Cherries are Red Flashcards
Autoantibodies against parietal cells and intrinsic factor are associated with
Pernicious anemia
A 3-month old infant is exhibiting pallor and fatigue. the pediatrician orders a CBC which displays a low RBC count…
Diamond Blackfan anemia
the WBC noted were seen when performing a peripheral smear examination. these could be observed in which of the following condition.
Megaloblastic Anemia
The mode of inheritance for G6PD deficiency is:
sex-linked
Which of the following is an important marker of the presence of immature T cells in patients with leukemia and lymphomas:
Terminal Deoxynucleotidyl transferase (TdT)
The laboratory professional notes about 20% spherocytes on a peripheral blood smear of a 4-year-old boy. An osmotic fragility test is performed. The control shows initial hemolysis at 0.50% NaCl and complete hemolysis at 0.35% NaCl. The patient sample has initial hemolysis 60% NaCl and complete hemolysis at 0.45% NaCl. What does this indicate?
The patient is exhibiting increased osmotic fragility.
n PNH, cells are susceptible to complement-induced lysis. This is thought to result from the lack of what two regulating factors?
Decay accelerating factor (DAF) and membrane inhibitor of reactive Lysis (MRL)
intravascular hemolysis releases this component into the peripheral blood and urine.
Hemoglobin
in the initial state of porphyrin synthesis, activated glycine combines with:
Succinyl CoA
laboratory findings in thalassemia often include which of the following?
Microcytic hypochromic anemia
neurological symptoms are prevalent in vitamin B12 deficiency because of:
Improper fatty acid metabolism
pyruvate kinase (PK) deficiency causes which of the following to occur in the erythrocyte?
Erythrocyte membrane failure with loss of potassium
which of the following is found to be a factor in the thrombotic thrombocytopenia purpura (TTP)?
Escherichia coli O157:H7
why are blister cells or bite cells NOT seen in PK deficiency?
Because Heinz bodies are not formed in PK deficiency
which of the following disorders has a defective vertical protein interaction between RBC skeleton and the membrane?
hereditary pyropoikilocytosis
a hypercellular marrow with a M:E ratio of 6:1 is most commonly due to:
granulocyte hyperplasia
which of the following sets of disorders is characterized by increased osmotic fragility?
Hereditary spherocytosis and thalassemia
which of the following organisms causes erythrocyte damage by releasing hemolytic toxins?
Clostridium sp.
which of the following mechanism is thought to cause exercise-induced hemoglobinuria?
erythrocyte membrane protein changes
A 5 year old girl has a WBC count of 11 x 10^9/L with 55% lymphocytes. which of the following best describes this phenomenon?
Absolute lymphocytes
Which of the following is a disorder with absent platelet glycoprotein Ib/IX/V and where the patient presents with moderate thrombocytopenia, large platelets, and normal aggregometry with all agents except ristocetin.
Bernard-Soulier syndrome
A 58 year old male visits his physician for extreme fatigue. after conducting a standard investigation, the physician strongly suspects that his patient is suffering from CML. which one of the following lab results would confirm the picture?
Positive molecular analysis for BCR/ABL1 with Ph chromosome
A 60-year-old patient visited his general practitioner because of fatigue and unexplained bruising. Physical examination revealed a frail, thin, pale man with widespread bruising.
A CBC was ordered and revealed abnormal granularity of platelets and leukocytes. Red cells appeared dimorphic. Bone marrow analysis showed 20 ringed sideroblasts with
dysplastic changes in RBC and WBC precursors. No cytogenetic abnormalities were detected. Based on this information, what is a probable diagnosis?
Myelodysplastic syndrome
A bone marrow sample is sent to the lab for cytomechanical staining MPO,SBB, AND NSE have been ordered. staining results come
as follows:
MPO: Positive SBB: Positive, Specific: Positive, NSE: Positive
Based on these findings what lineage(s) is/are most likely affected?
myeloid and monocytic
The CAP smear presented was sent to a hospital laboratory as part of an external quality control. which of the following test would also be useful in assessing this condition?
????
what is the pathogenesis of MAHA?
microthrombi and fibrin formed on damaged endothelial cells trap and break red cells
In the four large corner squares of a hemocytometer, 95,102,105, and 98 white cells were counted from a 1:20 dilution. select the correct interpretation for the white blood count calculated from these values.
normal for infant and elevated for an adult
A technologist is reviewing a blood smear of an AML patient. she notices single azurophilic needle-like inclusions in the cytoplasm of many of the circulating blasts. what is the most probable identification of the inclusions?
Auer rods
which of the following hemoglobins results from crossing over and fusion of delta and beta chain genes?
