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Hematology 2 Flashcards

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1
Q

How can the correct platelet count on a patient be determined when his or her platelets repeatedly clump in an EDTA specimen?

A

Re-collect in sodium citrate tube (blue top) and multiply by 1.1.

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2
Q

What is the last granulocyte in the maturation sequence able to undergo mitosis?

A

myelocyte

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3
Q

What directs the mitosis and maturation action of progenitor neutrophil cells in the bone marrow?

A

colony-stimulating factor cytokines.

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4
Q

Which of the following neutrophils is capable of chemotaxis?

A

segmented neutrophil

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5
Q

Response to parasitic infections is associated with an increase of which type of granulocyte?

A

eosinophils

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6
Q

Clumped platelets will cause which of the following spurious results when cell counts are performed on an automated hematology analyzer?

A

platelets low and white count high

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7
Q

Methods, such as using a fan to dry blood films faster, are especially important when

A

the patient is very anemic or high humidity exists

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8
Q

Which of the following has the most controversial morphologic identification system?

A

bands

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9
Q

What is the earliest stage of maturation where a neutrophil can be distinguished from an eosinophil?

A

myelocyte

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10
Q

A patient’s blood film had marked echinocytes and many broken and vacuolated neutrophils. The same patient’s blood film the day before did not show these features. Select the best course of action.

A

Collect a new sample and make the film within 5 hours.

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11
Q

Which accurately describes reticulated (stress) platelets?

A

Both a and c are true.

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12
Q

Which substance is stored in dense granules?

A

Serotonin

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13
Q

How are platelets released into peripheral circulation from the bone marrow?

A

Megakaryocytes exit the marrow with white cells, and then platelets fragment off once they reach the blood.

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14
Q

From where are additional platelets first derived when the circulating count decreases?

A

Spleen

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15
Q

Phospholipids in the platelet membrane are important for all of the following functions except:

A

receptor for plasma fibrinogen.

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16
Q

Which is the liver-secreted plasma enzyme that digests “unused VWF”?

A

ADAMTS-13

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17
Q

How many circulating platelets are produced from a single megakaryocyte?

A

2000 to 4000

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18
Q

Identify the platelet receptor and plasma protein required for normal platelet aggregation.

 Platelet receptor Plasma protein

A

GP IIb/IIIa fibrinogen

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19
Q

Which glycoprotein platelet membrane receptor increases the avidity of integrins α2β1and αIIbβ3?

A

GP VI

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20
Q

Identify the platelet receptor and plasma protein required for normal platelet adhesion.
Platelet receptor Plasma protein

A

Gp Ib/IX/V von Willebrand factor (VWF)

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21
Q

An automated hematology analyzer is used to evaluate a blood specimen. Which of the following, coming off the instrument, would require performance of a manual white cell differential as opposed to blood film review?

A

suppression of automated differential data

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22
Q

Select the most appropriate action for the results in Question 18.

A

Warm sample to 37° C and rerun.

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23
Q

Which of the following occurs if testing is not performed within 24 hours of specimen collection?

A

WBCs deteriorate and RBCs swell.

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24
Q

A patient’s white blood count comes off an automated cell counter as 380 ´ 109/L. Which of the following could be reported without any additional testing?

