FINAL Flashcards
(205 cards)
1
Q
In an electronic or laser particle cell counter clumped platelets may interfere with which of the following parameters?
A
WBC count
2
Q
An MCH of 30 pg suggests
A
normochromia
3
Q
An MCV of 75 fL suggests
A
microcytosis
4
Q
The last cell of the granulocyte series capable of dividing is the
A
myelocyte
5
Q
The normal adult hemoglobin value in a male is
A
14-18 g/dl
6
Q
A red cell which looks as if a bite has been taken out of it is often called:
A
helmet cell
7
Q
The normal value for a platelet count in an adult is approximately
A
150,000-350,000/L
8
Q
The normal RDW is:
A
11.5-14.5%
9
Q
The normal value for a red cell count in an adult female is approximately
A
4.0 - 5.0 x 10^6/L
10
Q
When using an electronic cell counter, which of the following results can occur in the presence of a cold agglutinin?
A
increased MCV and decreased RBC
11
Q
Which of the following parameters are derived ( tested directly) by the Coulter instrument?
A
MCV and RDW
12
Q
A patient who has increased serum proteins such as globulins may have red cells that stick together. This is called:
A
rouleaux
13
Q
A cell observed on a blood smear has a N:C of 4:1. The nucleus is round and stains dark blue-purple. The cytoplasm is light blue. There are very few to no granules in the cytoplasm. This cell is probably:
A
lymphocyte
14
Q
Lymphocytes account for what percentage of the total white cell population in peripheral blood?
A
20-40%
15
Q
T/F Hematocrit is a calculated value?
A
T
16
Q
On an electronic cell counter, hemoglobin determination may be falsely elevated owing to the presence of:
A
lipemia or elevated bilirubin concentration
17
Q
Unusual red cell size may include the term(s):
A
anisocytosis
18
Q
The normal MCHC value is:
A
32-36%
19
Q
The most buffering capacity is normally offered by the
A
hemoglobin system
20
Q
A cell observed on a blood smear appears to have bluish cytoplasm and a dark purple nucleus. The nucleus appears folded over and the N:C is about 2:1. The cell is identified as:
A
a monocyte
21
Q
The white cell which typically responds to parasitic infections is the:
A
eosinophil
22
Q
The normal value for a white cell count in an adult is approximately:
A
4.8-10.6 x 10^3/L
23
Q
Neutrophils normally account for what percentage of the total white cell population in peripheral blood?
A
50-70%
24
Q
The last cell in the RBC series which normally has a nucleus is the:
A
metarubricyte
25
The correct erythroid developmental sequence is the following
rubriblast, rubricyte, polychromatophilic erythrocyte
26
The normal value for reticulocytes in the adult peripheral blood is
0.5-2.0%
27
Cells involved in hemostasis are
thrombocytes
28
Specific (secondary) granules of the neutrophilic granulocyte
appear first at the myelocyte stage
29
The normal MCH value is
27 - 31 pg
30
Which of the following factors is NOT needed in the extrinsic pathway
tissue factor
VIII
X
V
fibrinogen
VIII
31
The average platelet count ranges from __________ of whole blood.
50 - 100 x 103/µl
350 - 600 x 103/µl
150 - 400 x 103/µl
50 - 300 x 103/µl
150 - 400 x 103/µl
32
Platelet production is regulated by
thrombopoietin
leukopoietin
erythropoietin
platepoietin
thrombopoietin
33
Approximately what portion of the platelets released into the circulating bloodstream are sequestered in the spleen
1/10
1/3
1/2
2/3
1/3
34
Platelets begin to be separated by ______________ within the platelet forming cell
demarcation membrane system
separating membrane system
plateletizing system
thrombocyting system
none of these
demarcation membrane system
35
Thrombocytosis is classified as:
Platelet count less than 400 x 103/µl
Platelet count more than 500 x 103/µl
Platelet count is 100-350 x 103/µl
Platelet count is more than 50 x 103/µl
Platelet count more than 500 x 103/µl
36
The process whereby blood is ready and able to become a solid in a needed area; and remain flowing as a liquid elsewhere is
coagulation
adhesion
hemostasis
homeostasis
hemostasis
37
Complete the equation: fibrinogen ---->_________________
thrombin
thromboplastin
fibrin
fibrinoplastin
fibrin
38
The average life span of a platelet in the peripheral blood is ________ days.
