heme II final Flashcards by Rebecca Graves

A red cell which is narrow and elongated, resembling a cigar shape is called:

an ovalocyte
an elliptocyte
a sickle cell  		
a burr cell

elliptocyte

How well did you know this?

Not at all

Perfectly

Which of the following parameters are derived ( tested directly) by the Coulter instrument?

MCV

MCH

RDW

MCV and RDW

MCV and RDW

How well did you know this?

Not at all

Perfectly

Most/all granulocytes:

have phagocytic potential

persist less than 1 day in the peripheral circulation

precursors begin development in the bone marrow before birth

all of the above

all of the above

How well did you know this?

Not at all

Perfectly

The most buffering capacity is normally offered by the:

hemoglobin system

bicarbonate system

plasma protein system

phosphate system

hemoglobin system

How well did you know this?

Not at all

Perfectly

Specific (secondary) granules of the neutrophilic granulocyte:

appear first at the myelocyte stage

contain alkaline phosphatase

are formed on the mitochondria

are derived from azurophilic (primary) granules

appear first at the myelocyte stage

How well did you know this?

Not at all

Perfectly

The normal RDW is:

9. 5-11.5%
10. 5-13.5%
11. 5-14.5%
12. 5-15.5%

11.5-14.5%

How well did you know this?

Not at all

Perfectly

A cell observed on a blood smear appears to have bluish cytoplasm and a dark purple nucleus. The nucleus appears folded over and the N:C is about 2:1. The cell is identified as:
a neutrophil
a lymphocyte
a monocyte
a basophil

a monocyte

How well did you know this?

Not at all

Perfectly

The correct sequence for peripheral WBC percentages going from highest to lowest is/are:
lymphocytes?granulocytes>eosinophils
eosinophils>basophils>lymphocytes
neutrophils>bands>basophils
granulocytes>eosinophils>lymphocytes

neutrophils>bands>basophils

How well did you know this?

Not at all

Perfectly

If a number of nucleated RBCs are seen in the peripheral circulation, it is possible that:
the patient is a newborn
some type of physiological change has occurred
Stress on the red cell-producing apparatus
all are correct

all are correct

How well did you know this?

Not at all

Perfectly

Neutrophils normally account for what percentage of the total white cell population in peripheral blood
0-4%
2-9%
20-40%
50-70%

50-70%

How well did you know this?

Not at all

Perfectly

a cell observed on a blood smear has a N:C of 4:1. The nucleus is round and stains dark blue-purple. The cytoplasm is light blue. There are very few to no granules in the cytoplasm. This cell is probably:
a band neutrophil
a monocyte
a lymphocyte
a basophil

a lymphocyte

How well did you know this?

Not at all

Perfectly

those parameters measured directly by the Coulter counter include:
RBC, WBC, and hematocrit
RBC and WBC
Hemoglobin
b and c are true

b and c are true

How well did you know this?

Not at all

Perfectly

a MCH of 30pg suggests
hypochromia
poikilocytosis
microcytosis
normochromia

normochromia

How well did you know this?

Not at all

Perfectly

The last cell in the RBC series which normally has a nucleus is the:
progenitor cell
metarubricyte
reticulocyte
answers b and c are true

metarubicyte

How well did you know this?

Not at all

Perfectly

An R3 flag on the Coulter instrument may mean:
a shift to the left
eosinophilia
neutrophilia
all of the above

all of the above

How well did you know this?

Not at all

Perfectly

The white cell which typically responds to parasitic infections is the:

neutrophil

lymphocyte

monocyte

eosinophil

eosinophil

How well did you know this?

Not at all

Perfectly

Electronic Impedance-

Relates the charge of the particle to the size of the signal

Relates the amplitude of the signal to the size of the particle

Is based on the fact that cells conduct electricity poorly

Only b and c are true

b and c are true

How well did you know this?

Not at all

Perfectly

The normal adult hemoglobin value in a male is:  
    10-14 g/dL    		
    12-16 g/dL    		
    14-18 g/dl   		
    14-22 g/dL

14-18 g/dL

How well did you know this?

Not at all

Perfectly

The normal MCH value is:    		
    23 - 25 pg    		
    25 - 27 pg    		
    27 - 31 pg    		
    31 - 35 pg

27-31 pg

How well did you know this?

Not at all

Perfectly

Calculated parameters include: 
    RBC    		
    MCV    		
    MPV    		
    Hematocrit

hematocrit

How well did you know this?

Not at all

Perfectly

Sources of error in the RBC count include:
high readings with RBC agglutination
microcytic specimens
macrocytic specimens
b and c are true

b and c are true

How well did you know this?

Not at all

Perfectly

On an electronic cell counter, hemoglobin determination may be falsely elevated owing to the presence of:
lipemia or elevated bilirubin concentration
a decreased WBC or lipemia
an elevated bilirubin concentration or rouleaux
rouleaux or lipemia

lipemia or elevated bilirubin concentration

How well did you know this?

Not at all

Perfectly

Another cell observed on a blood smear has a nucleus with 2 distinct lobes. The cytoplasm is a pink color. There are also large dark orangish-pink uniform granules in the cytoplasm. This cell is probably:		
    a segmented neutrophil    		
    a band neutrophil    		
    a basophil    		
    an eosinophil

an eosinophil

How well did you know this?

Not at all

Perfectly

The last cell of the granulocyte series capable of dividing is the:    		
    Myeloblast    		
    Promyelocyte    		
    Myelocyte    		
   Metamyelocyte

myelocyte

How well did you know this?

Not at all

Perfectly

The normal value for a red cell count in an adult female is approximately: 3. 0-4.0 x 106/L 3. 5-4.5 x 106/L 4. 0 - 5.0 x 106/L 5. 0-6.0 x 106/L

4.0-5.0 X 10(6)/L

``` Cells involved in hemostasis are: erythrocytes granulocytes lymphocytes thrombocytes ```

thrombocytes

``` A red cell which with a central bull's eye surrounded by a clear ring and then an outer red ring is called: a spherocyte an ovalocyte a stomatocyte a target cell ```

a target cell

``` The normal value for a platelet count in an adult is approximately: 100,000-150,000/L 150,000-350,000/L 150,000-350,000/L 350,000-500,000/L ```

150,000-350,000/L

Regarding B cells: produce antibodies G, A, M, D, and E are often stimulated by T cells become Plasma cells when stimulated all are correct

all are correct

``` Unusual red cell size may include the term(s): anisocytosis poikilocytosis hemochromotosis none of the above ```

anisocytosis

When using an electronic cell counter, which of the following results can occur in the presence of a cold agglutinin? increased MCV and decreased RBC increased MCV and normal RBC decreased MCV and increased RBC decreased MCV and RBC

increased MCV and decreased RBC

``` A cell observed on a blood smear has a nucleus with 2 distinct lobes which stains a dark blue. However, the nucleus is somewhat obscured by the large, coarse violet-blue granules in the cell. This cell is probably: a eosinophil a lymphocyte a basophil a monocyte ```

a basophil

``` The normal MCHC value is: 25-29% 29-32% 32-36% 36-40% ```

32-36%

``` A red cell which looks as if a bite has been taken out of it is often called: a sickle cell a schistocyte a helmet cell a burr cell ```

a helmet cell

The correct erythroid developmental sequence is the following: rubriblast, rubricyte, polychromatophilic erythrocyte prorubricyte, rubriblast, erythrocyte rubricyte, metarubricyte, prorubricyte rubriblast, metarubricyte, rubricyte

rubiblast, rubicyte, polychromatophilic erythrocyte

The macrophage is most notable for: antigen processing and presentation to the B cell antigen processing and presentation to the T cell phagocytosis of foreign antigens all are correct only b and c are correct

only b and c are correct

The normal value for a white cell count in an adult is approximately: 2. 5-6.5 x 103/L 3. 0-7.3 x 103/L 4. 8-10.6 x 103/L 5. 2-12.7 x 103/L

4.8-10.6 X 10(3)/L

``` Unusual red cell shape is referred to as: anisocytosis macrocytosis microcytosis poikilocytosis ```

poikilocytosis

``` In an electronic or laser particle cell counter clumped platelets may interfere with which of the following parameters? white blood cell count red blood cell count hemoglobin hematocrit ```

white blood cell count

``` A cell observed on a blood smear has pinkish cytoplasm containing light pink granules and the nucleus is reddish-purplish in the shape of a horseshoe. The cell is identified as: an eosinophil a band neutrophil a segmented neutrophil a basophil ```

a band neutrophil

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

spherocyte

Which of the following is the correct order of maturation of the granulocyte? Myeloblast, Myelocyte, Promyelocyte, Band Myelocyte, Band, Metamyelocyte Myeloblast, Myelocyte, Band Metamyelocyte, Promyelocyte, Myelocyte

myeloblast, myelocyte, band

``` An MCV of 75 fL suggests: microcytosis macrocytosis poikilocytosis all of the above ```

microcytosis

The normal value for reticulocytes in the adult peripheral blood is: 0. 0-1.0% 0. 5-2.0% 1. 5-3.0% 2. 5-4.0%

0.5-2.0%

The basophil: is the smallest of the granulocytes is sometimes called a "mast" cell in tissues releases histamine and other vasoactive substances causing anaphylaxis all are correct

all are correct

``` Lymphocytes account for what percentage of the total white cell population in peripheral blood? 0-4% 2-9% 20-40% 50-70% ```

20-40%

``` A patient who has increased serum proteins such as globulins may have red cells that stick together. This is called: agglutination aggregation rouleaux precipitation ```

rouleaux

The normal M:E ratio in an adult is: 1: 1.5 3: 1 5: 1 9: 1

3:1

``` Fragments of red cells are called: target cells sickle cells acanthocytes schistocytes ```

schistocytes

``` The antihemophilic factor is III V VIII XIII none of these ```

VIII

``` The "cascade" theories state that most of the activated coagulation factors function as enzymes proteins vitamins conglutinins ```

enzymes

``` In the extrinsic pathway, which of the following is NOT a part of the activation of factor X tissue thromboplastin factor VII HMWK calcium ```

HMWK

``` Approximately what portion of the platelets released into the circulating bloodstream are sequestered in the spleen 1/10 1/3 1/2 2/3 ```

1/3

``` As part of clot initiation, platelets release ADP serotonin PF3 Thromboxane A2 All of these ```

all of these

Thrombocytosis is classified as: Platelet count less than 400 x 103/µl Platelet count more than 500 x 103/µl Platelet count is 100-350 x 103/µl Platelet count is more than 50 x 103/µl

platelet count more than 500 X 10(3)/uL

``` A patient is placed on heparin therapy. The dosage is monitored using the following test: platelet count bleeding time prothrombin time partial thromboplastin time ```

partial thromboplastin time

``` Complete the equation: fibrinogen ---->_________________ thrombin thromboplastin fibrin fibrinoplastin ```

fibrin

In the equation: prothrombin ------> thrombin ,which of the following is a part of the process thrombcysthenin profibrin thromboplastin

thromboplastin

``` I II IV VIII IX XII XIII ``` ``` Answer A. fibrinogen B. fibrin stabilizing factor C. ionic calcium D. antihemophilic factor E. prothrombin F. Hageman factor G. Christmas factor ```

``` I - fibrinogen II- prothrombin IV- ironic calcium VIII- antihemophilic factor IX- christmas factor XII- Hageman factor XIII- fibrin stabilizing factor ```

The function of factor XIII is stabilize fibrin monomers initiate the extrinsic sequence initiate the intrinsic pathway act as a cofactor in the common pathway

stabilize fibrin monomers

``` Platelets begin to be separated by ______________ within the platelet forming cell demarcation membrane system separating membrane system plateletizing system thrombocyting system none of these ```

demarcation membrane system

``` A patient is placed on coumadin therapy. The dosage is monitored using the following test: platelet count bleeding time prothrombin time partial thromboplastin time ```

prothrombin time

``` A patient is suspected of having DIC (disseminated intravascular coagulation). Which of the following tests will tell the physician if fibrinolysis has been in process?: PT PTT FDP none of these ```

FDP

When plasmin attacks fibrinogen, it is called secondary hemostasis primary fibrinolysis primary hemostasis

primary fibrinolysis

``` The average life span of a platelet in the peripheral blood is ________ days. 2 5 10 14 ```

``` Platelet production is regulated by thrombopoietin leukopoietin erythropoietin platepoietin ```

thrombopoietin

``` The proteolytic enzyme that is responsible for fibrinolysis plasminogen fibrinogen proteothrombin plasmin ```

plasmin

``` What is needed to complete the equation: prothrombin ---------> thrombin iron fibrin calcium phosphorus ```

calcium

Following repair of the tissue, when the clot is no longer needed it is removed by fibrinolysis filtered by the spleen phagocytized by monocytes it is not removed - it is incorporated into the new tissue

fibrinolysis

``` Which of the following factors is NOT needed in the extrinsic pathway tissue factor VIII X V fibrinogen ```

VIII

``` Which coagulation factor can activate plasminogen VIII X VII XII ```

XII

``` The soluble pieces formed during fibrinolysis are called solufibrinogen plasminogen fibrin split products fibrin strands ```

fibrin split products

``` Immediately following blood vessel injury, platelets adhere to which of the following collagen fibers endothelial cells fibroblasts smooth muscle fibers ```

collagen fibers

``` Which of the following coagulation factors does NOT need vitamin K for it's synthesis 11 XIII VII IX ```

XIII

``` The process of breaking down a clot is called hemostasis fibrinolysis thrombolysis plasmonolysis ```

fibrinolysis

``` The average platelet count ranges from __________ of whole blood. 50 - 100 x 103/µl 350 - 600 x 103/µl 150 - 400 x 103/µl 50 - 300 x 103/µl ```

150 - 400 x 103/µl

Which of the following is NOT a function of platelets. clot retraction to secondary hemostatic plug shape change and release aggregation carry nutrients all are functions

carry nutrients

