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WorksheetsHematology
Total questions: 92
Worksheet time: 2hrs 32mins
The following tests are included in a complete blood count (CBC)
RBC count, Hb, Hct, WBC count, platelet count, MCV, MCH, MCHC, RDW, MPV, WBC differential
RBC count, Hb, Hct, WBC count, platelet count, MCV, MCH, MCHC, RDW, MPV
RBC count, WBC count, platelet count, MCV, MCH, MCHC, RDW, MPV
any of the choices, depending on where you work
An instrument printout reveals an RDW of 21. Which of the following would best correlate with those results
the presence of a dimorphic population on the peripheral blood smear
the presence of marked polychromatic on the peripheral blood smear
the presence of spherocytes on the peripheral blood smear
the presence of macroovalocytes on the peripheral blood smear
An increased red cell distribution width (RDW) usually indicates what abnormality
increase of average erythrocyte volume
increase of average weight of hemoglobin
decrease in ratio of hemoglobin mass to volume
variation in erythrocyte size
Platelet estimates are usually performed on a blood smear using which microscopic magnification
10X
40X
100X
1000X
At what magnification would a MLT observe for cold agglutinin and rouleaux
10X
100X
400X
1000X
Anisocytosis is defined as ____; Poikilocytosis is defined as:
variation in sizes of RBC; variation of color of RBC
Variation in shapes of RBC; variation of color of RBC
Variation in shapes of RBC: Variation in sizes of RBC
Variation in sizes of RBC; variation in shapes of RBC
Acanthocytes or spur cells have membranes with irregular distribution of spikes. What other significant features does this cell possess
Increased in size
Presence of Pappenheimer bodies
Decreased life span
Lack of central pallor
Codocytes are associated with all of the following conditions except:
Iron deficiency anemia
Thalassemia
Hemoglobinopathies
Hemolytic anemia
Howell-Jolly bodies are red cell inclusions associated with what disease state?
Lead poisoning
G6PD deficiency
Megaloblastic anemia
Normal reticulocytes
How does the mean cell volume value classify cells
Normochromic, hypo chromic, and hyperchromic
Normochromic, microcytic, macrocytic
Poikilocytosis
Polychromasis
What cell shape is most commonly associated with an increased MCHC
Teardrop
Target
Spherocyte
Sickle cell
What staining method cal be used to differentiate Pappenhemier bodies from reticulocytes
New methylene blue
Prussian blue
PAS
Any of the other options
What is the anticoagulant most commonly utilized tube in hematology, and how does it prevent coagulation from taking place?
Sodium citrate; chelates calcium
Sodium citrate; decreases thrombin activity
EDTA; chelates calcium
EDTA; chelates thrombin
A CBC is performed on a polycythemic patient. What must the MLT do to ensure that this specimen has an optimal blood smear?
increase the angle of the spreader slide
decrease the angle of the spreader slide
retry without the need of changing the spreader angle
dilute the specimen then remake the smear
A laboratory professional is reviewing differentials and notices that the last few smears appear blue. What can be done to correct this?
Lengthen the staining time
Change the buffer which may be too alkaline
Change the buffer which may be too acidic
Shorten the staining time
The ESR determination is based on
decrease in height of the erythrocyte column at a given time
decrease in absorbance as erythrocytes aggregate in column at a given time
distance that erythrocytes settle within a column in one hour
decrease of light by the erythrocyte aggregates I the column at 1 hour
A laboratory professional observes numerous smudge cells on a Wright-stained blood smear and experience difficulty performing the 100-cell differential. Wha should be done to obtain an accurate differential
recollect the sample using sodium citrate and prepare a smear
warm the blood to 37C for 15 minutes are prepare a smear
add one drop of isotonic saline to five drops of blood, mix, prepare smear
add one drop of 22% bovine albumin to five drops of blood, mix, prepare smear
Using the 10X objective to examine a peripheral blood smear, 150 WBCs were counted from 10 fields. What is the WBC estimate?
3 x103/dL
3x 103/L
3x 103/UI
30 x 103/UI
Generally as cells mature
total cell size decreased, N:C ratio increased, denser chromatin, less basophilia
total cell size decreased, N:C ratio decreased, denser chromatin, less basophilia
total cell size decrease, N:C ratio increased, lacy chromatin, less basophilia
total cell size decreased, N:C ratio decreased, lacy chromatin, less basophilia
An instrument printout shows a normal WBC count with a neutrophil count of 30%. What can be concluded from this?