A

platelet count

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25
What principle does the Sysmex SE-9000/9500 use to analyze and separate white cell populations?
low-frequency direct current and high-frequency current
26
Which of the following is always calculated on cell counters?
mean cell hemoglobin concentration (MCHC)
27
A patient sample comes off an automated cell counter with a failure of the red cell “rule of three.” The red count is lower than expected given the hemoglobin. The MCV, MCH, and MCHC are elevated. Which of the following is the most likely reason for this failure?
cold agglutinin
28
When the electronic impedance principle is used to count blood cells, what is done to increase platelet-counting sensitivity?
Decrease the size of the RBC/platelet aperture.
29
What technology minimizes the problems of a rigid aperture, including protein buildup, coincidence, and a single cell being counted twice?
hydrodynamic focusing
30
Platelet clumps would most likely interfere with which other automated parameter?
WBC count
31
Which is true of megakaryocytes as they mature?
Nucleus becomes polyploid.
32
Which is not a function of the platelet surface-connected canalicular system (SCCS)?
Produces energy for the cell.
33
Which megakaryocyte membrane marker disappears as differentiation proceeds?
CD34
34
What system is the “control center” for platelet activation?
Dense tubular system
35
Platelet agonists are substances that:
activate platelets.
36
All of the following can be determined from a blood film except
red cell estimate.
37
What is the most common reason for blood films having red cells that are gray and white cells that are too dark?
stain or buffer that is too alkaline
38
Why is the bone marrow (storage) pool of granulocytes so large compared with the total number found in peripheral blood?
They can be quickly released when needed to fight bacterial infection.
39
Which cells are normally produced in multiple sites including the bone marrow, thymus, and spleen?
lymphocytes
40
Macroscopic holes in a blood film most likely mean the patient has
increased lipids.
41
B cells and T cells are subgroups of what cell type?
lymphocytes
42
Mature mast cells are
tissue effector cells.
43
Which of the following is a feature of a normal segmented neutrophil?
small pink-lilac granules
44
What is the primary function of the neutrophils?
phagocytosis
45
What pools of neutrophils are included in the marginal neutrophil pool (MNP)?
only cells loosely localized to the vessel walls
46
Select the best course of action to remedy blood films that typically are too thick from newborns.
Decrease the spreader slide angle.
47
Which of the following cells is described as a large cell with abundant blue-grey cytoplasm containing minute granules, lacy or stringy chromatin, and an indented or folded nucleus? monocyte
monocyte
48
A segmented neutrophil performs all of the following except mitosis
49
Which cells are responsible for antibody production? plasma cells
50
A cell having a round nucleus with delicate chromatin, two to four prominent nucleoli, and a high N:C ratio of 8:1 with scant basophilic cytoplasm is an accurate description of a myeloblast
51
A MLT consistently makes wedge blood films that are too long and thin. What change in technique would improve the films? Increasing the acute angle of the pusher slide
52
What is the earliest morphologically identifiable cell in the granulocyte maturation sequence? myeloblast
53
Select the correct maturation sequence for granulocytes starting with youngest. myeloblast, promyelocyte, myelocyte, metamyelocyte, band, segmented
54
What is the absolute neutrophil count (ANC) (X 109/L) for the neutrophils if the total WBC count is 9.5 and there are 37% neutrophils see on the manual differential? 3.5
55
Coverslip smears are used primarily for bone marrow aspirates.
56
When monocytes reside in the tissues they are referred to as macrophages
57
Platelet volume normally increases as the sample sits in ethylenediaminetetraacetic acid (EDTA).
58
All of the following will be invalid when lipemia is present in a blood sample except MCV
59
What is the greatest limitation of automated cell counters? inherent specimen problems leading to occasional spurious results
60
Compared with manual methods, automated reticulocyte counting improved which of the following? all of the above
61
What is the mechanism for the three-part differential found in older Coulter machines or those designed for smaller laboratories? impedance after cytoplasm shrinkage
62
An elevated immature reticulocyte fraction is associated with bone marrow response to anemia.
63
What does the pneumatic system of cell counters do? operates the valves and moves the sample
64
How do Beckman Coulter and Abbott instruments count red cells and platelets? electrical impedance
65
Counting the number and size of electrical interferences created by blood cells as they pass through a small aperture is a description of which of the following principles? electronic impedance
66
Forward light scatter, when used in an instrument using the optical scatter principle, correlates with cell volume
67
Which of the following uses a peroxidase stain channel? Siemens Healthcare Diagnostics ADVIA 2120
68
What is the recommended method for establishing accuracy of automated hematology analyzers? Use commercially prepared whole blood calibrators
69
How do CELL-DYN instruments differentiate red cells and platelets from one another? differences in volume (fL) using electrical impedance principle
70
Which of the following is true regarding automated reticulocyte counts? Ribonucleic acid (RNA) is stained with various dyes that allow for detection of reticulocytes by optical scatter or fluorescence.
71
Which of the following is determined by light transmission between 525 and 555 nm on automated counting instrumentation? hemoglobin

Hematology 3.1 (5 decks)

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