2
5
10
14
10
39
Which coagulation factor can activate plasminogen
VIII
X
VII
XII
XII
40
Which of the following coagulation factors does NOT need vitamin K for it's synthesis
11
XIII
VII
IX
XIII
41
The proteolytic enzyme that is responsible for fibrinolysis
plasminogen
fibrinogen
proteothrombin
plasmin
plasmin
42
In the extrinsic pathway, which of the following is NOT a part of the activation of factor X
tissue thromboplastin
factor VII
HMWK
calcium
HMWK
43
What is needed to complete the equation: prothrombin ---------> thrombin
iron
fibrin
calcium
phosphorus
calcium
44
In the equation: prothrombin ------> thrombin ,which of the following is a part of the process
thrombcysthenin
profibrin
thromboplastin
thromboplastin
45
A patient is suspected of having DIC (disseminated intravascular coagulation). Which of the following tests will tell the physician if fibrinolysis has been in process?:
PT
PTT
FDP
none of these
FDP
46
When plasmin attacks fibrinogen, it is called
secondary hemostasis
primary fibrinolysis
primary hemostasis
primary fibrinolysis
47
The antihemophilic factor is
III
V
VIII
XIII
none of these
VIII
48
Immediately following blood vessel injury, platelets adhere to which of the following
collagen fibers
endothelial cells
fibroblasts
smooth muscle fibers
collagen fibers
49
A patient is placed on heparin therapy. The dosage is monitored using the following test:
platelet count
bleeding time
prothrombin time
partial thromboplastin time
partial thromboplastin time
50
The function of factor XIII is
stabilize fibrin monomers
initiate the extrinsic sequence
initiate the intrinsic pathway
act as a cofactor in the common pathway
stabilize fibrin monomers
51
A patient is placed on coumadin therapy. The dosage is monitored using the following test:
platelet count
bleeding time
prothrombin time
partial thromboplastin time
prothrombin time
52
The "cascade" theories state that most of the activated coagulation factors function as
enzymes
proteins
vitamins
conglutinins
enzymes
53
The soluble pieces formed during fibrinolysis are called
solufibrinogen
plasminogen
fibrin split products
fibrin strands
fibrin split products
54
As part of clot initiation, platelets release
ADP
serotonin
PF3
Thromboxane A2
All of these
All of these
55
Which of the following is NOT a function of platelets.
clot retraction to secondary hemostatic plug
shape change and release
aggregation
carry nutrients
all are functions
carry nutrients
56
Following repair of the tissue, when the clot is no longer needed it is removed by
fibrinolysis
filtered by the spleen
phagocytized by monocytes
it is not removed - it is incorporated into the new tissue
fibrinolysis
57
The process of breaking down a clot is called
hemostasis
fibrinolysis
thrombolysis
plasmonolysis
fibrinolysis
58
What is the primary risk to thalassemia major patients who are on a high transfusion program?
hyperviscosity of blood
iron overload
citrate toxicity
electrolyte imbalance
iron overload
59
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:
lactate dehydrogenase deficiency
G-6-PD deficiency
pyruvate kinase deficiency
hexokinase deficiency
G-6-PD deficiency
60
What factors contribute to the sickling of RBCs?
increase in pH and oxygenation
decrease in pH and oxygenation, and dehydration
increase in pH and decrease in oxygenation
decrease in dehydration and increase in pH and oxygenation
decrease in pH and oxygenation, and dehydration
61
Which of the following are not seen on the peripheral smear of a patient with megaloblastic anemia?
macro-ovalocytes
hypersegmented neutrophils
hyposegmented neutrophils
Howell-Jolly bodies
hyposegmented neutrophils
62
The most appropriate screening test for hereditary spherocytosis is:
osmotic fragility
sucrose hemolysis
heat instability test
Kleihauer-Betke
osmotic fragility
63
Which of the following is a cause of methemoglobinemia?
HbM variants
NADH-diaphorase deficiency
toxic substances
all of the above
all of the above
64
Heinz bodies are:
readily identified with polychrome stains
rarely found in glucose-6-phosphate dehydrogenase deficient erythrocytes
closely associated with spherocyte
denatured hemoglobin inclusions that are readily removed by the spleen
denatured hemoglobin inclusions that are readily removed by the spleen
65
Hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) is:
temperature dependent
complement independent
antibody mediated
caused by a red cell membrane defect
caused by a red cell membrane defect
66
A 15 year old girl is taking medication 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:
Howell-Jolly bodies
basophilic stippling
Heinz bodies
Pappenheimer bodies
Heinz bodies
67
Laboratory findings in hereditary spherocytosis do NOT include:
decreased osmotic fragility
increased autohemolysis
reticulocytosis
shortened erythrocyte survival
decreased osmotic fragility
68
In most cases of hereditary persistence of fetal hemoglobin (HPFH):
Hgb F is unevenly distributed throughout the erythrocytes
the black heterozygote has 75% Hgb F
beta and gamma chain synthesis is decreased
gamma chain production equals alpha chain production
gamma chain production equals alpha chain production
69
```
A patient has the following blood values:
RBC 6.5 x 106/L
Hgb 14.0 g/dL
Hct 42.0%
MCV 65 fL
MCH 21.5 pg
MCHC 33%
These results are compatible with:
```
iron deficiency
pregnancy
thalassemia minor
beta thalassemia major
thalassemia minor
70
Which disorder is considered to be a disorder of membrane cation permeability?
