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Medical Technology - Hematology 2 > Intensive Recap > Flashcards

Intensive Recap Flashcards

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USMLE® Step 1 flashcards
1
Q

Normal platelets have a circulating life span of approximately:

A

10 Days (9-10 Days)

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2
Q

Platelet dense granules contain:

A

Calcium, Storage ADP and Serotonin

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3
Q

which of the following measures platelet function?

A

Bleeding time

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4
Q

To evaluate normal platelet numbers in an appropriate area of a blood smear, approximately how many platelets should be observed per oil immersion field?

A

8-20

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5
Q

Thrombocytosis may be associated with:

A

Post-splenectomy and Polycythemia vera

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6
Q

Which o f the following is characteristic if Bernard-Soulier syndrome?

A

Giant platelets

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7
Q

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?

A

Template bleeding time

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8
Q

Platelet glycoprotein IIb/IIIa complex is:

A

Membrane receptor for fibrinogen

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9
Q

Which set of platelet responses would be most likely be associated with Glanzmann’s thrombasthenia?

A

Normal platelet aggregation response to ristocetin
Decrease response to collagen
ADP and epinephrine

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10
Q

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?

A

Von Willebrand disease and Bernard-Soulier syndrome

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11
Q

Which of the following platelet responses is most likely associated with classic Von Willebrand’s disease?

A

Decreased platelet aggregation to ristocetin

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12
Q

the preferred blood product for a bleeding patient with Von Willebrand’s disease is transfusion with:

A

Cryoprecipitated AHF

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13
Q

Acute disseminated intravascular coagulation is characterized by:

A

Hypofibrinogenemia

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14
Q

Which of the following is Vitamin K dependent?

A

Factor VII

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15
Q

Last factor to be depressed in Vitamin K deficiency:

A

Factor II

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16
Q

Coagulation factors affected by coumarin drugs are:

A

II, VII, IX and X

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17
Q

Which of the following is not present in BaSO4 adsorbed plasma?

A

II

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18
Q

Which of the following is NOT a contact factor?

A

Stable Factor (Factor VII)

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19
Q

Whcich one of the following factors typically shows an increase in liver disease?

A

Factor VIII

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20
Q

Which of the following factor deficiencies is associated with either no or only a minor bleeding tendency, even after trauma or surgery?

A

Factor XII

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21
Q

Classic Hemophilia is condition in which there may be a:

A

Prolonged APTT

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22
Q

In which of the following diseases would you most likely find an abnormal prothrombin time:

A

DIC

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23
Q

Increased APTT with normal PT would indicate a deficiency of:

A

Factor IX

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24
Q

In the APTT test, the patient’s plasma is mixed with:

A

Phospholipid and Calcium

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25
Q

PTT measure all factors except for:

A

VII and XIII

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26
Q

A patient on therapeutic warfarin will most likely have a(an):

A
  • Increased PT/INR
  • Increased APTT
  • Normal bleeding time
  • Normal platelet count
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27
Q

The intentional normalized ratio (INR) is useful for:

A

Monitoring warfarin therapy

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28
Q

Reversal of heparin overdose can be achieved by administration of:

A

Protamine sulfate

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29
Q

the following results are obtained:
PT - Normal
APTT - Prolonged
Absorbed Plasma - Corrects APTT

The factor deficiency is:

A

VIII

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30
Q

Which one of the following laboratory findings is associated with Factor XIII deficiency?

A

Clot solubility in a 5 molar urea solution or 1% monochrloroacetic acid

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31
Q

In Factor X deficiency, a prolonged PT or APTT is corrected by the addition of:

A

Aged Plasma (No. 5 & 8), Aged Serum (No. 1, 2, 5, 8 & 13) and Fresh Serum (No. 1, 5, 8 & 13)

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32
Q

The activity of the lupus anticoagulant and anti cardiolipin antibodies appears to be directed against:

A

Phospholipid

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33
Q

A prolonged Stypven (Russel viper venom) time is associated with deficiency if the following factors EXCEPT:

A

Factor VII

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34
Q

Normal PT and APTT results in a patient with a poor wound healing may be associated with:

A

Factor XIII deficiency

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35
Q

The laboratory test for monitoring heparin therapy is:

A

PTT

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36
Q

All of the following tests are affected by heparin therapy except:

A

Reptilase time

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37
Q

An abnormal thrombin time is associated with:

A

Fibrinogen deficiency

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38
Q

Which of the following will NOT cause the thrombin time to be prolonged?

