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Hema Flashcards

1
Q

As the red blood cell matures, the overall cell diameter:
a. Increases
b. Decreases
c. Remains the same
d. None of the above

A

b. Decreases

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2
Q

What is the immature erythrocyte found in the bone marrow with following characteristics: 12 to 17 mm in diameter, N:C ratio of 4:1, nucleoli not usually apparent, and basophilic cytoplasm?
a. Rubriblast
b. Reticulocyte
c. Metarubricyte
d. Prorubricyte

A

d. Prorubricyte

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3
Q

The alkaline denaturation test detects the presence of hemoglobin:
a. A1c
b. F
с. С
d. S

A

b. F → alkaline resistant

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4
Q

Paroxysmal nocturnal hemoglobinuria exhibits sensitivity of one population of red blood cells to:
a. Warm antibodies
b. Cold antibodies
c. Complement
d. Either A or B

A

c. Complement

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5
Q

Contains DNA or nuclear fragments:
a. Basophilic stippling
b. Howell-Jolly body
c. Heinz body
d. Pappenheimer bodies

A

b. Howell-Jolly body

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6
Q

What growth factors is produced by the kidneys and is used to treat anemia associated with kidney disease?
a. EPO
b. TPO
c. KIT ligand
d. G-CSF

A

a. EPO

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7
Q

If an alkaline pH 8.6 electrophoresis is performed, hemoglobin E has the same mobility as hemoglobin
A. S
B. F
C. A
D. C

A

D. C

A
F
SGD
A2CED

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8
Q

The average diameter of a normal erythrocyte is micrometer.
a. 5.2 um
b. 6.4 um
c. 7.2 um
d. 8.4 um

A

c. 7.2 um

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9
Q

The greatest portion of operational body iron is normally contained in what compound?
a Hemoglobin
b. ferritin
c. Cytochromes
d. Myoglobin

A

a. Hemoglobin

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10
Q

If globin synthesis is insufficient in a person, iron accumulates in the cell as ____ aggregates
a. Transferrin
b. Ferritin
c. Albumin
d. Heme

A

b. Ferritin

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11
Q

Increased amounts of 2,3-BPG, ______ the oxygen affinity of the hemoglobin molecule.
a. Increases
b. Decreases
c. Does not alter
d. None of the above

A

b. Decreases

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12
Q

Which of the following condition is characterized by the absence of CD55 (DAF) and CD59 (MIRL) on the surface of the RBs rendering the it susceptible to spontaneous lysis by complement?
a. PCH
b PNH
c. HUS
d. DIC

A

b. PNH

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13
Q

Physiologic programmed cell death:
a. Angiogenesis
b. Apoptosis
с. Necrosis
d. Apohematics

A

b. Apoptosis

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14
Q

The description of poikilocytosis is:
a. Variation in erythrocyte size
b. Larger than normal
c. Smaller than normal
d. Variation in erythrocyte shape

A

d. Variation in erythrocyte shape

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15
Q

If you are grading changes in erythrocytic size or shape using a scale of 0 to 4+ and many erythrocyte deviate from normal per microscopic field, the typical score would be
a. 1+
b. 2+
c. 3+
d. 4

A

c. 3+

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16
Q

Acanthocytes (Spur cells) may be associated with the clinical condition of:
a. Iron deficiency anemia
b. Abetalipoproteinemia
c. Pernicious anemia
d. None of the above

A

b. Abetalipoproteinemia

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17
Q
  1. Microspherocytes may be seen in:
    a. HD (Hepatic disease)
    b. HDFN (Hemolytic disease of the fetus and newborn)
    c. PA (Pernicious anemia)
    d. HB (Hemoglobinopathies)
A

b. HDFN (Hemolytic disease of the fetus and newborn)

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18
Q

What is the appropriate reagent for reticulocyte counting?
a. New methylene blue
b. Phloxine B
c. Solution that can lyse erythrocyte and darken the cell to be counted
d. None of the above

A

a. New methylene blue

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19
Q

In the preparation of films for reticulocyte counting, what is the ratio of blood to the stain?
a. 1:2
b. 2:1
c. 3:1
d. 1:1

A

d. 1:1

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20
Q

Disease characterized with a poikilocyte with membrane folded over (Fold cells):
a. Sickle cell anemia
b. Hemoglobin C disease
c. Hemoglobin H disease
d. Bart’s hemoglobin

A

b. Hemoglobin C disease

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21
Q

Schistocytes:
a. Fragmented RBC
b. RBC with no central pallor
c. Crenated RBC
d. Swollen RBC

