Hematology MLT Practice

Which of the following is most likely to interfere with the measurement of hemoglobin? A). Heparin B). Lipemia C). EDTA D). Leukocytopenia

Lipemia

What morphologically abnormal red blood cell is associated with "hyperchromia"? A). Spherocyte B). Macrocyte C). Microcyte D). Target cell

Spherocyte

Four tubes of CSF on the same patient were received in the laboratory. It was noted on the report that all four tubes contained visible blood. Which of the following is the best explanation for this finding? A). Traumatic tap B). Subarachnoid hemorrhage C). Meningitis D). WAHA

Subarachnoid hemorrhage

What is an appropriate use for molecular (DNA) tests for mutations of the HFE gene, the gene found in the majority of patients diagnosed with hereditary hemochromatosis (HH)? A). Testing family members of persons with HH B). Screening of all newborns C). Predicting the severity of iron overload D). Identifying persons with iron overload

Testing family members of persons with HH

Which of the following conditions is characterized by small clots made up of platelets and large forms of von Willebrand factor? A). Hemolytic uremic syndrome (HUS) B). Disseminated intravascular coagulation (DIC) C). Thrombotic thrombocytopenic purpura (TTP) D). Heparin induced thrombocytopenia (HIT)

Thrombotic thrombocytopenic purpura (TTP)

What does the red cell distribution width (RDW) indicate on the peripheral blood smear? A). Variability of RBC volume B). Poikilocytosis C). Macrocytosis D). Microcytosis

Variability of RBC volume

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.

Ristocetin enhances binding of vWF to platelet GPIba.

Which of the following tests may be used to confirm screening test results for a lupus anticoagulant (or antiphospholipid antibody)? A). Activated partial thromboplastin time B). Prothrombin time C). Factor assays D). Russell Viper Venom test

Russell Viper Venom test

In flow cytometry, the granularity of a cell is indicated by which of the following? A). Side scatter B). Forward scatter C). Hydrodynamic focusing D). Fluorochromes

Side scatter

In which of the following conditions are Cabot rings most likely to be observed on a Wright-stained peripheral blood smear? A). Megaloblastic anemia B). Moderate iron deficiency anemia C). Sickle cell trait D). Plasma cell myeloma

Megaloblastic anemia

A patient is admitted to the emergency room with lethargy and pallor. The CBC results are as follows: RBC = 4.1 x 1012/L Hemoglobin = 7.9 g/dL Hematocrit = 29% What would this be classified as? A). Microcytic, hypochromic B). Normocytic, normochromic C). Macrocytic, normochromic D). Microcytic, hyperchromic

Microcytic, hypochromic

Which of the following tests could be used to determine whether an abnormal screening coagulation test result (PT or aPTT) is caused by a factor deficiency or an inhibitor? A). Bleeding time B). D-Dimer C). Fibrinogen assay D). Mixing studies

Mixing studies

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

Myeloblast

The most immature neutrophil found in normal peripheral blood is which of the following? A). Segmented neutrophil B). Neutrophil band C). Metamyelocyte D). Myeloctye

Neutrophil band

What procedure(s) would be acceptable to run on an EDTA specimen containing a small clot? A). Platelet count only B). ESR only C). No procedures will be accurate D). Hemoglobin by cyanmet method

No procedures will be accurate

If greater than 50% lymphocytes were found on the peripheral blood smear of a 5 months old child you would suspect which of the following conditions? A). Immune deficiency syndrome B). Acute viral infection C). Normal finding D). Infectious hepatitis

Normal finding

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

On average, 25% to 35% of ingested iron is absorbed each day.

If present, how many Howell-Jolly bodies are usually seen within a given erythrocyte? A). One B). Two C). Three D). Four

One

Anticoagulant drugs which are direct thrombin inhibitors (such as argatroban and bivalirudin) can prolong which of the following clot-based assay/s? A). PT, aPTT, and Ecarin clotting time B). Activated thromboplastin time (aPTT) only C). PT and aPTT D). Ecarin clotting time only (ECT)

PT, aPTT and Ecarin clotting time

Degenerated erythrocyte cytoplasmic organelles that contain iron are called: A). Cabot rings B). Pappenheimer bodies C). Howell-Jolly bodies D). Heinz bodies

Pappenheimer bodies

What is another name used to designate a fully committed B-lymphocyte: A). Plasma cell B). Large lymphocyte C). Reactive lymphocyte D). T-lymphocyte

