L1 HEMA Flashcards
Factor VII deficiency:
A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT
B. Prolonged PT, Normal APTT, Normal TCT
Hemophilia A:
A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT
A. Normal PT, Prolonged APTT, Normal TCT
Factor X deficiency:
A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT
C. Prolonged PT and APTT, Normal TCT
Fibrinogen deficiency:
A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT
D. Prolonged PT, APTT and TCT
More than half of the cases have been described in Ashkenazi Jews, but individuals of any ethnic group may be affected:
A. Hemophilia A
B. Hemophilia B
C. Hemophilia C
D. vWD
C. Hemophilia C
No coagulation factor has been assigned to Roman numeral:
A. II
B. IV
C. VI
D. XI
C. VI
Clinical signs and symptoms commonly include low birth weight (<2,500 g), skin hyperpigmentation (café au lait spots), and short stature.
Other manifestations can include skeletal disorders (aplasia or hypoplasia of the thumb), renal malformations, microcephaly, hypogonadism, mental retardation, and strabismus.
A. Diamond-Blackfan anemia
B. Fanconi anemia
C. Sideroblastic anemia
D. Thalassemia
B. Fanconi anemia
RBC with membrane folded over:
A. Aplastic anemia
B. Iron deficiency anemia
C. Hemoglobin C, hemoglobin SC disease
D. Sickle cell anemia, thalassemia
C. Hemoglobin C, hemoglobin SC disease
The connective tissue cells actively involved in wound healing are:
A. Plasma cells
B. Mast cells
C. Macrophages
D. Fibroblasts
D. Fibroblasts
A 53-year-old woman with no prior illnesses has a routine checkup by her physician. On examination she has a blood pressure of 150/95 mm Hg. If her hypertension remains untreated for years, which of the following cellular alterations would most likely be seen in her myocardium?
A. Dysplasia
B. Fatty change
C. Hyperplasia
D. Hypertrophy
E. Metaplasia
E. Metaplasia
Due to chronic trauma induced by ill-fitting dentures:
A. Hypertrophy
B. Hyperplasia
C. Dysplasia
D. Metaplasia
B. Hyperplasia
Cell death due to ischemia is known as Infarction and is manifested by a characteristic histologic appearance which is:
A. Coagulation necrosis
B. Liquefaction necrosis
C. Fat necrosis
D. Caseous necrosis
A. Coagulation necrosis
It is a special form of cell death produced by the TUBERCLE BACILLUS.
A. Coagulation necrosis
B. Liquefaction necrosis
C. Fat necrosis
D. Caseous necrosis
D. Caseous necrosis
Smallest platelets seen:
A. Alport syndrome
B. Bernard-Soulier syndrome
C. May-Hegglin anomaly
D. Wiskott-Aldrich syndrome
D. Wiskott-Aldrich syndrome
Largest platelets seen:
A. Alport syndrome
B. Bernard-Soulier syndrome
C. May-Hegglin anomaly
D. Wiskott-Aldrich syndrome
B. Bernard-Soulier syndrome
The recommended type of microscopy for the performance of manual platelet counts is:
A. Electron
B. Darkfield
C. Light
D. Phase contrast
D. Phase contrast
The size threshold range used by electrical impedance methods to count particles as platelets is:
A. 0 to 10 fL
B. 2 to 20 fL
C. 15 to 40 fL
D. 35 to 90 fL
B. 2 to 20 fL
Thrombocytosis is a characteristic of:
A. Disseminated intravascular coagulation
B. Splenomegaly
C. Polycythemia vera
D. Idiopathic thrombocytopenic purpura
C. Polycythemia vera
The prothrombin time will detect deficiencies in the pathway(s) when calcium and a tissue factor source such as rabbit brain are added to plasma.
A. Extrinsic
B. Extrinsic and common
C. Intrinsic
D. Intrinsic and common
B. Extrinsic and common
Reticulocytes can be detected by using ____ stain.
A. New methylene blue
B. Thiazole orange
C. Propidium iodide
D. Both A and B
D. Both A and B
The hemorrhagic problems associated with scurvy are due to a deficiency of, which is a cofactor required for collagen synthesis.
A. Vitamin C
B. Prothrombin
C. Vitamin K
D. Protein C
A. Vitamin C
The number of platelets an average megakaryocyte generates is approximately:
A. 25 - 50
B. 50 - 200
C. 200 - 500
D. 2,000 - 4, 000
D. 2,000 - 4, 000
Of the following therapeutic agents, those considered to be antiplatelet medications are:
A. Aspirin and Plavix®
B. Coumadin®andheparin
C. Heparin and protamine sulfate
D. Tissue plasminogen activator and streptokinase
A. Aspirin and Plavix®
The size threshold range used by electrical impedance methods to count particles as platelets is:
A. 0 - 10 fL
B. 2 - 20 fL
C. 15 - 40 fL
D. 35 - 90 fL
B. 2 - 20 fL
The coagulation factors having a sex-linked recessive inheritance pattern are:
A. Factor V and factor VIII
B. Factor VIII and factor IX
C. Factor IX and factor X
D. von Willebrand factor and factor VIII
B. Factor VIII and factor IX
Which of the following will not cause the thrombin time to be prolonged?