``` The process whereby blood is ready and able to become a solid in a needed area; and remain flowing as a liquid elsewhere is coagulation adhesion hemostasis homeostasis ```

Hemostasis

Abnormal hemoglobins may produce severe disease states True False

true

``` The acid part of the Wright's stain will stain nuclei and some cytoplasmic structures red blue a mixture of red and blue none of these ```

red

Anemia is a result of all of these reduced hemoglobin concentration decrease in the number of circulating RBC ineffective erythropoiesis none of these

all of these

``` An increase in the production of cells is called polycythemia porphobilinogen polychromasia poikilocytosis ```

polycythemia

``` A cell line that will increase in response to viral infection is monocyte neutrophil lymphocyte eosinophil ```

lymphocyte

``` The cell seen under the microscope that has a round to oval nucleus with 'robins egg blue ' cytoplasm is a/an neutrophil eosinophil basophil lymphocyte none of these ```

lymphocyte

Cells are identified according to cell size, nuclear characteristics, and cytoplasmic characteristics cell size, nuclear characteristics, and chemical constituents age of the cell, chromatin quality, and the arrangement of lipid chemical constituents none of these

cell size, nuclear characteristics, and cytoplasmic characteristics

``` The yolk sac is the blood forming structure of the infant juvenile fetus adult ```

infant

``` Cells that arise in response to viral infections are monocytes lymphocytes neutrophils eosinophils ```

lymphocyte

``` A cell not normally found in the peripheral blood might be band metamyelocyte monocyte eosinophil none of these ```

metamyelocyte

``` RBC's that exhibit a variety of shapes are called poikilocytes anisocytes macrocytes microcytes none of these ```

poikilocytes

Hemoglobin contains a heme portion and albumin an iron containing portion called heme and a protein portion called globin an iron containing portion called globin and a protein containing portion called heme an iron containing portion called ferritin and a protein containing portion called albumin none of these

an iron containing portion called heme and a protein portion called globin

``` A hemoglobin reagent that contains cyanide and a buffer is called Drabkin's Dracula's methemoglobin all of these none of these ```

Drabkin's

``` Hemoglobin A1 consists of two types of globin chains alpha and delta alpha and epsilon alpha and gamma gamma and delta none of these ```

none of these

The following cells are granulocytes metamyelocytes, basophils, monocytes lymphocytes, basophils, neutrophils lymphocytes, monocytes, stabs myelocytes, metamyelocytes, bands none of these

metamyelocyte, metamyelocytes, bands

``` RBC's that are smaller than normal are called macrocytes polychromatic hypochromic microcytes anisocytes ```

microcytes

Segmented neutrophils have a pink cytoplasm have lobes connected by filaments have a constricted nucleus with 3-5 lobes all of these none of these

all of these

``` Leukopoiesis is the formation of red blood cells white blood cells blood cellular elements platelets none of these ```

white blood cells

``` Pernicious anemia is characterized by cells that are macrocytic microcytic hypochromic none of these ```

macrocytic

``` In the Wright's stain if the stain appears too red this may be an indication that the pH of the buffer is too acid too alkaline neutral none of these ```

too acid

An effective diluent for WBC counts allows only red blood cells to be counted you to distinguish nucleated RBC from WBC all cells to be counted at the same time all nonnucleated RBC to be hemolyzed

all nonnucleated RBC to be hemolyzed

``` Cells that respond to allergies and parasitic infections basophils lymphocytes monocytes eosinophils ```

eosinophils

``` Bands have a sausage shaped nucleus have several nucleoli have a kidney shaped nucleus have a round nucleus none of these ```

have a sausage shaped nucleus

``` Which of the following solutions is used to dilute WBC counts acetic acid Hayem's Drabkin's Turk's sodium hydroxide ```

acetic acid

``` The objective you used when you do a differential count is low high dry none of these oil immersion ```

oil immersion

``` The granules in the eosinophil contain histamine antihistamine lysozyme all of these ```

antihistamine

``` Cells responsible for recognizing abnormal substances B lymphocytes monocytes T lymphocytes null cells plasma cells ```

T lymphocytes

``` The mature neutrophil normally exhibits ______ lobe/s 3-5 none 1-2 5-7 ```

3-5

``` Neutrophils are associated with bacterial infections parasites iron deficiency bleeding ```

bacterial infections

``` The cell that stains uniformly pink with a pale central area is called a/an neutrophil erythrocyte thrombocyte eosinophil ```

erythrocyte

``` Hemoglobin molecule that is fully saturated with oxygen is called reduced hemoglobin oxidized hemoglobin oxyhemoglobin all of these none of these ```

oxyhemoglobin

``` A common method used for testing hemoglobin concentration is none of these Tallquists Oxyhemoglobin Drabkins Sahli ```

drabkins

``` In a normal differential you would expect to count ________% lymphocytes 2-10 60-75 25-35 0-1 ```

25-35

``` Normal adults have three hemoglobins in their red blood cells. These are A1,F,A2 A1,G,F F,A2,A3 A1,A2,S none of these ```

A1,F,A2

``` The concentration of normal saline is 0.65% 0.85% 0.95% 0.75% none of these ```

0.85%

The buffer used with the Wright's stain procedure must be pH _____ 4. 6 5. 7 6. 4 7. 6

6.4

``` The CellDyn printout ( like the one you used when doing diffs) provides an automated cell count histogram analysis 3 part differential none of these more than one of these ```

more than one of these

``` The stained blood smear should be rinsed with phosphate buffer tap water distilled water methyl alcohol none of these ```

distilled water

``` The term that refers to the formation of platelets is thrombopoiesis leukopoiesis erythropoiesis cytology ```

thrombopoiesis

``` A microcytic anemia would have the following MCV less than 80 fl MCH greater than 45 pg MCHC greater than 45% not related to MCV, MCH, MCHC ```

MCV less than 80fl

``` The cyanmethemoglobin procedure requires a spectrophotometer setting of 540 nm 440 nm 590 nm 625 nm ```

540 nm

``` Cells that increase in bacterial infections are lymphocytes neutrophils basophils eosinophils ```

neutrophils

``` A diluent used to count WBC may be normal saline 0.1N HCl 2% acetic acid purified water ```

2% acetic acid

The mature eosinophil may be increased in allergic reaction has no specific staining granules has a five lobed nucleus all of these none of these

may be increased in allergic reaction

Water is the classic _____________ solution hypotonic hypertonic isotonic

hypotonic

``` The most commonly seen WBC in a normal adult smear is basophil lymphocyte neutrophil erythrocyte ```

neutrophil

``` The cell that produce antibodies is called a/an eosinophil monocyte basophil lymphocyte ```

lymphocyte

``` The mature basophil has pale red cytoplasm moderate to heavy deep red cytoplasm none of these more that 3 lobe all of these ```

none of these

``` The most rare cell found in the normal peripheral smear is the basophil neutrophil lymphocyte monocyte eosinophil ```

basophil

``` The most common cell seen in a peripheral blood smear is a/an neutrophil basophil eosinophil lymphocyte none of these ```

neutrophil

1. Normal adults have three hemoglobins in their red blood cells. These are A1,F,A2 A1,G,F F,A2,A3 A1,A2,S none of these

A1, F, A2

1. The granules in the eosinophil contain histamine antihistamine lysozyme all of these

antihistamine

1. The mature neutrophil normally exhibits ______ lobe/s 3-5 none 1-2 5-7

3-5

1. A common method used for testing hemoglobin concentration is none of these Tallquists Oxyhemoglobin Drabkins Sahli

Drabkins

Abnormal hemoglobins may produce severe disease states True False

true

1. Hemoglobin contains a heme portion and albumin an iron containing portion called heme and a protein portion called globin an iron containing portion called globin and a protein containing portion called heme an iron containing portion called ferritin and a protein containing portion called albumin none of these

an iron containing portion called heme and a protein portion called globin

1. Segmented neutrophils have a pink cytoplasm have lobes connected by filaments have a constricted nucleus with 3-5 lobes all of these none of these

all of these

1. A microcytic anemia would have the following MCV less than 80 fl MCH greater than 45 pg MCHC greater than 45% not related to MCV, MCH, MCHC

MCV less than 80 fl

1. In the Wright's stain if the stain appears too red this may be an indication that the pH of the buffer is too acid too alkaline neutral none of these

too acid

1. The cyanmethemoglobin procedure requires a spectrophotometer setting of 540 nm 440 nm 590 nm 625 nm

540 nm

1. The buffer used with the Wright's stain procedure must be pH _____ 4. 6 5. 7 6. 4 7. 6

6.4

1. Neutrophils are associated with bacterial infections parasites iron deficiency bleeding

bacterial infections

1. Pernicious anemia is characterized by cells that are macrocytic microcytic hypochromic none of these

macrocytic

1. An effective diluent for WBC counts allows only red blood cells to be counted you to distinguish nucleated RBC from WBC all cells to be counted at the same time all nonnucleated RBC to be hemolyzed

all nonnucleated RBC to be hemolyzed

1. Cells that arise in response to viral infections are monocytes lymphocytes neutrophils eosinophils

lymphoctes

1. The CellDyn printout ( like the one you used when doing diffs) provides an automated cell count histogram analysis 3 part differential none of these more than one of these

more than one of these

1. The mature eosinophil may be increased in allergic reaction has no specific staining granules has a five lobed nucleus all of these none of these

may be increased in allergic reactions

1. The cell that produce antibodies is called a/an eosinophil monocyte basophil lymphocyte

lymphocyte

``` The most rare cell found in the normal peripheral smear is the basophil neutrophil lymphocyte monocyte eosinophil ```

basophil

``` The mature basophil has pale red cytoplasm moderate to heavy deep red cytoplasm none of these more than 3 lobes all of these ```

none of these

1. Bands have a sausage shaped nucleus have several nucleoli have a kidney shaped nucleus have a round nucleus none of these

have a sausage shaped nucleus

1. Leukopoiesis is the formation of red blood cells white blood cells blood cellular elements platelets none of these

white blood cells

1. The acid part of the Wright's stain will stain nuclei and some cytoplasmic structures red blue a mixture of red and blue none of these

red

1. The following cells are granulocytes metamyelocytes, basophils, monocytes lymphocytes, basophils, neutrophils lymphocytes, monocytes, stabs myelocytes, metamyelocytes, bands none of these

myelocytes, metamyelocytes, bands

1. A diluent used to count WBC may be normal saline 0.1N HCl 2% acetic acid purified water

2% acetic acid

1. The most commonly seen WBC in a normal adult smear is basophil lymphocyte neutrophil erythrocyte

neutrophil

1. A cell line that will increase in response to viral infection is monocyte neutrophil lymphocyte eosinophil

lymphocyte

1. The term that refers to the formation of platelets is thrombopoiesis leukopoiesis erythropoiesis cytology

thrombopoiesis

1. Cells that respond to allergies and parasitic infections basophils lymphocytes monocytes eosinophils

eosinophils

1. The most common cell seen in a peripheral blood smear is a/an neutrophil basophil eosinophil lymphocyte none of these

neutrophil

1. Hemoglobin molecule that is fully saturated with oxygen is called reduced hemoglobin oxidized hemoglobin oxyhemoglobin all of these none of these

oxyhemoglobin

1. The cell seen under the microscope that has a round to oval nucleus with 'robins egg blue ' cytoplasm is a/an neutrophil eosinophil basophil lymphocyte none of these

lymphocyte

1. Which of the following solutions is used to dilute WBC counts acetic acid Hayem's Drabkin's Turk's sodium hydroxide

acetic acid

1. An increase in the production of cells is called polycythemia porphobilinogen polychromasia poikilocytosis

polycythemia

1. In a normal differential you would expect to count ________% lymphocytes 2-10 60-75 25-35 0-1

25-35

1. RBC's that are smaller than normal are called macrocytes polychromatic hypochromic microcytes anisocytes

microcytes

1. The stained blood smear should be rinsed with phosphate buffer tap water distilled water methyl alcohol none of these

distilled water

1. The yolk sac is the blood forming structure of the infant juvenile fetus adult

fetus

1. The concentration of normal saline is 0. 65% 0. 85% 0. 95% 0. 75% none of these

0.85%

1. Cells are identified according to cell size, nuclear characteristics, and cytoplasmic characteristics cell size, nuclear characteristics, and chemical constituents age of the cell, chromatin quality, and the arrangement of lipid chemical constituents none of these

cell size, nuclear characteristics, and cytoplasmic characteristics

1. RBC's that exhibit a variety of shapes are called poikilocytes anisocytes macrocytes microcytes none of these

poikilocytes

1. Water is the classic _____________ solution hypotonic hypertonic isotonic

hypertonic

1. A cell not normally found in the peripheral blood might be band metamyelocyte monocyte eosinophil none of these

metamyelocyte

1. Hemoglobin A1 consists of two types of globin chains alpha and delta alpha and epsilon alpha and gamma gamma and delta none of these

none of these

1. The cell that stains uniformly pink with a pale central area is called a/an neutrophil erythrocyte thrombocyte eosinophil

erythrocyte

1. Cells that increase in bacterial infections are lymphocytes neutrophils basophils eosinophils

neutrophils

1. The objective you used when you do a differential count is low high dry none of these oil immersion

oil immersion

1. Cells responsible for recognizing abnormal substances B lymphocytes monocytes T lymphocytes null cells plasma cells

T lymphocytes

1. Anemia is a result of all of these reduced hemoglobin concentration decrease in the number of circulating RBC ineffective erythropoiesis none of these

all of these

1. A hemoglobin reagent that contains cyanide and a buffer is called Drabkin's Dracula's methemoglobin all of these none of these

