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BOC study (harr book) > heme externship rotation - heme, 1.1-1.2 > Flashcards

heme externship rotation - heme, 1.1-1.2 Flashcards

1
Q

insuffiecent centrifugation will result in:
- false increase of hct
- false decrease in hct
- no effect on hct
- all of the above

A

false increase of hct
- red cells not fully packed (still loosy goosy)

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2
Q

a variation in RBC size is called
- aniso
- poik
- hypochromic
- pleocytosis

A

aniso

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3
Q

which of the following is the preferred site for BM aspirates in adults
- iliac crest
- sternum
- tibia
- spinous process of vertebra

A

iliac crest
- easiest to access and safest

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4
Q

MCV calculation

A

mean cell volume looks at the size of red cells
- (hct 10)/RBC OR same but slightly different (hct/rbc)10

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5
Q

what term describes the change in shape of RBCs on peripheral smear

A

poik

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6
Q

an erythrocyte with iron granules is called a
- spherocyte
- leptocyte
- shistocyte
- siderocyte

A

siderocyte

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7
Q

a 7 mL EDTA tube was filled to 2mL. what test is most erroneous
- RBC count
- hgb
- hct
- WBC count

A

hct
- due to increased anticoagulant to cell, causes RBCs to shrink

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8
Q

if a patient has a retic count of 7% and a hct of 20% what is the corrected retic

A
  • equation: raw retic% * (pt hct/45)
  • answer: 3.1
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9
Q

a decreased osmotic fragility test would be associated with what condition
- sickle cell anemia
- HS
- HDFN
- acquired hemolytic anemia

A

sickle cell anemia
- all others are associated with spherocytes that have an increased osmotic fragility

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10
Q

what effect would using a buffer at pH of 6.0 have on wright-stained smear
- RBC too pink
- WBC cytoplasm too blue
- RBCs too blue
- RBCs lyse on slide

A

RBCs too pink
- more acidic environment = increased eosin uptake of cells = pink

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11
Q

which inclusion needs a supravital stain to be visualized
- basophilic stippling
- heinz bodies
- howel-jolley bodies
- siderotic bodies

A

heinz bodies
- ox injury hgb

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12
Q

what stain is used to manually count retics

A

supravital stain

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13
Q

the coulter principle for counting of cells is based on the fact that
- isotonic solutions conduct electricity better than cells do
- conductivity varies proportionally to the number of cells
- cells conduct electricity better than saline does
- isotonic solutions cannot conduct electricity

A

isotonic solutions conduct electricity better than cells do
- electrical impedance, as cells pass through they will impede the electricity proportional to their size

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14
Q

a correction is necessary for WBC sounts when nRBCs are seen because:
- WBC count would be falsely lower
- RBC count too low
- nRBCs are counts as leukocytes
- nRBCs are confused with giant PLTs

A

nRBCs are counted as leukocytes (due to the nucleus still being present)

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15
Q

using an electronic cell counter analyzer, an increased RDW should correlate wit:
- spherocytosis
- anisocytosis
- leukocytosis
- presence of nRBCs

A

anisocytosis

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16
Q

The coulter principle for counting cells is based on 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

A. Isotonic solutions conduct electricity better than cells do
- as cells pass through the aperature the electric flow is impeded relative to the size of the cells

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17
Q

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

A

C. Coefficient of variation (stdev/mean)*100 compares precision

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18
Q

Which of the following is considered a normal hgb
A. Carbocyhemoglobin
B. Methemoglobin
C. Sulfhemaglobun
D. Deoxyhemoglobin

A

D. Deoxy
Unloaded O2 hgb

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19
Q

Which condition will shift the oxyhemoglobin dissociation curve to the right
A. Acidosis
B. Alkalosis
C. Multiple blood transfusions
C. Increased quantities of hgb S or C

A

A. Acidosis
Decreased affinity of hgb for O2

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20
Q

What is the major type of leukocyte seen in the peripheral blood smear from a patient with aplastic anemia
A. Segmented neutrophil
B. Lymphocyte
C. Monocyte
D. Eosinophil

A

B. Lymphocyte
Lymphocytes are the last cell line to be affected by aplastic anemia

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21
Q

What is the normal BWC differential lymphocyte percentage range in adult population
A. 5-10%
B. 10-20%
C. 20-40%
D. 50-70%