A. Fibrin degradation products
B. Heparin
C. Factor I deficiency
D. Factor II deficiency
D. Factor II deficiency
A patient on therapeutic warfarin will most likely have a(n):
A. Normal PT/INR, increased aPTT, prolonged bleeding time, low platelet count
B. Increased PT/INR, increased aPTT,normal bleeding time, normal plateletcount
C. Normal PT/INR, normal aPTT, normal bleeding time, normal platelet count
D. Increased PT/INR, normal aPTT, prolonged bleeding time, low platelet count
B. Increased PT/INR, increased aPTT,normal bleeding time, normal plateletcount
Reversal of a heparin overdose can be achieved by administration of:
A. Vitamin K
B. Protamine sulfate
C. Antithrombin
D. Warfarin
B. Protamine sulfate
Cells known to be actively phagocytic include:
A. Neutrophils, monocytes, basophils
B. Neutrophils, eosinophils, monocytes
C. Monocytes, lymphocytes, neutrophils
D. Lymphocytes, eosinophils, monocytes
B. Neutrophils, eosinophils, monocytes
T cells are incapable of:
A. Collaborating with B cells in antibody responses
B. Secretion of immunoglobulins
C. Secretion of cytokines
D. Producing positive skin tests
B. Secretion of immunoglobulins
EDTA is used in concentrations of ____ of blood.
A. 0.5 mg/1 mL of whole blood
B. 1.5 mg/1 mL of whole blood
C. 2.5 mg/1 mL of whole blood
D. 3.5 mg/1 mL of whole blood
B. 1.5 mg/1 mL of whole blood
Sodium citrate in the concentration of a ________ solution has been adopted as the appropriate concentration by the ICSH and the International Society for Thrombosis and Hemostasis for coagulation studies.
A. 1.5%
B. 15%
C. 3.2%
D. 3.8%
C. 3.2%
Heparin is added ____ per mL of blood in each test tube.
A. 0.2 mcg per mL
B. 2.0 mcg per mL
C. 0.2 mg per mL
D. 2 mg per mL
C. 0.2 mg per mL
The term phlebotomy is derived form the Greek words that, literally translated, mean to:
A. Cut a vein
B. Draw blood
C. Stick a vein
D. Withdraw blood
A. Cut a vein
Phlebos - vein
tome - incision
Plastic red-top tubes used to collect blood specimens usually contain:
A. Anticoagulant
B. Clot activators
C. No additives
D. Preservatives
B. Clot activators
Glass - no additives
Plastic - clot activators activates factor XII
A pink-top tube containing EDTA is primarily used for:
A. Blood bank tests
B. Chemistry
C. Coagulation tests
D. Microbiology tests
A. Blood bank tests
How many times do you mix non additive tubes?
A. 2 or 3
B. 5 to 10
C. 8 to 12
D. None
D. None
Noneadditive tubes should not be mixed. In fact, mixing may cause hemolysis if the sample has already begun to clot
Insufficient mixing of an anticoagulatn tube can lead to:
A. Hemolysis of the specimen
B. Lipemia of the specimen
C. Microclots in the specimen
D. The sample clotting too fast
C. Microclots in the specimen
Labeling of the routine inpatient blood specimens should take place:
A. at the bedside immediately after collection
B. before the blood specimens are collected
C. in the lab processing area after collection
D. outside the patient’s room after collection
A. at the bedside immediately after collection
According to CLSI, depth of heel puncture should not exceed:
A. 1.5 mm
B. 2.0 mm
C. 2.4 mm
D. 4.9 mm
B. 2.0 mm
Which of the following can be a complication of a heel puncture that is too deep?
A. Osteoarthritis
B. Osteoporosis
C. Osteomyelitis
D. Osteosarcoma
C. Osteomyelitis
Select the needle most commonly used in standard venipuncture in an adult:
A. One inch, 18 gauge
B. One inch, 21 gauge
C. One- half inch, 23 gauge
D. One- half inch, 25 gauge
B. One inch, 21 gauge
This needle gauge is used primarily fo infacnt or child veins, and difficult or hard veins of adults:
A. 16
B. 18
C. 21
D. 23
D. 23
Which of the following veins are listed in the proper order of selection for venipuncture?
A. Basilic, cephalic, median cubital
B.Cephalic, median cubital, basilic
C. Median, median basilic, cephalic
D. Median cubital, cephalic, basilic
D. Median cubital, cephalic, basilic
According to CLSI, venipuncture should not be performed on leg, ankle, or foot veins unless:
A. Both arms have IVs or other intravascular devices
B. Permission of the patient’s physician has been obtained
C. There are no acceptable antecubital or hand veins
D. The patient does not have any coagulation problems
B. Permission of the patient’s physician has been obtained
An inpatient vehemently refuses to allow you to collect a blood specimen. What should you do?