Drabkin's

``` What is the term for the clinical course of homozygous thalassemias resulting from defects in - and -chain synthesis? Thalassemia minor Thalassemia major Thalassemia trait á-thalassemia ```

Thalassemia major

What factors contribute to the sickling of RBCs? increase in pH and oxygenation decrease in pH and oxygenation, and dehydration increase in pH and decrease in oxygenation decrease in dehydration and increase in pH and oxygenation

decrease in pH and oxygenation, and dehydration

All of the findings listed below may be seen in acquired hemolytic anemia of the autoimmune variety. The one considered to be the MOST characteristic is: increased osmotic fragility leukopenia and thrombocytopenia peripheral spherocytosis positive direct antiglobulin test

positive direct antiglobulin test

The Schilling test: evaluates the function of intrinsic factor evaluates the absorption of vitamin B12 evaluates the absorption of folic acid all of the above

evaluates the absorption of vitamin B12

``` The lab tests performed on a patient indicate macrocytosis, anemia, leukopenia, and thrombocytopenia. Which of the following disorders is the patient most likely to have? iron deficiency hereditary spherocytosis vitamin B12 deficiency acute hemorrhage ```

vitamin B12 deficiency

Which of the following represents characteristic features of iron metabolism in patients with anemia of a chronic disorder? serum iron is normal, transferrin saturation is normal, TIBC is normal serum iron is increased, transferrin saturation is increased, TIBC is normal or slightly increased serum iron is normal, transferrin saturation is markedly increased, TIBC is normal serum iron is decreased, transferrin saturation is decreased, TIBC is normal or decreased

serum iron is decreased, transferrin saturation is decreased, TIBC is normal or decreased

marrow hypoplasia inadequate erythropoietin vitamin B12 deficiency increased erythropoietin production

inadequate erythropoietin

``` Laboratory findings in hereditary spherocytosis do NOT include: decreased osmotic fragility increased autohemolysis reticulocytosis shortened erythrocyte survival ```

decreased osmotic fragility

The pathophysiology of megaloblastic anemia is : Defective RNA synthesis and abnormal cytoplasm maturation Defective DNA synthesis and abnormal nuclear maturation Defective RNA synthesis and abnormal nuclear maturation Defective DNA synthesis and abnormal cytoplasm maturation

defective DNA synthesis and abnormal nuclear maturation

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

pancytopenia and macrocytosis

``` Which of the following are not seen on the peripheral smear of a patient with megaloblastic anemia? macro-ovalocytes hypersegmented neutrophils hyposegmented neutrophils Howell-Jolly bodies ```

hyposegmented neutrophils

``` Hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) is: temperature dependent complement independent antibody mediated caused by a red cell membrane defect ```

caused by a red cell membrane defect

``` The most appropriate screening test for hereditary spherocytosis is: osmotic fragility sucrose hemolysis heat instability test Kleihauer-Betke ```

osmotic fragility

What is the amino acid substitution found in HbC disease? substitution of valine for glutamic acid in the sixth position from the NH2 terminal chain substitution of lysine for glutamic acid in the sixth position from the NH2 terminal chain substitution of lysine for glutamic acid in the 26th position from the NH2 terminal chain substitution of valine for glutamic acid in the 121st position from the NH2 terminal chain

substitution of lysine for glutamic acid in the sixth position from the NH2 terminal chain

``` A 15 year old girl is taking medication for a parasitic infection and notices her urine is a brownish color. A CBC shows mild anemia. The laboratorian performing the reticulocyte count notices numerous irregular shaped granules near the periphery of the RBC. These cellular inclusions are most likely: Howell-Jolly bodies basophilic stippling Heinz bodies Pappenheimer bodies ```

Heinz bodies

A patient's blood sample mixed with sucrose solution and incubated at 37C shows moderate hemolysis. The direct antiglobulin test was negative. These results are suggestive of: lupus erythromatosus polycythemia vera acquired autoimmune hemolytic anemia paroxysmal nocturnal hemoglobinuria

paroxysmal nocturnal hemoglobinuria

Patients with (A-) type G-6-PD deficiency are LEAST likely to have hemolytic episodes in which of the following situations? following the administration of oxidizing drugs the neonatal period during infections spontaneously

spontaneously

What deficiency causes hemoglobin to be oxidized from the ferrous to the ferric state? G6PD deficiency PK deficiency NADH-methemoglobin reductase deficiency lactate dehydrogenase deficiency

NADH-methemoglobin reductase deficiency

The anemia of chronic infection is characterized by: decreased iron stores in the reticuloendothelial system decreased serum iron levels macrocytic erythrocytes increased serum iron-binding capacity

decreased serum iron levels

``` The most appropriate screening test for hemoglobin S is: Kleihauer-Betke dithionite solubility osmotic fragility sucrose hemolysis ```

dithionite solubility

``` Which of the following is most likely and most easily seen in lead poisoning? iron overload in tissue codocytes basophilic stippling ringed sideroblasts ```

basophilic stippling

Which is the most frequent functional abnormality affecting membrane skeleton proteins in common hereditary elliptocytosis? defective binding of spectrin to ankyrin defective spectrin tetramer assembly defective binding of ankyrin to protein 3 deficiency of protein 4.1

defective spectrin tetramer assembly

``` What is the typical appearance of anemia associated with liver disease? normal red cell morphology hypochromic, microcytic macrocytic, normoblastic macrocytic, megaloblastic ```

macrocytic, normoblastic

``` They glycoprotein necessary for absorption of vitamin B12 is: albumin transcobalamin II haptoglobin intrinsic factor ```

intrinisic factor

What routine hematologic finding is indicative of thalassemia? microcytic, hypochromic anemia macrocytic, hypochromic anemia normocytic, normochromic anemia macrocytic, normochromic anemia

microcytic, hypochromic anemia

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

target cells

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 disorder is considered to be a disorder of membrane cation permeability? G6PD deficiency hereditary spherocytosis hereditary elliptocytosis hereditary stomatocytosis ```

hereditary stomatocytosis

The values below were obtained on an automated blood count system performed on a blood sample from a 25 year old man: Patient ValueNormal ValueWBC5.1 x 103/L5.0-10.0 x 103/LRBC3.00 x 106/L4.6-6.2 x 106/LHgb12 g/dL14-18 g/dLHct36%40-54%MCV120 fL82-90 fLMCH40 pg27-31 pgMCHC33%32-36% These results are most consistent with which of the following? megaloblastic anemia hereditary spherocytosis a high titer of cold agglutinins an elevated reticulocyte count

megablastic anemia

``` Which of the following is a cause of methemoglobinemia? HbM variants NADH-diaphorase deficiency toxic substances all of the above ```

all of the above

``` The most appropriate screening test for hemoglobin H is: dithionite solubility osmotic fragility sucrose hemolysis heat instability test ```

heat instability test

Which of the following findings would be indicative of heterozygous thalassemia? hemoglobin A2 level of 3.5-7% hemoglobin F level less than 2% hemoglobin A level of 65-85% hemoglobin A2 level less than 3.5%

hemoglobin A2 level of 3.5-7%

``` A patient has the following blood values: RBC 6.5 x 106/L Hgb 14.0 g/dL Hct 42.0% MCV 65 fL MCH 21.5 pg MCHC 33% These results are compatible with: iron deficiency pregnancy thalassemia minor beta thalassemia major ```

thalassemia minor

``` Which of the following is most closely associated with iron deficiency anemia? iron overload in tissue target cells basophilic stippling chronic blood loss ```

chronic blood loss

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

gamma chain production of equals alpha chain production

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

absence of 3 of 4 alpha genes

What causes the defect in PNH? rare red cell antigens lack of GPI-anchored proteins on the erythrocyte membrane excessive amounts of complement components C5 to C9 Glucose-6-phosphate-dehydrogenase enzyme deficiency

lack of GPI-anchored proteins on the erythrocyte membran

Which of the following sets of laboratory findings is consistent with hemolytic anemia? normal or slightly increased erythrocyte survival; normal osmotic fragility decreased erythrocyte survival; increased catabolism of heme decreased serum lactate dehydrogenase activity; normal catabolism of heme normal concentration of haptoglobin; marked hemoglobinuria

decreased erythrocyte survival; increased catabolism of heme

``` Anemia secondary to uremia characteristically is: microcytic, hypochromic hemolytic normocytic, normochromic macrocytic ```

normocytic, normochromic

``` Which of the following is NOT a cause of nonmegaloblastic anemia? alcoholism immunosuppressive drugs hypothyroidism hyperthyroidism ```

hyperthroidism

An enzyme deficiency associated with a moderate to severe hemolytic anemia after the patient is exposed to certain drugs and that is characterized by red cell inclusions formed by denatured hemoglobin is: lactate dehydrogenase deficiency G-6-PD deficiency pyruvate kinase deficiency hexokinase deficiency

G-6-PD deficiency

``` What is the treatment for anemia of inflammation? blood transfusion iron therapy treatment of the inflammation human recombinant IL-1 ```

treatment of the inflammation

Heinz bodies are: readily identified with polychrome stains rarely found in glucose-6-phosphate dehydrogenase deficient erythrocytes closely associated with spherocyte denatured hemoglobin inclusions that are readily removed by the spleen

denatured hemoglobin inclusions that are readily removed by the spleen

``` Which of the following is seen most often in thalassemia? chronic blood loss target cells basophilic stippling ringed sideroblasts ```

target cells

Which of the following are causes of anemia of inflammation? increased destruction of red cells impaired iron metabolism suppression of erythropoiesis by cytokines all of the above

all of the above

The hypochromic anemias represent a related group of disorders with: a quantitative defect in hemoglobin synthesis a qualitative defect in globin synthesis excess hemoglobin synthesis Vitamin B12 and folate deficiency

a quantitative defect in hemoglobin synthesis

``` What is the primary risk to thalassemia major patients who are on a high transfusion program? hyperviscosity of blood iron overload citrate toxicity electrolyte imbalance ```

iron overload

What is the amino acid substitution found in sickle cell anemia? substitution of valine for glutamic acid in the sixth position from the NH2 terminal chain substitution of lysine for glutamic acid in the sixth position from the NH2 terminal chain substitution of lysine for glutamic acid in the 26th position from the NH2 terminal chain substitution of valine for glutamic acid in the 121st position from the NH2 terminal chain

substitutionof valine for glutamic acid in the sixth position from the NH2 terminal chain

According to the morphological classification of anemias, megaloblastic anemia is a: macrocytic, hypochromic anemia macrocytic, hyperchromic anemia macrocytic, normochromic anemia normocytic, normochromic anemia

macrocytic, normochromic anemia

Thalassemias are characterized by: structural abnormalities in the hemoglobin molecule absence of iron in hemoglobin decreased rate of heme synthesis decreased rate of globin synthesis

decreased rate of globin synthesis

1. The cell which may be found in all types of Hodgkin's disease is: Sezary cell Flame cell Niemann-Pick cell Reed-Sternberg cell

Reed-Sternberg cell

1. The absence of the Philadelphia chromosome in granulocytic leukemia suggests: rapid progression of the disease a polyclonal origin to the disease excellent response to therapy nothing since the Philadelphia chromosome is not present in granulocytic leukemia

rapid progression of the disease

1. All stages of neutrophils are most likely to be seen in the peripheral blood of a patient with: chronic granulocytic leukemia myelofibrosis with myeloid metaplasia erythroleukemia acute granulocytic leukemia

chronic granulocytic leukemia

1. A patient's peripheral blood smear and bone marrow both show 70% blasts. These cells are negative for Sudan Black B. Given these data, which of the following is the most likely diagnosis? acute myelogenous leukemia chronic lymphocytic leukemia acute promyelocytic leukemia acute lymphocytic leukemia

acute lymphocytic leukemia

1. Increased numbers of basophils are often seen in: acute infections chronic granulocytic leukemia chronic lymphocytic leukemia erythroblastosis fetalis

chronic granulocytic leukemia

1. Which of the following is not a characteristic usually associated with hairy cell leukemia? pancytopenia mononuclear cells with ruffled edges splenomegaly increased resistance to infection

increased resistance to infection

1. The erythrocytosis seen in relative Polycythemia occurs because of: decreased arterial oxygen saturation decreased plasma volume of circulating blood increased erythropoietin levels increased erythropoiesis in the bone marrow

decreased plasma volume of circulating blood

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

acute lymphocytic

1. Repeated phlebotomy in patients with Polycythemia may lead to the development of: folic acid deficiency sideroblastic anemia iron deficiency anemia hemolytic anemia

iron deficiency anemia

1. Auer rods are most likely present in which of the following? chronic granulocytic leukemia myelofibrosis with myeloid metaplasia erythroleukemia acute granulocytic leukemia

acute granulocytic leukemia

1. Increased levels of Tdt activity are indicative of: Burkitt's lymphoma Acute granulocytic leukemia Acute lymphocytic leukemia Eosinophilia

acute lymphocytic leukemia

``` 1. The following results were obtained on a 55 year old man complaining of headaches and blurred vision: WBC 19.0 x 103/µL Differential RBC 7.2 x 106/µL Segs 84% Platelets 1056 x 103/µL Bands 10% Uric acid 13.0 mg/dL Lymphs 3% O2 saturation 93% Monos 2% Eos 1% Red cell volume 3911 (normal, 1600) These results are consistent with: ``` neutrophilic leukemoid reaction Polycythemia vera Chronic granulocytic leukemia Leukoerythroblastosis in myelofibrosis

polycythemia vera

