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heme II final Flashcards

1
Q

A red cell which is narrow and elongated, resembling a cigar shape is called:

an ovalocyte
an elliptocyte
a sickle cell  		
a burr cell
A

elliptocyte

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2
Q

Which of the following parameters are derived ( tested directly) by the Coulter instrument?

MCV

MCH

RDW

MCV and RDW
A

MCV and RDW

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3
Q

Most/all granulocytes:

have phagocytic potential

persist less than 1 day in the peripheral circulation

precursors begin development in the bone marrow before birth

all of the above
A

all of the above

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4
Q

The most buffering capacity is normally offered by the:

hemoglobin system

bicarbonate system

plasma protein system

phosphate system
A

hemoglobin system

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5
Q

Specific (secondary) granules of the neutrophilic granulocyte:

appear first at the myelocyte stage

contain alkaline phosphatase

are formed on the mitochondria

are derived from azurophilic (primary) granules
A

appear first at the myelocyte stage

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6
Q

The normal RDW is:

9. 5-11.5%
10. 5-13.5%
11. 5-14.5%
12. 5-15.5%
A

11.5-14.5%

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7
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 neutrophil
a lymphocyte
a monocyte
a basophil
A

a monocyte

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8
Q 
The correct sequence for peripheral WBC percentages going from highest to lowest is/are:
lymphocytes?granulocytes>eosinophils
eosinophils>basophils>lymphocytes
neutrophils>bands>basophils
granulocytes>eosinophils>lymphocytes
A

neutrophils>bands>basophils

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9
Q

If a number of nucleated RBCs are seen in the peripheral circulation, it is possible that:
the patient is a newborn
some type of physiological change has occurred
Stress on the red cell-producing apparatus
all are correct

A

all are correct

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10
Q 
Neutrophils normally account for what percentage of the total white cell population in peripheral blood
0-4%
2-9%
20-40%
50-70%
A

50-70%

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11
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 band neutrophil
a monocyte
a lymphocyte
a basophil
A

a lymphocyte

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12
Q 
those parameters measured directly by the Coulter counter include:
RBC, WBC, and hematocrit
RBC and WBC
Hemoglobin
b and c are true
A

b and c are true

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13
Q 
a MCH of 30pg suggests
hypochromia
poikilocytosis
microcytosis
normochromia
A

normochromia

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14
Q 
The last cell in the RBC series which normally has a nucleus is the:
progenitor cell
metarubricyte
reticulocyte
answers b and c are true
A

metarubicyte

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15
Q 
An R3 flag on the Coulter instrument may mean:
a shift to the left
eosinophilia
neutrophilia
all of the above
A

all of the above

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16
Q

The white cell which typically responds to parasitic infections is the:

neutrophil

lymphocyte

monocyte

eosinophil
A

eosinophil

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17
Q

Electronic Impedance-

Relates the charge of the particle to the size of the signal

Relates the amplitude of the signal to the size of the particle

Is based on the fact that cells conduct electricity poorly

Only b and c are true

A

b and c are true

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18
Q 
The normal adult hemoglobin value in a male is:  
    10-14 g/dL    		
    12-16 g/dL    		
    14-18 g/dl   		
    14-22 g/dL
A

14-18 g/dL

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19
Q 
The normal MCH value is:    		
    23 - 25 pg    		
    25 - 27 pg    		
    27 - 31 pg    		
    31 - 35 pg
A

27-31 pg

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20
Q 
Calculated parameters include: 
    RBC    		
    MCV    		
    MPV    		
    Hematocrit
A

hematocrit

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21
Q

Sources of error in the RBC count include:
high readings with RBC agglutination
microcytic specimens
macrocytic specimens
b and c are true

A

b and c are true

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22
Q

On an electronic cell counter, hemoglobin determination may be falsely elevated owing to the presence of:
lipemia or elevated bilirubin concentration
a decreased WBC or lipemia
an elevated bilirubin concentration or rouleaux
rouleaux or lipemia

A

lipemia or elevated bilirubin concentration

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23
Q 
Another cell observed on a blood smear has a nucleus with 2 distinct lobes. The cytoplasm is a pink color. There are also large dark orangish-pink uniform granules in the cytoplasm. This cell is probably:		
    a segmented neutrophil    		
    a band neutrophil    		
    a basophil    		
    an eosinophil
A

an eosinophil

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24
Q 
The last cell of the granulocyte series capable of dividing is the:    		
    Myeloblast    		
    Promyelocyte    		
    Myelocyte    		
   Metamyelocyte
A

myelocyte

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25
Q

The normal value for a red cell count in an adult female is approximately:

3. 0-4.0 x 106/L    		
3. 5-4.5 x 106/L    		
4. 0 - 5.0 x 106/L    		
5. 0-6.0 x 106/L
A

4.0-5.0 X 10(6)/L

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26
Q 
Cells involved in hemostasis are:    		
    erythrocytes    		
    granulocytes    		
    lymphocytes    		
    thrombocytes
A

thrombocytes

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27
Q 
A red cell which with a central bull's eye surrounded by a clear ring and then an outer red ring is called:    		
    a spherocyte    		
    an ovalocyte    		
    a stomatocyte    		
    a target cell
A

a target cell

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28
Q 
The normal value for a platelet count in an adult is approximately:    		
    100,000-150,000/L    		
    150,000-350,000/L    		
    150,000-350,000/L    		
    350,000-500,000/L
A

150,000-350,000/L

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29
Q

Regarding B cells:
produce antibodies G, A, M, D, and E
are often stimulated by T cells
become Plasma cells when stimulated
all are correct

A

all are correct

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30
Q 
Unusual red cell size may include the term(s):    		
    anisocytosis    		
    poikilocytosis    		
    hemochromotosis    		
    none of the above
A

anisocytosis

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31
Q

When using an electronic cell counter, which of the following results can occur in the presence of a cold agglutinin?
increased MCV and decreased RBC
increased MCV and normal RBC
decreased MCV and increased RBC
decreased MCV and RBC

A

increased MCV and decreased RBC

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32
Q 
A cell observed on a blood smear has a nucleus with 2 distinct lobes which stains a dark blue. However, the nucleus is somewhat obscured by the large, coarse violet-blue granules in the cell. This cell is probably:    		
    a eosinophil 
    a lymphocyte    		
    a basophil    		
    a monocyte
A

a basophil

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33
Q 
The normal MCHC value is:    		
    25-29%    		
    29-32%    		
    32-36%    		
    36-40%
A

32-36%

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34
Q 
A red cell which looks as if a bite has been taken out of it is often called:    		
    a sickle cell    		
    a schistocyte    		
    a helmet cell    		
    a burr cell
A

a helmet cell

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35
Q

The correct erythroid developmental sequence is the following:
rubriblast, rubricyte, polychromatophilic erythrocyte
prorubricyte, rubriblast, erythrocyte
rubricyte, metarubricyte, prorubricyte
rubriblast, metarubricyte, rubricyte

A

rubiblast, rubicyte, polychromatophilic erythrocyte

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36
Q

The macrophage is most notable for:
antigen processing and presentation to the B cell
antigen processing and presentation to the T cell
phagocytosis of foreign antigens
all are correct
only b and c are correct

A

only b and c are correct

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37
Q

The normal value for a white cell count in an adult is approximately:

2. 5-6.5 x 103/L    		
3. 0-7.3 x 103/L    		
4. 8-10.6 x 103/L    		
5. 2-12.7 x 103/L
A

4.8-10.6 X 10(3)/L

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38
Q 
Unusual red cell shape is referred to as:    		
    anisocytosis    		
    macrocytosis    		
    microcytosis    		
    poikilocytosis
A

poikilocytosis

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39
Q 
In an electronic or laser particle cell counter clumped platelets may interfere with which of the following parameters?    		
    white blood cell count    		
    red blood cell count    		
    hemoglobin    		
    hematocrit
A

white blood cell count

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40
Q 
A cell observed on a blood smear has pinkish cytoplasm containing light pink granules and the nucleus is reddish-purplish in the shape of a horseshoe. The cell is identified as:    		
    an eosinophil    		
    a band neutrophil    		
    a segmented neutrophil    		
    a basophil
A

a band neutrophil

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41
Q 
A red cell about 5m in diameter that stains bright red and shows no central pallor is a:    		
    spherocyte    		
    leptocyte    		
    microcyte    		
    macrocyte
A

spherocyte

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42
Q

Which of the following is the correct order of maturation of the granulocyte?
Myeloblast, Myelocyte, Promyelocyte, Band
Myelocyte, Band, Metamyelocyte
Myeloblast, Myelocyte, Band
Metamyelocyte, Promyelocyte, Myelocyte

A

myeloblast, myelocyte, band

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43
Q 
An MCV of 75 fL suggests:    		
    microcytosis    		
    macrocytosis    		
    poikilocytosis    		
    all of the above
A

microcytosis

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44
Q

The normal value for reticulocytes in the adult peripheral blood is:

0. 0-1.0%    		
0. 5-2.0%    		
1. 5-3.0%    		
2. 5-4.0%
A

0.5-2.0%

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45
Q

The basophil:
is the smallest of the granulocytes
is sometimes called a “mast” cell in tissues
releases histamine and other vasoactive substances causing anaphylaxis
all are correct

A

all are correct

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46
Q 
Lymphocytes account for what percentage of the total white cell population in peripheral blood?  		
    0-4%    		
    2-9%    		
    20-40%    		
    50-70%
A

20-40%

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47
Q 
A patient who has increased serum proteins such as globulins may have red cells that stick together. This is called:    		
    agglutination    		
    aggregation    		
    rouleaux    		
    precipitation
A

rouleaux

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48
Q

The normal M:E ratio in an adult is:

1: 1.5    		
3: 1    		
5: 1    		
9: 1
A

3:1

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49
Q 
Fragments of red cells are called:    		
    target cells    		
    sickle cells    		
    acanthocytes    		
    schistocytes
A

schistocytes

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50
Q 
The antihemophilic factor is    		
    III    		
    V    		
    VIII    		
    XIII    		
    none of these
A

VIII

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51
Q 
The "cascade" theories state that most of the activated coagulation factors function as    		
    enzymes    		
    proteins    		
    vitamins    		
    conglutinins
A

enzymes

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52
Q 
In the extrinsic pathway, which of the following is NOT a part of the activation of factor X    		
    tissue thromboplastin    		
    factor VII    		
    HMWK    		
    calcium
A

HMWK

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53
Q 
Approximately what portion of the platelets released into the circulating bloodstream are sequestered in the spleen    		
    1/10    		
    1/3    		
    1/2    		
    2/3
A

1/3

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54
Q 
As part of clot initiation, platelets release    		
    ADP    		
    serotonin    		
    PF3    		
    Thromboxane A2    		
    All of these
A

all of these

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55
Q

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

A

platelet count more than 500 X 10(3)/uL

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56
Q 
A patient is placed on heparin therapy. The dosage is monitored using the following test:    		
    platelet count    		
    bleeding time    		
    prothrombin time    		
    partial thromboplastin time
A

partial thromboplastin time

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57
Q 
Complete the equation: fibrinogen ---->\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_    		
    thrombin    		
    thromboplastin    		
    fibrin    		
    fibrinoplastin
A

fibrin

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58
Q

In the equation: prothrombin ——> thrombin ,which of the following is a part of the process
thrombcysthenin
profibrin
thromboplastin

A

thromboplastin

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59
Q 
I
    II  	
    IV 	
    VIII    	
    IX    	
    XII    	
    XIII
    Answer
    A.     fibrinogen
    B.     fibrin stabilizing factor
    C.     ionic calcium
    D.     antihemophilic factor
    E.     prothrombin
    F.     Hageman factor
    G.    Christmas factor
A 
I - fibrinogen
II- prothrombin
IV- ironic calcium
VIII- antihemophilic factor
IX- christmas factor
XII- Hageman factor
XIII- fibrin stabilizing factor
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60
Q

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

A

stabilize fibrin monomers

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61
Q 
Platelets begin to be separated by \_\_\_\_\_\_\_\_\_\_\_\_\_\_ within the platelet forming cell    		
    demarcation membrane system    		
    separating membrane system    		
    plateletizing system    		
    thrombocyting system    		
    none of these
A

demarcation membrane system

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62
Q 
A patient is placed on coumadin therapy. The dosage is monitored using the following test:    		
    platelet count    		
    bleeding time    		
    prothrombin time    		
    partial thromboplastin time
A

prothrombin time

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63
Q 
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
A

FDP

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64
Q

When plasmin attacks fibrinogen, it is called
secondary hemostasis
primary fibrinolysis
primary hemostasis

A

primary fibrinolysis

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65
Q 
The average life span of a platelet in the peripheral blood is \_\_\_\_\_\_\_\_ days.    		
    2    		
    5    		
    10    		
    14
A

10

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66
Q 
Platelet production is regulated by    		
    thrombopoietin    	
    leukopoietin    		
    erythropoietin    		
    platepoietin
A

thrombopoietin

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67
Q 
The proteolytic enzyme that is responsible for fibrinolysis    		
    plasminogen    		
    fibrinogen    		
    proteothrombin    		
    plasmin
A

plasmin

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68
Q 
What is needed to complete the equation: prothrombin ---------> thrombin    		
    iron    		
    fibrin    		
    calcium    		
    phosphorus
A

calcium

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69
Q

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

A

fibrinolysis

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70
Q 
Which of the following factors is NOT needed in the extrinsic pathway   		
    tissue factor    		
    VIII    		
    X    		
    V    		
    fibrinogen
A

VIII

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71
Q 
Which coagulation factor can activate plasminogen    		
    VIII    	
    X    		
    VII    		
    XII
A

XII

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72
Q 
The soluble pieces formed during fibrinolysis are called    		
    solufibrinogen    		
    plasminogen    		
    fibrin split products    		
    fibrin strands
A

fibrin split products

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73
Q 
Immediately following blood vessel injury, platelets adhere to which of the following    		
    collagen fibers    		
    endothelial cells    		
    fibroblasts    		
    smooth muscle fibers
A

collagen fibers

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74
Q 
Which of the following coagulation factors does NOT need vitamin K for it's synthesis    		
    11    		
    XIII    		
    VII    		
    IX
A

XIII

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75
Q 
The process of breaking down a clot is called    		
    hemostasis    		
    fibrinolysis    		
    thrombolysis    		
    plasmonolysis
A

fibrinolysis

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76
Q 
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
A

150 - 400 x 103/µl

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77
Q

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

A

carry nutrients

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78
Q 
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
A

