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WorksheetsMEDL 279 Hematology Review
Total questions: 91
Worksheet time: 46mins
Fill in the blank: Prenatal hematopoiesis in the yolk sac occurs at ______ months.
0-2
2-4
4-6
6-8
Fill in the blank: Prenatal hematopoiesis in the spleen occurs at ______ months.
2-5
1-2
7-9
10-12
Fill in the blank: Prenatal hematopoiesis in the liver occurs at ______ months.
2-7
1-2
8-10
10-12
Fill in the blank: Prenatal hematopoiesis in the bone marrow starts at ______ months on.
5
3
9
12
Which of the following is NOT a site of adult hematopoiesis?
Skull
Sternum
Falange's
Vertebrae
Which of the following is the correct order of erythroid cell maturation from youngest to most mature?
A) Pronormoblast(Rubriblast), Basophilic normoblast(Prorubricyte), Polychromtaic normoblast(rubricyte), Orthochromic normoblast(metarubricyte), Polychromatic Erythrocyte, Erythrocyte
B) Pronormoblast(Rubriblast), Basophilic normoblast(Prorubricyte), normoblast(rubricyte), Orthochromic normoblast(metarubricyte), Polychromatic Erythrocyte, Erythrocyte
C) Polychromatic Erythrocyte, ErythrocyteBasophilic normoblast(Prorubricyte), Polychromtaic normoblast(rubricyte), Orthochromic normoblast(metarubricyte),Pronormoblast(Rubriblast)
D) Erythrocyte, Polychromatic Erythrocyte, Orthochromic normoblast(metarubricyte), Polychromtaic normoblast(rubricyte), Basophilic normoblast(Prorubricyte), Pronormoblast(Rubriblast)
Fill in the blank: The hematopoietic stem cell gives rise to CFU-E, which matures into ______.
Erythrocyte
Neutrophil
Platelet
Monocyte
Which of the following is NOT a stage in granulocyte maturation?
Myeloblast
Promyelocyte
Reticuloblast
Band Neutrophil
What protein is responsible for iron transport in the blood?
Transferrin
Hemoglobin
Albumin
Ferritin
Which protein is the major iron storage form in the body?
Ferritin
Albumin
Transferrin
Hemoglobin
What is the H2O insoluble iron storage form called?
Hemosiderin
Ferritin
Transferrin
Hemoglobin
What condition is caused by excess iron stored in tissues and body organs, leading to tissue damage?
Hemochromatosis
Anemia
Hypokalemia
Osteoporosis
Porphyria's enzyme deficiencies cause build-up of heme precursors, resulting in what color urine?
Red or port wine colored urine
Green colored urine
Blue colored urine
Milky white urine
What are the early symptoms of porphyria's enzyme deficiencies?
Neuropsychiatric symptoms
Skin rash
Joint pain
Visual disturbances
What are the late symptoms of porphyria's enzyme deficiencies?
Cutaneous symptoms such as photosensitivity and facial hair
Severe joint pain and swelling
Sudden loss of vision
Persistent cough and chest pain
Which of the following is NOT a heme precursor?
Delta-aminolaevulinic acid
Porphobilinogen
Tyrosine
Uroporphyrinogen
What is the composition of adult hemoglobin (Hgb A)?
Alpha 2 & Beta 2
Alpha 2 & Gamma 2
Alpha 2 & Delta 2
Beta 2 & Gamma 2
What is the composition of newborn hemoglobin (Hgb F)?
Alpha 2 & Gamma 2
Alpha 2 & Beta 2
Alpha 2 & Delta 2
Alpha 2 & Epsilon 2
What is the normal reference range for hemoglobin in males?
10 +/- 2 g/dL
16 +/- 2 g/dL
20 +/- 2 g/dL
14 +/- 2 g/dL
What is the normal reference range for hemoglobin in females?
10 +/- 2 g/dL
16 +/- 2 g/dL
14 +/- 2 g/dL
12 +/- 2 g/dL
What is the normal reference range for hematocrit in males?
47 +/- 5%
42 +/- 5%
37 +/- 5%
52 +/- 5%
What is the normal reference range for hematocrit in females?
A) 47 +/- 5%
B) 42 +/- 5%
C) 37 +/- 5%
D) 52 +/- 5%
Which anticoagulant is used in the blue top tube for lab procedures?
Heparin
Sodium Citrate
EDTA
Potassium ferricyanide
Fill in the blank: The conversion of hemoglobin to cyanmethemoglobin is done by potassium cyanide and _________
potassium ferricyanide
potassium dichromate
sodium chloride
magnesium sulfate
Which of the following is NOT a potential error in hemoglobin measurement?
A) Lipemia/icterus
B) High WBC count
C) Hemoglobin variants SS, SC
D) Cold agglutinins
Which of the following is a potential error in the microhematocrit method?
Failure to seal tube
Use of sodium citrate
Use of potassium ferricyanide
Use of 1% ammonium oxalate
What is the dilution ratio for WBC/Platelet count using 1% ammonium oxalate?
1:10
1:100
1:1000
1:10000
What is the reference range for WBC count according to our textbook?