Plasma cell

In a patient with suspected malaria, which parasite demonstrates the following findings on a blood smear? Enlarged RBCs, some with fine brownish granules > 12 parasites in some cells Amoeboid structures Schuffner's dots A). Plasmodium falciparum B). Plasmodium ovale C). Plasmodium vivax D). Plasmodium malariae

Plasmodium vivax

A point-of-care test used to evaluate bleeding problems and monitor antiplatelet medication is called? A). Erythrocyte sedimentation rate (ESR) B). Prothrombin time (PT) C). Platelet function assay (PFA) D). Activated partial thromboplastin time (aPTT or PTT)

Platelet function assay (PFA)

The most striking laboratory finding of this myeloproliferative neoplasms is an absolute erythrocytosis and hemoglobin concentrations of greater than 18.5 g/dL? A). Chronic myelogenous leukemia (CML) B). Essential thrombocythemia (ET) C). Primary myelofibrosis (PMF) D). Polycythemia vera (PV)

Polycythemia vera (PV)

Which of the following stages of neutrophilic granulocyte cellular development is at the second stage from the least mature stage? A). Band neutrophil B). Promyelocyte C). Metamyelocyte D). Myeloblast

Promyelocyte

Which of the following is responsible for inhibiting the tissue plasminogen activator? A). Antithrombin B). Tissue Factor Pathway Inhibitor C). Thrombin D). Protein C

Protein C

The primary purpose of neutrophil granules is to: A). Facilitate nuclear maturation. B). Help distinguish neutrophils from lymphocytes. C). Prepare cells for removal from circulation. D). Provide microbicidal action.

Provide microbicidal action.

The vascular system contributes to hemostasis in all of the following ways EXCEPT: A). Production of tissue factor B). Diversion of blood flow around the damaged vessel C). Contraction of vessels D). Providing smooth endothelial surface

Providing smooth endothelial surface

MCV is calculated using which of the following parameters? A). Hgb and RBC B). Hct and Hgb C).RBC and Hct D). RBC and MCHC

RBC and Hct

Patients who undergo urologic procedures, as well as those with genitourinary tract diseases such as prostate cancer can sometimes be prone to diffuse hemorrhage. A possible cause of this could be which of the following? A). Dysfunction of platelets B). Release of urokinases C). Initiation of tissue factor released from endothelial cells D). Release of PGL (a prostacyclin ) from endothelial cells

Release of urokinases

What is a typical regimen for long-term maintenance therapy of individuals with hereditary hemochromatosis (HH)? A). Removal of 2 to 6 units of blood yearly B). Dietary restrictions on iron intake only C). Treatment with desferrioxamine D). Removal of one unit of blood once per week

Removal of 2 to 6 units of blood yearly

Which of the following statements characterize a reticulocyte? A). Reticulum visible with a supravital stain, such as new methylene blue B). Reticulum visible with Wright stain C). Contains some organelles used for hemoglobin production D). Pyknotic nucleus still present in the cell

Reticulum visible with a supravital stain, such as new methylene blue

An MCV is reported by the instrument as 82 fL. The MCV is flagged with a delta check alert as the previous MCV reported on this patient 12 hours earlier was 97 fL. What is a possible cause for this discrepancy? A). Transfusion B). Acute hemorrhage C). The specimens are not from the same patient D). The second specimen was hemolyzed

The specimens are not from the same patient

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 are never seen on normal peripheral blood smears. C). They stain blue-lavender/gray on Wright stain. D). They are often slightly larger than mature red blood cells and increased numbers are referred to as stress or shift reticulocytes.

They are never seen on normal peripheral blood smears.

You are analyzing a patient sample in the hematology laboratory when the instrument you use for automatic CBC flags your specimen for having a low platelet count. Upon performing a visual differential of the slide, you notice that there are indeed very few platelets on the slide. You also notice numerous, fragmented red blood cells. What would this be associated with? A). Thrombotic Thrombocytopenic Purpura (TTP) B). The patient has bone marrow failure C). The patient is undergoing chemotherapy for multiple myeloma D). Myelodysplastic Syndrome

Thrombotic Thrombocytopenic Purpura (TTP)

To produce hemoglobin S (HbS), glutamic acid that is normally present in the sixth position on the beta globin chain is substituted with which of the following? A). Cystine B). Guanine C). Valine D). Thyamine

Valine

What cellular characteristic of red blood cells is described by the term poikilocytosis? A). Variability in size B). Variability in shape C). Presence of nuclear material D). Concentration of hemoglobin

Variability in shape

A deficiency in which of these vitamins leads to increased clotting time and may result in hemorrhagic disease? A). Riboflavin B). Pyridoxine C). Vitamin C D). Vitamin K

