Hematology Flashcards by Jillian Jarrell

How does GPIb become activated in vivo and in vitro, respectively?

shear force, ristocetin

ristocetin, compression

activation of ADP receptor, ristocetin

binding vWF, epinephrine

shear force, ristocetin

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The M:E ratio in polycythemia vera is usually:

4:1

10:1

50:1

75:15

4:1

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Alloantibodies are found in:

congenital hemophilia

acquired hemophilia

congenital von Willebrand disease

acquired von Willebrand disease

congenital hemophilia

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A pediatric cardiac patient presents with a prolonged PT= 18.1 sec (11.5-13.5 sec) and an abnormal aPTT = 51 sec (25-35 sec) with a normal platelet count. Symptoms include bruising and nosebleeds. This is the patients third cardiac surgery, and previously all coagulation results have been normal. A mixing study does not correct for both the PT and aPTT. What should be considered next?

lupus anticoagulant
acquired factor inhibitor
-dysfibrinogenemia
DIC evaluation

acquired factor inhibitor

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A patient with a clot presents with the results shown in this table:

DIC
hypofibrinogenemia
dysfibrinogenemia
afibrinogenemia

dysfibrinogenemia

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Patients with chronic granulomatous disease suffer from frequent pyogenic infections due to the inability of:

lymphocytes to produce bacterial antibodies

eosinophils to degranulate in the presence of bacteria

neutrophils to kill phagocytized bacteria

basophils to release histamine in the presence of bacteria

neutrophils to kill phagocytized bacteria

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The type of vWD that has enhanced ristocetin activity is:

type 2A

type 2B

type 2M

type 2N

type 2B

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The disease most closely associated with cytoplasmic granule fusion is:

Chédiak-Higashi syndrome

Pelger-Huët anomaly

May-Hegglin anomaly

Alder-Reilly anomaly

Chédiak-Higashi syndrome

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A 60-year-old man has a painful right knee and a slightly enlarged spleen. Hematology results include:
This is most compatible with:

congenital spherocytosis

rheumatoid arthritis with reactive thrombocytosis

myelofibrosis

idiopathic thrombocythemia (essential or primary)

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A useful chemical test for the diagnosis of hairy cell leukemia is the:

peroxidase test

Sudan black test

periodic acid-Schiff test

tartrate-resistant acid phosphatase test

tartrate-resistant acid phosphatase test (TRAP)

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The presence of HbH may be demonstrated by:

Prussian blue stain

Wright stain

Giemsa stain

brilliant cresyl blue

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A patient has been taking aspirin regularly for arthritic pain. Which one of the following tests is most likely to be abnormal in this patient?

platelet count

PFA-100

prothrombin time

activated partial thromboplastin time

PFA-100

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Chronic lymphocytic leukemia is defined as a(n):

malignancy of the thymus

accumulation of prolymphocytes

accumulation of hairy cells in the spleen

accumulation of monoclonal B cells

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What is the most common cause of inherited thrombophilia?

antiphospholipid syndrome

prothrombin G20210A mutation

factor V Leiden

hyperhomocysteinemia

factor V Leiden

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Which of the RBC indices is a measure of the amount of hemoglobin in individual red blood cells?

MCHC

MCV

HCT

MCH

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A patient has been treated for a malignant tumor for several years. His blood smear now shows:

-oval macrocytes
-Howell-Jolly bodies
h-ypersegmented neutrophils
-large, agranular platelets

The most probable cause of this blood picture is:

iron deficiency
alcoholism
dietary B12 deficiency
chemotherapy

chemotherapy

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A 65-year-old multiple myeloma patient presents with bruising and hematuria. PT is normal and aPTT and thrombin time are prolonged and do not correct with a mixing study. Fibrinogen and reptilase times are normal. This may be caused by:

heparin-like anticoagulant

acquired vitamin K deficiency

factor deficiency

factor Inhibitor

heparin-like anticoagulant

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In a patient with an increased red cell mass into the 99th percentile and serum erythropoietin level below reference range for normal, which of the following criteria confirms a diagnosis of polycythemia vera?

bone marrow panmyelosis

inv(16) mutation

JAK2 V617F mutation

BCR/ABL1 translocation

JAK2 V617F mutation

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Heinz bodies are:

readily identified with polychrome stains

remnants of RNA

closely associated with spherocytes

denatured hemoglobin inclusions

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The principle of platelet aggregation is based on:

decreased light transmission

increased light transmission

decreased light absorbance

increased light absorbance

increased light transmission

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A flag of immature granulocytes (IG) is reported from a hematology analyzer. The next step is to perform a(an):

auto verification

smear review

manual differential

pathology review

manual differential

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Which of the following hemoglobinopathies is associated with rod shaped crystals?

HbS

HbC

HbSC

HbD

HbC

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This AML with recurrent cytogenetic abnormality often presents with disseminated intravascular coagulation:

inv(3)

t(6;9)

t(8;21)

t(15;17)

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A patient sample has been tested in the routine laboratory with a PT and an aPTT. Six hours later factor assays are ordered on the same sample. Which factor is the most labile?

VII

VIII

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Occasional spontaneous bleeding may occur in a hemophiliac who is classified as: acquired mild moderate severe

moderate

In HELLP syndrome patients present with: normal liver enzymes elevated platelets high blood pressure hemochromatosis

high blood pressure

Disorders of platelet aggregation are found in: von Willebrand disease Bernard-Soulier Glanzmann thrombasthenia storage pool deficiency

Glanzmann thrombasthenia

In comparison to malignant lymphocytes, reactive lymphocytes: have a denser nuclear chromatin have a regular cell shape have more cytoplasm and more mitochondria are morphologically more variable throughout the smear

are morphologically more variable throughout the smear

Biological assays for antithrombin (AT) are based on the inhibition of: factor VIII heparin serine proteases anti-AT globulin

serine proteases

Which of the following is used for staining reticulocytes? Giemsa stain Wright stain new methylene blue Prussian blue

new methylene blue

Which of the following values is calculated from the red blood cell indices in an automated hematology analzyer? red blood cell count (RBC) hematocrit (HCT) mean corpuscular volume (MCV) red cell distribution width (RDW)

hematocrit (HCT)

Which of the following statements about hemoglobins D and G is true? they are clinically abnormal they both migrate with HbS on alkaline gel they are both caused by mutations in the beta-globin gene they cannot be separated by solubility testing

they both migrate with HbS on alkaline gel

Biochemical abnormalities characteristic of polycythemia vera include: increased serum B12 binding capacity hypouricemia hypohistaminemia increased erythropoietin

increased erythropoietin

Which of the following is a WHO classification of myelodysplastic syndrome? chronic myelomonocytic leukemia (CMML) MDS with low blasts refractory anemia with excessive blasts (RAEB) refractory neutrophilia

