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HEMATOLOGY ASSESSMENT EXAM SEMINAR 1&2

Total questions: 110

Worksheet time: 1hrs 8mins

Name
Class
Date
1.

Which of the following cells is considered pathognomonic for Hodgkin’s disease?

a)

Niemann-Pick cells

b)

Reactive lymphocytes

c)

Flame cells

d)

Reed-Sternberg cells

2.

In which of the following conditions does LAP show the least activity?

a)

Leukomoid reactions

b)

IMF

c)

PV

d)

Chronic Myelogenous Leukemia

3.

What is the anticoagulant of choice for coagulation studies?

a)

EDTA

b)

Sodium fluoride

c)

Sodium citrate

d)

Acid citrate dextrose

4.

Which of the following does not characterize anemia of chronic disease?

a)

Decreased serum iron

b)

Increased ferritin

c)

Decreased % saturation

d)

Increased TIBC

5.

With what leukemia is disseminated intravascular coagulation associated?

a)

M1

b)

M3

c)

M6

d)

CML

6.

The characteristic cell found to be increased in infectious mononucleosis is

a)

Eosinophil

b)

Variant lymphocyte

c)

Monocyte

d)

Neutrophil

7.

The following are compounds formed in the synthesis of heme:

1. coproporphyrin

2. porphobilinogen

3. urophorphyrinogen

4. protoporphyrinogen

Which of the following responses lists these compounds in the order in which they are formed?

a)

4, 3, 2,1

b)

2, 3, 1, 4

c)

4, 2, 3, 1

d)

2, 1, 3,4

8.

The majority of the iron in an adult is found as a constituent of:

a)

hemoglobin

b)

hemosiderin

c)

myoglobin

d)

transferrin

9.

The main function of the hexose monophosphate shunt in the erythrocyte is:

a)

regulate the level of 2,3 DPG

b)

Provide reduced glutathione to prevent oxidation of hemoglobin

c)

Prevent the reduction of heme iron

d)

provide energy for membrane maintenance

10.

In order for hemoglobin to combine reversibly with oxygen, the iron must be:

a)

complexed with haptoglobulin

b)

freely circulating in the cytoplasm

c)

attached to transferrin

d)

in the ferrous state

11.

In which of the following disease states are teardrops cells and abnormal platelets most characteristically seen?

a)

hemolytic anemia

b)

multiple myeloma

c)

G6PD deficiency

d)

Myeloid Metaplasia

12.

The characteristic erythrocyte found in pernicious anemia

a)

microcytic

b)

spherocytic

c)

hypochromic

d)

macrocytic

13.

Platelet originates in the bone marrow from:

a)

Megaloblasts

b)

Myeloblasts

c)

Macrophages

d)

Monocytes

e)

Megakaryocytes

14.

Teardrop shaped RBC’s

a)

Megalocyte

b)

Elliptocyte

c)

Dacryocyte

d)

Drepanocyte

e)

Codocyte

15.

Target cells

a)

Megalocyte

b)

Elliptocyte

c)

Dacryocyte

d)

Drepanocyte

e)

Codocyte

16.

RBC inclusion body seen in megaloblastic anemia:

a)

Basophilic stipplings

b)

Howell Jolly bodies

c)

Hemoglobin H inclusion bodies

d)

Heinz bodies

17.

Red blood cell inclusions are removed without destroying the cell itself by the:

a)

Liver

b)

Spleen

c)

Kidney

d)

Bone marrow

18.

Hemoglobin Bart’s is composed of

a)

Four alpha chains

b)

Four beta chains

c)

Four gamma chains

d)

Two alpha and tow gamma chains

19.

Which of the following is characteristically seen in abetalipoproteinemia?

a)

Discocytes

b)

Acanthocytes

c)

Stomatocytes

d)

Codocytes

e)

Spherocytes

20.

The Prussian blue staining of peripheral blood identifies:

a)

Howell-Jolly bodies

b)

siderotic granules

c)

reticulocytes

d)

basophilic stippling

21.

