Heme & UA MediaLab

What is the nucleated blood cell in this image? Segmented neutrophil Band neutrophil Eosinophil Basophil

Segmented neutrophil

Calculate the mean corpuscular hemoglobin content (MCHC) when Hgb = 15 g/dL (150 g/L), RBC count = 4.50 x 106/µL (4.50 x 1012/L), and Hct = 47% (0.47). Please select the single best answer 34.7 g/dL 10.4 g/dL 31.9 g/dL 33.9 g/dL

31.9 g/dL

What is the approximate percentage of individuals in the US who are heterozygous for HFE mutations for hereditary hemochromatosis? Please select the single best answer 0.05% to 0.10% 1% to 2% 10% to 12% 20% to 25%

10% to 12%

Adult (normal) Hemoglobin is made up of the following composition: Please select the single best answer >90% HbA, 1% HbA2, 5% HbF >95% HbA, <3.5% HbA2, <1-2% HbF <90% HbA, 10% HbA2, 5% HbF >90% HbA, 1% HbA2, 5-10% HbF

>95% HbA, <3.5% HbA2, <1-2% HbF

A technologist is having trouble differentiating between red blood cells, oil droplets, and yeast cells on a urine microscopy. Acetic acid should be added to the sediment to: Lyse the yeast cells Lyse the red blood cells Dissolve the oil droplets Crenate the red blood cells

Lyse the red blood cells

alculate the red cell indices from the following set of patient data: RBC count = 5.22 x 1012/L Hemoglobin = 17.5 g/dL Hematocrit = 53% Please select the single best answer MCV = 100 fL, MCH = 28 pg, MCHC = 36 g/dL MCV = 102 fL, MCH = 34 pg, MCHC = 36 g/dL MCV = 100 fL, MCH = 28 pg, MCHC = 33 g/dL MCV = 102 fL, MCH = 34 pg, MCHC = 33 g/dL

MCV = 102 fL, MCH = 34 pg, MCHC = 33 g/dL

What are the microscopic elements that are indicated by arrows in this image? Please select the single best answer Bacteria Calcium oxalate crystals Triple phosphate crystals Artifact

Bacteria

Where does most cerebrospinal fluid (CSF) originate? Please select the single best answer Cerebral arachnoid space Choroid plexus Ventricles Lumbar region

Choroid plexus

The image is a stained smear of cerebrospinal fluid. The cells present in this field may indicate what condition? Allergic reaction Bacterial meningitis Leukemia with CNS involvement Viral meningitis

Leukemia with CNS involvement

What organ is associated with the production of the majority of clotting factors? Thymus Duodenum Liver Kidney

Liver

Which of the following cells would be increased if the cerebrospinal fluid (CSF) of a patient suspected of having multiple sclerosis? Please select the single best answer Neutrophils Lymphocytes Macrophages Monocytes

Lymphocytes

Identify the urine sediment elements shown by the arrow: Please select the single best answer WBC casts RBC casts Waxy casts Granular casts

WBC casts

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 10^4 2.06 x 10^4 4.62 x 10^4 9.25 x 10^4

2.06 x 104 Cells/µL = # of cells counted x dilution / # of large squares counted x 0.1µL (chamber depth)

Urine pH values can normally vary between: 4.5 to 8.0 5.0 to 6.0 7.0 to 8.0 3.0 to 7.0

4.5 to 8.0

The genetic analysis of a patient suspected of having beta thalassemia resulted in the pattern shown. This drawing most likely depicts which beta chain genotype ? Beta thalassemia minor Beta thalassemia intermedia Beta thalassemia major Delta-beta thalassemia minor

Beta thalassemia minor

Bacterial contamination of a urine specimen from a normal healthy individual could originate from all of the following except: Please select the single best answer Contaminated urine container Vagina Bladder Vulva

Bladder

The inclusions that are seen in the white cell indicated by the arrow in this image are characteristic of which of the following conditions? Chediak-Higashi syndrome Infection Pelger-Huët anomaly Infectious mononucleosis