A

Factor II deficiency

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39
Q

The observation of a normal reptilase time and a prolonged thrombin time is indicative of:

A

Presence of heparin

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40
Q

The active enzyme of fibrinolysis:

A

Plasmin

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41
Q

The D-dimer test is a specific test for:

A

Plasmin degradation of fibrin

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42
Q

A positive protamine sulfate is suggestive of:

A

DIC

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43
Q

EDTA-induced pseudothrombocytopenia can be identified on a blood smear by:

A

Finding the platelet adhering to the WBC’s

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44
Q

For which of the following procedures would heparin be a recommended anticoagulant?

A

OFT

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45
Q

What is the proper angle of needle insertion for phlebotomy?

A

15 Degrees

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46
Q

An important marker on hematopoietic progenitor cells is:

A

CD 34

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47
Q

Which of the following is the preferable site for bone marrow aspiration and biopsy in an adult?

A

Illiac crest

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48
Q

What is the first type of cell produced by the developing embryo?

A

Erythrocyte

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49
Q

When distinguishing between mature and immature leukocytes, the most reliable morphologic characteristic is:

A

Nuclear chromatin pattern

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50
Q

The correct maturation order of erythrocyte morphologic stages is:

A

Rubriblast - prorubricyte - rubricyte - metarubricyte

51
Q

Compared to a rubricyte, a metarubricyte looks different because of its:

A

Pyknotic nucleus

52
Q

Primary granules in the neutrophil appear at which stage:

A

Promyelocyte

53
Q

Specific (secondary) granules of the neutrophilic granulocyte:

A

Appear first at the myelocyte stage

54
Q

The neutrophilic mitotic pool includes:

A

Promyelocytes, Myeloblasts and Myelocytes

55
Q

The earliest stage in the myeloid series at which it is possible to classify a given cell:

A

Myelocyte

56
Q

The last cell in thte granulocytic series, capable of mitosis is the :

A

Myelocyte

57
Q

In the neutrophil series of leukocyte development, the earliest stage to normally appear in the peripheral blood is the:

A

Band

58
Q

Antigen-independent lymphopoiesis occurs primary lymphoid tissue located in the:

A

Thymus and Bone Marrow

59
Q

The largest hematopoietic cells in normal bone marrow are:

A

Megakaryocytes

60
Q

Which of the following is characteristic of cellular changes as meagakaryocytes mature into megakaryocytes within the bone marrow?

A

Nuclear division without cytoplasmic division

61
Q

The type of niclear reproduction seen in megakaryocytes is:

A

Endomitosis

62
Q

Programmed cell death is called:

A

Apoptosis

63
Q

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:

A

Intracellular K+

64
Q

Approximately 70% of the body iron is found in the form of:

A

Hemoglobin

65
Q

The major storage form of iron is:

A

Ferritin

66
Q

Which of the following depicts the structure of the hemoglobin molecule?

A

Four heme groups and Four globin chains

67
Q

These pairs of chains make up the majority of hemoblobin in normal adults:

A

alpha 2 and Beta 2

68
Q

With respect to globin chain genes, which of the following statements is correct?

A

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

69
Q

Most of the erythrocyte’s energy comes from the:

A

Embden-Meyerhof pathway

70
Q

The enzyme deficiency in the Embden-Meyerhof pathway responsible for most cases of hereditary nonspherotic hemolytic anemia is:

A

Pyruvate kinase

71
Q

This metabollic pathway facilitates the oxygen release from hemoglobin to tissues:

A

Rapoport-Leubering pathway

72
Q

A shift to the right in the ODC occurs when there is a(an):

A

Increase in CO2

73
Q

The major site of removal of normal, aged erythrocytes is the:

A

Spleen

74
Q

What is the process wherein the spleen is able to trap and phagocytose senescent and abnormal red blood cells?

A

Culling

75
Q

Approximately_______ percent of RBC’s are replaced daily in the adult.

A

1.0

76
Q

The substance that is present in the urine is increased amounts if intravascular hemolysis is increased but there is no intravascular hemolysis:

A

Urobilinogen

77
Q

Which of the following laboratory result is NOT consistent with accelerated red cell destruction?

A

Increased serum haptoglobin

78
Q

The following are compounds formed in the synthesis of heme:

A

Porhobilinogen, Uroporphobilinogen, Coproporphobilinogen and Protoporphophyrinogen

79
Q

Asynchronous development of hematopoietic cells within the bone marrow is the result of:

A

Impaired DNA synthesis

80
Q

The macrocytes typically seen in megaloblastic processes are:

A

Ovalocytic

81
Q

Megaloblastic anemia is characterized by all of the following, EXCEPT:

A

Increased platelets

82
Q

Bite cells are associated with

A

G6PD

83
Q

What disorder is associated with erythrocytes that are thermally unstable and fragment when heard heated to 45 degrees to 46 decrees Celsius?

