L1 HEMA Flashcards by Karl Dashley Atinen

Factor VII deficiency:

A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT

B. Prolonged PT, Normal APTT, Normal TCT

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Hemophilia A:

A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT

A. Normal PT, Prolonged APTT, Normal TCT

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Factor X deficiency:

A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT

C. Prolonged PT and APTT, Normal TCT

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Fibrinogen deficiency:

A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT

D. Prolonged PT, APTT and TCT

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More than half of the cases have been described in Ashkenazi Jews, but individuals of any ethnic group may be affected:

A. Hemophilia A
B. Hemophilia B
C. Hemophilia C
D. vWD

C. Hemophilia C

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No coagulation factor has been assigned to Roman numeral:

A. II
B. IV
C. VI
D. XI

C. VI

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Clinical signs and symptoms commonly include low birth weight (<2,500 g), skin hyperpigmentation (café au lait spots), and short stature.
Other manifestations can include skeletal disorders (aplasia or hypoplasia of the thumb), renal malformations, microcephaly, hypogonadism, mental retardation, and strabismus.

A. Diamond-Blackfan anemia
B. Fanconi anemia
C. Sideroblastic anemia
D. Thalassemia

B. Fanconi anemia

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RBC with membrane folded over:

A. Aplastic anemia
B. Iron deficiency anemia
C. Hemoglobin C, hemoglobin SC disease
D. Sickle cell anemia, thalassemia

C. Hemoglobin C, hemoglobin SC disease

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The connective tissue cells actively involved in wound healing are:

A. Plasma cells
B. Mast cells
C. Macrophages
D. Fibroblasts

D. Fibroblasts

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A 53-year-old woman with no prior illnesses has a routine checkup by her physician. On examination she has a blood pressure of 150/95 mm Hg. If her hypertension remains untreated for years, which of the following cellular alterations would most likely be seen in her myocardium?

A. Dysplasia
B. Fatty change
C. Hyperplasia
D. Hypertrophy
E. Metaplasia

E. Metaplasia

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Due to chronic trauma induced by ill-fitting dentures:

A. Hypertrophy
B. Hyperplasia
C. Dysplasia
D. Metaplasia

B. Hyperplasia

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Cell death due to ischemia is known as Infarction and is manifested by a characteristic histologic appearance which is:

A. Coagulation necrosis
B. Liquefaction necrosis
C. Fat necrosis
D. Caseous necrosis

A. Coagulation necrosis

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It is a special form of cell death produced by the TUBERCLE BACILLUS.

A. Coagulation necrosis
B. Liquefaction necrosis
C. Fat necrosis
D. Caseous necrosis

D. Caseous necrosis

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Smallest platelets seen:

A. Alport syndrome
B. Bernard-Soulier syndrome
C. May-Hegglin anomaly
D. Wiskott-Aldrich syndrome

D. Wiskott-Aldrich syndrome

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Largest platelets seen:

A. Alport syndrome
B. Bernard-Soulier syndrome
C. May-Hegglin anomaly
D. Wiskott-Aldrich syndrome

B. Bernard-Soulier syndrome

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The recommended type of microscopy for the performance of manual platelet counts is:

A. Electron
B. Darkfield
C. Light
D. Phase contrast

D. Phase contrast

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The size threshold range used by electrical impedance methods to count particles as platelets is:

A. 0 to 10 fL
B. 2 to 20 fL
C. 15 to 40 fL
D. 35 to 90 fL

B. 2 to 20 fL

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Thrombocytosis is a characteristic of:

A. Disseminated intravascular coagulation
B. Splenomegaly
C. Polycythemia vera
D. Idiopathic thrombocytopenic purpura

C. Polycythemia vera

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The prothrombin time will detect deficiencies in the pathway(s) when calcium and a tissue factor source such as rabbit brain are added to plasma.

A. Extrinsic
B. Extrinsic and common
C. Intrinsic
D. Intrinsic and common

B. Extrinsic and common

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Reticulocytes can be detected by using ____ stain.

A. New methylene blue
B. Thiazole orange
C. Propidium iodide
D. Both A and B

D. Both A and B

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The hemorrhagic problems associated with scurvy are due to a deficiency of, which is a cofactor required for collagen synthesis.

