5. Evaluation of Cell Morphology and Introduction to Platelet and White Cell Morphology

Question 1

1. A prominent morphologic clue when suspecting lead poisoning is the presence of which of the following on a peripheral smear?
   a.Heinz bodies
   b.Target cells
   c. Siderotic granules
   d.Basophilic stippling

Answer 1

d.Basophilic stippling

Question 2

2. In which of the following disease states would you expect to find oval macrocytes on the peripheral smear?
   a. Iron deficiency anemia
   b.Lead poisoning
   c.Megaloblastic anemia
   d.Hereditary spherocytosis

Answer 2

c.Megaloblastic anemia

Question 3

3.All but one of the following are possible mechanisms for the production of macrocytes:

a. Liver disease
b. Postsplenectomy status
c. pernicious anemia
d. Thalassemia minor

Answer 3

d. Thalassemia minor

Question 4

4. An abnormal erythrocyte seen in liver disease and hemo-globinopathies and thalassemias and is characterized by the “bull’s eye” area is known as a:
   a.Stomatocyte
   b. target cell
   c. Schistocyte
   d. Hypochromic cell

Answer 4

b. target cell

Question 5

5. Morphological abnormalities found in cases of severe burns, microangiopathic hemolytic anemias,and disseminated intravascular coagulation (DIC)are:
   a. Schistocytes
   b.Crenated cells
   c.Ovalocytes
   d.Stomatocytes

Answer 5

a. Schistocytes

Question 6

6. Oat-shaped cells may be associated with:
   a.Myelofibrosis
   b. Hereditary spherocytosis
   c. Burns
   d.Sickle cell anemia

Answer 6

d.Sickle cell anemia

Question 7

7.How would a cell be classified that has a diameter of 9 μm and an MCV of 104 fL?
a.Macrocytic
b.Microcytic
c.Normal
d. Either normal or slightly microcytic

Answer 7

a.Macrocytic

Question 8

8.Abnormal platelet morphology may be observed most prominently in:
a. Idiopathic myelofibrosis
b.Anemia of chronic disorders
c. Hereditary spherocytosis
d.Septic shock

Answer 8

a. Idiopathic myelofibrosis

Question 9

9.Which type of red cell inclusion is a DNA remnant?
a.Heinz body
b.Howell-Jolly body
c. Pappenheimer body
d.Cabot ring

Answer 9

b.Howell-Jolly body

Question 10

10.Which of the following are considered microcytic/hypochromic anemias?

a. Autoimmune hemolytic anemia
b. Pernicious anemia
c. Iron deficiency anemia
d.Megaloblastic anemia

Answer 10

c. Iron deficiency anemia

Question 11

11. A hypersegmented neutrophil may be seen in which of the following anemias?
    a.Iron deficiency
    b.Megaloblastic
    c. Autoimmune hemolytic anemia
    d. anemia of chronic disorders

Answer 11

b.Megaloblastic

Question 12

12. Precipitates of denatured hemoglobin found primarily in patients with hemolytic anemia resulting from oxidant stress describe:
    a.Howell-Jolly bodies
    b.Heinz bodies
    c. Basophilic stippling
    d. Pappenheimer bodies

Answer 12

b.Heinz bodies

Question 13

13. Pappenheimer inclusions are formed from:

a. Excess a-chains
b. Excess b-chains
c. Excess iron
d. Oxidant stress

Answer 13

c. Excess iron

Question 14

14. RBC inclusions resulting from an acceleration in hemoglobin biosynthesis and consists of RNA:

a. Howell-jolly bodies
b. Heinz bodies
c. Basophilics stippling
d. Pappenheimer bodies

Answer 14

c. Basophilics stippling

Question 15

The following anwer pool is used for items 15 to 19 (Match):

a. Anisocytosis
b. Poikilocytosis
c. Hypochromasia
d. Microcytic
e. Depranocyte
f. Polychromasia
g. Microspherocytes
h. Target cells
i. stomatocytes
j. Blister cells
k. Schistocytes
l. Rouleaux
m. Acanthocytes
n. Dacrocytes
o. Echinocytes

15. RBC’s with a large area of central pallor
16. Variation in the size of the red blood cells
17. Also known as codacytes
18. RBC’s appearing stacked on each other
19. MCV of 65%
20. RBC’s with mouthlike central pallor
21. RBC’s without an area of central pallor
22. RBC’s with evently distributed spicules on the membrane
23. RBC fragments
24. RBC’s appearing bluish in color
25. Variation in the shape of the RBCs
26. Congenital abetalipoproteinemia
27. The formation of a vacuole in an RBC ‘‘Trapped’’ by fibrin
28. Formed when an RBC with an inclusion squeezes out of a tight space
29. Seen in HbS disease

Answer 15

15. RBC’s with a large area of central pallor
    C. Hypochromasia
16. Variation in the size of the red blood cells
    a. Anisocytosis
17. Also known as codacytes
    h. Target cells
18. RBC’s appearing stacked on each other
    l. Rouleaux
19. MCV of 65%
    d. Microcytic
20. RBC’s with mouthlike central pallor
    i. stomatocytes
21. RBC’s without an area of central pallor
    g. Microspherocytes
22. RBC’s with evently distributed spicules on the membrane
    o. Echinocytes
23. RBC fragments
    k. Schistocytes
24. RBC’s appearing bluish in color
    f. Polychromasia
25. Variation in the shape of the RBCs
    b. Poikilocytosis
26. Congenital abetalipoproteinemia
    m. Acanthocytes
27. The formation of a vacuole in an RBC ‘‘Trapped’’ by fibrin
    j. Blister cells
28. Formed when an RBC with an inclusion squeezes out of a tight space
    n. Dacrocytes
29. Seen in HbS disease
    e. Depranocyte