybridoma cell producing a unique antibody b. The fusion of immune T cells with a myeloma partner to produce an immortalized hybridoma cell producing a unique antibody c. The fusion of immune B cells with a myeloma partner to produce an immortalized hybridoma cell producing a unique antigen d. The fusion of immune T cells with a myeloma partner to produce an immortalized hybridoma cell producing a unique antigen
a. The fusion of immune B cells with a myeloma partner to produce an immortalized hybridoma cell producing a unique antibody
What is the definition of flow cytometry? a. The measurement of cellular (or particle) properties as they move in a fluid (flow) past a stationary set of detectors b. The measurement of ionic particles as they move in a fluid (flow) past a stationary set of detectors c. An instrument that measures light intensity; composed of a source of radiant energy, filter for wavelength selection, cuvette holder, detector, and a readout device d. A device used to isolate a certain wavelength or range of wavelengths
a. The measurement of cellular (or particle) properties as they move in a fluid (flow) past a stationary set of detectors
All of the following are helpful morphological abnormalities in the diagnosis of MDS EXCEPT: a. Vacuolated eosinophils b. Pseudo Pelger-Huet and hypogranulation c. Ringed sideroblasts d. Micromegakaryocytes, monolobular megakaryocytes
a. Vacuolated eosinophils (Except)
What is the correct list for the number and type of globin chains in normal adult hemoglobin?
b. 2 alpha, 2 nonalpha chains
What is true concerning delayed hemolytic transfusion reactions? a. Antibodies are not demonstrable in patient serum until 10-14 days after transfusion b. Antibodies are usually IgG formed from a secondary response c. Hemoglobinemia and hemoglobinuria are present d. Findings include a negative direct antiglobulin test result and antibody screen
b. Antibodies are usually IgG formed from a secondary response
What is the principle of the Donath-Landsteiner test? a. Antibody binds red cells at 37C and causes lysis at 4C b. Antibody binds red cells at 4C and causes lysis at 31C c. Antibody binds red cells at 4C or 37C and causes immediate lysis d. Antibody binds red cells at 4C or 31C but causes lysis only at 4C
b. Antibody binds red cells at 4C and causes lysis at 31C
What immune system abnormality results in the loss of self-recognition for an individual's own red cell antigens? a. Alloimmune hemolytic anemia b. Autoimmune hemolytic anemia c. Drug-induced immune hemolytic anemia d. None of the above
b. Autoimmune hemolytic anemia
What factors contribute to the sickling of RBCs? a. Increase in pH and oxygenation b. Decrease in pH and oxygenation and dehydration c. Increase in pH and decrease in oxygenation d. Decrease in dehydration and increase in pH and oxygenation
b. Decrease in pH and oxygenation and dehydration
The pathophysiology of megaloblastic anemia is: a. Defective DNA synthesis and abnormal cytoplasm maturation b. Defective DNA synthesis and abnormal nuclear maturation c. Defective RNA synthesis and abnormal nuclear maturation d. Defective DNA synthesis and abnormal cytoplasm maturation
b. Defective DNA synthesis and abnormal nuclear maturation
What is the hemoglobin defect found in thalassemia syndromes? a. Abnormal incorporation of iron molecule b. Defective production of the globin portion c. Excessive production of porphyrins d. Amino acid substitution
b. Defective production of the globin portion
What term refers to the accumulation of excess iron in macrophages? a. Sideroblastic anemia b. Hemosiderosis c. Porphyria d. Thalassemia
b. Hemosiderosis
What is the enzyme deficiency in Tay-Sachs disease? a. Sphingomyelinase b. Hexosaminidase A c. Beta-glucocerebrosidase d. Alpha-galactosidase
b. Hexosaminidase A
Which type of red blood cell inclusion is a DNA remnant? a. Heinz bodies b. Howell-Jolly bodies c. Pappenheimer bodies d. Cabot rings
b. Howell-Jolly bodies
Which of the following is not seen on the peripheral smear of a patient with megaloblastic anemia? a. Macro-ovalocytes b. Hypersegmented neutrophils c. Hyposegmented neutrophils d. Howell-Jolly bodies
b. Hypersegmented neutrophils
What are the laboratory findings in polycythemia vera? a. Decreased hemoglobin and/or hematocrit, increased RBCs and granulocytes, decreased platelets b. Increased hemoglobin and/or hematocrit, increased RBCs, granulocytes, and platelets c. Normal hemoglobin and hematocrit, normal RBCs, increased granulocytes, and platelets d. Increased hemoglobin and/or hematocrit, increased RBCs, decreased granulocytes and platelets