A

C. 20-40%

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22
Q

Which is the first stage of eyerhrocytic maturation in which the cytoplasm is pink because of the formation of hgb
A. Reticulocyte
B. Pronormoblast
C. Basophilic normoblast
D. Polychromatic normoblast

A

D. Polychromatic normoblast

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23
Q

Which of the following can shift the hgb oxygen dissociation curve to the right
A. Increase 2,3 DPG
B. Acidosis
C. Hypoxia
D all do these

A

D. All of these
More o2 releases to the cells, less affinity of hgb for o2

24
Q

which of the following hgb configurations is characteristic of hgb H
A. gamma 4
B. ahpa 2- gamma 2
c. beta 4
D. alpha 2 - beta 2

A

C. beta 4

25
Q

autoagglutination of RBCs at room temp can cause which of the following abnormal test results
A. low RBC count
B. high MCV
C. low HCT
D. all of these

A

D. all of these

26
Q

hypersplenism is characterized by:
A. polycythemia
B. pancytosis
C. Leukopenia
C. myelodysplasia

A

C. leukopenia

27
Q

which of the folliwng organs is responsible for ‘pitting process’ in RBCs
A. liver
B. spleen
C. kidney
D. lymph nodes

A

B. Spleen
- pitting process refers to inclusion removal

28
Q

spherocytes differ from normal RBCs in all of the following except
A. decreased surface to volume
B. no central pallor
C. decreased resistance to hypotonis saline
D. increased deformability

A

D. increased deformatbility
- spherocytes are stiff due to defect in spectrin

29
Q

which of the following is not associated with HS
A. increased osmotic fragility
B. MCHC greater than 36%
C. intravascular hemolysis
D. extravascular hemolysis

A

C. intravasular hemolysis
- hemolysis is extravascular (taking place in the spleen)

30
Q

which of the following disorders has an increase in osmotic fragility
A. IDA
B. HE
C. hereditary stomatocytosis
D. hereditary spherocytosis

A

D. hereditary spherocytois
- spherocytes are stiff and will burst sooner

31
Q

the anemia seen in sickle cell disease is usually
A. microcytic, normochromic
B. microcytic hypochromic
C. normocytic normochromic
D. normocytic hypochromic

A

C. normocytic normochromic
- hemolytic anemia

32
Q

which of the major hgb found in RBCs of patients with sickle cell trait
A. hgb S
B. hgb F
C. Hgb A2
D. hgb A

A

D. Hgb A
- sickle cell trait entails they have decreased beta chain production but still functional while hgb S is the second most common hgb

33
Q

selct the amino acid sub that is responsible for sickle cell anemia
A. lysine is substituted for glutamic acid at the 6th pos of the alpha chain
B. valine is sub for glutamic acid at the 6th pos of beta chain
C. valine is substituted for glutamic acid at the 6th pos of the alpha chain
D. glutamine is sub for glutamic acid at the 6th pos of the beta chain

A

B. valine is sub for glutamic acid at the 6th pos of the beta chain

34
Q

all of the following are usually found in hgb C disease except :
A. hgb C crystals
B. target cells
C. lysine sub for glutamic acid at the 6th pos of the beta chain
D. fast mobility of hgb C at pH of 8.6

A

D. fast mobility
- substitution of a pos charge amino acid for a neg charged results in slwoer mobility

35
Q

which of the following hgbs migrate =s to the same pos as Hgb A2 at pH 8.6
A. hgb H
B. hgb F
C. hgb C
D. hgb S

A

C, hgb C

36
Q

which of the following electrophoretic results is consistent with a diagnosis of sickle cell trait
A. hgb A 40%, hgb S 35%, hgb F 5%
B. A 60%, S 40%, A2 2%
C. A 0%, A2 5%, F 95%
D. A 80%, s 10%, A2 10%

A

B.
- hgb A is still the main hgb and beta chains still functional = small amount A2 but not F

37
Q

in which of the following conditions will autosplenectomy most likely occur
A. thal major
B. hgb C disease
C. hgb SC disease
D. sickle cell disease

A

D. sickle cell disease
- repeated infarcts to spleen

38
Q

which of the following is most true of PNH
A. rare acquired stem cell disorder that results in hemolysis
B. inherited as a sec linked trait
C. autosomal dominant
D. autosomal recessive

A

A. rare aquired stem cell disorder

39
Q

hemolytic uremic syndrom (HUS) is characterized by all of the following except
A. hemorrhage
B. thrombocytopenia
C. hemoglobinuria
D. reticulocytopenia

