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Medical Laboratory Technician Exam > Hematology > Flashcards

Hematology Flashcards

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USMLE® Step 1 flashcards
1
Q

Insufficient centrifugation will result in:
a. a false increase in hematocrit value
b. a flalse decrease in Hct value
c. no effect on Hct value
d. all of the above depending on the patient

A

a false increase in hematocrit value

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2
Q

Erythrocytes that vary in size from the normal 6-8 um are described as exhibiting
a. anisocytosis
b. hypochromia
c. poikilocytosis
d. pleocytosis

A

anisocytosis

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3
Q

Which of the following is the preferable site for bone marrow aspiration and biopsy in an adult?

A

Iliac crest

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4
Q

Mean cell volume (MCV) is calculated using what formula?

A

(Hct/RBC)x10

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5
Q

What term describes the change in shape of erythrocytes seen on a wright’s stained peripheral blood smear?

A

poikilocytosis

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6
Q

When an erythrocyte containing iron granules is stained with Prussian blue, the cell is called a:

A

Siderocytes

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7
Q

a 7.0 mL etheylenediaminetetraacetic acid (EDTA) tube is received in the laboratory containing only 2.0 mL of blood. If the laboratory is using manual techniques, which of the following tests will most likely be erroneous?
a. RBC count
b. Hemoglobin (Hgb)
c. Hct
d. WBC count

A

Hct [excessive anticoagulant causes shrinkage of cells thus the Hct will be affected. RBC and WBC counts remain the same as does the Hgb content.]

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8
Q

What phagocytic cells produce lysozyme that are bacteriocidal?
a. Eosinophils
b. lymphocytes
c. platelets
d. Neutrophils

A

Neutrophils

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9
Q

A decreased osmotic fragility test would be associated with which of the following conditions?
a. sickle cell anemia
b. hereditary spherocytosis
c. hemolytic disease of the newborn
d. acquired hemolytic anemia

A

Sickle cell anemia

[test is increased in the presence of spherocytes and decreased with sickle cells, target cells and poikilocytes]

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10
Q

What effect would using a buffer at pH 6.0 have on a wright’s stained smear?
a. red cells would be stained to pink
b. White cell cytoplasm would be stained too blue
c. red cells would be stained too blue
d. red cells would lyse on the slide

A

red cells would be stained too pink

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11
Q

Which of the following erythrocyte inclusions can be visualized with supra vital stain but cannot be detected on a wright’s stained blood smear?
a. basophilic stippling
b. Heinz bodies
c. Howell-jolly bodies
d. siderotic granules

A

Heinz bodies

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12
Q

A falsely elevated Hct is obtained. Which of the following calculated values will NOT be affected?
a. MCV
b. MCH
c. MCHC
d. Red cell distribution width (RDW)

A

MCH

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13
Q

A miller disk is an ocular device used to facilitate counting of:
a. platelets
b. reticulocytes
c. sickle cells
d. nucleated red blood cells

A

Reticulocytes

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14
Q

RBC indices obtained on a patient are as follows: MCV 88 um (fl); MCH 30 pg; MCHC 34%. The RBCs on the peripheral smear would appear:
a. microcytic, hypochromic
b. microcytic, normochromic
c. normocytic, normochromic
d. normocytic, hypochromic

A

Normocytic, normochromic
[because the MCV< MCH, and MCHC are all within the normal reference range

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15
Q

All of the following factors may influence the erythrocyte sedimentation rate (ESR) EXCEPT:
a. blood drawn into a sodium citrate tube
b. anisocytosis, poikilocytosis
c. plasma proteins
d. caliber of the tube

A

a. blood drawn into a sodium citrate tube

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16
Q

Which staining method is used most frequently to stain and count reticulocytes?
a. immunofluorescence
b. supra vital staining
c. romanowsky staining
d. cytochemical staining

A

b. supra vital staining

17
Q

The Coulter principle for counting of cells is based upon the fact that:
a. isotonic solutions conduct electricity better than cells do
b. conductivity varies proportionally to the number of cells
c. cells conduct electricity better than saline does
d. isotonic solutions cannot conduct electricity

A

Isotonic solutions conduct electricity better than cells do

18
Q

A correction is necessary for WBC counts when nucleated RBCs are seen on the peripherential smear because:
a. The WBC count would be falsely lower
b. The RBC count is to low
c. Nucleated RBCs are counted as leukocytes
d. Nucleated RBCs are confused with giant platelets

A

c. nucleated RBCs are counted as leukocytes

19
Q

Using a Coulter counter analyzer, an increased RDW should correlate with:
a. spherocytosis
b. anisocytosis
c. leukocytosis
d. presence of NRBCs

A

B. Anisocytosis

20
Q

Which of the following statistical terms reflects the best index of precision?
a. Mean
b. Median
c. coefficient of variation
d. standard deviation

A

C. Coefficient of variation

21
Q

Which of the following is considered a normal hemoglobin?
a. carboxyhemoglobin
b. methemoglobin
c. sulfahemoglobin
d. deoxyhemoglonin

A

d. deoxyhemoglobin
a physiological Hgb that results from the unloading of oxygen by Hgb. This is accompanied by the widening of the space between B chains and the binding of 2,3 DPG.

