Hema

Question 1

Fill in the blanks: Clot retraction is to platelet number and to fibrinogen concentration.

Answer 1

Directly proportional; inversely proportional

Question 2

What test is intended to measure a specific fragment arising from the degradation of cross-linked fibrin?

Answer 2

D-Dimer immunoassay

Question 3

Which of the following factors is inhibited by antithrombin?

Answer 3

All of the choices

Question 4

Which of the following statements below correctly identifies the similarities and differences between primary hemostasis and secondary hemostasis?
I. Primary hemostasis is activated by release of tissue factor by the damaged endothelial cell, whereas secondary hemostasis is activated when the injury is large enough and subendothelial collagen is exposed.
II. Platelets play a role in both primary and secondary hemostasis.
III. The final product of primary hemostasis is white thrombus, which is composed of platelets and fibrin strands, while the final product of secondary hemostasis is red thrombus which is composed of blood elements and fibrin strands.

Answer 4

II only

Question 5

Platelet function deficiencies are reflected in diminished or absent aggregation. Which of the following aggregation results is true for Bernard-Soulier Syndrome?

Answer 5

Normal aggregation with Arachidonic acid and Collagen; Abnormal aggregation with Ristocetin

Question 6

Which of the following are causes of too alkaline smears? I. Leucocytosis with many blasts form
II. Heparin in blood sample
III. Old smear
IV. Prolonged washing V. Inadequate fixation VI. Humid environment

Answer 6

I, II and III

Question 7

Momiji Nishiya is having a hard time in making good quality blood films to be examined by the morning shift staff. In desperation, she endorsed smears that are good in length, smooth transition from thick to thin but appears to be bullet in shaped. What would be course of action of the Medical Technologist to read the slides?

Answer 7

He/she would prepare a new one, bullet shaped smears cause uneven distribution

Question 8

Which of the following is indicated by the increase levels of FDPs especially Fragments D and E?

Answer 8

Degradation and lysis of fibrinogen

Question 9

Which process describes the formation of blood cells outside of the bone marrow?

Answer 9

Extramedullary hematopoiesis

Question 10

A 6-month-old female infant presents in the clinic with a congenital giant hemangioma in the posterior region of her neck. She has on the right lower quadrant of her abdomen. Upon laboratory examinations, the following results were obtained: WBC 9.7 × 109/L; RBC 3.3 × 1012/L; Hgb 87 g/L; platelets 23 × 109/L. Schistocytes are also found in the PBS. What is the possible diagnosis for the patient?

Answer 10

Kasabach-Merritt syndrome

Question 11

Which best describes the location of heme in each globin chain?

Answer 11

Between F8 and E7 histidine residues

Question 12

What is the concentration of the NaCl to be used in OFT?

Answer 12

0.5%

Question 13

In mechanical coagulometry, what is the expected endpoint once fibrin threads are formed in the sample?

Answer 13

Slowing movement of the ball

Question 14

Which of the following factors affect bleeding time?

Answer 14

All of the choices

Question 15

Which of the following sites is considered the best site when collecting blood for infants?

Answer 15

Lateral or medial plantar surface of the heel

Question 16

What should be the size of the drop of blood when doing your manual wedge smear?

Answer 16

2-3 mm

Question 17

Which developmental period is responsible for erythropoiesis in the erythropoietic islands?

Answer 17

Mesenchymal period

Question 18

How can medications cause thrombocytopenia?
1 - redistribution of platelet pools
2 - formation of an autoantibody that binds to a specific platelet membrane glycoprotein 3 - increased platelet consumption or sequestration
4 - suppress bone marrow megakaryocyte production

Answer 18

2 and 4

Question 19

An erythroid precursor described to have mixtures of hemoglobin with the blue of RNA in varying shades of gray in its cytoplasm.