Hemostasis

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79
Q

Abnormal hemoglobins may produce severe disease states

True

False
A

true

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80
Q 
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
A

red

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81
Q

Anemia is a result of
all of these
reduced hemoglobin concentration
decrease in the number of circulating RBC
ineffective erythropoiesis
none of these

A

all of these

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82
Q 
An increase in the production of cells is called    		
    polycythemia    		
    porphobilinogen    		
    polychromasia    		
    poikilocytosis
A

polycythemia

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83
Q 
A cell line that will increase in response to viral infection is    		
    monocyte    		
    neutrophil    		
    lymphocyte    		
    eosinophil
A

lymphocyte

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84
Q 
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
A

lymphocyte

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85
Q

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

A

cell size, nuclear characteristics, and cytoplasmic characteristics

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86
Q 
The yolk sac is the blood forming structure of the    		
    infant    		
    juvenile    		
    fetus    		
    adult
A

infant

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87
Q 
Cells that arise in response to viral infections are    		
    monocytes    		
    lymphocytes    		
    neutrophils    		
    eosinophils
A

lymphocyte

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88
Q 
A cell not normally found in the peripheral blood might be    		
    band    		
    metamyelocyte    		
    monocyte    		
    eosinophil    		
    none of these
A

metamyelocyte

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89
Q 
RBC's that exhibit a variety of shapes are called    		
    poikilocytes    		
    anisocytes    		
    macrocytes    		
    microcytes    		
    none of these
A

poikilocytes

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90
Q

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

A

an iron containing portion called heme and a protein portion called globin

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91
Q 
A hemoglobin reagent that contains cyanide and a buffer is called    		
    Drabkin's    		
    Dracula's    		
    methemoglobin    		
    all of these    		
    none of these
A

Drabkin’s

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92
Q 
Hemoglobin A1 consists of two types of globin chains    		
    alpha and delta    		
    alpha and epsilon    		
    alpha and gamma    		
    gamma and delta    		
    none of these
A

none of these

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93
Q

The following cells are granulocytes
metamyelocytes, basophils, monocytes
lymphocytes, basophils, neutrophils
lymphocytes, monocytes, stabs
myelocytes, metamyelocytes, bands
none of these

A

metamyelocyte, metamyelocytes, bands

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94
Q 
RBC's that are smaller than normal are called    		
    macrocytes    		
    polychromatic    		
    hypochromic    		
    microcytes    		
    anisocytes
A

microcytes

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95
Q

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

A

all of these

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96
Q 
Leukopoiesis is the formation of    		
    red blood cells    		
    white blood cells    		
    blood cellular elements    		
    platelets    		
    none of these
A

white blood cells

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97
Q 
Pernicious anemia is characterized by cells that are    		
    macrocytic    		
    microcytic    		
    hypochromic    		
    none of these
A

macrocytic

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98
Q 
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
A

too acid

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99
Q

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

A

all nonnucleated RBC to be hemolyzed

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100
Q 
Cells that respond to allergies and parasitic infections    		
    basophils    		
    lymphocytes    		
    monocytes    		
    eosinophils
A

eosinophils

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101
Q 
Bands    		
    have a sausage shaped nucleus    		
    have several nucleoli    		
    have a kidney shaped nucleus    		
    have a round nucleus    		
    none of these
A

have a sausage shaped nucleus

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102
Q 
Which of the following solutions is used to dilute WBC counts    		
    acetic acid    		
    Hayem's    		
    Drabkin's    		
    Turk's    		
    sodium hydroxide
A

acetic acid

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103
Q 
The objective you used when you do a differential count is    		
    low    		
    high dry    		
    none of these    		
    oil immersion
A

oil immersion

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104
Q 
The granules in the eosinophil contain    		
    histamine    		
    antihistamine    		
    lysozyme    		
    all of these
A

antihistamine

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105
Q 
Cells responsible for recognizing abnormal substances    		
    B lymphocytes    		
    monocytes    		
    T lymphocytes    		
    null cells    		
    plasma cells
A

T lymphocytes

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106
Q 
The mature neutrophil normally exhibits \_\_\_\_\_\_ lobe/s    		
    3-5    		
    none    		
    1-2    		
    5-7
A

3-5

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107
Q 
Neutrophils are associated with    		
    bacterial infections    		
    parasites    		
    iron deficiency    		
    bleeding
A

bacterial infections

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108
Q 
The cell that stains uniformly pink with a pale central area is called a/an    		
    neutrophil    		
    erythrocyte    		
    thrombocyte    		
    eosinophil
A

erythrocyte

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109
Q 
Hemoglobin molecule that is fully saturated with oxygen is called    		
    reduced hemoglobin    		
    oxidized hemoglobin    		
    oxyhemoglobin    		
    all of these    		
    none of these
A

oxyhemoglobin

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110
Q 
A common method used for testing hemoglobin concentration is    		
    none of these    		
    Tallquists    		
    Oxyhemoglobin    		
    Drabkins    		
    Sahli
A

drabkins

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111
Q 
In a normal differential you would expect to count \_\_\_\_\_\_\_\_% lymphocytes    		
    2-10    		
    60-75    		
    25-35    		
    0-1
A

25-35

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112
Q 
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
A

A1,F,A2

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113
Q 
The concentration of normal saline is    		
    0.65%    		
    0.85%    		
    0.95%    		
    0.75%    		
    none of these
A

0.85%

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114
Q

The buffer used with the Wright’s stain procedure must be pH _____

4. 6    		
5. 7    		
6. 4    		
7. 6
A

6.4

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115
Q 
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
A

more than one of these

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116
Q 
The stained blood smear should be rinsed with    		
    phosphate buffer    		
    tap water    		
    distilled water    		
    methyl alcohol    		
    none of these
A

distilled water

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117
Q 
The term that refers to the formation of platelets is    		
    thrombopoiesis    		
    leukopoiesis    		
    erythropoiesis    		
    cytology
A

thrombopoiesis

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118
Q 
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
A

MCV less than 80fl

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119
Q 
The cyanmethemoglobin procedure requires a spectrophotometer setting of    		
    540 nm    		
    440 nm    		
    590 nm    		
    625 nm
A

540 nm

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120
Q 
Cells that increase in bacterial infections are    		
    lymphocytes    		
    neutrophils    		
    basophils    		
    eosinophils
A

neutrophils

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121
Q 
A diluent used to count WBC may be    		
    normal saline    		
    0.1N HCl    		
    2% acetic acid    		
    purified water
A

2% acetic acid

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122
Q

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

A

may be increased in allergic reaction

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123
Q

Water is the classic _____________ solution
hypotonic
hypertonic
isotonic

A

hypotonic

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124
Q 
The most commonly seen WBC in a normal adult smear is    		
    basophil    		
    lymphocyte    		
    neutrophil    		
    erythrocyte
A

neutrophil

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125
Q 
The cell that produce antibodies is called a/an    		
    eosinophil    		
    monocyte    		
    basophil    		
    lymphocyte
A

lymphocyte

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126
Q 
The mature basophil has    		
    pale red cytoplasm    		
    moderate to heavy deep red cytoplasm    		
    none of these    		
    more that 3 lobe    		
    all of these
A

none of these

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127
Q 
The most rare cell found in the normal peripheral smear is the    		
    basophil    		
    neutrophil    		
    lymphocyte    		
    monocyte    		
    eosinophil
A

basophil

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128
Q 
The most common cell seen in a peripheral blood smear is a/an    		
    neutrophil    		
    basophil    		
    eosinophil    		
    lymphocyte    		
    none of these
A

neutrophil

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129
Q
  1. Normal adults have three hemoglobins in their red blood cells. These areA1,F,A2A1,G,FF,A2,A3A1,A2,Snone of these
A

A1, F, A2

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130
Q
  1. The granules in the eosinophil containhistamineantihistaminelysozymeall of these
A

antihistamine

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131
Q
  1. The mature neutrophil normally exhibits ______ lobe/s3-5none1-25-7
A

3-5

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132
Q
  1. A common method used for testing hemoglobin concentration isnone of theseTallquistsOxyhemoglobinDrabkinsSahli
A

Drabkins

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133
Q

Abnormal hemoglobins may produce severe disease states
True
False

A

true

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134
Q
  1. Hemoglobin containsa heme portion and albuminan iron containing portion called heme and a protein portion called globinan iron containing portion called globin and a protein containing portion called hemean iron containing portion called ferritin and a protein containing portion called albuminnone of these
A

an iron containing portion called heme and a protein portion called globin

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135
Q
  1. Segmented neutrophilshave a pink cytoplasmhave lobes connected by filamentshave a constricted nucleus with 3-5 lobesall of thesenone of these
A

all of these

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136
Q
  1. A microcytic anemia would have the followingMCV less than 80 flMCH greater than 45 pgMCHC greater than 45%not related to MCV, MCH, MCHC
A

MCV less than 80 fl

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137
Q
  1. In the Wright’s stain if the stain appears too red this may be an indication that the pH of the buffer istoo acidtoo alkalineneutralnone of these
A

too acid

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138
Q
  1. The cyanmethemoglobin procedure requires a spectrophotometer setting of540 nm440 nm590 nm625 nm
A

540 nm

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139
Q
  1. The buffer used with the Wright’s stain procedure must be pH _____
    1. 6
    2. 7
    3. 4
    4. 6
A

6.4

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140
Q
  1. Neutrophils are associated withbacterial infectionsparasitesiron deficiencybleeding
A

bacterial infections

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141
Q
  1. Pernicious anemia is characterized by cells that aremacrocyticmicrocytichypochromicnone of these
A

macrocytic

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142
Q
  1. An effective diluent for WBC counts allowsonly red blood cells to be countedyou to distinguish nucleated RBC from WBCall cells to be counted at the same timeall nonnucleated RBC to be hemolyzed
A

all nonnucleated RBC to be hemolyzed

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143
Q
  1. Cells that arise in response to viral infections aremonocyteslymphocytesneutrophilseosinophils
A

lymphoctes

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144
Q
  1. The CellDyn printout ( like the one you used when doing diffs) providesan automated cell counthistogram analysis3 part differentialnone of thesemore than one of these
A

more than one of these

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145
Q
  1. The mature eosinophilmay be increased in allergic reactionhas no specific staining granuleshas a five lobed nucleusall of thesenone of these
A

may be increased in allergic reactions

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146
Q
  1. The cell that produce antibodies is called a/aneosinophilmonocytebasophillymphocyte
A

lymphocyte

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147
Q 
The most rare cell found in the normal peripheral smear is the
basophil
neutrophil
lymphocyte
monocyte
eosinophil
A

basophil

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148
Q 
The mature basophil has
pale red cytoplasm
moderate to heavy deep red cytoplasm
none of these
more than 3 lobes
all of these
A

none of these

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149
Q
  1. Bandshave a sausage shaped nucleushave several nucleolihave a kidney shaped nucleushave a round nucleusnone of these
A

have a sausage shaped nucleus

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150
Q
  1. Leukopoiesis is the formation ofred blood cellswhite blood cellsblood cellular elementsplateletsnone of these
A

white blood cells

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151
Q
  1. The acid part of the Wright’s stain will stain nuclei and some cytoplasmic structuresredbluea mixture of red and bluenone of these
A

red

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152
Q
  1. The following cells are granulocytesmetamyelocytes, basophils, monocyteslymphocytes, basophils, neutrophilslymphocytes, monocytes, stabsmyelocytes, metamyelocytes, bandsnone of these
A

myelocytes, metamyelocytes, bands

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153
Q
  1. A diluent used to count WBC may benormal saline0.1N HCl2% acetic acidpurified water
A

2% acetic acid

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154
Q
  1. The most commonly seen WBC in a normal adult smear isbasophillymphocyteneutrophilerythrocyte
A

neutrophil

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155
Q
  1. A cell line that will increase in response to viral infection ismonocyteneutrophillymphocyteeosinophil
A

lymphocyte

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156
Q
  1. The term that refers to the formation of platelets isthrombopoiesisleukopoiesiserythropoiesiscytology
A

thrombopoiesis

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157
Q
  1. Cells that respond to allergies and parasitic infectionsbasophilslymphocytesmonocyteseosinophils
A

eosinophils

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158
Q
  1. The most common cell seen in a peripheral blood smear is a/anneutrophilbasophileosinophillymphocyte
    none of these
A

neutrophil

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159
Q
  1. Hemoglobin molecule that is fully saturated with oxygen is calledreduced hemoglobinoxidized hemoglobinoxyhemoglobinall of thesenone of these
A

oxyhemoglobin

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160
Q
  1. The cell seen under the microscope that has a round to oval nucleus with ‘robins egg blue ‘ cytoplasm is a/anneutrophileosinophilbasophillymphocytenone of these
A

lymphocyte

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161
Q
  1. Which of the following solutions is used to dilute WBC countsacetic acidHayem’sDrabkin’sTurk’ssodium hydroxide
A

acetic acid

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162
Q
  1. An increase in the production of cells is calledpolycythemiaporphobilinogenpolychromasiapoikilocytosis
A

polycythemia

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163
Q
  1. In a normal differential you would expect to count ________% lymphocytes2-1060-7525-350-1
A

25-35

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164
Q
  1. RBC’s that are smaller than normal are calledmacrocytespolychromatichypochromicmicrocytesanisocytes
A

microcytes

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165
Q
  1. The stained blood smear should be rinsed withphosphate buffertap waterdistilled watermethyl alcoholnone of these
A

distilled water

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166
Q
  1. The yolk sac is the blood forming structure of theinfantjuvenilefetusadult
A

fetus

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167
Q
  1. The concentration of normal saline is
    1. 65%
    2. 85%
    3. 95%
    4. 75%
    none of these
A

0.85%

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168
Q
  1. Cells are identified according tocell size, nuclear characteristics, and cytoplasmic characteristicscell size, nuclear characteristics, and chemical constituentsage of the cell, chromatin quality, and the arrangement of lipidchemical constituentsnone of these
A

cell size, nuclear characteristics, and cytoplasmic characteristics

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169
Q
  1. RBC’s that exhibit a variety of shapes are calledpoikilocytesanisocytesmacrocytesmicrocytesnone of these
A

poikilocytes

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170
Q
  1. Water is the classic _____________ solutionhypotonichypertonicisotonic
A

hypertonic

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171
Q
  1. A cell not normally found in the peripheral blood might bebandmetamyelocytemonocyteeosinophilnone of these
A

metamyelocyte

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172
Q
  1. Hemoglobin A1 consists of two types of globin chainsalpha and deltaalpha and epsilonalpha and gammagamma and delta
    none of these
A

none of these

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173
Q
  1. The cell that stains uniformly pink with a pale central area is called a/anneutrophilerythrocytethrombocyteeosinophil
A

erythrocyte

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174
Q
  1. Cells that increase in bacterial infections arelymphocytesneutrophilsbasophilseosinophils
A

neutrophils

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175
Q
  1. The objective you used when you do a differential count islowhigh drynone of theseoil immersion
A

oil immersion

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176
Q
  1. Cells responsible for recognizing abnormal substancesB lymphocytesmonocytesT lymphocytesnull cellsplasma cells
A