Vitamin K

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. A). 40%, 20% B). 30%, 20% C). 20%, 30% D). 20%, 40%

30%, 20%

A laboratory professional is going to perform a mixing study to differentiate between a factor deficiency and a coagulation inhibitor as the cause of a prolonged prothrombin time (PT) or activated partial thromboplastin time (aPTT) test result. The mixing study should be performed within what time frame following collection of the specimen? A). 4 hours B). 8 hours C). 24 hours D). 48 hours

4 hours

Whole blood if composed of approximately: A). 45% formed elements and 55% plasma B). 75% formed elements and 25% plasma C). 60% formed elements and 40% plasma D). 30% formed elements and 70% plasma

45% formed elements and 55% plasma

How long are healthy neutrophils expected to reside in the peripheral blood of an adult? A). 3 days B). 1 day C). 7-8 hours D). 12-14 hours

7-8 hours

Which of the following statements best describes a normal mature erythrocyte? A). A biconcave disc, 7 µm in diameter, with a salmon-colored cytoplasm and condensed nucleus B). A biconcave disc, 6-8 µm in diameter, that stains pinkish-orange (salmon) in color C). A biconcave disc, 6-8 µm in diameter, containing ribosomes and mitochondria D). A biconcave disc, 7 µm in diameter, responsible for transporting myoglobin

A biconcave disc, 6-8 µm in diameter, that stains pinkish-orange (salmon) in color

A balloon-like bulge filled with blood formed due to a weakness in the wall of a blood vessel is known as: A). Phlebitis B). Embolism C). Thrombosis D). Aneurysm

Aneurysm

A low platelet count, along with a low white blood cell count and red blood cell count is most likely caused by: A). Increased platelet destruction B). Ineffective erythropoiesis C). Bone marrow hypoplasia D). DIC (disseminated intravascular coagulation)

Bone marrow hypoplasia

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

Both platelet satellitism and platelet clumping

A 72-year-old patient has a routine check-up and CBC. The CBC shows a high absolute neutrophil count of 28,000/µl, with slightly elevated bands, a few immature myeloid cells, and slight toxic granulation. Upon further examination of the patient, hepatomegaly and splenomegaly are noted. Because of the splenomegaly and the lack of obvious infection, a bone marrow exam is performed which shows hypercellularity of the granulocytes. Molecular testing yields a CSF3R mutation. The most likely diagnosis is: A). Pelger-Huet anomaly B). Chronic Neutrophilic Leukemia (CNL) C). Chronic Myelogenous Leukemia (CML) D). Primary Myelofibrosis (PMF)

Chronic Neutrophilic Leukemia (CNL)

What are function(s) of the platelet? A). Clotting and plug formation B). Maintain vascular integrity C). Release serotonin D). Clotting, plug formation, release of serotonin, and repair of the injured tissues.

Clotting, plug formation, release of serotonin, and repair of the injured tissues.

Which hemoglobin will be increased in delta-beta thalassemia? A). Hb H B). Hb F C). Hb A D). Hb A2

Hb F

The bone marrow in alpha thalassemia major usually demonstrates: A). Aplasia B). Hyperplasia C). Hypoplasia D). Normoplasia

Hyperplasia

The D-dimer is useful in detecting activity in which aspect of hemostasis? A). Primary hemostasis B). Secondary hemostasis C). Fibrinolysis D). Quaternary hemostasis

Fibrinolysis

What is the platelet precursor cell found in the bone marrow? A). Megaloblast B). Megakaryocyte C). Myeloblast D). Pronormoblast

Megakaryocyte

What are the PRIMARY reagents used in the activated partial thromboplastin time (aPTT)? A). Activated partial thromboplastin and calcium B). Activated partial thromboplastin and potassium C). Thromboplastin and sodium chloride D). Actin and sodium chloride

Activated partial thromboplastin and calcium

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

Alpha thalassemia minor

When monitoring the use of low-molecular-weight heparins becomes necessary, which of the following laboratory tests is recommended? A). Prothrombin Time (PT) B). Activated partial thromboplastin time (APTT) C). Anti-Xa D). Fibrinogen level

Anti-Xa

Each of the following has been shown to induce platelet aggregation EXCEPT? A). Epinephrine B). ADP C). Aspirin D). Collagen

Aspirin

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

B lymphocyte

Which of the following is responsible for the humoral immune response: A). Neutrophils B). Basophils C). B lymphocytes D). Monocytes

B lymphocytes

The mediator cell type that binds to IgE antibodies is the: A). Basophil B). Eosinophil C). Polymorphonuclear neutrophil (PMN) D). Macrophage