A. Vitamin C
B. Prothrombin
C. Vitamin K
D. Protein C

A. Vitamin C

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The number of platelets an average megakaryocyte generates is approximately:

A. 25 - 50
B. 50 - 200
C. 200 - 500
D. 2,000 - 4, 000

D. 2,000 - 4, 000

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Of the following therapeutic agents, those considered to be antiplatelet medications are:

A. Aspirin and Plavix®
B. Coumadin®andheparin
C. Heparin and protamine sulfate
D. Tissue plasminogen activator and streptokinase

A. Aspirin and Plavix®

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The size threshold range used by electrical impedance methods to count particles as platelets is:

A. 0 - 10 fL
B. 2 - 20 fL
C. 15 - 40 fL
D. 35 - 90 fL

B. 2 - 20 fL

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The coagulation factors having a sex-linked recessive inheritance pattern are: A. Factor V and factor VIII B. Factor VIII and factor IX C. Factor IX and factor X D. von Willebrand factor and factor VIII

B. Factor VIII and factor IX

Which of the following will not cause the thrombin time to be prolonged? A. Fibrin degradation products B. Heparin C. Factor I deficiency D. Factor II deficiency

D. Factor II deficiency

A patient on therapeutic warfarin will most likely have a(n): A. Normal PT/INR, increased aPTT, prolonged bleeding time, low platelet count B. Increased PT/INR, increased aPTT,normal bleeding time, normal plateletcount C. Normal PT/INR, normal aPTT, normal bleeding time, normal platelet count D. Increased PT/INR, normal aPTT, prolonged bleeding time, low platelet count

B. Increased PT/INR, increased aPTT,normal bleeding time, normal plateletcount

Reversal of a heparin overdose can be achieved by administration of: A. Vitamin K B. Protamine sulfate C. Antithrombin D. Warfarin

B. Protamine sulfate

Cells known to be actively phagocytic include: A. Neutrophils, monocytes, basophils B. Neutrophils, eosinophils, monocytes C. Monocytes, lymphocytes, neutrophils D. Lymphocytes, eosinophils, monocytes

B. Neutrophils, eosinophils, monocytes

T cells are incapable of: A. Collaborating with B cells in antibody responses B. Secretion of immunoglobulins C. Secretion of cytokines D. Producing positive skin tests

B. Secretion of immunoglobulins

EDTA is used in concentrations of ____ of blood. A. 0.5 mg/1 mL of whole blood B. 1.5 mg/1 mL of whole blood C. 2.5 mg/1 mL of whole blood D. 3.5 mg/1 mL of whole blood

B. 1.5 mg/1 mL of whole blood

Sodium citrate in the concentration of a ________ solution has been adopted as the appropriate concentration by the ICSH and the International Society for Thrombosis and Hemostasis for coagulation studies. A. 1.5% B. 15% C. 3.2% D. 3.8%

C. 3.2%

Heparin is added ____ per mL of blood in each test tube. A. 0.2 mcg per mL B. 2.0 mcg per mL C. 0.2 mg per mL D. 2 mg per mL

C. 0.2 mg per mL

The term phlebotomy is derived form the Greek words that, literally translated, mean to: A. Cut a vein B. Draw blood C. Stick a vein D. Withdraw blood

A. Cut a vein ## Footnote Phlebos - vein tome - incision

Plastic red-top tubes used to collect blood specimens usually contain: A. Anticoagulant B. Clot activators C. No additives D. Preservatives

B. Clot activators ## Footnote Glass - no additives Plastic - clot activators activates factor XII

A pink-top tube containing EDTA is primarily used for: A. Blood bank tests B. Chemistry C. Coagulation tests D. Microbiology tests

A. Blood bank tests

How many times do you mix non additive tubes? A. 2 or 3 B. 5 to 10 C. 8 to 12 D. None

D. None ## Footnote Noneadditive tubes should not be mixed. In fact, mixing may cause hemolysis if the sample has already begun to clot

Insufficient mixing of an anticoagulatn tube can lead to: A. Hemolysis of the specimen B. Lipemia of the specimen C. Microclots in the specimen D. The sample clotting too fast

C. Microclots in the specimen

Labeling of the routine inpatient blood specimens should take place: A. at the bedside immediately after collection B. before the blood specimens are collected C. in the lab processing area after collection D. outside the patient's room after collection

A. at the bedside immediately after collection

According to CLSI, depth of heel puncture should not exceed: A. 1.5 mm B. 2.0 mm C. 2.4 mm D. 4.9 mm