T lymphocytes

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177
Q
  1. Anemia is a result ofall of thesereduced hemoglobin concentrationdecrease in the number of circulating RBCineffective erythropoiesisnone of these
A

all of these

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178
Q
  1. A hemoglobin reagent that contains cyanide and a buffer is calledDrabkin’sDracula’smethemoglobinall of thesenone of these
A

Drabkin’s

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179
Q 
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
A

Thalassemia major

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180
Q

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

A

decrease in pH and oxygenation, and dehydration

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181
Q

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

A

positive direct antiglobulin test

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182
Q

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

A

evaluates the absorption of vitamin B12

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183
Q 
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
A

vitamin B12 deficiency

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184
Q

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

A

serum iron is decreased, transferrin saturation is decreased, TIBC is normal or decreased

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185
Q

marrow hypoplasia
inadequate erythropoietin
vitamin B12 deficiency
increased erythropoietin production

A

inadequate erythropoietin

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186
Q 
Laboratory findings in hereditary spherocytosis do NOT include:    		
    decreased osmotic fragility    		
    increased autohemolysis    		
    reticulocytosis    		
    shortened erythrocyte survival
A

decreased osmotic fragility

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187
Q

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

A

defective DNA synthesis and abnormal nuclear maturation

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188
Q 
Peripheral blood smears from patients with untreated pernicious anemia are characterized by:    		
    pancytopenia and macrocytosis    		
    pancytopenia and leukocytosis    		
    leukocytosis and ovalocytosis    		
    pancytopenia and microcytosis
A

pancytopenia and macrocytosis

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189
Q 
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
A

hyposegmented neutrophils

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190
Q 
Hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) is:    		
    temperature dependent    		
    complement independent    		
    antibody mediated    		
    caused by a red cell membrane defect
A

caused by a red cell membrane defect

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191
Q 
The most appropriate screening test for hereditary spherocytosis is:    		
    osmotic fragility    		
    sucrose hemolysis    		
    heat instability test    		
    Kleihauer-Betke
A

osmotic fragility

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192
Q

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

A

substitution of lysine for glutamic acid in the sixth position from the NH2 terminal chain

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193
Q 
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
A

Heinz bodies

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194
Q

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

A

paroxysmal nocturnal hemoglobinuria

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195
Q

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

A

spontaneously

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196
Q

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

A

NADH-methemoglobin reductase deficiency

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197
Q

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

A

decreased serum iron levels

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198
Q 
The most appropriate screening test for hemoglobin S is:    		
    Kleihauer-Betke    		
    dithionite solubility    		
    osmotic fragility    		
    sucrose hemolysis
A

dithionite solubility

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199
Q 
Which of the following is most likely and most easily seen in lead poisoning?    		
    iron overload in tissue    		
    codocytes    		
    basophilic stippling    		
    ringed sideroblasts
A

basophilic stippling

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200
Q

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

A

defective spectrin tetramer assembly

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201
Q 
What is the typical appearance of anemia associated with liver disease?    		
    normal red cell morphology    		
    hypochromic, microcytic    		
    macrocytic, normoblastic    		
    macrocytic, megaloblastic
A

macrocytic, normoblastic

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202
Q 
They glycoprotein necessary for absorption of vitamin B12 is:    		
    albumin    		
    transcobalamin II    		
    haptoglobin    		
    intrinsic factor
A

intrinisic factor

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203
Q

What routine hematologic finding is indicative of thalassemia?
microcytic, hypochromic anemia
macrocytic, hypochromic anemia
normocytic, normochromic anemia
macrocytic, normochromic anemia

A

microcytic, hypochromic anemia

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204
Q 
A characteristic morphologic feature in hemoglobin C disease is:    		
    macrocytosis    		
    spherocytosis    		
    rouleaux formation    		
    target cells
A

target cells

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205
Q

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

a quantitative deficiency in RNA resulting in decreased globin chain production

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206
Q 
Which disorder is considered to be a disorder of membrane cation permeability?    		
    G6PD deficiency    		
    hereditary spherocytosis    		
    hereditary elliptocytosis    		
    hereditary stomatocytosis
A

hereditary stomatocytosis

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207
Q

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

A

megablastic anemia

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208
Q 
Which of the following is a cause of methemoglobinemia?    		
    HbM variants    		
    NADH-diaphorase deficiency    		
    toxic substances    		
    all of the above
A

all of the above

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209
Q 
The most appropriate screening test for hemoglobin H is:    		
    dithionite solubility    		
    osmotic fragility    		
    sucrose hemolysis    		
    heat instability test
A

heat instability test

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210
Q

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%

A

hemoglobin A2 level of 3.5-7%

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211
Q 
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
A

thalassemia minor

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212
Q 
Which of the following is most closely associated with iron deficiency anemia?    		
    iron overload in tissue    		
    target cells    		
    basophilic stippling    		
    chronic blood loss
A

chronic blood loss

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213
Q

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

A

gamma chain production of equals alpha chain production

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214
Q 
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
A

absence of 3 of 4 alpha genes

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215
Q

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

A

lack of GPI-anchored proteins on the erythrocyte membran

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216
Q

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

A

decreased erythrocyte survival; increased catabolism of heme

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217
Q 
Anemia secondary to uremia characteristically is:    		
    microcytic, hypochromic    		
    hemolytic    		
    normocytic, normochromic    		
    macrocytic
A

normocytic, normochromic

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218
Q 
Which of the following is NOT a cause of nonmegaloblastic anemia?    		
    alcoholism    		
    immunosuppressive drugs    		
    hypothyroidism    		
    hyperthyroidism
A

hyperthroidism

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219
Q

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

A

G-6-PD deficiency

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220
Q 
What is the treatment for anemia of inflammation?    		
    blood transfusion    		
    iron therapy    		
    treatment of the inflammation    		
    human recombinant IL-1
A

treatment of the inflammation

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221
Q

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

A

denatured hemoglobin inclusions that are readily removed by the spleen

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222
Q 
Which of the following is seen most often in thalassemia?    		
    chronic blood loss    		
    target cells    		
    basophilic stippling    		
    ringed sideroblasts
A

target cells

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223
Q

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

A

all of the above

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224
Q

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

a quantitative defect in hemoglobin synthesis

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225
Q 
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
A

iron overload

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226
Q

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

A

substitutionof valine for glutamic acid in the sixth position from the NH2 terminal chain

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227
Q

According to the morphological classification of anemias, megaloblastic anemia is a:
macrocytic, hypochromic anemia
macrocytic, hyperchromic anemia
macrocytic, normochromic anemia
normocytic, normochromic anemia

A

macrocytic, normochromic anemia

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228
Q

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

A

decreased rate of globin synthesis

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229
Q
  1. The cell which may be found in all types of Hodgkin’s disease is:Sezary cellFlame cellNiemann-Pick cellReed-Sternberg cell
A

Reed-Sternberg cell

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230
Q
  1. The absence of the Philadelphia chromosome in granulocytic leukemia suggests:rapid progression of the diseasea polyclonal origin to the diseaseexcellent response to therapynothing since the Philadelphia chromosome is not present in granulocytic leukemia
A

rapid progression of the disease

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231
Q
  1. All stages of neutrophils are most likely to be seen in the peripheral blood of a patient with:chronic granulocytic leukemiamyelofibrosis with myeloid metaplasiaerythroleukemiaacute granulocytic leukemia
A

chronic granulocytic leukemia

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232
Q
  1. 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 leukemiachronic lymphocytic leukemiaacute promyelocytic leukemiaacute lymphocytic leukemia
A

acute lymphocytic leukemia

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233
Q
  1. Increased numbers of basophils are often seen in:acute infectionschronic granulocytic leukemiachronic lymphocytic leukemiaerythroblastosis fetalis
A

chronic granulocytic leukemia

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234
Q
  1. Which of the following is not a characteristic usually associated with hairy cell leukemia?pancytopeniamononuclear cells with ruffled edgessplenomegalyincreased resistance to infection
A

increased resistance to infection

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235
Q
  1. The erythrocytosis seen in relative Polycythemia occurs because of:decreased arterial oxygen saturationdecreased plasma volume of circulating bloodincreased erythropoietin levelsincreased erythropoiesis in the bone marrow
A

decreased plasma volume of circulating blood

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236
Q
  1. The most common form of childhood leukemia is:acute lymphocyticacute granulocyticacute monocyticchronic granulocytic
A

acute lymphocytic

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237
Q
  1. Repeated phlebotomy in patients with Polycythemia may lead to the development of:folic acid deficiencysideroblastic anemiairon deficiency anemiahemolytic anemia
A

iron deficiency anemia

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238
Q
  1. Auer rods are most likely present in which of the following?chronic granulocytic leukemiamyelofibrosis with myeloid metaplasiaerythroleukemiaacute granulocytic leukemia
A

acute granulocytic leukemia

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239
Q
  1. Increased levels of Tdt activity are indicative of:Burkitt’s lymphomaAcute granulocytic leukemiaAcute lymphocytic leukemiaEosinophilia
A

acute lymphocytic leukemia

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240
Q 
1.	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
A

polycythemia vera

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241
Q 
1.	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
A

neutrophilic leukemoid reaction

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242
Q
  1. Hairy cell leukemia is:an acute myelocytic leukemiaa chronic leukemia of myelocytic origina chronic leukemia of lymphocytic originan acute myelocytic monocytic type leukemia
A

a chronic leukemai of lymphocytic origin

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243
Q
  1. In the FAB classification, acute lymphocytic leukemia is divided into groups according too:prognosisimmunologycytochemistrymorphology
A

morphology

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244
Q
  1. The age group associated with Hodgkin’s disease is:15-3540-50over 50a and c are correct
A

a and c are correct

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245
Q
  1. Which of the following is most closely associated with chronic myelogenous leukemia?ringed sideroblastsdisseminated intravascular coagulationmicromegakaryocytesPhiladelphia chromosome
A

Philadelphia chromosome

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246
Q
  1. Non-Hodgkin’s lymphomas may be caused by:damaged DNAmutagenic effects of radiationmutagenic effects of chemicalsall of the above
A

all of the above

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247
Q
  1. In essential thrombocythemia, the platelets are:increased in number and functionally abnormalnormal in number and functionally abnormaldecreased in number and functionaldecreased in number and functionally abnormal
A

increased in number and functionally abnormal

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248
Q
  1. In myelofibrosis, the characteristic abnormal red cell morphology is that of:target cellsschistocytesteardrop cellsovalocytes
A

teardrop cells

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249
Q 
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
A

fine chromatin

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250
Q

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

A

an accumulation of monoclonal B cells with a block in cell maturation

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251
Q

Heavy chain disease is:
overproduction of monoclonal IgM antibodies
is characterized by the inability of the plasma clees to produce light chains
overproduction of abnormal plasma cells
underproduction of the heavy chain portion of the antibody unit

A

is characterized by the inability of the plasma cells to produce light chains

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252
Q 
Polycythemia vera is characterized by:
increased plasma volume
pancytopenia
decreased oxygen saturation
absolute increase in the total read cell mass
A

absolute increase in the total red cell mass

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253
Q 
The infectious agent most commonly associated with the pathogenenesis of Hodgkin's disease is:
echovirus
herpes virus
hepatitis virus
eptstein-barr virus
A

Epstein-Barr virus

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254
Q 
50-90% myeloblasts in a periphral blood sample is typical of which of the following?
chronic granulocytic leukemia
myelofibrosis with myeloid metaplasia
erythroleukemia
acute granulocytic leukemia
A

acute granulocytic leukemia

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255
Q

the morphologic characteristic(s) associated with the Chediak=Higashi syndrome is/are:
plae blue cytoplasmic inclusions
giant lysosomal granules
small, dark staining granules and condensed nuclei
nuclear hyposegmentation

A

giant lysosomal granules

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256
Q 
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
A

Sudan Black B

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257
Q 
the characteristic morphologic feature in multiple myeloma is:
cytotoxic T cells
rouleaux formation
spherocytes
macrocytosis
A

Rouleaux formation

258
Q

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
polycythmia assocaited with renal disease

A

Polycythemia associated with renal disease

259
Q 
Inthe FAB classification, myelomonocytic leukemia would be:
M1 and M2
M3
M4
M5
A

M4

260
Q

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

A

Polycythemia secondary to hypoxia

261
Q

in infectious mononucleosis, lymphocytes tend to be:
small with little cytoplasm
normal
decreased in number
enlarged and indented by surrounding structures

A

enlarged and indented by surrounding structures

262
Q 
which type of anemia is most common in myelodystplastic syndromes?
micorcytic, hypochromic
normaocytic, hypochromic
macrocytic, normochromic
dimorphic
A

macrocytic, normochromic

263
Q 
Auer rods may be seen in all of the following EXCEPT:
acute myelomonocytic leukemia
acute lymphoblastic leukemia
acute myeloblastic leukemia
acute promyelocytic leukemia
A

acute lymphoblastic leukemia

264
Q 
in which age group does ALL occur with the highest frequency?
1-15 yrs
20-35yrs
45-60yrs
60-75yrs
A

1-15 years

265
Q
  1. Which FAB designation is called the true monocytic leukemia and follows an acute or subacute course characterized by monoblasts, promonocytes, and monocytes?M1M3M4M5
A

M5

266
Q
  1. In chronic myelocytic leukemia, blood histamine concentrations tend to reflect the:number of platelets presentserum uric acid concentrationsnumber of basophils presenttotal number of granulocytes
A

number of basophils present

267
Q
  1. All of the following are myeloproliferative disorders Except:granulocytic leukemialymphocytic leukemiaPolycythemia veraIdiopathic thrombocythemia
A

lymphocytic leukemia

268
Q
  1. Which of the following is typical of Polycythemia vera?increased serum iron concentrationdecreased platelet countincreased erythropoietinincreased LAP
A

increased LAP

269
Q
  1. Which type of anemia is usually present in a patient with acute leukemia?microcytic, hyperchromicmicrocytic, hypochromicnormocytic, normochromicmacrocytic, normochromic
A

normocytic, normochromic

270
Q
  1. Features of secondary Polycythemia include all of the following except:splenomegalydecreased oxygen saturationincreased red cell massincreased erythropoietin
A

splenomegaly

271
Q 
1.	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
A

chronic granulocytic leukemia

272
Q
  1. Patients with chronic granulomatous disease suffer from frequent pyogenic infections owing to the inability of:lymphocytes to produce bacterial antibodieseosinophils to degranulate in the presence of bacterianeutrophils to kill phagocytized bacteriabasophils to release histamine in the presence of bacteria
A

neutrophils to kill phagocytized bacteria

273
Q

Qualitative and quantitative neutrophil changes noted in response to infection include all of the following EXCEPT:

neutrophilia

pelgeroid hyposegmentation

toxic granulation

vacuolization
A

pelgeroid hyposegmentation

274
Q

Disseminated intravascular coagulation is most often associated with which of the following FAB designations of acute leukemia?