G6PD deficiency
hereditary spherocytosis
hereditary elliptocytosis
hereditary stomatocytosis
hereditary stomatocytosis
71
The Schilling test:
evaluates the function of intrinsic factor
evaluates the absorption of vitamin B12
evaluates the absorption of folic acid
all of the above
evaluates the absorption of vitamin B12
72
A patient's blood sample mixed with sucrose solution and incubated at 37C shows moderate hemolysis. The direct antiglobulin test was negative. These results are suggestive of:
lupus erythromatosus
polycythemia vera
acquired autoimmune hemolytic anemia
paroxysmal nocturnal hemoglobinuria
paroxysmal nocturnal hemoglobinuria
73
The most appropriate screening test for hemoglobin H is:
dithionite solubility
osmotic fragility
sucrose hemolysis
heat instability test
heat instability test
74
Peripheral blood smears from patients with untreated pernicious anemia are characterized by:
pancytopenia and macrocytosis
pancytopenia and leukocytosis
leukocytosis and ovalocytosis
pancytopenia and microcytosis
pancytopenia and macrocytosis
75
Which of the following are causes of anemia of inflammation?
increased destruction of red cells
impaired iron metabolism
suppression of erythropoiesis by cytokines
all of the above
all of the above
76
Which of the following is most likely and most easily seen in lead poisoning?
iron overload in tissue
codocytes
basophilic stippling
ringed sideroblasts
basophilic stippling
77
Patients with (A-) type G-6-PD deficiency are LEAST likely to have hemolytic episodes in which of the following situations?
following the administration of oxidizing drugs
the neonatal period
during infections
spontaneously
spontaneously
78
The values below were obtained on an automated blood count system performed on a blood sample from a 25 year old man:
Patient ValueNormal ValueWBC5.1 x 103/L5.0-10.0 x 103/LRBC3.00 x 106/L4.6-6.2 x 106/LHgb12 g/dL14-18 g/dLHct36%40-54%MCV120 fL82-90 fLMCH40 pg27-31 pgMCHC33%32-36%
These results are most consistent with which of the following?
megaloblastic anemia
hereditary spherocytosis
a high titer of cold agglutinins
an elevated reticulocyte count
megaloblastic anemia
79
A characteristic morphologic feature in hemoglobin C disease is:
macrocytosis
spherocytosis
rouleaux formation
target cells
target cells
80
The hypochromic anemias represent a related group of disorders with:
a quantitative defect in hemoglobin synthesis
a qualitative defect in globin synthesis
excess hemoglobin synthesis
Vitamin B12 and folate deficiency
a quantitative defect in hemoglobin synthesis
81
Which of the following is NOT a cause of nonmegaloblastic anemia?
alcoholism
immunosuppressive drugs
hypothyroidism
hyperthyroidism
hyperthyroidism
82
What is the amino acid substitution found in HbC disease?
substitution of valine for glutamic acid in the sixth position from the NH2 terminal chain
substitution of lysine for glutamic acid in the sixth position from the NH2 terminal chain
substitution of lysine for glutamic acid in the 26th position from the NH2 terminal chain
substitution of valine for glutamic acid in the 121st position from the NH2 terminal chain
substitution of lysine for glutamic acid in the sixth position from the NH2 terminal chain
83
Anemia secondary to uremia characteristically is:
microcytic, hypochromic
hemolytic
normocytic, normochromic
macrocytic
normocytic, normochromic
84
What is the typical appearance of anemia associated with liver disease?
normal red cell morphology
hypochromic, microcytic
macrocytic, normoblastic
macrocytic, megaloblastic
macrocytic, normoblastic
85
The anemia of chronic infection is characterized by:
decreased iron stores in the reticuloendothelial system
decreased serum iron levels
macrocytic erythrocytes
increased serum iron-binding capacity
decreased serum iron levels
86
Hemoglobin H disease results from:
absence of 3 of 4 alpha genes
absence of 2 of 4 alpha genes
absence of 1 of 4 alpha genes
absence of all 4 alpha genes
absence of 3 of 4 alpha genes
87
What is the term for the clinical course of homozygous thalassemias resulting from defects in - and -chain synthesis?