A. Convince the patient to cooperate and collect the sample anyway
B. Have the nurse physically restrain the patient and draw the specimen
C. Notify the patient;s nurse and document the patient’s refusal
D. Return to the lab, cancel the test request and inform the physician
C. Notify the patient;s nurse and document the patient’s refusal
A diabetic outpatient has had a mastectomy on her right side and cannot straighten her left arm because of arthritis. The best place to collect a blood specimen is
A. an ankle or foot vein on either of her legs
B. The left forearm or hand, using a butterfly
C. The right arm below the antecubital fossa
D. THe right hand, using a capillary puncture
B. The left forearm or hand, using a butterfly
If you have no other choice but to collect a specimen form an arm with a hematoma, collect the specimen:
A. Above it
B. Beside it
C. Distal to it
D. Through it
C. Distal to it
When encountering a patient with a fistula, the phlebotomist should:
A. Apply the tourniquet below the fistula
B. Use the other arm
C. Collect the blood from the fistula
D. Attach a syringe to the T-tube connector
B. Use the other arm
Peak levels of this analyte typically occur around 0800 hours.
A. Bilirubin
B. Cortisol
C. Eosinophil
D. Glucose
B. Cortisol
Increase: 8am - 9 am
Decrease: 10 pm -11 pm
Which of the following analytes is typically increased in chronic smokers?
A. Bicarbonate
B. Hemoglobin
C. O2 Saturation
D. Vitamin B12
B. Hemoglobin
Chronic effects of smoking lead to increased Hb concentration, erythrocyte count, MCV, and WBC count
The best specimens to use for establishing inpatient reference ranges for blood tests are:
A. Basal state specimens
B. Fasting specimens
C. Postprandial specimens
D. Steady state specimens
A. Basal state specimens
Going without food or drink except water for 8 to 12 hours is defined as:
A. Fasting
B. NPO
C. Routine
D. TDM
A. Fasting
A 12-hour fast is normally required in testing for this analyte:
A. Bilirubin
B. Calcium
C. Electrolytes
D. Triglycerides
D. Triglycerides
A patient who is NPO:
A. Cannot have any food or drink
B. Cannot have anything but water
C. Is in critical but stable condition
D. Is recovering from minor surgery
A. Cannot have any food or drink
Which specimen has priority over all other specimens during processing and testing?
A. ASAP
B. fasting
C. STAT
D. timed
C. STAT
What is the proper order fo rputting protective clothing?
A. Gloves, gown, mask
B. Gown, gloves, mask
C. Gown, mask, gloves
D. Mask, gown, gloves
C. Gown, mask, gloves
Which order of events should be followed at the conclusion of a laboratory worker’s shift in order to prevent the spread of bloodborne pathogens?
A. Remove gloves, disinfect area, wash hands, remove lab coat
B. Disinfect area, remove gloves, remove lab coat, wash hands
C. Disinfect area, remove gloves, weash hands, remove lab coat
D. Remove gloves, wash hands, remove lab coat, disinfect area
B. Disinfect area, remove gloves, remove lab coat, wash hands
Which of hte following bleach dilutions is recommended for cleaning the surfaces of contaminated specimen collection areas?
A. 1:1
B. 1:2
C. 1:10
D. 1:25
C. 1:10
Prolonged BT, Normal PT, Normal APTT
A. Qualitative platelet disorder
B. Hemophilia A
C. Fibrinogen deficiency
D. DIC
E. vWD
F. Factor X deficiency
A. Qualitative platelet disorder
Prolonged BT, Normal PT, Prolonged APTT
A. Qualitative platelet disorder
B. Hemophilia A
C. Fibrinogen deficiency
D. DIC
E. vWD
F. Factor X deficiency
E. vWD
Normal BT, Normal PT, Prolonged APTT
A. Qualitative platelet disorder
B. Hemophilia A
C. Fibrinogen deficiency
D. DIC
E. vWD
F. Factor X deficiency
B. Hemophilia A
Normal BT, Prolonged PT, Prolonged APTT, Normal TT
A. Qualitative platelet disorder
B. Hemophilia A
C. Fibrinogen deficiency
D. DIC
E. vWD
F. Factor X deficiency
F. Factor X deficiency
Normal BT, Prolonged PT, Prolonged APTT, Prolonged TT
A. Qualitative platelet disorder
B. Hemophilia A
C. Fibrinogen deficiency
D. DIC
E. vWD
F. Factor X deficiency
C. Fibrinogen deficiency
Prolonged BT, Prolonged PT, Prolonged APTT, Prolonged TT
A. Qualitative platelet disorder
B. Hemophilia A
C. Fibrinogen deficiency
D. DIC
E. vWD
F. Factor X deficiency
D. DIC
PT = normal
APTT = prolonged
APTT + fresh plasma = corrected
APTT + adsorbed plasma = corrected
APTT + aged serum = not corrected
A. II
B. V
C. VIII
D. IX
C. VIII
PT = normal
APTT = prolonged
APTT + fresh plasma = corrected
APTT + adsorbed plasma = not corrected
APTT + aged serum = corrected
A. II
B. V
C. VIII
D. IX
D. IX
PT = prolonged
APTT = prolonged
APTT + fresh plasma = corrected
APTT + adsorbed plasma = corrected
APTT + aged serum = not corrected
A. IX
B. VII
C. X
D. I
D. I
PT = prolonged
APTT = prolonged
PT + fresh plasma = corrected
PT + adsorbed plasma = corrected
PT + aged plasma = not corrected
A. II
B. X
C. I
D. V
D. V
PT = prolonged
APTT = prolonged
APTT + fresh plasma = corrected
APTT + adsorbed plasma = not corrected
APTT + aged serum = corrected
A. I
B. V
C. X
D. II
C. X
PT = prolonged
APTT = prolonged
PT + fresh plasma = corrected
PT + adsorbed plasma = not corrected
PT + aged serum = not corrected
A. I
B. V
C. X
D. II
D. II
PT = normal
APTT = prolonged
APTT + fresh plasma = corrected
APTT + adsorbed plasma = corrected
APTT + aged serum = corrected
2 possible answers
XI and XII
To differentiate:
XI deficiency - hemophilia C
XII deficiency - no bleeding
In factor X deficiency, a prolonged PT or APTT can be corrected by additon of:
1. Fresh serum
2. Aged serum
3. Aged plasma
4. Adsorbed plasma
A. 1 and 2
B. 2 and 3
C. 1,2, and 3
D. 1,2,3 and 4
C. 1,2, and 3
If a pateint presents with a prolonged APTT that does not correct upon mixing the next performed test should be:
A. Factor II assay
B. Factor VIII assay
C. Platelet count
D. Dilute Russel Viper Venom Time
D. Dilute Russel Viper Venom Time
No correction in mixing studies/ substitution test with the presence of a circulating anticoagulant e.g. Lupus Inhibitor
- Dilute RVVT
- Platelet neutralization
Which of the following abnormalities is consistent with the presence of lupus anticoagulant?