Basophil

Which of the following tests is used to quantify a coagulation inhibitor? A). Prothrombin time B). Thrombin time C). Mixing study D). Bethesda assay

Bethesda assay

Pelger-Huet anomaly is characterized by which of the following? A). Giant gray-green bodies and giant lysosomes in the cytoplasm of neutrophils B). Dohle-like-bodies in the cytoplasm of neutrophils C). Bilobed or round nuclei in neutrophils (hyposegmented) D). Large purplish granules in the cytoplasm of all leukocytes

Bilobed or round nuclei in neutrophils (hyposegmented)

Which of the following will impact platelet aggregation when it becomes deficient? A). Factor XIII B). Fibrinogen C). Stuart-Prower Factor D). Factor VIII

Fibrinogen

Which of the following mutations is most commonly found in hereditary hemochromatosis (HH)? A). H63D B). BCR/ABL1 C). C282Y D). S65C

C282Y

Which of the following markers is associated with normal mature B cell expression? A). CD19 B). CD8 C). CD14 D). CD42

CD19

Which one of the following sets of laboratory results is consistent with hemolytic anemia? A). Increased concentration of haptoglobin; negative hemoglobinuria B). Decreased erythrocyte survival; increased catabolism of heme; decreased haptoglobin levels C). Decreased serum LDH activity; normal catabolism of heme D). Normal concentration of haptoglobin; marked hemoglobinuria

Decreased erythrocyte survival; increased catabolism of heme; decreased haptoglobin levels

Anemia of chronic inflammation, also known as anemia of chronic disease, can be caused by all of the following mechanisms EXCEPT: A). EPO production inhibited by cytokines B). Direct cytokine inhibition of erythropoiesis C). Shortened erythrocyte survival D). Decreased ferritin

Decreased ferritin

Which of the following would describe hypochromia? A). Decreased size of RBC's. B). Variation in the shape of RBC's. C). Increased variation of size of RBC's. D). Decreased hemoglobin concentration in RBCs.

Decreased hemoglobin concentration in RBCs.

Which of the following is NOT a way hemoglobinopathies can be caused? A). Deletion of a globin chain. B). Substitution of amino acids in a globin chain. C). Deletion of an amino acid in a globin chain. D). Addition of an amino acid in a globin chain.

Deletion of a globin chain.

What drug may be used to decrease iron levels in patients with iron overload? A). Cobalamin B). Desferrioxamine C). Antibiotics D). Eculizumab

Desferrioxamine

Which of the following red blood cell morphologies are frequently artifactual? A). Drepanocytes, echinocytes, dacryocytes B). Drepanocytes, dacryocytes C). Echinocytes, stomatocytes D). Stomatocytes, acanthocytes, elliptocytes

Echinocytes, stomatocytes

High platelet count and over-proliferation of the megakaryocytic line showing JAK2 mutation are characteristic of: A). Essential Thrombocythemia B). Iron deficiency anemia C). Chronic Myelogenous Leukemia D). Reactive thrombocytosis

Essential Thrombocythemia

Treatment of "sequestration crisis," often seen in infants and young children with sickle cell disease, involves which of the following? A). Bone marrow transplantation. B). Exchange transfusions, and/or splenectomy. C). Antibiotic treatment, for example with penicillin. D). Treatment with hydroxyurea (hydroxy carbamide).

Exchange transfusions, and/or splenectomy.

The prothrombin time test will detect deficiencies in which pathways? A). Extrinsic and intrinsic pathways B). Intrinsic pathway and common pathways C). Intrinsic pathway only D). Extrinsic and common pathways

Extrinsic and common pathways

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

Factor IX

Which of the following factors is Vitamin K-dependent? A). Factor IX B). Factor I C). Factor XI D). Factor VIII

Factor IX

Which coagulation factor is found ONLY in the extrinsic pathway? A). Factor VII B). Factor VIII C). Factor IX D). Factor X

Factor VII

The dissolution of a clot with 5M urea indicates which one of the following factor deficiencies? A). Factor II B). Factor XIII C). von Willebrand disease D). Factor IX

Factor XIII

Which of the following will give the best overall picture of a patient's iron stores: A). Albumin B). Transferrin C). Haptoglobin D). Ferritin

Ferritin

An isolated crenated erythrocyte with spicules is seen on an otherwise normocytic normochromic peripheral blood smear. Which of the following statements is true? A). Finding is indicative of possible abeta-lipoproteinemia B). Morphology suggests likelihood of disseminated intravascular coagulation C). Morphology indicates hemoglobinopathy such as thalassemia D). Finding is most likely an artifact caused by poor smear preparation