``` 1. The following results were obtained on a 45 year old man complaining of chills and fever: WBC 23.0 x 103/µL Differential: Segs 60% Bands 21% Lymphs 11% Monos 3% Metas 2% Myelos 3% Toxic granulation, Dohle bodies, and vacuoles LAP 200 Philadelphia chromosome negative These results are consistent with: ``` neutrophilic leukemoid reaction polycythemia vera chronic granulomatous disease leukoerythroblastosis in myelofibrosis

neutrophilic leukemoid reaction

1. Hairy cell leukemia is: an acute myelocytic leukemia a chronic leukemia of myelocytic origin a chronic leukemia of lymphocytic origin an acute myelocytic monocytic type leukemia

a chronic leukemai of lymphocytic origin

1. In the FAB classification, acute lymphocytic leukemia is divided into groups according too: prognosis immunology cytochemistry morphology

morphology

1. The age group associated with Hodgkin's disease is: 15-35 40-50 over 50 a and c are correct

a and c are correct

1. Which of the following is most closely associated with chronic myelogenous leukemia? ringed sideroblasts disseminated intravascular coagulation micromegakaryocytes Philadelphia chromosome

Philadelphia chromosome

1. Non-Hodgkin's lymphomas may be caused by: damaged DNA mutagenic effects of radiation mutagenic effects of chemicals all of the above

all of the above

1. In essential thrombocythemia, the platelets are: increased in number and functionally abnormal normal in number and functionally abnormal decreased in number and functional decreased in number and functionally abnormal

increased in number and functionally abnormal

1. In myelofibrosis, the characteristic abnormal red cell morphology is that of: target cells schistocytes teardrop cells ovalocytes

teardrop cells

``` Reactive lymphocytes may best be distinguished from blasts by which of the following morphologic characteristics? fine chromatin high N:C ratio prominent nucleoli basophilic cytoplasm ```

fine chromatin

Chronic lymphocytic leukemia is defined as: a malignancy of the thymus an accumulation of prolymphocytes an accumulation of hairy cells in the spleen an accumulation of monoclonal B cells with a block in cell maturation

an accumulation of monoclonal B cells with a block in cell maturation

Heavy chain disease is: overproduction of monoclonal IgM antibodies is characterized by the inability of the plasma clees to produce light chains overproduction of abnormal plasma cells underproduction of the heavy chain portion of the antibody unit

is characterized by the inability of the plasma cells to produce light chains

``` Polycythemia vera is characterized by: increased plasma volume pancytopenia decreased oxygen saturation absolute increase in the total read cell mass ```

absolute increase in the total red cell mass

``` The infectious agent most commonly associated with the pathogenenesis of Hodgkin's disease is: echovirus herpes virus hepatitis virus eptstein-barr virus ```

Epstein-Barr virus

``` 50-90% myeloblasts in a periphral blood sample is typical of which of the following? chronic granulocytic leukemia myelofibrosis with myeloid metaplasia erythroleukemia acute granulocytic leukemia ```

acute granulocytic leukemia

the morphologic characteristic(s) associated with the Chediak=Higashi syndrome is/are: plae blue cytoplasmic inclusions giant lysosomal granules small, dark staining granules and condensed nuclei nuclear hyposegmentation

giant lysosomal granules

``` In myeloid cells, the stain that selectively identifies phospholipids in the membranes of both primary and secondary granules is: PAS myeloperoxidase sudan black b Tdt ```

Sudan Black B

``` the characteristic morphologic feature in multiple myeloma is: cytotoxic T cells rouleaux formation spherocytes macrocytosis ```

Rouleaux formation

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 polycythmia assocaited with renal disease

Polycythemia associated with renal disease

``` Inthe FAB classification, myelomonocytic leukemia would be: M1 and M2 M3 M4 M5 ```

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

Polycythemia secondary to hypoxia

in infectious mononucleosis, lymphocytes tend to be: small with little cytoplasm normal decreased in number enlarged and indented by surrounding structures

enlarged and indented by surrounding structures

``` which type of anemia is most common in myelodystplastic syndromes? micorcytic, hypochromic normaocytic, hypochromic macrocytic, normochromic dimorphic ```

macrocytic, normochromic

``` Auer rods may be seen in all of the following EXCEPT: acute myelomonocytic leukemia acute lymphoblastic leukemia acute myeloblastic leukemia acute promyelocytic leukemia ```

acute lymphoblastic leukemia

``` in which age group does ALL occur with the highest frequency? 1-15 yrs 20-35yrs 45-60yrs 60-75yrs ```

1-15 years

1. Which FAB designation is called the true monocytic leukemia and follows an acute or subacute course characterized by monoblasts, promonocytes, and monocytes? M1 M3 M4 M5

1. In chronic myelocytic leukemia, blood histamine concentrations tend to reflect the: number of platelets present serum uric acid concentrations number of basophils present total number of granulocytes

number of basophils present

1. All of the following are myeloproliferative disorders Except: granulocytic leukemia lymphocytic leukemia Polycythemia vera Idiopathic thrombocythemia

lymphocytic leukemia

1. Which of the following is typical of Polycythemia vera? increased serum iron concentration decreased platelet count increased erythropoietin increased LAP

increased LAP

1. Which type of anemia is usually present in a patient with acute leukemia? microcytic, hyperchromic microcytic, hypochromic normocytic, normochromic macrocytic, normochromic

normocytic, normochromic

1. Features of secondary Polycythemia include all of the following except: splenomegaly decreased oxygen saturation increased red cell mass increased erythropoietin

splenomegaly

``` 1. The following results were obtained on a 35 year old woman complaining of fatigue and weight loss: WBC = 1.8 x 103/µL Differential RBC = 4.6 x 106/µL Segs = 30% Platelets = 903 x 103/µL Bands = 17% Uric acid = 6.4 ng/dL Lymphs = 13% LAP = 0 Monos = 3% Philadelphia chromosome pos Eos = 4% Baso = 6% Metas = 3% Myelos = 20% Promyelo = 3% Blasts = 1% These results are consistent with: ``` neutrophilic leukemoid reaction idiopathic thrombocythemia chronic granulocytic leukemia leukoerythroblastosis in myelofibrosis

chronic granulocytic leukemia

1. Patients with chronic granulomatous disease suffer from frequent pyogenic infections owing 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

Qualitative and quantitative neutrophil changes noted in response to infection include all of the following EXCEPT: neutrophilia pelgeroid hyposegmentation toxic granulation vacuolization

pelgeroid hyposegmentation

Disseminated intravascular coagulation is most often associated with which of the following FAB designations of acute leukemia? M1 M3 M4 M5

1. The familial condition of Pelger-Huet anomaly is important to recognize because this disorder must be differentiated from: infectious mononucleosis May-Hegglin anomaly Shift to the left increase in immature granulocytes G-6-PD deficiency

Shift to the left increase in immature granulocytes

1. All of the following are contained in the primary granules of the neutrophil except: lactoferrin myeloperoxidase histamine alkaline phosphatase

Histamine

The normal value for a white cell count in an adult is approximately: 2. 5-6.5 x 103/L 3. 0-7.3 x 103/L 4. 8-10.6 x 103/L 5. 2-12.7 x 103/L

4.8-10.6 x 103/L

``` Which disorder is considered to be a disorder of membrane cation permeability? G6PD deficiency hereditary spherocytosis hereditary elliptocytosis hereditary stomatocytosis ```

hereditary stomatocytosis

``` Coagulation studies have been ordered for a patient who is suspected of having Factor X deficiency. You should expect prolonged values from which of the following tests? PT bleeding time Antithrombin III fibrinogen ```

``` Patients with hemophilia B typically have abnormal: Factor V fibrinogen PT APTT ```

APTT

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

female carrier

``` The following lab results have been obtained from a 40 year old woman: PT = 20 seconds, APTT = 50 seconds, Thrombin time = 18 seconds. What is the most probable diagnosis? Factor VII deficiency Factor VIII deficiency Factor X deficiency Hypofibrinogenemia ```

Hypofibrinogenemia

Thrombocytopenia is a characteristic of: classic von Willebrand's disease hemophilia A Glanzmann's thrombasthenia May-Hegglin anomaly

May-Hegglin anomaly

The normal value for reticulocytes in the adult peripheral blood is: 0. 0-1.0% 0. 5-2.0% 1. 5-3.0% 2. 5-4.0%

0.5-2.0%

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

``` Neutrophils normally account for what percentage of the total white cell population in peripheral blood? 0-4% 2-9% 20-40% 50-70% ```

50-70%

The cause of megaloblastic anemia is: decrease in hemoglobin, hematocrit, and MCV ineffective erythropoiesis mutations of spectrin defective nuclear maturation

defective nuclear maturation

``` The following results were obtained on a patient: prolonged bleeding time, normal platelet count, normal PT, and prolonged APTT. Which of the following disorders is most consistent with these results? Hemophilia A Hemophilia B Von Willebrand's disease Glanzmann's thrombasthenia ```

Von Willebrand's disease

``` A patient who has increased serum proteins such as globulins may have red cells that stick together. This is called: agglutination aggregation rouleaux precipitation ```

rouleaux

increased MCV and decreased RBC

``` The normal value for a platelet count in an adult is approximately: 100,000-150,000/L 150,000-500,000/µL 150,000-350,000/L 350,000-500,000/L ```

150,000-350,000/L

``` Which of the following is characteristic of Bernard-Soulier syndrome? giant platelets normal bleeding time abnormal aggregation with ADP increased platelet count ```

giant platelets

Patients may be susceptible to thrombosis if they have inherited: Protein C deficiency Protein S deficiency Both protein C and S deficiency None of the above

Both protein C and S deficiency

``` The most appropriate screening test for hereditary spherocytosis is: osmotic fragility sucrose hemolysis heat instability test Kleihauer-Betke ```

osmotic fragility

``` All stages of neutrophils are most likely to be seen in the peripheral blood of a patient with: chronic granulocytic leukemia myelofibrosis with myeloid metaplasia acute granulocytic leukemia erythroleukemia ```

chronic granulocytic leukemia

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

absence of 3 of 4 alpha genes

``` A patient has a normal PT and abnormal PTT. After mixing studies with normal plasma, there is still an increased PTT. The most likely cause is: Factor VIII deficiency circulating anticoagulant Factor XII deficiency hypocalcemia ```

circulating anticoagulant

``` Lymphocytes account for what percentage of the total white cell population in peripheral blood? 0-4% 2-9% 20-40% 50-70% ```

20-40%

``` Which of the following is a symptom of multiple myeloma? high serum calcium levels bone destruction infections all of the above ```

all of the above

``` In the FAB classification, myelomonocytic leukemia would be: M1 and M2 M3 M4 M5 ```

Heavy chain disease is: overproduction of monoclonal IgM antibodies is characterized by the inability of the plasma cells to produce light chains overproduction of abnormal plasma cells underproduction of the heavy chain portion of the antibody unit

is characterized by the inability of the plasma cells to produce light chains

Specific (secondary) granules of the neutrophilic granulocyte: appear first at the myelocyte stage appear first at the promyelocyte stage appear first at the metamyelocyte stage are derived from azurophilic (primary) granules

appear first at the myelocyte stage

``` What is the typical appearance of anemia associated with liver disease? normal red cell morphology hypochromic, microcytic macrocytic, normoblastic macrocytic, megaloblastic ```

macrocytic, normoblastic

``` The infectious agent most commonly associated with the pathogenesis of Hodgkin's disease is: Echovirus Herpes virus Hepatitis virus Epstein-Barr virus ```

Epstein-Barr virus

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

Philadelphia chromosome

Which of the following are not seen on the peripheral smear of a patient with megaloblastic anemia? macro-ovalocytes hypersegmented neutrophils hyposegmented neutrophils Howell-Jolly bodies

hyposegmented neutrophils

``` The following results are obtained: PT Normal PTT Prolonged Absorbed plasma Corrects APTT The factor deficiency is: VIII IX X V ```

VIII

Reactive lymphocytes may best be distinguished from blasts by which of the following morphologic characteristics? blasts have finer chromatin reactive lymphs have very little cytoplasm nucleoli are only present in blasts reactive lymphs do not have dark blue cytoplasm

blasts have finer chromatin

The following lab results were obtained for a patient with an inherited autosomal dominant trait: Bleeding time Prolonged Platelet adhesiveness Abnormal PT Normal PTT Normal These findings are most consistent with: hemorrhagic disease of the newborn Factor X deficiency Factor XI deficiency von Willebrand's disease

von Willebrand's disease

Hairy cell leukemia is: an acute myelocytic leukemia a chronic leukemia of myelocytic origin a chronic leukemia of lymphocytic origin an acute myelocytic monocytic type leukemia

a chronic leukemia of lymphocytic origin

Which of the following platelet responses is most likely associated with classic von Willebrand's disease? decreased platelet aggregation to ristocetin normal platelet aggregation to ristocetin absent aggregation to epinephrine, ADP, and collagen decreased amount of ADP in platelets

decreased platelet aggregation to ristocetin

``` Qualitative and quantitative neutrophil changes noted in response to infection include all of the following EXCEPT: neutrophilia pelgeroid hyposegmentation toxic granulation vacuolization ```

pelgeroid hyposegmentation

``` Which of the following is most closely associated with iron deficiency anemia? iron overload in tissue target cells basophilic stippling chronic blood loss ```

chronic blood loss

A 53 year old man was in recovery following a triple bypass operation. Oozing was noted from his surgical wound. The following lab data was obtained: Hgb 12.5 g/dL Hct 37% PT 12.3 seconds APTT 34 seconds Platelet count 40.0 x 103/µL Fibrinogen 250 mg/dL The most likely cause of bleeding would be: dilution of coagulation factors due to massive transfusion intravascular coagulation secondary to microaggregates c hypofibrinogenemia dilutional thrombocytopenia

