HEME ONLINE BOOK

22. Which of the following conditions is not associated with secondary warm autoimmune hemolytic anemia? a. CLL b. Idiopathic onset c. Rheumatoid arthritis d. Viral infections

Idiopathic onset

21. Warm autoimmune hemolytic anemia is usually caused by which of the following? a. IgA antibodies b. IgG antibodies c. IgM antibodies d. Complement

IgG antibodies

66. Therapy for CML often includes the use of a targeted tyrosine kinase inhibitor, such as: a. Imatinib mesylate b. All-trans retinoic acid c. Ablative chemotherapy d. 2-CDA/ cladribine

Imatinib mesylate

93. A patient's genotype is − α/ − α. This patient will have a CBC that shows which of the following? a. Decreased RBC count with numerous target cells b. Decreased RBC count with microcytic/ hypochromic RBCs c. Increased RBC count with normal RBCs d. Increased RBC count with microcytic/ hypochromic RBCs

Increased RBC count with microcytic/ hypochromic RBCs

12. Fanconi's anemia is an inherited aplastic anemia with mutations that lead to: a. Increased chromosome fragility b. Myelophthisic anemia c. Pancreatic issues d. RBC enzymatic defects

Increased chromosome fragility

40. A 4-year-old male patient presents with a slightly elevated WBC count, and occasional blasts are present on the differential. Flow cytometry is performed with the following results: CD10( +), CD19 (+), CD22( +), CD79a( +), TdT( +). Which of the following diagnoses is the most likely? a. Intermediate B-cell ALL b. Pre- B-cell ALL c. T-cell ALL d. Pre- T-cell ALL

Intermediate B-cell ALL

6. A patient has a macrocytic anemia, and the physician suspects pernicious anemia. Which test would best rule in a definitive diagnosis of pernicious anemia? a. Homocysteine b. Intrinsic factor antibodies c. Ova and parasite examination for D. latum d. Bone marrow examination

Intrinsic factor antibodies

2. A 68-year-old woman visited her physician with reports of fatigue and weakness. A CBC was ordered, and the patient's results were as follows: RBC 2.50 × 1012/ L Hct 18.8% MCH 24.8 pg Hgb 6.2 g/ dL MCV 75.2 fL MCHC 33% Which of the following would be a plausible diagnosis for this patient? a. Iron-deficiency anemia b. Vitamin B12 deficiency c. Anemia of chronic inflammation d. Hemochromatosis

Iron-deficiency anemia

4. Given the following results of iron studies, which disorder is the most likely? ↓ Serum iron ↑ TIBC ↓ Ferritin ↓ % Saturation a. Iron-deficiency anemia b. Sideroblastic anemia c. Anemia of chronic inflammation d. Hemochromatosis

Iron-deficiency anemia

53. Which of the following best describes the function of the Rapoport-Luebering pathway? a. It produces ATP to help maintain RBC membrane deformability b. It results in the reduction of glutathione c. It produces 2,3 diphosphoglycerate (2,3 DPG) d. It produces cytochrome b reductase

It produces 2,3 diphosphoglycerate (2,3 DPG)

86. Which of the following best describes the function of the hexose-monophosphate pathway? a. It produces ATP to help maintain RBC membrane deformability b. It results in the reduction of glutathione c. It produces 2,3 diphosphoglycerate (2,3 DPG) d. It produces cytochrome b reductase

It results in the reduction of glutathione

35. Which mutation is shared by a large percentage of patients with polycythemia vera, essential thrombocythemia, and primary myelofibrosis? a. BCR/ ABL b. JAK2 V617F c. PDGFR d. RUNX1

JAK2 V617F

36. A patient has a CBC and peripheral smear with an elevated WBC count and left shift, suggestive of a diagnosis of CML. Which of the following tests would be the most helpful in confirming the suspected diagnosis? a. Cytochemical staining for myeloperoxidase and LAP b. Karyotyping for the Philadelphia chromosome c. Flow cytometry for myeloid cell markers d. Lymph node biopsies for metastasis