MDS with low blasts

Which substrate is used for the detection of specific esterase? acetate chloroacetate pararosanilin acetate phenylene diacetate

chloroacetate

A bone marrow shows foam cells ranging from 20 - 100 µm, vacuolated cytoplasm containing sphingomyelin and faint PAS positivity. This cell type is most characteristic of: Gaucher disease myeloma with Russell bodies DiGuglielmo disease Niemann-Pick disease

Niemann-Pick disease

Which of the following are found in association with megaloblastic anemia? neutropenia and thrombocytopenia decreased LD activity increased erythrocyte folate levels decreased plasma bilirubin levels

neutropenia and thrombocytopenia

A 30-year-old man who had been diagnosed as having leukemia 2 years previously is readmitted because of cervical lymphadenopathy. Laboratory findings are shown in this table: These results are most consistent with: acute myeloid leukemia erythroleukemia chronic myelogenous leukemia (CML) CML in blast transformation

CML in blast transformation

A 56-year-old man is admitted to the hospital for treatment of a bleeding ulcer. The laboratory data shown in this table are obtained: Examination of the bone marrow reveals the absence of iron stores. This data is most consistent with which of these conditions? iron deficiency anemia anemia of chronic inflammation hemochromatosis acute blood loss

iron deficiency anemia

The calculated erythrocyte indices on an adult man are MCV = 89 fL, MCH = 29 pg and MCHC = 38%. The calculations have been rechecked; erythrocytes on the peripheral blood smear appear normocytic and normochromic with no abnormal forms. The next step is to: report the results examine another smear repeat the hemoglobin and hematocrit repeat the erythrocyte count and hematocrit

repeat the hemoglobin and hematocrit

Heparin induced thrombocytopenia (HIT) is an immune mediated complication associated with heparin therapy. Antibodies are produced against: ACLA PF4 AT B2GP1

PF4

The disease most frequently present in patients with reactive lymphocytosis and persistently negative heterophile antibody tests is: toxoplasmosis cytomegalovirus (CMV) infection herpes virus infection viral hepatitis

cytomegalovirus (CMV) infection

A newborn baby boy is known to have a homozygous protein C deficiency. This puts him at a risk for: DVT warfarin induced skin necrosis increased risk of thrombosis purpura fulminans

purpura fulminans

One of the major glands in an infant primarily responsible for producing lymphocytes is the: thymus adrenal thyroid pituitary

thymus

The major serine protease responsible for clot breakdown is: TPA alpha-2 antiplasmin streptokinase PAI-1

TPA

Which of the following cytokines is most responsible for eosinophil differentiation and release from the bone marrow? IL-1 IL-2 IL-4 IL-5

IL-5

Which of the following is most closely associated with acute promyelocytic leukemia? ringed sideroblasts disseminated intravascular coagulation micromegakaryocytes Philadelphia chromosome

disseminated intravascular coagulation

Hemoglobin H disease results from: absence of 3 of 4 alpha genes absence of 2 of 4 alpha genes absence of 1 of 1 alpha genes absence of all 4 alpha genes

absence of 3 of 4 alpha genes

The cell in the center of the photomicrograph is a: Promyelocyte lymphocyte neutrophil monocyte

Monocyte (beware there are punched out vacuoles AND red dots on this...it doesn't look like a mono to me)

Given the data in this table, what is the absolute lymphocyte count? Table: WBC 8.5 x 10^3 uL Neutrophils 56% Bands 2% Lymphs 30% Monos 6% Eos. 6% 170/µL (0.17 × 109/L) 510/µL (0.51 × 109/L) 2550/µL (2.55 × 109/L) 4760/µL (4.76 × 109/L)

2550/µL (2.55 × 109/L)

In most cases of hereditary persistence of fetal hemoglobin (HPFH): hemoglobin F is unevenly distributed throughout the erythrocytes the black heterozygote has 75% hemoglobin F beta- and gamma-chain synthesis is decreased gamma-chain production equals alpha-chain production

gamma-chain production equals alpha-chain production

What cell shape is most commonly associated with an increased MCHC? teardrop cells target cells spherocytes sickle cells

spherocytes

Which of the following is most closely associated with idiopathic hemochromatosis? iron overload in tissue target cells Cabot rings ringed sideroblasts

iron overload in tissue

What is the most common presentation of acute erythroid leukemia? >80% of nucleated marrow cells are erythroid precursors >50% of nucleated marrow cells are erythroid precursors and >20% of nonerythroid cells are myeloblasts >50% of nucleated marrow cells are erythroid precursors and <20% of nonerythroid cells are myeloblasts 80% blasts with 20% erythroid precursors, >20% myeloblasts

>80% of nucleated marrow cells are erythroid precursors

Which of the following is the most common cause of anemia in hospitalized patients? inadequate iron intake inadequate folate intake hemolytic anemia anemia of chronic inflammation

anemia of chronic inflammation

Which of the following tumors are associated with erythrocytosis due to excessive erythropoietin production? renal cell carcinoma sarcoma basal cell carcinoma squamous cell carcinoma of the lung

renal cell carcinoma

Antithrombin inhibits factors: IIa and Xa Va and VIIIa VIIa and XIIa IXa and Va

IIa and Xa

The type of bleeding that is the most characteristic in patients with platelet disorders is: deep muscle hemorrhages retroperitoneal hemorrhages mucous membrane hemorrhages severely prolonged clotting times

mucous membrane hemorrhages

Which abnormal RBC morphology is associated with pyruvate kinase deficiency? acanthocytes dacryocytes echinocytes drepanocytes

echinocytes

Which of the following will not affect the PFA-100 closure time? aspirin thrombocytopenia anemia leukopenia

leukopenia

In patients who present with bleeding disorders caused by platelets, the most common type of bleeding is: mucosal bleeding hemarthrosis delayed bleeding deep hematomas

mucosal bleeding

A differential is performed on an asymptomatic patient. The differential included 60% neutrophils, 55 of which had 2 lobes and 5 had 3 lobes. There are no other abnormalities. This is consistent with which of these anomalies? Pelger-Huët May-Hegglin Alder-Reilly Chédiak-Higashi