Answer 19

Rubricyte

Question 20

A bone marrow biopsy was performed as part of the cancer staging protocol for a patient with Hodgkin lymphoma. Although no evidence of spread of the tumor was apparent in the marrow, other abnormal findings were noted, including a slightly elevated myeloid-to-erythroid ratio. WBC and RBC morphology appeared normal. However, the Prussian blue stain showed abundant stainable iron in the marrow macrophages. The patient’s CBC revealed a hemoglobin of 10.8 g/dL (low), but RBC indices were within reference intervals. RBC morphology was unremarkable. These findings would be consistent with which anemia?

Answer 20

Sideroblastic anemia

Question 21

RBC pipette is used for direct platelet count. What is the volume of the RBC pipette bulb?

Answer 21

100

Question 22

All the following are WBC diluting fluids except which of these?

Answer 22

Toisson’s Fluid

Question 23

Platelets are counted within what cell volume?

Answer 23

2-30 fL

Question 24

Which organ does not produce TPO?

Answer 24

All choices produce TPO

Question 25

Which is true of procoagulants in Fibrinogen group

Answer 25

They are consumed in coagulation.

Question 26

What is the correction factor used in specimens with a low hematocrit where reticulocytes may be falsely elevated

Answer 26

45

Question 27

Chel, a 78-year-old man presents with a three-year history of an elevated leukocyte count with recent fatigue and anemia. He has received two red blood cell transfusions in the past two months. His past medical history includes coronary artery disease and hypertension. His physical examination is unremarkable. The patient’s white blood cell (WBC) count is 75,000/uL, hemoglobin is 9.3 g/dL, and platelet count is 71,000/uL with a WBC differential including 60% neutrophils, 19% lymphocytes, 15% monocytes, and 6% eosinophils. What is the absolute count of PMNs?

Answer 27

45,000/mm3

Question 28

Which of the following apparatus can be used for both determination of ESR and Hematocrit?

Answer 28

Wintrobe tube

Question 29

The activity of Factors XII and XI can be determined using what clotting time method?

Answer 29

Drop Slide Method

Question 30

Which of the following statements presents the difference between T cells and B cells?

Answer 30

T cells function in cellular immunity while B cells function in humoral immunity.

Question 31

EDTA is not preferred as an anticoagulant in performing assays for hemostasis. Why?

Answer 31

Tend to round up

Question 32

Which of the following accelerates the conversion of prothrombin to thrombin?

Answer 32

A complex of Xa and Va

Question 33

What is the coagulation protein measured by the 5.0 M urea solubility clot test?

Answer 33

Fibrin stabilizing factor

Question 34

When using Wright’s stain, what should be the appearance of the platelets?

Answer 34

Gray blue with purple granules and 2-4 μm in size

Question 35

Which of the following is the best possible treatment for a patient with DIC?

Answer 35

Resolve the underlying cause of the DIC

Question 36

Each large corner square of the Improved Neubauer counting chamber is further divided into how many smaller squares?

Answer 36

16

Question 37

Why is Factor VII the first to be depleted in Vitamin K antagonism?

Answer 37

It has the shortest half-life

Question 38

Which of the following white blood cell has the smallest percentage as seen on a normal peripheral smear?

Answer 38

Basophil

Question 39

Which of the following procoagulant structures of the vascular intima activates platelets by binding to vWF?

Answer 39

Collagen

Question 40

Majority of the adult hemoglobin is composed of which 2 identical pairs of unlike polypeptide chains?

Answer 40

Alpha 2, Beta 2

Question 41

Tilting of the blood-filled tube in the during the process of measuring ESR would result to?

Answer 41

Increased ESR

Question 42

During the preparation for the microhematocrit method, Lenlen, a Medical Technologist of Dilawan Laboratory, improperly sealed the capillary tube. What is the possible effect of this error?

Answer 42

Decreased hematocrit reading

Question 43

What is the effect of platelet satellitisms in the platelet count?

Answer 43

Pseudothrombocytopenia

Question 44

A specimen was sent to the laboratory for platelet count determination. Machine flagging indicated the presence of platelet clumps. There is a presence of platelet satellitism upon checking the smear. What anticoagulant should be used as a corrective measure?

