Hema Redemption Exam Flashcards by SHEEN CLARK S. CABA�EROS

An important marker associated with T-lymphocytes:

CD 2
CD 19
CD 56
CD 34

CD 2

How well did you know this?

Not at all

Perfectly

These are fused primary granules seen in myeloblasts:

ACP
Auer rods
Lysozymes
Barr bodies

Auer Rods

How well did you know this?

Not at all

Perfectly

Part of the platelet that maintains its shape:

Sol gel zone
Peripheral zone
Organelle zone
Membranous system

Sol gel zone

How well did you know this?

Not at all

Perfectly

Which of the following is not considered as a storage pool defect due to a deficiency of platelet granules?

Bernard-Soulier syndrome
Hermansky-Pudlak syndrome
Gray platelet syndrome
Wiskott-Aldrich syndrome
None of the above

Bernard-Soulier syndrome

How well did you know this?

Not at all

Perfectly

One of the following is not a qualitative platelet disorder:

Bernard-Soulier syndrome
Thrombotic thrombocytopenic purpura
Gray platelet syndrome
Wiskott-Aldrich syndrome
None of the above

Thrombotic thrombocytopenic purpura

How well did you know this?

Not at all

Perfectly

The most preferable site of puncture in the Duke’s method of bleeding time determination is the:

Ring finger
Toe
Thumb
Middle finger
Earlobe

Earlobe

How well did you know this?

Not at all

Perfectly

What combination of reagents is used to measure haemoglobin?

Hydrochloric acid and p-dimethyl aminobenzaldehyde
Sodium citrate and hydrogen peroxide
Sodium bisulfite and sodium metabisulfite
Potassium ferricyanide and potassium cyanide
NOTC

Potassium ferricyanide and potassium cyanide

How well did you know this?

Not at all

Perfectly

Which of the following is not associated with causing a falsely low ESR?

Column use is slanted
EDTA tube is clotted
EDTA tube is 1/3 full
EDTA specimen is 24 hours old
NOTC

Column use is slanted

How well did you know this?

Not at all

Perfectly

To best preserve cellular morphology, differential smears from an EDTA specimen should be made no more than how many hours after collection?

24
12
5
1

How well did you know this?

Not at all

Perfectly

The blood smear made on a patient with polycythemia vera is too short. What should be done to correct this problem?

Use a smaller drop of blood
Adjust the angle of the spreader slide to 45 degrees
Increase the angle of the spreader slide
Decrease the angle of the spreader slide
Do nothing

Decrease the angle of the spreader slide

How well did you know this?

Not at all

Perfectly

The components of Wright’s stain include:

Methylene blue and eosin
Crystal violet and safranin
New methylene blue and carbolfuchsin
Hematoxylin and eosin

Methylene blue and eosin

How well did you know this?

Not at all

Perfectly

What is the reason for red blood cells to be bright red and the WBC nuclei to be poorly stained when using Wright’s stain?

The staining time is too long
The stain or buffer is too acidic
The stain or buffer is too alkaline
The smear was not washed long enough

The stain or buffer is too acidic

How well did you know this?

Not at all

Perfectly

If 60 reticulocytes are counted in 1000 RBC, an RBC count of 3.00x10^12/L (3.0x10^6/µL). The calculated absolute reticulocyte count reported in SI units is:

1.8 x 10^9/L
18 x 10^9/L
180 x 10^9/L
180 x 10^3/µL

180 x 10^9/L

How well did you know this?

Not at all

Perfectly

Evaluate the LAP activity and which condition best fits the result?

PV
CML
Leukemoid Reaction
NOTC

How well did you know this?

Not at all

Perfectly

What is the principle of automated impedance cell counters?

Angle of laser beam scatter by cells
Amplification of an electrical current by cells
Change in optical density of the solution containing cells
Interruption of an electrical current by cells
NOTC

Amplification of an electrical current by cells

How well did you know this?

Not at all

Perfectly

Which of the following statement about microhematocrit is false?

Hemolysis causes falsely low results
Trapped plasma causes falsely high results
A tube less than half full causes falsely low results
Excessive centrifugation causes falsely low results

Excessive centrifugation causes falsely low results

How well did you know this?

Not at all

Perfectly

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

20 – 50
1 – 4
4 – 10
10 – 20
8 – 20

8-20

How well did you know this?

Not at all

Perfectly

A CSF has 285 red blood cells counted in the 5 red blood cell squares after being diluted in an Unopette (1:100). What is the calculated RBC count/µL?

142,500
2,850,000
285, 000
750,000
1, 425, 000

1,425,000

How well did you know this?