B. 2.0 mm

Which of the following can be a complication of a heel puncture that is too deep? A. Osteoarthritis B. Osteoporosis C. Osteomyelitis D. Osteosarcoma

C. Osteomyelitis

Select the needle most commonly used in standard venipuncture in an adult: A. One inch, 18 gauge B. One inch, 21 gauge C. One- half inch, 23 gauge D. One- half inch, 25 gauge

B. One inch, 21 gauge

This needle gauge is used primarily fo infacnt or child veins, and difficult or hard veins of adults: A. 16 B. 18 C. 21 D. 23

D. 23

Which of the following veins are listed in the proper order of selection for venipuncture? A. Basilic, cephalic, median cubital B.Cephalic, median cubital, basilic C. Median, median basilic, cephalic D. Median cubital, cephalic, basilic

D. Median cubital, cephalic, basilic

According to CLSI, venipuncture should not be performed on leg, ankle, or foot veins unless: A. Both arms have IVs or other intravascular devices B. Permission of the patient's physician has been obtained C. There are no acceptable antecubital or hand veins D. The patient does not have any coagulation problems

B. Permission of the patient's physician has been obtained

An inpatient vehemently refuses to allow you to collect a blood specimen. What should you do? A. Convince the patient to cooperate and collect the sample anyway B. Have the nurse physically restrain the patient and draw the specimen C. Notify the patient;s nurse and document the patient's refusal D. Return to the lab, cancel the test request and inform the physician

C. Notify the patient;s nurse and document the patient's refusal

A diabetic outpatient has had a mastectomy on her right side and cannot straighten her left arm because of arthritis. The best place to collect a blood specimen is A. an ankle or foot vein on either of her legs B. The left forearm or hand, using a butterfly C. The right arm below the antecubital fossa D. THe right hand, using a capillary puncture

B. The left forearm or hand, using a butterfly

If you have no other choice but to collect a specimen form an arm with a hematoma, collect the specimen: A. Above it B. Beside it C. Distal to it D. Through it

C. Distal to it

When encountering a patient with a fistula, the phlebotomist should: A. Apply the tourniquet below the fistula B. Use the other arm C. Collect the blood from the fistula D. Attach a syringe to the T-tube connector

B. Use the other arm

Peak levels of this analyte typically occur around 0800 hours. A. Bilirubin B. Cortisol C. Eosinophil D. Glucose

B. Cortisol ## Footnote Increase: 8am - 9 am Decrease: 10 pm -11 pm

Which of the following analytes is typically increased in chronic smokers? A. Bicarbonate B. Hemoglobin C. O2 Saturation D. Vitamin B12

B. Hemoglobin ## Footnote Chronic effects of smoking lead to increased Hb concentration, erythrocyte count, MCV, and WBC count

The best specimens to use for establishing inpatient reference ranges for blood tests are: A. Basal state specimens B. Fasting specimens C. Postprandial specimens D. Steady state specimens

A. Basal state specimens

Going without food or drink except water for 8 to 12 hours is defined as: A. Fasting B. NPO C. Routine D. TDM

A. Fasting

A 12-hour fast is normally required in testing for this analyte: A. Bilirubin B. Calcium C. Electrolytes D. Triglycerides

D. Triglycerides

A patient who is NPO: A. Cannot have any food or drink B. Cannot have anything but water C. Is in critical but stable condition D. Is recovering from minor surgery

A. Cannot have any food or drink

Which specimen has priority over all other specimens during processing and testing? A. ASAP B. fasting C. STAT D. timed

C. STAT

What is the proper order fo rputting protective clothing? A. Gloves, gown, mask B. Gown, gloves, mask C. Gown, mask, gloves D. Mask, gown, gloves

C. Gown, mask, gloves

Which order of events should be followed at the conclusion of a laboratory worker's shift in order to prevent the spread of bloodborne pathogens? A. Remove gloves, disinfect area, wash hands, remove lab coat B. Disinfect area, remove gloves, remove lab coat, wash hands C. Disinfect area, remove gloves, weash hands, remove lab coat D. Remove gloves, wash hands, remove lab coat, disinfect area

B. Disinfect area, remove gloves, remove lab coat, wash hands

Which of hte following bleach dilutions is recommended for cleaning the surfaces of contaminated specimen collection areas? A. 1:1 B. 1:2 C. 1:10 D. 1:25

C. 1:10

Prolonged BT, Normal PT, Normal APTT A. Qualitative platelet disorder B. Hemophilia A C. Fibrinogen deficiency D. DIC E. vWD F. Factor X deficiency