A. decreased APTT/ bleeding complications
B. prolonged APTT/ thrombosis
C. prolonged APTT/ thrombocytosis
D. thrombocytosis/ thrombosis
B. prolonged APTT/ thrombosis
Mrs. Smith has the following laboratory results, and no bleeding history:
APTT: prolonged
APTT results on a 1:1 mixture of the patient’s plasma with normal plasma:
Preincubation: prolonged APTT
2-hour incubation: prolonged APTT
These results are consistent with:
A.Factor VIII deficiency
B. Factor VIII inhibitor
C. Lupus anticoagulant
D. Protein C deficiency
C. Lupus anticoagulant
Which of the following is an appropriate screening test for the diagnosis of lupus anticoagulant?
A. Thrombin time test
B. Diluted Russel’s viper venom test (DRVVT)
C. D-dimer test
D. FDP test
B. Diluted Russel’s viper venom test (DRVVT)
Diagnosis of lupus anticoagulant is confirmed by which of the following criteria?
A. Decreased APTT
B. Correction of the APTT by mixing studies
C. Neutralization of the antibody by high concentration of platelets
D. Confirmation that abnormal coagulation tests are time and temperature dependent
C. Neutralization of hte antibody by high concentration of platelets
As a remedy for lipemic or icterus sample for hemostasis test, laboratory manager should use:
A. Optical instrument
B. Mechanical endpoint coagulometer
C. Adjust anticoagulant volume
D. Use reagent known to be insensitive to heparin
B. Mechanical endpoint coagulometer
A decrease in serum haptoglobin accompanies which of the following?
A. Extravascular hemolysis
B. Intravascular hemolysis
C. Extramedullary hematopoiesis
D. Suppressed erythropoiesis
B. Intravascular hemolysis
According to the WHO classification of MDS, what percentage of blasts would constitute transformation to an acute leukemia?
A. 5%
B. 10%
C. 20%
D. 30%
C. 20%
Select the needle most commonly used in standard venipuncture in an adult:
A. One inch, 18 gauge
B. One inch, 21 gauge
C. One-half inch, 23 gauge
D. One-half inch, 25 gauge
B. One inch, 21 gauge
The most important step in phlebotomy is:
A. Cleansing the site
B. Identifying the patient
C. Selecting the proper needle length
D. Using the correct evacuated tube
B. Identifying the patient
The venipuncture needle should be inserted into the arm with the bevel facing:
A. Down and an angle of insertion between 15 and 30 degrees
B. Up and an angle of insertion less than 30 degrees
C. Down and an angle of insertion greater than 45 degrees
D. Up and an angle of insertion between 30 and 45 degrees
B. Up and an angle of insertion less than 30 degrees
Which of the following gathers, organizes, and directs light through the specimen?
A. Eyepiece
B. Objective lens
C. Condenser
D. Optical tube
C. Condenser
The recommended cleaner for removing oil from objectives is:
A. 70% alcohol or lens cleaner
B. Xylene
C. Water
D. Benzene
A. 70% alcohol or lens cleaner
The “control center” of the cell is the:
A. Nucleus
B. Cytoplasm
C. Membrane
D. Microtubular system
A. Nucleus
Protein synthesis occurs in the:
A. Nucleus
B. Mitochondria
C. Ribosomes
D. Golgi apparatus
C. Ribosomes
The energy source for cells is the:
A. Golgi apparatus
B. Endoplasmic reticulum
C. Nucleolus
D. Mitochondrion
D. Mitochondrion
During the second trimester of fetal development, the primary site of blood cell production is the:
A. Bone marrow
B. Spleen
C. Lymph nodes
D. Liver
D. Liver
Physiologic programmed cell death is termed:
A. Angiogenesis
B. Apoptosis
C. Aneurysm
D. Apohematics
B. Apoptosis
Which organ is the site of sequestration of platelets?