``` All of the following are characteristics of classic hemophilia A except: normal bleeding time sex-linked inheritance severe hemarthrosis decreased vWF:Ag ```

decreased vWF:Ag

``` On a blood smear, cells with a nucleus slightly off center with a fine chromatin pattern were seen. Several of these cells have nucleoli. The cytoplasm is dark blue with red granules that cover the nucleus. The cells are most likely: myeloblasts atypical lymphs promyelocytes myelocytes ```

promyelocytes

The normal RDW is: 9. 5-11.5% 10. 5-13.5% 11. 5-14.5% 12. 5-15.5%

11.5-14.5%

Electronic Impedance- Relates the charge of the particle to the size of the signal Relates the amplitude of the signal to the size of the particle

Relates the amplitude of the signal to the size of the particle

Which of the following is associated with Glanzmann's thrombasthenia? normal bleeding time normal ADP aggregation abnormal initial wave ristocetin aggregation absence of clot retraction

absence of clot retraction

decreased erythrocyte survival; increased catabolism of heme

A platelet count performed by phase microscopy is 200 x 103/µL. A standardized template bleeding time on the same person is 15 minutes (normal, 4.5 +/- 1.5 minutes). This indicates that: the Duke method should have been used for the bleeding time the manual platelet count is in error abnormal platelet function should be suspected the results are as expected

abnormal platelet function should be suspected

What routine hematologic finding is indicative of thalassemia? microcytic, hypochromic anemia macrocytic, hypochromic anemia normocytic, normochromic anemia macrocytic, normochromic anemia

microcytic, hypochromic anemia

substitution of valine for glutamic acid in the sixth position from the NH2 terminal chain

``` A red cell which is narrow and elongated, resembling a cigar shape is called: an ovalocyte an elliptocyte a sickle cell a burr cell ```

an elliptocyte

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

hypofibrinogenemia

vitamin B12 deficiency

G-6-PD deficiency

``` The white cell which typically responds to parasitic infections is the: neutrophil lymphocyte monocyte eosinophil ```

eosinophil

``` Which of the following is a characteristic of Factor XII deficiency? negative bleeding history normal clotting times decreased risk of thrombosis epistaxis ```

negative bleeding history

``` A patient's peripheral blood smear and bone marrow both show 70% blasts. These cells are negative for Sudan Black B. Given these data, which of the following is the most likely diagnosis? acute myelogenous leukemia chronic lymphocytic leukemia acute promyelocytic leukemia acute lymphocytic leukemia ```

acute lymphocytic leukemia

``` Increased numbers of basophils are often seen in: acute infections chronic granulocytic leukemia chronic lymphocytic leukemia erythroblastosis fetalis ```

chronic granulocytic leukemia

``` In an electronic or laser particle cell counter clumped platelets may interfere with which of the following parameters? white blood cell count red blood cell count hemoglobin hematocrit ```

white blood cell count

``` Which of the following acquired conditions could lead to thrombosis? oral contraceptives heparin therapy lupus anticoagulant all of the above ```

all of the above

All of the following are characteristics of TTP except: renal dysfunction thrombocytosis microangiopathic hemolytic anemia neurologic abnormalities

thrombocytosis

The Schilling test: evaluates the function of intrinsic factor evaluates the absorption of vitamin B12 evaluates the absorption of folic acid all of the above

evaluates the absorption of vitamin B12

serum iron is decreased, transferrin saturation is decreased, TIBC is normal or decreased

``` Which of the following is characteristic of platelet disorders? deep muscle hemorrhages retroperitoneal hemorrhages mucous membrane hemorrhages severely prolonged clotting times ```

mucous membrane hemorrhages

``` The normal adult hemoglobin value in a male is: 10-14 g/dL 12-16 g/dL 14-18 g/dl 14-22 g/dL ```

14-18 g/dl

``` An MCH of 25 pg suggests: hypochromia poikilocytosis microcytosis hyperchromia ```

hypochromia

``` Auer rods are most likely present in which of the following? M1 M3 M5 M7 ```

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

target cells

``` An MCV of 75 fL suggests: microcytosis macrocytosis poikilocytosis all of the above ```

microcytosis

The normal value for a red cell count in an adult female is approximately: 3. 0-4.0 x 106/L 3. 5-4.5 x 106/L 4. 0 - 5.0 x 106/L 5. 0-6.0 x 106/L

4.0 - 5.0 x 106/L

Which of the following is the most common cause of an abnormality in hemostasis? decreased plasma fibrinogen level decreased Factor VIII level decreased Factor IX level quantitative abnormality of platelets

quantitative abnormality of platelets

``` Which of the following could cause reactive lymphocytosis? infectious mononucleosis drug reactions autoimmune diseases all of the above ```

all of the above

``` The most appropriate screening test for hemoglobin S is: Kleihauer-Betke dithionite solubility osmotic fragility sucrose hemolysis ```

dithionite solubility

Thalassemias are characterized by: structural abnormalities in the hemoglobin molecule absence of iron in hemoglobin decreased rate of heme synthesis decreased rate of globin synthesis

decreased rate of globin synthesis

``` An increased fibrinogen may be caused by: dysfibrinogenemia lupus acute DIC inflammation or sepsis ```

inflammation or sepsis

Polycythemia vera is characterized by: increased plasma volume pancytopenia decreased oxygen saturation absolute increase in the total red cell mass

absolute increase in the total red cell mass

Auer rods are: a normal aggregation of lysosomes or primary (azurophilic) granules predominately found in acute myelogenous leukemia peroxidase negative alkaline phosphatase positive

predominately found in acute myelogenous leukemia

Heinz bodies are found in: G6PD deficiency and thalassemic syndromes as denatured hemoglobin hemolytic anemias as nuclear remnants sideroblastic anemias and hemoglobinopathies as nonheme iron lead intoxication and megaloblastic anemia as ribonucleoprotein and mitochondrial remnants

G6PD deficiency and thalassemic syndromes as denatured hemoglobin

Which of the following is typical of Polycythemia vera? increased serum iron concentration decreased platelet count increased erythropoietin increased LAP

increased LAP

``` Primary fibrinolysis may be differentiated from DIC by: the PT the APTT D-dimer thrombin time ```

D-dimer

``` Coagulation factors affected by coumarin drugs are: VIII, IX, and X I, II, V, and VII II, VII, IX, and X II, V, and VII ```

II, VII, IX, and X

Which of the following is most useful in differentiating hemophilias A and B? pattern of inheritance clinical history activated partial thromboplastin time mixing studies

mixing studies

``` Autoimmune hemolytic anemia is: a disease against self can be detected with the direct antiglobulin test involves autoantibody all of the above ```

all of the above

``` Which of the following measures platelet function? bleeding time prothrombin time thrombin time partial thromboplastin time ```

bleeding time

``` In DIC, which of the following is a predisposing condition? adenocarcinoma sepsis liver disease all of the above ```

all of the above

``` Non-Hodgkin's lymphomas may be caused by: damaged DNA mutagenic effects of radiation mutagenic effects of chemicals all of the above ```

all of the above

What causes the red cell defect in PNH? rare red cell antigens lack of GPI-anchored proteins on the erythrocyte membrane excessive amounts of complement components C5 to C9 Glucose-6-phosphate-dehydrogenase enzyme deficiency

lack of GPI-anchored proteins on the erythrocyte membrane

``` Which of the following factor deficiencies is associated with either no bleeding or only a minor bleeding tendency, even after trauma or surgery? Factor X Factor XII Factor XIII Factor V ```

Factor XII

``` Hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) is: temperature dependent complement independent antibody mediated caused by a red cell membrane defect ```

caused by a red cell membrane defect

Which of the following is a true statement about acute ITP? it is found primarily in adults spontaneous remission usually occurs within several weeks women are more commonly affected peripheral destruction of platelets is decreased

spontaneous remission usually occurs within several weeks

``` In myelofibrosis, the characteristic abnormal red cell morphology is that of: target cells schistocytes teardrop cells ovalocytes ```

teardrop cells

``` A cell observed on a blood smear has a N:C of 4:1. The nucleus is round and stains dark blue-purple. The cytoplasm is light blue. There are very few to no granules in the cytoplasm. This cell is probably: a band neutrophil a monocyte a lymphocyte a basophil ```

a lymphocyte

``` In which age group does ALL occur with the highest frequency? 1-15 years 20-35 years 45-60 years 60-75 years ```

1-15 years

``` In myeloid cells, the stain that selectively identifies phospholipids in the membranes of both primary and secondary granules is: PAS Myeloperoxidase Sudan Black B Tdt ```

Sudan Black B

G-6-PD deficiency

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

target cells

1. What is the typical appearance of anemia associated with liver disease? normal red cell morphology hypochromic, microcytic macrocytic, normoblastic macrocytic, megaloblastic

macrocytic, normoblastic

1. Heinz bodies are: readily identified with polychrome stains rarely found in glucose-6-phosphate dehydrogenase deficient erythrocytes closely associated with spherocyte denatured hemoglobin inclusions that are readily removed by the spleen

denatured hemoglobin inclusions that are readily removed by the spleen

1. Patients with (A-) type G-6-PD deficiency are LEAST likely to have hemolytic episodes in which of the following situations? following the administration of oxidizing drugs the neonatal period during infections spontaneously

spontaneously

1. What is the treatment for anemia of inflammation? blood transfusion iron therapy treatment of the inflammation human recombinant IL-1

treatment of the inflammation

1. The Schilling test: evaluates the function of intrinsic factor evaluates the absorption of vitamin B12 evaluates the absorption of folic acid all of the above

evaluates the absorption of vitamin B12

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

gamma chain production equals alpha chain production

1. Which of the following is most likely and most easily seen in lead poisoning? iron overload in tissue codocytes basophilic stippling ringed sideroblasts

basophilic stippling

1. What deficiency causes hemoglobin to be oxidized from the ferrous to the ferric state? G6PD deficiency PK deficiency NADH-methemoglobin reductase deficiency lactate dehydrogenase deficiency

NADH-methemoglobin reductase deficiency

1. 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

1. Which of the following findings would be indicative of heterozygous thalassemia? hemoglobin A2 level of 3.5-7% hemoglobin F level less than 2% hemoglobin A level of 65-85% hemoglobin A2 level less than 3.5%

hemoglobin A2 level of 3.5-7%

1. Laboratory findings in hereditary spherocytosis do NOT include: decreased osmotic fragility increased autohemolysis reticulocytosis shortened erythrocyte survival

decreased osmotic fragility

1. The most appropriate screening test for hereditary spherocytosis is: osmotic fragility sucrose hemolysis heat instability test Kleihauer-Betke

osmotic fragility

1. A patient's blood sample mixed with sucrose solution and incubated at 37C shows moderate hemolysis. The direct antiglobulin test was negative. These results are suggestive of: lupus erythromatosus polycythemia vera acquired autoimmune hemolytic anemia paroxysmal nocturnal hemoglobinuria

paroxysmal nocturnal hemoglobinuria

1. The anemia of chronic infection is characterized by: decreased iron stores in the reticuloendothelial system decreased serum iron levels macrocytic erythrocytes increased serum iron-binding capacity

decreased serum iron levels

1. The values below were obtained on an automated blood count system performed on a blood sample from a 25 year old man: Patient ValueNormal ValueWBC5.1 x 103/L5.0-10.0 x 103/LRBC3.00 x 106/L4.6-6.2 x 106/LHgb12 g/dL14-18 g/dLHct36%40-54%MCV120 fL82-90 fLMCH40 pg27-31 pgMCHC33%32-36% These results are most consistent with which of the following? megaloblastic anemia hereditary spherocytosis a high titer of cold agglutinins an elevated reticulocyte count

megaloblastic anemia

1. The most appropriate screening test for hemoglobin S is: Kleihauer-Betke dithionite solubility osmotic fragility sucrose hemolysis

dithionite solubility

1. Thalassemias are characterized by: structural abnormalities in the hemoglobin molecule absence of iron in hemoglobin decreased rate of heme synthesis decreased rate of globin synthesis

decreased rate of globin synthesis

1. Which of the following is NOT a cause of nonmegaloblastic anemia? alcoholism immunosuppressive drugs hypothyroidism hyperthyroidism

hyperthyroidism

decrease in pH and oxygenation, and dehydration

1. They glycoprotein necessary for absorption of vitamin B12 is: albumin transcobalamin II haptoglobin intrinsic factor

intrinsic factor

1. Which of the following are causes of anemia of inflammation? increased destruction of red cells impaired iron metabolism suppression of erythropoiesis by cytokines all of the above

all of the above

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

pancytopenia and macrocytosis

1. A 15 year old girl is taking medication for a parasitic infection and notices her urine is a brownish color. A CBC shows mild anemia. The laboratorian performing the reticulocyte count notices numerous irregular shaped granules near the periphery of the RBC. These cellular inclusions are most likely: Howell-Jolly bodies basophilic stippling Heinz bodies Pappenheimer bodies