Thalassemia minor
Thalassemia major
Thalassemia trait
á-thalassemia
Thalassemia major
88
What is the amino acid substitution found in sickle cell anemia?
substitution of valine for glutamic acid in the sixth position from the NH2 terminal chain
substitution of lysine for glutamic acid in the sixth position from the NH2 terminal chain
substitution of lysine for glutamic acid in the 26th position from the NH2 terminal chain
substitution of valine for glutamic acid in the 121st position from the NH2 terminal chain
substitution of valine for glutamic acid in the sixth position from the NH2 terminal chain
89
The most appropriate screening test for hemoglobin S is:
Kleihauer-Betke
dithionite solubility
osmotic fragility
sucrose hemolysis
dithionite solubility
90
Which of the following sets of laboratory findings is consistent with hemolytic anemia?
normal or slightly increased erythrocyte survival; normal osmotic fragility
decreased erythrocyte survival; increased catabolism of heme
decreased serum lactate dehydrogenase activity; normal catabolism of heme
normal concentration of haptoglobin; marked hemoglobinuria
decreased erythrocyte survival; increased catabolism of heme
91
What routine hematologic finding is indicative of thalassemia?
microcytic, hypochromic anemia
macrocytic, hypochromic anemia
normocytic, normochromic anemia
macrocytic, normochromic anemia
microcytic, hypochromic anemia
92
Evidence indicates that the genetic defect in thalassemia usually results in:
the production of abnormal globin chains
a quantitative deficiency in RNA resulting in decreased globin chain production
a structural change in the heme portion of the hemoglobin
an abnormality in the alpha or beta chain binding or affinity
a quantitative deficiency in RNA resulting in decreased globin chain production
93
Which of the following is most closely associated with iron deficiency anemia?
iron overload in tissue
target cells
basophilic stippling
chronic blood loss
chronic blood loss
94
Which of the following findings would be indicative of heterozygous thalassemia?
hemoglobin A2 level of 3.5-7%
hemoglobin F level less than 2%
hemoglobin A level of 65-85%
hemoglobin A2 level less than 3.5%
hemoglobin A2 level of 3.5-7%
95
According to the morphological classification of anemias, megaloblastic anemia is a:
macrocytic, hypochromic anemia
macrocytic, hyperchromic anemia
macrocytic, normochromic anemia
normocytic, normochromic anemia
macrocytic, normochromic anemia
96
Thalassemias are characterized by:
structural abnormalities in the hemoglobin molecule
absence of iron in hemoglobin
decreased rate of heme synthesis
decreased rate of globin synthesis
decreased rate of globin synthesis
97
Which is the most frequent functional abnormality affecting membrane skeleton proteins in common hereditary elliptocytosis?
defective binding of spectrin to ankyrin
defective spectrin tetramer assembly
defective binding of ankyrin to protein 3
deficiency of protein 4.1
defective spectrin tetramer assembly
98
The pathophysiology of megaloblastic anemia is :
Defective RNA synthesis and abnormal cytoplasm maturation
Defective DNA synthesis and abnormal nuclear maturation
Defective RNA synthesis and abnormal nuclear maturation
Defective DNA synthesis and abnormal cytoplasm maturation
Defective DNA synthesis and abnormal nuclear maturation
99
The glycoprotein necessary for absorption of vitamin B12 is:
albumin
transcobalamin II
haptoglobin
intrinsic factor
intrinsic factor
100
Factors commonly involved in producing anemia in patients with chronic renal disease include:
marrow hypoplasia
inadequate erythropoietin
vitamin B12 deficiency
increased erythropoietin production
inadequate erythropoietin
101
Which of the following represents characteristic features of iron metabolism in patients with anemia of a chronic disorder?
serum iron is normal, transferrin saturation is normal, TIBC is normal
serum iron is increased, transferrin saturation is increased, TIBC is normal or slightly increased
serum iron is normal, transferrin saturation is markedly increased, TIBC is normal
serum iron is decreased, transferrin saturation is decreased, TIBC is normal or decreased
serum iron is decreased, transferrin saturation is decreased, TIBC is normal or decreased
102
What causes the defect in PNH?
rare red cell antigens
lack of GPI-anchored proteins on the erythrocyte membrane
excessive amounts of complement components C5 to C9
Glucose-6-phosphate-dehydrogenase enzyme deficiency
lack of GPI-anchored proteins on the erythrocyte membrane
103
What is the treatment for anemia of inflammation?
blood transfusion
iron therapy
treatment of the inflammation
human recombinant IL-1
treatment of the inflammation
104
All of the findings listed below may be seen in acquired hemolytic anemia of the autoimmune variety. The one considered to be the MOST characteristic is:
increased osmotic fragility
leukopenia and thrombocytopenia
peripheral spherocytosis
positive direct antiglobulin test
positive direct antiglobulin test
105
What deficiency causes hemoglobin to be oxidized from the ferrous to the ferric state?