A. Liver
B. Thymus
C. Spleen
D. Bone marrow
C. Spleen
What pathway anaerobically generates energy in the form of ATP?
A. Hexose monophosphate pathway
B. Rapoport-Luebering pathway
C. Embden-Meyerhof pathway
D. 2,3-BPG pathway
C. Embden-Meyerhof pathway
What is the normal distribution of hemoglobins in healthy adults?
A. 80% to 90% Hb A, 5% to 10% Hb A2, 1% to 5% Hb F
B. 80% to 90% Hb A2, 5% to 10% Hb A, 1% to 5% Hb F
C. >95% Hb A, ❤.5% Hb A2, 1% to 2% Hb F
D. >90% Hb A, 5% Hb F, <5% Hb A
C. >95% Hb A, ❤.5% Hb A2, 1% to 2% Hb F
What plasma protein is essential to platelet adhesion?
A. VWF
B. Factor VIII
C. Fibrinogen
D. P-selectin
A. VWF
Which of the following molecules is stored in platelet dense granules?
A. Serotonin
B. Fibrinogen
C. PF4
D. Platelet-derived growth factor
A. Serotonin
Folate and vitamin B12 work together in the production of:
A. Amino acids
B. RNA
C. Phospholipids
D. DNA
D. DNA
The primary pathophysiologic mechanism of anemia associated with chronic kidney disease is:
A. Inadequate production of erythropoietin
B. Excessive hemolysis
C. Hematopoietic stem cell mutation
D. Toxic destruction of stem cells
A. Inadequate production of erythropoietin
Which of the following tests provides a good indication of accelerated erythropoiesis?
A. Urine urobilinogen level
B. Hemosiderin level
C. Reticulocyte count
D. Glycated hemoglobin level
C. Reticulocyte count
Acanthocytes are found in association with:
A. Abetalipoproteinemia
B. G6PD deficiency
C. Rh deficiency syndrome
D. Vitamin B12 deficiency
A. Abetalipoproteinemia
A Group A Rh-negative mother gave birth to a Group O Rh-positive baby. The baby is at risk for HDFN if:
A. This was the mother’s first pregnancy
B. The mother has IgG ABO antibodies
C. The mother was previously immunized to the D antigen
D. The mother received Rh immune globulin prior to delivery
C. The mother was previously immunized to the D antigen
Which of the following lysosomal storage diseases is characterized by macrophages with striated cytoplasm and storage of glucocerebroside?
A. Sanfilippo syndrome
B. Gaucher disease
C. Fabry disease
D. Niemann-Pick disease
B. Gaucher disease
Which of the following chromosome abnormalities is associated with CML?
A. t(15;17)
B. t(8;14)
C. t(9;22)
D. Monosomy 7
C. t(9;22)
What coagulation plasma protein should be assayed when platelets fail to aggregate properly?
A. Factor VIII
B. Fibrinogen
C. Thrombin
D. Factor X
B. Fibrinogen
When using anaerobic jar, it is important to include reliable indicator of anaerobiasis like:
A. Eosin
B. Methyl red
C. Methylene blue
D. Palladium chloride
C. Methylene blue
Which of the following methods for quantitation of bacteria can be used to measure the total number of viable cells?
A. Turbidimetric determination
B. Microscopic chamber count
C. Total amount of nitrogen
D. Plate count
D. Plate count
Fermentation end-products are often used to aid in the identification of bacteria. Fermentation results in which of the following?
A. Conversion of glucose to pyruvate
B. Lactic acid, mixed acids, alcohols, CO2 production
C. CO2 and water
D. Specific teichoic acids
B. Lactic acid, mixed acids, alcohols, CO2 production
Forward-angle light scatter is an indicator of cell:
A. Granularity.
B. Density.
C. Size.
D. Number.
C. Size.
Destruction of the myelin sheath of axons caused by the presence of antibody is characteristic of which disease?
A. MS
B. MG
C. Graves disease
D. Goodpasture’s syndrome
A. MS
Antimitochondrial antibodies are strongly associated with which disease?
A. Autoimmune hepatitis
B. Celiac disease
C. Primary biliary cirrhosis
D. Goodpasture’s syndrome
C. Primary biliary cirrhosis
The hemorrhagic problems associated with scurvy are due to a deficiency of ______, which is a cofactor required for collagen synthesis.
A. Vitamin C
B. Prothrombin
C. Vitamin K
D. Protein C
A. Vitamin C
Of the following therapeutic agents, those considered to be anti-platelet medications are:
A. Aspirin and Plavix
B. Coumadin and heparin
C. Heparin and protamine sulfate
D. Tissue plasminogen activator and streptokinase
A. Aspirin and Plavix
This term describes the balanced or “steady state” condition normally maintained by the body.
A. Anabolism
B. Catabolism
C. Hemostasis
D. Homeostasis
D. Homeostasis
Which of the following items is unnecessary when performing a routine venipuncture?
A. Evacuated tubes
B. Safety needle
C. Skin disinfectant
D. Tourniquet
C. Skin disinfectant
Antiseptics, not disinfectants, are used when performing routine venipuncture.
Which of the following are all anticoagulants that remove calcium from the specimen by forming insoluble calcium salts and therefore preventing coagulation?