A

a. Fragmented RBC

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22
Q

Bite cells:
a. PK deficiency
b. G6PD deficiency
c. PK and G6PD deficiency
d. None of the above

A

b. G6PD deficiency

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23
Q

A screening test for PNH is:
a. Heat instability test
b. Sucrose hemolysis test
c. Osmotic fragility
d. Dithionite solubility

A

b. Sucrose hemolysis test

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24
Q

Patient with thrombocytopenia, decrease in hemoglobin, fragmented RBCs. Which of the following diseases is the most probable cause?
a. HUS
b. ITP
с. HHT
d. None of the above

A

a. HUS

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25
Q

What is the formula for RDW?
a. SD x 100/ mean
b. HCT/RBC x 10
c. HGB/RBC x 10
d. HGB/HCT x 100

A

a. SD x 100/ mean

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26
Q

Which of the following metabolic pathway prevents oxidation of heme ron?
a. Embden-Meyerhof pathway
b. Hexose-monophosphate pathway
c. Methemoglobin reductase pathway
d. Luebering-Rapaport pathway

A

c. Methemoglobin reductase pathway

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27
Q

If the RBC distribution on a histogram demonstrates a homogenous pattern and a small SD, the periphera: blood smear would probably exhibit:
a. Extreme anisocytosis
b. Very little anisocytosis
c. A single population of spherocytes
d. A single population of macrocytes

A

b. Very little anisocytosis

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28
Q

430.The RDW and MCV are both quantitative descriptors of RBC size. If both are increased, the most probable erythrocytic abnormality would be:
a. Iron deficiency anemia
b. Acquired aplastic anemia
c. Megaloblastic anemia
d. Hemoglobinopathy

A

c. Megaloblastic anemia

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29
Q

What is the most common mechanism resulting in hereditary stomatocytosis?
a. A deficient cytoskeletal protein
b. Inability to repair oxidative stress damage
c. Abnormal Na+/K+ permeability
d. ATP depletion due to glycolytic enzyme deficiency

A

c. Abnormal Na+/K+ permeability

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30
Q

Azurophilic granules were produced in what stage?
a. Promyelocyte
b. Myelocyte
c. Metamyelocyte
d. Band

A

a. Promyelocyte

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31
Q

Cells that produces antibodies and lymphokines:
a. Erythrocytes
b. Granulocytes
c. Lymphocytes
d. Thrombocytes

A

c. Lymphocytes

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32
Q

Which one of the following cells is a product of the CLP?
a. Megakaryocytes
b. T lymphocyte
c. Erythrocyte
d. Granulocyte

A

b. T lymphocyte

CLP common lymphoid progenitor

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33
Q

In Gaucher disease, as the result of ß-glucocerebrosidase deficiency, what accumulates in (macrophages) histiocytes?
a. Glucocerebroside and sphingomyelin
b. Glucocerebroside
c. Sphingomyelin
d. None of the above

A

b. Glucocerebroside

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34
Q

Niemann-Pick disease affects which cell type?
a. Neutrophils
b. Lymphocytes
c. Erythrocytes
d. Platelets

A

b. Lymphocytes

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35
Q

Which antibody test has replaced the LE cell preparation in the diagnosis of SLE?
a. Rheumatoid arthritis factor
b. ANA test
c. Complement fixation test
d. Antibody Smith test

A

b. ANA test

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36
Q

The abnormal protein frequently found in the urine of persons with multiple myeloma is:
a. Albumin
b. Globulin
c. IgG
d. Bence Jones

A

d. Bence Jones

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37
Q

The WHO classification requires what percentage for the blast count in the blood or bone marrow for the diagnosis of AML?
a. At least 30%
b. At least 20%
c. At least 10%
d. Any percentage

A

b. At least 20%

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38
Q

Which of the following refers to the number, form, size, and arrangement of chromosomes within the nucleus?
a. Punnett squares
b. Karyotyping
c. Phage typing
d. None of the above

A

b. Karyotyping

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39
Q

Occur when there is a breakage in two chromosomes and each of the broken pieces reunites with another chromosomes:
a. Inversion
b. Translocation
c. Mutation
d. None of the above

A

b. Translocation

40
Q

What influence does the Philadelphia (Ph1) chromosome have on the prognosis of patients with CML?
a. It is not predictive
b. The prognosis is better if Ph1 is present
c. The prognosis is worse if Ph1 is present
d. The disease usually transforms into AML when Ph1 is present

