Intensive Recap Flashcards
Normal platelets have a circulating life span of approximately:
10 Days (9-10 Days)
Platelet dense granules contain:
Calcium, Storage ADP and Serotonin
which of the following measures platelet function?
Bleeding time
To evaluate normal platelet numbers in an appropriate area of a blood smear, approximately how many platelets should be observed per oil immersion field?
8-20
Thrombocytosis may be associated with:
Post-splenectomy and Polycythemia vera
Which o f the following is characteristic if Bernard-Soulier syndrome?
Giant platelets
a patient has been taking aspirin regularly for arthritic pain. Which one of the following tests is most likely to be abnormal in this patient?
Template bleeding time
Platelet glycoprotein IIb/IIIa complex is:
Membrane receptor for fibrinogen
Which set of platelet responses would be most likely be associated with Glanzmann’s thrombasthenia?
Normal platelet aggregation response to ristocetin
Decrease response to collagen
ADP and epinephrine
Platelet aggregation studies revealed normal aggregation curves with collagen, epinephrine, and ADP, but an abnormal aggregation curve with ristocetin. Based on these findings, what is the differential diagnosis?
Von Willebrand disease and Bernard-Soulier syndrome
Which of the following platelet responses is most likely associated with classic Von Willebrand’s disease?
Decreased platelet aggregation to ristocetin
the preferred blood product for a bleeding patient with Von Willebrand’s disease is transfusion with:
Cryoprecipitated AHF
Acute disseminated intravascular coagulation is characterized by:
Hypofibrinogenemia
Which of the following is Vitamin K dependent?
Factor VII
Last factor to be depressed in Vitamin K deficiency:
Factor II
Coagulation factors affected by coumarin drugs are:
II, VII, IX and X
Which of the following is not present in BaSO4 adsorbed plasma?
II
Which of the following is NOT a contact factor?
Stable Factor (Factor VII)
Whcich one of the following factors typically shows an increase in liver disease?
Factor VIII
Which of the following factor deficiencies is associated with either no or only a minor bleeding tendency, even after trauma or surgery?
Factor XII
Classic Hemophilia is condition in which there may be a:
Prolonged APTT
In which of the following diseases would you most likely find an abnormal prothrombin time:
DIC
Increased APTT with normal PT would indicate a deficiency of:
Factor IX
In the APTT test, the patient’s plasma is mixed with:
Phospholipid and Calcium
PTT measure all factors except for:
VII and XIII
A patient on therapeutic warfarin will most likely have a(an):
- Increased PT/INR
- Increased APTT
- Normal bleeding time
- Normal platelet count
The intentional normalized ratio (INR) is useful for:
Monitoring warfarin therapy
Reversal of heparin overdose can be achieved by administration of:
Protamine sulfate
the following results are obtained:
PT - Normal
APTT - Prolonged
Absorbed Plasma - Corrects APTT
The factor deficiency is:
VIII
Which one of the following laboratory findings is associated with Factor XIII deficiency?
Clot solubility in a 5 molar urea solution or 1% monochrloroacetic acid
In Factor X deficiency, a prolonged PT or APTT is corrected by the addition of:
Aged Plasma (No. 5 & 8), Aged Serum (No. 1, 2, 5, 8 & 13) and Fresh Serum (No. 1, 5, 8 & 13)
The activity of the lupus anticoagulant and anti cardiolipin antibodies appears to be directed against:
Phospholipid
A prolonged Stypven (Russel viper venom) time is associated with deficiency if the following factors EXCEPT:
Factor VII
Normal PT and APTT results in a patient with a poor wound healing may be associated with:
Factor XIII deficiency
The laboratory test for monitoring heparin therapy is:
PTT
All of the following tests are affected by heparin therapy except:
Reptilase time
An abnormal thrombin time is associated with:
Fibrinogen deficiency
Which of the following will NOT cause the thrombin time to be prolonged?