b. Increased hemoglobin and/or hematocrit, increased RBCs, granulocytes, and platelets
What is the primary risk to thalassemia major patients who are on a high-transfusion (hypertransfusion) program? a. Hyperviscosity of the blood b. Iron overload c. Citrate toxicity d. Electrolyte imbalance
b. Iron overload
What are the two major categories of iron deficiency? a. Defects in globin synthesis and iron incorporation b. Low availability and increased loss of iron c. Defective RBC catabolism arid recovery of iron d. Problems with transport and storage of iron
b. Low availability and increased loss of iron
What condition is not a cause of anemia? a. Dietary deficiency b. Moderate exercise c. Decreased RBC production d. Increased RBC destruction or loss
b. Moderate exercise
What is the "gold standard" for classifying lymphomas and leukemias? a. Immunophenotyping b. Morphological classification c. Crossmatching d. Immunoelectrophoresis
b. Morphological classification
What is the origin of the myeloproliferative disorders? a. Fibroid infiltration of major organs b. Neoplastic transformation of multipotential stem cells c. Widespread deterioration of cellular function d. Splenic sequestration of normal blood cells
b. Neoplastic transformation of multipotential stem cells
What is the predominant abnormal characteristic erythrocyte morphology associated with idiopathic myelofibrosis? a. Schistocytes b. Ovalocytes c. Teardrop cells d. Target cells
b. Ovalocytes
What is the primary function of iron? a. Molecular stability b. Oxygen transport c. Cellular metabolism d. Cofactor
b. Oxygen transport
What steps occur in the intravascular breakdown of senescent RBCs? a. RES cells phagocytize red cells; iron is coupled to transferrin and returned to bone marrow; globin is returned to amino acid pool; biliverdin is converted to bilirubin; bilirubin is coupled to albumin and transported to liver; bilirubin, glucoronide is converted to urobilinogen and excreted. b. RBCs breakdown in lumen of vessel; haptoglobin-hemoglobin complex goes to liver; unbound hemoglobin dimers are excreted through kidney as hemosiderin, hemoglobin or methemoglobin; haptoglobin is broken down to be excreted as urobilinogen c. RES cells phagocytize red cells; iron is coupled to transferrin and returned to bone-marrow; globin is returned to amino acid pool; haptoglobin-hemoglobin complex goes to liver; unbound hemoglobin dimers are excreted through kidney as hemosiderin, hemoglobin, or methemoglobin; haptoglobin is broken down to be excreted as urobilinogen d. RBCs breakdown in lumen of vessel; haptoglobin picks up dissociated hemoglobin; haptoglobin-hemoglobin complex goes to liver; biliverdin is converted to bilirubin; bilirubin is coupled to albumin and transported to liver; bilirubin, glucuronide is converted to urobilinogen and excreted
b. RBCs breakdown in lumen of vessel haptoglobin-hemoglobin complex goes to liver unbound hemoglobin dimers are excreted through kidney as hemosiderin, hemoglobin or methemoglobin haptoglobin is broken down to be excreted as urobilinogen
The diffuse aggressive lymphomas are: a. Seldom curable b. Rapidly fatal if untreated c. Best treated with a combination of surgery and radiotherapy d. Preferably treated with single-agent chemotherapy
b. Rapidly fatal if untreated
Which of the following cells is caused by iron accumulation? a. Acanthocyte b. Ringed sideroblast c. Burr Cell d. Schistocyte
b. Ringed sideroblast
In a patient with an MCHC >36%, one would expect to observe: a. Target cells b. Spherocytes c. Helmet cells d. Elliptocytes
b. Spherocytes
A microcytic cell can be described as possessing: a. A thin rim of hemoglobin b. A blue-gray color c. A size of less than 7 u d. An oval shape
c. A size of less than 7 u
Which of the following is not a characteristic of hemoglobinopathies? a. Conditions in which abnormal hemoglobins are synthesized b. Result from inherited abnormalities or genetic mutations c. All are manifested in clinically significant conditions d. Result in a defect in structural integrity of function of the hemoglobin molecule
c. All are manifested in clinically significant conditions
What is meant by "gating"? a. The chromatic arrangement of cellular populations b. Process by which one cell population adheres to another population c. An electronic window separating one subpopulation of cells d. An electronic device measuring all populations of cells
c. An electronic window separating one subpopulation of cells