Answer 44

3.2% sodium citrate

Question 45

Determine the specific factor deficiency/disease with the following results in mixing and substitution study based on the following results. PT: prolonged APTT: prolonged TT: normal Normal plasma: corrected Adsorbed plasm: not corrected Aged serum: not corrected

Answer 45

Prothrombin deficiency

Question 46

Which of the following factor deficiencies is PT most sensitive to?

Answer 46

Factor VII deficiency

Question 47

How many leukocytes are counted in a routine WBC differential cell count?

Answer 47

100

Question 48

The following laboratory findings are consistent with which of the following conditions? Clot retraction - abnormal Bleeding time - prolonged Primary Aggregation - absent with ADP, thrombin, collagen, epinephrine Ristocetin-induced Platelet Aggregation - Positive (Normal)

Answer 48

Glanzmann Thrombasthenia

Question 49

Which of these involves consumptive coagulation entrapping platelets in the intravascular fibrin clots?

Answer 49

DIC

Question 50

What do you call the multipotent common myeloid progenitor?

Answer 50

CFU-GEMM

Question 51

Reticulated platelets are seen in a patient’s peripheral blood smear. As a medical technologist, what can you assume about the patient’s condition?

Answer 51

The patient has increased need in platelets thus increasing the rate of production

Question 52

Why is there an increase of leukocytes in the peripheral blood?

Answer 52

Increase mobilization from maturation-storage compartment to circulating pool

Question 53

Which of the following can possibly result to a platelet count of 45,000/uL?

Answer 53

Thrombocytopenia

Question 54

Which of the following antibodies is present in early HIT?

Answer 54

Anti-platelet factor 4

Question 55

What qualitative platelet disorder is likely associated with the following platelet aggregation results: Abnormal aggregation to collagen, ADP, and epinephrine; Normal aggregation to Ristocetin?

Answer 55

Glanzmann Thrombasthenia

Question 56

Small platelets and thrombocytopenia can be characteristically seen in which condition?

Answer 56

Wiskott-Aldrich syndrome

Question 57

It refers to the diverse group of genetic disorders characterized by a primary, quantitative reduction in globin chain synthesis.

Answer 57

Thalassemia

Question 58

All the following leukocytes exhibit a cytoplasm that is filled with granules and whose nuclei are segmented or lobulated except which one of these?

Answer 58

Lymphocyte

Question 59

Which of the following will convert plasminogen to plasmin?

Answer 59

TPA

Question 60

What is the effect of Aspirin in primary hemostasis?

Answer 60

Aspirin inactivates platelet cyclooxygenase.

Question 61

Which among the following describes hemoglobin? I. Transport carbon dioxide from the tissues to the lungs II. Contributes to the acid-base balance III. One gram of hemoglobin carries 1.54 mL of oxygen IV. Transport oxygen from the tissues to lungs

Answer 61

I and II

Question 62

Which RBC maturation stage does not belong with the others listed?

Answer 62

Diffusely basophilic erythrocyte

Question 63

Which of these clinical conditions would result to an abnormally high platelet count? 1- DIC, TTP, HUS 2- Hypersplenism 3- ITP 4- Myeloproliferative disorders 5- Postoperative stress 6- Postsplenectomy

Answer 63

4, 5, and 6

Question 64

The effects of which of the following therapies is being monitored by APTT?

Answer 64

Unfractionated heparin

Question 65

It is a rare autoimmune disease caused by binding of the Donath-Landsteiner autoantibody to the patient’s red cells following cold exposure.

Answer 65

Paroxysmal cold hemoglobinuria

Question 66

Determine the patient’s RBC count result given the values below. Average number of red blood cells counted: 1170 Blood was aspirated up to the 0.5 mark Number of squares counted: 5

Answer 66

5,850 x 1012/L

Question 67

Which of the following cells can be found in the maturation pool? 1-Myeloblast 2-Metamyelocyte 3-Band 4-Myelocyte

Answer 67

2 and 3

Question 68

Which of the following cells has the characteristic large blue-black granules in its cytoplasm?