M1

M3

M4

M5
A

M3

275
Q
  1. The familial condition of Pelger-Huet anomaly is important to recognize because this disorder must be differentiated from:infectious mononucleosisMay-Hegglin anomalyShift to the left increase in immature granulocytesG-6-PD deficiency
A

Shift to the left increase in immature granulocytes

276
Q
  1. All of the following are contained in the primary granules of the neutrophil except:lactoferrinmyeloperoxidasehistaminealkaline phosphatase
A

Histamine

277
Q

The normal value for a white cell count in an adult is approximately:

2. 5-6.5 x 103/L    		
3. 0-7.3 x 103/L    		
4. 8-10.6 x 103/L    		
5. 2-12.7 x 103/L
A

4.8-10.6 x 103/L

278
Q 
Which disorder is considered to be a disorder of membrane cation permeability?    		
    G6PD deficiency    		
    hereditary spherocytosis    		
    hereditary elliptocytosis    		
    hereditary stomatocytosis
A

hereditary stomatocytosis

279
Q 
Coagulation studies have been ordered for a patient who is suspected of having Factor X deficiency. You should expect prolonged values from which of the following tests?    		
    PT    		
    bleeding time    		
    Antithrombin III    		
    fibrinogen
A

PT

280
Q 
Patients with hemophilia B typically have abnormal:    		
    Factor V    		
    fibrinogen    		
    PT    		
    APTT
A

APTT

281
Q 
A hemophiliac male and a normal female can produce a:    		
    female carrier    		
    male carrier    		
    male hemophiliac    		
    normal female
A

female carrier

282
Q 
The following lab results have been obtained from a 40 year old woman: PT = 20 seconds, APTT = 50 seconds, Thrombin time = 18 seconds. What is the most probable diagnosis?    		
    Factor VII deficiency    		
    Factor VIII deficiency    		
    Factor X deficiency    		
    Hypofibrinogenemia
A

Hypofibrinogenemia

283
Q

Thrombocytopenia is a characteristic of:
classic von Willebrand’s disease
hemophilia A
Glanzmann’s thrombasthenia
May-Hegglin anomaly

A

May-Hegglin anomaly

284
Q

The normal value for reticulocytes in the adult peripheral blood is:

0. 0-1.0%    		
0. 5-2.0%    		
1. 5-3.0%    		
2. 5-4.0%
A

0.5-2.0%

285
Q

Which of the following types of polycythemia is a severely burned patient most likely to have?
polycythemia vera
polycythemia, secondary to hypoxia
relative polycythemia associated with dehydration
polycythemia associated with renal disease

A

relative polycythemia associated with dehydration

286
Q 
Neutrophils normally account for what percentage of the total white cell population in peripheral blood?    		
    0-4%    		
    2-9%    		
    20-40%    		
    50-70%
A

50-70%

287
Q

The cause of megaloblastic anemia is:
decrease in hemoglobin, hematocrit, and MCV
ineffective erythropoiesis
mutations of spectrin
defective nuclear maturation

A

defective nuclear maturation

288
Q 
The following results were obtained on a patient: prolonged bleeding time, normal platelet count, normal PT, and prolonged APTT. Which of the following disorders is most consistent with these results?    		
    Hemophilia A    		
    Hemophilia B    		
    Von Willebrand's disease    		
    Glanzmann's thrombasthenia
A

Von Willebrand’s disease

289
Q 
A patient who has increased serum proteins such as globulins may have red cells that stick together. This is called:    		
    agglutination    		
    aggregation    		
    rouleaux    		
    precipitation
A

rouleaux

290
Q

When using an electronic cell counter, which of the following results can occur in the presence of a cold agglutinin?
increased MCV and decreased RBC
increased MCV and normal RBC
decreased MCV and increased RBC
decreased MCV and RBC

A

increased MCV and decreased RBC

291
Q 
The normal value for a platelet count in an adult is approximately:    		
    100,000-150,000/L    		
    150,000-500,000/µL    		
    150,000-350,000/L    		
    350,000-500,000/L
A

150,000-350,000/L

292
Q 
Which of the following is characteristic of Bernard-Soulier syndrome?    		
    giant platelets    		
    normal bleeding time    		
    abnormal aggregation with ADP    		
    increased platelet count
A

giant platelets

293
Q

Patients may be susceptible to thrombosis if they have inherited:
Protein C deficiency
Protein S deficiency
Both protein C and S deficiency
None of the above

A

Both protein C and S deficiency

294
Q 
The most appropriate screening test for hereditary spherocytosis is:    		
    osmotic fragility    		
    sucrose hemolysis    		
    heat instability test    		
    Kleihauer-Betke
A

osmotic fragility

295
Q 
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 
    acute granulocytic leukemia	
    erythroleukemia
A

chronic granulocytic leukemia

296
Q 
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
A

absence of 3 of 4 alpha genes

297
Q 
A patient has a normal PT and abnormal PTT. After mixing studies with normal plasma, there is still an increased PTT. The most likely cause is:    		
    Factor VIII deficiency    		
    circulating anticoagulant    		
    Factor XII deficiency    		
    hypocalcemia
A

circulating anticoagulant

298
Q 
Lymphocytes account for what percentage of the total white cell population in peripheral blood?    		
    0-4%    		
    2-9%    		
    20-40%    		
    50-70%
A

20-40%

299
Q 
Which of the following is a symptom of multiple myeloma?    		
    high serum calcium levels    		
    bone destruction    		
    infections    		
    all of the above
A

all of the above

300
Q 
In the FAB classification, myelomonocytic leukemia would be:    		
    M1 and M2    		
    M3    		
    M4    		
    M5
A

M4

301
Q

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

A

is characterized by the inability of the plasma cells to produce light chains

302
Q

Specific (secondary) granules of the neutrophilic granulocyte:
appear first at the myelocyte stage
appear first at the promyelocyte stage
appear first at the metamyelocyte stage
are derived from azurophilic (primary) granules

A

appear first at the myelocyte stage

303
Q 
What is the typical appearance of anemia associated with liver disease?    		
    normal red cell morphology    		
    hypochromic, microcytic    		
    macrocytic, normoblastic    		
    macrocytic, megaloblastic
A

macrocytic, normoblastic

304
Q 
The infectious agent most commonly associated with the pathogenesis of Hodgkin's disease is:    		
    Echovirus    		
    Herpes virus    		
    Hepatitis virus    		
    Epstein-Barr virus
A

Epstein-Barr virus

305
Q

Which of the following is most closely associated with chronic myelogenous leukemia?
ringed sideroblasts
disseminated intravascular coagulation
micromegakaryocytes
Philadelphia chromosome

A

Philadelphia chromosome

306
Q

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
A

hyposegmented neutrophils

307
Q 
The following results are obtained:
    PT Normal
    PTT Prolonged
    Absorbed plasma Corrects APTT
    The factor deficiency is:    		
    VIII    		
    IX    		
    X    		
    V
A

VIII

308
Q

Reactive lymphocytes may best be distinguished from blasts by which of the following morphologic characteristics?
blasts have finer chromatin
reactive lymphs have very little cytoplasm
nucleoli are only present in blasts
reactive lymphs do not have dark blue cytoplasm

A

blasts have finer chromatin

309
Q

The following lab results were obtained for a patient with an inherited autosomal dominant trait: Bleeding time Prolonged
Platelet adhesiveness Abnormal
PT Normal
PTT Normal
These findings are most consistent with:
hemorrhagic disease of the newborn
Factor X deficiency
Factor XI deficiency
von Willebrand’s disease

A

von Willebrand’s disease

310
Q

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

a chronic leukemia of lymphocytic origin

311
Q

Which of the following platelet responses is most likely associated with classic von Willebrand’s disease?
decreased platelet aggregation to ristocetin
normal platelet aggregation to ristocetin
absent aggregation to epinephrine, ADP, and collagen
decreased amount of ADP in platelets

A

decreased platelet aggregation to ristocetin

312
Q 
Qualitative and quantitative neutrophil changes noted in response to infection include all of the following EXCEPT:    		
    neutrophilia    		
    pelgeroid hyposegmentation    		
    toxic granulation    		
    vacuolization
A

pelgeroid hyposegmentation

313
Q 
Which of the following is most closely associated with iron deficiency anemia?    		
    iron overload in tissue    		
    target cells    		
    basophilic stippling    		
    chronic blood loss
A

chronic blood loss

314
Q

A 53 year old man was in recovery following a triple bypass operation. Oozing was noted from his surgical wound. The following lab data was obtained:
Hgb 12.5 g/dL
Hct 37%
PT 12.3 seconds
APTT 34 seconds
Platelet count 40.0 x 103/µL
Fibrinogen 250 mg/dL
The most likely cause of bleeding would be:
dilution of coagulation factors due to massive transfusion
intravascular coagulation secondary to microaggregates
c hypofibrinogenemia
dilutional thrombocytopenia

A

q

315
Q 
All of the following are characteristics of classic hemophilia A except:    		
    normal bleeding time    		
    sex-linked inheritance    		
    severe hemarthrosis    		
    decreased vWF:Ag
A

decreased vWF:Ag

316
Q 
On a blood smear, cells with a nucleus slightly off center with a fine chromatin pattern were seen. Several of these cells have nucleoli. The cytoplasm is dark blue with red granules that cover the nucleus. The cells are most likely:    		
    myeloblasts    		
    atypical lymphs    		
    promyelocytes    		
    myelocytes
A

promyelocytes

317
Q

The normal RDW is:

9. 5-11.5%    		
10. 5-13.5%    		
11. 5-14.5%    		
12. 5-15.5%
A

11.5-14.5%

318
Q

Electronic Impedance-
Relates the charge of the particle to the size of the signal
Relates the amplitude of the signal to the size of the particle

A

Relates the amplitude of the signal to the size of the particle

319
Q

Which of the following is associated with Glanzmann’s thrombasthenia?
normal bleeding time
normal ADP aggregation
abnormal initial wave ristocetin aggregation
absence of clot retraction

A

absence of clot retraction

320
Q

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

A

decreased erythrocyte survival; increased catabolism of heme

321
Q

A platelet count performed by phase microscopy is 200 x 103/µL. A standardized template bleeding time on the same person is 15 minutes (normal, 4.5 +/- 1.5 minutes). This indicates that:
the Duke method should have been used for the bleeding time
the manual platelet count is in error
abnormal platelet function should be suspected
the results are as expected

A

abnormal platelet function should be suspected

322
Q

What routine hematologic finding is indicative of thalassemia?
microcytic, hypochromic anemia
macrocytic, hypochromic anemia
normocytic, normochromic anemia
macrocytic, normochromic anemia

A

microcytic, hypochromic anemia

323
Q

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

A

substitution of valine for glutamic acid in the sixth position from the NH2 terminal chain

324
Q 
A red cell which is narrow and elongated, resembling a cigar shape is called:    		
    an ovalocyte    		
    an elliptocyte    		
    a sickle cell    		
    a burr cell
A

an elliptocyte

325
Q 
Acute disseminated intravascular coagulation is characterized by:    		
    hypofibrinogenemia    		
    thrombocytosis    		
    negative D-dimer    		
    shortened thrombin time
A

hypofibrinogenemia

326
Q 
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
A

vitamin B12 deficiency

327
Q

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

A

G-6-PD deficiency

328
Q 
The white cell which typically responds to parasitic infections is the:    		
    neutrophil    		
    lymphocyte    		
    monocyte    		
    eosinophil
A

eosinophil

329
Q 
Which of the following is a characteristic of Factor XII deficiency?    		
    negative bleeding history    		
    normal clotting times    		
    decreased risk of thrombosis    		
    epistaxis
A

negative bleeding history

330
Q 
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
A

acute lymphocytic leukemia

331
Q 
Increased numbers of basophils are often seen in:    		
    acute infections    		
    chronic granulocytic leukemia    		
    chronic lymphocytic leukemia    		
    erythroblastosis fetalis
A

chronic granulocytic leukemia

332
Q 
In an electronic or laser particle cell counter clumped platelets may interfere with which of the following parameters?    		
    white blood cell count    		
    red blood cell count    		
    hemoglobin    		
    hematocrit
A

white blood cell count

333
Q 
Which of the following acquired conditions could lead to thrombosis?    		
    oral contraceptives    		
    heparin therapy    		
    lupus anticoagulant    		
    all of the above
A

all of the above

334
Q

All of the following are characteristics of TTP except:
renal dysfunction
thrombocytosis
microangiopathic hemolytic anemia
neurologic abnormalities

A

thrombocytosis

335
Q

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

A

evaluates the absorption of vitamin B12

336
Q

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

A

serum iron is decreased, transferrin saturation is decreased, TIBC is normal or decreased

337
Q 
Which of the following is characteristic of platelet disorders?    		
    deep muscle hemorrhages    		
    retroperitoneal hemorrhages    		
    mucous membrane hemorrhages    		
    severely prolonged clotting times
A

mucous membrane hemorrhages

338
Q 
The normal adult hemoglobin value in a male is:    		
    10-14 g/dL    		
    12-16 g/dL    		
    14-18 g/dl    		
    14-22 g/dL
A

14-18 g/dl

339
Q 
An MCH of 25 pg suggests:    		
    hypochromia    		
    poikilocytosis    		
    microcytosis    		
    hyperchromia
A

hypochromia

340
Q 
Auer rods are most likely present in which of the following?    		
    M1    		
    M3    		
    M5    		
    M7
A

M3

341
Q 
A characteristic morphologic feature in hemoglobin C disease is:    		
    macrocytosis    		
    spherocytosis    		
    rouleaux formation    		
    target cells
A

target cells

342
Q 
An MCV of 75 fL suggests:    		
    microcytosis    		
    macrocytosis    		
    poikilocytosis    		
    all of the above
A

microcytosis

343
Q

The normal value for a red cell count in an adult female is approximately:

3. 0-4.0 x 106/L    		
3. 5-4.5 x 106/L    		
4. 0 - 5.0 x 106/L    		
5. 0-6.0 x 106/L
A

4.0 - 5.0 x 106/L

344
Q

Which of the following is the most common cause of an abnormality in hemostasis?
decreased plasma fibrinogen level
decreased Factor VIII level
decreased Factor IX level
quantitative abnormality of platelets

A

quantitative abnormality of platelets

345
Q 
Which of the following could cause reactive lymphocytosis?    		
    infectious mononucleosis    		
    drug reactions    		
    autoimmune diseases    		
    all of the above
A

all of the above

346
Q 
The most appropriate screening test for hemoglobin S is:    		
    Kleihauer-Betke    		
    dithionite solubility    		
    osmotic fragility    		
    sucrose hemolysis
A

dithionite solubility

347
Q

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

A

decreased rate of globin synthesis

348
Q 
An increased fibrinogen may be caused by:    		
    dysfibrinogenemia    		
    lupus    		
    acute DIC    		
    inflammation or sepsis
A

inflammation or sepsis

349
Q

Polycythemia vera is characterized by:
increased plasma volume
pancytopenia
decreased oxygen saturation
absolute increase in the total red cell mass

A

absolute increase in the total red cell mass

350
Q

Auer rods are:
a normal aggregation of lysosomes or primary (azurophilic) granules
predominately found in acute myelogenous leukemia
peroxidase negative
alkaline phosphatase positive

A

predominately found in acute myelogenous leukemia

351
Q

Heinz bodies are found in:
G6PD deficiency and thalassemic syndromes as denatured hemoglobin
hemolytic anemias as nuclear remnants
sideroblastic anemias and hemoglobinopathies as nonheme iron
lead intoxication and megaloblastic anemia as ribonucleoprotein and mitochondrial remnants

A

G6PD deficiency and thalassemic syndromes as denatured hemoglobin

352
Q

Which of the following is typical of Polycythemia vera?
increased serum iron concentration
decreased platelet count
increased erythropoietin
increased LAP

A

increased LAP

353
Q 
Primary fibrinolysis may be differentiated from DIC by:    		
    the PT    		
    the APTT    		
    D-dimer    		
    thrombin time
A

D-dimer

354
Q 
Coagulation factors affected by coumarin drugs are:    		
    VIII, IX, and X    		
    I, II, V, and VII    		
    II, VII, IX, and X    		
    II, V, and VII
A

II, VII, IX, and X

355
Q

Which of the following is most useful in differentiating hemophilias A and B?
pattern of inheritance
clinical history
activated partial thromboplastin time
mixing studies

A

mixing studies

356
Q 
Autoimmune hemolytic anemia is:    		
    a disease against self    		
    can be detected with the direct antiglobulin test    		
    involves autoantibody    		
    all of the above
A

all of the above

357
Q 
Which of the following measures platelet function?    		
    bleeding time    		
    prothrombin time    		
    thrombin time    		
    partial thromboplastin time
A

bleeding time

358
Q 
In DIC, which of the following is a predisposing condition?    		
    adenocarcinoma    		
    sepsis    		
    liver disease    		
    all of the above
A

all of the above

359
Q 
Non-Hodgkin's lymphomas may be caused by:    		
    damaged DNA    		
    mutagenic effects of radiation    		
    mutagenic effects of chemicals    		
    all of the above
A

all of the above

360
Q

What causes the red cell 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

A

lack of GPI-anchored proteins on the erythrocyte membrane

361
Q 
Which of the following factor deficiencies is associated with either no bleeding or only a minor bleeding tendency, even after trauma or surgery?    		
    Factor X    		
    Factor XII    		
    Factor XIII    		
    Factor V
A

Factor XII

362
Q 
Hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) is:    		
    temperature dependent    		
    complement independent    		
    antibody mediated    		
    caused by a red cell membrane defect
A

caused by a red cell membrane defect

363
Q

Which of the following is a true statement about acute ITP?
it is found primarily in adults
spontaneous remission usually occurs within several weeks
women are more commonly affected
peripheral destruction of platelets is decreased

A

spontaneous remission usually occurs within several weeks

364
Q 
In myelofibrosis, the characteristic abnormal red cell morphology is that of:    		
    target cells    		
    schistocytes    		
    teardrop cells    		
    ovalocytes
A

teardrop cells

365
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 band neutrophil    		
    a monocyte    		
    a lymphocyte    		
    a basophil
A

a lymphocyte

366
Q 
In which age group does ALL occur with the highest frequency?    		
    1-15 years    		
    20-35 years    		
    45-60 years    		
    60-75 years
A

1-15 years

367
Q 
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
A

Sudan Black B

368
Q

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
A

G-6-PD deficiency

369
Q
  1. A characteristic morphologic feature in hemoglobin C disease is:macrocytosisspherocytosisrouleaux formationtarget cells
A

target cells

370
Q
  1. What is the typical appearance of anemia associated with liver disease?normal red cell morphologyhypochromic, microcyticmacrocytic, normoblasticmacrocytic, megaloblastic
A

macrocytic, normoblastic

371
Q
  1. Heinz bodies are:readily identified with polychrome stainsrarely found in glucose-6-phosphate dehydrogenase deficient erythrocytesclosely associated with spherocytedenatured hemoglobin inclusions that are readily removed by the spleen
A

denatured hemoglobin inclusions that are readily removed by the spleen

372
Q
  1. 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 drugsthe neonatal periodduring infectionsspontaneously
A

spontaneously

373
Q
  1. What is the treatment for anemia of inflammation?blood transfusioniron therapytreatment of the inflammationhuman recombinant IL-1
A

treatment of the inflammation

374
Q
  1. The Schilling test:evaluates the function of intrinsic factorevaluates the absorption of vitamin B12evaluates the absorption of folic acidall of the above
A

evaluates the absorption of vitamin B12

375
Q
  1. In most cases of hereditary persistence of fetal hemoglobin (HPFH):Hgb F is unevenly distributed throughout the erythrocytesthe black heterozygote has 75% Hgb Fbeta and gamma chain synthesis is decreasedgamma chain production equals alpha chain production
A

gamma chain production equals alpha chain production

376
Q
  1. Which of the following is most likely and most easily seen in lead poisoning?iron overload in tissuecodocytesbasophilic stipplingringed sideroblasts
A

basophilic stippling

377
Q
  1. What deficiency causes hemoglobin to be oxidized from the ferrous to the ferric state?G6PD deficiencyPK deficiencyNADH-methemoglobin reductase deficiencylactate dehydrogenase deficiency
A

NADH-methemoglobin reductase deficiency

378
Q
  1. Evidence indicates that the genetic defect in thalassemia usually results in:the production of abnormal globin chainsa quantitative deficiency in RNA resulting in decreased globin chain productiona structural change in the heme portion of the hemoglobinan abnormality in the alpha or beta chain binding or affinity
A

a quantitative deficiency in RNA resulting in decreased globin chain production

379
Q
  1. 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%
A

hemoglobin A2 level of 3.5-7%

380
Q
  1. Laboratory findings in hereditary spherocytosis do NOT include:decreased osmotic fragilityincreased autohemolysisreticulocytosisshortened erythrocyte survival
A

decreased osmotic fragility

381
Q
  1. The most appropriate screening test for hereditary spherocytosis is:osmotic fragilitysucrose hemolysisheat instability testKleihauer-Betke
A

osmotic fragility

382
Q
  1. 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 erythromatosuspolycythemia veraacquired autoimmune hemolytic anemiaparoxysmal nocturnal hemoglobinuria
A

paroxysmal nocturnal hemoglobinuria

383
Q
  1. The anemia of chronic infection is characterized by:decreased iron stores in the reticuloendothelial systemdecreased serum iron levelsmacrocytic erythrocytesincreased serum iron-binding capacity
A

decreased serum iron levels

384
Q
  1. 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 anemiahereditary spherocytosisa high titer of cold agglutininsan elevated reticulocyte count
A

megaloblastic anemia

385
Q
  1. The most appropriate screening test for hemoglobin S is:Kleihauer-Betkedithionite solubilityosmotic fragilitysucrose hemolysis
A

dithionite solubility

386
Q
  1. Thalassemias are characterized by:structural abnormalities in the hemoglobin moleculeabsence of iron in hemoglobindecreased rate of heme synthesisdecreased rate of globin synthesis
A

decreased rate of globin synthesis

387
Q
  1. Which of the following is NOT a cause of nonmegaloblastic anemia?alcoholismimmunosuppressive drugshypothyroidismhyperthyroidism
A

hyperthyroidism

388
Q

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
A

decrease in pH and oxygenation, and dehydration

389
Q
  1. They glycoprotein necessary for absorption of vitamin B12 is:albumintranscobalamin IIhaptoglobinintrinsic factor
A

intrinsic factor

390
Q
  1. Which of the following are causes of anemia of inflammation?increased destruction of red cellsimpaired iron metabolismsuppression of erythropoiesis by cytokinesall of the above
A

all of the above

391
Q
  1. Peripheral blood smears from patients with untreated pernicious anemia are characterized by:pancytopenia and macrocytosispancytopenia and leukocytosisleukocytosis and ovalocytosispancytopenia and microcytosis
A

pancytopenia and macrocytosis

392
Q
  1. 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 bodiesbasophilic stipplingHeinz bodiesPappenheimer bodies
A

Heinz bodies

393
Q
  1. What routine hematologic finding is indicative of thalassemia?microcytic, hypochromic anemiamacrocytic, hypochromic anemianormocytic, normochromic anemiamacrocytic, normochromic anemia
A

microcytic, hypochromic anemia

394
Q
  1. The hypochromic anemias represent a related group of disorders with:a quantitative defect in hemoglobin synthesisa qualitative defect in globin synthesisexcess hemoglobin synthesisVitamin B12 and folate deficiency
A

a quantitative defect in hemoglobin synthesis

395
Q
  1. 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 deficiencyhereditary spherocytosisvitamin B12 deficiencyacute hemorrhage
A

vitamin B12 deficiency

396
Q
  1. Factors commonly involved in producing anemia in patients with chronic renal disease include:marrow hypoplasiainadequate erythropoietinvitamin B12 deficiencyincreased erythropoietin production
A

inadequate erythropoietin

397
Q
  1. 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 fragilityleukopenia and thrombocytopeniaperipheral spherocytosispositive direct antiglobulin test
A

positive direct antiglobulin test

398
Q
  1. Which is the most frequent functional abnormality affecting membrane skeleton proteins in common hereditary elliptocytosis?defective binding of spectrin to ankyrindefective spectrin tetramer assemblydefective binding of ankyrin to protein 3deficiency of protein 4.1
A

defective spectrin tetramer assembly

399
Q 
1.	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
A

thalassemia minor

400
Q
  1. What is the amino acid substitution found in HbC disease?substitution of valine for glutamic acid in the sixth position from the NH2 terminal chainsubstitution of lysine for glutamic acid in the sixth position from the NH2 terminal chainsubstitution of lysine for glutamic acid in the 26th position from the NH2 terminal chainsubstitution of valine for glutamic acid in the 121st position from the NH2 terminal chain
A

substitution of lysine for glutamic acid in the sixth position from the NH2 terminal chain

401
Q
  1. Which of the following is most closely associated with iron deficiency anemia?iron overload in tissuetarget cellsbasophilic stipplingchronic blood loss
A

chronic blood loss

402
Q
  1. Which of the following sets of laboratory findings is consistent with hemolytic anemia?normal or slightly increased erythrocyte survival; normal osmotic fragilitydecreased erythrocyte survival; increased catabolism of hemedecreased serum lactate dehydrogenase activity; normal catabolism of hemenormal concentration of haptoglobin; marked hemoglobinuria
A

decreased erythrocyte survival; increased catabolism of heme

403
Q
  1. What is the term for the clinical course of homozygous thalassemias resulting from defects in - and -chain synthesis?Thalassemia minorThalassemia majorThalassemia traitá-thalassemia
A

Thalassemia major

404
Q
  1. What causes the defect in PNH?rare red cell antigenslack of GPI-anchored proteins on the erythrocyte membraneexcessive amounts of complement components C5 to C9Glucose-6-phosphate-dehydrogenase enzyme deficiency
A

lack of GPI-anchored proteins on the erythrocyte membrane

405
Q
  1. Which disorder is considered to be a disorder of membrane cation permeability?G6PD deficiencyhereditary spherocytosishereditary elliptocytosishereditary stomatocytosis
A

hereditary stomatocytosis

406
Q
  1. Which of the following is a cause of methemoglobinemia?HbM variantsNADH-diaphorase deficiencytoxic substancesall of the above
A

all of the above

407
Q
  1. What is the primary risk to thalassemia major patients who are on a high transfusion program?hyperviscosity of bloodiron overloadcitrate toxicityelectrolyte imbalance
A

iron overload

408
Q
  1. According to the morphological classification of anemias, megaloblastic anemia is a:macrocytic, hypochromic anemiamacrocytic, hyperchromic anemiamacrocytic, normochromic anemianormocytic, normochromic anemia
A

macrocytic, normochromic anemia

409
Q
  1. Which of the following is seen most often in thalassemia?chronic blood losstarget cellsbasophilic stipplingringed sideroblasts
A

target cells

410
Q
  1. 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 normalserum iron is increased, transferrin saturation is increased, TIBC is normal or slightly increasedserum iron is normal, transferrin saturation is markedly increased, TIBC is normalserum iron is decreased, transferrin saturation is decreased, TIBC is normal or decreased
A

serum iron is decreased, transferrin saturation is decreased, TIBC is normal or decreased

411
Q
  1. Hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) is:temperature dependentcomplement independentantibody mediatedcaused by a red cell membrane defect
A

caused by a red cell membrane defect

412
Q
  1. The most appropriate screening test for hemoglobin H is:dithionite solubilityosmotic fragilitysucrose hemolysisheat instability test
A

heat instability test

413
Q
  1. Hemoglobin H disease results from:absence of 3 of 4 alpha genesabsence of 2 of 4 alpha genesabsence of 1 of 4 alpha genesabsence of all 4 alpha genes
A

absence of 3 of 4 alpha genes

414
Q
  1. Anemia secondary to uremia characteristically is:microcytic, hypochromichemolyticnormocytic, normochromicmacrocytic
A

normocytic, normochromic

415
Q
  1. 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 chainsubstitution of lysine for glutamic acid in the sixth position from the NH2 terminal chainsubstitution of lysine for glutamic acid in the 26th position from the NH2 terminal chainsubstitution of valine for glutamic acid in the 121st position from the NH2 terminal chain
A

substitution of valine for glutamic acid in the sixth position from the NH2 terminal chain