Plasma from a patient with lupus coagulation inhibitor (lupus anticoagulant) can show:

a)

a prolonged APTT and normal PT

b)

may exhibit bleeding tendencies

c)

no change with platelet neutralization

d)

complete correction when incubated with normal plasma

22.

A patient is diagnosed as having bacterial septicemia. Which of the following would best describe the expected change in his peripheral blood?

a)

granulocytic leukemoid reaction

b)

lymphocytic leukemoid reaction

c)

neutropenia

d)

eosinophilia

23.

Which of the following stains is most frequently used to differentiate acute myelocytic (AML) from acute lymphocytic leukemia (ALL)?

a)

alkaline phosphatase

b)

nonspecific esterase

c)

acid phosphatase

d)

peroxidase

24.

Which of the following stains is helpful in the diagnosis of suspected erythroleukemia?

a)

peroxidase

b)

nonspecific esterase

c)

periodic acid-Schiff (PAS)

d)

acid phosphatase

25.

The combination of increased capillary fragility and prolonged bleeding time suggests a deficiency in

a)

thromboplastin

b)

prothrombin

c)

platelets

d)

fibrinogen

26.

Of the following, the disease most closely associated with pale blue inclusions in granulocytes and giant platelets is:

a)

Gaucher's disease

b)

Alder-Reilly anomaly

c)

May-Hegglin anomaly

d)

Pelger-Huet anomaly

27.

Aspirin affects platelet function by interfering with platelets' metabolism of:

a)

prostaglandins

b)

lipids

c)

carbohydrates

d)

nucleic acids

28.

A patient has a congenital nonspherocytic hemolytic anemia. After exposure to antimalarial drugs, the patient experiences a severe hemolytic episode. This episode is characterized by red cell inclusions caused by hemoglobin denaturation. Which of the following conditions is most consistent with these findings?

a)

G-6-PD deficiency

b)

thalassemia major

c)

pyruvate kinase deficiency

d)

paroxysmal nocturnal hemoglobinuria

29.

A useful chemical test for the diagnosis of hairy-cell leukemia is the:

a)

peroxidase test

b)

Sudan black B test

c)

periodic acid-Schiff test

d)

tartrate-resistant acid phosphatase test

30.

Leukocyte alkaline phosphatase activity is decreased in:

a)

acute infections

b)

pregnant women

c)

polycythemia Vera

d)

paroxysmal nocturnal hemoglobinuria

31.

Which of the following bone marrow findings favors the diagnosis of multiple myeloma?

a)

presence of Reed-Sternberg cells

b)

sheaths of immature plasma cells

c)

presence of flame cells and Russell bodies

d)

presence of plasmacytic satellitosis

32.

Which of the following stains is used to demonstrate iron, ferritin, and hemosiderin?

a)

peroxidase

b)

Sudan black B

c)

periodic acid-Schiff (PAS)

d)

Prussian blue

33.

Which of the following may be used to stain glycogen, polysaccharides, and glycoproteins?

a)

peroxidase

b)

Sudan black B

c)

periodic acid-Schiff (PAS)

d)

nitroblue tetrazolium (NBT)

34.

Which of the following cells is the largest cell in the bone marrow:

a)

megakaryocyte

b)

histiocyte

c)

osteoblast

d)

monocytes

35.

The Philadelphia chromosome is formed by a translocation between the:

a)

long arm of chromosome 22 and long arm of chromosome 9

b)

long arm of chromosome 21 and long arm of chromosome 9

c)

long arm of chromosome 21 and short arm of chromosome 6

d)

long arm of chromosome 22 and short arm of chromosome 6

36.

The most likely cause of the macrocytosis that often accompanies anemia of myelofibrosis is:

a)

folic acid deficiency

b)

increased reticulocyte count

c)

inadequate B12 absorption

d)

pyridoxine deficiency

37.

A hypercellular marrow with an M:E ratio of 6:l is most commonly due to:

a)

lymphoid hyperplasia

b)

granulocytic hyperplasia

c)

normoblastic hyperplasia

d)

myeloid hypoplasia

38.