Not at all

Perfectly

The white blood cell count is 10.5. There are 5 nucleated red blood cells seen on the 100 cell differential. What is the corrected WBC count?

5.0
9.5
10
10.5
5.5

How well did you know this?

Not at all

Perfectly

All of the following may cause a falsely decreased platelet count except:

Schistocytes
Giant platelets
Platelet clumps
Platelet satellitosis
Clotted sample

Schistocytes

How well did you know this?

Not at all

Perfectly

A leukocyte count greater than the linearity of the automated analyser will falsely elevate which other CBC parameter?

WBC
Hgb
RDW
Hct
RBC

Hgb

How well did you know this?

Not at all

Perfectly

If a WBC count is performed on a 1:100 dilution and the number of cells counted in total of 8 squares is 50. Then what is the WBC count?

5,000
6,250
50,000
62,500
3,000

6,250

How well did you know this?

Not at all

Perfectly

How many WBCs should be counted when lymphocytes counted is greater than neutrophils?

50
100
200
400
500

200

How well did you know this?

Not at all

Perfectly

Platelet estimate of 150,000/ µL

Low normal
Slightly increased
Normal
Moderately increased
Markedly increased

Low Normal

How well did you know this?

Not at all

Perfectly

1% ammonium oxalate in distilled water is a type of diluent for what type of cell count? Eosinophil Reticulocyte Platelet WBC RBC

Platelet

Effect of grounded electricity in CBC count: falsely high falsely low no effect

Falsely high

Detergent in automated systems are used for: Cleaning agent in probes Lysing agent Reduce reaction times Clearing agent in cuvettes None of the above

Lysing Agent

This coagulation factor is called Christmas factor Factor IX Factor XI Factor XII Factor XIII

Factor IX

Calcium, a phospholipid substitute for platelet and an activator are added to the patient’s fresh plasma. The generation of fibrin is the endpoint: Bleeding time Protime APTT Thrombin time Reptilase time

APTT

A modification of which procedure can be used to measure fibrinogen? PT APTT Thrombin time Fibrin degradation products All of the above

Thrombin Time

Which of the following clotting factors are measured by the APTT test? II, VII, IX, X VII, X, V, II, I XII, XI, IX, VIII, X, V, II, I XII, VII, X, V, II, I XIII

XII, XI, IX, VIII, X, V, II, I

Which coagulation tests would be abnormal in a vitamin K deficient patient? Fibrinogen level PT only PT and APTT Thrombin time Reptilase time

PT & APTT

Which of the following is the most likely coagulation disorder? Platelet count – decreased bleeding time – prolonged clotting time – normal APTT – normal PT – normal Thrombocytopenia Factor VIII deficiency Glanzmann’s thrombasthenia Liver disease

Thrombocytopenia

A patient with a severe decrease in Factor X activity would demonstrate normal: aPTT PT Thrombin time Bleeding time

Bleeding Time

Patient profile: PT – normal APTT – prolonged Mixing studies : APTT + fresh plasma –CORRECTED APTT + aged serum – NOT CORRECTED APTT + adsorbed plasma –CORRECTED Factor VIII Factor VIII Factor IX Factor VII Factor X Factor XIII

Factor VIII

When performing a microhematocrit, where should one read the percentage of packed red blood cell column from a microhematocrit reading device? Below the buffy coat Above the buffy coat Below the plasma Above the clay

Below the buffy coat

Fragile white blood cells seen in leukemia patients may cause pseudoleukopenia which in turn may cause automated WBC and WBC estimate not to match. What action should be taken if this occurs? Incubate the specimen at 37°C for 15 minutes Perform a plasma replacement procedure Perform a manual WBC hemacytometer count Prepare a buffy coat for the WBC estimate Add 22% bovine albumin to stabilize the WBC

Perform a manual WBC hemacytometer count

Smudge cells can cause the automated WBC and the WBC estimate not to match. What action can be taken to prevent this occurrence? Incubate the specimen at 37°C for 15 minutes Perform a plasma replacement procedure Perform a manual WBC hemacytometer count Prepare a buffy coat for the WBC estimate Add 22% bovine albumin to stabilize the WBC

Add 22% bovine albumin to stabilize the WBC

Which one of the following can produce a normal MCV but hypochromic red blood cells to appear on the peripheral blood smear? Platelet satellitism Cold agglutinin Hyperglycemia Cryoglobulin

Hyperglycemia

Alpha-naphtol-AS-D-acetate esterase (NASDA): 3+ NASDA with sodium fluoride: 1+ ALL AML AMoL AMML AEL