Hb D
Bone marrow review on a 15 year old girl with acute leukemia revealed many blast with the following characteristics: high N;C ratio, prominent nucleoli, open chromatin pattern and basophilic cytoplasm. Cytochemical staining revealed negative reactivity with MPO and SBB nonspecific esterase was positive. No cytogenetic abnormalities were detected. What is the most likely lineage of the blast cells in question?
Monocytic
CML is characterized by which of the following?
a left shift in WBC granulocyte
which of the following anomalies is an autosomal dominant disorder characterized by irregularity sized inclusions in polymorphonuclear neutrophils , and monocytes, abnormal giant platelets and often thrombocytopenia?
May-Hegglin anomaly
Hairy cell leukemia and chronic lymphocytic leukemia appear morphologically similar to the untrained eye. which of the following tests would help differentiate between the two?
TRAP stain
in the identification of the pelger-Huet cells, what nuclear characteristic other than the dumbbell shape aids in differentiating theses cells from bands?
excessive coarse clumping of chromatin
a patient presents with 25% blasts (nonerythroid) 34% monocytic cells, and 31% granulocytic cells in the bone marrow. the peripheral blood smear has 10% monocytes. the alpha-naphthyl esterase and chloroacetate esterase are positive. what is the probable diagnosis of theses finings?
acute myelomonocytic leukemia
a patient presents with a leukocyte count of 120x10^9/L and splenomegaly. The blood smear reveals a shift to the left with promyelocytes, myelocytes, metamyelocytes and bands. the platelets are increased and the LAP is decreased. what condition is associated with theses results?
CML
A PAS stain is ordered on a leukemic patient. the test is performed, and the technologist confirms that the PAS stain is positive with Block course granularity. Immunophenotyping showed glycophorin positivity. based on these findings, from what is the patient most likely suffering?
acute erythroleukemia
A benign condition has the following characteristics: WBC count 55 x 10^9/L with a left shift and it occurs in response to inflammatory processes. what is this condition?
leukemoid reaction
A healthy individual has his blood drawn as part of a routine physical. the laboratory professional performing the differential notes a neutrophil with a nucleus that appears dumbbell shaped. after scanning the entire slide, it appears the vast majority of neutrophils have the same nuclei. all the other leukocytes appear normal. what can be concluded from this?
The patient has Pelger Huet anomaly
A 34 year old woman has just given birth to a healthy baby boy. after the delivery of the baby, the physician proceeds to deliver the placenta. after it has been extracted from the mother uterus, the resident examines it and notes that it appears incomplete. then try to deliver the remainder, but are unsuccessful. A few moments later, the mother loses consciousness, and and is bleeding profusely from her uterus. blood is collected and the results are shown below.
DIC
acceptable sites for bone marrow aspiration in an adult include the:
the anterior or posterior iliac crest and midline of the sternum.
A patient being treated with heparin therapy has 65% decrease in platelet count from the baseline count after 6 days of being on the anticoagulant. what is the probable cause of the disease?
Heparin Induced Thrombocytopenia (HT)
a patient has a platelet count of 80 x 10^9/L, a bleeding time of 15 min and 3+ positive tourniquet test. from what is the patient most likely suffering?
A quantitative platelet disorder
a patient has severe liver disease. what test results would you expect?
prolonged PT, APTT, increased FDP
George Jones is admitted to the hospital with abdominal pain. upon physical examination, the attending physician notices a yellow ring around georges green eyes. george has a significant swelling in his abdomen, and has been suffering from swollen joints for the last month. the physician runs a battery for labs. The results are below:
Liver Disease
Interpret the results below
- PT= 32 sec
- APTT= 92 sec
- TT= 20 sec
What is the most likely reason for these aberrant results?
There us heparin contamination of the sample
Interpret the following results:
PT: 11.8 sec (RR: 11.2-13.8 sec)
INR: 1.07
APTT: 57 sec (RR: @3-32 sec)
BT: 12 min
Ristocetin aggregation; decreased aggregation
Based on this information, from what is the patient most likely suffering?
Hemophilia A
Patients with protein C and or S deficiencies are at risk for which type of complication
Thrombosis
Proper collection and processing of coagulation specimens is necessary for optimum results. what should be avoided when processing the sodium citrated specimens for testing?
clotting of the specimen and underfilling the tube
A 5- year old boy visits his PCP after a bike accident. He fell on his knees…. Physician notes small hematomas on his elbows and knees.. Blood results below:
PT: 12.2 sec (RR: 11.3-12.8 sec)
INR: 1.12
APTT: 72 sec (RR:23-32 sec)
Platelet aggregation studies: normal aggregation with all agonists
The physician admits him to the area hospital.
What should the physicians next course of action be in investigating these results?
He should order factor assays of the intrinsic pathway
A 15-year old boy sees his physician because of a prolonged fever and swollen lymph glands. His PB smear shows 20% reactive lymphocytes with a 16 x 10^9L WBC count. What can you conclude from this?
