Test Questions

Question 1

What test is hard to interpret if the patient has severe thrombocytopenia?

Answer 1

BMBT

Question 2

Which condition is most likely if both PT and PTT are prolonged?

Answer 2

Vitamin K antagonism

Question 3

Which provides supportive evidence for DIC?

Answer 3

Increased FDP

Question 4

Why would poikilocytes be present in iron deficient anemias?

Answer 4

Iron deficient poorly hemoglobinized erythrocytes are fragile during slide making.

Question 5

Numerous clusters of polygonal cohesive cells are present on a mildly proteinaceous and hemorrhagic background. The cells have deeply basophilic cytoplasm and a low to very high nuclear: cytoplasmic ratio. Anisocytosis is moderate to marked. Nuclei are round with fine chromatin and multiple prominent irregularly shaped nucleoli. Anisokaryosis is also marked. Mitotic figures are present.

Answer 5

This description suggests a carcinoma - the cohesive nature supports epithelial origin, and then malignancy is suggested by variable N:C ratio, anisocytosis, anisokaryosis, nucleoli, and mitotic figures.

Question 6

What causes rouleaux formation?

Answer 6

High protein concentration.

Question 7

If your interpretation of leukocytes was: Leukocytosis with neutrophilic and lymphopenia - stress leukogram, what would you expect to see in the leukocyte compartment of the bone marrow?

Answer 7

No changes since involves demargination, maybe minor decrease in neutrophil reserves. There is no increased demand for cells.

Question 8

The slides contained mild to moderate hemorrhage and a single population of individualized spindle cells. These cells had indistinct cytoplasmic borders, deeply basophilic granular cytoplasm with occasional punctate vacuoles, and a prominent Golgi zone. The nuclei were round to oval with fine chromatin, and prominent multiple irregular nucleoli. Bi and multi nucleation were common. There was up to 4 fold anisokaryosis and 3 fold anisocytosis. Frequent mitotic figures were observed.

Answer 8

Malignant mesenchymal cell neoplasia (sarcoma)
Mesenchymal cell type due to spindle shape and indistinct cytoplasmic borders. Malignant neoplasia due to multiple irregular nucleoli, bi and multi-nucleation, anisokaryosis, anisocytosis and presence of mitotic figures