AMoL

What is the most frequently acquired inhibitor in hereditary deficiencies? Anti-von Willebrand factor Lupus like anticoagulant Anti-VIII Anti – I Anti-plasmin

Anti-VIII

The following results are available on a 25-year old male patient: PT: 13.4 second INR: 1.2 PTT: 56.8 seconds A mixing study was performed and the corrected results are as follows: PTT (unincubated): 55.8 seconds PTT (incubated): 57.0 seconds The results indicate the presence of a(n): Circulating anticoagulant Vitamin K deficiency Factor deficiency Liver disease DIC

Circulating anticoagulant

If a coagulation test is prolonged due to a deficiency of a plasma coagulation factor, then the test should be corrected by the addition of which of the following? Protamine sulfate Normal plasma Vitamin Heparin Barium sulfate

Normal plasma

A 27 year old female complains of mucous membrane bleeding: PT: 40.2 seconds INR: 4.0 PTT: 158.5 seconds Fibrinogen: 73 mg/dL D-dimer: 5.46 These lab results are consistent with which diagnosis: Disseminated intravascular coagulopathy Von Willebrand’s disease Vitamin K deficiency Classic Hemophilia Factor Deficiency

Disseminated intravascular coagulopathy

Which of the following is a hereditary platelet disorder characterized by decreased platelet production accompanied by the presence of Döhle bodies in polymorphonuclear cells? Bernard – Soulier syndrome Wiskott-Aldrich anomaly Ehlers-Danlos syndrome May-Hegglin anomaly Chediak-Higashi anomaly

May-Hegglin anomaly

A falsely decrease ESR may be caused by: Vibrations from opening and closing the refrigerator and freezer doors Heat released from the refrigerator Lower temperatures from air rushing out on opening the freezer AOTC NOTC

Lower temperatures from air rushing out on opening the freezer

Which of the following blood film findings indicate EDTA induced pseudothrombocytopenia? The platelets are pushed to the feathered end The platelets are adhering to WBCs No platelets at all are seen on the film The slide has a bluish discoloration when examined macroscopically The platelet aggregate with each other

The platelets are adhering to WBCs

Which of the following inherited leukocyte disorders might be seen in Hurler syndrome? Pelger-Huet anomaly Chediak-Higashi syndrome Alder-Reilly anomaly May-Hegglin anomaly

Alder-Reilly anomaly

Modified True or False A. May-Hegglin inclusions and Dohle-Amato bodies are both composed of RNA B. May-Hegglin inclusions and Dohle-Amato bodies may be both observed in neutrophils. A is true, B is false B is true, A is false both are true neither are true

both are true

A. Pernicious anemia and PelgerHuet anomaly are disorders that affect neutrophil nucleus. B. The nuclei in both disorders have a characteristic “pince-nez” appearance. A is true, B is false B is true, A is false both are true neither are true

A is true, B is false

All of the following may produce neutrophilia except: Nutritional deficiency Appendicitis Rheumatoid arthritis Corticosteroids RBC hemolysis

Nutritional deficiency

Which of the following would be least helpful in distinguishing CML from neutrophilic leukemoid reaction? An extreme leukocytosis with increased neutrophilic bands, metamyelocytes, and myelocytes Leukocyte alkaline phosphatase score Presence of marked splenomegaly Neutrophils with Dohle bodies and toxic granulation

An extreme leukocytosis with increased neutrophilic bands, metamyelocytes, and myelocytes

A monocyte that has phagocytized a nucleus is called: LE cell Flame cell Tart cells Smudge cells Faggot cells

Tart cells

After use what should be done to the hemacytometer and the cover glass? Wiped with gauze moistened with alcohol Washed with distilled water and detergent, after which they are dried with cloth and placed in absolute alcohol Wiped with a piece of cloth, soaked in Normal Saline solution and dried All of the above can be done

Washed with distilled water and detergent, after which they are dried with cloth and placed in absolute alcohol

What is the large cell with characteristics mirror – image nuclei and prominent nucleoli, likened to an owl‘s eyes? Reed – Sternberg cell Osteroclast Ferrata cell Gaucher‘s cell Pelger-Huet cell

Reed – Sternberg cell

In multichannel counter employing the electrical impedance method, particles larger than 35 fl are considered Platelets Leukocytes Lymphocytes RBCs Monocytes

Lymphocytes

The cells are counted in consecutive fields as the blood film is moved from side to side. Crenellation Technique Longitudinal method Battlement method None of the above