416
Q
  1. The pathophysiology of megaloblastic anemia is :Defective RNA synthesis and abnormal cytoplasm maturationDefective DNA synthesis and abnormal nuclear maturationDefective RNA synthesis and abnormal nuclear maturationDefective DNA synthesis and abnormal cytoplasm maturation
A

Defective DNA synthesis and abnormal nuclear maturation

417
Q
  1. Which of the following are not seen on the peripheral smear of a patient with megaloblastic anemia?macro-ovalocyteshypersegmented neutrophilshyposegmented neutrophilsHowell-Jolly bodies
A

hyposegmented neutrophils

418
Q
  1. In acute granulocytic leukemia, a positive peroxidase stain is of diagnostic value
    True
    False
A

True

419
Q
  1. Chronic lymphocytic leukemia is a disease usually found among people 20-40 years of ageFalseTrue
A

False

420
Q
  1. Diagnostic symptoms of many hemolytic anemias includeelevated indirect bilirubin+DATicteric serumall of the above
A

all of the above

421
Q
  1. In chronic granulocytic leukemia, the basophils are usually increased
    True
    False
A

True

422
Q
  1. In the absence of treatment, chronic post hemorrhagic anemia may develop into __________________ anemiairon deficiencyhemolyticsideroblasticpernicious
A

iron deficiency

423
Q
  1. Aplastic anemia may be the result ofantibioticsG-6-PD deficiencyincompatible blood transfusioncirrhosis of the liver
A

antibiotics

424
Q
  1. Chronic lymphocytic leukemiamarked chromatin/parachromatin separation in mature cellsblast formsblast forms with Auer rodsagranulocytosisgranulocytosis
A

marked chromatin/parachromatin separation in mature cells

425
Q
  1. The Schilling test is used to diagnoseMegaloblastic anemiasickle cell anemiabeta thalassemiahereditary spherocytosis
A

Megaloblastic anemia

426
Q
  1. Leukocyte alkaline phosphatase stain is/are ________ in leukemiagranulocytes decreasedmonocytes positivegranulocytes positivenormoblasts positivereticulocytes positive
A

granulocytes decreased

427
Q
  1. A middle aged white male is admitted to the hospital complaining of abdominal pain.
    Physical examination: enlargement in the area of the spleen, darkening of the
    skin around the ankles
    Peripheral blood: moderately decreased hemoglobin/hematocrit, increased
    osmotic fragility, smear shows microspherocytes.
    A probable diagnosis is:hereditary spherocytosisautoimmune hemolytic anemiaacanthocytosisparoxysmal nocturnal hemoglobinuria
A

hereditary spherocytosis

428
Q
  1. The report “RBC’s appear hypochromic” indicates which of the followingconfirm with a low MCVthe color of the cells is decreasedthe RBC count should be lowall of these
A

the color of the cells is decreased

429
Q
  1. The presence of an Auer rod suggests a probable diagnosis ofCMLAMLALLCLL
A

AML

430
Q
  1. The Philadelphia chromosome is associated with which of the following disorderschronic granulocytic anemiachronic lymphocytic anemiaacute granuocytic anemiaacute lymphocytic anemia
A

chronic granulocytic anemia

431
Q
  1. Myelomonocytic leukemia may resemble B12 deficiencies and these two disorders must be differentiated
    True
    False
A

False

432
Q
  1. Progressive anemia may result inbone marrow suppressionmild hepatitisCNS involvementall of thesenone of these
A

none of these

433
Q
  1. The following tests would be indicated when testing for a probable hemolytic anemiaosmotic fragilityHam’s sugar water testdirect Coomb’sall of thesenone of these
A

all of these

434
Q
  1. Anemia results from a reduced quantity ofmore than one of thesehemoglobincirculating RBCthrombocytes
A

more than one of these

435
Q
  1. The white count is uniformly elevated in acute granulocytic leukemia
    True
    False
A

False

436
Q
  1. Acquired autoimmune hemolytic anemia is characterized bydecreased leukocyte countincreased hematocritdecreased reticulocyte countincreased bilirubin
A

increased bilirubin

437
Q
  1. Periodic Acid Shiff (PAS) stains are positive ingranulocytesreticulocytesnormoblastsmonocytesnot clinically significant
    1.
A

monocytes

438
Q
  1. Which of the following findings are common in chronic granulocytic anemiaperipheral blood basophiliaall stages of myeloid maturation in peripheral blooda low leukocyte alkaline phosphataseall of thesenone of these
A

all of these

439
Q
  1. Case study: A 42 year old man has the following:
    Hgb-11.9 gm/dl; Hct-25.5%; RBC-3,950,000/mm3; Platelets-250,000/mm3; WBC-
    80,000/mm3;
    Differential: 62 segs, 11 stabs, 7 metas, 6 myelocytes, 5 pros, 3 blasts,
    1 eo, 5 lymphs
    Clinical Findings: splenomegaly, hepatomegaly
    The diagnosis isCMLAMLAMMLCLLALL
A

CML

440
Q
  1. The anemia that has an increase in HbF rather than HbA isthalassemiaHbS diseaseHbC diseaseall of thesenone of these
A

all of these

441
Q
  1. An example of an anemia that may result from a hemorrhage might bepernicious anemiaautoimmune hemolytic anemiairon deficiency anemiasideroblastic anemia
A

iron deficiency anemia

442
Q
  1. Thalassemia is caused bydeletion of an alpha geneimpaired synthesis of a beta chainan autosomal recessive geneall of thesenone of these
A

all of these

443
Q
  1. Patients with hereditary spherocytosis show a/an ___________ RBC survivaldecreasednormalincreasedunimportant to the diagnosis
A

decreased

444
Q
  1. Differentiation of granules in the white cell takes place at the stage ofmyeloblastpromyelocytemetamyelocytemyelocyte
A

myelocyte

445
Q
  1. Which of the following tests would be of value in distinguishing myeloid metaplasia from chronic myelogenous leukemiaserum protein electrophoresisNBT testDATleukocyte alkaline phosphatase
A

leukocyte alkaline phosphatase

446
Q
  1. Red cell fragments seen in hemolytic anemias are calledschistocytesdrepanocytessiderocyteskeratocytes
A

schistocytes

447
Q
  1. Acute myelogenous leukemiablast formsblast forms with Auer rodsmarked chromatin/parachromatin separation in mature cellsagranulocytosisgranulocytosis
A

blast forms with Auer rods

448
Q
  1. Which of the following is NOT useful in the diagnosis of pernicious anemiagastric analysisblood smearSchilling testnone of these - all are useful
A

none of these - all are useful

449
Q
  1. A patient has repeated positive tests for hemoglobin in his urine upon waking. He is 45 years of age and shows a slightly decreased hemoglobin/ hematocrit. Seven months prior this patient was diagnosed as having aplastic anemia. The lab analysis shows no cell abnormalities except for a slight macrocytosis of the RBC, hyperbilirubinemia, and the previous mentioned hemoglobinuria. The patient also complains of occasional lower back pain. With these clinical findings you might expect a diagnosis ofautoimmune hemolytic anemiaparoxysmal nocturnal hemoglobinuriahereditary spherocytosisacanthocytosis
A

paroxysmal nocturnal hemoglobinuria

450
Q
  1. Which of the following anemias is characterized by oval macrocytesaplastic anemiasickle cell diseasethalassemia majorall of thesenone of these
A

none of these

451
Q
  1. In the anemias, which of the following indicates increased RBC productionelevated RPIpolychromasianucleated RBCall of these
A

q

452
Q
  1. In aplastic anemia, you would expect the platelet count to bebelow normalabove normalnormalunimportant to the diagnosis
A

below normal

453
Q
  1. Blast cells or secondary stem cell usually havenucleolibasophilic cytoplasm and nucleolilarge nucleus without nucleoliacidophilic cytoplasm
A

basophilic cytoplasm and nucleoli

454
Q
  1. Hemolytic anemias as a group are characterized byincreased osmotic fragilityin vivo hemolysispresence of specific autoantibodiesfamily inter-marriages
A

in vivo hemolysis

455
Q
  1. The most common type of leukemia in four year old children is _________________ leukemiachronic lymphocyticacute myelogenousacute lymphoblasticmyelomonocytic
A

acute lymphoblastic

456
Q
  1. Chronic myelogenous leukemiablast formsblast forms with Auer rodmarked chromatin/parchromatin separation in mature cellsagranulocytosisgranulocytosis
A

granulocytosis

457
Q
  1. Iron deficiency is generally classified as a/an ____________ anemiahypochromic, microcytichypochromic, macrocytichyperchromic, normocyticnormochromic, macrocytic
A

hypochromic, microcytic

458
Q
  1. In pernicious anemia, the MCV isslightly decreasedslightly increasedmarkedly increasedmarkedly decreased
A

markedly increased

459
Q
  1. The diagnosis of leukemia may be suspected when you do hematocrit determination and seehemolysishigh hematocritheavy buffy coaticteric plasma
A

heavy buffy coat

460
Q
  1. This patient was admitted with moderate anemia, showing moderate anisocytosis, some macrocytes, and a few microspherocytes. Occasional red cells are seen engulfed by macrophages. The direct Coombs is positive with a warm antibody. A slight purpura is also noted. The serology for syphilis is positive, but the patient denies sexual contact. With this clinical picture, a likely diagnosis might behereditary spherocytosisacanthocytosisautoimmune hemolytic anemiaparoxysmal nocturnal hemoglobinuria
A

autoimmune hemolytic anemia

461
Q
  1. The onset of chronic granulocytic leukemia is usually abrupt and it develops rapidly
    True
    False
A

False

462
Q
  1. Acute myelogenous leukemiahas an age incidence similar to chronic lymphocytic leukemiais never preceded by a preleukemia statecan be differentiated from acute lymphocytic leukemia because blasts usually contain Auer rodsis often related to immunoglobulin abnormalities
A

can be differentiated from acute lymphocytic leukemia because blasts usually contain Auer rods

463
Q
  1. A patient has been diagnosed as having chronic myelogenous leukemia. Which of the following abnormalities would you expect to see on the blood smearteardrop shaped red blood cellsnucleated red blood cellsvariable white countdecreased platelet with some giant forms
A

variable white count

464
Q
  1. In iron deficiency anemia, there is an increase inMCHTIBCserum ironall of these
A

TIBC

465
Q
  1. Symptoms of anemia includepallordyspneafatigueall of thesenone of these
A

all of these

466
Q
  1. DiGuglielmo’s syndrome is a condition characterized in the blood smear byimmature, atypical nucleated red blood cellsthe presence of ‘hairy’ cellsplasma cellsmast cells
A

immature, atypical nucleated red blood cells

467
Q
  1. The mean corpuscular hemoglobin measuresthe average shape of the RBCthe average diameter of the RBCthe average volume of the erythrocytesall of thesenone of these
A

none of these

468
Q
  1. Acute lymphocytic leukemiablast forms with Auer rodsmarked chromatin/parachromatin separation in mature cellsblast formsagranulocytosisgranulocytosis
A

blast forms

469
Q
  1. Macrocytes are morphologically diagnostic of anemias caused byiron deficiencyacute blood lossdeficiency of hematopoietic factorsautoimmune hemolytic anemias
A

deficiency of hematopoietic factors

470
Q
  1. An anemia caused by an acute blood loss is typicallymicrocytichypochromicnormochromicmacrocytic
A

normochromic

471
Q
  1. In the early stages of chronic granulocytic leukemia, the platelet count may be increased
    True
    False
A

False

472
Q
  1. In acute granulocytic leukemia the predominating cell is the neutrophilic myelocyte
    True
    False
A

False

473
Q
  1. Blasts are found normally in all butperipheral bloodlymphatic tissuebone marrowmyeloid tissue
A

peripheral blood

474
Q
  1. Blasts are found normally in all butperipheral bloodlymphatic tissuebone marrowmyeloid tissue
A

peripheral blood

475
Q
  1. Blasts (secondary stem cells) usually havedeeply basophilic cytoplasm and nucleolilarge nucleusno nucleolinucleolideeply basophilic cytoplasm
A

deeply basophilic cytoplasm and nucleoli

476
Q

Identify the inclusion at the end of the arrow.

Dohle body

toxic granulation

phagocytized bacteria

auer body
A

Dohle body

477
Q
  1. Which type of anemia is most common in myelodysplastic syndromes?microcytic, hypochromicnormocytic, hypochromicmacrocytic, normochromicdimorphic
A

microcytic, hypochromic

478
Q
  1. The familial condition of Pelger-Huet anomaly is important to recognize because this disorder must be differentiated from:infectious mononucleosisMay-Hegglin anomalyShift to the left increase in immature granulocytesG-6-PD deficiency
A

Shift to the left increase in immature granulocytes

479
Q
  1. An example of an anemia that may result from a hemorrhage might beiron deficiency anemiapernicious anemiaautoimmune hemolytic anemiasideroblastic anemia
A

iron deficiency anemia

480
Q
  1. In chronic myelocytic leukemia, blood histamine concentrations tend to reflect the:number of platelets presentserum uric acid concentrationsnumber of basophils presenttotal number of granulocytes
A

number of basophils present

481
Q

Identify the cell at the end of the arrow. (Your spelling must be accurate)

A

spherocyte

482
Q
  1. The following tests would be indicated when testing for a probable hemolytic anemiaall of theseosmotic fragilityHam’s sugar water testdirect Coomb’s (DAT)
A

all of these

483
Q

The primary cell type in this field is a

segmented form

band form

metamyelocyte form

myelocyte form

promyelocyte
A

promyelocyte

484
Q
  1. Patients with hereditary spherocytosis show a/an ___________ RBC survival
    decreasednormalincreasedunimportant to the diagnosis
A

decreased

485
Q

Identify the anomaly.

Chediak-Higashi

Alder-Reilly

Pelger-Huet

May-Hegglin
A

Alder-Reilly

486
Q
  1. In response to hypoxia, a hormone is produced to stimulate the production of RBC. This is produced by thepituitaryheartliverkidneynone of the above
A

kidney

487
Q
  1. In the FAB classification, acute lymphocytic leukemia is divided into groups according too:prognosisimmunologycytochemistrymorphology
A

morphology

488
Q
  1. Iron deficiency is generally classified as a/an ____________ anemiahypochromic, microcytichypochromic, macrocytichyperchromic, normocyticnormochromic, macrocytic
A

hypochromic, microcytic

489
Q

What is the cell at the end of the arrow.

Name on disorder where it is found.