Pelger-Huët

Vasoconstriction is caused by several regulatory molecules, which include: fibrinogen and vWF ADP and EPI thromboxane A2 and serotonin collagen and actomyosin

thromboxane A2 and serotonin

What subendothelial structural protein triggers coagulation through activation of FVII? thrombomodulin nitric oxide tissue factor silica

tissue factor

The test used to quantitate a factor inhibitor is the: factor assay multimer test ristocetin cofactor Bethesda assay

Bethesda assay

A patient that has a lupus anticoagulant may bleed due to: antibodies to prothrombin factor VII deficiency infection factor VIII deficiency

antibodies to prothrombin

Which of the following platelet responses is most likely associated with type IIb von Willebrand disease? decreased platelet aggregation to low-dose ristocetin normal platelet aggregation to low-dose ristocetin increased aggregation to low-dose ristocetin decreased aggregation to high-dose ristocetin

increased aggregation to low-dose ristocetin

Whole blood evaluation of blood clotting can be performed by using thromboelastography. This methodology looks at: clot onset, agglutination, fibrinolysis clot onset, aggregation, clot strength aggregation, clot onset, clot strength clot onset, clot strength, fibrinolysis

clot onset, clot strength, fibrinolysis

Which of the following stains is used to demonstrate iron, ferritin and hemosiderin? myeloperoxidase methylene blue specific esterase Prussian blue

Prussian blue

Acute disseminated intravascular coagulation is characterized by: hypofibrinogenemia thrombocytosis negative D-dimer shortened thrombin time

hypofibrinogenemia

von Willebrand factor mediates platelet adhesion by binding to platelet receptor: GPIb/IIa GPIb/GPIX/GPV GPIIb/IIa GPIb/GPIIIa/GP X

GPIb/GPIX/GPV

A phase-platelet count is performed and the total platelet count is 356,000/µL (3.56 × 1012/L). Ten high power (100x) fields on the stained blood smear are examined for platelets and the results per field were: 16, 18, 15, 20, 19, 17, 19, 18, 20, 16 The next step would be to: report the phase-platelet count since it correlated well with the slide repeat the phase-platelet count on a recollected specimen and check for clumping check 10 additional fields on the blood smear repeat the platelet count using a different method

report the phase-platelet count since it correlated well with the slide

In the Clauss fibrinogen assay the time for clot formation in plasma is measured after the addition of: calcium thrombin phospholipids fibrin

thrombin

A 68-year-old male presents with tingling in hands and feet, an irregular heart beat, severe fatigue and difficulty in swallowing. Coagulation results show an abnormal PT and aPTT, which completely correct to normal with a mixing study. The factor most likely that contributes to this is a deficiency in: factor VII factor X factor VIII factor XIII

factor X

What type of morphologically abnormal cells proliferate in acute myelogenous leukemia with inv(16)? lymphocytes erythrocytes platelets eosinophils

eosinophils

Peripheral blood smears from patients with untreated pernicious anemia are characterized by: pancytopenia and macrocytosis leukocytosis and elliptocytosis leukocytosis and ovalocytosis pancytopenia and microcytosis

pancytopenia and macrocytosis

A patient presents with a factor VIII level of 2%. The vWF activity (ristocetin cofactor) is <1% with a vWF antigen of 3%. The most likely diagnosis is: hemophilia A hemophilia B type II vWD type III vWD

type III vWD

Which of the following markers are usually negative in hairy cell leukemia? CD5 CD11c CD25 CD103

CD5

A 20-year-old woman with sickle cell anemia, whose usual hemoglobin concentration is 8 g/dL (80 g/L), develops fever, increased weakness and malaise. The hemoglobin concentration is 4 g/dL (40 g/L) and the reticulocyte count is 0.1%. The most likely explanation for her clinical picture is: increased hemolysis due to hypersplenism aplastic crisis thrombotic crisis occult blood loss

aplastic crisis

The most common form of childhood leukemia is: acute lymphocytic acute granulocytic acute monocytic chronic granulocytic

acute lymphocytic

The white cell feature most characteristic of pernicious anemia is: eosinophilia toxic granulation hypersegmentation reactive lymphocytes

hypersegmentation

The disease most closely associated with granulocyte hyposegmentation is: May-Hegglin anomaly Pelger-Huët anomaly Chédiak-Higashi syndrome Gaucher disease

Pelger-Huët anomaly

A patient that has a lupus anticoagulant may bleed due to: factor VIII deficiency drugs antibodies to prothrombin infection

antibodies to prothrombin

The reactive lymphocyte seen in the peripheral blood smear of patients with infectious mononucleosis is probably derived from which of these cell types? T lymphocytes B lymphocytes monocytes mast cells

T lymphocytes

Spontaneous bleeding occurs when the platelet count is: <10 × 10^3/µL <20 × 10^3/µL <50 × 10^3/µL <100 × 10^3/µL

<20 × 10^3/µL

A patient is on unfractionated heparin after surgery and has an aPTT of 65 seconds, however the patient has developed a DVT. The best test to monitor this patient with is: factor X assay factor II assay anti-Xa assay antithrombin assay

anti-Xa assay

Which of the following is associated with May-Hegglin anomaly? membrane defect of lysosomes Döhle bodies and giant platelets chronic myelogenous leukemia mucopolysaccharidosis

Döhle bodies and giant platelets

What protein is commonly defective in hereditary elliptocytosis? ankyrin spectrin band 4.1 elliptocin

spectrin

Which of the following cytogenetic abnormalities is associated with a more stable clinical course in myelodysplastic syndromes (MDSs)? monosomy 7 del 5q loss of Y del 20q

del 5q

A 60-year-old female presents with blurred vision, confusion, fever and severe bruising with a platelet count of 29 × 10^3/µL (29 × 10^9/L). Test results: PT 12.1 sec (range 11.4 - 13.5) and aPTT 32.6 sec (range 25 - 35). The CBC RBC morphology shows schistocytes. The differential diagnosis should include: ITP TTP HUC DIC

TTP

Which of the following markers is expressed in most cases of AML? CD2 CD10 CD11b CD117

CD117

The hemoglobin variant that is seen frequently in the South East Asian population, demonstrates a microcytic blood smear, and migrates with HbC at pH 8.6 is: HbBarts HbF HbE HbH

HbE

Which of the following RBC inclusions are seen in sideroblastic anemia and contain high amounts of iron? Cabot rings Howell-Jolly bodies Heinz bodies Pappenheimer bodies