What is the enzyme deficiency seen in Gaucher's disease? a. Sphingomyelinase b. Hexosaminidase A c. Beta-glucocerebrosidase d. Alpha-galactosidase
c. Beta-glucocerebrosidase
How is hematocrit determined on automated hematology instruments? a. Centrifugation b. Photometrically c. Calculation (MCV X RBC count) d. Calculation (MCH X RBC count)
c. Calculation (MCV X RBC count)
Which of the following laboratory tests would not be typical of hereditary spherocytosis? a. Increased osmotic fragility b. Spherocytes on peripheral smear c. Decreased MCHC d. Increased reticulocyte production index (RPI)
c. Decreased MCHC
The defect in chronic granulomatous disease is attributed to: a. Delayed degranulation caused by interference from aggregated lysosomal granules b. Deficiency in myeloperoxidase enzyme c. Deficiency or defect in cytochrome b d. Arrested maturation of neutrophils at the promyelocyte stage
c. Deficiency or defect in cytochrome b
Which metabolic pathway generates 90% of the ATP needed by RBCs? a. Methemoglobin reductase pathway b. Hexose monophosphate shunt c. Embden-Meyerhof pathway d. Leubering-Rapoport shunt
c. Embden-Meyerhof pathway
Infectious mononucleosis is caused by which of the following? a. Heterophil virus b. Bordetella pertussis c. Epstein-Barr virus d. None of the above
c. Epstein-Barr virus
Reactive lymphocytes may best be distinguished from blasts by the presence of which of the following morphological features? a. Prominent nucleoli b. Fine chromatin c. Heterogeneous cell population d. High nuclear to cytoplasmic (N:C) ratio
c. Heterogeneous cell population
What is the appearance of the bone marrow biopsy in aplastic anemia? a. Hypercellular b. Normocellular c. Hypocellular d. Fibrotic
c. Hypocellular
Which is the most common cause of aplastic anemia? a. Drug ingestion b. Toxic exposure c. Idiopathic d. Ionizing radiation
c. Idiopathic
Which of the following is not characteristic for immediate hemolytic transfusion reactions? a. Acute intravascular hemolysis b. Most commonly caused by ABO IgM complement-activating antibodies c. Increase in plasma haptoglobin d. Hemoglobinemia, hemoglobinuria, and hemosiderinuria
c. Increase in plasma haptoglobin
The elliptocyte is a prominent morphology in: a. Myeloid metaplasia b. Hemolytic anemia c. Iron-deficiency anemia d. Sickle cell anemia
c. Iron-deficiency anemia
What is the definition of pure red cell aplasia? a. Lack of hematopioetic precursors in the bone marrow b. Abnormal giant normoblasts in the bone marrow c. Lack of erythroid precursors with normal white blood cell and megakaryocyte precursors d. Dysplastic red cell precursors with normal white blood cell and megakaryocyte precursors
c. Lack of erythroid precursors with normal white blood cell and megakaryocyte precursors
A patient has the following results: Hct 26%; Hgb 8 g/dl; and RBC count 3.5 x 10 (6)/ul. Calculate the RBC indices (MCV, MCH, and MCHC) and determine the classification of the anemia. a. MCV 88 m(3); MCH 30 pg; MCHC 33 g/dl; normocytic, normochromic b. MCV 101 m(3); MCH 33 pg; MCHC 35 g/dl; macrocytic, normochromic c. MCV 74 m(3); MCH 22 pg; MCHC 31 g/dl; microcytic, hypochromic
c. MCV 74 m(3) MCH 22 pg MCHC 31 g/dl microcytic, hypochromic
The type of anemia most commonly encountered in myelodysplastic syndrome (MDS) is: a. Microcytic, hypochromic b. Normocytic, hypochromic c. Macrocytic, normochromic d. Dimorphic
c. Macrocytic, normochromic
According to the morphological classification of anemias, megaloblastic anemia is a: a. Macrocytic, hypochromic anemia b. Macrocytic, hyperchromic anemia c. Macrocytic, normochromic anemia d. Normocytic, normochromic anemia
c. Macrocytic, normochromic anemia
What deficiency causes hemoglobin to be oxidized from the ferrous to the ferric state? a. G6PD deficiency b. Pyruvate kinase deficiency c. NADH-methemoglobin reductase deficiency d. Lactate dehydrogenase deficiency
c. NADH-methemoglobin reductase deficiency
Which is not a characteristic of warm autoimmune hemolytic anemia? a. Variable anemia b. Reticulocytosis and spherocytosis c. Positive result for Donath-Landsteiner test d. DAT result usually positive for both IgG and C3d
c. Positive result for Donath-Landsteiner test
The cell characteristic of all types of Hodgkin's disease is the: a. Lacunar cell b. L & H Cell c. Reed-Sternberg cell d. Sezary cell
c. Reed-Sternberg cell
The blood smear of a patient with a prosthetic heart valve may show: a. Target cells b. Burr cells c. Schistocytes d. Elliptocytes
c. Schistocytes
Which abnormal RBC is not caused by a structural membrane defect?
