Examination of the Peripheral Blood Film and Correlation with the Complete Blood Count

Question 1

1. A laboratory science student consistently makes wedgetechnique blood films that are too long and thin. What
   change in technique would improve the films?
   a. Increasing the downward pressure on the pusher slide
   b. Decreasing the acute angle of the pusher slide
   c. Placing the drop of blood closer to the center of the slide
   d. Increasing the acute angle of the pusher slide

Answer 1

d. Increasing the acute angle of the pusher slide

Question 2

2. When a blood film is viewed through the microscope, the
   RBCs appear redder than normal, the neutrophils are barely
   visible, and the eosinophils are bright orange. What is the
   most likely cause?
   a. The slide was overstained.
   b. The stain was too alkaline.
   c. The buffer was too acidic.
   d. The slide was not rinsed adequately

Answer 2

c. The buffer was too acidic.

Question 3

3. A stained blood film is held up to the light and observed to
   be bluer than normal. What microscopic abnormality might
   be expected on this film?
   a. Rouleaux
   b. Spherocytosis
   c. Reactive lymphocytosis
   d. Toxic granulation

Answer 3

a. Rouleaux

Question 4

4. A laboratorian using the 40x objective lens sees the following numbers of WBCs in 10 fields: 8, 4, 7, 5, 4, 7, 8, 6, 4, 6. Which of the following WBC counts most closely correlates
   with the estimate?
   a. 1.5 x 109/L
   b. 5.9 x 109/L
   c. 11.8 x 109/L
   d. 24 x 109/L

Answer 4

c. 11.8 x 109/L

Question 5

5. A blood film for a very anemic patient with an RBC count
   of 1.25 x1012/L shows an average of seven platelets per oil
   immersion field. Which of the following values most closely
   correlates with the estimate per microliter?
   a. 14,000
   b. 44,000
   c. 140,000
   d. 280,000

Answer 5

b. 44,000

Question 6

6. A blood film for a patient with a normal RBC count has an
   average of 10 platelets per oil immersion field. Which of the
   following values best correlates with the estimate per microliter?
   a. 20,000
   b. 100,000
   c. 200,000
   d. 400,000

Answer 6

c. 200,000

Question 7

7. What is the absolute count (x 109/L) for the lymphocytes
   if the total WBC count is 9.5 x 109/L and there are 37%
   lymphocytes?
   a. 3.5
   b. 6.5
   c. 13
   d. 37

Answer 7

a. 3.5

Question 8

8. Which of the following blood film findings indicates
   EDTA-induced pseudothrombocytopenia?
   a. The platelets are pushed to the feathered end.
   b. The platelets are adhering to WBCs.
   c. No platelets at all are seen on the film.
   d. The slide has a bluish discoloration when examined
   macroscopically

Answer 8

b. The platelets are adhering to WBCs.

Question 9

9. Which of the following is the best area to review or perform a differential on a stained blood film?
   a. Red blood cells are all overlapped in groups of three or
   more.
   b. Red blood cells are mostly separated, with a few overlapping.
   c. Red blood cells look flattened, with none touching.
   d. Red blood cells are separated and holes appear among
   the cells.

Answer 9

b. Red blood cells are mostly separated, with a few overlapping.

Question 10

10. Use the reference intervals provided inside the front cover of this text. Given the following data, summarize the following blood picture:
    WBC: 86.3 x 109/L
    HGB: 9.7 g/dL (97 g/L)
    HCT: 24.2%
    MCV: 87.8 fL
    MCHC: 33.5%
    PLT: 106 x 109/L

a. Leukocytosis, normocytic-normochromic anemia, thrombocytopenia
b. Microcytic-hypochromic anemia, thrombocytopenia
c. Neutrophilia, macrocytic anemia, thrombocytosis
d. Leukocytosis, thrombocytopenia

Answer 10

a. Leukocytosis, normocytic-normochromic anemia, thrombocytopenia