HEMA - Kalog Quiz 1 Flashcards by Marielle Tristine

EDTA-induced pseudothrombocytopenia can be identified on blood smear by:

a. Finding platelets pushed to the feathered end
b. Finding platelets adhering to WBCs
c. Finding no platelets at all on the smear
d. Bluish discoloration to the macroscopic appearance of the slide

b. Finding platelets adhering to WBCs

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Which ratio of anticoagulant to blood is correct for coagulation procedures?

a. 1:4
b. 1:5
c. 1:9
d. 1:10

c. 1:9

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The bevel of the needle should be held _____ in the performance of a venipuncture.

a. Sideways
b. Upward
c. Downward
d. In any direction

b. Upward

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Most common complication encountered in obtaining a blood specimen:

a. Ecchymosis (bruise)
b. Hematoma
c. Hemoconcentration
d. Anemia

a. Ecchymosis (bruise)

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Blood collection tubes are labeled:

a. As soon as the test order is received
b. Before the specimen is even collected
c. Immediately after specimen collection
d. After returning to the laboratory

c. Immediately after specimen collection

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A blood sample is needed from a patient with IV fluids running in both arms. Which of the following is an acceptable procedure?

a. Any obtainable vein is satisfactory.
b. Obtain sample from above the IV site.
c. Obtain sample from below the IV site with special restrictions.
d. Disconnect the IV line.

c. Obtain sample from below the IV site with special restrictions.

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The recommended cleaner for removing oil from objectives is:

a. 70% alcohol or lens cleaner
b. Xylene
c. Water
d. Benzene

a. 70% alcohol or lens cleaner

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Blood drop size in the manual wedge technique:

a. 1 to 2 mm in diameter
b. 2 to 3 mm in diameter
c. 4 to 5 mm in diameter
d. 5 to 6 mm in diameter

b. 2 to 3 mm in diameter

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In the preparing wedge smear from blood samples of polycythemic patients, the angle between the two slides should be:

a. 25
b. 30
c. 35
d. 45

a. 25

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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. Slide was overstained
b. Stain was too alkaline
c. Buffer was too acidic
d. Slide was not rinsed adequately

c. Buffer was too acidic

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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

a. Rouleaux

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The normal sequence of blood cell development is:

a. Yolk sac—red bone marrow—liver and spleen
b. Yolk sac—thymus—liver and spleen—red bone marrow
c. Yolk sac—liver and spleen—red bone marrow
d. Liver and spleen—yolk sac—red

c. Yolk sac—liver and spleen—red bone marrow

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The best source of acttive bone marrow from a 20-year old would be:

a. Iliac crest
b. Femur
c. Distal radius
d. Tibia

a. Iliac crest

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Primary target cells of G-CSF, EXCEPT:
a. Fibroblasts
b. Leukemic myeloblasts
c. Neutrophil precursors
d. T and B cells

d. T and B cells

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Bone marrow cellularity refers to the ratio of:

a. Red cell precursors to white cell precursors
b. Hematopoietic tissue to adipose tissue
c. Granulocytic cells to erythrocytic cells
d. Extravascular tissue to intravascular

b. Hematopoietic tissue to adipose tissue

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What is the recommended order of draw when the evacuated tube system is used?

a. Gel separator, nonadditive, coagulation, and blood culture
b. Additive, nonadditive, gel separator, and blood culture
c. Nonadditive, blood culture, coagulation, and other additives
d. Blood culture, coagulation, nonadditive, and gel separator or other additives

d. Blood culture, coagulation, nonadditive, and gel separator or other additives

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The most important step in phlebotomy is:

a. Cleansing the site
b. Identifying the patient
c. Selecting the proper needle length
d. Using the correct evacuated tube

b. Identifying the patient

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Which of the following skin puncture areas is (are) acceptable for the collection of capillary blood from an infant?

a. Previous puncture site
b. Posterior curve of the heel
c. The arch
d. Medial or lateral plantar surface

d. Medial or lateral plantar surface

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Vein of choice for performing a venipuncture is the:

a. Basilic
b. Cephalic or accessory cephalic
c. Median or median cubital
d. One of the hand veins

c. Median or median cubital

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Which characteristic is inaccurate with respect to the anticoagulant K3 EDTA?

a. Removes ionized calcium (Ca2+) from fresh whole blood by the process of
chelation
b. Is used for most routine coagulation studies
c. Is the most commonly used anticoagulant in hematology
d. Is conventionally placed in lavender-stoppered evacuated tubes

b. Is used for most routine coagulation studies

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Number of inversions of light blue top evacuated tube:

a. None
b. 3 to 4
c. 5 to 6
d. 8

c. Median or median cubital

Adjuvant for infectious disease therapy

a. Interleukin 2
b. Interleukin 3
c. Interleukin 6
d. Interleukin 12

d. Interleukin 12

All of the following are examples of pre-analytical errors, EXCEPT:

a. Specimen obtained from the wrong patient
b. Specimen collected in the wrong tube or container
c. Incorrect labeling of specimen
d. Failure to report critical values immediately

c. Incorrect labeling of specimen

Heel punctures in infants should not be made more than __ mm deep because of the risk of bone injury and possible infection (osteomyelitis).

a. Not more than 1 mm deep
b. Not more than 2 mm deep
c. Not more than 3 mm deep
d. Not more than 5 mm deep

b. Not more than 2 mm deep

25. Counterproductive smear drying technique because the moisture causes RBCs to become echinocytic (crenated) or to develop water artifact (also called drying artifact): a. Natural drying b. Use of small fan c. Blowing of breath d. None of these

c. Blowing of breath

26. Which of the following best describes the function of the Rapoport Luebering pathway? a. It produces ATP to help maintain RBC membrane deformability b. It results in reduction of glutathione c. It produces 2,3 diphosphoglycerate (2,3 DPG) d. It produces cytochrome reductase

c. It produces 2,3 diphosphoglycerate (2,3 DPG)

