Hematology- Basic Hematology Concepts and Laboratory Procedures

Question 1

1. Insufficient centrifugation will result in:
   A. A false increase in hematocrit (Hct) value
   B. A false decrease in Hct value
   C. No effect on Hct value
   D. All of these options, depending on the patient

Answer 1

A. A false increase in hematocrit (Hct) value

Question 2

2. Variation in red cell size observed on the
   peripheral smear is described as:
   A. Anisocytosis
   B. Hypochromia
   C. Poikilocytosis
   D. Pleocytosis

Answer 2

A. Anisocytosis

Question 3

3. Which of the following is the preferable site for
   bone marrow aspiration and biopsy in an adult?
   A. Iliac crest
   B. Sternum
   C. Tibia
   D. Spinous processes of a vertebra

Answer 3

A. Iliac crest

Question 4

4. Mean cell volume (MCV) is calculated using the
   following formula:
   A. (Hgb ÷ RBC) × 10
   B. (Hct ÷ RBC) × 10
   C. (Hct ÷ Hgb) × 100
   D. (Hgb ÷ RBC) × 100

Answer 4

B. (Hct ÷ RBC) × 10

Question 5

5. What term describes the change in shape of
   erythrocytes seen on a Wright’s-stained peripheral
   blood smear?
   A. Poikilocytosis
   B. Anisocytosis
   C. Hypochromia
   D. Polychromasia

Answer 5

A. Poikilocytosis

Question 6

6. Calculate the mean cell hemoglobin concentration
   (MCHC) using the following values:
   Hgb: 15 g/dL (150 g/L)
   Hct: 47 mL/dL (0.47)
   RBC: 4.50 × 106/μL (4.50 ×1012/L)

A. 9.5% (.095)
B. 10.4% (.104)
C. 31.9% (.319)
D. 33.3% (.333)

Answer 6

C. 31.9% (.319)

Question 7

7. A manual white blood cell (WBC) count was
   performed. A total of 36 cells were counted in
   all 9-mm2 squares of a Neubauer-ruled
   hemacytometer. A 1:10 dilution was used. What
   is the WBC count?
   A. 0.4 × 109/L
   B. 2.5 × 109/L
   C. 4.0 × 109/L
   D. 8.0 × 109/L

Answer 7

A. 0.4 × 109/L

Question 8

8. When an erythrocyte containing iron granules is
   stained with Prussian blue, the cell is called a:
   A. Spherocyte
   B. Leptocyte
   C. Schistocyte
   D. Siderocyte

Answer 8

D. Siderocyte

Question 9

9. A 7.0-mL ethylenediaminetetraacetic 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

Answer 9

C. Hct

Question 10

10. A 1:200 dilution of a patient’s sample was
    made and 336 red cells were counted in an area
    of 0.2 mm2. What is the RBC count?
    A. 1.68 × 1012/L
    B. 3.36 × 1012/L
    C. 4.47 × 1012/L
    D. 6.66 × 1012/L

Answer 10

B. 3.36 × 1012/L

Question 11

11. What phagocytic cells produce lysozymes that are
    bacteriocidal?
    A. Eosinophils
    B. Lymphocytes
    C. Platelets
    D. Neutrophils

Answer 11

D. Neutrophils

Question 12

12. If a patient has a reticulocyte count of 7% and an
    Hct of 20%, what is the corrected reticulocyte
    count?
    A. 1.4%
    B. 3.1%
    C. 3.5%
    D. 14%

Answer 12

B. 3.1%

Retic % X Hct ÷ 45

÷45=average normal Hct

Question 13

13. 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

Answer 13

A. Sickle cell anemia

Question 14

14. What effect would using a buffer at pH 6.0 have
    on a Wright’s-stained smear?
    A. Red cells would be stained too 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

Answer 14

A. Red cells would be stained too pink

Question 15

15. Which of the following erythrocyte inclusions can
    be visualized with supravital 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

Answer 15

B. Heinz bodies

Question 16

16. 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)

Answer 16

B. MCH

Question 17

17. A Miller disk is an ocular device used to facilitate
    counting of:
    A. Platelets
    B. Reticulocytes
    C. Sickle cells
    D. Nucleated red blood cells (NRBCs)

Answer 17

B. Reticulocytes

Question 18

18. SITUATION: RBC indices obtained on an anemic
    patient are as follows:
    MCV 88 μm3 (fL);
    MCH 30 pg;
    MCHC 34% (.340).