Heinz bodies

1. What routine hematologic finding is indicative of thalassemia? microcytic, hypochromic anemia macrocytic, hypochromic anemia normocytic, normochromic anemia macrocytic, normochromic anemia

microcytic, hypochromic anemia

1. The hypochromic anemias represent a related group of disorders with: a quantitative defect in hemoglobin synthesis a qualitative defect in globin synthesis excess hemoglobin synthesis Vitamin B12 and folate deficiency

a quantitative defect in hemoglobin synthesis

1. The lab tests performed on a patient indicate macrocytosis, anemia, leukopenia, and thrombocytopenia. Which of the following disorders is the patient most likely to have? iron deficiency hereditary spherocytosis vitamin B12 deficiency acute hemorrhage

vitamin B12 deficiency

1. Factors commonly involved in producing anemia in patients with chronic renal disease include: marrow hypoplasia inadequate erythropoietin vitamin B12 deficiency increased erythropoietin production

inadequate erythropoietin

1. All of the findings listed below may be seen in acquired hemolytic anemia of the autoimmune variety. The one considered to be the MOST characteristic is: increased osmotic fragility leukopenia and thrombocytopenia peripheral spherocytosis positive direct antiglobulin test

positive direct antiglobulin test

1. Which is the most frequent functional abnormality affecting membrane skeleton proteins in common hereditary elliptocytosis? defective binding of spectrin to ankyrin defective spectrin tetramer assembly defective binding of ankyrin to protein 3 deficiency of protein 4.1