G6PD deficiency
PK deficiency
NADH-methemoglobin reductase deficiency
lactate dehydrogenase deficiency
NADH-methemoglobin reductase deficiency
106
Which of the following is seen most often in thalassemia?
chronic blood loss
target cells
basophilic stippling
ringed sideroblasts
target cells
107
The lab tests performed on a patient indicate macrocytosis, anemia, leukopenia, and thrombocytopenia. Which of the following disorders is the patient most likely to have?
iron deficiency
hereditary spherocytosis
vitamin B12 deficiency
acute hemorrhage
vitamin B12 deficiency
108
Segmented neutrophils
have a pink cytoplasm
have lobes connected by filaments
have a constricted nucleus with 3-5 lobes
all of these
none of these
all of these
109
Normal adults have three hemoglobins in their red blood cells. These are
A1, F, A2
A1, G, F
F, A2, A3
A1, A2, S
none of these
A1, F, A2
110
An increase in the production of cells is called
polycythemia
porphobilinogen
polychromasia
poikilocytosis
polycythemia
111
A microcytic anemia would have the following
MCV less than 80 fl
MCH greater than 45 pg
MCHC greater than 45%
not related to MCV, MCH, MCHC
MCV less than 80 fl
112
Cells that respond to allergies and parasitic infections
basophils
lymphocytes
monocytes
eosinophils
eosinophils
113
A common method used for testing hemoglobin concentration is
none of these
Tallquists
Oxyhemoglobin
Drabkins
Sahli
Drabkins
114
The mature eosinophil
may be increased in allergic reaction
has no specific staining granules
has a five lobed nucleus
all of these
none of these
may be increased in allergic reaction
115
The cell that produce antibodies is called a/an
eosinophil
monocyte
basophil
lymphocyte
lymphocyte
116
Hemoglobin molecule that is fully saturated with oxygen is called
reduced hemoglobin
oxidized hemoglobin
oxyhemoglobin
all of these
none of these
oxyhemoglobin
117
The objective you used when you do a differential count is
low
high dry
none of these
oil immersion
oil immersion
118
The acid part of the Wright's stain will stain nuclei and some cytoplasmic structures
red
blue
a mixture of red and blue
none of these
red
119
The cell seen under the microscope that has a round to oval nucleus with 'robins egg blue ' cytoplasm is a/an
neutrophil
eosinophil
basophil
lymphocyte
none of these
lymphocyte
120
In the Wright's stain if the stain appears too red this may be an indication that the pH of the buffer is
too acid
too alkaline
neutral
none of these
too acid
121
Anemia is a result of
all of these
reduced hemoglobin concentration
decrease in the number of circulating RBC
ineffective erythropoiesis
none of these
all of these
122
The mature basophil has
pale red cytoplasm
moderate to heavy deep red cytoplasm
none of these
more that 3 lobe
all of these
none of these
123
The following cells are granulocytes
metamyelocytes, basophils, monocytes
lymphocytes, basophils, neutrophils
lymphocytes, monocytes, stabs
myelocytes, metamyelocytes, bands
none of these
myelocytes, metamyelocytes, bands
124
Water is the classic _____________ solution
hypotonic
hypertonic
isotonic
hypotonic
125
Which of the following solutions is used to dilute WBC counts
acetic acid
Hayem's
Drabkin's
Turk's
sodium hydroxide
acetic acid
126
An effective diluent for WBC counts allows
only red blood cells to be counted
you to distinguish nucleated RBC from WBC
all cells to be counted at the same time
all nonnucleated RBC to be hemolyzed
all nonnucleated RBC to be hemolyzed
127
Hemoglobin contains
a heme portion and albumin
an iron containing portion called heme and a protein portion called globin
an iron containing portion called globin and a protein containing portion called heme
an iron containing portion called ferritin and a protein containing portion called albumin
none of these
an iron containing portion called heme and a protein portion called globin
128
RBC's that exhibit a variety of shapes are called
poikilocytes
anisocytes
macrocytes
microcytes
none of these
poikilocytes
129
The stained blood smear should be rinsed with
phosphate buffer
tap water
distilled water
methyl alcohol
none of these
distilled water
130
The mature neutrophil normally exhibits ______ lobe/s
3-5
none
1-2
5-7
3-5
131
The cell that stains uniformly pink with a pale central area is called a/an
neutrophil
erythrocyte
thrombocyte
eosinophil
erythrocyte
132
The most commonly seen WBC in a normal adult smear is
basophil
lymphocyte
neutrophil
erythrocyte
neutrophil
133
Abnormal hemoglobins may produce severe disease states
True
False
True
134
Cells that increase in bacterial infections are
lymphocytes
neutrophils
basophils
eosinophils
neutrophils
135
Bands
have a sausage shaped nucleus
have several nucleoli