The RBCs on the
peripheral smear would appear:
A. Microcytic, hypochromic
B. Microcytic, normochromic
C. Normocytic, normochromic
D. Normocytic, hypochromic

Answer 18

C. Normocytic, normochromic

Question 19

19. 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

Answer 19

A. Blood drawn into a sodium citrate tube

Question 20

20. What staining method is used most frequently to
    stain and manually count reticulocytes?
    A. Immunofluorescence
    B. Supravital staining
    C. Romanowsky staining
    D. Cytochemical staining

Answer 20

B. Supravital staining

Question 21

21. 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

Answer 21

A. Isotonic solutions conduct electricity better than
cells do

Question 22

22. A correction is necessary for WBC counts when
    nucleated RBCs are seen on the peripheral smear
    because:
    A. The WBC count would be falsely lower
    B. The RBC count is too low
    C. Nucleated RBCs are counted as leukocytes
    D. Nucleated RBCs are confused with giant
    platelets
    Hematology/E

Answer 22

C. Nucleated RBCs are counted as leukocytes

Question 23

23. Using an electronic cell counter analyzer, an
    increased RDW should correlate with:
    A. Spherocytosis
    B. Anisocytosis
    C. Leukocytosis
    D. Presence of NRBCs

Answer 23

B. Anisocytosis

Question 24

24. Given the following values, which set of red blood
    cell indices suggests spherocytosis?
    A. MCV 76 μm3 MCH 19.9 pg MCHC 28.5%
    B. MCV 90 μm3 MCH 30.5 pg MCHC 32.5%
    C. MCV 80 μm3 MCH 36.5 pg MCHC 39.0%
    D. MCV 81 μm3 MCH 29.0 pg MCHC 34.8%

Answer 24

C. MCV 80 μm3 MCH 36.5 pg MCHC 39.0%

Question 25

25. Which of the following statistical terms reflects
    the best index of precision when comparing two
    CBC parameters?
    A. Mean
    B. Median
    C. Coefficient of variation
    D. Standard deviation

Answer 25

C. Coefficient of variation

Question 26

26. Which of the following is considered a normal
    hemoglobin?
    A. Carboxyhemoglobin
    B. Methemoglobin
    C. Sulfhemoglobin
    D. Deoxyhemoglobin

Answer 26

D. Deoxyhemoglobin

Question 27

27. Which condition 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

Answer 27

A. Acidosis

Question 28

28. 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

Answer 28

B. Lymphocyte

Question 29

29. What is the normal WBC differential lymphocyte
    percentage (range) in the adult population?
    A. 5%–10%
    B. 10%–20%
    C. 20%–44%
    D. 50%–70%

Answer 29

C. 20%–44%

Question 30

30. In which age group would 60% lymphocytes be a
    normal finding?
    A. 6 months–2 years
    B. 4–6 years
    C. 11–15 years
    D. 40–60 years

Answer 30

A. 6 months–2 years

Question 31

31. Which of the following results on an automated
    differential suggests that a peripheral smear should
    be reviewed manually?
    A. Segs = 70%
    B. Band = 6%
    C. Mono = 15%
    D. Eos = 2%

Answer 31

C. Mono = 15%

Question 32

32. Which is the first stage of erythrocytic maturation
    in which the cytoplasm is pink due to the
    formation of hemoglobin?
    A. Reticulocyte
    B. Pronormoblast
    C. Basophilic normoblast
    D. Polychromatic normoblast

Answer 32

D. Polychromatic normoblast

Question 33

33. 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 these options

Answer 33

D. All of these options

Question 34

34. Which of the following Hgb configurations is
    characteristic of Hgb H?
    A. γ4
    B. α2-γ2
    C. β4
    D. α2-β2

Answer 34

C. β4

Question 35

35. Autoagglutination of red cells at room temperature
    can cause which of the following abnormal test
    results?
    A. Low RBC count
    B. High MCV
    C. Low hematocrit
    D. All of these options

Answer 35

D. All of these options