defective spectrin tetramer assembly

``` 1. A patient has the following blood values: RBC 6.5 x 106/L Hgb 14.0 g/dL Hct 42.0% MCV 65 fL MCH 21.5 pg MCHC 33% These results are compatible with: ``` iron deficiency pregnancy thalassemia minor beta thalassemia major

thalassemia minor

1. What is the amino acid substitution found in HbC disease? substitution of valine for glutamic acid in the sixth position from the NH2 terminal chain substitution of lysine for glutamic acid in the sixth position from the NH2 terminal chain substitution of lysine for glutamic acid in the 26th position from the NH2 terminal chain substitution of valine for glutamic acid in the 121st position from the NH2 terminal chain

substitution of lysine for glutamic acid in the sixth position from the NH2 terminal chain

1. Which of the following is most closely associated with iron deficiency anemia? iron overload in tissue target cells basophilic stippling chronic blood loss

chronic blood loss

1. Which of the following sets of laboratory findings is consistent with hemolytic anemia? normal or slightly increased erythrocyte survival; normal osmotic fragility decreased erythrocyte survival; increased catabolism of heme decreased serum lactate dehydrogenase activity; normal catabolism of heme normal concentration of haptoglobin; marked hemoglobinuria

decreased erythrocyte survival; increased catabolism of heme

1. What is the term for the clinical course of homozygous thalassemias resulting from defects in - and -chain synthesis? Thalassemia minor Thalassemia major Thalassemia trait á-thalassemia

Thalassemia major

1. What causes the defect in PNH? rare red cell antigens lack of GPI-anchored proteins on the erythrocyte membrane excessive amounts of complement components C5 to C9 Glucose-6-phosphate-dehydrogenase enzyme deficiency

lack of GPI-anchored proteins on the erythrocyte membrane

1. Which disorder is considered to be a disorder of membrane cation permeability? G6PD deficiency hereditary spherocytosis hereditary elliptocytosis hereditary stomatocytosis

hereditary stomatocytosis

1. Which of the following is a cause of methemoglobinemia? HbM variants NADH-diaphorase deficiency toxic substances all of the above

all of the above

1. What is the primary risk to thalassemia major patients who are on a high transfusion program? hyperviscosity of blood iron overload citrate toxicity electrolyte imbalance

iron overload

1. According to the morphological classification of anemias, megaloblastic anemia is a: macrocytic, hypochromic anemia macrocytic, hyperchromic anemia macrocytic, normochromic anemia normocytic, normochromic anemia

macrocytic, normochromic anemia

1. Which of the following is seen most often in thalassemia? chronic blood loss target cells basophilic stippling ringed sideroblasts

target cells

1. Which of the following represents characteristic features of iron metabolism in patients with anemia of a chronic disorder? serum iron is normal, transferrin saturation is normal, TIBC is normal serum iron is increased, transferrin saturation is increased, TIBC is normal or slightly increased serum iron is normal, transferrin saturation is markedly increased, TIBC is normal serum iron is decreased, transferrin saturation is decreased, TIBC is normal or decreased

serum iron is decreased, transferrin saturation is decreased, TIBC is normal or decreased

1. Hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) is: temperature dependent complement independent antibody mediated caused by a red cell membrane defect

caused by a red cell membrane defect

1. The most appropriate screening test for hemoglobin H is: dithionite solubility osmotic fragility sucrose hemolysis heat instability test

heat instability test

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

absence of 3 of 4 alpha genes

1. Anemia secondary to uremia characteristically is: microcytic, hypochromic hemolytic normocytic, normochromic macrocytic

normocytic, normochromic

1. What is the amino acid substitution found in sickle cell anemia? substitution of valine for glutamic acid in the sixth position from the NH2 terminal chain substitution of lysine for glutamic acid in the sixth position from the NH2 terminal chain substitution of lysine for glutamic acid in the 26th position from the NH2 terminal chain substitution of valine for glutamic acid in the 121st position from the NH2 terminal chain

substitution of valine for glutamic acid in the sixth position from the NH2 terminal chain

1. The pathophysiology of megaloblastic anemia is : Defective RNA synthesis and abnormal cytoplasm maturation Defective DNA synthesis and abnormal nuclear maturation Defective RNA synthesis and abnormal nuclear maturation Defective DNA synthesis and abnormal cytoplasm maturation

Defective DNA synthesis and abnormal nuclear maturation

1. Which of the following are not seen on the peripheral smear of a patient with megaloblastic anemia? macro-ovalocytes hypersegmented neutrophils hyposegmented neutrophils Howell-Jolly bodies

hyposegmented neutrophils

1. In acute granulocytic leukemia, a positive peroxidase stain is of diagnostic value True False

True

1. Chronic lymphocytic leukemia is a disease usually found among people 20-40 years of age False True

False

1. Diagnostic symptoms of many hemolytic anemias include elevated indirect bilirubin +DAT icteric serum all of the above

all of the above

1. In chronic granulocytic leukemia, the basophils are usually increased True False

True

1. In the absence of treatment, chronic post hemorrhagic anemia may develop into __________________ anemia iron deficiency hemolytic sideroblastic pernicious

iron deficiency

1. Aplastic anemia may be the result of antibiotics G-6-PD deficiency incompatible blood transfusion cirrhosis of the liver

antibiotics

1. Chronic lymphocytic leukemia marked chromatin/parachromatin separation in mature cells blast forms blast forms with Auer rods agranulocytosis granulocytosis

marked chromatin/parachromatin separation in mature cells

1. The Schilling test is used to diagnose Megaloblastic anemia sickle cell anemia beta thalassemia hereditary spherocytosis

Megaloblastic anemia

1. Leukocyte alkaline phosphatase stain is/are ________ in leukemia granulocytes decreased monocytes positive granulocytes positive normoblasts positive reticulocytes positive

granulocytes decreased

1. A middle aged white male is admitted to the hospital complaining of abdominal pain. Physical examination: enlargement in the area of the spleen, darkening of the skin around the ankles Peripheral blood: moderately decreased hemoglobin/hematocrit, increased osmotic fragility, smear shows microspherocytes. A probable diagnosis is: hereditary spherocytosis autoimmune hemolytic anemia acanthocytosis paroxysmal nocturnal hemoglobinuria

hereditary spherocytosis

1. The report "RBC's appear hypochromic" indicates which of the following confirm with a low MCV the color of the cells is decreased the RBC count should be low all of these

the color of the cells is decreased

1. The presence of an Auer rod suggests a probable diagnosis of CML AML ALL CLL

AML

1. The Philadelphia chromosome is associated with which of the following disorders chronic granulocytic anemia chronic lymphocytic anemia acute granuocytic anemia acute lymphocytic anemia

chronic granulocytic anemia

1. Myelomonocytic leukemia may resemble B12 deficiencies and these two disorders must be differentiated True False

False

1. Progressive anemia may result in bone marrow suppression mild hepatitis CNS involvement all of these none of these

none of these

1. The following tests would be indicated when testing for a probable hemolytic anemia osmotic fragility Ham's sugar water test direct Coomb's all of these none of these

all of these

1. Anemia results from a reduced quantity of more than one of these hemoglobin circulating RBC thrombocytes

more than one of these

1. The white count is uniformly elevated in acute granulocytic leukemia True False

False

1. Acquired autoimmune hemolytic anemia is characterized by decreased leukocyte count increased hematocrit decreased reticulocyte count increased bilirubin

increased bilirubin

1. Periodic Acid Shiff (PAS) stains are positive in granulocytes reticulocytes normoblasts monocytes not clinically significant 1.

monocytes

1. Which of the following findings are common in chronic granulocytic anemia peripheral blood basophilia all stages of myeloid maturation in peripheral blood a low leukocyte alkaline phosphatase all of these none of these

all of these

1. Case study: A 42 year old man has the following: Hgb-11.9 gm/dl; Hct-25.5%; RBC-3,950,000/mm3; Platelets-250,000/mm3; WBC- 80,000/mm3; Differential: 62 segs, 11 stabs, 7 metas, 6 myelocytes, 5 pros, 3 blasts, 1 eo, 5 lymphs Clinical Findings: splenomegaly, hepatomegaly The diagnosis is CML AML AMML CLL ALL

CML

1. The anemia that has an increase in HbF rather than HbA is thalassemia HbS disease HbC disease all of these none of these

all of these

1. An example of an anemia that may result from a hemorrhage might be pernicious anemia autoimmune hemolytic anemia iron deficiency anemia sideroblastic anemia

iron deficiency anemia

1. Thalassemia is caused by deletion of an alpha gene impaired synthesis of a beta chain an autosomal recessive gene all of these none of these

all of these

1. Patients with hereditary spherocytosis show a/an ___________ RBC survival decreased normal increased unimportant to the diagnosis

decreased

1. Differentiation of granules in the white cell takes place at the stage of myeloblast promyelocyte metamyelocyte myelocyte

myelocyte

1. Which of the following tests would be of value in distinguishing myeloid metaplasia from chronic myelogenous leukemia serum protein electrophoresis NBT test DAT leukocyte alkaline phosphatase

leukocyte alkaline phosphatase

1. Red cell fragments seen in hemolytic anemias are called schistocytes drepanocytes siderocytes keratocytes

schistocytes

1. Acute myelogenous leukemia blast forms blast forms with Auer rods marked chromatin/parachromatin separation in mature cells agranulocytosis granulocytosis

blast forms with Auer rods

1. Which of the following is NOT useful in the diagnosis of pernicious anemia gastric analysis blood smear Schilling test none of these - all are useful

none of these - all are useful

1. A patient has repeated positive tests for hemoglobin in his urine upon waking. He is 45 years of age and shows a slightly decreased hemoglobin/ hematocrit. Seven months prior this patient was diagnosed as having aplastic anemia. The lab analysis shows no cell abnormalities except for a slight macrocytosis of the RBC, hyperbilirubinemia, and the previous mentioned hemoglobinuria. The patient also complains of occasional lower back pain. With these clinical findings you might expect a diagnosis of autoimmune hemolytic anemia paroxysmal nocturnal hemoglobinuria hereditary spherocytosis acanthocytosis

paroxysmal nocturnal hemoglobinuria

1. Which of the following anemias is characterized by oval macrocytes aplastic anemia sickle cell disease thalassemia major all of these none of these

none of these

1. In the anemias, which of the following indicates increased RBC production elevated RPI polychromasia nucleated RBC all of these

1. In aplastic anemia, you would expect the platelet count to be below normal above normal normal unimportant to the diagnosis

below normal

1. Blast cells or secondary stem cell usually have nucleoli basophilic cytoplasm and nucleoli large nucleus without nucleoli acidophilic cytoplasm

basophilic cytoplasm and nucleoli

1. Hemolytic anemias as a group are characterized by increased osmotic fragility in vivo hemolysis presence of specific autoantibodies family inter-marriages

in vivo hemolysis

1. The most common type of leukemia in four year old children is _________________ leukemia chronic lymphocytic acute myelogenous acute lymphoblastic myelomonocytic

acute lymphoblastic

1. Chronic myelogenous leukemia blast forms blast forms with Auer rod marked chromatin/parchromatin separation in mature cells agranulocytosis granulocytosis

granulocytosis

1. Iron deficiency is generally classified as a/an ____________ anemia hypochromic, microcytic hypochromic, macrocytic hyperchromic, normocytic normochromic, macrocytic

hypochromic, microcytic

1. In pernicious anemia, the MCV is slightly decreased slightly increased markedly increased markedly decreased

markedly increased

1. The diagnosis of leukemia may be suspected when you do hematocrit determination and see hemolysis high hematocrit heavy buffy coat icteric plasma

heavy buffy coat

1. This patient was admitted with moderate anemia, showing moderate anisocytosis, some macrocytes, and a few microspherocytes. Occasional red cells are seen engulfed by macrophages. The direct Coombs is positive with a warm antibody. A slight purpura is also noted. The serology for syphilis is positive, but the patient denies sexual contact. With this clinical picture, a likely diagnosis might be hereditary spherocytosis acanthocytosis autoimmune hemolytic anemia paroxysmal nocturnal hemoglobinuria

autoimmune hemolytic anemia

1. The onset of chronic granulocytic leukemia is usually abrupt and it develops rapidly True False

False

1. Acute myelogenous leukemia has an age incidence similar to chronic lymphocytic leukemia is never preceded by a preleukemia state can be differentiated from acute lymphocytic leukemia because blasts usually contain Auer rods is often related to immunoglobulin abnormalities

can be differentiated from acute lymphocytic leukemia because blasts usually contain Auer rods

1. A patient has been diagnosed as having chronic myelogenous leukemia. Which of the following abnormalities would you expect to see on the blood smear teardrop shaped red blood cells nucleated red blood cells variable white count decreased platelet with some giant forms

variable white count

1. In iron deficiency anemia, there is an increase in MCH TIBC serum iron all of these

TIBC

1. Symptoms of anemia include pallor dyspnea fatigue all of these none of these

all of these

1. DiGuglielmo's syndrome is a condition characterized in the blood smear by immature, atypical nucleated red blood cells the presence of 'hairy' cells plasma cells mast cells

immature, atypical nucleated red blood cells

1. The mean corpuscular hemoglobin measures the average shape of the RBC the average diameter of the RBC the average volume of the erythrocytes all of these none of these

none of these

1. Acute lymphocytic leukemia blast forms with Auer rods marked chromatin/parachromatin separation in mature cells blast forms agranulocytosis granulocytosis

blast forms

1. Macrocytes are morphologically diagnostic of anemias caused by iron deficiency acute blood loss deficiency of hematopoietic factors autoimmune hemolytic anemias

deficiency of hematopoietic factors

1. An anemia caused by an acute blood loss is typically microcytic hypochromic normochromic macrocytic

normochromic

1. In the early stages of chronic granulocytic leukemia, the platelet count may be increased True False

False

1. In acute granulocytic leukemia the predominating cell is the neutrophilic myelocyte True False

False

1. Blasts are found normally in all but peripheral blood lymphatic tissue bone marrow myeloid tissue

peripheral blood

1. Blasts are found normally in all but peripheral blood lymphatic tissue bone marrow myeloid tissue

peripheral blood

1. Blasts (secondary stem cells) usually have deeply basophilic cytoplasm and nucleoli large nucleus no nucleoli nucleoli deeply basophilic cytoplasm

deeply basophilic cytoplasm and nucleoli

Identify the inclusion at the end of the arrow. Dohle body toxic granulation phagocytized bacteria auer body

Dohle body

1. Which type of anemia is most common in myelodysplastic syndromes? microcytic, hypochromic normocytic, hypochromic macrocytic, normochromic dimorphic

microcytic, hypochromic

Shift to the left increase in immature granulocytes

1. An example of an anemia that may result from a hemorrhage might be iron deficiency anemia pernicious anemia autoimmune hemolytic anemia sideroblastic anemia

iron deficiency anemia

number of basophils present

Identify the cell at the end of the arrow. (Your spelling must be accurate)

spherocyte

1. The following tests would be indicated when testing for a probable hemolytic anemia all of these osmotic fragility Ham's sugar water test direct Coomb's (DAT)

all of these

The primary cell type in this field is a segmented form band form metamyelocyte form myelocyte form promyelocyte

promyelocyte

1. Patients with hereditary spherocytosis show a/an ___________ RBC survival decreased normal increased unimportant to the diagnosis

decreased

Identify the anomaly. Chediak-Higashi Alder-Reilly Pelger-Huet May-Hegglin

Alder-Reilly

1. In response to hypoxia, a hormone is produced to stimulate the production of RBC. This is produced by the pituitary heart liver kidney none of the above

kidney

1. In the FAB classification, acute lymphocytic leukemia is divided into groups according too: prognosis immunology cytochemistry morphology

morphology

1. Iron deficiency is generally classified as a/an ____________ anemia hypochromic, microcytic hypochromic, macrocytic hyperchromic, normocytic normochromic, macrocytic

hypochromic, microcytic

What is the cell at the end of the arrow. | Name on disorder where it is found.

oval macrocyte | any of the megaloblastic anemias

cell size, nuclear characteristics, and cytoplasmic characteristics

1. Hemolytic anemias as a group are characterized by intravascular hemolysis increased osmotic fragility presence of specific autoantibodies family inter-marriages

intravascular hemolysis

1. Cells responsible for cell mediated immunity T lymphocytes B lymphocytes monocytes null cells plasma cells 1 points

T lymphocytes

1. Increased levels of Tdt activity are indicative of: Burkitt's lymphoma Acute granulocytic leukemia Acute lymphocytic leukemia Eosinophilia

Acute lymphocytic leukemia

1. Which of the following types of Polycythemia is most often associated with emphysema? Polycythemia vera Polycythemia secondary to hypoxia Relative Polycythemia associated with dehydration Relative Polycythemia associated with renal disease

Polycythemia secondary to hypoxia

Identify the nucleated cells. (Your spelling must be accurate.)

polychromatophilic polychromatophilic normoblast rubricytes rubricyte

1. Myeloblasts have no granules in their cytoplasm never contain Auer rods seldom have a nucleolus are the first differentiated cell of the monocytic series

have no granules in their cytoplasm

1. A decreased WBC is to be expected in infectious hepatitis diabetes bacterial pneumonia pernicious anemia none of these

infectious hepatitis

1. Reticulocytes are cells seen immediately following the loss of the _____ in the cytoplasm. blue cytoplasm nucleus nucleoli RNA none of the above

nucleus

Identify the abnormality. keratocytes drepanocytes acanthocyte dacryocytes none of the above

drepanocytes

1. Anemia results from a reduced quantity of more than one of these hemoglobin circulating RBC thrombocytes

more than one of these

Identify the abnormality. echinocyte acanthocyte keratocyte schistocyte none of the above

echinocyte

Identify the abnormality. keratocytes drepanocytes acanthocyte dacryocytes

drepanocytes

1. The following cells are granulocytes myelocytes, metamyelocytes, bands metamyelocytes, basophils, monocytes lymphocytes, basophils, neutrophils lymphocytes, monocytes, bands none of these

myelocytes, metamyelocytes, bands

1. Bands have a sausage shaped nucleus have several nucleoli have an indented nucleus have a round nucleus none of these

have a sausage shaped nucleus

1. The hereditary form of Pelger-Huet is asymptomatic contagious acute fatal none of these

asymptomatic

1. In myelofibrosis, the characteristic abnormal red cell morphology is that of: target cells schistocytes teardrop cells ovalocytes

target cells

Identify the cell at the end of the arrow. List at least 1 disorder in which these cells are found.

basophilic stippling - lead poisoning

1. Which of the following is NOT useful in the diagnosis of pernicious anemia none of these - all are useful gastric analysis blood smear Schilling test

none of these - all are useful

Which of the following best describes this field? 4+ anisocytosis 2+ poikilocytosis schistocytes spherocytes microcytes all of the above none of the above

all of the above

1. The earliest differentiated cell of the lymphocytic series is the lymphoblast metalymphocyte prolymphocyte_ none of these

lymphoblast

1. A hemoglobin in which valine replaces glutamic acid in the 6th position is called HbC HbD HbE HbS

HbS

1. An abnormal RBC associated with myelofibrosis which results in a tear drop shaped cell is schistocyte dacryocyte drepanocyte leptocyte none of the above

dacryocyte

1. A cell that is NOT found in the normal blood smear is a/an orthochromatic normoblast reticulocyte erythrocyte all are abnormal cells and not normally found all are normally found 1 points

orthochromatic normoblast

1. All of the following are myeloproliferative disorders EXCEPT: granulocytic leukemia lymphocytic leukemia Polycythemia vera Idiopathic thrombocythemia

lymphocytic leukemia

1. An anemia caused by an acute blood loss is typically ___ at the onset. normochromic microcytic hypochromic macrocytic

normochromic

increased in number and functionally abnormal

1. The cell which may be found in all types of Hodgkin's disease is: Sezary cell Flame cell Niemann-Pick cell Reed-Sternberg cell

Reed-Sternberg cell

Identify the cell at the end of the arrow. codocyte dacryocyte elliptocyte keratocyte none of the above

elliptocyte

1. RBC size is estimated in a differential smear by comparing the cell to the size of a platelet in the same field a normal monocyte the size of a nucleus of a small lymph the average sized segmented neutrophil none of the above

the size of a nucleus of a small lymph

1. 50-90% myeloblasts in a peripheral blood sample is typical of which of the following? chronic granulocytic leukemia myelofibrosis with myeloid metaplasia erythroleukemia acute granulocytic leukemia

acute granulocytic leukemia

1. Blasts are usually found in all of the following EXCEPT peripheral blood myeloid tissue red bone marrow lymphatic tissue none of these

peripheral blood

The cell at the end of the arrow could best be described as hypochromic microcytic polychromatophilic macrocytic

macrocytic

1. The anemia that has an increase in HbF rather than HbA is all of these thalassemia HbS disease HbC disease

all of these

1. Transferrin functions in transporting ____ to the developing RBC. iron RNA amino acids globin none of the above

iron

1. Aplastic anemia may be the result of antibiotics G-6-PD deficiency incompatible blood transfusion cirrhosis of the liver

antibiotics

1. In looking at a bone marrow preparation, you see a cell with deeply blue cytoplasm, a large nucleus in relation to the rest of the cell, and the chromatin is finely reticular with nucleoli present. This is probably a/an orthochromatic erythroblast pronormoblast basophilic erythroblast polychromatic erythroblast none of the above

pronormoblast

1. In response to hypoxia, a hormone is produced to stimulate the production of RBC. This is called hematopoietin thrombopoietin leukopoietin erythropoietin none of the above

erythropoietin

Identify the anomaly. Chediak-Higashi Alder-Reilly May-Hegglin Pelger-Huet there is no anomaly - this is a normal patient

May-Hegglin

The primary cell type in this field is a segmented form band form metamyelocyte form myelocyte form

metamyelocyte form

1. Disseminated intravascular coagulation is most often associated with which of the following FAB designations of acute leukemia? M1 M3 M4 M5

1. On a sheet of paper (see instructors desk) describe the maturation of blood cells beginning from the stem cell. This question will be worth an additional 5 points.

what is your answer???

1. The MOST COMMONLY found toxic change in neutrophils is toxic granulation Auer rods drumstick formation Dohle bodies

toxic granulation

1. The mature basophil has none of these pale red cytoplasm moderate to heavy deep red cytoplasm more that 3 lobes all of these

none of these

1. This patient was admitted with moderate anemia, showing moderate anisocytosis, some macrocytes, and a few microspherocytes. Occasional red cells are seen engulfed by macrophages. The direct Coombs (DAT) is positive with a warm antibody. A slight purpura is also noted. The serology for syphilis is positive, but the patient denies sexual contact. With this clinical picture, a likely diagnosis might be autoimmune hemolytic anemia hereditary spherocytosis acanthocytosis paroxysmal nocturnal hemoglobinuria

autoimmune hemolytic anemia

Which term best describes this cell band segmented hyposegmented hypersegmented

hypersegmented

Identify the cell at the end of the arrow. codocyte dacryocyte elliptocyte keratocyte none of the above

elliptocyte

Identify the cells at the end of the arrows. sickle cell schistocyte elliptocyte keratocyte none of the above

keratocyte

On the right side of the screen there is 1 intact cell. Describe it in terms of chromatin, cytoplasm, and identify the cell

Nucleus: finely reticular Cytoplasm: relatively clear, basophilic, Overall the cell is quite large Pronormoblast/ Rubriblast

1. An example of an anemia that may result from a hemorrhage might be iron deficiency anemia pernicious anemia autoimmune hemolytic anemia sideroblastic anemia

iron deficiency anemia

1. In pernicious anemia, the MCV is markedly increased slightly decreased slightly increased markedly decreased

markedly increased

1. The age group associated with Hodgkin's disease is: 15-35 40-50 over 50 a and c are correct

a and c are correct

1. The mean corpuscular hemoglobin measures none of these the average shape of the RBC the average diameter of the RBC the average volume of the erythrocytes

none of these

1. A hemoglobin in which lysine replaces glutamic acid in the 6th position is called HbS HbC HbD HbE

HbC

Identify the cells at the end of the arrows. pronormoblast orthochromatophilic normoblast reticulocyte basophilic pronormoblast

orthochromatophilic normoblast

1. Which type of anemia is usually present in a patient with acute leukemia? microcytic, hyperchromic microcytic, hypochromic normocytic, normochromic macrocytic, normochromic

normocytic, normochromic

1. The mature eosinophil may be increased in allergic reaction has no specific staining granules has a five lobed nucleus all of these none of these

may be increased in allergic reaction

1. The report "RBC's appear hypochromic" indicates which of the following the color of the cells is decreased confirm with a low MCV the RBC count should be low all of these

the color of the cells is decreased

The nucleated cell at the top of this field is at what stage of white cell maturation? blast promyelocyte myelocyte metamyelocyte band segmented

metamyelocyte

1. Auer rods may be seen in all of the following EXCEPT: acute myelomonocytic leukemia acute lymphoblastic leukemia acute myeloblastic leukemia acute promyelocytic leukemia

acute lymphoblastic leukemia

1. In iron deficiency anemia, there is an increase in TIBC MCH serum iron all of these

TIBC

1. Red cell fragments seen in hemolytic anemias are called schistocytes drepanocytes siderocytes keratocytes

schistocytes

The nucleated cell at the top of this field is at what stage of white cell maturation? blast promyelocyte myelocyte metamyelocyte band segmented

metamyelocyte

1. Basophilic stippling is found in megaloblastic anemia lead poisoning anemia with impaired heme synthesis all of the above none of the above

all of the above

1. RBC with many blunt projections, resulting from hyper-osmotic solutions is schistocyte dacryocyte drepanocyte leptocyte none of the above

none of the above

1. Granulocytes are characterized SOLELY by the presence of none of these Barr bodies_ specific granules in the cytoplasm predominant Golgi complexes nuclear chromatin pattern

specific granules in the cytoplasm

Identify the anomaly. Chediak-Higashi Alder-Reilly Pelger-Huet May-Hegglin

Pelger-Huet

These cells are seen in patients with Chediak-Higashi Alder-Reilly Infectious mononucleosis monocytic leukemia healthy patients

Infectious mononucleosis

1. The Schilling test is used to diagnose none of these sickle cell anemia beta Thalassemia hereditary spherocytosis

none of these

Identify the cells at the end of the arrows. codocyte elliptocyte keratocyte stomatocyte none of the above

stomatocyte

Which of the following best describes the inclusions in the cell at the end of the arrow? Dohle bodies Alder-Reilly toxic granulation toxic vacuoles

toxic granulation

neutrophils to kill phagocytized bacteria

1. Chronic lymphocytic leukemia is defined as: a malignancy of the thymus an accumulation of prolymphocytes an accumulation of hairy cells in the spleen an accumulation of monoclonal B cells with a block in cell maturation

an accumulation of monoclonal B cells with a block in cell maturation

Describe the field. (Ignore the arrow as you review the field) polychromasia basophilic stippling Howell Jolly bodies NRBC all of the above none of the above

all of the above

Identify the cells at the end of the arrows. codocyte target cell leptocyte all of the above none of the above

all of the above

1. Repeated phlebotomy in patients with Polycythemia may lead to the development of: folic acid deficiency sideroblastic anemia iron deficiency anemia hemolytic anemia

folic acid deficiency

1. In the absence of treatment, chronic post hemorrhagic anemia may develop into _____ anemia iron deficiency hemolytic sideroblastic pernicious

iron deficiency

Identify the cells at the end of the arrows. (Your spelling must be accurate.)

Exact Match orthochromatophilic normoblast Exact Match metarubricyte Exact Match orthochromatophilic normoblasts Exact Match metarubricyte

1. Acquired autoimmune hemolytic anemia is characterized by increased bilirubin decreased leukocyte count increased hematocrit decreased reticulocyte count

increased bilirubin

Identify the nucleated cell. neutrophilic myelocyte neutrophilic metamyelocyte neutrophilic band not a neutrophil

neutrophilic metamyelocyte

Identify the inclusion at the end of the arrow. Dohle body toxic granulation phagocytized bacteria auer body

Dohle body

What stage of white cell maturation best describes this cell blast promyelocyte myelocyte metamyelocyte band segmented

band

1. In the anemias, which of the following indicates increased RBC production all of these elevated reticulocyte production index (RPI) polychromasia nucleated RBC

all of these