In normal adult bone marrow, the most common granulocyte is the:

a)

basophil

b)

myeloblast

c)

eosinophil

d)

metamyelocyte

39.

Megaloblastic asynchronous development in the bone marrow indicates which one of the following?

a)

proliferation of erythrocyte precursors

b)

impaired synthesis of DNA

c)

inadequate production of erythropoietin

d)

deficiency of G-6-PD

40.

Which of the following platelet responses is most likely associated with hemophilia A (Factor VIII deficiency)?

a)

defective ADP release; normal response to ADP

b)

decreased amount of ADP in platelets

c)

absent aggregation to epinephrine, ADP, and collagen

d)

normal platelet aggregation

41.

Giant, bizarre-shaped, multinucleated erythroid precursors are present in which of the following

a)

chronic granulocytic leukemia

b)

myelofibrosis with myeloid metaplasia

c)

erythroleukemia

d)

acute granulocytic leukemia

42.

Terminal deoxynucleotidyl transferase (TdT) is a marker found on:

a)

hairy cells

b)

myeloblasts

c)

monoblasts

d)

lymphoblasts

43.

The M:E ratio in chronic granulocytic leukemia is usually:

a)

normal

b)

high

c)

low

d)

variable

44.

The characteristic morphologic feature in lead poisoning is:

a)

macrocytosis

b)

target cells (codocytes)

c)

basophilic stippling

d)

rouleaux formation

45.

The morphologic feature most characteristic of hemolytic anemia is

a)

spherocytosis

b)

rouleaux formation

c)

basophilic stippling

d)

target cells

46.

Heparin acts by:

a)

precipitating calcium

b)

binding calcium

c)

activating plasmin

d)

inhibiting thrombin

47.

Supravital staining is important for reticulocytes since the cells must be living in order to stain the:

a)

remaining RNA in the cell

b)

iron before it precipitates

c)

cell membrane before it dries out

d)

denatured hemoglobin in the cell

48.

Most childhood leukemias are:

a)

acute lymphocytic

b)

acute monocytic

c)

chronic myelocytic

d)

chronic lymphocytic

49.

Prothrombin is

a)

a protein formed by the liver in the presence of vitamin K

b)

an enzyme that converts fibrinogen into fibrin threads

c)

the end product of the reaction between fibrinogen and thrombin

d)

a protein released by platelets during coagulation

50.

Which of the following coagulation factors is considered to be labile?

a)

II

b)

V

c)

VII

d)

X

51.

A coagulation factor synthesized in the liver and vitamin K dependent is:

a)

I

b)

II

c)

VIII

d)

XIII

52.

Which of the following factors is used only in the extrinsic coagulation pathway?

a)

II

b)

V

c)

VII

d)

VIII

53.

What cell shape is MOST commonly associated with an increased MCHC?

a)

teardrop cells

b)

target cells

c)

spherocytes

d)

sickle cells

54.

Contains Sodium fluoride:

a)

pink top

b)

blue top

c)

gray top

d)

green top

55.

Contains lithium heparin as anticoagulant:

a)

blue top

b)

pink top

c)

gray top

d)

green top

56.

Three methods of venipuncture except:

a)

arterial

b)

ETS

c)

syringe

d)

butterfly

57.

Which of the following is NOT a characteristic of the Brachial Artery?

a)

It has pulse

b)

The wall is thicker than a vein

c)

The blood is bright red

d)

It is preferred for venipuncture

58.

Which of the following may result in the hemolysis of blood?

a)

Using a needle with too small a lumen

b)

Removing the needle before the tourniquet

c)

Storing the tube at room temperature

d)

Allowing the tube to fill to the exhaustion of the vacuum

59.
Using a butterfly needle is beneficial for 
a)
heel punctures
b)
routine venipuncture in health adults
c)
geriatric patients
d)
patients who have prominent muscles
60.
What is the best angle for needle insertion during venipuncture?
a)
5 degrees
b)
30 degrees or less
c)
45 degrees 
d)
more than 45 degrees
61.