A

Hereditary pyropoikilocytosis

84
Q

Many microspherocytosis and shictocytes and budding off of spherocytes can be seen on peripheral blood smears of patients with:

A

Extensive burns

85
Q

Which of the following is most likely to be seen in lead poisoning?

A

Basophilic stipplings

86
Q

What cell shape is MOST commonly associated with an increased MCHC?

A

Spherocytes

87
Q

Microangiopathic hemolytic anemia is characterized by:

A

Schistocytes and nucleated RBCs

88
Q

In myelofibrosis, the characteristic abnormal red cell morphology is:

A

Teardrop cells

89
Q

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:

A

G6PD deficiency

90
Q

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:

A

Heinz bodies

91
Q

Select the amino acid substitution that is responsible for sickle cell anemia?

A

Valine is substituted for glutamic acid at the sixth position of the beta chain

92
Q

Which of the following hemoglobin electrophoresis results is most typical of sickle cell trait?

A

45% HbS and 55% HbA

93
Q

What is the pathophysiology of B-thalassemia?

A

Decreased synthesis of B-chains

94
Q

Patients with beta thalassemia:

A
  • Occasional target cells

- Increased hemoglobin A2

95
Q

The abnormally increased hemoglobin electrophoresis value(s) that would usually exclude the possibility of alpha thalassemis is (are):

A

HbA2 and HbF

96
Q

Iron deficiency anemia may be distinguished from anemia of chronic infection by:

A

TIBC

97
Q

Which antibiotic is most often implicated in the development of aplastic anemia?

A

Chloramphenicol

98
Q

Which of the following is a pure red cell aplasia?

A

Diamond-Blackfan anemia

99
Q

Laboratory findings in acute hemolytic anemia:

A

Hemoglobinemia and Hemoglobinuria

100
Q

Wich antibiotic is most often implicated in the development of aplastic anemia

A

Chloramphenicol

101
Q

Which of the following is a pure red cell aplasia?

A

Diamond-Blackfan anemia

102
Q

Laboratory findings in acute hemolytic anemia:

A

Hemoglobinuria and Hemoglobinemia

103
Q

In an anemia caused by hemorrhafe or hemolysis what would you expect to find in your laboratory investigation?

A

Presence of polychromatophilic macrocytes on the peripheral blood smear

104
Q

Spherocytes may be seen in the peripheral blood of patients with:

A

Autoimmune hemolytic anemia

105
Q

Hemolytic anemia caused by intrinsic caused by intrinsic erythrocyte abnormalities include:

A

Hereditary spherocytosis

106
Q

Rouleaux of red blood cells when seen in the monolayer of a blood smear is characteristic of:

A

Multiple Myeloma

107
Q

A laboratory test that’s always useful in the differential diagnosis of relative and absolute erythrocytosis is:

A

Red cell mass quantitation

108
Q

PV is characterized by:

A

Absolute increase in total red cell mass

109
Q

Relative polycythemia is characterized by:

A

Normal total red cell mass and Decreased plasma volume

110
Q

Which of these hemoglobin derivatives cannot be reduced back to normal hemoglobin?

A

Sulfhemoglobin

111
Q

Neutrophil granules contains:

A
  • Myeloperoxidase
  • Lysozome
  • Lactoferrin
  • ALP
112
Q

Causes of monocytosis:

A
  • SBE
  • Tuberculosis
  • Syphilis
113
Q

In which of the following are eosinophils NOT increased?

A

Cushing syndrome

114
Q

Which of the following is associated with Chediak-Higashi syndrome?

A

Membrane defect of lysosomes

115
Q

Which of the following is associated with Alder-Reilly inclusions?

A

Mucopolyssaccharidosis

116
Q

Of the following, the disease most closely associated with pale blue inclusions in granulocytes and giant platelets is:

A

May-Hegglin anomaly

117
Q

Of the following, the disease most closely associated with glucocerobrosidase deficiency is:

A

Gaucher’s Disease

118
Q

In the FAB classification, myelomonocytic leukemia would be:

A

M4

119
Q

A cytogenic abnormality is found in almost 50% of the patients with which of the following classifications of acute nonlymphocytic leukemia?

A

M3

120
Q

DIC is most often associated with which of the following FAB designation of acute leukemia?

A

M3

121
Q

Which of the following stains is helpful in the diagnosis of suspected erythroleukemia?

A

Periodic Acid-Schiff

122
Q

In the FAB classification, acute lymphocityc leukemia is divided into groups according to:

A

Morphology

123
Q

The FAB classification of ALL seen most commonly in children is:

A

L1

Medical Technology - Hematology 2 (1 decks)

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