Crenellation Technique

Which of the following diseases is associated with a positive Tdt and PAS stain? ALL AML CML CGD

ALL

Insufficient centrifugation will result in: A false increase in hematocrit (Hct) value A false decrease in Hct value No effect on Hct value All of these options, depending on the patient

A false increase in hematocrit (Hct) value

Mean cell volume (MCV) is calculated using the following formula: (Hgb ÷ RBC) × 10 (Hct ÷ RBC) × 10 (Hct ÷ Hgb) × 100 (Hgb ÷ RBC) × 100

(Hct ÷ RBC) × 10

A Miller disk is an ocular device used to facilitate counting of: Platelets Reticulocytes Sickle cells Nucleated red blood cells (NRBCs)

Reticulocytes

All of the following factors may influence the erythrocyte sedimentation rate (ESR) except: Anisocytosis, poikilocytosis Plasma proteins Blood drawn into a sodium citrate tube Caliber of the tube

Blood drawn into a sodium citrate tube

What is the major type of leukocyte seen in the peripheral smear of a patient with aplastic anemia? Segmented neutrophil Lymphocyte Monocyte Eosinophil

Lymphocyte

In which age group would 60% lymphocytes be a normal finding? 6 months–2 years 4–6 years 11–15 years 40–60 years

6 months–2 years

Which of the following results on an automated differential suggests that a peripheral smear should be reviewed manually? Segs = 70% Band = 6% Mono = 15% Eos = 2%

Mono = 15%

Auer rods may be seen in all of the following except: L1 M4 M1 M3 M6

Which type of anemia is usually present in a patient with acute leukemia? Microcytic, hyperchromic Microcytic, hypochromic Normocytic, normochromic Macrocytic, normochromic

Normocytic, normochromic

In leukemia, which term describes a peripheral blood finding of leukocytosis with a shift to the left, accompanied by nucleated red cells? Leukoerythroblastosis Myelophthisis Dysplasia Megaloblastosis

Leukoerythroblastosis

Which of the following is a characteristic of Auer rods? They are composed of azurophilic granules They stain periodic acid–Schiff (PAS) positive They are predominantly seen in chronic myelogenous leukemia (CML) They are nonspecific esterase positive

They are composed of azurophilic granules

A peripheral smear shows 75% blasts. These stain positive for both Sudan Black B (SBB) and peroxidase. Given these values, which of the following disorders is most likely? Acute myelocytic leukemia (AML) CML Acute undifferentiated leukemia (AUL) Acute lymphocytic leukemia (ALL)

Acute myelocytic leukemia (AML)

In myeloid cells, the stain that selectively identifies phospholipid in the membranes of both primary and secondary granules is: PAS Myeloperoxidase Sudan Black B stain Terminal deoxynucleotidyl transferase

Sudan Black B stain

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

Features of secondary polycythemia include all of the following except: Splenomegaly Decreased oxygen saturation Increased red cell mass Increased erythropoietin

Splenomegaly

What influence does the Philadelphia (Ph1) chromosome have on the prognosis of patients with chronic myelocytic leukemia? It is not predictive The prognosis is better if Ph1 is present The prognosis is worse if Ph1 is present The disease usually transforms into AML when Ph1 is present

The prognosis is better if Ph1 is present

The basic pathophysiological mechanisms responsible for producing signs and symptoms in leukemia include all of the following except: Replacement of normal marrow precursors by leukemic cells causing anemia Decrease in functional leukocytes causing infection Hemorrhage secondary to thrombocytopenia Decreased erythropoietin production

Decreased erythropoietin production

What is the characteristic finding seen in the peripheral smear of a patient with multiple myeloma? Microcytic hypochromic cells Intracellular inclusion bodies Rouleaux Hypersegmented neutrophils

Rouleaux

The pathology of multiple myeloma includes which of the following? Expanding plasma cell mass Overproduction of monoclonal immunoglobulins Production of osteoclast activating factor (OAF) and other cytokines All of these options

All of these options

Waldenström’s macroglobulinemia is a malignancy of the: Lymphoplasmacytoid cells Adrenal cortex Myeloblastic cell lines Erythroid cell precursors

Lymphoplasmacytoid cells

Cells that exhibit a positive stain with acid phosphatase and are not inhibited with tartaric acid are characteristically seen in: Infectious mononucleosis Infectious lymphocytosis Hairy cell leukemia T-cell acute lymphoblastic leukemia

Hairy cell leukemia

In certain instances, platelet counts done in a peripheral blood smear are low although the patient is healthy. This is probably because: Platelets tend to clump on one area of the smear Platelets tend to enlarge so they are mistaken for red cells Platelets tend to enlarge so they are mistaken for white cells Platelets dissolved easily when exposed to atmospheric oxygen