A. Qualitative platelet disorder

Prolonged BT, Normal PT, Prolonged APTT A. Qualitative platelet disorder B. Hemophilia A C. Fibrinogen deficiency D. DIC E. vWD F. Factor X deficiency

E. vWD

Normal BT, Normal PT, Prolonged APTT A. Qualitative platelet disorder B. Hemophilia A C. Fibrinogen deficiency D. DIC E. vWD F. Factor X deficiency

B. Hemophilia A

Normal BT, Prolonged PT, Prolonged APTT, Normal TT A. Qualitative platelet disorder B. Hemophilia A C. Fibrinogen deficiency D. DIC E. vWD F. Factor X deficiency

F. Factor X deficiency

Normal BT, Prolonged PT, Prolonged APTT, Prolonged TT A. Qualitative platelet disorder B. Hemophilia A C. Fibrinogen deficiency D. DIC E. vWD F. Factor X deficiency

C. Fibrinogen deficiency

Prolonged BT, Prolonged PT, Prolonged APTT, Prolonged TT A. Qualitative platelet disorder B. Hemophilia A C. Fibrinogen deficiency D. DIC E. vWD F. Factor X deficiency

D. DIC

PT = normal APTT = prolonged APTT + fresh plasma = corrected APTT + adsorbed plasma = corrected APTT + aged serum = not corrected A. II B. V C. VIII D. IX

C. VIII

PT = normal APTT = prolonged APTT + fresh plasma = corrected APTT + adsorbed plasma = not corrected APTT + aged serum = corrected A. II B. V C. VIII D. IX

D. IX

PT = prolonged APTT = prolonged APTT + fresh plasma = corrected APTT + adsorbed plasma = corrected APTT + aged serum = not corrected A. IX B. VII C. X D. I

D. I

PT = prolonged APTT = prolonged PT + fresh plasma = corrected PT + adsorbed plasma = corrected PT + aged plasma = not corrected A. II B. X C. I D. V

D. V

PT = prolonged APTT = prolonged APTT + fresh plasma = corrected APTT + adsorbed plasma = not corrected APTT + aged serum = corrected A. I B. V C. X D. II

C. X

PT = prolonged APTT = prolonged PT + fresh plasma = corrected PT + adsorbed plasma = not corrected PT + aged serum = not corrected A. I B. V C. X D. II

D. II

PT = normal APTT = prolonged APTT + fresh plasma = corrected APTT + adsorbed plasma = corrected APTT + aged serum = corrected 2 possible answers

XI and XII ## Footnote To differentiate: XI deficiency - hemophilia C XII deficiency - no bleeding

In factor X deficiency, a prolonged PT or APTT can be corrected by additon of: 1. Fresh serum 2. Aged serum 3. Aged plasma 4. Adsorbed plasma A. 1 and 2 B. 2 and 3 C. 1,2, and 3 D. 1,2,3 and 4

C. 1,2, and 3

If a pateint presents with a prolonged APTT that does not correct upon mixing the next performed test should be: A. Factor II assay B. Factor VIII assay C. Platelet count D. Dilute Russel Viper Venom Time

D. Dilute Russel Viper Venom Time ## Footnote No correction in mixing studies/ substitution test with the presence of a circulating anticoagulant e.g. Lupus Inhibitor - Dilute RVVT - Platelet neutralization

Which of the following abnormalities is consistent with the presence of lupus anticoagulant? A. decreased APTT/ bleeding complications B. prolonged APTT/ thrombosis C. prolonged APTT/ thrombocytosis D. thrombocytosis/ thrombosis

B. prolonged APTT/ thrombosis

Mrs. Smith has the following laboratory results, and no bleeding history: APTT: prolonged APTT results on a 1:1 mixture of the patient's plasma with normal plasma: Preincubation: prolonged APTT 2-hour incubation: prolonged APTT These results are consistent with: A.Factor VIII deficiency B. Factor VIII inhibitor C. Lupus anticoagulant D. Protein C deficiency

C. Lupus anticoagulant

Which of the following is an appropriate screening test for the diagnosis of lupus anticoagulant? A. Thrombin time test B. Diluted Russel's viper venom test (DRVVT) C. D-dimer test D. FDP test