Leaving a tourniquet on for too long can cause what complication?

a)

Syncope

b)

Hematoma

c)

Hemolysis

d)

Hemoconcentration

62.

Shaking a tube rather than inverting it, can cause what complication?

a)

Syncope

b)

Hematoma

c)

Hemolysis

d)

Hemoconcentration

63.

Thalassemias are characterized by:

a)

structural abnormalities in the hemoglobin molecule

b)

absence of iron in hemoglobin

c)

decreased rate of heme synthesis

d)

decreased rate of globin synthesis

64.

The anemia of chronic infection is characterized by:

a)

decreased iron stores in the reticuloendothelial system

b)

decreased serum iron levels

c)

macrocytic erythrocytes

d)

increased serum iron-binding capacity

65.

Which of the following is associated with Chediak-Higashi syndrome?

a)

membrane defect of lysosomes

b)

Dohle bodies and giant platelets

c)

two-lobed neutrophils

d)

mucopolysaccharidosis

66.

Patients with chronic granulomatous disease suffer from frequent pyogenic infections owing to the inability of:

a)

lymphocytes to produce bacterial antibodies

b)

eosinophils to degranulate in the presence of bacteria

c)

neutrophils to kill phagocytized bacteria

d)

basophils to release histamine in the presence of bacteria

67.

Which of the following is most closely associated with iron deficiency anemia?

a)

iron overload in tissue

b)

target cells

c)

basophilic stippling

d)

chronic blood loss

68.

Auer rods are:

a)

a normal aggregation of lysosomes or primary (azurophilic) granules

b)

predominantly found in acute myelogenous leukemia

c)

peroxidase negative

d)

alkaline phosphatase positive

69.

Morphologic variants of plasma cells do NOT include:

a)

flame cells

b)

morula cells

c)

grape cells

d)

Gaucher's cells

70.

Which of the following cell types is characteristic of Pelger Huet anomaly?

a)

band form

b)

pince-nez form

c)

normal neutrophil

d)

myelocyte

71.

Which of the following is the formula for mean corpuscular volume (MCV)?

a)

(Hgb x 10)/RBC

b)

Hgb/Hct

c)

(Hct x 10)/RBC

d)

RBC/Hct

72.

The ideal capillary blood collection site on a newborn is

a)

tip of the thumb

b)

ear lobe

c)

plantar surface of the heel

d)

the great toe

73.

Of the following, the disease most closely associated with glucocerebrosidase deficiency is:

a)

Gaucher's disease

b)

Chediak-Higashi syndrome

c)

Pelger-Huet anomaly

d)

May-Hegglin anomaly

74.

Of the following, the disease most closely associated with cytoplasmic granule fusion is:

a)

Chediak-Higashi syndrome

b)

Pelger-Huet anomaly

c)

May-Hegglin anomaly

d)

Alder-Reilly anomaly

75.

Which of the following characteristics are common to hereditary spherocytosis, hereditary elliptocytosis, hereditary stomatocytosis, and paroxysmal nocturnal hemoglobinuria?

a)

autosomal dominant inheritance

b)

red cell membrane defects

c)

positive direct antiglobulin test

d)

measured platelet count

76.

Variation in red cell size observed on the peripheral smear is described as:

a)

Anisocytosis

b)

Hypochromia

c)

Poikilocytosis

d)

Pleocytosis

77.

Which of the following erythrocyte inclusions can be visualized with supravital stain but cannot be detected on a Wright’s-stained blood smear?

a)

Basophilic stippling

b)

Heinz bodies

c)

Howell–Jolly bodies

d)

Siderotic granules

78.

Which is the first stage of erythrocytic maturation in which the cytoplasm is pink due to the formation of hemoglobin?

a)

Reticulocyte

b)

Pronormoblast

c)

Basophilic normoblast

d)

Polychromatic normoblast

79.

