Part 1 Flashcards
What is the composition of the inclusion seen in this RBC?
A. DNA
B. RNA
C Iron
D. Denatured hemoglobin
Deficiencies of cell membrane proteins
This cell is a spherocyte and is most often associated with a deficiency or defect of membrane spectrin, though other proteins (band 3, ankyrin) may also be deificient or defective.
The smear represented below displays
A. Congenital ovalocytosis
B. Hemoglobin C disease
C.Poor RBC fixation
D. Delay in smear preparation
Hemoglobin C disease
Hemoglobin C crystals can be seen in patients with hemoglobin C disease. 768
With this blood picture, an additional test indicated is:
A. Alkali denaturation
B. Alkaline phosphatase stain
C. Peroxidase stain
D. Hemoglobin electrophoresis
Hemoglobin electrophoresis
Feedback
Hemoglobin C crystals can be seen in patients with hemoglobin C disease, but the condition must be confirmed with hemoglobin electrophoresis.
The cell seen in the image below is most consistent with:
A. Chronic myelogenous leukemia
B. Infectious mononucleosis
C. Hairy cell leukemia
D. Sezary syndrome
Hairy cell leukemia
Feedback
A variable number of malignant cells in hairy cell leukemia (HCL) will stain positive with tartrate resistant acid phosphatase (TRAP+). Although this cytochemical reaction is fairly specific for HCL, TRAP activity has occasionally been reported in B-cell and rarely T-cell leukemia.
When performing platelet aggregation studies, which set of platelet aggregation results would most likely be associated with Bernard–Soulier syndrome?
A. Normal platelet aggregation to collagen, ADP and ristocetin
B.
C. Normal platelet aggregation to epinephrine and ristocetin; dcreased aggregation to collagen and ADP
D. Normal platelet aggregation to epinephrine, ristocetin and collagen; decreased aggregation to ADP
The cell seen in the image below is most consistent with ?
A. Chronic myelogenous leukemia
B. Infectious mononucleosis
C. Hairy cell leukemia
D. Sezary syndrome
c. Hairy cells
Hairy cell leukemia
Which of the following can affect the PFA-100 closure time?
A. Aspirin
B. Thrombocytopenia
C. Anemia
D. All of the above
D. PLATELET FUNCTION ASSAY (PFA)
The PFA-100 assay measures platelet function to exposing a blood sample to high shear forces and causing the platelets to aggregate, thereby simulating platelet plug formation, The time for the aperture to close is directly proportional to platelet function. However, not only do platelet function interfere with the PFA-100 closure times but thrombocytopenic and anemic samples can also give artifactual lengthened closure times.
A confirmatory test for paroxysmal nocturnal hemoglobinuria is ?
A. Heat instability test
B. Sucrose hemolysis
C. Flow cytometric immunophenotyping
D. Dithionite solubility
C. Flow cytometric immunophenotyping
Flow cytometry Immunophenotyphing is used to confirm PNH.
CD 55 negative, CD 59 negative
Which of the following test results are consistent with a diagnosis of paroxysmal nocturnal hemoglobinuria (PNH)?
A. Decreased conversion of NADH to NAD
B. Increased production of globulin
C.Decreased hemolysis in acidified serum
D.Diminished CD55 in hematopoietic cells
D.Diminished CD55 in hematopoietic cells
CD55 is normal associated with all hematopoietic cells and PNH shows low intensity staining for these molecules.
The anticoagulant that directly inhibits thrombin is:
A. LMWH
B.Argatroban
C.Warfarin
D.Rivorxaban
B. Argatroban
ARGATROBAN is a direct thrombin inhibitor that reversibly binds and inactivated free and clot bound thrombin.
What staining method is used most frequently to stain and manually count reticulocytes?
A.Immunofluorescence
B. Supravital staining
C.Romanowsky staining
D.Cytochemical staining
B.Supravital staining
The reticulum within the reticulocytes consists of ribonucleic acid (RNA), which cannot be stained with Wright’s stain. Supravital staining with new methylene blue is used to identify the reticulocytes.
The WHO classification requires what percentage for the blast count in the blood or bone marrow for the diagnosis of AML?
A. At least 30%
B. At least 20%
C. At least 10%
D. Any percentage
B. At least 20%
The WHO classification of AML requires that ≥20% of nucleated bone marrow cells be blasts, while the FAB classification generally requires ≥30%. WHO classifies AML into five subgroups: These are acute myeloid leukemias with recurrent genetic disorders; acute myeloid leukemia with multilineage dysplasia; acute myeloid leukemia and myelodysplastic syndromes, therapy related; acute myeloid leukemia not otherwise categorized; and acute leukemia of ambiguous lineage.
The erythrocytosis seen in relative polycythemia occurs because of:
In which of the following conditions does LAP show the least activity?