Pappenheimer bodies

A 14-year-old boy is seen in the ER complaining of a sore throat, swollen glands and fatigue. The CBC results are: What is the most likely diagnosis? acute lymphocytic leukemia chronic lymphocytic leukemia viral hepatitis infectious mononucleosis

infectious mononucleosis

Given this normal scattergram, the area indicated as a “6” represents which cell population? monocytes large unstained cells platelet clumps nucleated RBCs

monocytes

The disease state that presents with a quantitative platelet disorder is: von Willebrand disease hemophilia A Glanzmann thrombasthenia May-Hegglin anomaly

May-Hegglin anomaly

Which of the following is associated with Alder-Reilly inclusions? membrane defect of lysosomes Döhle bodies and giant platelets 2-lobed neutrophils mucopolysaccharidosis

mucopolysaccharidosis

In secondary hemostasis, coagulation proteins become activated to form a fibrin clot. Prior to these proteins being activated, their inactive proenzymes are known as: serine proteases cofactors zymogens substrates

zymogens

Specific (secondary) granules of the neutrophilic granulocyte: appear first at the myelocyte stage contain esterases are formed on the mitochondria are derived from azurophil (primary) granules

appear first at the myelocyte stage

A patient has a high cold agglutinin titer. Automated hematology analyzer results reveal an elevated MCV, MCH and MCHC as well as a decreased RBC. Individual erythrocytes appear normal on a stained smear, but agglutinates are noted. The appropriate course of action would be to: perform the RBC, HGB, and HCT determinations using manual methods perform the RBC determination by a manual method; use the automated results for the HGB and HCT repeat the determinations using a microsample of diluted blood repeat the determinations using a prewarmed microsample of diluted blood

repeat the determinations using a prewarmed microsample of diluted blood

Which of the following is characteristic of hemoglobin H? it is a tetramer of gamma chains it is relatively stable electrophoretically, it represents a “fast” hemoglobin it has a lower oxygen affinity than hemoglobin A

electrophoretically, it represents a “fast” hemoglobin

vWF antigen can be found in which of the following? myeloblasts monoblasts lymphoblasts megakaryocytes

megakaryocytes

A hemophiliac male and a normal female can produce a: female carrier male carrier male hemophiliac normal female

female carrier

Q 104 in Heme section The laboratory data shown in this table are obtained: These results are consistent with essential thrombocythemia polycythemia vera chronic myelocytic leukemia primary myelofibrosis

primary myelofibrosis

A medical technologist is examining a peripheral smear and notices 7 large segmented neutrophils with between 5 and 7 lobes. Everything else about the CBC is otherwise normal. This observed morphologic change might develop months ahead of which of the following changes: an increase in MCV, MCH, and RDW a decrease in MCV, MCH, and RDW an increase in metamyelocytes and bands a bone marrow showing aplasia

an increase in MCV, MCH, and RDW

Only an abnormal aPTT would be seen in the following disorder: deficiencies of factors X, V, and II disseminated intravascular coagulation liver disease anti-FVIII antibodies

anti-FVIII antibodies

The activation of plasminogen to plasmin resulting in the degradation of fibrin occurs by: PAI-1 alpha-2 antiplasmin tPA alpha-2 macroglobulin

tPA

Evidence of a hemolytic event is present in the peripheral blood smear when which of the following is seen? basophilic stippling increased polychromasia increased target cells stomatocytes

increased polychromasia

Cells for the transport of O2 and CO2 are: erythrocytes granulocytes lymphocytes thrombocytes

erythrocytes

A patient is on 100 mg of aspirin/day to prevent the formation of clots caused by platelets. The mechanism in which aspirin impairs platelet function is by: inactivating cyclooxygenase which blocks thromboxane A2 impairs vWF by via GPIb/IX/V receptor decreased amounts of arachidonic acid inactivation of ADP and phospholipase A2

inactivating cyclooxygenase which blocks thromboxane A2

The 2 factors that differentiate liver disease from vitamin K deficiency are: II and VII IX and VII VIII and IX V and VII

V and VII

A platelet aggregation tracing appears to confirm the diagnosis of Glanzmann thrombasthenia in a patient presenting with a platelet disorder. How would these tracings look if they were performed using light transmittance optical density aggregation? decreased platelet aggregation to ristocetin increased platelet aggregation to ristocetin normal response for all agonists markedly decreased aggregation to epinephrine, ADP and collagen

markedly decreased aggregation to epinephrine, ADP and collagen

A patient presents to the emergency department (ED) for a laceration to his arm that requires stitches. Procedure is uncomplicated and leaves the ED. He returns 15 hours later to the ED with excess bleeding. All PT, aPTT, fibrinogen and platelet counts are normal. The differential diagnosis should include: chronic DIC lupus factor XII deficiency factor XIII deficiency

factor XIII deficiency

Patients diagnosed with hemophilia can now be prescribed: cryoprecipitate direct thrombin inhibitors extended half-life products LMWH

extended half-life products

In a patient diagnosed with liver disease, which one of the following factors typically shows an increase? factor VII factor VIII factor IX factor X

factor VIII

Auer rods are most likely present in which of the following? chronic myelocytic leukemia primary myelofibrosis erythroleukemia acute myelocytic leukemia

acute myelocytic leukemia

Q 117 in Heme A patient is admitted with a history of chronic bleeding secondary to peptic ulcer. Hematology results reveal a severe microcytic, hypochromic anemia. Iron studies are requested. Which result set would be expected in this case? result a result b result c result d

result c

The erythrocyte sedimentation rate (ESR) can be falsely elevated by: tilting the tube refrigerated blood air bubbles in the column specimen being too old

tilting the tube

Which of the following conditions may contribute to lethargy, abdominal pain, and hemoglobinuria in some patients with a G6PD deficiency? dehydration excess iron ingesting fava beans increased glucose

ingesting fava beans

What is the minimum percentage of prolymphocytes that must be present for a diagnosis of prolymphocytic leukemia? >10% >25% >55% >75%

>55%

A false elevation in a manual hematocrit (microhematocrit) determination may result from: prolonged centrifugation in vitro hemolysis trapped plasma incomplete sealing of the hematocrit tube

trapped plasma

Dwarf or micromegakaryocytes may be found in the peripheral blood of patients with: pernicious anemia polycythemia primary myelofibrosis chronic lymphocytic leukemia

primary myelofibrosis

Warfarin is classified as a vitamin K antagonist. The factors that are impacted by warfarin therapy are: VIII, IX and X I, II, V and VII II, VII, IX and X II, V and VII