Which of the following can shift the hemoglobin oxygen dissociation curve to the right?

a)

Increases in 2,3 DPG

b)

Acidosis

c)

Hypoxia

d)

All of these options

80.

Which is the major Hgb found in the RBCs of patients with sickle cell trait?

a)

Hgb S

b)

Hgb F

c)

Hgb A2

d)

Hgb A1

81.

The morphological classification of anemias is based on which of the following?

a)

M:E (myeloid:erythroid) ratio

b)

Prussian blue stain

c)

RBC indices

d)

Reticulocyte count

82.

Which antibiotic(s) is (are) most often implicated in the development of aplastic anemia

a)

Sulfonamides

b)

Penicillin

c)

Tetracycline

d)

Chloramphenicol

83.

Iron deficiency anemia is characterized by

a)

Decreased plasma iron, decreased % saturation, increased total iron-binding capacity (TIBC)

b)

Decreased plasma iron, decreased plasma ferritin, normal RBC porphyrin

c)

Decreased plasma iron, decreased % saturation, decreased TIBC

d)

Decreased plasma iron, increased % saturation, decreased TIBC

84.

Which morphological classification is characteristic of megaloblastic anemia?

a)

Normocytic, normochromic

b)

Microcytic, normochromic

c)

Macrocytic, hypochromic

d)

Macrocytic, normochromic

85.

Components of quality assurance/assessment programs includes all of the following except?

a)

Preexamination variables

b)

Examination variables

c)

Post examination variables

d)

None of the given choices

86.

Which of the following is not included in the examination/analytical phase of testing?

a)

laboratory staff competence

b)

assay and instrument selection

c)

accuracy in transcription and filing of results

d)

external and internal quality control

e)

assay validation

87.

It is a sample of known quantity and are prepared from the same matrix as patient specimens and are sampled alongside patient specimens to accomplish within-run assay validation.

a)

Calibrators

b)

Standard

c)

Controls

d)

Blank reagent

88.

When controls are run, they must fall within predetermined dispersal limits, typically at ________________.

a)

+1SD

b)

+2SD

c)

+3SD

d)

+4SD

89.

These are materials used to adjust instrument accuracy by configuring an instrument to provide a result for a sample within an acceptable range.

a)

Calibrators

b)

Standard

c)

Controls

d)

Blank reagent

90.

It is a measure of the smallest increment/amount of the analyte that can be distinguished by the assay.

a)

Accuracy

b)

Precision

c)

Specificity

d)

Sensitivity

91.

Cells that is produced as early as mesoblastic stage of hematopoiesis.

a)

Erythrocytes

b)

Lymphocytes

c)

Monocytes

d)

Granuloytes

e)

Megakaryocytes

92.

At what hematopoietic stage does Hgb F produced?

a)

Hepatic Stage

b)

Mesoblastic Stage

c)

Myeloid Stage

d)

Medullary Stage

93.

Which hemoglobin contains 2 alpha chains and 2 delta chains.

a)

HgB A1

b)

Hgb A2

c)

Hgb F

d)

Hgb A1c

94.

This is considered the first human hematopoietic growth factor to be identified.

a)

Thrombopoietin

b)

Erythropoietin

c)

Progesterone

d)

Growth Hormone

95.

Which of the following statement is incorrect as RBC matures?

a)

The overall diameter of the cell decreases cytoplasm changes from blue to salmon pink.

b)

The diameter of the nucleus decreases more rapidly and the size of the cell. As a result, the N:C ratio also decreases

c)

The nuclear chromatin pattern becomes coarser, clumped, and condensed as RBC matures.

d)

Nucleoli remains until the RBC matures and released in the bloodstream.

96.

Which of the following is incorrectly paired:

a)

Pronormoblasts aka Rubriblasts

b)

Basophilic Normoblasts aka Prorubricyte

c)

Polychromatophilic Normoblast aka Rubricyte

d)

Orthochromic normoblast aka Polychromatophilic erythrocyte

e)

Reticulcyte aka Diffusely Basophilic Erythrocyte

97.