Karyotyping for the Philadelphia chromosome

65. A newly diagnosed patient has an acute leukemia. Which of the following would initially be the most useful in determining the origin of the blasts seen? a. Leukocyte alkaline peroxidase (LAP) and nonspecific esterase (NSE) b. Periodic acid- Schiff (PAS) and tartrate-resistant acid phosphatase (TRAP) c. Myeloperoxidase (MPO) and terminal dexoynucleotidyl transferase (TdT) d. Sudan black B and brilliant cresyl blue

Myeloperoxidase (MPO) and terminal dexoynucleotidyl transferase (TdT)

84. The diagnostic cell type seen in Hodgkin lymphoma is: a. Binucleate plasma cell b. Reed Sternberg cell c. Bence Jones lymphocyte d. Burkitt lymphocyte

Reed Sternberg cell

99. A 36-year-old man visited the emergency department because of alternating episodes of fever and chills that persisted over several days. The patient stated he had not felt well since returning from a mission trip to Africa. The physician ordered a CBC with the following results. What should be done with this sample next? a. Rerun the sample to make sure it is not clotted b. Clean the stainer and make another slide to examine c. Refer the sample to the pathologist for further identification d. Report the results, because the results are normal

Refer the sample to the pathologist for further identification

69. The genetic mutation associated with CML is: a. t (15,17)( q22, q12) b. t( 11,14)( p15, q11) c. t( 9: 22)( q34, q11.2) d. t( 8: 21)( q22, q22)

t( 9: 22)( q34, q11.2)

33. Which of the following cytochemical stains is best used to distinguish cells of monocytic origin? a. α-Naphthyl acetate esterase b. Naphthol AS-D chloroacetate esterase c. Myeloperoxidase d. Periodic acid- Schiff

α-Naphthyl acetate esterase

50. Hemoglobin A contains which of the following configurations of globin chains? a. α2β2 b. α2δ2 c. α2γ2 d. α2ɛ2

α2β2

30. A 3-year-old female patient is seen in the hematology clinic to investigate the cause of her persistent anemia. Hemoglobin electrophoresis was ordered, and results showed an elevation in Hgb F, with a small increase in Hgb A2. What is the most likely disorder based on these results? a. α-Thalassemia major b. β-Thalassemia major c. α-Thalassemia minor d. Hemoglobin H disease

β-Thalassemia major

23. The mutation seen in sickle cell anemia is: a. β6Glu → Val b. β6Glu → Lys c. β26Glu → Lys d. β63Glu → Arg

β6Glu → Lys

71. What is the minimum percentage of ringed sideroblasts present in the bone marrow for a diagnosis of refractory anemia with ringed sideroblasts? a. 10% b. 15% c. 20% d. > 25%

15%

96. A manual hemocytometer count was required to check a patient's total WBC count. A 1: 20 dilution was made and used when the four large "W" squares were counted on both sides of the hemacytometer. A total of 105 cells were counted between the two sides. What was the patient's total WBC count? a. 0.33 × 109/ L b. 2.1 × 109/ L c. 2.6 × 109/ L d. 5.3 × 109/ L

2.6 × 109/ L

89. A bone marrow sample for a patient with newly diagnosed chronic myelogenous leukemia would often be expected to have an M/ E ratio of: a. 1: 1 b. 2: 1 c. 1: 2 d. 10: 1

10: 1

75. Most of the chromosome abnormalities seen in myelodysplastic syndrome involve which of the following chromosomes? a. 5, 7, 8, 11, 13, 20 b. 2, 3, 9, 15, 16, 26 c. 3, 6, 10, 14, 21 d. 1, 4, 15, 17, 21

5, 7, 8, 11, 13, 20

54. A 3-year-old male patient visits the pediatrician for a well-child checkup and routine CBC. He has a total WBC count of 5.0 × 109/ L, RBC count of 3.8 × 1012/ L, and platelet count of 225 × 109/ L. The differential showed 25% segmented neutrophils, 62% lymphocytes, 10% monocytes, and 3% eosinophils. This patient is likely: a. A normal child b. Suffering from an acute bacterial infection c. Immunosuppressed d. A patient with leukemia