A

b. The prognosis is better if Ph1 is present

41
Q

An acute leukemia can be described as being:
a. of short duration with many mature leukocyte forms in the peripheral blood
b. of short duration with many immature leukocyte forms in the peripheral blood
c. of short duration with little alteration of the leukocytes of the peripheral blood
d. of long duration with many mature leukocyte forms in the peripheral blood

A

b. of short duration with many immature leukocyte forms in the peripheral blood

42
Q

Hematopoietic stem cells produce all lineages of blood cells in sufficient quantities over the lifetime of an individual because they:
a. Are unipotent
b. Have the ability of self-renewal by asymmetric division
c. Are present in large numbers in the bine marrow niches
d. Have a low mitotic potential in response to growth factors.

A

b. Have the ability of self-renewal by asymmetric division

43
Q

Promyelocytes predominate in the bone marrow:
A. M1
B. M2
C. M3
D. M4

A

C. M3

44
Q

Which of the cytokine has the current/potential therapeutic application as an adjuvant for infectious disease therapy?

a. IL-3
b. GM-CSF
c. IL-12
d. IFN-a

A

c. IL-12

45
Q

Three-part differential:
a. Lymphocytes, monocytes, and granulocytes
b. Lymphocytes, mononuclear, and granulocytes
c. Lymphocytes, monocytes, neutrophil
d. Lymphocyte, monocyte, neutrophil, eosinophil

A

a. Lymphocytes, monocytes, and granulocytes

46
Q

Electrical impedance principle of cell counting was originally developed by:
a. Coulter
b. Abbott
c. Beckman
d. Sysmex

A

a. Coulter

47
Q

In the photo-optical method, the change in light transmission versus the
is used to determine
the activity of coagulation factors or stages.
a. amount of patient’s plasma
b. amount of test reagent
c. time
d. temperature

A

c. time

48
Q

When a specimen has been flagged as being icteric by an automated coagulation analyzer, which method would be most susceptible to erroneous results because of interfering substance?
a. Mechanical clot detection
b. Immunologic antigen-antibody reaction detection
c. Photo-optical clot detection
d. Chromogenic end-point detection

A

c. Photo-optical clot detection

49
Q

The abbreviation laser
stands for
a. light-associated simulated emission of radiation
b. largely amplified by simulated emission of radiation
c. light amplified by stimulated emission of radiation
d. liquid amplified by stimulated emission of radiation

A

c. light amplified by stimulated emission of radiation

50
Q

Which parameters are calculated rather than directly measured?
a. Hematocrit and erythrocyte distribution width
b. Erythrocyte count and leukocyte count
c. Leukocyte count and hematocrit
d. Platelet count and platelet volume

A

a. Hematocrit and erythrocyte distribution width

51
Q

In an erythrocyte histogram, the erythrocytes that are larger than normal will be to the _____ of the normal distribution curve.
a. Right
b. Left
c. In the middle
d. Bimodal

A

a. Right

52
Q

The majow application of flow-cytometry is:
a. Determing cell size and granularity
b. Sorting of cells and cellular identification using monoclonal antibodies
c. Treating cancer cells and identifying specific virus types
d. Counting leukocytes and platelets

A

b. Sorting of cells and cellular identification using monoclonal antibodies

53
Q

A combined scatter histogram measure:
a. Overall size versus nuclear size
b. Cell size and granularity
c. Cell shape and cytoplasmic color
d. Cytoplasm to nucleus ratio

A

b. Cell size and granularity

54
Q

What is the principle of mechanical endpoint detection in coagulation instruments:
a. Decrease in light transmittance as fibrin forms
b. Increase in light absorbance as latex particles coated with sepcific antibody are agglutinated by antigen
c. Increase in light absorbance at 405 nm as para-nitroaniline is cleaved from synthetic substrate by the coagulation enzyme
d. Change in movement of steel ball when clot forms

A

d. Change in movement of steel ball when clot forms

55
Q

Anticoagulant to avoid platelet satellitism:
a. EDTA
b. Oxalate
c. Citrate
d. Heparin

A

C. Citrate then mutiply by 1.1

56
Q

Which characterisit is inaccurate with respect to the anticoagulant K3 EDTA?
a. Removes ionized calcium from fresh whole blood by the procss of chelation
b. Is the most commonly used anticoagualnt in hematology
c. Is conventionally placed in lavender-stoppered tubes.
d. Is used for most routine coagulation studies