Which of the following is incorrectly paired:

a)

Pronormoblasts aka Rubriblasts

b)

Basophilic Normoblasts aka Prorubricyte

c)

Polychromatophilic Normoblast aka Rubricyte

d)

Orthochromic normoblast aka Polychromatophilic erythrocyte

e)

Reticulcyte aka Diffusely Basophilic Erythrocyte

98.

Which of the following RBC maturation stage does hemoglobin first appear?

a)

Rubricyte

b)

Metarubricyte

c)

Reticulocyte

d)

Rubriblasts

99.

This pathway of RBC metabolism is the aerobic pathway.

a)

Pentose phosphate pathway

b)

Embden Meyerhoff Pathway

c)

Rapoprt-Luebering Pathway

d)

Methemoglobin Pathway

100.

It is the reference method for hemoglobin assay that is performed manually but has been adapted to automated instruments.

a)

Alkaline Agar Electrophoresis

b)

Citrate Agar Electrophoresis

c)

Cyanmethemoglbin method

d)

Copper Sulfate Method

101.

Which of the following is incorrect regarding anemia?

a)

Anemia refers to the decrease in the oxygen carrying capacity of the blood which can arise if there is insufficient hemoglobin or the hemoglobin has impaired function.

b)

Anemia is operationally defined as the reduction in the hemoglobin content of blood that can be caused by a decrease in RBCs, hemoglobin, and hematocrit below the reference interval for healthy individuals of similar age, sex, and race, under similar environmental conditions.

c)

Anemia can be acute or chronic.

d)

Anemia occurs when there is a decrease in the number of leukocyte precursors in the bone marrow.

102.

A type of anemia that is usually associated with traumatic conditions such as an accident or severe injury and an anemia that may occur during or after surgery.

a)

Chronic Blood Loss Anemia

b)

Acute Blood Loss Anemia

c)

Aplastic Anemia

d)

Iron deficiency Anemoa

103.

A type of anemia that is frequently associated with disorders of the gastrointestinal (GI) tract, although chronic blood loss may be related to heavy menstruation in women or urinary tract abnormalities.

a)

Chronic Blood Loss Anemia

b)

Acute Blood Loss Anemia

c)

Aplastic Anemia

d)

Iron deficiency Anemoa

104.

A full manifestation of iron deficiency anemia will exhibit ___________________ red cell pattern.

a)

hypochromic and microcytic

b)

Hyperchromic and microcytic

c)

Hyperchromic and macrocytic

d)

hypochromic and normocytic

105.

A type of autoimmune hemolytic anemia that is due to immunoglobulin G (IgG) coating of erythrocytes with or without complement fixation.

a)

Warm Autoimmune Hemolytic Anemia

b)

Cold Autoimmune Hemolytic Anemia

c)

Isoimmune Hemolytic Anemia

d)

Drug Induced Hemolytic Anemia

106.

Which granulocyte maturation stage does secondary granules occurs?

a)

Myeloblast

b)

Myelocyte

c)

Promyelocyte

d)

Metamyelocyte

107.

The nucleus of this cell is eccentric and exhibits cartwheel like pattern and has well-defined hof/perinuclear halo in the cytoplasm

a)

Plasmablast

b)

Plasma cell

c)

Monocyte

d)

Small Lymphocyte

108.

It is a plasma cell with red to pink cytoplasm that is found in multiple myeloma.

a)

Tart Cell

b)

LE cell

c)

Flame cell

d)

Hairy Cell

109.

This lipid storage disease is mainly due to deficiency in Glucocerebrosidase or Beta-glucosidase.

a)

Gaucher's Disease

b)

Niemann-pick Disease

c)

Tay-Sachs

d)

Sandhoff

110.

It formed from degenerated /disintegrated nucleus of a ruptured white blood cell usually found in Chronic Lymphocytic

Leukemia (CLL).

a)

Tart Cell

b)

LE cell

c)

Flame cell

d)

Basket cell

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