A normal child

76. Which of the following is not one of the recurrent genetic abnormalities seen in cases of acute myeloid leukemia? a. AML with t( 8,21)( q22, q22), AML1( CBFα)/ ETO b. AML with t( 15,17)( q22, q12), (PML/ RARα) c. AML with inv( 16)/ p( 13, q22), (CBFβ/ MYH11) d. AML with t( 1,19)( q23, q13), (E2A/ PBX1)

AML with t( 1,19)( q23, q13), (E2A/ PBX1)

42. A 28-year-old female patient presented to the emergency department with symptoms suggestive of DIC. A CBC and coagulation studies were ordered. The peripheral smear showed blasts and immature cells with heavy granulation and Auer rods. Which of the following disorders would be the most likely? a. AML with t( 9,11)( p22, q23), MLLT3-MLL b. AML with t( 15,17)( q22, q12), PML-RARα c. ALL with t( 12,21)( p13, q22), ETV6-RUNX1 d. ALL with t( 9,22)( q34, q11.2), BCR-ABL1

AML with t( 15,17)( q22, q12), PML-RARα

11. Which of the following values is the most likely to be normal in a patient with aplastic anemia? a. RBC count b. Absolute neutrophil count c. Absolute lymphocyte count d. Platelet count

Absolute lymphocyte count

98. Primary neutrophil granules contain: a. Acetyltransferase, collagenase, gelatinase, lysozyme, β2-microglobulin b. Alkaline phosphatase, cytochrome b558, complement receptor 1, complement 1q receptor, vesicle-associated membrane-2 c. β2-Microglobulin, collagenase, gelatinase lactoferrin, neutrophil gelatinase-associated lipocalin d. Acid β-glycerophosphatase, cathespins, defensins, elastase, myeloperoxidase, proteinase-3

Acid β-glycerophosphatase, cathespins, defensins, elastase, myeloperoxidase, proteinase-3

80. A 69-year-old female patient presented with symptoms of fatigue and easy bruising. A CBC was ordered. The peripheral smear showed a large number of blasts, anemia, and thrombocytopenia. A bone marrow examination was performed, revealing hypercellularity and a blast appearance similar to that of the peripheral smear. Flow cytometry revealed cells positive for CD 13, CD 33, CD 34, CD 38, CD 117, and HLA-DR. Cells were negative for TdT, myeloperoxidase, and nonspecific esterase. Based on this information, which of the following is most likely? a. AML with minimal differentiation b. AML without maturation c. B-cell ALL without maturation d. Acute monoblastic leukemia

AML with minimal differentiation

43. A patient presents with an elevated WBC count, increased monocytes, and blasts present on the differential. Flow cytometry is performed with the following results: CD4 +, CD11b +, CD11c +, CD13 +, CD14 +, CD33 +, CD36 +, CD64 +. Which of the following diagnoses is the most likely? a. AML with minimal differentiation b. AML with maturation c. Acute myelomonocytic leukemia d. Acute monoblastic leukemia

Acute myelomonocytic leukemia

79. Which of the following disorders is considered to be classified by WHO as an AML, not otherwise classified? a. Acute erythroid leukemia b. Acute megakaryoblastic leukemia c. Acute promyelocytic leukemia d. AML without maturation

Acute promyelocytic leukemia

15. Which of the following disorders does not have a hemolytic component? a. Sickle cell anemia b. Autoimmune hemolytic anemia c. Glucose-6-phosphate dehydrogenase deficiency d. Anemia of chronic disease

Anemia of chronic disease

60. Which of the following disorders is classified as a myelodysplastic/ myeloproliferative disease? a. Acute promyelocytic leukemia b. Chronic lymphocytic leukemia c. Atypical chronic myelogenous leukemia d. Essential thrombocythemia

Atypical chronic myelogenous leukemia

19. Which of the following disorders is not classified as a microangiopathic hemolytic anemia? a. Disseminated intravascular coagulation b. Hemolytic uremic syndrome c. Traumatic cardiac hemolytic anemia d. Thrombotic thrombocytopenic purpura