B. Diluted Russel's viper venom test (DRVVT)

Diagnosis of lupus anticoagulant is confirmed by which of the following criteria? A. Decreased APTT B. Correction of the APTT by mixing studies C. Neutralization of the antibody by high concentration of platelets D. Confirmation that abnormal coagulation tests are time and temperature dependent

C. Neutralization of hte antibody by high concentration of platelets

As a remedy for lipemic or icterus sample for hemostasis test, laboratory manager should use: A. Optical instrument B. Mechanical endpoint coagulometer C. Adjust anticoagulant volume D. Use reagent known to be insensitive to heparin

B. Mechanical endpoint coagulometer

A decrease in serum haptoglobin accompanies which of the following? A. Extravascular hemolysis B. Intravascular hemolysis C. Extramedullary hematopoiesis D. Suppressed erythropoiesis

B. Intravascular hemolysis

According to the WHO classification of MDS, what percentage of blasts would constitute transformation to an acute leukemia? A. 5% B. 10% C. 20% D. 30%

C. 20%

Select the needle most commonly used in standard venipuncture in an adult: A. One inch, 18 gauge B. One inch, 21 gauge C. One-half inch, 23 gauge D. One-half inch, 25 gauge

B. One inch, 21 gauge

The most important step in phlebotomy is: A. Cleansing the site B. Identifying the patient C. Selecting the proper needle length D. Using the correct evacuated tube

B. Identifying the patient

The venipuncture needle should be inserted into the arm with the bevel facing: A. Down and an angle of insertion between 15 and 30 degrees B. Up and an angle of insertion less than 30 degrees C. Down and an angle of insertion greater than 45 degrees D. Up and an angle of insertion between 30 and 45 degrees

B. Up and an angle of insertion less than 30 degrees

Which of the following gathers, organizes, and directs light through the specimen? A. Eyepiece B. Objective lens C. Condenser D. Optical tube

C. Condenser

The recommended cleaner for removing oil from objectives is: A. 70% alcohol or lens cleaner B. Xylene C. Water D. Benzene

A. 70% alcohol or lens cleaner

The “control center” of the cell is the: A. Nucleus B. Cytoplasm C. Membrane D. Microtubular system

A. Nucleus

Protein synthesis occurs in the: A. Nucleus B. Mitochondria C. Ribosomes D. Golgi apparatus

C. Ribosomes

The energy source for cells is the: A. Golgi apparatus B. Endoplasmic reticulum C. Nucleolus D. Mitochondrion

D. Mitochondrion

During the second trimester of fetal development, the primary site of blood cell production is the: A. Bone marrow B. Spleen C. Lymph nodes D. Liver

D. Liver

Physiologic programmed cell death is termed: A. Angiogenesis B. Apoptosis C. Aneurysm D. Apohematics

B. Apoptosis

Which organ is the site of sequestration of platelets? A. Liver B. Thymus C. Spleen D. Bone marrow

C. Spleen

What pathway anaerobically generates energy in the form of ATP? A. Hexose monophosphate pathway B. Rapoport-Luebering pathway C. Embden-Meyerhof pathway D. 2,3-BPG pathway

C. Embden-Meyerhof pathway

What is the normal distribution of hemoglobins in healthy adults? A. 80% to 90% Hb A, 5% to 10% Hb A2, 1% to 5% Hb F B. 80% to 90% Hb A2, 5% to 10% Hb A, 1% to 5% Hb F C. >95% Hb A, ❤.5% Hb A2, 1% to 2% Hb F D. >90% Hb A, 5% Hb F, <5% Hb A

C. >95% Hb A, ❤.5% Hb A2, 1% to 2% Hb F

What plasma protein is essential to platelet adhesion? A. VWF B. Factor VIII C. Fibrinogen D. P-selectin

A. VWF

Which of the following molecules is stored in platelet dense granules? A. Serotonin B. Fibrinogen C. PF4 D. Platelet-derived growth factor

A. Serotonin

Folate and vitamin B12 work together in the production of: A. Amino acids B. RNA C. Phospholipids D. DNA

D. DNA

The primary pathophysiologic mechanism of anemia associated with chronic kidney disease is: A. Inadequate production of erythropoietin B. Excessive hemolysis C. Hematopoietic stem cell mutation D. Toxic destruction of stem cells

A. Inadequate production of erythropoietin

Which of the following tests provides a good indication of accelerated erythropoiesis? A. Urine urobilinogen level B. Hemosiderin level C. Reticulocyte count D. Glycated hemoglobin level