Factor II deficiency
The observation of a normal reptilase time and a prolonged thrombin time is indicative of:
Presence of heparin
The active enzyme of fibrinolysis:
Plasmin
The D-dimer test is a specific test for:
Plasmin degradation of fibrin
A positive protamine sulfate is suggestive of:
DIC
EDTA-induced pseudothrombocytopenia can be identified on a blood smear by:
Finding the platelet adhering to the WBC’s
For which of the following procedures would heparin be a recommended anticoagulant?
OFT
What is the proper angle of needle insertion for phlebotomy?
15 Degrees
An important marker on hematopoietic progenitor cells is:
CD 34
Which of the following is the preferable site for bone marrow aspiration and biopsy in an adult?
Illiac crest
What is the first type of cell produced by the developing embryo?
Erythrocyte
When distinguishing between mature and immature leukocytes, the most reliable morphologic characteristic is:
Nuclear chromatin pattern
The correct maturation order of erythrocyte morphologic stages is:
Rubriblast - prorubricyte - rubricyte - metarubricyte
Compared to a rubricyte, a metarubricyte looks different because of its:
Pyknotic nucleus
Primary granules in the neutrophil appear at which stage:
Promyelocyte
Specific (secondary) granules of the neutrophilic granulocyte:
Appear first at the myelocyte stage
The neutrophilic mitotic pool includes:
Promyelocytes, Myeloblasts and Myelocytes
The earliest stage in the myeloid series at which it is possible to classify a given cell:
Myelocyte
The last cell in thte granulocytic series, capable of mitosis is the :
Myelocyte
In the neutrophil series of leukocyte development, the earliest stage to normally appear in the peripheral blood is the:
Band
Antigen-independent lymphopoiesis occurs primary lymphoid tissue located in the:
Thymus and Bone Marrow
The largest hematopoietic cells in normal bone marrow are:
Megakaryocytes
Which of the following is characteristic of cellular changes as meagakaryocytes mature into megakaryocytes within the bone marrow?
Nuclear division without cytoplasmic division
The type of niclear reproduction seen in megakaryocytes is:
Endomitosis
Programmed cell death is called:
Apoptosis
The Na+ - K+ cation pump is an important mechanism in keeping the red blood cell inact. Its function is to maintain a high level of:
Intracellular K+
Approximately 70% of the body iron is found in the form of:
Hemoglobin
The major storage form of iron is:
Ferritin
Which of the following depicts the structure of the hemoglobin molecule?
Four heme groups and Four globin chains
These pairs of chains make up the majority of hemoblobin in normal adults:
alpha 2 and Beta 2
With respect to globin chain genes, which of the following statements is correct?
The genes for the alpha globin chains are located on chromosome 16 and the genes for the gamma, delta and beta chains are located on chromosome 11
Most of the erythrocyte’s energy comes from the:
Embden-Meyerhof pathway
The enzyme deficiency in the Embden-Meyerhof pathway responsible for most cases of hereditary nonspherotic hemolytic anemia is:
Pyruvate kinase
This metabollic pathway facilitates the oxygen release from hemoglobin to tissues:
Rapoport-Leubering pathway
A shift to the right in the ODC occurs when there is a(an):
Increase in CO2
The major site of removal of normal, aged erythrocytes is the:
Spleen
What is the process wherein the spleen is able to trap and phagocytose senescent and abnormal red blood cells?
Culling
Approximately_______ percent of RBC’s are replaced daily in the adult.
1.0
The substance that is present in the urine is increased amounts if intravascular hemolysis is increased but there is no intravascular hemolysis:
Urobilinogen
Which of the following laboratory result is NOT consistent with accelerated red cell destruction?
Increased serum haptoglobin
The following are compounds formed in the synthesis of heme:
Porhobilinogen, Uroporphobilinogen, Coproporphobilinogen and Protoporphophyrinogen
Asynchronous development of hematopoietic cells within the bone marrow is the result of:
Impaired DNA synthesis
The macrocytes typically seen in megaloblastic processes are:
Ovalocytic
Megaloblastic anemia is characterized by all of the following, EXCEPT:
Increased platelets
Bite cells are associated with
G6PD
What disorder is associated with erythrocytes that are thermally unstable and fragment when heard heated to 45 degrees to 46 decrees Celsius?