Traumatic cardiac hemolytic anemia

32. A 38-year-old male patient has the following CBC results: WBC 32.5 × 109/ L RBC 5.50 × 1012/ L Hgb 16.0 g/ dL Hct 48.0% Platelet 225 × 109/ L Differential: 49% segmented neutrophils, 9% bands, 25% lymphocytes, 9% monocytes, 1% eosinophils, 4% metamyelocytes, 3% myelocytes. RBC and platelet morphology appear normal Which of the following conditions is the most likely cause of these results? a. Bacterial infection b. CML c. Refractory anemia d. Viral infection

Bacterial infection

72. All of the following are considered to be signs of dyserythropoiesis except: a. Multinucleate RBCs b. Basophilic stippling c. Döhle bodies d. Oval macrocytes

Basophilic stippling

55. Which of the following cell types exhibit IgE receptors on their surface membranes? a. Basophils b. Eosinophils c. Band neutrophils d. Monocytes

Basophils

51. Which of the following locations is not a site of extramedullary hematopoiesis? a. Bone marrow b. Liver c. Spleen d. Thymus

Bone marrow

37. A patient has a splenomegaly, and his CBC shows a left shift bizarre RBCs, including dacryocytes and notable platelet abnormalities. Which of the following would be the most helpful in determining the patient's diagnosis? a. Bone marrow biopsy b. LAP staining c. Karyotyping for the Philadelphia chromosome d. Spleen biopsy

Bone marrow biopsy

87. A patient has a reticulocyte count of 3.5%. This shows which of the following? a. Bone marrow response in producing more RBCs because of increased need b. A normal reticulocyte count c. Patient transfusion of whole blood d. Lack of response to vitamin therapy after a diagnosis of iron-deficiency anemia

Bone marrow response in producing more RBCs because of increased need

85. Which of the following appearances describes the types of cells seen in Sézary syndrome? a. Plasma cells containing immunoglobulin deposits b. Large circulating micromegakaryocytes c. Lymphocytes with convoluted, cerebriform nuclei d. Prolymphocytes with prominent azurophilic granules

Lymphocytes with convoluted, cerebriform nuclei

46. Which of the following sets of CD markers are associated with T lymphocytes? a. CD2, CD3, CD4 b. CD13, CD14, CD15 c. CD19, CD20, CD22 d. CD34, CD71, CD117

CD2, CD3, CD4

59. Flow cytometry for monitoring a patient with acquired immunodeficiency syndrome should include markers for which of the following? a. CD30 and CD42 b. CD4 and CD8 c. CD34 and CD33 d. CD21 and CD22

CD4 and CD8

39. The WHO system classifies this disorder as a Myeloproliferative/ Myelodysplastic syndrome. a. Refractory Anemia with Ringed Sideroblasts b. 5q − Syndrome c. Chronic Myelomonocytic Leukemia d. Refractory Anemia with Multilineage Dysplasia

Chronic Myelomonocytic Leukemia

64. The nitroblue tetrazolium reduction test is used to assist in the diagnosis of: a. Leukocyte adhesion disorders (LADs) b. Chronic granulomatous disease (CGD) c. May-Hegglin anomaly d. Pelger-Huet anomaly

Chronic granulomatous disease (CGD)

44. A 75-year-old male patient visits his physician for an annual checkup. His CBC showed an elevated WBC count with numerous small lymphocytes and smudge cells, and a subsequent bone marrow biopsy and aspirate showed hypercellularity with increased lymphoid cells. What is a presumptive diagnosis based on this information? a. Acute lymphoblastic leukemia b. Chronic lymphocytic leukemia/ small cell lymphocytic lymphoma c. Hairy cell leukemia d. Therapy-related acute myelogenous leukemia

Chronic lymphocytic leukemia/ small cell lymphocytic lymphoma

47. Bone marrow cellularity is most often estimated by examining which of the following? a. Aspirate b. Buffy coat c. Core biopsy d. Crush preparations

Core biopsy

58. Patients with infectious mononucleosis often have the following CBC results: a. Lymphocytosis, including increased variant/ reactive lymphocytes b. Lymphocytopenia with numerous small lymphocytes c. Neutrophilia, including a predominant shift to the left d. Neutropenia with a distinct predominance of toxic granulation