A

d. Is used for most routine coagulation studies

57
Q

If a blood smear stains too red on microscopic examination of Wright-stained preparation, possible causes include that:
a. The staining time was too long
b. The stain was too basic
c. The buffer was too acidic and the exposure time was too short
d. The buffer was too basic and the exposure time was too long

A

c. The buffer was too acidic and the exposure time was too short

58
Q

Acceptable limits of control value must fall:
a. Within ‡1SD of the mean
b. Within 1 and 2 SD of the mean c. Within +2 SD of the mean
d. Within 13 SD of the mean

A

c. Within +2 SD of the mean

59
Q

The delta check method of quality control
a. uses the patient’s own data to monitor population values
b. uses batches of 20 samples to track MCV, MCH, and MCHC values
c. compares the patient’s leukocyte and platelet counts with his or her previous results
d. monitors the patient’s values within two SDs of the mean

A

c. compares the patient’s leukocyte and platelet counts with his or her previous results

60
Q

The reagent used in the traditional sickle screening test is:
a. Sodium chloride
b. Sodium metabisulfite
d. Sodium citrate
d. None of the above

A

b. Sodium metabisulfite

61
Q

What clinical condition will produce a decreased.
Westergren ESR value? a a.Polycythemia vera
b. Acute leukemia
c. Viral infection
d. Megaloblastic anemia.

A

a.Polycythemia vera

62
Q

What is the appropriate procedure and characteristic for the Westergren method?
a. The diluting solution lyses erythrocytes with propylene glycol and contains sodium carbonate and water.
b. The procedure measures the rate of erythrocyte settling.
c. Ferrous ions are oxidized to the ferric state.
d. The diluting solution is either 1% HCI or 2% acetic acid.

A

b. The procedure measures the rate of erythrocyte settling

63
Q

Which test is most affected when there is excessive anticoagulant?
a. RBC counf
b. ESR
c. Hemoglobin
d.Hematocrit

A

d.Hematocrit

Shrink RBC

64
Q

The normal range for reticulocytes in adults is:
a. 0 to 0.5%
b: 0.5% to 1.0%
c. 0.5% to 1.5%
d. 1.5% to 2.5%

A

c. 0.5% to 1.5%

65
Q

Using white blood cell as the reference, what is the effect of leukocytosis in the ESR?
a. Increased
b. Decreased
c. Variable
d. None of the above

A

b. Decreased

66
Q

Megakaryopoiesis is associated with:
a. Endomitosis
b. Meiosis
c. Mitosis
d. None of the above

A

a. Endomitosis

67
Q

The cellular ultrastructural component unique to platelet is:
a. Cytoplasmic membrane
b. Mitochondria
c. Microtubules
d. Glycocalyx

A

d. Glycocalyx

68
Q

Platelet aggregation will occur with the end product of:
a. Cyclooxygenase
bThrombofare
b. Arachidonic acid
c. Prostacyclin
d. Thromboxane A2

A

d. Thromboxane A2

69
Q

Which of the following blood film findings indicates EDTA-induced pseudo thrombocytopenia?
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

A

b. The platelets are adhering to WBCs

70
Q

Agents that are capable of aggregating platelets include:
a. Collagen
b. Thrombin
c. Serotonin
d. All of the above

A

d. All of the above

71
Q

Which organ is the site of sequestration of platelets?
a. Liver
b. Thymus
C. Spleen
d. Bone marrow

A

C. Spleen

72
Q

An example of an acquired platelet dysfunction:
a. Uremia
b. von Willebrand’s disease
c. Aspirin ingestion
d. None of the above

A

A. Uremia

73
Q

The clot retraction test is:
a. A visible reaction to the activation of platelet actomyosin (thrombasthenin)
b. A reflection of the quantity and quality of platelets and other factors
c. A measurement of the ability of platelets to stick to glass
d. A measurement of the cloudiness of blood

A

b. A reflection of the quantity and quality of platelets and other factors

74
Q

The bleeding time test measures a. the ability of platelets to stick together
b. platelet adhesion and aggregation on locally injured vascular subendothelium
c. the quantity and quality of platelets
d. antibodies against platelets

A

b. platelet adhesion and aggregation on locally injured vascular subendothelium

75
Q

Fletcher factor:
a. Prekallikrein
b. HMWK
c. Factor XI
d. Factor XII

A
76
Q

Which clotting factors (cofactors) are inhibited by protein S?
a. Factor V and X
b. Factor Va and VIlla
c. Factor VIII and IX
d. Factor VIlI and X