have a kidney shaped nucleus
have a round nucleus
none of these
have a sausage shaped nucleus
136
Hemoglobin A1 consists of two types of globin chains
alpha and delta
alpha and epsilon
alpha and gamma
gamma and delta
none of these
none of these
137
The cyanmethemoglobin procedure requires a spectrophotometer setting of
540 nm
440 nm
590 nm
625 nm
540 nm
138
Leukopoiesis is the formation of
red blood cells
white blood cells
blood cellular elements
platelets
none of these
white blood cells
139
The CellDyn printout ( like the one you used when doing diffs) provides
an automated cell count
histogram analysis
3 part differential
none of these
more than one of these
more than one of these
140
Cells responsible for recognizing abnormal substances
B lymphocytes
monocytes
T lymphocytes
null cells
plasma cells
T lymphocytes
141
The yolk sac is the blood forming structure of the
infant
juvenile
fetus
adult
fetus
142
The most rare cell found in the normal peripheral smear is the
basophil
neutrophil
lymphocyte
monocyte
eosinophil
basophil
143
The buffer used with the Wright's stain procedure must be pH _____
4. 6
5. 7
6. 4
7. 6
6.4
144
The most common cell seen in a peripheral blood smear is a/an
neutrophil
basophil
eosinophil
lymphocyte
none of these
neutrophil
145
RBC's that are smaller than normal are called
macrocytes
polychromatic
hypochromic
microcytes
anisocytes
microcytes
146
Cells that arise in response to viral infections are
monocytes
lymphocytes
neutrophils
eosinophils
lymphocytes
147
In a normal differential you would expect to count ________% lymphocytes
2-10
60-75
25-35
0-1
25-35
148
The term that refers to the formation of platelets is
thrombopoiesis
leukopoiesis
erythropoiesis
cytology
thrombopoiesis
149
A diluent used to count WBC may be
normal saline
0.1N HCl
2% acetic acid
purified water
2% acetic acid
150
The concentration of normal saline is
0. 65%
0. 85%
0. 95%
0. 75%
none of these
0.85%
151
Neutrophils are associated with
bacterial infections
parasites
iron deficiency
bleeding
bacterial infections
152
Cells are identified according to
cell size, nuclear characteristics, and cytoplasmic characteristics
cell size, nuclear characteristics, and chemical constituents
age of the cell, chromatin quality, and the arrangement of lipid
chemical constituents
none of these
cell size, nuclear characteristics, and cytoplasmic characteristics
153
A hemoglobin reagent that contains cyanide and a buffer is called
Drabkin's
Dracula's
methemoglobin
all of these
none of these
Drabkin's
154
A cell line that will increase in response to viral infection is
monocyte
neutrophil
lymphocyte
eosinophil
lymphocyte
155
The granules in the eosinophil contain
histamine
antihistamine
lysozyme
all of these
antihistamine
156
A cell not normally found in the peripheral blood might be
band
metamyelocyte
monocyte
eosinophil
none of these
metamyelocyte
157
Pernicious anemia is characterized by cells that are
macrocytic
microcytic
hypochromic
none of these
macrocytic
158
Repeated phlebotomy in patients with Polycythemia may lead to the development of:
folic acid deficiency
sideroblastic anemia
iron deficiency anemia
hemolytic anemia
iron deficiency anemia
159
In essential thrombocythemia, the platelets are:
increased in number and functionally abnormal
normal in number and functionally abnormal
decreased in number and functional
decreased in number and functionally abnormal
increased in number and functionally abnormal
160
Features of secondary Polycythemia include all of the following except:
splenomegaly
decreased oxygen saturation
increased red cell mass
increased erythropoietin
splenomegaly
161
Reactive lymphocytes may best be distinguished from blasts by which of the following morphologic characteristics?
fine chromatin
high N:C ratio
prominent nucleoli
basophilic cytoplasm
fine chromatin
162
The cell which may be found in all types of Hodgkin's disease is:
Sezary cell
Flame cell
Niemann-Pick cell
Reed-Sternberg cell
Reed-Sternberg cell
163
The absence of the Philadelphia chromosome in granulocytic leukemia suggests:
rapid progression of the disease
a polyclonal origin to the disease
excellent response to therapy
nothing since the Philadelphia chromosome is not present in granulocytic leukemia
rapid progression of the disease
164
The characteristic morphologic feature in multiple myeloma is:
cytotoxic T cells
Rouleaux formation
Spherocytes
Macrocytosis
Rouleaux formation
165
In myeloid cells, the stain that selectively identifies phospholipids in the membranes of both primary and secondary granules is:
PAS
Myeloperoxidase
Sudan Black B
Tdt
Sudan Black B
166
Which type of anemia is most common in myelodysplastic syndromes?