Patient is suffering from infection
There is a normal neutrophil concentration
Patient has a relative neutropenia
Patient is an infant
What characteristic that is present in promyelocytes morphologically differentiates a promyelocyte from a myeloblast
Primary granules
Secondary granules
Loss of nucleoli
Pink cytoplasm
what is the earliest identifiable cell in the granulocyte maturation sequence
pluripotent stem cell
CFU-GEMM
myeloblast
myelocyte
The hallmark for differentiating myelocyte from promyelocyte morphologically is the visual identification of
loss of nucleoli
primary granules
secondary granules
pink cytoplasm
A segmented neutrophil performs all of the following except
chemotaxis
phaocytosis
mitosis
pinocytosis
A patient has 20% eosinophils. Which of the following can probably be eliminated
allergy
parasitic infection
pertussis
an immediate precursor of the macrophage is the
myeloblast
monoblast
pronormoblast
monocyte
All of the following are included in the kill mechanism of a neutrophil except
chemoattraction of neutrophils to infectious agent
diapedesis of neutrophils from blood into tissues
the formation of the phagolysosome by the neutrophil
the presentation of the infectious agent to a monocyte for phagocytosis
Which of the following is associated with an increased leukocyte concentration
Birth, pregnancy, infection
Older adults, birth
Older adults, pregnancy
Tissue necrosis, whole body irradiation
A cell having a round nucleus with delicate chromatin, prominent nucleoli, and scant basophilic cytoplasm without or a possible rare azurophilic granule is an accurate description of a
myeloblast
myelocyte
metamyelocyte
band
Which of the following is a feature of a normal segmented neutrophil
basophilic cytoplasm
round nucleus with fine chromatin
small pink-lilac granules
prominent primary granules
Auer rods are most likely to be present in which of the following
myelocytic cells
lymphocytic cells
erythrocytic cells
all of the other options
The primary granules of the promyelocytes contian
heparin
myeloperoxidase
histamine
A cell with a 20 um size, round nucleus with fine chromatin and several nucleoli, deep blue cytoplasm with large bluish-purplish granules describe with stage of neutrophil maturation
promyelocyte
metamyelocyte
band neutrophil
myelocyte
Which of the following cells in the peripheral blood is described as large cell with abundant cytoplasm containing minute granules, lacy chromatin, and an indented or curved nucleus
monocyte
macrophage
lymphocyte
basophil
A 45 year old male visited his physical for a routine check up. his absolute neutrophil count was 8.5 x 10^9/L. Which of the following terms describes these results
Absolute neutrophilia
Relative neutrophila
Acute neutrophilia
Intermediate neutrophilic
Which of the following characteristics is associated with the neutrophilia that accompanies bacterial infection
left shift
toxic granulation
Dohle body
all of the other choices
A patient has a fever and a WBC of 25 x 10^9/L with bands and metamyelocytes present. Which of the following conditions describes these results
reaction leukopenia
pseudoneutrophilia
left shift
May-Hegglin anomaly
A patient presents with neutrophilia of 40 x10^0/L with many circulating immature cells. The blood contains may bands, metas, myelocytes, promyelocytes, and a rare blast. What disease state is likely with these results?
Leukoerythroblastosis
Hypersenitivity reaction
Tissue damage from burns
Neutrophilic leukemia reaction
Which of the following is most likely able to distinguish a leukemia reaction from CML
LAP score
platelet count
shift to the left
all of the other choices
A healthy individual has his blood drawn as part of a routine physical. The lab technician performing the differential notes a neutrophil with a nucleus that appears dumbbell shaped. After scanning the entire slide, it appears that the vast majority of neutrophils have the same nuclei. All other leukocytes appear normal. That conclusion from this is that the patient has:
May-Hegglin anomaly
Hypersegmented neutrophils
Alder-Reilly anomaly
Pelger-Huët anomaly
Which of the following can result in basophilia
chronic myeloproliferative neoplasm
parasitic infections
connective tissue disorders
all of the other choices
A disorder characteristic by a defect in glucocerebrosidase that results in a macrophage with cytoplasm appearing wrinkled and striated is
Neimann-Pick's disease
Gaucher's disease
Fabry's disease
Tay-Sachs disease
How does immediate neutrophilia differ from acute neutrophilia
Immediate neutrophilia occurs within 4-5 hours, acute occurs within 30 minutes
immediate neutrophilia lasts 20-30 minutes, whereas acute lasts hours to days
In immediate neutrophilia, circulation neutrophils show an increase in early neutrophil precursors, acute neutrophilia has mature neutrophil
In immediate neutrophilia, the leukocytes return to normal as the bone marrow production increases, acute neutrophilia has more mature neutrophils
which of the following anomalies is morphologically similar to toxic granulation and is often seen in patients who have poor mucopolysaccharide degradation
May-Hegglin
Pelger-Huët
Chédiak-Higashi
Alder-Reilly
Interpret the following results: WBC count 1.4 x 10^9/L; bone marrow shows myeloid hypoplasia with a decreased M:E ratio of 1:1. There is no history of medication or drug exposure. What can be concluded?