3.6-10.6/uL
4.8-12.8/uL
1.5-10.5/uL
10.6-18.6/uL
What is the basic reference range for platelet count according to the worksheet?
150,000-450,000/uL
50,000-100,000/uL
500,000-700,000/uL
10,000-50,000/uL
The reference range for RBC in males is:
4.7-6.1 million/µL
3.5-5.0 million/µL
6.5-8.0 million/µL
2.0-4.0 million/µL
The reference range for RBC in females is:
3.8-5.8 million/µL
4.5-6.5 million/µL
2.5-4.5 million/µL
5.0-7.0 million/µL
The function of Neutrophils is:
Oxygen transport
Blood clotting
Phagocytosis of pathogens
Production of antibodies
The function of Lymphocytes is:
Transport oxygen
Humoral & Cell mediated immunity
Allergic response regulator
Inflammatory response mediator
The function of Monocytes is:
Oxygen transport
Blood clotting
Phagocytosis of pathogens
Production of antibodies
The function of Basophils is:
Phagocytosis of bacteria
Production of antibodies
Release of histamine and heparin
Transport of oxygen
The function of Eosinophils is:
Phagocytosis of bacteria
Production of antibodies
Destruction of parasitic worms and modulation of allergic responses
Blood clotting
What is the formula for calculating the cell count using a hemocytometer?
Total Cells = # of cells X dilution factor / area X depth
Total Cells = number of cells x dilution factor
Total Cells = area x depth / number of cells
Total Cells = dilution factor X area / # of cells X depth
How many squares are counted for a WBC count in a hemocytometer?
9 squares
4 squares
16 squares
25 squares
How many squares are counted for a platelet count in a hemocytometer?
25 squares in center larger square
16 small squares in the corner
9 large squares in the entire grid
5 small squares in the center
What are the sources of error in Wright stain during blood smear examination?
Stain red pH of buffer or stain too acidic, prolonged washing; Stain blue pH of buffer or stain too basic, prolonged staining
Stain red due to excessive heat, stain blue due to insufficient drying
Stain red due to high humidity, stain blue due to low humidity
Stain red due to over-fixation, stain blue due to under-fixation
How do you calculate the absolute value in leukocyte differential?
Relative value (%) X Total WBC count
Total WBC count / Relative value (%)
Relative value (%) + Total WBC count
Relative value (%) - Total WBC count
Match the following WBC morphologies with their associated conditions:
Which of the following is associated with Hypersegmented Neutrophils?
Megaloblastic anemia
Myelodysplastic syndrome
Bacterial infection
Viral infection
What is the average number of platelets per oil immersion field multiplied by to estimate platelet count?
20,000
10,000
5,000
50,000
If platelets seem low during a platelet estimate, what should be done?
Repeat the estimate and check for clumping
Ignore the result
Increase the sample volume
Report immediately without verification
How do you correct WBC count in the presence of NRBCs?
WBC count x 100 / (100 + #NRBC) = corrected count
WBC count x (100 + #NRBC) / 100 = corrected count
WBC count / (100 + #NRBC) x 100 = corrected count
WBC count + #NRBC x 100 = corrected count
What is the MCV range for normocytic RBCs?
80-100 fl
60-75 fl
100-120 fl
50-65 fl
What is the MCV value for microcytic RBCs?
MCV < 80
MCV > 100
MCV 80-100
MCV = 100
What is the MCV value for macrocytic cells?
MCV > 100
MCV < 80
MCV 80-100
MCV = 100
What does anisocytosis refer to?
Variation in cell size
Increase in cell number
Decrease in cell size
Change in cell shape
Which of the following describes normochromic cells?
MCHC of 32-36g/dL
MCHC of < 32
MCHC of > 36
Which of the following describes hypochromic cells?
MCHC of 32-36g/dL
MCHC of < 32
MCHC of > 36
Which of the following describes RBC cells with a MCHC higher than 36g/dL?
Spherocytic
Hypochromic
Normochromic
Hyperchromic
What is polychromasia?
Blue color in the RBC
Increase in WBC count
Decrease in platelet count
Yellow color in the plasma
What is poikilocytosis?
Variation in cell shape
Increase in cell number
Decrease in cell size
Presence of immature cells
Which crystal is bar shaped?
HbC
HbSC
HbA
HbF
Which crystal is described as 'Hand in glove' or 'Washington monument morphology'?
HbC
HbSC
HbA
HbF
Pernicious anemia is:
A deficiency of vitamin B12 due to lack of intrinsic factor
A type of iron deficiency anemia
Anemia caused by chronic blood loss
Anemia due to folic acid deficiency
Red Cell Inclusions: What is the composition of Howell-jolly bodies?
DNA
RNA
Iron
Hemoglobin
Red Cell Inclusions: Which stain is used for Basophilic stippling?
Wright/New Methylene blue
Sudan Black B
Prussian Blue
Periodic Acid-Schiff (PAS)
Red Cell Inclusions: What is the indication for the presence of Pappenheimer bodies?
Sideroblastic anemia, Hemoglobinopathies
Iron deficiency anemia
Hereditary spherocytosis
Autoimmune hemolytic anemia
Red Cell Inclusions: Heinz Bodies are composed of what?