microcytic, hypochromic
normocytic, hypochromic
macrocytic, normochromic
dimorphic
macrocytic, normochromic
167
Hairy cell leukemia is:
an acute myelocytic leukemia
a chronic leukemia of myelocytic origin
a chronic leukemia of lymphocytic origin
an acute myelocytic monocytic type leukemia
a chronic leukemia of lymphocytic origin
168
All of the following are contained in the primary granules of the neutrophil except:
lactoferrin
myeloperoxidase
histamine
alkaline phosphatase
histamine
169
The infectious agent most commonly associated with the pathogenesis of Hodgkin's disease is:
Echovirus
Herpes virus
Hepatitis virus
Epstein-Barr virus
Epstein-Barr virus
170
Increased levels of Tdt activity are indicative of:
Burkitt's lymphoma
Acute granulocytic leukemia
Acute lymphocytic leukemia
Eosinophilia
Acute lymphocytic leukemia
171
The morphologic characteristic(s) associated with the Chediak-Higashi syndrome is/are:
pale blue cytoplasmic inclusions
giant lysosomal granules
small, dark staining granules and condensed nuclei
nuclear Hyposegmentation
giant lysosomal granules
172
Which of the following is typical of Polycythemia vera?
increased serum iron concentration
decreased platelet count
increased erythropoietin
increased LAP
increased LAP
173
```
The following results were obtained on a 55 year old man complaining of headaches and blurred vision:
WBC 19.0 x 103/µL Differential
RBC 7.2 x 106/µL Segs 84%
Platelets 1056 x 103/µL Bands 10%
Uric acid 13.0 mg/dL Lymphs 3%
O2 saturation 93% Monos 2%
Eos 1%
Red cell volume 3911 (normal, 1600)
These results are consistent with:
```
neutrophilic leukemoid reaction
Polycythemia vera
Chronic granulocytic leukemia
Leukoerythroblastosis in myelofibrosis
Polycythemia vera
174
A patient has a tumor that concentrates erythropoietin. He is most likely to have which of the following types of Polycythemia?
Polycythemia vera
Polycythemia secondary to hypoxia
Benign familial Polycythemia
Polycythemia associated with renal disease
Polycythemia associated with renal disease
175
```
The following results were obtained on a 45 year old man complaining of chills and fever:
WBC 23.0 x 103/µL
Differential:
Segs 60%
Bands 21%
Lymphs 11%
Monos 3%
Metas 2%
Myelos 3%
Toxic granulation, Dohle bodies, and vacuoles
LAP 200 Philadelphia chromosome negative
These results are consistent with:
```
neutrophilic leukemoid reaction
polycythemia vera
chronic granulomatous disease
leukoerythroblastosis in myelofibrosis
neutrophilic leukemoid reaction
176
Increased numbers of basophils are often seen in:
acute infections
chronic granulocytic leukemia
chronic lymphocytic leukemia
erythroblastosis fetalis
chronic granulocytic leukemia
177
In infectious mononucleosis, lymphocytes tend to be:
small with little cytoplasm
normal
decreased in number
enlarged and indented by surrounding structures
enlarged and indented by surrounding structures
178
50-90% myeloblasts in a peripheral blood sample is typical of which of the following?
chronic granulocytic leukemia
myelofibrosis with myeloid metaplasia
erythroleukemia
acute granulocytic leukemia
acute granulocytic leukemia
179
Disseminated intravascular coagulation is most often associated with which of the following FAB designations of acute leukemia?
M1
M3
M4
M5
M3
180
Which FAB designation is called the true monocytic leukemia and follows an acute or subacute course characterized by monoblasts, promonocytes, and monocytes?
M1
M3
M4
M5
M5
181
Which of the following is most closely associated with chronic myelogenous leukemia?
ringed sideroblasts
disseminated intravascular coagulation
micromegakaryocytes
Philadelphia chromosome
Philadelphia chromosome
182
All of the following are myeloproliferative disorders Except:
granulocytic leukemia
lymphocytic leukemia
Polycythemia vera
Idiopathic thrombocythemia
lymphocytic leukemia
183
Auer rods are most likely present in which of the following?
chronic granulocytic leukemia
myelofibrosis with myeloid metaplasia
erythroleukemia
acute granulocytic leukemia
acute granulocytic leukemia
184
Qualitative and quantitative neutrophil changes noted in response to infection include all of the following EXCEPT:
neutrophilia
pelgeroid hyposegmentation
toxic granulation
vacuolization
pelgeroid hyposegmentation
185
In the FAB classification, myelomonocytic leukemia would be:
M1 and M2
M3
M4
M5
M4
186
In chronic myelocytic leukemia, blood histamine concentrations tend to reflect the:
number of platelets present
serum uric acid concentrations
number of basophils present
total number of granulocytes
number of basophils present
187
Non-Hodgkin's lymphomas may be caused by:
damaged DNA
mutagenic effects of radiation
mutagenic effects of chemicals
all of the above
all of the above
188
The erythrocytosis seen in relative Polycythemia occurs because of:
decreased arterial oxygen saturation
decreased plasma volume of circulating blood
increased erythropoietin levels
increased erythropoiesis in the bone marrow
decreased plasma volume of circulating blood
189
Which of the following types of Polycythemia is most often associated with emphysema?