22
Q

Which condition will shift the oxyhemoglobin dissociated curve to the right?
a. acidosis
b. alkalosis
c. multiple blood transfusions
d. increased quantities of hemoglobin S or C

A

a. acidosis
acidosis is associated with a shift to the right of the oxyhemoglobin dissociation curve and therefore increased oxygen release (decreased affinity of Hgb for oxygen). Alkalosis does the opposite. Multiple blood transfusions shift the curve to the left because transfused blood is low in 2,3 DPG. Hgb S and Hgb C do not change the affinity of oxygen for hemoglobin. However man hemoglobinopathies do.

23
Q

What is the major type of leukocyte seen in the peripheral smear of a patient with aplastic anemia?
a. segmented neutrophil
b. lymphocyte
c. monocyte
d. eosinophil

A

b. lymphocyte…constitute the majority of the nucleated cells seen. The bone marrow in aplastic anemia is spotty with patches of normal cellularity. Absolute granulocytopenia is usually present; however, lymphocyte production is less affected

24
Q

What is the normal WBC differential lymphocyte percentage (range) in the adult population?
a. 20-50%
b. 10-20%
c. 5-10%
d. 50-70%

A

a. 20-50%. This range is higher in the pediatric population

25
Q

In which age group would 60% Lymphocytes be a normal finding?
a. 40-60 years
b. 11-15 years
c. 6 months - 2 years
d. 4-6 years

A

c. 6 months to 2 years
there is a relative neutropenia in children from ages 4 months to 4 years of age. Because of this, the percentage of lymphocytes is increased in this population. This is commonly referred to as a reversal in the normal differential percentage ( or inverted differential).

26
Q

Which of the following results on a automated differential suggests that a peripheral smear should be reviewed manually?
a. segs=70%
b. band=6%
c. Mono=15%
d. Eos=2%

A

c. Mono=15%
A relative monocyte count of 15% is abnormal, given that the baseline monocyte count in a normal differential is between 1-8%. An increased monocyte count may signal a myeloproliferative process such chronic myelomonocytic leukemia, an inflammatory response, or abnormal lymphocytes that may have been counted as monocytes by an automated cell counter.

27
Q

In which stage of erythrocytic maturation does Hgb formation begin?
a. reticulocyte
b. pronormoblast
c. basophilic normoblast
d. polychromatic normoblast

A

d. polychromatic normoblast
in normal erythrocyte maturation, Hgb formation begins in the polychromatic normoblast and is seen as a pink coloration of the cytoplasm. The red cell continues to produce Hgb through the reticulocyte stage of development

28
Q

Which of the following can shift the hemoglobin oxygen dissociation curve to the right?
a. increases in 2,3 DPG
b. Acidosis
c. hypoxia
d. all of the above1`

A

d. all of the above
increases in 2,3 DPG, acidosis, hypoxia and a rise in body temperature all shift the hemoglobin oxygen dissociation curve to the right. In anemia, although the number of RBCs is reduced, the cells are more efficient at oxygen delivery because there is an increase in red cell 2,3 DPG. This causes the oxyhemoglobin dissociation curve to shift to the right, allowing more oxygen to be released to the tissues

29
Q

Which of the following Hg configurations is characteristic of Hgb H?
a. gamma 4
b. alpha 2-gamma 2
c. Beta 4
d. alpha 2-beta 2

A

c. beta 4
the structure of Hgb H is beta 4. Hgb H disease is a severe clinical expression of alpha thalassemia in which only one alpha gene out of four is functioning

30
Q

Autoagglutination of red cells at room temperature can result in which of the following?
a. low RBC count
b. High MCV
c. Low hematocrit
d. All of the above

A

d. All of the above
autoagglutination at room temp may cause low RBC count and high Mcv from an electronic counter. The Hct will be low because it is calculated from the RBC count. Low RBC count and low Hct cause falsely high calculations of MCH and MCHC

Medical Laboratory Technician Exam (7 decks)

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