Platelets tend to clump on one area of the smear

Measurement of the bleeding time is principally a test of The interaction between platelets and blood vessels The interaction between platelets only The integrity of the blood vessels alone None of these

The interaction between platelets and blood vessels

Blood specimen collected using EDTA is unacceptable in Kaplow'sMethod of LAP because EDTA is inhibitory against the activity of neutrophil alkaline phosphatase Acidic pH prematurely activates the alkaline phosphatase enzyme EDTA destroys neutrophilic granules EDTA dilutes blood specimen

EDTA is inhibitory against the activity of neutrophil alkaline phosphatase

Excessive lysing of RBC's because of delay either in making the larger dilution after addition of the lysing agent will cause: Negative error Positive error Either Both at the same time

Negative error

Factors that affect the rate of sedimentation of erythrocytes include: Tilting the tubeUsing refrigerated blood Use of specimen collected 24 hours previously Using heparin as anticoagulant AOTC

AOTC

In an electronic particle counter, the height of the peak on the oscilloscope screen is proportional to the: Weight of the particle Size of the particle Density of the particle Speed of passage Dilution of the sample

Size of the particle

The laboratory test that is essential in the diagnosis of autoimmune hemolytic anemia? Total RBC count Reticulocyte count Platelet count Direct Antiglobulin test Acidified serum test

Direct Antiglobulin test

Reticulocyte count is increased in all of the following except: Hemolytic anemia Sickle cell anemia Beta thalassemia Untreated aplastic anemia Erythroblastosis fetalis

Untreated aplastic anemia

The erythrocytes on a smear stain blue-green and the nuclear chromatin of leukocytes stains blue purple when There is prolonged buffering of the smear There is insufficient staining time The Wright's staining reaction is too acidic The Wright's staining reaction is too alkaline The methyl alcohol has oxidized to formic acid

The Wright's staining reaction is too alkaline

Optimum pH of the buffer during staining of blood film is between: 6.2 - 6.8 6.2 - 7.0 6.4 - 6.8 7.0 - 8.0

6.4 - 6.8

Westergren tube: Approximately 300 cm in length Approximately 2.55 mm internal bore Approximately 5.5 mm external bore Has graduation of up to 100 mm

Approximately 2.55 mm internal bore

Kaolin, celite, glass, ellagic acid and micronized silica is used in the aPTT to: activate FXI activate FXII provide calcium ions stimulate platelet factor 3 release stimulate factor IX - VIII - X combination

activate FXII

Fuchs Rosenthal hemocytometer is ___ deep 0.1 mm 0.2 mm 0.3 mm 0.5 mm NOTC

0.2 mm

A patient with a hematocrit of 35% has a corrected reticulocyte count of 5%. Give the RPI 4.6% 3.3% 0.3% None of the above

3.3%

4 - 6 WBCs / hpf is approximate equivalent to a WBC count of 13,000 - 18,000 cu mm 10,000 - 13,000 cu mm 7,000 - 10,000 cu mm 4,000 - 7,000 cu mm

7,000 - 10,000 cu mm

After centrifugation of a blood specimen contained in a capillary tube, the platelets amd the leukocytes may be found in the: Top layer Second layer Third layer Fourth layer

Third layer

If the anticipated WBC count of the patient is around 110 x 109/L, then the recommended dilution and the type of Thoma pipet to use is 1:20, WBC Thoma pipet 1:10, WBC Thoma pipet 1:200, RBC Thoma pipet 1:100, RBC Thoma pipet

1:200, RBC Thoma pipet

When the absolute numbers of each of the individual leukocyte types are totaled, the sum should be equal to: WBC count 100 The WBC count minus the absolute neutrophil count 50% of the WBC count

WBC count

What is the critical value for the hemoglobin level? <50 g/L and 100 g/L 50 g/L and 110 g/L 70 g/L and 300 g/L 70 g/L and 200 g/L

70 g/L and 200 g/L

If the medtech multiplies the RBC count of a normal individual by three, the resulting value will most probably reflect the: Hgb of the patient Hct of the patient MCV of the patient Weight of the patient

Hgb of the patient

The morphological characteristic(s) associated with the Chédiak–Higashi syndrome is (are): Pale blue cytoplasmic inclusions Giant lysosomal granules Small, dark-staining granules and condensed nuclei Nuclear hyposegmentation

Giant lysosomal granules

Hema Redemption Exam Flashcards

(100 cards)