II, VII, IX and X

Bleeding doesn't correlate well with factor levels in a deficiency of: factor VIII factor IX factor XI factor VII

factor XI

Which of the following conditions is a myeloproliferative neoplasm? refractory anemia secondary erythrocytosis myelomonocytic leukemia essential thrombocythemia

essential thrombocythemia

The direct antiglobulin test can help distinguish: inherited from acquired spherocytosis intravascular from extravascular hemolysis heterozygous from homozygous thalassemia sickle cell trait from sickle cell disease

inherited from acquired spherocytosis

Q 127 in Heme The nucleated cell in the photomicrograph may be seen in the peripheral blood of a normal newborn and is classified as a(an): basophilic normoblast polychromatophilic normoblast orthochromatic normoblast megaloblastic normoblast

orthochromatic normoblast

When screening for a lupus anticoagulant in the routine coagulation laboratory the best reagent would be: aPTT reagent with a high concentration of phospholipids aPTT reagent with a low concentration of phospholipids PT reagent with a high concentration of phospholipids PT reagent with a low concentration of phospholipids

aPTT reagent with a low concentration of phospholipids

The disease state that presents with a quantitative platelet disorder is: von Willebrand disease hemophilia A Glanzmann thrombasthenia May-Hegglin anomaly

May-Hegglin anomaly

Automated methods of measuring hemoglobin cannot detect this form: methemoglobin carboxyhemoglobin deoxyhemoglobin sulfhemoglobin

sulfhemoglobin

A hypercellular marrow with an M:E ratio of 6:1 is most commonly due to: lymphoid hyperplasia granulocytic hyperplasia normoblastic hyperplasia myeloid hypoplasia

granulocytic hyperplasia

What is the most common immunoglobulin present in plasma cell myeloma? IgG IgA light chains IgD

IgG

A native of Thailand has a normal hemoglobin level. Hemoglobin electrophoresis on cellulose acetate shows 70% HbA and approximately 30% of a hemoglobin with the mobility of HbA2. This is most consistent with hemoglobin: C trait E trait O trait D trait

E trait

Which of these is the formula to calculate a manual white cell count? (number of cells counted × dilution × 10)/number of squares counted (number of cells counted × dilution)/10 × number of squares counted number of cells counted × dilution number of cells counted × number of squares counted

(number of cells counted × dilution × 10)/number of squares counted

The large cell in the center of the photomicrograph would be best described as a(n): neutrophil basophil eosinophil myelocyte

basophil

Many microspherocytes, schistocytes and spherocytes with budding cytoplasm can be seen on peripheral blood smears of patients with: hereditary spherocytosis pyruvate kinase deficiency thalassemia extensive burns

extensive burns

Platelet aggregation will occur with the end production of: cyclooxygenase arachidonic acid prostacyclin thromboxane A2

thromboxane A2

Which of these cell types is most likely identified in lesions of mycosis fungoides? T lymphocytes B lymphocytes monocytes mast cells

T lymphocytes

A patient is diagnosed with a factor V Leiden mutation. The factor V activity level should be: shortened prolonged undetectable within reference range

within reference range

Question 140 in Heme Individuals with Fanconi anemia characteristically show: increased HbF intravascular hemolysis ringed sideroblasts thrombocytosis

increased HbF

A term that means varying degrees of leukocytosis with a shift to the left and occasional nucleated red cells in the peripheral blood is: polycythemia vera erythroleukemia leukoerythroblastosis megaloblastoid

leukoerythroblastosis

In which of the following types of cells is CD5 usually expressed? mature T cells pro B cells macrophages endothelial cells

mature T cells

Excess D-dimers indicate that clots have been: converted to fibrin monomers released into the circulation stimulated to activate platelets formed and are being excessively lysed

formed and are being excessively lysed

A FXI assay gives different values at different dilutions. The results are as follows: 1:10 = 23%; 1:20= 42%, 1:140= 80%. This can be caused by a(n): clot factor deficiency inhibitor bad draw

inhibitor

If a patient is diagnosed as a severe hemophiliac, their FVIII level will be in the range of: <1% 1-5% 6-30% > 30%

<1%

When a patient is placed on warfarin therapy, the first factor that will be decreased is: factor II factor V factor VII factor VIII

factor VII

Autoimmune hemolytic anemia is often a complication of: PV CML CLL HCL

CLL

Q 148 of Heme The laboratory results shown in this table are obtained on a 55-year-old man complaining of headaches and blurred vision: These results are consistent with: neutrophilic leukemoid reaction polycythemia vera chronic myelocytic leukemia primary myelofibrosis

polycythemia vera

Q 149 Heme Which area in the histogram shown for an automated hematology analyzer represents the platelet distribution curve? Area A Area B Area C Area E

Area E

A patient has a tumor that concentrates erythropoietin. He is most likely to have which of the following types of polycythemia? polycythemia vera polycythemia, secondary to hypoxia benign familial polycythemia polycythemia associated with renal disease

polycythemia associated with renal disease

Q 151 of Heme To distinguish between hemophilia and von Willebrand disease, a patient with von Willebrand will present with which of the following test results? Result A Result B Result C Result D

Result C

Acute (pure) erythroid leukemia is characterized by the presence of: more than 20% bone marrow myeloblasts less than 20% bone marrow proerythroblasts more than 30% bone marrow proerythroblasts less than 80% bone marrow erythroid precursors

more than 30% bone marrow proerythroblasts

Q 153 of Heme The platelet aggregation tracing shown in this figure represents: von Willebrand disease storage pool disease Glanzmann thrombasthenia aspirin

Glanzmann thrombasthenia

Which of the following is associated with pseudo-Pelger-Huët anomaly? aplastic anemia iron deficiency anemia chronic myeloid leukemia Chédiak-Higashi syndrome

chronic myeloid leukemia

A patient with a positive family history of bleeding presents to the ED with the results shown in this table: aPTT= 29.5 sec (range 25-35 sec) PT= 19.2 sec (range 10.5-12.5 sec) The patient is not on any medication and so is likely to be deficient in factor: II V VII VIII

VII

Which of these following bone marrow findings favors the diagnosis of multiple myeloma? presence of Reed Sternberg cells sheaths of immature plasma cells presence of occasional flame cell presence of plasmacytic satellitosis

sheaths of immature plasma cells

The most likely cause of the macrocytosis that often accompanies primary myelofibrosis is: folic acid deficiency increased reticulocyte count inadequate B12 absorption pyridoxine deficiency

folic acid deficiency

Large blue inclusions bodies in WBC are found in patients with: Wiskott-Aldrich syndrome May-Hegglin Anomaly Ehlers-Danlos syndrome Heřmanský-Pudlák syndrome