A. EDTA, lithium heparin, citrate
B. NaF, sodium heparin, EDTA
C. Oxalate, SPS, sodium heparin
D. Sodium citrate, EDTA, oxalate
D. Sodium citrate, EDTA, oxalate
Which of the following is a disinfectant?
A. Benzalkonium chloride
B. Chlorhexidine gluconate
C. Household bleach
D. Hydrogen peroxide
C. Household bleach
PT prolonged
APTT prolonged
APTT + fresh plasma = corrected
APTT + adsorbed plasma = not corrected
APTT + aged serum = not corrected
Most likely coagulation factor deficient:
A. Factor I
B. Factor V
C. Factor X
D. Factor II
D. Factor II
Patient with severe bleeding
PT normal
APTT prolonged
APTT + fresh plasma = corrected
APTT + adsorbed plasma = corrected
APTT + aged serum = corrected
Most likely coagulation factor deficient:
A. Factor VIII
B. Factor IX
C. Factor XI
D. Factor XII
C. Factor XI
Patient with no bleeding tendency
PT normal
APTT prolonged
APTT + fresh plasma = corrected
APTT + adsorbed plasma = corrected
APTT + aged serum = corrected
Most likely coagulation factor deficient:
A. Factor VIII
B. Factor IX
C. Factor XI
D. Factor XII
D. Factor XII
PT normal
APTT prolonged
APTT + fresh plasma = corrected
APTT + adsorbed plasma = corrected
APTT + aged serum = not corrected
Most likely coagulation factor deficient:
A. Factor I
B. Factor VII
C. Factor VIII
D. Factor IX
C. Factor VIII
PT normal
APTT prolonged
APTT + fresh plasma = corrected
APTT + adsorbed plasma = not corrected
APTT + aged serum = corrected
A. Factor I
B. Factor VII
C. Factor VIII
D. Factor IX
D. Factor IX
INR range recommended for most indications (e.g., treatment or prophylaxis of deep venous thrombosis [DVT], or prevention of further clotting in patients who have had a myocardial infarction):
A. 1.0 to 1.5
B. 1.5 to 2.0
C. 2.0 to 3.0
D. 2.5 to 3.5
C. 2.0 to 3.0
INR recommended for patients with prosthetic heart valves:
A. 1.0 to 1.5
B. 1.5 to 2.0
C. 2.0 to 3.0
D. 2.5 to 3.5
D. 2.5 to 3.5
The target INR for pulmonary embolism (PE) treatment is ____ for the duration of anticoagulation.
A. 1.0
B. 2.0
C. 2.5
D. 3.0
D. 3.0
EDTA is used in concentrations of __ of blood.
A. 0.5 mg/1 mL of whole blood
B. 1.5 mg/1 mL of whole blood
C. 2.5 mg/1 mL of whole blood
D. 3.5 mg/1 mL of whole blood
B. 1.5 mg/1 mL of whole blood
Sodium citrate in the concentration of a _____ solution has been adopted as the appropriate concentration by the ICSH and the International Society for Thrombosis and Hemostasis for coagulation studies.
A. 1.5%
B. 15%
C. 3.2%
D. 3.8%
C. 3.2%
NEW TYPES OF THROMBOPLASTINS for measuring the PT are mixtures of phospholipids and recombinantly derived from:
A. Rabbit tissue factor
B. Human tissue factor
C. Horse tissue factor
D. Sheep tissue factor
B. Human tissue factor
The recommended type of microscopy for the performance of manual platelet counts is:
A. Electron
B. Darkfield
C. Light
D. Phase contrast
D. Phase contrast
The size threshold range used by electrical impedance methods to count particles as platelets is:
A. 0 to 10 fL
B. 2 to 20 fL
C. 15 to 40 fL
D. 35 to 90 fL
B. 2 to 20 fL
Most common complication encountered in obtaining a blood specimen:
A. Ecchymosis (bruise)
B. Hematoma
C. Hemoconcentration
D. None of these
A. Ecchymosis (bruise)
It is caused by leakage of a SMALL AMOUNT OF BLOOD in the tissue around the puncture site:
A. Ecchymosis (bruise)
B. Hematoma
C. Hemoconcentration
D. None of these
A. Ecchymosis (bruise)
Leakage of a LARGE AMOUNT OF BLOOD around the puncture site causes the area to rapidly swell:
A. Ecchymosis (bruise)
B. Hematoma
C. Hemoconcentration
D. None of these
B. Hematoma
Your patient is not wearing an ID band. You see that the ID band is taped to the nightstand. The information matches your requisition. What do you do?
A. Ask the patient to state her name; if it matches the requisition, continue.
B. Ask the patient’s nurse to attach an ID band and proceed when it is attached.
C. Go to the nurses’ station, get an ID bracelet, attach it, and then proceed.
D. Tell the nurse that you will not collect the specimen and return to the lab.
B. Ask the patient’s nurse to attach an ID band and proceed when it is attached.
Smallest platelets seen:
A. Alport syndrome
B. Bernard-Soulier syndrome
C. May-Hegglin anomaly
D. Wiskott-Aldrich syndrome
D. Wiskott-Aldrich syndrome
Largest platelets seen:
A. Alport syndrome
B. Bernard-Soulier syndrome
C. May-Hegglin anomaly
D. Wiskott-Aldrich syndrome
B. Bernard-Soulier syndrome
An inpatient vehemently refuses to allow you to collect a blood specimen. What should you do?