A

oval macrocyte

any of the megaloblastic anemias

490
Q
  1. Cells are identified according tocell size, nuclear characteristics, and cytoplasmic characteristicscell size, nuclear characteristics, and chemical constituentsage of the cell, chromatin quality, and the arrangement of lipid chemical constituentsnone of these
A

cell size, nuclear characteristics, and cytoplasmic characteristics

491
Q
  1. Hemolytic anemias as a group are characterized byintravascular hemolysisincreased osmotic fragilitypresence of specific autoantibodiesfamily inter-marriages
A

intravascular hemolysis

492
Q
  1. Cells responsible for cell mediated immunityT lymphocytesB lymphocytesmonocytesnull cellsplasma cells
    1 points
A

T lymphocytes

493
Q
  1. Increased levels of Tdt activity are indicative of:Burkitt’s lymphomaAcute granulocytic leukemiaAcute lymphocytic leukemiaEosinophilia
A

Acute lymphocytic leukemia

494
Q
  1. Which of the following types of Polycythemia is most often associated with emphysema?Polycythemia veraPolycythemia secondary to hypoxiaRelative Polycythemia associated with dehydrationRelative Polycythemia associated with renal disease
A

Polycythemia secondary to hypoxia

495
Q

Identify the nucleated cells. (Your spelling must be accurate.)

A

polychromatophilic polychromatophilic normoblast
rubricytes
rubricyte

496
Q
  1. Myeloblastshave no granules in their cytoplasmnever contain Auer rodsseldom have a nucleolusare the first differentiated cell of the monocytic series
A

have no granules in their cytoplasm

497
Q
  1. A decreased WBC is to be expected ininfectious hepatitisdiabetesbacterial pneumoniapernicious anemianone of these
A

infectious hepatitis

498
Q
  1. Reticulocytes are cells seen immediately following the loss of the _____ in the cytoplasm.blue cytoplasmnucleusnucleoliRNAnone of the above
A

nucleus

499
Q

Identify the abnormality.

keratocytes

drepanocytes

acanthocyte

dacryocytes

none of the above
A

drepanocytes

500
Q
  1. Anemia results from a reduced quantity ofmore than one of thesehemoglobincirculating RBCthrombocytes
A

more than one of these

501
Q

Identify the abnormality.

echinocyte

acanthocyte

keratocyte

schistocyte

none of the above
A

echinocyte

502
Q

Identify the abnormality.

keratocytes

drepanocytes

acanthocyte

dacryocytes
A

drepanocytes

503
Q
  1. The following cells are granulocytesmyelocytes, metamyelocytes, bandsmetamyelocytes, basophils, monocyteslymphocytes, basophils, neutrophilslymphocytes, monocytes, bandsnone of these
A

myelocytes, metamyelocytes, bands

504
Q
  1. Bandshave a sausage shaped nucleushave several nucleolihave an indented nucleushave a round nucleusnone of these
A

have a sausage shaped nucleus

505
Q
  1. The hereditary form of Pelger-Huet isasymptomaticcontagiousacutefatalnone of these
A

asymptomatic

506
Q
  1. In myelofibrosis, the characteristic abnormal red cell morphology is that of:target cellsschistocytesteardrop cellsovalocytes
A

target cells

507
Q

Identify the cell at the end of the arrow. List at least 1 disorder in which these cells are found.

A

basophilic stippling - lead poisoning

508
Q
  1. Which of the following is NOT useful in the diagnosis of pernicious anemianone of these - all are usefulgastric analysisblood smearSchilling test
A

none of these - all are useful

509
Q

Which of the following best describes this field?

4+ anisocytosis

2+ poikilocytosis

schistocytes

spherocytes

microcytes

all of the above

none of the above
A

all of the above

510
Q
  1. The earliest differentiated cell of the lymphocytic series is thelymphoblastmetalymphocyteprolymphocyte_none of these
A

lymphoblast

511
Q
  1. A hemoglobin in which valine replaces glutamic acid in the 6th position is calledHbCHbDHbEHbS
A

HbS

512
Q
  1. An abnormal RBC associated with myelofibrosis which results in a tear drop shaped cell isschistocytedacryocytedrepanocyteleptocytenone of the above
A

dacryocyte

513
Q
  1. A cell that is NOT found in the normal blood smear is a/anorthochromatic normoblastreticulocyteerythrocyteall are abnormal cells and not normally foundall are normally found
    1 points
A

orthochromatic normoblast

514
Q
  1. All of the following are myeloproliferative disorders EXCEPT:granulocytic leukemialymphocytic leukemiaPolycythemia veraIdiopathic thrombocythemia
A

lymphocytic leukemia

515
Q
  1. An anemia caused by an acute blood loss is typically ___ at the onset.normochromicmicrocytichypochromicmacrocytic
A

normochromic

516
Q
  1. In essential thrombocythemia, the platelets are:increased in number and functionally abnormalnormal in number and functionally abnormaldecreased in number and functionaldecreased in number and functionally abnormal
A

increased in number and functionally abnormal

517
Q
  1. The cell which may be found in all types of Hodgkin’s disease is:Sezary cellFlame cellNiemann-Pick cellReed-Sternberg cell
A

Reed-Sternberg cell

518
Q

Identify the cell at the end of the arrow.

codocyte

dacryocyte

elliptocyte

keratocyte

none of the above
A

elliptocyte

519
Q
  1. RBC size is estimated in a differential smear by comparing the cell tothe size of a platelet in the same fielda normal monocytethe size of a nucleus of a small lymphthe average sized segmented neutrophilnone of the above
A

the size of a nucleus of a small lymph

520
Q
  1. 50-90% myeloblasts in a peripheral blood sample is typical of which of the following?chronic granulocytic leukemiamyelofibrosis with myeloid metaplasiaerythroleukemiaacute granulocytic leukemia
A

acute granulocytic leukemia

521
Q
  1. Blasts are usually found in all of the following EXCEPTperipheral bloodmyeloid tissuered bone marrowlymphatic tissuenone of these
A

peripheral blood

522
Q

The cell at the end of the arrow could best be described as

hypochromic

microcytic

polychromatophilic

macrocytic
A

macrocytic

523
Q
  1. The anemia that has an increase in HbF rather than HbA isall of thesethalassemiaHbS diseaseHbC disease
A

all of these

524
Q
  1. Transferrin functions in transporting ____ to the developing RBC.ironRNAamino acidsglobinnone of the above
A

iron

525
Q
  1. Aplastic anemia may be the result ofantibioticsG-6-PD deficiencyincompatible blood transfusioncirrhosis of the liver
A

antibiotics

526
Q
  1. In looking at a bone marrow preparation, you see a cell with deeply blue cytoplasm, a large nucleus in relation to the rest of the cell, and the chromatin is finely reticular with nucleoli present. This is probably a/anorthochromatic erythroblastpronormoblastbasophilic erythroblastpolychromatic erythroblastnone of the above
A

pronormoblast

527
Q
  1. In response to hypoxia, a hormone is produced to stimulate the production of RBC. This is calledhematopoietinthrombopoietinleukopoietinerythropoietinnone of the above
A

erythropoietin

528
Q

Identify the anomaly.

Chediak-Higashi

Alder-Reilly

May-Hegglin

Pelger-Huet

there is no anomaly - this is a normal patient
A

May-Hegglin

529
Q

The primary cell type in this field is a

segmented form

band form

metamyelocyte form

myelocyte form
A

metamyelocyte form

530
Q
  1. Disseminated intravascular coagulation is most often associated with which of the following FAB designations of acute leukemia?M1M3M4M5
A

M3

531
Q
  1. On a sheet of paper (see instructors desk) describe the maturation of blood cells beginning from the stem cell.
    This question will be worth an additional 5 points.
A

what is your answer???

532
Q
  1. The MOST COMMONLY found toxic change in neutrophils istoxic granulationAuer rodsdrumstick formationDohle bodies
A

toxic granulation

533
Q
  1. The mature basophil hasnone of thesepale red cytoplasmmoderate to heavy deep red cytoplasmmore that 3 lobesall of these
A

none of these

534
Q
  1. This patient was admitted with moderate anemia, showing moderate anisocytosis, some macrocytes, and a few microspherocytes. Occasional red cells are seen engulfed by macrophages. The direct Coombs (DAT) is positive with a warm antibody. A slight purpura is also noted. The serology for syphilis is positive, but the patient denies sexual contact. With this clinical picture, a likely diagnosis might beautoimmune hemolytic anemiahereditary spherocytosisacanthocytosisparoxysmal nocturnal hemoglobinuria
A

autoimmune hemolytic anemia

535
Q

Which term best describes this cell

band

segmented

hyposegmented

hypersegmented
A

hypersegmented

536
Q

Identify the cell at the end of the arrow.

codocyte

dacryocyte

elliptocyte

keratocyte

none of the above
A

elliptocyte

537
Q

Identify the cells at the end of the arrows.

sickle cell

schistocyte

elliptocyte

keratocyte

none of the above
A

keratocyte

538
Q

On the right side of the screen there is 1 intact cell. Describe it in terms of chromatin, cytoplasm, and identify the cell

A

Nucleus: finely reticular
Cytoplasm: relatively clear, basophilic,
Overall the cell is quite large
Pronormoblast/ Rubriblast

539
Q
  1. An example of an anemia that may result from a hemorrhage might beiron deficiency anemiapernicious anemiaautoimmune hemolytic anemiasideroblastic anemia
A

iron deficiency anemia

540
Q
  1. In pernicious anemia, the MCV ismarkedly increasedslightly decreasedslightly increasedmarkedly decreased
A

markedly increased

541
Q
  1. The age group associated with Hodgkin’s disease is:15-3540-50over 50a and c are correct
A

a and c are correct

542
Q
  1. The mean corpuscular hemoglobin measuresnone of thesethe average shape of the RBCthe average diameter of the RBCthe average volume of the erythrocytes
A

none of these

543
Q
  1. A hemoglobin in which lysine replaces glutamic acid in the 6th position is calledHbSHbCHbDHbE
A

HbC

544
Q

Identify the cells at the end of the arrows.

pronormoblast

orthochromatophilic normoblast

reticulocyte

basophilic pronormoblast
A

orthochromatophilic normoblast

545
Q
  1. Which type of anemia is usually present in a patient with acute leukemia?microcytic, hyperchromicmicrocytic, hypochromicnormocytic, normochromicmacrocytic, normochromic
A

normocytic, normochromic

546
Q
  1. The mature eosinophilmay be increased in allergic reactionhas no specific staining granuleshas a five lobed nucleusall of thesenone of these
A

may be increased in allergic reaction

547
Q
  1. The report “RBC’s appear hypochromic” indicates which of the followingthe color of the cells is decreasedconfirm with a low MCVthe RBC count should be lowall of these
A

the color of the cells is decreased

548
Q

The nucleated cell at the top of this field is at what stage of white cell maturation?

blast

promyelocyte

myelocyte

metamyelocyte

band

segmented
A

metamyelocyte

549
Q
  1. Auer rods may be seen in all of the following EXCEPT:acute myelomonocytic leukemiaacute lymphoblastic leukemiaacute myeloblastic leukemiaacute promyelocytic leukemia
A

acute lymphoblastic leukemia

550
Q
  1. In iron deficiency anemia, there is an increase inTIBCMCHserum ironall of these
A

TIBC

551
Q
  1. Red cell fragments seen in hemolytic anemias are calledschistocytesdrepanocytessiderocyteskeratocytes
A

schistocytes

552
Q

The nucleated cell at the top of this field is at what stage of white cell maturation?

blast

promyelocyte

myelocyte

metamyelocyte

band

segmented
A

metamyelocyte

553
Q
  1. Basophilic stippling is found inmegaloblastic anemialead poisoninganemia with impaired heme synthesisall of the abovenone of the above
A

all of the above

554
Q
  1. RBC with many blunt projections, resulting from hyper-osmotic solutions isschistocytedacryocytedrepanocyteleptocytenone of the above
A

none of the above

555
Q
  1. Granulocytes are characterized SOLELY by the presence ofnone of theseBarr bodies_specific granules in the cytoplasmpredominant Golgi complexesnuclear chromatin pattern
A

specific granules in the cytoplasm

556
Q

Identify the anomaly.

Chediak-Higashi

Alder-Reilly

Pelger-Huet

May-Hegglin
A

Pelger-Huet

557
Q

These cells are seen in patients with

Chediak-Higashi

Alder-Reilly

Infectious mononucleosis

monocytic leukemia

healthy patients
A

Infectious mononucleosis

558
Q
  1. The Schilling test is used to diagnosenone of thesesickle cell anemiabeta Thalassemiahereditary spherocytosis
A

none of these

559
Q

Identify the cells at the end of the arrows.

codocyte

elliptocyte

keratocyte

stomatocyte

none of the above
A

stomatocyte

560
Q

Which of the following best describes the inclusions in the cell at the end of the arrow?

Dohle bodies

Alder-Reilly

toxic granulation

toxic vacuoles
A

toxic granulation

561
Q
  1. Patients with chronic granulomatous disease suffer from frequent pyogenic infections owing to the inability of:lymphocytes to produce bacterial antibodieseosinophils to degranulate in the presence of bacterianeutrophils to kill phagocytized bacteriabasophils to release histamine in the presence of bacteria
A

neutrophils to kill phagocytized bacteria

562
Q
  1. Chronic lymphocytic leukemia is defined as:a malignancy of the thymusan accumulation of prolymphocytesan accumulation of hairy cells in the spleenan accumulation of monoclonal B cells with a block in cell maturation
A

an accumulation of monoclonal B cells with a block in cell maturation

563
Q

Describe the field. (Ignore the arrow as you review the field)

polychromasia

basophilic stippling

Howell Jolly bodies

NRBC

all of the above

none of the above
A

all of the above

564
Q

Identify the cells at the end of the arrows.

codocyte

target cell

leptocyte

all of the above

none of the above
A

all of the above

565
Q
  1. Repeated phlebotomy in patients with Polycythemia may lead to the development of:folic acid deficiencysideroblastic anemiairon deficiency anemiahemolytic anemia
A

folic acid deficiency

566
Q
  1. In the absence of treatment, chronic post hemorrhagic anemia may develop into _____ anemiairon deficiencyhemolyticsideroblasticpernicious
A

iron deficiency

567
Q

Identify the cells at the end of the arrows. (Your spelling must be accurate.)

A

Exact Match orthochromatophilic normoblast
Exact Match metarubricyte
Exact Match orthochromatophilic normoblasts
Exact Match metarubricyte

568
Q
  1. Acquired autoimmune hemolytic anemia is characterized byincreased bilirubindecreased leukocyte countincreased hematocritdecreased reticulocyte count
A

increased bilirubin

569
Q

Identify the nucleated cell.

neutrophilic myelocyte

neutrophilic metamyelocyte

neutrophilic band

not a neutrophil
A

neutrophilic metamyelocyte

570
Q

Identify the inclusion at the end of the arrow.