Denatured precipitated hemoglobin
Aggregated ribosomal RNA
Iron granules (siderotic granules)
Nuclear remnants (Howell-Jolly bodies)
Red Cell Inclusions: Cabot Ring is an inclusion composed of remnants of what?
Remnants of mitotic spindle
Remnants of ribosomal RNA
Remnants of nuclear envelope
Remnants of hemoglobin
Red Cell Inclusions: Which inclusion is associated with parasitic infection?
Trypanosomes
Howell-Jolly bodies
Heinz bodies
Pappenheimer bodies
Which stain is used to identify Pappenheimer bodies?
Prussian blue
Giemsa stain
Sudan Black B
Periodic acid-Schiff (PAS)
Which red cell inclusion is an indication of G6PD deficiency or Thalassemia?
Heinz Bodies
Howell-Jolly bodies
Basophilic stippling
Pappenheimer bodies
What is the Rule of Three in hematology?
Hb x 3 = Hct +/- 3%
RBC x 3 = Hb +/- 3%
WBC x 3 = Platelets +/- 3%
MCV x 3 = MCH +/- 3%
Which of the following is NOT a source of error in the Rule of Three?
Clotted sample
Cold agglutinin
Normal sample
Lipemic, icteric, or grossly hemolyzed sample
What does ESR measure?
The rate of fall of RBCs through plasma.
The amount of hemoglobin in blood.
The number of white blood cells.
The clotting time of blood.
What is the basic reference range for ESR in males?
0-15 mm/hr
0-20 mm/hr
15-30 mm/hr
5-25 mm/hr
What is the basic reference range for ESR in females?
0-20 mm/hr
0-10 mm/hr
20-40 mm/hr
10-30 mm/hr
Which of the following is a potential error that can increase ESR?
Decrease in temperature
Increase in tilting tube, standing too long, increase in temperatures, excess EDTA ratio
QNS specimens
None of the above
Which stains are used for retic count?
New methylene blue
Brilliant cresyl blue
Brom cresol green
None of the above
What is the formula for calculating % retic?
# retics in 1000 RBC's / 10
# retics in 100 RBC's / 10
# retics in 1000 RBC's x 10
# retics in 100 RBC's x 100
What is the basic reference range for retic count?
0.5-1.5%
2.0-3.0%
5.0-10.0%
<0.1%
What is the reference range for megakaryocytes in bone marrow preps?
5/lpf
0.5/lpf
50/lpf
20/lpf
What is the myeloid:erythroid ratio in bone marrow preps?
3:1 – 4:1
1:1 – 2:1
5:1 – 6:1
10:1 – 12:1
In hemoglobin electrophoresis using cellulose acetate at pH 8.6, what is the order of migration from cathode to anode?
C > S > F > A
A > F > S > C
F > A > S > C
S > C > A > F
In hemoglobin electrophoresis using citrate agar at pH 6.2, what is the order of migration?
F > A > S > C
A > F > S > C
S > F > A > C
C > S > A > F
Which hemoglobin variant is associated with sickle cell disease?
Hemoglobin S
Hemoglobin A
Hemoglobin C
Hemoglobin F
Which hemoglobin variant may show bar-shaped crystals and target cells on smear?
Hemoglobin C
Hemoglobin S
Hemoglobin E
Hemoglobin F
Which method is used to confirm hemoglobin types by electrophoresis?
Cellulose acetate
Paper chromatography
Gel filtration
Immunoassay
On citrate agar electrophoresis, which hemoglobin type separates from the others?
A
S
C
F
Beta thalassemia is characterized by a decrease or absent production of which chains?
Beta chains
Alpha chains
Gamma chains
Delta chains
Alpha thalassemia with 3 deleted genes ( - / - / - alpha ) is associated with which disease?
Hemoglobin H disease
Sickle cell anemia
Beta thalassemia major
Hereditary spherocytosis
What is the result of 4 deleted alpha genes ( - / - / - / - ) in alpha thalassemia?
Hydrops fetalis or nonviable fetus
Mild anemia with microcytosis
Beta thalassemia major
Sickle cell disease
Erythrocytosis is defined as an increase in the number of which cells?
Red blood cells (RBCs)
White blood cells (WBCs)
Platelets
Plasma cells
Which White Cell Disease State is associated with increased mucopolysaccharides?
Alder-Reilly
Chediak-Higashi
May-Hegglin
Which White Cell Disease State is associated with albinism and increased susceptibility to infection?
Alder-Reilly
Chediak-Higashi
May-Hegglin
Which of the following is associated with Dohle bodies in SEGS, monos, and lymphs?
Pelger-Huet
Hyposegmented SEGS
Normal Function
What is the WBC function in Pelger-Huet anomaly?
Abnormal Function
Normal Function
Increased Function
Which myelodysplastic syndrome is characterized by <5% blasts and ringed sideroblasts?
Refractory anemia with sideroblasts (RARS)
Refractory anemia with excess blasts (RAEB)
Chronic myelomonocytic leukemia (CMML)
Refractory cytopenia with multilineage dysplasia (RCMD)