Chediak-Higashi syndrome

A reagent strip test for hemoglobin has been reported positive. Microscopic examination fails to yield red blood cells. This patient's urine condition can be called: Please select the single best answer Hematuria Hemoglobinuria Oliguria Hemosiderinuria

Hemoglobinuria

The oxidation of hemoglobin to methemoglobin in acidic urine after several hours may cause which of the following color to produce? White Yellow Blue to green Red to brown

Red to brown

A copper reduction method (e.g. Clinitest® or Benedict's) is performed on pediatric specimens in order to check for the presence of: Reducing substances Aspirin Protein Ketones

Reducing substances

The most common screening test for Hb S, the hemoglobin solubility test, is based on which of the following principles? Decreased solubility of deoxygenated Hb S in solution produces visible turbidity. The reduction of iron from the ferrous to the ferric state produces visible turbidity. Increased solubility of deoxygenated HbS in solution produces visible turbidity. The fact that any unstable hemoglobin will result in visible turbidity.

Decreased solubility of deoxygenated Hb S in solution produces visible turbidity.

What is the identification of this crystal seen in a urine specimen with an alkaline pH? Please select the single best answer Uric acid Ammonium biurate Triple phosphate Calcium carbonate

Ammonium biurate

What is the MOST likely explanation for a patient with sickle cell anemia whose hemoglobin has dropped to 4 g/dL and has a reticulocyte count of 0.1%? Increased hemolysis due to hypersplenism Aplastic crisis Thrombotic crisis Occult blood loss

Aplastic crisis

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

Ascorbic acid

All of the following are likely the causes of an abnormal thrombin time (TT) EXCEPT: Please select the single best answer Fibrin split products Heparin Aspirin Dysfibrinogenemia

Aspirin

Nucleated RBCs are most likely to be seen in the peripheral blood of which type of beta thalassemia? Please select the single best answer Beta thalassemia minima Beta thalassemia minor Beta thalassemia intermedia Beta thalassemia major

Beta thalassemia major

All of the following CD markers are present on a normal mature T cell, EXCEPT? Please select the single best answer CD20 CD7 CD3 CD5

CD20

Fresh frozen plasma should be used for which of the following? Platelet replacement Coagulation deficiencies Volume replacement Albumin replacement

Coagulation deficiencies

Which of the following red blood cell morphologies, commonly seen as an artifact, is predominant in the photomicrograph? Please select the single best answer Acanthocytes Echinocytes Stomatocytes Codocytes

Echinocytes

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

Factor XI

All of the following tests are part of the routine semen analysis, EXCEPT: Please select the single best answer pH Motility Fructose level Morphology

Fructose level

The RBC inclusions shown in the photograph represent which of the following? Howell-Jolly bodies Artifact Pappenheimer bodies Basophilic stippling

Howell-Jolly bodies

A technologist performed urine microscopic testing on a patient who submitted a urine sample following strenuous exercising. Which of the following casts is most likely to be found in this urine sample? Hyaline casts White cell casts Granular casts Waxy casts

Hyaline casts

Which of the following is an FDA-approved therapeutic agent for treating sickle cell patients? Butyric acid Erythropoietin Hydroxyurea Nitric oxide

Hydroxyurea

A typical Bronchoalveolar lavage differential contains all the cells EXCEPT: Please select the single best answer Ciliated lining cells Mesothelial cells Macrophages Lymphocytes

Mesothelial cells

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

Iron binding capacity

A CSF sample was cytocentrifuged and the smear was stained. Which of the following statements is true about the type of cell shown in the image? Increased numbers of this cell is seen in patients with bacterial meningitis. It lines the arachnoid space (central nervous system). It is a monocyte. It is a malignant cell.

