HSC HEMATOLOGY INTERVIEW Q'S

Question 1

What signifies anemia?

Answer 1

Decreased hemoglobin and hematocrit

Question 2

What are the RBC indices of microcytic/hyperchromic anemias?

Answer 2

Low MCV, MCH and MCHC

Question 3

What are the microcytic/hyperchromic anemias?

Answer 3

Iron deficiency, Beta Thalassemia, Alpha Thalassemia, Sideroblastic, anemia of chronic disease or inflammation

Question 4

What are the RBC indices of macrocytic/normochromic anemias?

Answer 4

High MCV,MCH and normal MCHC

Question 5

What are the macrocytic/hyperchromic anemias?

Answer 5

Megaloblastic anemia, Liver disease, alcoholism

Question 6

What are the 2 types of megaloblastic anemia?

Answer 6

Folate deficiency and B12 deficiency

Question 7

How do you identify hereditary spherocytosis?

Answer 7

Osmotic fragility test and hemolysis test, DAT=negative

Question 8

What are the PBS features of Microangiopathic anemia?

Answer 8

NN anemia with thrombocytopenia, smear will show schistocytes.

Question 9

What can affect Hemoglobin parameters?

Answer 9

Transfusion (high hgb), blood loss (low hgb), sample is diluted due to fluids, tubidity, anemia, polycythemia, etc.

Question 10

List 4 examples of preanalytical errors

Answer 10

1) Hemolysis due to difficult collection - causes falsely decreasing results for RBC, HCT and APTT
2) Misidentification of a patient
3)Diluted sample- can falsely lower CBC results
4) Improper mixing of a sample, can cause clots which will affect results ex. lower platelet count

Question 11

You need to return RBC back into inventory, what needs to be checked first?

Answer 11

Ports are intact not open and there are some remaining, no leakage, front label is intact, visual inspection (ex, colour and air bubbles), haven’t been out for longer than 1hr.

Question 12

You have an MTP, stroke sample, CSF and the phone is ringing, what do you do first?

Answer 12

-Ignore the phone call
- Stroke sample–put it on quickly
- MTP (the first cooler of RBCs has to be ready within 15min of receiving the requisition) and prepare frozen plasma thaw 20-30min at 30-37 C
- Check back on the stroke sample to make sure the results went through and are valid
-CSF next
- Prepare the second cooler of plasma (has to be within 45min of req)

Question 13

What factors affect PT?

Answer 13

Under filled tube (prolong results), coumadin/warfarin (high pt/inr), quick clot (check for clot, see if the patient was issued factor VIIa

Question 14

What factors affect APTT?

Answer 14

Heparin (prolonged), clot, IV line (contamination), difficult collection (quick clot)

Question 15

What happens if you get a Fib-RP lower than 1.5g/L?

Answer 15

Reflexes to generate Clauss Fibrinogen –more accurate quantitative measurement

Question 16

What are the aspects of a good clot curve?

Answer 16

Has a baseline, acceleration, and plateau phase

Question 17

RBC reference range

Answer 17

M: 4.60 -6
Fem: 4-5.4

Question 18

WBC reference range

Answer 18

4.5-11.5

Question 19

Hgb Reference range

Answer 19

M: 140-180
F: 120-150

Question 20

Hct Reference range

Answer 20

M: 0.4- 0.54
F: 0.39 -0.49

Question 21

MCV reference range

Answer 21

80-100 fL

Question 22

MCH reference range

Answer 22

27-31

Question 23

MCHC reference range

Answer 23

32-36

Question 24

PLT reference range

Answer 24

150-450

Question 25

PT reference range

Answer 25

11-13 sec

Question 26

APTT reference range

Answer 26

20-30sec

Question 27

When should a plasma replacement be done?

Answer 27

If the MCHC is >375 g/L, RBC should be within 5% of following replacement

Question 28

When should a blood sample be warmed?

Answer 28

MCHC is greater than >375 and system flags RBC agglutinin, rerun the sample and warm it for a minimum of 15min at 37C