This boy has clinical features of infectious mononucleosis
An instrument printout shows a WBC count of 4.5 x 10^9/L with 75% neutrophils. What is the absolute neutrophil count?
3.4 x 10^9/L
Choose the hemoglobin that has the highest oxygen affinity.
Hb F
What analyte may help to differentiate between intravascular and extravascular hemolysis?
Haptoglobin
Pernicious anemia can be distinguished from folate deficiency by the:
presence of autoantibodies to IF
The leukemia smear presented shows (arrowed cells):
faggot cell with auer rods
Which of following are typical laboratory results for anemia of chronic inflammation/disorder (ACI)?
low serum iron and low TIBC
What is the test commonly used to monitor the high heparin doses used in cardiac bypass surgery?
aPTT
What is the most important step in the phlebotomy procedure?
proper patient identification
Twenty cells are counted in one of the nine large squares of a hemocytometer. The sample is diluted 1:10. How many cells are present per mL?
2000
Toxic granulation, Dohle bodies and vacuolization in neutrophils are often found together in
Bacterial infection
The urea solubility test evaluates factor:
XIII
Homozygous alpha thalassemia (–/–) has what clinical outcome?
incompatible with life
How do sickle cells or spherocytes interfere with the ESR?
prevent rouleaux formation, so falsely decrease
The following smear was obtained from a patient suffering from an anemia. Based on this smear, which additional test would be useful to further evaluate the anemia
????
The smear presented was obtained from a 27 year old male suffering from an anemia. Which of the following would also be expected laboratory result for this patient?
????
This smear was obtained from a 7 year old girl at a childrens hospital suspected of suffering from an leukemia. This smear suggests the child could be suffering from:
????
The peripheral smear presented was obtained from a female suffering from an anemia. Its morphological presentation suggests:
????
The following smear was obtained from a patient suffering from an acute leukemia. based on the smear presented what additional biochemistry result would be expected?
????
The smear presented indicates:
CLL
A urine specimen is tested and has the following results:
reagent strip:
glucose 3+
protein 1+
microscopic findings:
>100 WBCs/ hpf
many yeast cells
Diabetes mellitus
A patient presenting with polyuria, nocturia, polydipsia, and high specific gravity is exhibiting symptoms.
diabetes insipidus
A slightly hazy CSF specimen is diluted 1:10 with acetic acid. A total number of 25 cells are counted. Five large squares on each side of the Neubauer counting chamber were used in the evaluation. The count is reported as:
500 WBCs cell
Ammonium sulfate is added to a red colored urine. The urine had a positive reaction for blood, but there were no red blood cells in the sediment. After centrifugation, the sedimented ammonium sulfate is clear. This abnormal color is caused by:
myoglobin
if sediment was red it would be due to hemoglobin
Calculate the creatinine clearance from the information provided below: 24hr urine volume: 1000ml ; Serum creatinine: 2.0mg/dL; urine creatinine: 200mg/dL
((200)(1000)) / (2.0)
= 100,000 ml/min
Clue cells are derived from:
Squamous epithelial cells
The following crystals were detected using phase microscopy on a synovial fluid from a patient with symptoms of gout. These crystals are most likely:
Monosodium urate
Which of the following characteristics best differentiates waxy cast from fibers that may contaminate urine sediment?
Waxy casts do not polarize light: fibers do
Identify the cast on the color plate presented below
Hyaline cast
Identify the crystals shown in the picture below:
triple phosphate
Lumbar puncture for cerebrospinal fluid analysis is most essential to diagnose which of the following conditions?
meningitis
Identifying the urine crystals below from a patient with kidney stones:
uric acid crystals
Phenylketonuria is caused by:
Lack of enzyme phenylalanine hydroxylase
A urine showing a spotted or speckled reaction on the reagent strip for blood can indicate:
Hematuria
Tests for the detection of occult blood rely on which chemical reaction?
The psuedo-peroxidase activity of hemoglobin
Which of the following statements regarding sperm concentration is true?
In normal ejaculate, sperm concentration ranges from 20 million to 250 million per milliliter.
The presence of a white precipitate in freshly voided urine can be caused by:
Amorphous phosphates in alkaline urine
Which of the following specimens usually eliminates contamination of the urine with entities from the external genitalia and distal urethra?
Midstream “clean catch” specimen”
The tubes of CSF are submitted to the laboratory. They are numbered 1, 2, 3 and show blood in all tubes, but decreasing in amount as one inspects tubes through 1 and 3. This observation should be interpreted as:
A traumatic or bloody tap is suspected and, in all likelihood, no pathogenic significance should be attached to the presence of the blood
During the microscopic examination of urine sediment, which of the following are numerated using low-power magnification?
casts