May-Hegglin Anomaly

Which of the following represent residual nuclear fragments? Pappenheimer bodies Cabot rings Heinz bodies target cells

Cabot rings

Phagocytosis in neutrophils can be described as a process to: defend against parasites mediate sensitivity reactions neutralize products from mast cells kill and degranulate bacteria

kill and degranulate bacteria

A patient is on aspirin 100 mg/day to prevent the formation of clots caused by platelets. The mechanism in which aspirin impairs platelet function is by: inactivating cyclooxygenase which blocks thromboxane A2 impairs vWF by via GPIb/IX/V receptor decreased amounts of arachidonic acid inactivation of ADP and phospholipase A2

inactivating cyclooxygenase which blocks thromboxane A2

The M:E ratio in chronic myelocytic leukemia is usually: Normal High Low Variable

High

On a smear made directly from a finger stick, no platelets are found in the counting area. The first thing to do is: examine the slide for clumping obtain another smear perform a total platelet count request another finger stick

examine the slide for clumping

One of the major differences between extravascular and intravascular hemolysis is: free hemoglobin increased bilirubin decreased haptoglobin increased LDH

free hemoglobin

Q 165 of Heme In the photomicrograph the small nucleated cell seen in the lower left corner is a: polychromatophilic normoblast (rubricyte) mature lymphocyte plasma cell lymphoblast

mature lymphocyte

Acquired hemophilia is distinguished from inherited hemophilia in that acquired hemophilia is: found in young people alloantibody autoimmune disease occurs in males

autoimmune disease

Which of the following features define chronic myelogenous leukemia? JAK2 mutation myelocyte “bulge” basophilia, eosinophilia, and thrombocytosis t(9;22)

t(9;22)

A patient with multimer pattern that has all bands present but in decreased concentrations would be diagnosed with: hemophilia type 1 vWD type 2 vWD type 3 vWD

type 1 vWD

Which of the following is true of acute lymphoblastic leukemia (ALL)? occurs most commonly in children 1 - 2 years of age patient is asymptomatic primitive lymphoid-appearing cells accumulate in bone marrow children under 1 year of age have a good prognosis

primitive lymphoid-appearing cells accumulate in bone marrow

A patient is being worked up for a lupus anticoagulant and the physician requests a dilute Russel viper venom test (DRVV). The DRVV screen is 62 seconds and the confirm is 49 seconds. The final ratio is: 0.79 1.27 3.04 13

1.27

Which of the following cells is the largest cell in the bone marrow: megakaryocyte histiocyte osteoblast mast cell

megakaryocyte

Which of the following is the formula to calculate an absolute cell count? number of cells counted/total count total count/number of cells counted 10× total count % of cells counted × total count

% of cells counted × total count

Q 173 of Heme A patient presents to his physician with excessive bleeding. He was previously on aspirin, but it was discontinued 3 weeks ago, but he was placed on antibiotics for a streptococcal infection. Coagulation results are as follows: Bleeding may be due to: aspirin platelet dysfunction vitamin K deficiency liver disease

vitamin K deficiency

Q 174 of Heme A leukocyte count and differential on a 40-year-old Caucasian man revealed: This data represents: absolute lymphocytosis relative neutrophilia absolute neutropenia leukopenia

absolute neutropenia

Patients with factor XIII deficiency have: an abnormal aPTT delayed bleeding tissue damage joint bleeds

delayed bleeding

Q 176 of Heme The tracing in this figure is from a cardiac surgery patient using thromboelastography. This tracing shows the patient during cardiac surgery is: under-anticoagulated sufficiently anticoagulated over-anticoagulated normal

sufficiently anticoagulated

A patient presents with an aPTT of 24 seconds (25 - 35 seconds) which is below the normal range. A possible explanation for this result is the presence of a(n): DVT lupus anticoagulant acute phase reactant inhibitor

acute phase reactant

Which of the following sets of laboratory findings is consistent with hemolytic anemia? decreased bilirubin; normal reticulocyte count increased serum lactate dehydrogenase; increased catabolism of heme decreased serum lactate dehydrogenase; normal catabolism of heme increased concentration of haptoglobin; marked hemoglobinuria

increased serum lactate dehydrogenase; increased catabolism of heme

The initial platelet adhesion to subendothelial matrix proteins is abnormal in: von Willebrand disease and Bernard-Soulier syndrome hemophilia A or B GPIIb/IIIa inhibitors factor XIII deficiency

von Willebrand disease and Bernard-Soulier syndrome

A deficiency of protein C is associated with which of the following? prolonged aPTT decreased fibrinogen level (<100 mg/dL [<1.0 g/L]) increased risk of thrombosis spontaneous hemorrhage

increased risk of thrombosis

A patient who presents with renal impairment is being started on oral anticoagulant therapy. The DOAC that should be avoided would be: dabigatran apixaban rivaroxaban warfarin

dabigatran

Q. 182 of Heme The white cell count is flagged on a routine CBC. In reviewing the scatter plot shown from the analyzer, what cells will be present on the differential? reactive lymphocytes increased eosinophils increased lymphocytes nucleated red blood cells

increased eosinophils

The best test to determine if a sample contains residual heparin: fibrinogen thrombin time prothrombin time D-dimer

thrombin time

In an uncomplicated case of infectious mononucleosis, which type of cells is affected? erythrocytes lymphocytes monocytes thrombocytes

lymphocytes

After the removal of red blood cells from the circulation hemoglobin is broken down into: iron, porphyrin, and amino acids iron, heme, and globin heme, protoporphyrin, and amino acids heme, hemosiderin, and globin

iron, heme, and globin

A specimen analyzed on an automated hematology instrument has a platelet count of 19 × 10^3/µL (19 × 10^9/L). The first procedure to follow is: report the count after the batch run is completed request a new specimen review the stained blood smear notify the laboratory manager

review the stained blood smear

A characteristic morphologic feature in hemoglobin C disease is: macrocytosis spherocytosis rouleaux formation target cells

target cells

A patient presents with an aPTT of 62.5 seconds (25 - 35 seconds) and the only factor that is decreased is factor XII. What is the clinical picture for this patient? negative bleeding history prolonged PFA decreased risk of thrombosis epistaxis

negative bleeding history

A patient is placed on clopidogrel. The clinician wants to determine if the dose is sufficient to impair platelet function. A platelet aggregation test is ordered. The agonist which would result in a decreased aggregation pattern would be: collagen epinephrine ristocetin adenosine diphosphate

adenosine diphosphate

Anemia secondary to uremia and chronic renal disease characteristically is: microcytic, hypochromic hemolytic normocytic, normochromic macrocytic

normocytic, normochromic

The specimen of choice for preparation of blood films for manual differential leukocyte counts is whole blood collected in: EDTA oxalate citrate heparin