Lymphocytosis, including increased variant/ reactive lymphocytes

48. A dry tap may be seen in bone marrow aspirations in all of the following conditions except: a. Aplastic anemia b. Hairy cell leukemia c. Multiple myeloma d. Primary myelofibrosis

Multiple myeloma

92. The following statement is true of mutations in α-thalassemia compared to those seen in β-thalassemia: a. Mutations in α-thalassemia occur as a result of reduced or absent expression of the globin gene b. Mutations in α-thalassemia occur as a result of the deletion of one or more globin genes c. The α-globin gene is expressed on chromosome 11 d. The β-globin gene is expressed on chromosome 16

Mutations in α-thalassemia occur as a result of the deletion of one or more globin genes

16. A patient presents with evidence of a hemolytic anemia. Spherocytes, polychromasia, and macrocytosis are observed. Which of the following would best help to distinguish the cause of the anemia? a. Osmotic fragility b. DAT c. G6PD activity assay d. Vitamin B12 level

DAT

68. Polycythemia vera can be differentiated from secondary polycythemia because of polycythemia vera presenting with which of the following? a. Elevated hemoglobin results b. Decreased erythropoietin levels c. Normal to decreased WBC counts d. Erythroid hyperplasia in the marrow

Decreased erythropoietin levels

83. Multiple myeloma exhibits laboratory features except which of the following? a. Occasional plasma cells in the peripheral blood b. Rouleaux c. Hypercalcemia d. Decreased immunoglobulin

Decreased immunoglobulin

52. Patients with renal failure often exhibit compromised hematopoietic activity because of which of the following? a. Concurrent depression of thyroid hormones b. Decreased production of erythropoietin c. Decreased production of GM-CSF d. Bone marrow suppression caused by medications

Decreased production of erythropoietin

38. Which of the following peripheral blood findings would not be expected in a patient with a myelodysplastic syndrome? a. Hypogranular neutrophils b. Binucleate neutrophils and NRBCs c. Circulating micromegakaryocytes d. Decreased vitamin B12 and folic acid

Decreased vitamin B12 and folic acid

7. Megaloblastic anemias result from which of the following? a. Deficiencies in free erythrocyte protoporphyrin b. Deficiencies in Vitamin B12 and folic acid c. Increases in iron and hepcidin d. Decreases in liver function

Deficiencies in Vitamin B12 and folic acid

88. Which of the following cases does not warrant a bone marrow examination? a. Presence of blasts on the peripheral smear b. Postchemotherapy assessment for minimal residual disease c. Diagnosis of iron-deficiency anemia d. Diagnosis of suspected systemic fungal infection

Diagnosis of suspected systemic fungal infection

100. Patients with suspected paroxysmal cold hemoglobinuria can be confirmed by performing which of the following? a. Direct antiglobulin test (DAT) b. Donath-Landsteiner test c. Osmotic fragility test d. G6PD activity assay

Donath-Landsteiner test

18. G6PD deficiency episodes are related to which of the following? a. Exposure to oxidant damage b. Defective globin chains c. Antibodies to RBCs d. Abnormal protein structures

Exposure to oxidant damage

57. A CBC on a patient with Chediak-Higashi syndrome is expected to exhibit which of the following? a. Giant platelets and Döhle-like inclusions in the cytoplasm of all granulocytes b. Large, darkly staining cytoplasmic granules in all WBCs c. Giant fused granules and lysosomes in WBC cytoplasm d. Leukocytosis and bilobed eosinophils

Giant fused granules and lysosomes in WBC cytoplasm

34. A positive tartrate-resistant acid phosphatase (TRAP) stain is indicative of: a. Burkitt's lymphoma b. Chronic myelogenous leukemia c. Hairy cell leukemia d. Multiple myeloma

Hairy cell leukemia

13. Which of the following is decreased in cases of intravascular hemolytic anemia? a. Bilirubin b. Urine hemosiderin c. Haptoglobin d. Plasma hemoglobin

Haptoglobin

90. Which of the following is not implicated as a cause of nonmegaloblastic macrocytic anemia? a. Alcoholism b. Hemochromatosis c. Hypothyroidism d. Liver disease