A

D. reticulocytopenia
- HUS will not reduce amount of retics formed, it will increase retic formation due to increased hemolysis

40
Q

the autohemolysis test results in positive in all of the following conditions except
A. G6PD deficiency
B. HS
C. PK deficiency
D. PNH

A

D. PNH
- pnh requires sucrose to enhance complement binding, all others listed the addition of sucrose in autohemolysis test will correct the hemolysis

41
Q

which antibody is associated with PCH
A. anti-I
B. anti-i
C. anti-M
D. anti-P

A

D. anti-P
- paroxysmal cold hemoglobinuria has to do with anti-P attaching when cold and lysing when warm
- its a pee problem and anti-P is the problem

42
Q

all of the following are associated with intravascular hemolysis except
A. methemoglobinemia
B. hemoglobinuria
C. hemoglobinemia
D. decreased haptoglobin

A

A. methemoglobinemia
- methemoglobinemia is in regards to iron in oxidized ferric state, not hemolysis

43
Q

autoimmune hemolytic anemia (AIHA) is best characterized by which of the following
A. increased levels of plasma C3
B. spherocytic RBCs
D. decreased osmotic fragility
D. decreased unconjugated bilirubin

A

B, spherocytic RBCs
- autoantibodies cause destruction of RBCs and spherocytes are indications of hemolysis

44
Q

bite cells are usually seen in patients with
A. Rh null trait
B. chronic granulomatous disease
C. G6PD deficiency
D. PK deficiency

A

C. G6PD deficiency
- in Dawns words ‘G6PD defieicny = heinz bodies’

44
Q

the morphological classification of anemias is based on which of the following
A. M:E ratio
B. prussian blue stain
C. RBC indices
D. reticulocyte count

A

C. RBC indices

45
Q

which of the following is a common finding in aplastic anemia
A. monoclonal disorder
B. tumor infiltration
C. peripheral pancytopenia
D. defective DNA synthesis

A

C. peripheral pancytopenia

46
Q

congenital dyserythropoitetic anemias (CDAs) are characterized by
A. bizarre multinucleated erythroblasts
B. cytogenetic disorders
C. megaloblastic erythropoiesis
D. elevated M:E ratio

A

A. bizarre multinucleated erythroblasts

47
Q

microangiopathic hemolytic anemia (MAHA) is charaterized by
A. target cells and cabot rings
B. toxic granulation and dohle bodies
C. pappenheimer bodies and basophilic stippling
D. shistocytes and nRBCs

A

D. shistocytes and nRBCs
- MAHA is fibrin strand spiderwebs in the vasculature leading to hemolysis

48
Q

which antibiotic(s) is (are) most often implicated in the development of aplastic anemia?
A. sulfonamides
B. penicillin
C. tetracycline
D. chloramphenicol

A

D. chloramphenicol

49
Q

sickle cell disorders are:
A. hereditary, intracorpuscular RBC defects
B. hereditary, extracorpuscular RBC defects
C. acquired, intracorpuscular RBC defects
D. acquired, extracorpuscular RBC dectes

A

A.

50
Q

which of the following conditions may produce spherocytes in peripheral blood smear
A. pelger huet anomaly
B. pernicious anemia
C. AIHA
D. sideroblastic anemia

A

C. AIHA
- pernicious = retics
- sideroblastic = basophilic

51
Q

a patients PS reveals nRBC, poik, polychromasia, decreased H/H, what other CBC parameters may be anticipated
A. reduced PLTs
B. increased MCHC
C. increased MCV
D. decreased RDW

A

C. increased MCV
- increased production of retics leads to increased RDW and larger red cells (which increases MCV)

52
Q

what RBC inclusion may be seen in PS from a patient post spelnectomy
A. toxic gran
B. HJ bodies
C. malarial parasites
D. siderotic granules

A

B. HJ bodies
- remnant DNA chunk on peripheral of RBC normally taken out by spleen

53
Q

reticulocytosis usually indicates
A. response to inflammatino
B. neoplastic process
C. aplastic anemia
D. RBC regeneration

A

D. RBC regeneration

54
Q

hereditary pyropoikilocytosis (HP) is an RBC membrane defect characterized by:
A. increased pencil shaped
B. increased oal macrocytes
C. misshapen budding framgented cells
D. bite cells

A

C. misshapen budding fragmented cells
- HP is related to spectrin abnormality and thermal instability

BOC study (harr book) (16 decks)

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