c. Siderocytes
Which of the following is not a factor to be evaluated in the interpretation of a bone marrow aspirate smear? a. Maturation of red and white blood cell series b. M:E ratio c. Type and amount of hemoglobin d. Estimate of bone marrow activity
c. Type and amount of hemoglobin
What is the composition of normal adult hemoglobin? a. 92-95% HgbA; 5-8% HgbA2; 1-2% Hgb F b. 90-92% Hgb A; 2-3% Hgb A2; 2-5% Hgb F c. 80-85% HgbA; 2-3% HgbA2; 1-2% HgbF d. 95-97% Hgb A, 2-3% Hgb A2; 1-2% Hgb F
d. 95-97% Hgb A, 2-3% Hgb A2 1-2% Hgb F
The WBC is 15 x 10(9)/L with 90% blasts, 6% segs, and 4% monos. The blasts are relatively large and have abundant cytoplasm. Over 90% of them are positive with the nonspecific esterase stain and an occasional blast is positive with the Sudan black. What is the diagnosis? a. AML, M2 type b. AML, M3 type c. AML, M4 type d. AML, M5 type
d. AML, M5 type
Which of the following influence(s) iron absorption? a. Amount and type of iron in food b. Function of GI mucosa and pancreas c. Erythropioetic needs and iron stores d. All of the above
d. All of the above (Amount and type of iron in food, Function of GI mucosa and pancreas, Erythropioetic needs and iron stores)
Malignant lymphomas may best be differentiated from infectious mononucleosis by which of the following features? a. Clonality b. Monotony c. Pattern of lymphadenopathy d. All of the above
d. All of the above (Clonality, Monotony, Pattern of lymphadenopathy)
What are the mechanisms of immune hemolysis? a. IgG or IgM antibodies that activate the classic complement cascade b. Antibody-dependent cellular cytoxicity (ADCC) mediated by natural-killer (NK) cells, monocytes/macrophages, and granulocytes c. Complement and phagocytic cells in a reaction of immune adherence d. All of the above
d. All of the above (IgG or IgM antibodies that activate the classic complement cascade, Antibody-dependent cellular cytoxicity (ADCC) mediated by natural-killer (NK) cells, monocytes/macrophages, and granulocytes, Complement and phagocytic cells in a reaction of immune adherence)
Which of the following is a proposed mechanism for drug-induced hemolytic anemia? a. Immune complex b. Drug absorption (hapten) c. Membrane modification d. All of the above
d. All of the above (Immune complex, Drug absorption (hapten), Membrane modification)
What are causes for nonimmune hemolytic anemia? a. Infections b. Mechanical, chemical, and physical agents c. Acquired membrane disorders d. All of the above
d. All of the above (Infections, Mechanical, chemical, and physical agents, Acquired membrane disorders)
Which of-the following conditions shows reactive lymphocytes? a. Infectious mononucleosis b. Cytomegalovirus c. Hepatitis B d. All of the above
d. All of the above (Infectious mononucleosis, Cytomegalovirus, Hepatitis B)
What is (are) the main components of the flow cytometer? a. Laser light source b. Fluidics c. Photodetectors d. All of the above
d. All of the above (Laser light source, Fluidics, Photodetectors)
Which of the following organisms ate associated with hemolytic anemia? a. Mycoplasma pneumonia b. Epstein-Barr virus c. Babesia microti d. All of the above
d. All of the above (Mycoplasma pneumonia, Epstein-Barr virus, Babesia microti)
Burkitt's lymphoma is histologically characterized by which of the following: a. Uniform nuclei b. High mitotic rate c. "Starry-sky" pattern d. All of the above
d. All of the above (Uniform nuclei, High mitotic rate, "Starry-sky" pattern)
What are the features of cold agglutinin syndrome? a. Usually an IgM antibody b. Reticulocytosis and positive DAT result c. Tendency for spontaneous autoagglutination of RBC samples d. All of the above
d. All of the above (Usually an IgM antibody, Reticulocytosis and positive DAT result, Tendency for spontaneous autoagglutination of RBC samples)
What is the most commonly accepted method of measuring hemoglobin? a. Conversion of hemoglobin to oxyhemoglobin, followed by spectrophotometric measurement b. Iron content measured by RIA technique c. Copper sulfate measured by specific gravity d. Conversion of hemoglobin to cyanmethemoglobin followed by spectrophotometric measurement