Hemochromatosis

27. A peripheral smear review shows mildly anemic sample with target cells and oblong hexagonal crystalloids. What is a possible identity for the crystalloids? a. Hemoglobin S b. Hemoglobin C c. Hemoglobin SC d. Hemoglobin E

Hemoglobin C

26. Which laboratory test is best used for definitive diagnosis of sickle cell anemia? a. Solubility testing b. Hemoglobin electrophoresis c. Peripheral smear review for sickle cells d. Bone marrow analysis

Hemoglobin electrophoresis

91. Which of the following results is consistent with a diagnosis of aplastic anemia? a. Hypocellular bone marrow, absolute neutrophil count of 0.5 × 109/ L, platelet count of 40 × 109/ L, Hgb 8 g/ dL b. Hypocellular bone marrow, absolute neutrophil count of 2.5 × 109/ L, platelet count of 75 × 109/ L, Hgb 10 g/ dL c. Hypercellular bone marrow, absolute neutrophil count of 1.5 × 109/ L, platelet count of 100 × 109/ L, Hgb 14 g/ dL d. Hypocellular bone marrow, absolute neutrophil count of 0.5 × 109/ L, platelet count of 90 × 109/ L, Hgb 11 g/ dL

Hypocellular bone marrow, absolute neutrophil count of 0.5 × 109/ L, platelet count of 40 × 109/ L, Hgb 8 g/ dL

61. All of the following cells are derived from CFU-GEMM, common myeloid progenitor cells except: a. Basophils b. Lymphocytes c. Neutrophils d. RBCs

Lymphocytes

14. Typical CBC findings in hemolytic anemia include: a. Microcytic, hypochromic cells with increased poikilocytosis b. Macrocytic, normochromic cells with increased polychromasia c. Microcytic, normochromic cells with increased poikilocytosis d. Macrocytic, hypochromic cells with increased polychromasia

Macrocytic, normochromic cells with increased polychromasia

5. Acquired sideroblastic anemia may be present in all of the following except: a. Alcoholism b. Lead poisoning c. Malabsorption d. Myelodysplastic syndromes

Malabsorption

49. The largest hematopoietic cells present in the bone marrow are: a. Lymphoblasts b. Megakaryocytes c. Osteoblasts d. Pronormoblasts

Megakaryocytes

74. The peripheral blood and bone marrow picture sometimes will look similar in myelodysplastic syndromes and some RBC disorders. Which of the following RBC disorders tends to have a peripheral smear appearance similar to cases of myelodysplastic syndromes? a. Iron deficiency anemia b. α-Thalassemia minor c. Megaloblastic anemia d. Warm autoimmune hemolytic anemia

Megaloblastic anemia

77. AML with 11q23 (MLL) abnormalities are associated with which cell line? a. Eosinophil b. Erythrocyte c. Monocyte d. Neutrophil

Monocyte

17. Paroxysmal nocturnal hemoglobinuria is characterized by flow cytometry results that are: a. Negative for CD55 and CD59 b. Positive for CD55 and CD59 c. Negative for CD4 and CD8 d. Positive for all normal CD markers

Negative for CD55 and CD59

67. A 58-year-old female was seen by her physician for increasing fatigue. Her CBC shows the following results: WBC 15.5 × 109/ L RBC 5.90 × 1012/ L Hgb 17.5 g/ dL Hct 53.0% Platelet 425 × 109/ L Differential: 55% segmented neutrophils, 3% bands, 30% lymphocytes, 9% monocytes, 1% eosinophils, 2% metamyelocytes RBC and platelet morphology appear normal Which of the following conditions is the most likely cause of these results? a. Chronic myelogenous leukemia b. Polycythemia vera c. Acute bacterial infection d. The patient is normal

Polycythemia vera

25. Patients with sickle cell trait usually have RBC morphology that includes which of the following? a. Normocytic, normochromic RBCs with occasional target cells b. Normocytic, normochromic RBCs with rare sickle cells c. Hypochromic, microcytic RBCs with moderate target cells d. Macrocytic, normochromic cells with occasional NRBCs