A.Leukomoid reactions
B.Idiopathic myelofibrosis
C.Polycythemia vera
D.Chronic myelogenous leukemia
D. Chronic myelogenous leukemia
Cells that exhibit a positive stain with acid phosphatase and are not inhibited with tartaric acid are characteristically seen in:
A.Infectious mononucleosis
B.Infectious lymphocytosis
C.Hairy cell leukemia
D.T-cell acute lymphoblastic leukemia
C. Hairy cell leukemia
When performing platelet aggregation studies, which set of platelet aggregation results would most likely be associated with Bernard–Soulier syndrome?
A.Normal platelet aggregation to collagen, ADP and ristocetin
B.Normal platelet aggregation to collagen, ADP and epinephrine; decreased aggregation to ristocetin
C.Normal platelet aggregation to epinephrine and ristocetin; dcreased aggregation to collagen and ADP
D.Normal platelet aggregation to epinephrine, ristocetin and collagen; decreased aggregation to ADP
B. Normal platelet aggregation to collagen, ADP and epinephrine; decreased aggregation to ristocetin
Which of the following is an appropriate screening test for the diagnosis of lupus anticoagulant?
A.Thrombin time test
B.Diluted Russell’s viper venom test (DRVVT)
C. D-dimer test
D. FDP test
B. Diluted Russell’s viper venom test (DRVVT)
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
What is the interpretation when an Ouchterlony plate shows crossed lines between wells 1 and 2 (antigen is placed in the center well and antisera in wells 1 and 2)?
X
A.No reaction between wells 1 and 2
B.Partial identity between wells 1 and 2
C. Nonidentity between wells 1 and 2
D. Identity between wells 1 and 2
C. Nonidentity between wells 1 and 2
Which statement best describes passive agglutination reactions used for serodiagnosis?
A. Such agglutination reactions are more rapid because they are a single-step process
B. Reactions require the addition of a second antibody
C. Passive agglutination reactions require biphasic incubation
D. Carrier particles for antigen such as latex particles are used
D. Carrier particles for antigen such as latex particles are used
Interpret the following results for HIV infection. ELISA: positive; repeat ELISA: negative; Western blot: no bands
A. Positive for HIV
B. Negative for HIV
C. Indeterminate
D. Further testing needed
B. Negative for HIV
These results are not indicative of an HIV infection and may be due to a testing error in the first ELISA assay. Known false-positive ELISA reactions occur in autoimmune diseases, syphilis, alcoholism, and lymphoproliferative diseases. A sample is considered positive for HIV if it is repeatedly positive by ELISA or other screening method and positive by a confirmatory method.
Antibodies to thyroid peroxidase can be detected by using agglutination assays. Which of the following diseases may show positive results with this type of assay?
A. Graves’ disease and Hashimoto’s thyroiditis
B. Myasthenia gravis
C. Granulomatous thyroid disease
D.Addison’s disease
A. Graves’ disease and Hashimoto’s thyroiditis
Blood is crossmatched on an A positive person with a negative antibody screen. The patient received a transfusion of A positive RBCs 3 years ago. The donors chosen for crossmatch were A positive. The crossmatch was run on the Ortho Provue and yielded 3+ incompatibility. How can these results be explained?
A. The patient has an antibody to a low-frequency antigen
B. The patient has an antibody to a high-frequency antigen
C. The patient is an A2 with anti-A1
D.The patient is an A1 with anti-A2
C. The patient is an A2 with anti-A1
What type RBCs can be transfused to an A2 person with anti-A1
A. A2 only
B. A2 or O
C. B
D. AB
B. A2 or O
What should be done if all forward and reverse ABO results as well as the autocontrol are positive?
A. Wash the cells with warm saline, autoadsorb the serum at 4°C
B. Retype the sample using a different lot number of reagents
C. Use polyclonal typing reagents
D. Report the sample as group AB
A. Wash the cells with warm saline, autoadsorb the serum at 4°C
If a patient has a positive direct antiglobulin test, should you perform a weak D test on the cells?
A.No, the cells are already coated with antibody
B. No, the cells are Rh null
C. Yes, the immunoglobulin will not interfere with the test
D.Yes, Rh reagents are enhanced in protein media
A. No, the cells are already coated with antibody
If a patient has a positive direct antiglobulin test, should you perform a weak D test on the cells?
A.No, the cells are already coated with antibody
B. No, the cells are Rh null
C. Yes, the immunoglobulin will not interfere with the test
D.Yes, Rh reagents are enhanced in protein media
A. No, the cells are already coated with antibody
A unit of whole blood is collected at 10:00 a.m. and stored at 20°C–24°C. What is the last hour platelet concentrates may be made from this unit?
A. 4:00 pm
B. 6:00 pm
C. 7:00 pm
D. 8:00 pm
B. 6:00 pm
Platelets preparation from whole blood must be done within 8 hours of collection.