patient has pseudoneutropenia
patient has neutropenia resulting from decreased production
patient has neutropenia from increased loss in circulation
patient has neutropenia resulting from toxin exposure
In the identification of Pelger-Huët cells, what nuclear characteristic other than dumbbell shape aids in differentiating these from band cells
excessive coarse clumping of chromatin
lack of primary granules
presence of Dohle bodies
toxic granules present
What disease state correlates highly with the presence of cytoplasmic vacuoles in freshly drawn blood
Ehrliche sp. infection
Septicemia
HIV infection
Malaria
A neutrophil contains may giant gray-green peroxidase positive bodies and giant lysosomes. Which is associated
May-Hegglin
Chédiak-Higashi
Pelger-Huët
Alder-Reilly
Which of the following diseases is characterized by a defect in sphingomyelinase, which results in macrophages with a foamy appearance
Gaucher's
Niemann-Pick
Tay-Sachs
Fabry's
A peripheral blood smear exam shows many WBCs with many blue-staining round inclusions. Thrombocytopenia with giant platelets is present. What autosomal dominant disease is associated with these findings?
May-Hegglin
Alder-Reilly
Chédiak-Higashi
Megaloblastic anemia
Which of the following is characteristic of T lymphocytes
phagocytosis of bacteria
antibody synthesis
cytokine secretion
few in number within peripheral blood
An instrument printout show a normal WBC count on an adult with a lymphocyte count of 30%. What can be concluded from this
patient is suffering from infection
normal lymphocyte concentration
patient is an infant
patient has leukemia
Which two CD markers are used to differentiate helper T cells and cytotoxic T cells
CD1 and CD3
CD4 and CD8
CD10 and CD19
BCR and TCR
A 6 year old has a WBC count of 7 x 10^9/L with 48% lymphocytes. Which of the following best describes this phenomenon
Absolute lymphocytosis
Relative lymphocytosis
Normal leukocyte count
Absolute lymphocytopenia
All of the following are expected of findings of AIDS except
Lymphocytopenia
Leukocytopenia
Anemia
Thrombocytosis
A negative heterophiles antibody test in a patient with symptoms of infectious mononucleosis count be caused by what factor if the patient is being treated for cancer
infection by another virus
level of the antibody not high enough to be detected
immunosuppressed antibody response
CMV infection
Which of the following disorders is associated with lymphocytosis
X-linked immunodeficiency syndrome
AIDS
SCID
Whooping cough
Which of the following is characteristic of cellular changes as megakaryoblasts mature into megakarycyte within the bone marrow
progressive decrease in overall size
increasing basophilia of the cytoplasm
nuclear division without cytoplasmic division
fusion of the nuclear lobes
Which of the following describes how platelet clumping artificially alters platelet parameters
increases both the PDW and MPV
decreases both the PDW and MPV
increases the PDW and decreases the MPV
decrease the PDW and increases the MPV
What is the first step in platelet function after an injury
fibrin formatin
release of ADP
platelet aggregation
platelet adhesion to collagen
Congenital immunodeficiencies can be caused by defects of T or B lymphocytes, or both
True
False
Which is the last nucleated stage of erythrocytic maturation
pronormaoblast
orthochromic normoblast
polychromatophilic normoblast
basophilic normoblast
Hemoglobin beings to appear in which of the following erythrocyte stages
probomoblast
basophilic normoblast
polychromatophilic normoblast
orthochromic normoblast
The higher the N:C ratio is, the more mature the cell
True
False
For each pronormaoblast precursor cell, ___ mature RBCs are produced
4
8
12
16
The enucleate mature RBC has no ability to produce proteins
True
False
What is the red cell protein the is responsible for deformability and flexibility fo the red cell
Spectrin
Glycoprotein
Glycine
EPO
For a RBC to live its full 120-day life span what condition is necessary
must be deformable
must have enough granules
must always remain in round shape
must be enough hemoglobin, regardless of function