Normocytic, normochromic RBCs with occasional target cells

62. A patient's differential count shows an elevated eosinophil count. This is consistent with which of the following? a. Aplastic anemia b. Bacterial infection c. Parasitic infection d. Viral infection

Parasitic infection

31. A 36-year-old male patient has a CBC performed as part of a routine work physical. The WBC count was 6.5 × 109/ L with a differential count of 48% neutrophils, 40% lymphocytes, 8% monocytes, 3% eosinophils, and 1% basophils. The majority of the neutrophils were mature but hyposegmented, showing bandlike or single nuclei. What disorder would be suspected? a. Alder-Reilly anomaly b. Leukocyte adhesion deficiency c. Pelger-Huet anomaly d. Reed Sternberg syndrome

Pelger-Huet anomaly

8. A patient's bone marrow showed erythroid hyperplasia with signs of dysplastic maturation, particularly in the RBC precursors. This is consistent with which of the following? a. Sickle cell anemia b. β-Thalassemia major c. Pernicious anemia d. G6PD deficiency

Pernicious anemia

63. Antibodies are produced by which of the following: a. Macrophages b. T lymphocytes c. Plasma cells d. Basophils

Plasma cells

A physician wants to obtain a measure of a patient's iron stores. Which of the following tests would be the most suitable? a. Serum iron b. Serum transferrin (TIBC) c. Serum ferritin d. Transferrin saturation

Serum ferritin

3. A peripheral smear shows a decreased RBC count with microcytic, hypochromic cells with small grapelike inclusions in the RBCs on both Wright stain and Prussian blue stain. This is consistent with: a. Iron-deficiency anemia b. Sideroblastic anemia c. Pernicious anemia d. β-Thalassemia minor

Sideroblastic anemia

73. Features of dysmyelopoiesis and dysmegakaryopoiesis seen on a peripheral smear or bone marrow in cases of myelodysplastic syndromes include all of the following except: a. Pelgeroid neutrophils b. Neutrophils showing hypogranulation c. Giant abnormal platelets with abnormal granules d. Siderotic granules

Siderotic granules

97. Hereditary elliptocytosis results from defects in which of the following? a. Ankyrin b. Band 3 protein c. Spectrin d. Pyruvate

Spectrin

45. Which of the following is not considered a disorder of plasma cells? a. Monoclonal gammopathy of undetermined significance b. Multiple myeloma c. Sézary syndrome d. Waldenström's macroglobulinemia

Sézary syndrome

95. The thymus is a site used as a maturation compartment for: a. B cells b. T cells c. Megakaryocytes d. Monocytes

T cells

78. T-cell ALL most commonly affects which of the following? a. Infants b. Teenaged males c. Adult females d. Elderly males

Teenaged males

94. Patients with sickle cell anemia and β-thalassemia major may not show clinical symptoms until the patient is at least 6 months of age because of which of the following? a. The mutations are acquired after the child is born b. The mutations are activated by dietary and maternal factors c. The mutations may not manifest clinically at birth because the presence of hemoglobin F decreases d. The mutations lead to elevations in α genes that compensate for the decreased gene expression

The mutations may not manifest clinically at birth because the presence of hemoglobin F decreases

56. A 62-year-old female patient's CBC showed the following results: total WBC count of 14.0 × 109/ L, RBC count of 3.95 × 1012/ L, and platelet count of 245 × 109/ L. The differential showed 65% segmented neutrophils, 10% bands, 15% lymphocytes, and 10% monocytes. Toxic granulation and Döhle bodies were seen in many of the neutrophils. Which of the following is most likely? a. The patient had just finished running a half marathon b. The patient has a bacterial infection c. The patient is normal d. The patient has a helminth infection