``` 1. The following results were obtained on a 45 year old man complaining of chills and fever: WBC 23.0 x 103/µL Differential: Segs 60% Bands 21% Lymphs 11% Monos 3% Metas 2% Myelos 3% Toxic granulation, Dohle bodies, and vacuoles LAP pos (200) and Philadelphia chromosome negative These results are consistent with: ``` neutrophilic leukemoid reaction polycythemia vera chronic granulomatous disease leukoerythroblastosis in myelofibrosis

neutrophilic leukemoid reaction

1. Polycythemia vera is characterized by: increased plasma volume pancytopenia decreased oxygen saturation absolute increase in the total red cell mass

absolute increase in the total red cell mass

1. The characteristic morphologic feature in multiple myeloma is: cytotoxic T cells Rouleaux formation Spherocytes Macrocytosis

Rouleaux formation

1. Differentiation of the granules in the WBC takes place at which stage myelocyte myeloblast promorphonuclear cell metamyelocyte promyelocyte_

myelocyte

``` Question 105 1. The following results were obtained on a 35 year old woman complaining of fatigue and weight loss: WBC = 1.8 x 103/µL RBC = 4.6 x 106/µL Platelets = 903 x 103/µL Uric acid = 6.4 ng/dL LAP = 0 Philadelphia chromosome pos Differential: Segs = 30% Lymphs = 13% Monos = 3% Bands = 17% Eos = 4% Baso = 6% Metas = 3% Myelos = 20% Promyelo = 3% Blasts = 1% These results are consistent with: ``` neutrophilic leukemoid reaction idiopathic thrombocythemia chronic granulocytic leukemia leukoerythroblastosis in myelofibrosis

chronic granulocytic leukemia

Identify the cells at the end of the arrows. codocyte elliptocyte keratocyte stomatocyte none of the above

stomatocyte

This field is typical for multiple myeloma patients. What is it and what is causing it?

rouleaux - caused by abnormal proteins (Ig's) caudsing the rbc to "coin stack)

1. The morphologic characteristic(s) associated with the Chediak-Higashi syndrome is/are: pale blue cytoplasmic inclusions giant lysosomal granules small, dark staining granules and condensed nuclei nuclear Hyposegmentation

giant lysosomal granules

1. In infectious mononucleosis, lymphocytes tend to be: small with little cytoplasm normal decreased in number enlarged and indented by surrounding structures

enlarged and indented by surrounding structures

Which of the following best describes the field. Select as many of the responses as fits with your diagnosis. 2+ hypochromasia 1+ anisocytosis polychromasia sl poikilocytosis normochromic, normocytic

Correct Answers: 2+ hypochromasia 1+ anisocytosis sl poikilocytosis

1. The deformability of RBC is a result of _______________________ in the cytoskeleton actin 2,3-DPG spectrin actin and 2,3-DPG actin and spectrin

actin and spectrin

1. Qualitative and quantitative neutrophil changes noted in response to infection include all of the following EXCEPT: neutrophilia pelgeroid hyposegmentation toxic granulation vacuolization

pelgeroid hyposegmentation

Identify the cell at the end of the arrow. dacryocyte drepanocyte keratocyte codocyte none of the above

drepanocyte

1. Progressive anemia may result in none of these bone marrow suppression mild hepatitis CNS involvement

none of these

Which term best describes this cell band segmented hyposegmented hypersegmented

hypersegmented

1. Which of the following anemias is characterized by oval macrocytes none of these thalassemia major aplastic anemia sickle cell disease pernicious anemia

pernicious anemia

1. Metamyelocytes have a kidney shaped nucleus do not precede the band in the maturation sequence have no specific granules all of these have a visible filament

have a kidney shaped nucleus

1. Which of the following is considered to be toxic changes in neutrophilia all of these Dohle bodies vacuoles dark granules none of these

all of these

1. RBC's exhibiting macrocytes and microcytes would be termed poikilocytes hypochromasia anisocytes polychromasia none of the above

anisocytes

These cells are seen in patients with Chediak-Higashi Alder-Reilly Infectious mononucleosis monocytic leukemia healthy patients

Infectious mononucleosis

Which of the following best describes the field. Select as many of the responses as fits with your diagnosis. 2+ hypochromasia 1+ anisocytosis polychromasia sl poikilocytosis normochromic, normocytic

Correct Answers: 2+ hypochromasia 1+ anisocytosis sl poikilocytosis

Identify the nucleated cell. Is it a granulocyte with a pycnotic nucleus orthochtomatophilic normoblast (metarubricyte) macroplatelet none of the above

granulocyte with a pycnotic nucleus

1. Which of the following might also be a reticulocyte all of these basophilic stippling polychromasia diffuse basophilia

all of these

1. Promyelocytes_ have nonspecific granules have several nucleoli belong to the erythrocytic series have an extremely small nucleus

have nonspecific granules

Identify the cell at the end of the arrow. (Your spelling must be accurate.)

Exact Match basophilic normoblast | Exact Match prorubricyte

Identify the anomaly. Chediak-Higashi Alder-Reilly Pelger-Huet May-Hegglin

Pelger-Huet

1. A cell not normally found in the peripheral blood might be metamyelocyte band monocyte eosinophil none of these

metamyelocyte

1. Auer rods are most likely present in which of the following? chronic granulocytic leukemia myelofibrosis with myeloid metaplasia erythroleukemia acute granulocytic leukemia

acute granulocytic leukemia

1. In aplastic anemia, you would expect the platelet count to be below normal above normal normal unimportant to the diagnosis

below normal

1. An increase in neutrophilic bands (and earlier cells)would be considered a shift to the left a shift to the right a viral response none of these_ normal and not important 1 points

a shift to the left

Which of the following best describes this field

Exact Match 4+ anisocytosis with numerous microcytes Exact Match 2+ poikilocytosis with dacryocytes and codocytes Exact Match NRBC Exact Match all of the above Exact Match none of the above

1. A middle aged white male is admitted to the hospital complaining of abdominal pain. Physical examination shows enlargement in the area of the spleen, darkening of the skin around the ankles. Peripheral bloodshows moderately decreased hemoglobin/hematocrit, increased osmotic fragility, smear shows microspherocytes. A probable diagnosis is: hereditary spherocytosis autoimmune hemolytic anemia acanthocytosis paroxysmal nocturnal hemoglobinuria

hereditary spherocytosis

1. What do these RBC - stippled cells, reticulocytes, and polychromatophilic cells - have in common hemosiderin DNA ferritin RNA none of the above

RNA

1. Diagnostic symptoms of many hemolytic anemias include all of the above elevated indirect bilirubin +DAT icteric serum

all of the above

Which of the following best describes this cell normal blast leukemia leukemic cell with auer rods normal blast with auer bodies

leukemic cell with auer rods

Identify the anomaly. Chediak-Higashi Alder-Reilly Pelger-Huet May-Hegglin

Alder-Reilly

1. According to an Arneth count, an increase in the number of multi-segmented neutrophils (>4 lobes) is shift to the right shift to the left leukocytosis leukopenia none of these

shift to the right

1. Thalassemia is caused by deletion of an alpha gene impaired synthesis of a beta chain an autosomal recessive gene all of these 1 points

all of these

Identify the inclusion in the cell at the end of the arrow. basophilic stippling Cabot Rings Howell Jolly bodies NRBC none of the above

basophilic stippling

Identify the inclusion in the cell at the end of the arrow. basophilic stippling Cabot Rings Howell Jolly bodies NRBC none of the above

basophilic stippling

Which of the following best describes the inclusions in the cell at the end of the arrow? Dohle bodies Alder-Reilly toxic granulation toxic vacuoles

toxic granulation

Identify the cells at the end of the arrows. codocyte target cell leptocyte all of the above none of the above 1 points

all of the above

1. A patient has repeated positive tests for hemoglobin in his urine upon waking. He is 45 years of age and shows a slightly decreased hemoglobin/ hematocrit. Seven months prior this patient was diagnosed as having aplastic anemia. The lab analysis shows no cell abnormalities except for a slight macrocytosis of the RBC, hyperbilirubinemia, and the previous mentioned hemoglobinuria. The patient also complains of occasional lower back pain. With these clinical findings you might expect a diagnosis of: paroxysmal nocturnal hemoglobinuria autoimmune hemolytic anemia hereditary spherocytosis acanthocytosis

paroxysmal nocturnal hemoglobinuria

1. Segmented neutrophils all of these have a pink cytoplasm have lobes connected by filaments have a constricted nucleus with 3-5 lobes none of these

all of these

1. The initial blood forming organ is the yolk sac liver spleen bone marrow

yolk sac

1. Increased numbers of basophils are often seen in: acute infections chronic granulocytic leukemia chronic lymphocytic leukemia erythroblastosis fetalis

chronic granulocytic leukemia

Describe and identify the following including a description of the nucleus and cytoplasm. top/ center (slightly below the top of the screen) far bottom/ left NOTE the mitotic figure that is in the bottom center of the field. These are unusual but may occassionally be seen in bone marrow preps.

top cell: nuc- coarsely clumped, cyto- basophilic/ basophilic normoblast (prorubricyte) bottom R: nuc-nucleoli present, cyto- abundant, basophilic/ pronormoblast/ (rubriblast)

1. A cell that occurs as a result of an abnormal hemoglobin that forms tactoids (a form of crystal) when under decreased oxygen tension is schistocyte dacryocyte drepanocyte leptocyte none of the above

drepanocyte

1. 2,3-DPG is important to membrane function iron stabilization ATP production oxygen affinity

oxygen affinity

1. Which FAB designation is called the true monocytic leukemia and follows an acute or subacute course characterized by monoblasts, promonocytes, and monocytes? M1 M3 M4 M5

What stage of white cell maturation best describes this cell? blast promyelocyte myelocyte metamyelocyte band segmented

promyelocyte

1. All of the following are contained in the primary granules of the neutrophil EXCEPT: lactoferrin myeloperoxidase histamine alkaline phosphatase

histamine

1. Symptoms of anemia include all of these pallor dyspnea fatigue

all of these

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

acute lymphocytic

1. In which age group does ALL occur with the highest frequency? 1-15 years 20-35 years 45-60 years 60-75 years

1-15 years

1. Which of the following is most closely associated with chronic myelogenous leukemia? ringed sideroblasts disseminated intravascular coagulation micromegakaryocytes Philadelphia chromosome

Philadelphia chromosome

1. The discovery of an Auer rod in the cytoplasm of a cell tells you that the cell is definitely NOT a lymphoblast monoblast rubriblast myeloblast none of these

lymphoblast

1. In the FAB classification, myelomonocytic leukemia would be: M1 and M2 M3 M4 M5

1. You are looking at a bone marrow preparation and you see a cell with a relatively small nucleus; coarse clumped, pyknotic nucleus; with a cytoplasm that is predominantly red-pink with very little basophilia. This is probably a/an orthochromatic normoblast pronormoblast basophilic erythroblast polychromatic erythroblast none of the above

orthochromatic normoblast

Identify the cell to the left in this field. What stain was used? reticulocyte, new methylene blue orthochromatophilic normoblast, Wright's stain ringed sideroblast, prussian blue none of the above

ringed sideroblast, prussian blue

The cell at the end of the arrow could best be described as spherocytic hypochromic polychromatophilic siderotic none of the above

spherocytic

Identify the cell to the left in this field. What stain was used? Explain what is going on with this cell

``` ringed sideroblast Prussian blue (+ Perle's) Iron in the mitochondria - surroundin the nucleus but not able to be incorporated into the cell. ```

1. Myelocytes can be either neutrophilic, eosinophilic, or basophilic have a large indented nucleus may have several nucleoli present all of these none of these

can be either neutrophilic, eosinophilic, or basophilic

1. Which of the following are embryonic hemoglobins Gowers I and II Gowers I and F F and A2 Gowers F and A2 none of these

Gowers I and II

1. Globin synthesis occurs in the ribosome codon endoplasmic reticulum nucleolus mitochondria

ribosome

1. In response to hypoxia, a hormone is produced to stimulate the production of RBC. This is produced by the pituitary heart liver kidney none of the above

kidney

1. The mature RBC has Dohle bodies neutrophilic granules pink cytoplasm a nucleus

pink cytoplasm

1. Hairy cell leukemia is: an acute myelocytic leukemia a chronic leukemia of myelocytic origin a chronic leukemia of lymphocytic origin an acute myelocytic monocytic type leukemia

chronic leukemia of lymphocytic origin