Hereditary pyropoikilocytosis
Many microspherocytosis and shictocytes and budding off of spherocytes can be seen on peripheral blood smears of patients with:
Extensive burns
Which of the following is most likely to be seen in lead poisoning?
Basophilic stipplings
What cell shape is MOST commonly associated with an increased MCHC?
Spherocytes
Microangiopathic hemolytic anemia is characterized by:
Schistocytes and nucleated RBCs
In myelofibrosis, the characteristic abnormal red cell morphology is:
Teardrop cells
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:
G6PD deficiency
A 15-year old girl is taking primaquine 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:
Heinz bodies
Select the amino acid substitution that is responsible for sickle cell anemia?
Valine is substituted for glutamic acid at the sixth position of the beta chain
Which of the following hemoglobin electrophoresis results is most typical of sickle cell trait?
45% HbS and 55% HbA
What is the pathophysiology of B-thalassemia?
Decreased synthesis of B-chains
Patients with beta thalassemia:
- Occasional target cells
- Increased hemoglobin A2
The abnormally increased hemoglobin electrophoresis value(s) that would usually exclude the possibility of alpha thalassemis is (are):
HbA2 and HbF
Iron deficiency anemia may be distinguished from anemia of chronic infection by:
TIBC
Which antibiotic is most often implicated in the development of aplastic anemia?
Chloramphenicol
Which of the following is a pure red cell aplasia?
Diamond-Blackfan anemia
Laboratory findings in acute hemolytic anemia:
Hemoglobinemia and Hemoglobinuria
Wich antibiotic is most often implicated in the development of aplastic anemia
Chloramphenicol
Which of the following is a pure red cell aplasia?
Diamond-Blackfan anemia
Laboratory findings in acute hemolytic anemia:
Hemoglobinuria and Hemoglobinemia
In an anemia caused by hemorrhafe or hemolysis what would you expect to find in your laboratory investigation?
Presence of polychromatophilic macrocytes on the peripheral blood smear
Spherocytes may be seen in the peripheral blood of patients with:
Autoimmune hemolytic anemia
Hemolytic anemia caused by intrinsic caused by intrinsic erythrocyte abnormalities include:
Hereditary spherocytosis
Rouleaux of red blood cells when seen in the monolayer of a blood smear is characteristic of:
Multiple Myeloma
A laboratory test that’s always useful in the differential diagnosis of relative and absolute erythrocytosis is:
Red cell mass quantitation
PV is characterized by:
Absolute increase in total red cell mass
Relative polycythemia is characterized by:
Normal total red cell mass and Decreased plasma volume
Which of these hemoglobin derivatives cannot be reduced back to normal hemoglobin?
Sulfhemoglobin
Neutrophil granules contains:
- Myeloperoxidase
- Lysozome
- Lactoferrin
- ALP
Causes of monocytosis:
- SBE
- Tuberculosis
- Syphilis
In which of the following are eosinophils NOT increased?
Cushing syndrome
Which of the following is associated with Chediak-Higashi syndrome?
Membrane defect of lysosomes
Which of the following is associated with Alder-Reilly inclusions?
Mucopolyssaccharidosis
Of the following, the disease most closely associated with pale blue inclusions in granulocytes and giant platelets is:
May-Hegglin anomaly
Of the following, the disease most closely associated with glucocerobrosidase deficiency is:
Gaucher’s Disease
In the FAB classification, myelomonocytic leukemia would be:
M4
A cytogenic abnormality is found in almost 50% of the patients with which of the following classifications of acute nonlymphocytic leukemia?
M3
DIC is most often associated with which of the following FAB designation of acute leukemia?
M3
Which of the following stains is helpful in the diagnosis of suspected erythroleukemia?
Periodic Acid-Schiff
In the FAB classification, acute lymphocityc leukemia is divided into groups according to:
Morphology
The FAB classification of ALL seen most commonly in children is:
L1