Polycythemia vera
Polycythemia secondary to hypoxia
Relative Polycythemia associated with dehydration
Relative Polycythemia associated with renal disease
Polycythemia secondary to hypoxia
190
The familial condition of Pelger-Huet anomaly is important to recognize because this disorder must be differentiated from:
infectious mononucleosis
May-Hegglin anomaly
Shift to the left increase in immature granulocytes
G-6-PD deficiency
Shift to the left increase in immature granulocytes
191
All stages of neutrophils are most likely to be seen in the peripheral blood of a patient with:
chronic granulocytic leukemia
myelofibrosis with myeloid metaplasia
erythroleukemia
acute granulocytic leukemia
chronic granulocytic leukemia
192
In which age group does ALL occur with the highest frequency?
1-15 years
20-35 years
45-60 years
60-75 years
1-15 years
193
```
The following results were obtained on a 35 year old woman complaining of fatigue and weight loss:
WBC = 1.8 x 103/µL Differential
RBC = 4.6 x 106/µL Segs = 30%
Platelets = 903 x 103/µL Bands = 17%
Uric acid = 6.4 ng/dL Lymphs = 13%
LAP = 0 Monos = 3%
Philadelphia chromosome pos Eos = 4%
Baso = 6%
Metas = 3%
Myelos = 20%
Promyelo = 3%
Blasts = 1%
These results are consistent with:
```
neutrophilic leukemoid reaction
idiopathic thrombocythemia
chronic granulocytic leukemia
leukoerythroblastosis in myelofibrosis
chronic granulocytic leukemia
194
Which of the following is not a characteristic usually associated with hairy cell leukemia?
pancytopenia
mononuclear cells with ruffled edges
splenomegaly
increased resistance to infection
increased resistance to infection
195
In myelofibrosis, the characteristic abnormal red cell morphology is that of:
target cells
schistocytes
teardrop cells
ovalocytes
teardrop cells
196
Auer rods may be seen in all of the following EXCEPT:
acute myelomonocytic leukemia
acute lymphoblastic leukemia
acute myeloblastic leukemia
acute promyelocytic leukemia
acute lymphoblastic leukemia
197
Chronic lymphocytic leukemia is defined as:
a malignancy of the thymus
an accumulation of prolymphocytes
an accumulation of hairy cells in the spleen
an accumulation of monoclonal B cells with a block in cell maturation
an accumulation of monoclonal B cells with a block in cell maturation
198
Polycythemia vera is characterized by:
increased plasma volume
pancytopenia
decreased oxygen saturation
absolute increase in the total red cell mass
absolute increase in the total red cell mass
199
Which type of anemia is usually present in a patient with acute leukemia?
microcytic, hyperchromic
microcytic, hypochromic
normocytic, normochromic
macrocytic, normochromic
normocytic, normochromic
200
Heavy chain disease is:
overproduction of monoclonal IgM antibodies
is characterized by the inability of the plasma cells to produce light chains
overproduction of abnormal plasma cells
underproduction of the heavy chain portion of the antibody unit
is characterized by the inability of the plasma cells to produce light chains
201
In the FAB classification, acute lymphocytic leukemia is divided into groups according too:
prognosis
immunology
cytochemistry
morphology
morphology
202
The age group associated with Hodgkin's disease is:
15-35
40-50
over 50
a and c are correct
a and c are correct
203
A patient's peripheral blood smear and bone marrow both show 70% blasts. These cells are negative for Sudan Black B. Given these data, which of the following is the most likely diagnosis?
acute myelogenous leukemia
chronic lymphocytic leukemia
acute promyelocytic leukemia
acute lymphocytic leukemia
acute lymphocytic leukemia
204
Patients with chronic granulomatous disease suffer from frequent pyogenic infections owing to the inability of:
lymphocytes to produce bacterial antibodies
eosinophils to degranulate in the presence of bacteria
neutrophils to kill phagocytized bacteria
basophils to release histamine in the presence of bacteria
neutrophils to kill phagocytized bacteria
205
The most common form of childhood leukemia is:
acute lymphocytic
acute granulocytic
acute monocytic
chronic granulocytic
acute lymphocytic