EDTA

A patient presents with a low protein S activity and low total and free protein S antigens. The C4b binding protein is normal. This is classified as: no deficiency Type I Type II Type III

type I

Which of the following best represents the 3 steps of normal hemostasis (in order)? decreased heart rate, adhesion of platelets, plug formation platelet aggregation, formation of FXIII, fibrin plug vasoconstriction, platelet aggregation, fibrin formation vascular damage, stasis, endothelial injury

vasoconstriction, platelet aggregation, fibrin formation

Which of the following are characteristic of a factor XII deficiency? negative bleeding history negative screening test decreased risk of thrombosis decreased platelet count

negative bleeding history

Q 195 of Heme A 40-year-old Caucasian male is admitted to the hospital for treatment of anemia, and presents with symptoms of lassitude, weight loss, and loss of libido. Admission laboratory data are shown in the table: Examination of the bone marrow reveals erythroid hyperplasia with a shift to the left of erythroid precursors. Prussian blue staining reveals markedly elevated iron stores noted with occasional sideroblasts seen. This data is most consistent with which of the following conditions? iron deficiency anemia anemia of chronic inflammation hemochromatosis acute blood loss

hemochromatosis

Elevation of the total granulocyte count above 7.5 × 10^3/µL (7.5 × 10^9/L) is termed: relative lymphocytosis leukocytosis relative neutrophilic leukocytosis absolute neutrophilic leukocytosis

absolute neutrophilic leukocytosis

Hemophilia B is a sex-linked recessive disorder that presents with a decrease in factor: VIII IX X XI

Which of the following genetic alterations is associated with a favorable prognosis in pre-B-ALL? t(1;19) t(4;11) t(9;22) t(12;21)

t(12;21)

The characteristic morphologic feature in folic acid deficiency is: macrocytosis target cells basophilic stippling rouleaux formation

macrocytosis

Which of the following types of polycythemia is a severely burned patient most likely to have? polycythemia vera polycythemia, secondary to hypoxia relative polycythemia associated with dehydration polycythemia associated with renal disease

relative polycythemia associated with dehydration

Which of the following tests provides an appropriate laboratory confirmation of immune mediated heparin induced thrombocytopenia (type 2)? anti-PF3 antibody serotonin release assay ristocetin induced platelet aggregation assay reptilase assay

serotonin release assay

The presence of excessive rouleaux formation on a blood smear is often accompanied by an increased: reticulocyte count sedimentation rate hematocrit erythrocyte count

sedimentation rate

Which of the following is associated with mycosis fungoides? Sézary cells hairy cells prolymphocytes large granular lymphocytes

Sézary cells

The anticoagulant that directly inhibits thrombin is: LMWH argatroban warfarin rivaroxaban

argatroban

A new PT reagent is being set up in the coagulation laboratory. The ISI of the new reagent is 1.0; the previous reagent had an ISI of 2.1. The new reagent is said to be: more sensitive less sensitive insensitive no change

more sensitive

Alpha granules are found on the platelet in the: peripheral zone sol gel zone organelle zone membranes

organelle zone

The measurement principle that uses a fixed concentration of factor Xa added to patient plasma and applied to a specific substrate is a: factor assay chromogenic assay ELISA assay immunologic assay

chromogenic assay

In order for hemoglobin to combine reversibly with oxygen, the iron must be: complexed with haptoglobin freely circulating in the cytoplasm attached to transferrin in the ferrous state

in the ferrous state

Q 209 of Heme A patient has the laboratory results shown in this table: Which of the following tests would contribute toward the diagnosis? reticulocyte count platelet factor 3 serum B12 and folate leukocyte alkaline phosphatase

serum B12 and folate

Elevation of the total white cell count above 11.0 × 10^3/µL (11.0 × 10^9/L) is termed: relative lymphocytosis absolute lymphocytosis leukocytosis relative neutrophilic leukocytosis

leukocytosis

Question 211 of Heme Which area in the histogram shown for an automated hematology analyzer represents the RBC distribution curve? area A Area B Area C Area D

Area D

A patient is being worked up for a lupus anticoagulant. The DRVV screen is prolonged at 75 seconds with the pooled normal plasma at 35 seconds. The DRVV confirm is 38 seconds with the pooled normal plasma at 36 seconds. What is the normalized ratio? 1.97 0.51 0.97 2.03

2.03

Increased levels of TdT activity are indicative of: Burkitt lymphoma acute promyelocytic leukemia acute lymphocytic leukemia eosinophilia

acute lymphocytic leukemia

Q 214 of Heme A 50-year-old man is admitted into the hospital with acute leukemia. Laboratory findings include the results shown in this table: These results are most consistent with: acute myelogenous leukemia chronic lymphocytic leukemia in lymphoblastic transformation T-cell acute lymphocytic leukemia chronic myelogenous leukemia in lymphoblastic transformation

chronic myelogenous leukemia in lymphoblastic transformation

In hemolytic uremic syndrome, patients present with: severe CNS symptoms fever acute renal failure decreased ADAMTS13

acute renal failure

The M:E ratio in erythroleukemia is usually: normal high low variable

low

Post-transfusion purpura is a rare form of: autoimmune disorder qualitative platelet disorder alloimmune thrombocytopenia antibody platelet destruction

antibody platelet destruction

In the World Health Organization (WHO) classification, acute myelomonocytic leukemia would be named acute myeloid leukemia (AML): with myelodysplastic-related changes with recurrent cytogenetic changes not otherwise specified therapy-related

not otherwise specified

A Wright-stained peripheral blood smear reveals blue, ring-shaped inclusions with red chromatin dots in several of the red blood cells. These inclusions are consistent with: Howell-Jolly bodies Cabot rings basophilic stippling malarial parasites

malarial parasites

Evidence indicates that the genetic defect in thalassemia usually results in: the production of abnormal globin chains a quantitative deficiency in RNA resulting in decreased globin chain production a structural change in the heme portion of the hemoglobin an abnormality in the alpha- or beta-chain binding or affinity

a quantitative deficiency in RNA resulting in decreased globin chain production

Which of the following is a characteristic of Hodgkin lymphoma? bimodal age distribution high incidence of peripheral blood infiltration unpredictable lymph node involvement uniformly fatal

bimodal age distribution

How does the bone marrow respond to anemic stress? expand production, release RBCs prematurely expand production, rush platelets into circulation diminish production, increase M:E diminish production, M:E remains normal

expand production, release RBCs prematurely

Q 223 of Heme The tracing shown in this figure represents a patient with: type 1 vW disease type 2 vW disease type 3 vW disease no vW disease

no vW disease

Q 224 of Heme An oncology patient has the results shown in this table: The most probable explanation is: Chemotherapy Cold Antibody Clotted Specimen Inadequate Mixing