A. Convince the patient to cooperate and collect the sample anyway.
B. Have the nurse physically restrain the patient and draw the specimen.
C. Notify the patient’s nurse and document the patient’s refusal.
D. Return to the lab, cancel the test request, and inform the physician.
C. Notify the patient’s nurse and document the patient’s refusal.
Factor VII deficiency:
A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT
B. Prolonged PT, Normal APTT, Normal TCT
Hemophilia A:
A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT
A. Normal PT, Prolonged APTT, Normal TCT
Factor X deficiency:
A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT
C. Prolonged PT and APTT, Normal TCT
Fibrinogen deficiency:
A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT
D. Prolonged PT, APTT and TCT
Disseminated intravascular coagulation (DIC) is most often associated with which of the following types of acute leukemia?
A. Acute myeloid leukemia without maturation
B. Acute promyelocytic leukemia
C. Acute myelomonocytic leukemia
D. Acute monocytic leukemia
B. Acute promyelocytic leukemia
Cardiovascular complications of phlebotomy:
1.Cardiac arrest
2.Hypotension
3.Syncope
4.Shock
A. 1 and 2
B. 1 and 3
C. 1, 2 and 3
D. 1, 2, 3 and 4
D. 1, 2, 3 and 4
Phlebotomy complications including diaphoresis, seizure, pain, and nerve damage:
A. Cardiovascular complications
B. Vascular complications
C. Neurological complications
D. Infections
C. Neurological complications
Acute, uncompensated DIC
1. Prolonged PT, PTT and TT
2. Normal fibrinogen
3. Increased FDPs
A. 1 only
B. 1 and 2
C. 1 and 3
D. 1, 2 and 3
C. 1 and 3
The only abnormal test result in CHRONIC DIC:
A. PT
B. APTT
C. Thrombin time
D. D-dimer
D. D-dimer
What coagulation plasma protein should be assayed when platelets fail to aggregate properly?
A. Factor VIII
B. Fibrinogen
C. Thrombin
D. Factor X
B. Fibrinogen
What clotting factors (cofactors) are inhibited by protein S?
A. V and X
B. Va and VIIIa
C. VIII and IX
D. VIII and X
B. Va and VIIIa
A prolonged thrombin time is indicative of which of the following antithrombotic therapies?
A. Prasugrel
B. Clopidogrel
C. Aspirin
D. Heparin
D. Heparin
A patient on therapeutic warfarin will most likely have a(n)
A. Normal PT/INR, increased APTT, prolonged bleeding time, low platelet count
B. Increased PT/INR, increased APTT, normal bleeding time, normal platelet count
C. Normal PT/INR, normal APTT, normal bleeding time, normal platelet count
D. Increased PT/INR, normal APTT, prolonged bleeding time, low platelet count
B. Increased PT/INR, increased APTT, normal bleeding time, normal platelet count
If a child ingested rat poison, which of the following tests should be performed to test the effect of the poison on the child’s coagulation mechanism?
A. APTT
B. PT
C. Fibrinogen assay
D. Thrombin time
B. PT
What test is used to monitor heparin therapy?
A. INR
B. APTT
C. TT
D. PT
B. APTT
POCT/BEDSIDE
Which of the following is the preferred method to monitor heparin therapy at the point of care during cardiac surgery?
A. APTT
B. Activated clotting time test (ACT)
C. PT
D. TT
B. Activated clotting time test (ACT)
When encountering a patient with a fistula, the phlebotomist should:
A. Apply the tourniquet below the fistula
B. Use the other arm
C. Collect the blood from the fistula
D. Attach a syringe to the T-tube connector
B. Use the other arm
Neutrophil in the maturation-storage phase:
A. 7 to 10 hours
B. 7 to 10 days
C. 8.5 hours
D. 12 hours
B. 7 to 10 days
Basophil in the maturation-storage phase:
A. 7 to 10 hours
B. 7 to 10 days
C. 8.5 hours
D. 12 hours
D. 12 hours
Eosinophil in the maturation-storage phase:
A. 2.5 days
B. 3.5 days
C. 8.5 hours
D. 12 hours
A. 2.5 days
Average life span of neutrophils in circulating blood:
A. 7 to 10 hours
B. 7 to 10 days
C. 8.5 hours
D. 12 hours
A. 7 to 10 hours
Average life span of basophils in circulating blood:
A. 7 to 10 hours
B. 7 to 10 days
C. 8.5 hours
D. 12 hours
C. 8.5 hours
What is the correct order for removing protective clothing?
A. Gloves, gown, mask
B. Gown, gloves, mask
C. Gown, mask, gloves
D. Mask, gown, gloves
A. Gloves, gown, mask
What is the proper order for putting on protective clothing?