The patient has a bacterial infection

82. A 78-year-old man was previously diagnosed with chronic lymphocytic leukemia (CLL). Periodic CBCs were ordered, and several months of CBCs maintained an appearance consistent with cases of CLL. WBC 58.5 × 1012/ L RBC 3.90 × 1012/ L Hgb 12.0 g/ dL Hct 36.0% MCV 92 fL MCH 3 pg MCHC 33% Platelet 132 × 109/ L Differential: 70% lymphocytes, 8% segmented neutrophils, 2% monocytes, 20% unidentified cells with lymphoid appearance and a prominent nucleolus Which of the following is most likely? a. The patient has developed Sézary syndrome b. The patient has developed prolymphocytic leukemia c. The patient has developed multiple myeloma d. The patient now has a concurrent case of CLL and ALL

The patient has developed prolymphocytic leukemia

41. Which of the following may predict a better prognosis in patients with ALL? a. The patient is a child b. Peripheral blood blast counts greater than 30 × 109/ L c. The Philadelphia chromosome is present d. The patient is hypodiploid

The patient is a child

28. An 18-year-old man has a CBC done when visiting his physician for a persistent sore throat. He has the following results: WBC 12.5 × 109/ L RBC 6.00 × 1012/ L Hgb 10.0 g/ dL Hct 30.0% MCV 60 fL MCH 20 pg MCHC 33% Platelet 218 × 109/ L Which of the following is most likely? a. This patient is normal with a slightly elevated WBC count because of his sore throat b. This patient has infectious mononucleosis and warm autoimmune hemolytic anemia c. This patient is likely to have β-thalassemia minor d. There is a specimen quality issue because of a cold agglutinin

This patient is likely to have β-thalassemia minor

20. A previously healthy 36-year-old woman with visited her physician because of a sudden onset of easy bruising and bleeding. Of the following, which is the most likely cause of her laboratory results? WBC 10.5 × 109/ L RBC 3.00 × 1012/ L Hgb 8.0 g/ dL Hct 25.0% MCV 83 fL MCH 26 pg MCHC 32% Platelets 18 × 109/ L Differential: Normal WBCs with moderate schistocytes and polychromasia PT: 12.8 seconds aPTT: 34 seconds a. Sickle cell anemia b. Chronic myelogenous leukemia c. Disseminated intravascular coagulation d. Thrombotic thrombocytopenic purpura

Thrombotic thrombocytopenic purpura

81. A 3-year-old female patient was having symptoms of lethargy and bruising and reported pain in her legs. Her mother also mentioned noticing several swollen lymph nodes when bathing the child. The pediatrician ordered a CBC, which had the following results. WBC 18.5 × 1012/ L RBC 3.00 × 1012/ L Hgb 9.0 g/ dL Hct 27.0% MCV 90 fL MCH 30 pg MCHC 33% Platelet 58 × 109/ L Differential: 80% blastocytes, 6% segmented neutrophils, 8% lymphocytes, 6% monocytes. RBC morphology was normal, and platelets were markedly decreased What is the most likely reason that the physician ordered a lumbar puncture after receiving the CBC results? a. To rule out an acute case of meningitis b. To look for leukemia cells in the spinal fluid c. To rule out infectious mononucleosis d. To rule out multiple sclerosis

To look for leukemia cells in the spinal fluid

10. The majority of acquired aplastic anemia cases usually results from which of the following? a. Unknown causes b. Pregnancy c. Chloramphenicol exposure d. Radiation exposure

Unknown causes

24. The majority of hospitalizations associated with sickle cell anemia are due to: a. Cardiomegaly b. Cholelithiasis c. Pneumonia d. Vasoocclusion

Vasoocclusion

9. The CBC for a 57-year-old man had the following results. Which tests would be best to order next? RBC 2.50 × 1012/ L Hct 26.0% MCH 34 pg Hgb 8.5 g/ dL MCV 104 fL MCHC 33% a. Iron studies b. Vitamin B12 and folic acid levels c. Bone marrow examination d. Intrinsic factor antibodies

Vitamin B12 and folic acid levels

70. Which of the following is not classified as a myeloproliferative neoplasm? a. Chronic eosinophilic leukemia b. Essential thrombocythemia c. Mastocytosis d. Waldenström's macroglobulinemia

Waldenström's macroglobulinemia

29. Hemoglobin H disease is described as: a. − −/ − α b. − α/ − α c. − −/ ββ d. − β/ − β

− −/ − α