Chemothrapy

One of the main difference between TTP and HUS is: presence of neurological involvement degree of kidney dysfunction presence of thrombocytopenia degree of microangiopathic hemolytic anemia

degree of kidney dysfunction

The characteristic erythrocyte found in pernicious anemia is: microcytic spherocytic hypochromic macrocytic

macrocytic

Which of the following features of G6PD deficiency are typically present on a Wright-Giemsa stained peripheral blood smear? Cabot rings microcytosis bite cells Heinz bodies

bite cells

Q 228 of Heme The red blood cells in this image are representative of an anemia that is: microcytic, hypochromic nonmegaloblastic macrocytic normocytic, normochromic myelodysplastic

nonmegaloblastic macrocytic

Which of the following types of polycythemia is most often associated with lung disease? polycythemia vera polycythemia, secondary to hypoxia relative polycythemia associated with dehydration polycythemia associated with renal disease

polycythemia, secondary to hypoxia

Q 230 of Heme The laboratory results shown in this table are obtained on a 45-year-old man complaining of chills and fever: These results are consistent with: neutrophilic leukemoid reaction polycythemia vera chronic myelocytic leukemia leukoerythroblastosis in myelofibrosis

neutrophilic leukemoid reaction

The mechanism causing catecholamine-induced neutrophilia includes: a shift in granulocytes from the marginating pool to the circulating pool an increased exit of granulocytes from the circulation a decreased exit of granulocytes from the bone marrow granulocyte return from the tissues to the circulating pool

a shift in granulocytes from the marginating pool to the circulating pool

What does the secondary wave of platelet aggregation seen with the biphasic low-dose ADP and epinephrine response represent? increased binding to collagen release of platelet granules increased activation by collagen formation of fibrin dimers

release of platelet granules

One of the coagulation test results that correlates with mortality in patients with the SARS-CoV-2 virus was: PT aPTT D-dimer thrombin time

D-dimer

What is the most common mechanism resulting in hereditary stomatocytosis? abnormal Na/K permeability deficient cytoskeletal structural proteins inability to repair oxidative stress damage ATP depletion due to glycolytic enzyme deficiency

abnormal Na/K permeability

What are patients with homozygous protein C deficiency particularly at an increased risk of developing? posttransfusion purpura warfarin skin necrosis purpura fulminans thrombocytophilia

purpura fulminans

An additional test to perform in a patient having a lupus workup after the DRVV would be: thrombin time hexagonal phase fibrinogen reptilase time

hexagonal phase

A red blood cell about 5 µm in diameter that stains bright red and shows no central pallor is a: spherocyte leptocyte microcyte macrocyte

spherocyte

Heparin induced thrombocytopenia (HIT) is an immune mediated complication associated with heparin therapy. Antibodies are produced against: ACLA PF4 AT B2GP1

PF4

Q 239 of Heme A 30-year-old woman is admitted to the hospital for easy bruising and menorrhagia. Laboratory findings included the results shown in this table: The cells identified as “abnormal immature” are described as having lobulated nuclei with prominent nucleoli; the cytoplasm has intense azurophilic granulation over the nucleus, with some cells containing 1 - 20 Auer rods, frequently grouped in bundles. A t(15;17) chromosomal translocation is noted. Cells are myeloperoxidase positive. Which of these types of acute leukemia is most likely? myeloblastic promyelocytic myelomonocytic monocytic

promyelocytic

The electrical resistance method of cell counting requires: equal-sized particles a conductive liquid 2 internal electrodes for current 3 apertures for counting

a conductive liquid

A 65-year-old male with metastatic pancreatic carcinoma shows elevated PT and aPTT, platelet count 15 × 10^3/µL (15 × 10^9/L) and elevated D-dimer. A blood smear would show: Howell-Jolly bodies macro-ovalocytes schistocytes target cells

schistocytes

Two samples arrive from the emergency room (ER) on the same patient within 10 minutes of each other. Sample 1 has a WBC of 8.5 × 10^9/L and Sample 2 has a WBC of 20.5 × 10^9/L. What is the best course of action? report both results determine how the samples were collected determine if the samples are from the same patient consider a redraw of the specimen

consider a redraw of the specimen

Large blue inclusions bodies in WBCs are found in patients with: Wiskott-Aldrich syndrome May-Hegglin anomaly Ehlers-Danlos syndrome Heřmanský-Pudlák syndrome

May-Hegglin anomaly

Elevation of the lymphocyte percentage above 45% is termed: relative lymphocytosis absolute lymphocytosis leukocytosis absolute neutrophilic leukocytosis

relative lymphocytosis

How does tissue factor pathway inhibitor inhibit coagulation? inhibition of tissue factor-factor VIIa-factor Xa complex conversion of thrombin to prothrombin uncoupling factor XIII dependent crosslinking of fibrin binding and hiding tissue factor on the endothelial surface

inhibition of tissue factor-factor VIIa-factor Xa complex

Q 246 of Heme A 48-year-old male is screened pre-operatively. He has a positive family history for bleeding. The patient is of Ashkenazi Jewish descent. His results are as follows: Based on this history and the results of these tests, this patient's most likely diagnosis is a deficiency in factor: VIII IX XI XII

A coagulation reagent should be sensitive to factor deficiencies. A reagent is considered sensitive to a factor when the level of factor activity is approximately: 30% 40% 50% 60%

30%

Terminal deoxynucleotidyl transferase (TdT) is a marker found on: hairy cells myeloblasts monoblasts lymphoblasts

lymphoblasts

When using the turbidity (solubility) method for detecting the presence of hemoglobin S, an incorrect interpretation may be made when there is a(n): increased reticulocyte count glucose concentration >150 mg/dL (8.3 mmol/L) blood specimen >2 hours old decreased hematocrit

decreased hematocrit

The replacement of normal marrow precursor cells by an accumulation of blasts is a hallmark of: chronic lymphocytic leukemia myelodysplastic syndromes polycythemia vera acute myelocytic leukemia

acute myelocytic leukemia