d. Conversion of hemoglobin to cyanmethemoglobin followed by spectrophotometric measurement
Which of the following would not be seen in sideroblastic conditions? a. Increased RDW b. Pappenheimer bodies c. Ringed sideroblasts d. Decreased serum iron
d. Decreased serum iron
What infectious agent is most commonly associated with the pathogenesis of Hodgkin's disease? a. Echovirus b. Herpes virus c. Helicobacter pylori d. Epstein-Barr virus
d. Epstein-Barr virus
Oxidative denaturation of hemoglobin results in formation of small particles that are visualized with supra-vital staining. What is the term for these particles? a. Basophilic stippling b. Howell-Jolly bodies c. Pappenheimer bodies d. Heinz bodies
d. Heinz bodies
Which inclusion cannot be visualized on Wright's stain? a. Basophilic stippling b. Pappenheimer bodies c. Howell-Jolly bodies d. Heinz bodies
d. Heinz bodies
All of the following are clinical manifestations of both vitamin B12 and folate deficiency EXCEPT: a. Anemia and jaundice b. Weakness and shortness of breath c. Thrombocytopenia and bleeding d. Hemoglobinuria
d. Hemoglobinuria (Except)
What are the characteristics of Gaucher's cells? a. Atypical lymphocytes with foamy cytoplasm b. Hypersegmented neutrophils with foamy cytoplasm c. Large, multilobed monocytes with prominent red granules d. Histiocytes with blue, folded cytoplasm
d. Histiocytes with blue, folded cytoplasm
Pelger-Huet anomaly may be characterized by: a. Large neutrophils with hypersegmentation of the nucleus with more than six lobes b. Dark-staining, coarse granules in cytoplasm of neutrophils, eosinophils, basophils and monocytes c. Pale blue inclusions of the cytoplasm of neutrophils and giant platelets d. Hyposegmentation of nucleus with most neutrophils bilobed or monolobed
d. Hyposegmentation of nucleus with most neutrophils bilobed or monolobed
The glycoprotein necessary for absorption of vitamin B12 is: a. Albumin b. Transcobalamin II c. Haptocorrin d. Intrinsic factor
d. Intrinsic factor
Which features are the most important characteristics of chronic myelogenous leukemia that distinguish it from myelofibrosis? a. Presence of increased platelets and fibroblasts b. Decreased erythrocytes with abnormal morphology c. Increased leukocytes with hypercellular bone marrow d. Low LAP score and presence of Philadelphia chromosome
d. Low LAP score and presence of Philadelphia chromosome
Which cell may be found in mucopolysaccharide disorders? a. Large, foamy histiocytes with blue or green granules b. Neutrophils with toxic granulation c. Neutrophils with Dohle bodies d. Lymphocytes with Alder-Reilly bodies
d. Lymphocytes with Alder-Reilly bodies
What nonspecific laboratory findings are characteristic for PNH? a. Microcytic, hypochromic anemia; leukocytosis; thrombocytosis; decreased indirect bilirubin b. Macrocytic, hypochromic anemia; leukopenia with decreased lymphocytes; normal to elevated LAP, thrombocytopenia; increased haptoglobin c. Normocytic, hypochromic anemia; leukopenia with decreased neutrophils; thrombocytosis with giant platelets; decreased plasma hemoglobin d. Normocytic, normochromic anemia; leukopenia with decreased granulocytes; low LAP; thrombocytopenia; urine hemosiderin
d. Normocytic, normochromic anemia leukopenia with decreased granulocytes low LAP thrombocytopenia; urine hemosiderin
Basophilic stippling is composed of: a. DNA b. Precipitated stain c. Denatured hemoglobin d. RNA
d. RNA
Which of the following would not be characteristically found on a peripheral blood smear in the case of anemia? a. Anisocytosis and/or poikilocytosis b. Basophilic stippling, Howell-Jolly bodies, and Pappenheimer bodies c. Cabots rings and Heinz bodies d. Rouleaux and Dohle bodies
d. Rouleaux and Dohle bodies
Which of the following represents the most complete list of causes for aplastic anemia? a. Secondary and congenital b. Idiopathic and congenital c. Secondary and idiopathic d. Secondary, idiopathic, and congenital
d. Secondary, idiopathic, and congenital
The staging system for Hodgkin's and non-Hodgkin's lymphomas is: a. The Working formulation b. The Duke's staging system c. The Rye staging system d. The Ann Arbor staging system
d. The Ann Arbor staging system