27. Which conditions will shift the oxyhemoglobin dissociation curve to the right? a. Acidosis b. Alkalosis c. Multiple blood transfusions d. Increased quantities of hemoglobin S or C

a. Acidosis

28. What is the last nucleated stage in development of erythrocyte? a. Prorubricyte b. Rubricyte c. Metarubricyte d. Reticulocyte

c. Metarubricyte

29. Which one of the following morphologic changes occurs during normal blood cell maturation? a. Increase in cell diameter b. Development of cytoplasmic basophilia c. Condensation of nuclear chromatin d. Appearance of nucleoli

c. Condensation of nuclear chromatin

30. Bite cells are usually seen in patients with: a. Rh null disease b. Chronic granulomatous disease c. G6PD deficiency d. Pyruvate kinase deficiency

c. G6PD deficiency

31. Which of the following organs is responsible for the “pitting process” for RBCs? a. Liver b. Spleen c. Kidney d. Lymph nodes

b. Spleen

32. A hemoglobin molecule is composed of: a. 4 heme, 4 globin, 2 iron b. 2 heme, 2 globin, 2 iron c. 4 heme, 4 globin, 4 iron d. 4 heme, 2 globin, 2 iron

c. 4 heme, 4 globin, 4 iron

33. Schistocytes, ovalocytes, and acanthocytes are examples of abnormal changes in RBC: a. Volume b. Shape c. Inclusions d. Hemoglobin concentration

b. Shape

34. A morphological description of echinocytes is: a. short, scalloped, or spike-like projections that are regularly distributed around the cell b. fragments of erythrocytes c. the scooped-out part of an erythrocyte that remains after a blister cell ruptures d. compact round shape

a. short, scalloped, or spike-like projections that are regularly distributed around the cell

35. Which of the following is decreased in cases of intravascular hemolytic anemia? a. Bilirubin b. Urine hemosiderin c. Haptoglobin d. Serum hemoglobin

c. Haptoglobin

36. The maturational sequence(s) of the erythrocyte is (are): a. Rubriblast—prorubricyte—metarubricyte—rubricyte—reticulocyte—mature erythrocyte b. Rubriblast—prorubricyte—rubricyte—metarubricyte—reticulocyte—mature erythrocyte c. Pronormoblast—basophilic normoblast—polychromatophilic normoblast—orthochromic normoblast—reticulocyte—mature erythrocyte d. Both B and C

d. Both B and C

37. With a normal diet, an erythrocyte remains in the reticulocyte stage in the circulating blood for: a. 1 day b. 2.5 days c. 3 days d. 120 days

a. 1 day

38. In a Wright-stained peripheral blood film, the reticulocyte will have a blue appearance. This is referred to as: a. Megaloblastic maturation b. Bluemia c. Polychromatophilia d. Erythroblastosis

c. Polychromatophilia

39. The final steps in heme synthesis, including the formation of protoporphyrin take place in: a. Cell’s nucleus b. Cell’s cytoplasm c. Spleen d. Mitochondria

d. Mitochondria

40. In an alkaline pH (pH of 8.6) electrophoresis is performed, hemoglobin E has the same mobility as hemoglobin: a. S b. F c. A d. C

d. C

41. The type of hemoglobin that is detectable with the Kleihauer-Betke test is: a. A b. A2 c. F d. S

c. F

42. Basophilic stippling represents: a. DNA b. Precipitated denatured hemoglobin c. Granules of ribosomes and RNA d. Aggregates of iron, mitochondria and ribosomes

c. Granules of ribosomes and RNA

43. The most versatile type of stem cell, can develop into any human cell type, including development from embryo into fetus: a. Multipotential stem cell b. Pluripotential stem cell c. Totipotential stem cell d. Semipotential stem cell

c. Totipotential stem cell

44. What is the normal distribution of hemoglobin in healthy adults? a. 80% to 90% Hb A, 5% to 10% Hb A2, 1% to 5% Hb F b. 80% to 90% Hb A2, 5% to 10% Hb A, 1% to 5% Hb F c. Greater than 95% Hb A, less than 3.5% Hb A2, 1% to 2% Hb F d. Greater than 90% Hb A, 5% Hb F, less than 5% Hb A2

c. Greater than 95% Hb A, less than 3.5% Hb A2, 1% to 2% Hb F

45. Which of the following is considered a normal hemoglobin? a. Carboxyhemoglobin b. Methemoglobin c. Sulfhemoglobin d. Deoxyhemoglobin

d. Deoxyhemoglobin

46. Which of the following hemoglobins migrates to the same position as Hgb A2 at pH 8.6? a. Hgb H b. Hgb F c. Hgb C d. Hgb S

c. Hgb C

47. What staining method is used most frequently to stain and manually count reticulocytes? a. Immunofluorescence b. Supravital staining c. Romanowsky staining d. Cytochemical staining

b. Supravital staining

48. As a blood cell matures, the ratio of nucleus to cytoplasm (N:C) in most cases: a. Increases b. Decreases c. Remains the same d. Variable

b. Decreases

49. Apoptosis: 1. Cell size enlarged due to swelling 2. Cell size reduced due to shrinkage 3. Nucleus condensation and fragmentation 4. Nucleus exhibits random breaks and lysis (karyolysis) a. 1 and 3 b. 1 and 4 c. 2 and 3 d. 2 and 4

c. 2 and 3

50. The positive predictive value predicts the probability that an individual with a positive assay result ____ the disease or condition. a. Has (have) b. Could have c. May have d. Will have

a. Has (have)