C. Reticulocyte count

Acanthocytes are found in association with: A. Abetalipoproteinemia B. G6PD deficiency C. Rh deficiency syndrome D. Vitamin B12 deficiency

A. Abetalipoproteinemia

A Group A Rh-negative mother gave birth to a Group O Rh-positive baby. The baby is at risk for HDFN if: A. This was the mother’s first pregnancy B. The mother has IgG ABO antibodies C. The mother was previously immunized to the D antigen D. The mother received Rh immune globulin prior to delivery

C. The mother was previously immunized to the D antigen

Which of the following lysosomal storage diseases is characterized by macrophages with striated cytoplasm and storage of glucocerebroside? A. Sanfilippo syndrome B. Gaucher disease C. Fabry disease D. Niemann-Pick disease

B. Gaucher disease

Which of the following chromosome abnormalities is associated with CML? A. t(15;17) B. t(8;14) C. t(9;22) D. Monosomy 7

C. t(9;22)

What coagulation plasma protein should be assayed when platelets fail to aggregate properly? A. Factor VIII B. Fibrinogen C. Thrombin D. Factor X

B. Fibrinogen

When using anaerobic jar, it is important to include reliable indicator of anaerobiasis like: A. Eosin B. Methyl red C. Methylene blue D. Palladium chloride

C. Methylene blue

Which of the following methods for quantitation of bacteria can be used to measure the total number of viable cells? A. Turbidimetric determination B. Microscopic chamber count C. Total amount of nitrogen D. Plate count

D. Plate count

Fermentation end-products are often used to aid in the identification of bacteria. Fermentation results in which of the following? A. Conversion of glucose to pyruvate B. Lactic acid, mixed acids, alcohols, CO2 production C. CO2 and water D. Specific teichoic acids

B. Lactic acid, mixed acids, alcohols, CO2 production

Forward-angle light scatter is an indicator of cell: A. Granularity. B. Density. C. Size. D. Number.

C. Size.

Destruction of the myelin sheath of axons caused by the presence of antibody is characteristic of which disease? A. MS B. MG C. Graves disease D. Goodpasture’s syndrome

A. MS

Antimitochondrial antibodies are strongly associated with which disease? A. Autoimmune hepatitis B. Celiac disease C. Primary biliary cirrhosis D. Goodpasture’s syndrome

C. Primary biliary cirrhosis

The hemorrhagic problems associated with scurvy are due to a deficiency of ______, which is a cofactor required for collagen synthesis. A. Vitamin C B. Prothrombin C. Vitamin K D. Protein C

A. Vitamin C

Of the following therapeutic agents, those considered to be anti-platelet medications are: A. Aspirin and Plavix B. Coumadin and heparin C. Heparin and protamine sulfate D. Tissue plasminogen activator and streptokinase

A. Aspirin and Plavix

This term describes the balanced or “steady state” condition normally maintained by the body. A. Anabolism B. Catabolism C. Hemostasis D. Homeostasis

D. Homeostasis

Which of the following items is unnecessary when performing a routine venipuncture? A. Evacuated tubes B. Safety needle C. Skin disinfectant D. Tourniquet

C. Skin disinfectant ## Footnote Antiseptics, not disinfectants, are used when performing routine venipuncture.

Which of the following are all anticoagulants that remove calcium from the specimen by forming insoluble calcium salts and therefore preventing coagulation? A. EDTA, lithium heparin, citrate B. NaF, sodium heparin, EDTA C. Oxalate, SPS, sodium heparin D. Sodium citrate, EDTA, oxalate

D. Sodium citrate, EDTA, oxalate

Which of the following is a disinfectant? A. Benzalkonium chloride B. Chlorhexidine gluconate C. Household bleach D. Hydrogen peroxide

C. Household bleach

PT prolonged APTT prolonged APTT + fresh plasma = corrected APTT + adsorbed plasma = not corrected APTT + aged serum = not corrected Most likely coagulation factor deficient: A. Factor I B. Factor V C. Factor X D. Factor II

D. Factor II

Patient with severe bleeding PT normal APTT prolonged APTT + fresh plasma = corrected APTT + adsorbed plasma = corrected APTT + aged serum = corrected Most likely coagulation factor deficient: A. Factor VIII B. Factor IX C. Factor XI D. Factor XII