It lines the arachnoid space (central nervous system)

The following results correlate with which of the following myelodysplastic syndromes? 2 cyotpenias in the peripheral blood; 11% blasts in the peripheral blood; 18% blasts in the bone marrow; Auer rods present. MDS-EB-2 MDS-SLD MDS-MLD MDS-U

MDS-EB-2

A semen sample for semen analysis should generally be received at the testing site within what period of time? Please select the single best answer One hour Two hours Three hours Four hour

One hour

When scanning a Wright's stained blood smear, which of the following would describe the optimum area to begin your blood smear analysis and differential white blood cell count? RBCs are fairly far apart showing a "cobblestone effect." RBCs are lying singly, barely touching, with occasional overlapping. RBCs are stacked like coins with the majority of cells overlapping. RBCs are aggregated.

RBCs are lying singly, barely touching, with occasional overlapping.

What is the identity of the cells that are indicated by the arrow in this image? Please select the single best answer White blood cells (WBCs) Red blood cells (RBCs) Yeast Squamous epithelial cells (SECs)

Squamous epithelial cells (SECs)

What are the abnormal red cells indicated by the arrows in this field? Target cells (codocytes) Burr cells (echinocytes) Sickle cells (drepanocytes) Stomatocytes

Target cells (codocytes)

Urinalysis & Other Body Fluids Urinalysis Chemical A urine specimen was collected at 6:00 a.m. and remained at room temperature until it was received in the laboratory at 3:30 p.m. How may the pH of the specimen be affected by the extended time at room temperature if bacteria are present in the specimen? The pH may become more acidic. The pH may become more alkaline. The pH will become neutral. The pH would probably not be affected.

The pH may become more alkaline.

A negative glucose oxidase test and a positive test for reducing sugars in urine indicate: Please select the single best answer True glycosuria A false-negative glucose oxidation reaction The presence of a non-glucose reducing sugar such as galactose These results are normal

The presence of a non-glucose reducing sugar such as galactose

A urine concentration test was performed on a patient after a fluid intake deprivation period with the following findings: After 12 hours Urine Osmolality = 850 mOsm/KgAfter 16 hours Urine Osmolality = 850 mOsm/Kg What do these results indicate? This represents normal kidney function. This represents a loss of tubular function and concentrating ability. This represents a laboratory error, as these results are not medically possible. These results represent end-stage renal disease.

This represents normal kidney function

What term is used to describe the color in these tubes of cerebrospinal fluid (CSF)? Please select the single best answer Jaundice Xanthochromia Icterus Normal

Xanthochromia

A phlebotomist notices that an activated partial thromboplastin time (APTT or PTT) has been ordered by the patient's physician. She is speaking to the patient before collection and states that "we need to collect a blood sample so that we can obtain serum for a blood test your physician ordered". What part of what the phlebotomist said to the patient is incorrect? Please select the single best answer Nothing is incorrect. All of what the phlebotomist said is correct. An APTT (or PTT) is done on whole blood, not serum. An APTT (or PTT) is done on plasma, not serum. An APTT (or PTT) isn't performed on blood.

An APTT (or PTT) is done on plasma, not serum

CSF lymphocytosis is associated with all of the following EXCEPT: Cerebral abscess Viral meningitis Chronic fungal meningitis Chronic tuberculous meningitis

Cerebral abscess

A CBC performed on a 10-year-old African-American male who was brought to the emergency department with rapid, shallow breathing and fever provided the following results: Parameter Patient Result Reference Interval WBC 28.0 x 109/L 3.2- 9.8 x 109/L RBC 3.88 x 1012/L 4.50 - 5.70 x 1012/L Hemoglobin 10.0 g/dL 13.6 - 17.2 g/dL MCV 82 fL 80 - 110 fL RDW 23 11 - 14.5 Reticulocyte 8.0% 0.5 - 1.5% The image is a representative field from the peripheral blood smear. What cells are indicated by the arrows in this smear? Please select the single best answer Sickle cells Ovalocytes Schistocytes Acanthocytes

Sickle cells

How does ion concentration in the urine relate to specific gravity? Specific gravity increases as ionic concentration increases. Specific gravity decreases as ionic concentration increases. There is no relationship between SG and ionic concentration. Specific gravity stays the same regardless of the ionic concentration.

Specific gravity increases as ionic concentration increases.