A. Gloves first, then gown, mask last
B. Gown first, then gloves, mask last
C. Gown first, then mask, gloves last
d. Mask first, then gown, gloves last
C. Gown first, then mask, gloves last
NEW TYPES OF THROMBOPLASTINS for measuring the PT are mixtures of phospholipids and recombinantly derived from:
A. Rabbit tissue factor
B. Human tissue factor
C. Horse tissue factor
D. Sheep tissue factor
B. Human tissue factor
The recommended type of microscopy for the performance of manual platelet counts is:
A. Electron
B. Darkfield
C. Light
D. Phase contrast
D. Phase contrast
The size threshold range used by electrical impedance methods to count particles as platelets is:
A. 0 to 10 fL
B. 2 to 20 fL
C. 15 to 40 fL
D. 35 to 90 fL
B. 2 to 20 fL
Most common complication encountered in obtaining a blood specimen:
A. Ecchymosis (bruise)
B. Hematoma
C. Hemoconcentration
D. None of these
A. Ecchymosis (bruise)
It is caused by leakage of a SMALL AMOUNT OF BLOOD in the tissue around the puncture site:
A. Ecchymosis (bruise)
B. Hematoma
C. Hemoconcentration
D. None of these
A. Ecchymosis (bruise)
Leakage of a LARGE AMOUNT OF BLOOD around the puncture site causes the area to rapidly swell:
A. Ecchymosis (bruise)
B. Hematoma
C. Hemoconcentration
D. None of these
B. Hematoma
Your patient is not wearing an ID band. You see that the ID band is taped to the nightstand. The information matches your requisition. What do you do?
A. Ask the patient to state her name; if it matches the requisition, continue.
B. Ask the patient’s nurse to attach an ID band and proceed when it is attached.
C. Go to the nurses’ station, get an ID bracelet, attach it, and then proceed.
D. Tell the nurse that you will not collect the specimen and return to the lab.
B. Ask the patient’s nurse to attach an ID band and proceed when it is attached.
Smallest platelets seen:
A. Alport syndrome
B. Bernard-Soulier syndrome
C. May-Hegglin anomaly
D. Wiskott-Aldrich syndrome
D. Wiskott-Aldrich syndrome
Largest platelets seen:
A. Alport syndrome
B. Bernard-Soulier syndrome
C. May-Hegglin anomaly
D. Wiskott-Aldrich syndrome
B. Bernard-Soulier syndrome
An inpatient vehemently refuses to allow you to collect a blood specimen. What should you do?
A. Convince the patient to cooperate and collect the sample anyway.
B. Have the nurse physically restrain the patient and draw the specimen.
C. Notify the patient’s nurse and document the patient’s refusal.
D. Return to the lab, cancel the test request, and inform the physician.
C. Notify the patient’s nurse and document the patient’s refusal.
Cardiovascular complications of phlebotomy:
1. Cardiac arrest
2. Hypotension
3. Syncope
4. Shock
A. 1 and 2
B. 1 and 3
C. 1, 2 and 3
D. 1, 2, 3 and 4
D. 1, 2, 3 and 4
Acute, uncompensated DIC
1. Prolonged PT, PTT and TT
2. Normal fibrinogen
3. Increased FDPs
A. 1 only
B. 1 and 2
C. 1 and 3
D. 1, 2 and 3
C. 1 and 3
Phlebotomy complications including diaphoresis, seizure, pain, and nerve damage:
A. Cardiovascular complications
B. Vascular complications
C. Neurological complications
D. Infections
C. Neurological complications
The only abnormal test result in CHRONIC DIC:
A. PT
B. APTT
C. Thrombin time
D. D-dimer
D. D-dimer
What coagulation plasma protein should be assayed when platelets fail to aggregate properly?
A. Factor VIII
B. Fibrinogen
C. Thrombin
D. Factor X
B. Fibrinogen
What clotting factors (cofactors) are inhibited by protein S?
A. V and X
B. Va and VIIIa
C. VIII and IX
D. VIII and X
B. Va and VIIIa
A prolonged thrombin time is indicative of which of the following antithrombotic therapies?
A. Prasugrel
B. Clopidogrel
C. Aspirin
D. Heparin
D. Heparin
A patient on therapeutic warfarin will most likely have a(n)
A. Normal PT/INR, increased APTT, prolonged bleeding time, low platelet count
B. Increased PT/INR, increased APTT, normal bleeding time, normal platelet count
C. Normal PT/INR, normal APTT, normal bleeding time, normal platelet count
D. Increased PT/INR, normal APTT, prolonged bleeding time, low platelet count
B. Increased PT/INR, increased APTT, normal bleeding time, normal platelet count
If a child ingested rat poison, which of the following tests should be performed to test the effect of the poison on the child’s coagulation mechanism?
A. APTT
B. PT
C. Fibrinogen assay
D. Thrombin time
B. PT
What test is used to monitor heparin therapy?
A. INR
B. APTT
C. TT
D. PT
B. APTT
POCT/BEDSIDE
Which of the following is the preferred method to monitor heparin therapy at the point of care during cardiac surgery?
A. APTT
B. Activated clotting time test (ACT)
C. PT
D. TT
B. Activated clotting time test (ACT)
When encountering a patient with a fistula, the phlebotomist should:
A. Apply the tourniquet below the fistula
B. Use the other arm
C. Collect the blood from the fistula
D. Attach a syringe to the T-tube connector
B. Use the other arm