Dohle body

toxic granulation

phagocytized bacteria

auer body
A

Dohle body

571
Q

What stage of white cell maturation best describes this cell

blast

promyelocyte

myelocyte

metamyelocyte

band

segmented
A

band

572
Q
  1. In the anemias, which of the following indicates increased RBC productionall of theseelevated reticulocyte production index (RPI)polychromasianucleated RBC
A

all of these

573
Q 
1.	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 pos (200) and Philadelphia chromosome negative
These results are consistent with: 
neutrophilic leukemoid reaction

polycythemia vera

chronic granulomatous disease

leukoerythroblastosis in myelofibrosis
A

neutrophilic leukemoid reaction

574
Q
  1. Polycythemia vera is characterized by:increased plasma volumepancytopeniadecreased oxygen saturationabsolute increase in the total red cell mass
A

absolute increase in the total red cell mass

575
Q
  1. The characteristic morphologic feature in multiple myeloma is:cytotoxic T cellsRouleaux formationSpherocytesMacrocytosis
A

Rouleaux formation

576
Q
  1. Differentiation of the granules in the WBC takes place at which stagemyelocytemyeloblastpromorphonuclear cellmetamyelocytepromyelocyte_
A

myelocyte

577
Q 
Question 105 
1.	The following results were obtained on a 35 year old woman complaining of fatigue and weight loss:
WBC = 1.8 x 103/µL 
RBC = 4.6 x 106/µL 
Platelets = 903 x 103/µL 
Uric acid = 6.4 ng/dL 
LAP = 0 
Philadelphia chromosome pos 
Differential:
Segs = 30%
Lymphs = 13%
Monos = 3%
Bands = 17%
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
A

chronic granulocytic leukemia

578
Q

Identify the cells at the end of the arrows.

codocyte

elliptocyte

keratocyte

stomatocyte

none of the above
A

stomatocyte

579
Q

This field is typical for multiple myeloma patients. What is it and what is causing it?

A

rouleaux - caused by abnormal proteins (Ig’s) caudsing the rbc to “coin stack)

580
Q
  1. The morphologic characteristic(s) associated with the Chediak-Higashi syndrome is/are:pale blue cytoplasmic inclusionsgiant lysosomal granulessmall, dark staining granules and condensed nucleinuclear Hyposegmentation
A

giant lysosomal granules

581
Q
  1. In infectious mononucleosis, lymphocytes tend to be:small with little cytoplasmnormaldecreased in numberenlarged and indented by surrounding structures
A

enlarged and indented by surrounding structures

582
Q

Which of the following best describes the field. Select as many of the responses as fits with your diagnosis.

2+ hypochromasia

1+ anisocytosis

polychromasia

sl poikilocytosis

normochromic, normocytic
A

Correct Answers:
2+ hypochromasia

1+ anisocytosis

sl poikilocytosis

583
Q
  1. The deformability of RBC is a result of _______________________ in the cytoskeletonactin2,3-DPGspectrinactin and 2,3-DPGactin and spectrin
A

actin and spectrin

584
Q
  1. Qualitative and quantitative neutrophil changes noted in response to infection include all of the following EXCEPT:neutrophiliapelgeroid hyposegmentationtoxic granulationvacuolization
A

pelgeroid hyposegmentation

585
Q

Identify the cell at the end of the arrow.

dacryocyte

drepanocyte

keratocyte

codocyte

none of the above
A

drepanocyte

586
Q
  1. Progressive anemia may result innone of thesebone marrow suppressionmild hepatitisCNS involvement
A

none of these

587
Q

Which term best describes this cell

band

segmented

hyposegmented

hypersegmented
A

hypersegmented

588
Q
  1. Which of the following anemias is characterized by oval macrocytesnone of thesethalassemia majoraplastic anemiasickle cell diseasepernicious anemia
A

pernicious anemia

589
Q
  1. Metamyelocyteshave a kidney shaped nucleusdo not precede the band in the maturation sequencehave no specific granulesall of thesehave a visible filament
A

have a kidney shaped nucleus

590
Q
  1. Which of the following is considered to be toxic changes in neutrophiliaall of theseDohle bodiesvacuolesdark granulesnone of these
A

all of these

591
Q
  1. RBC’s exhibiting macrocytes and microcytes would be termedpoikilocyteshypochromasiaanisocytespolychromasianone of the above
A

anisocytes

592
Q

These cells are seen in patients with

Chediak-Higashi

Alder-Reilly

Infectious mononucleosis

monocytic leukemia

healthy patients
A

Infectious mononucleosis

593
Q

Which of the following best describes the field. Select as many of the responses as fits with your diagnosis.

2+ hypochromasia

1+ anisocytosis

polychromasia

sl poikilocytosis

normochromic, normocytic
A

Correct Answers:
2+ hypochromasia

1+ anisocytosis

sl poikilocytosis

594
Q

Identify the nucleated cell. Is it a

granulocyte with a pycnotic nucleus

orthochtomatophilic normoblast (metarubricyte)

macroplatelet

none of the above
A

granulocyte with a pycnotic nucleus

595
Q
  1. Which of the following might also be a reticulocyteall of thesebasophilic stipplingpolychromasiadiffuse basophilia
A

all of these

596
Q
  1. Promyelocytes_have nonspecific granuleshave several nucleolibelong to the erythrocytic serieshave an extremely small nucleus
A

have nonspecific granules

597
Q

Identify the cell at the end of the arrow. (Your spelling must be accurate.)

A

Exact Match basophilic normoblast

Exact Match prorubricyte

598
Q

Identify the anomaly.

Chediak-Higashi

Alder-Reilly

Pelger-Huet

May-Hegglin
A

Pelger-Huet

599
Q
  1. A cell not normally found in the peripheral blood might bemetamyelocytebandmonocyteeosinophilnone of these
A

metamyelocyte

600
Q
  1. Auer rods are most likely present in which of the following?chronic granulocytic leukemiamyelofibrosis with myeloid metaplasiaerythroleukemiaacute granulocytic leukemia
A

acute granulocytic leukemia

601
Q
  1. In aplastic anemia, you would expect the platelet count to bebelow normalabove normalnormalunimportant to the diagnosis
A

below normal

602
Q
  1. An increase in neutrophilic bands (and earlier cells)would be considereda shift to the lefta shift to the righta viral responsenone of these_normal and not important
    1 points
A

a shift to the left

603
Q

Which of the following best describes this field

A

Exact Match 4+ anisocytosis with numerous microcytes
Exact Match 2+ poikilocytosis with dacryocytes and codocytes
Exact Match NRBC
Exact Match all of the above
Exact Match none of the above

604
Q
  1. A middle aged white male is admitted to the hospital complaining of abdominal pain. Physical examination shows enlargement in the area of the spleen, darkening of the
    skin around the ankles.
    Peripheral bloodshows moderately decreased hemoglobin/hematocrit, increased osmotic fragility, smear shows microspherocytes.
    A probable diagnosis is:hereditary spherocytosisautoimmune hemolytic anemiaacanthocytosisparoxysmal nocturnal hemoglobinuria
A

hereditary spherocytosis

605
Q
  1. What do these RBC - stippled cells, reticulocytes, and polychromatophilic cells - have in commonhemosiderinDNAferritinRNAnone of the above
A

RNA

606
Q
  1. Diagnostic symptoms of many hemolytic anemias includeall of the aboveelevated indirect bilirubin+DATicteric serum
A

all of the above

607
Q

Which of the following best describes this cell

normal

blast

leukemia

leukemic cell with auer rods

normal blast with auer bodies
A

leukemic cell with auer rods

608
Q

Identify the anomaly.

Chediak-Higashi

Alder-Reilly

Pelger-Huet

May-Hegglin
A

Alder-Reilly

609
Q
  1. According to an Arneth count, an increase in the number of multi-segmented neutrophils (>4 lobes) isshift to the rightshift to the leftleukocytosisleukopenianone of these
A

shift to the right

610
Q
  1. Thalassemia is caused bydeletion of an alpha geneimpaired synthesis of a beta chainan autosomal recessive geneall of these
    1 points
A

all of these

611
Q

Identify the inclusion in the cell at the end of the arrow.

basophilic stippling

Cabot Rings

Howell Jolly bodies

NRBC

none of the above
A

basophilic stippling

612
Q

Identify the inclusion in the cell at the end of the arrow.

basophilic stippling

Cabot Rings

Howell Jolly bodies

NRBC

none of the above
A

basophilic stippling

613
Q

Which of the following best describes the inclusions in the cell at the end of the arrow?

Dohle bodies

Alder-Reilly

toxic granulation

toxic vacuoles
A

toxic granulation

614
Q

Identify the cells at the end of the arrows.

codocyte

target cell

leptocyte

all of the above

none of the above 1 points
A

all of the above

615
Q
  1. A patient has repeated positive tests for hemoglobin in his urine upon waking. He is 45 years of age and shows a slightly decreased hemoglobin/ hematocrit. Seven months prior this patient was diagnosed as having aplastic anemia. The lab analysis shows no cell abnormalities except for a slight macrocytosis of the RBC, hyperbilirubinemia, and the previous mentioned hemoglobinuria. The patient also complains of occasional lower back pain. With these clinical findings you might expect a diagnosis of:paroxysmal nocturnal hemoglobinuriaautoimmune hemolytic anemiahereditary spherocytosisacanthocytosis
A

paroxysmal nocturnal hemoglobinuria

616
Q
  1. Segmented neutrophilsall of thesehave a pink cytoplasmhave lobes connected by filamentshave a constricted nucleus with 3-5 lobesnone of these
A

all of these

617
Q
  1. The initial blood forming organ is theyolk sacliverspleenbone marrow
A

yolk sac

618
Q
  1. Increased numbers of basophils are often seen in:acute infectionschronic granulocytic leukemiachronic lymphocytic leukemiaerythroblastosis fetalis
A

chronic granulocytic leukemia

619
Q
  1. All stages of neutrophils are most likely to be seen in the peripheral blood of a patient with:chronic granulocytic leukemiamyelofibrosis with myeloid metaplasiaerythroleukemiaacute granulocytic leukemia
A

chronic granulocytic leukemia

620
Q

Describe and identify the following including a description of the nucleus and cytoplasm.
top/ center (slightly below the top of the screen)
far bottom/ left
NOTE the mitotic figure that is in the bottom center of the field. These are unusual but may occassionally be seen in bone marrow preps.

A

top cell: nuc- coarsely clumped, cyto- basophilic/ basophilic normoblast (prorubricyte)
bottom R: nuc-nucleoli present, cyto- abundant, basophilic/ pronormoblast/ (rubriblast)

621
Q
  1. A cell that occurs as a result of an abnormal hemoglobin that forms tactoids (a form of crystal) when under decreased oxygen tension isschistocytedacryocytedrepanocyteleptocytenone of the above
A

drepanocyte

622
Q
  1. 2,3-DPG is important tomembrane functioniron stabilizationATP productionoxygen affinity
A

oxygen affinity

623
Q
  1. Which FAB designation is called the true monocytic leukemia and follows an acute or subacute course characterized by monoblasts, promonocytes, and monocytes?M1M3M4M5
A

M5

624
Q

What stage of white cell maturation best describes this cell?

blast

promyelocyte

myelocyte

metamyelocyte

band

segmented
A

promyelocyte

625
Q
  1. All of the following are contained in the primary granules of the neutrophil EXCEPT:lactoferrinmyeloperoxidasehistaminealkaline phosphatase
A

histamine

626
Q
  1. Symptoms of anemia includeall of thesepallordyspneafatigue
A

all of these

627
Q
  1. The most common form of childhood leukemia is:acute lymphocyticacute granulocyticacute monocyticchronic granulocytic
A

acute lymphocytic

628
Q
  1. In which age group does ALL occur with the highest frequency?1-15 years20-35 years45-60 years60-75 years
A

1-15 years

629
Q
  1. Which of the following is most closely associated with chronic myelogenous leukemia?ringed sideroblastsdisseminated intravascular coagulationmicromegakaryocytesPhiladelphia chromosome
A

Philadelphia chromosome

630
Q
  1. The discovery of an Auer rod in the cytoplasm of a cell tells you that the cell is definitely NOT alymphoblastmonoblastrubriblastmyeloblastnone of these
A

lymphoblast

631
Q
  1. In the FAB classification, myelomonocytic leukemia would be:M1 and M2M3M4M5
A

M4

632
Q
  1. You are looking at a bone marrow preparation and you see a cell with a relatively small nucleus; coarse clumped, pyknotic nucleus; with a cytoplasm that is predominantly red-pink with very little basophilia. This is probably a/anorthochromatic normoblastpronormoblastbasophilic erythroblastpolychromatic erythroblastnone of the above
A

orthochromatic normoblast

633
Q

Identify the cell to the left in this field.
What stain was used?

reticulocyte, new methylene blue

orthochromatophilic normoblast, Wright's stain

ringed sideroblast, prussian blue

none of the above
A

ringed sideroblast, prussian blue

634
Q

The cell at the end of the arrow could best be described as

spherocytic

hypochromic

polychromatophilic

siderotic

none of the above
A

spherocytic

635
Q

Identify the cell to the left in this field.
What stain was used?
Explain what is going on with this cell

A 
ringed sideroblast
Prussian blue (+ Perle's)
Iron in the mitochondria - surroundin the nucleus but not able to be incorporated into the cell.
636
Q
  1. Myelocytescan be either neutrophilic, eosinophilic, or basophilichave a large indented nucleusmay have several nucleoli presentall of thesenone of these
A

can be either neutrophilic, eosinophilic, or basophilic

637
Q
  1. Which of the following are embryonic hemoglobinsGowers I and IIGowers I and FF and A2Gowers F and A2none of these
A

Gowers I and II

638
Q
  1. Globin synthesis occurs in theribosomecodonendoplasmic reticulumnucleolusmitochondria
A

ribosome

639
Q
  1. In response to hypoxia, a hormone is produced to stimulate the production of RBC. This is produced by thepituitaryheartliverkidneynone of the above
A

kidney

640
Q
  1. The mature RBC hasDohle bodiesneutrophilic granulespink cytoplasma nucleus
A

pink cytoplasm

641
Q
  1. Hairy cell leukemia is:an acute myelocytic leukemiaa chronic leukemia of myelocytic origina chronic leukemia of lymphocytic originan acute myelocytic monocytic type leukemia
A

chronic leukemia of lymphocytic origin

heme II (2 decks)

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