Finding is most likely an artifact caused by poor smear preparation

Which of the following laboratory tests would be most helpful in determining the number of T cells in circulation? A). Complete blood count B). Nitroblue tetrazolium (NBT) C). Manual differential D). Flow cytometry

Flow cytometry

An alpha thalassemia patient is diagnosed as having three of their four genes deleted which code for alpha hemoglobin chains. Which one of the following types of hemoglobin is abnormal and would be found in such a patient? A). Hb A B). Hb S C). Hb F D). Hb H

Hb H

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

Heinz bodies

The volume percentage of red blood cells in whole blood is called: A). Hemoglobin B). Hematocrit C). Reticulocyte count D). Glycosylated Hemoglobin/HbA1c

Hematocrit

Which genetic description will NOT contain Bart's hemoglobin at birth ? A). Heterozygous alpha thalassemia-1/alpha thalassemia-2 B). Heterozygous alpha thalassemia-1 C). Homozygous alpha thalassemia-2 D). Heterozygous alpha thalassemia-2

Heterozygous alpha thalassemia-2

Which HFE genotype is most common in patients with hereditary hemochromatosis (HH)? A). Heterozygous for C282Y B). Homozygous for H63D C). Heterozygous for H63D D). Homozygous for C282Y

Homozygous for C282Y

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

Howell-Jolly bodies

What is the site used MOST frequently in the adult patient when performing a bone marrow biopsy? A). Vertebrae B). Sternum C). Clavicle D). Iliac crest

Iliac crest

Spherocytes are associated with which of the following conditions? A). Hereditary stomatocytosis B). Immune hemolytic anemia C). Thalassemia D). Iron deficiency

Immune hemolytic anemia

All of the following are laboratory findings in cases of hemolytic uremic syndrome (HUS) EXCEPT: A). Thrombocytopenia B). Increased serum bilirubin C). Increased uric acid D). Decreased haptoglobin

Increased uric acid

Basophils' primary role involves: A). Phagocytosis B). Initiation of allergic inflammation C). Long term immunity D). Antibody production

Initiation of allergic inflammation

Hemoglobin H bodies can directly alter which of the following? A). Function of the liver B). Bone marrow micro-environment C). Rate of hemoglobin production D). Integrity of the RBC membrane

Integrity of the RBC membrane

Which of the following statements is true regarding macrophages (histiocytes)? A). It is a type of monocyte that has entered the tissues via diapedesis. B). It is a form of lymphocyte that is capable of cell lysis. C). It is a cell found in tissues with numerous basophilic granules in the cytoplasm. D). It is a type of eosinophil that has immunoglobulins on the surface to recognize invading parasites.

It is a type of monocyte that has entered the tissues via diapedesis.

The first time a cell containing HbSS is deoxygenated, it forms a sickle cell. Upon reoxygenation, which of the following is true for the sickle cell? A). It will remain sickled. B). It will turn into a codocyte (target cell). C). It will return to a normal biconcave shape. D). It will appear as an echinocyte (burr cell).

It will return to a normal biconcave shape.

In almost all cases of polycythemia vera, which of the following genetic abnormalities is present? A). Philadelphia chromosome B). JAK2 mutation C). BCR/ABL1 D). t(15:17)(q22;q12)

JAK2 mutation

What MINIMUM level of a particular factor will cause the aPTT test to become prolonged? A). Less than 40% B). Less than 50% C). Less than 60% D). Less than 70%

Less than 40%

A patient initially has a prolonged PT. After reviewing the patient's case and laboratory findings, the physician administers intravenous vitamin K. The repeat PT results are normal after 24 hours of vitamin K therapy. What clinical condition is MOST likely to produce these results? A). Liver disease B). Factor XI deficiency C). Fibrinogen deficiency D). vWF deficency

Liver disease

Which of the following is considered one of the most common coagulation inhibitors? A). Lupus anticoagulant (antiphospholipid antibody) B). Anti-factor II C). Anti-factor V D). Anti-factor X

Lupus anticoagulant (anti-phospholipid antibody)

Which of the following cells have pale blue cytoplasm with a few azurophilic granules and an oval or indented nucleus? A). Monocyte B). Lymphocyte C). Eosinophil D). Segmented neutrophil

Lymphocyte

In patients with Sickle cell disease, upon sickling what laboratory test will see an increase? A). MCV B). RBCs C). MCHC D). Hematocrit

MCHC

Which of the following RBC indices is expressed in femtoliters? A). RDW B). MCV C). MCH D). MCHC

MCV