Which of the following electrolytes maintains its highest concentration within the RBC cytoplasm as opposed to circulating in the plasma
Sodium
Bicarbondate
Potassium
Chloride
Increased plasma cholesterol may lead to
Spherocytes
Target cells
Microcytes
Helmet cells
Reversible sickled cells are described as having which of the following shapes
Crescent shape with one pointed projection
Crescent shape with two pointed projections
Half moon shape with rounded ends
Half moon shape with pointed projection
When iron is present in an oxidized state as Fe+3 or ferric iron, the resulting hemoglobin is known as
Methemoglobin
Sulfhemoglobin
Carboxyhemoglobin
Deoxyhemoglobin
Abnormal hemoglobins have a lower affinity for oxygen
True
False
90% of in vivo hemolysis is intravascular
True
False
Which of the following is a definitive sign of intravascular lysis
bilirubinemia
decrease RBC count
hemoglobinura
elevated LDH
Which organ(s) is(are) the most affected during extravascular lysis
Liver and spleen
Kidneys
Pancreas
Heart
Which is true about iron absorption
it occurs in the stomach
phytates and tannates enhance absorption
ascorbic acid inhibits its absorption
it must be in ferrous form for absorption
where is the largest percentage of iron in the body located
bone marrow
liver
attached to hemoglobin in RBCs
in the cytoplasm of macrophages
An elevated reticulocyte count rules out which of the following
acute blood loss
aplastic crisis
acute hemolysis
successful patient response to iron therapy
an analyzer report has a platelet count of 850 x10^9/L. This would be interpreted as
normal platelet count
thrombocytosis
thrombocytopenia
cannot be determined
A patient's peripheral blood smear reveals many giant platelets. All platelet function tests show normal aggregation with the exception of ristocetin. From what is the patient most likely suffering from?
Glanzmann's thrombasthenia
Bernard-Soulier
Storage pool disorder
Wiscott-Aldrich
Acquired inhibitor of a single factor can be acquired after treatment of factor deficiency
True
False
Interpret: PT 11.8 sec (11.2-13.8); INR 1.07; APTT 57 sec (23-32); BT 15 min. (increased); Ristocetin: decreased aggregation. What is the patient most likely suffering from?
Hemophilia A
Bernard-Soulier
DIC
vWD
Primary fibrinolysis is a disorder closely related to DIC. All of the coagulation profile assays are the same as that for DIC with the exceptionof
D-dimer, which is increased
Fibrinogen, which is decreased
Platelet count, which is normal
PT/INR, which is increased
Which assay would be useful in identifying the presence of primary fibrinolysis
Fibrinogen and FDP
FDP and D-dimer
D-dimer and plasmin
Fibrinogen and platelet count
Early fragments
X and Y
D and E
X, Y, D, and E
The best way to monitor oral anticoagulant therapy is
PT
APTT
PT and APTT
Proper specimen collection for coagulation testing must be performed to eliminate contamination of substances that will interfere with the test results. Which of the following are considered contaminants for coagulation testing?
Sodium citation and heparin anticoagulant
Tissue factor and anticoagulant carryover
Ari and tissue factor
High hematocrit and anticoagulant carryover
Thrombin time is prolonged with a patient who has
increased levels of FDPs
increased levels of fibrinogen
factor deficiencies
presence of lupus anticoagulants
A patient's laboratory coagulation test results in an immediate correction of the PT and APTT after mixing studies and no correction after performing the PT and APTT after a 2-hour incubation at 37C. What is the possible inhibitor or deficiency?
factor deficiency
lupuslike anticoagulant
F-VIII inhibitor
F-V loss
Interpret the following results. PT= 32 sec. APTT = 92 sec. TT = 20 sec. What is the most likely reason for these results?
Patient in DIC
Heparin contamination of sample
Patient is taking coumadin
Patient has liver disease
A patient has severe liver disease, what test results would you expect
Prolonged PT, TT, increased FDP
Prolonged APTT, normal TT
Decreased fibrinogen and normal TT
Prolonged BT and normal APTT