A

b. Factor Va and VIlla

77
Q

Refer to the following results:
PT= prolonged
APTT= prolonged
PLT count= decreased
Which disorder may be indicated?
a. Factor VIII deficiency
b. von Willebrand disease
c. Disseminated intravascular coagulation
d. Factor IX deficiency Lo consumption coastupathy

A

c. Disseminated intravascular coagulation

78
Q

The function of thromboplastin in the prothrombin test is to provide ____to the assay.
a. Kaolin
b. Fibrinogen
c. Phospholipoprotein
d. Thrombin

A

c. Phospholipoprotein

79
Q

The intrinsic pathway of coagulation beings with
Incog Lectures
a. Factor II
b. Factor I
c. Factor XII
d. Factor V

A

c. Factor XII

80
Q

Abnormal results in dysfibrinogenemia, except:
a. PT 4
b. aPTT
c. TT
d. Fibrinogen level

A

d. Fibrinogen level

81
Q

Single factor deficiency with normal PT, PTT, and TCT:
a. I
b. XI
c. XIII
d. II

A

c. XIII

82
Q

PT is performed in what temperature?
a. 4 degrees Celsius
b. 20 degrees Celsius
c. 37 degrees Celsius
d. 38 degrees Celsius

A

c. 37 degrees celsius

83
Q

If a child ingested rat poison, which of the following tests should be performed to test the effect of the poison on the child’s coagulation mechanism?
a. aPTT
b. PT
c. Fibrinogen assay
d. None of the above

A

b. PT

84
Q

The deficient factor is factor VIII. What would be the result for PT, PTT, and TCT, respectively, using clot-based screening assays?
a. Normal, prolonged, normal
b. Prolonged, prolonged, prolonged
c. Prolonged, normal, normal
d. Prolonged, normal, prolonged

A

a. Normal, prolonged, normal

85
Q

Fibrinogen level in patients with hemophilia A, B and C?
a. Decreased, normal, decreased
b Normal, normal, normal
C. Decreased, decreased, decreased
d. Normal, decreased, decreased

A

b Normal, normal, normal

86
Q

Fibrinogen level in patients with primary and secondary fibrinolysis?
a. Normal, normal
b. Decreased, decreased
c. Normal, decreased
d. Decreased, normal

A

b. Decreased, decreased

87
Q

Conditions associated with disseminated intravascular coagulation can be grouped by mechanism. Which of the following is an example of endotoxins that activate cytokine?
a. Hypovolemic and hemorrhagic shock
b. Bacterial, protozoal, fungal, and viral infections
c. Graft rejection
d. Snake or spider envenomation

A

b. Bacterial, protozoal, fungal, and viral infections

88
Q

If a pediatric preoperative patient has a family history of bleeding but has never had a bleeding episode herself, what test should be included in a coagulation profile in addition to the PT, aPTT, and platelet count?
a. Lee-White clotting time
b. Clot retraction
c. Bleeding time
d. Fibrin split products

A

c. Bleeding time

89
Q

Which of the following parameters can be
NORMAL in classic von Willebrand disease type 1?
a. Bleeding time
b. aPTT
c. Platelet count
d. All of the above

A

c. Platelet count

90
Q

Which of the following demonstrates the
SMALLEST platelet seen?
a. May Hegglin
b. Bernard Soulier
c. Alport syndrome
d. Wiskott-Aldrich

A

d. Wiskott-Aldrich

91
Q

Which of the following demonstrates the
LARGEST platelets seen and is also referred to as giant platelet syndrome?
a. May Hegglin
b. Bernard Soulier
c. Alport syndrome
d. Wiskott-Aldrich

A

b. Bernard Soulier

92
Q

The final common pathway of the intrinsic-extrinsic pathway is: a. Factor X activation
b. Factor Il activation
c. Factor I activation
d. Factor XIII activation

A

a. Factor X activation

93
Q

Which of the following is a transglutaminase:
a. Factor V
b. Factor XIII
c. HMWK
d. Factor VIII

A

b. Factor XIII

94
Q

Fitzgerald factor:
a. Factor I
b. Prekallikrein
c. HMWK
d. Factor VIII

A

c. HMWK

95
Q

Major categories of thrombocytosis are
associated with which of the following?
1. Germline mutation of the thrombopoietin gene
2. Somatic mutation of JAK2
3. Reactive conditions
a. 1 and 3
b.1, 2, and 3
c. 1 and 2
d. 3 and 4

A

b.1, 2, and 3

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