Answer 68

Basophil

Question 69

What is the other term used for Hematocrit?

Answer 69

Packed Cell Volume

Question 70

Which of the following describes a fibrinogen molecule?

Answer 70

There are 6 N-terminals in the central region and 3 carboxyl terminals at both ends of the outer region.

Question 71

Bart wanted to donate his blood during the annual Mass Blood Donation in their Barangay. The Medical Technologist wanted to check his hemoglobin using the Copper Sulfate Method. A drop of blood is allowed to fall through the copper sulfate solution. After 10 seconds his blood drop remained on the surface of the solution. What is the possible explanation for this?

Answer 71

Bart is deferred from blood donation due to low hemoglobin

Question 72

What area of the counting chamber are RBCs being counted at?

Answer 72

5 intermediate squares of the middle large square

Question 73

Which of the following laboratory findings is most suggestive of a megaloblastic anemia?

Answer 73

Macroovalocytes and hypersegmented neutrophil in PBS

Question 74

Which of the WBC maturation series is the last stage capable of cell division?

Answer 74

Myelocyte

Question 75

Which is the role of thrombin?

Answer 75

Cleaves fibrinogen to form fibrinopeptides A and B

Question 76

What could be the result of Lee White Clotting Time when the Medical Technologist used the blood sample obtained from a traumatic venipuncture?

Answer 76

Falsely shortened clotting time due to contamination of tissue fluids.

Question 77

A blood picture of Howell-Jolly bodies as a product karyorrhexis was observed. Upon examination of bone marrow smear, population of erythrocytic precursors are mostly characterized by megaloblastic than normoblastic maturation. How could be this phenomenon be possible?

Answer 77

DNA synthesis is defective but cytoplasmic maturation is normal

Question 78

What is the formula in getting the mean corpuscular hemoglobin concentration?

Answer 78

MCHC, measured in g/dl = [Hb/Hct]

Question 79

What is the scientific name of the snake responsible for activation of Factor X through the presence of Factor V, phospholipid, and calcium?

Answer 79

Russel’s viper venom

Question 80

Which of these holds and stores majority of iron readily available for future use?

Answer 80

Ferritin

Question 81

Which of the following is the characteristic change as megakaryoblast mature into megakaryocyte within the bone marrow?

Answer 81

Nuclear division without cytoplasmic division

Question 82

In performing CRT, what could be observed in the sample after 4 hours?

Answer 82

Clear yellow serum, red cells are well separated from the serum, red cell mass has been fully retracted

Question 83

Which teardrop-shaped poikilocyte can be observed in the peripheral blood smear of an individual with malignant infiltrative disorder in the bone marrow and rarely in autoimmune disorders?

Answer 83

Dacryocyte

Question 84

Which is the ratio of anticoagulant to whole blood in a citrated tube for coagulation testing?

Answer 84

1:9

Question 85

Which of the following conditions will show hyperextensible skin, hypermobility and laxity of joints, fragile tissues, presence of bleeding and subcutaneous hematoma?

Answer 85

Ehlers-Danlos Syndrome

Question 86

Which structure is present on the red cell membrane responsible for the repulsive electric zeta potential between other cells due to its negative charge?

Answer 86

Sialic acid

Question 87

What should be the volume of bleach and water when preparing a 1000mL 10% hypochlorite solution?

Answer 87

900mL and 100mL bleach

Question 88

Which is not a characteristic of hematopoietic growth factor?

Answer 88

Individual growth factor has single biologic activities

Question 89

Which of the following platelet receptors for collagen triggers aggregation?

Answer 89

GP VI

Question 90

In a laboratory, a medical technologist assigned in the hematology section performed a clot retraction time test, upon finishing the procedure, he observed that specimen has 27% of serum that is extruded. What result will be reflected in the laboratory workup?

Answer 90

Clot Retraction Time – 3+