C. Factor XI

Patient with no bleeding tendency PT normal APTT prolonged APTT + fresh plasma = corrected APTT + adsorbed plasma = corrected APTT + aged serum = corrected Most likely coagulation factor deficient: A. Factor VIII B. Factor IX C. Factor XI D. Factor XII

D. Factor XII

PT normal APTT prolonged APTT + fresh plasma = corrected APTT + adsorbed plasma = corrected APTT + aged serum = not corrected Most likely coagulation factor deficient: A. Factor I B. Factor VII C. Factor VIII D. Factor IX

C. Factor VIII

PT normal APTT prolonged APTT + fresh plasma = corrected APTT + adsorbed plasma = not corrected APTT + aged serum = corrected A. Factor I B. Factor VII C. Factor VIII D. Factor IX

D. Factor IX

INR range recommended for most indications (e.g., treatment or prophylaxis of deep venous thrombosis [DVT], or prevention of further clotting in patients who have had a myocardial infarction): A. 1.0 to 1.5 B. 1.5 to 2.0 C. 2.0 to 3.0 D. 2.5 to 3.5

C. 2.0 to 3.0

INR recommended for patients with prosthetic heart valves: A. 1.0 to 1.5 B. 1.5 to 2.0 C. 2.0 to 3.0 D. 2.5 to 3.5

D. 2.5 to 3.5

The target INR for pulmonary embolism (PE) treatment is ____ for the duration of anticoagulation. A. 1.0 B. 2.0 C. 2.5 D. 3.0

D. 3.0

EDTA is used in concentrations of __ of blood. A. 0.5 mg/1 mL of whole blood B. 1.5 mg/1 mL of whole blood C. 2.5 mg/1 mL of whole blood D. 3.5 mg/1 mL of whole blood

B. 1.5 mg/1 mL of whole blood

Sodium citrate in the concentration of a _____ solution has been adopted as the appropriate concentration by the ICSH and the International Society for Thrombosis and Hemostasis for coagulation studies. A. 1.5% B. 15% C. 3.2% D. 3.8%

C. 3.2%

NEW TYPES OF THROMBOPLASTINS for measuring the PT are mixtures of phospholipids and recombinantly derived from: A. Rabbit tissue factor B. Human tissue factor C. Horse tissue factor D. Sheep tissue factor

B. Human tissue factor

The recommended type of microscopy for the performance of manual platelet counts is: A. Electron B. Darkfield C. Light D. Phase contrast

D. Phase contrast

The size threshold range used by electrical impedance methods to count particles as platelets is: A. 0 to 10 fL B. 2 to 20 fL C. 15 to 40 fL D. 35 to 90 fL

B. 2 to 20 fL

Most common complication encountered in obtaining a blood specimen: A. Ecchymosis (bruise) B. Hematoma C. Hemoconcentration D. None of these

A. Ecchymosis (bruise)

It is caused by leakage of a SMALL AMOUNT OF BLOOD in the tissue around the puncture site: A. Ecchymosis (bruise) B. Hematoma C. Hemoconcentration D. None of these

A. Ecchymosis (bruise)

Leakage of a LARGE AMOUNT OF BLOOD around the puncture site causes the area to rapidly swell: A. Ecchymosis (bruise) B. Hematoma C. Hemoconcentration D. None of these

B. Hematoma

Your patient is not wearing an ID band. You see that the ID band is taped to the nightstand. The information matches your requisition. What do you do? A. Ask the patient to state her name; if it matches the requisition, continue. B. Ask the patient’s nurse to attach an ID band and proceed when it is attached. C. Go to the nurses’ station, get an ID bracelet, attach it, and then proceed. D. Tell the nurse that you will not collect the specimen and return to the lab.

B. Ask the patient’s nurse to attach an ID band and proceed when it is attached.

Smallest platelets seen: A. Alport syndrome B. Bernard-Soulier syndrome C. May-Hegglin anomaly D. Wiskott-Aldrich syndrome

D. Wiskott-Aldrich syndrome

Largest platelets seen: A. Alport syndrome B. Bernard-Soulier syndrome C. May-Hegglin anomaly D. Wiskott-Aldrich syndrome

B. Bernard-Soulier syndrome

An inpatient vehemently refuses to allow you to collect a blood specimen. What should you do? A. Convince the patient to cooperate and collect the sample anyway. B. Have the nurse physically restrain the patient and draw the specimen. C. Notify the patient’s nurse and document the patient’s refusal. D. Return to the lab, cancel the test request, and inform the physician.

C. Notify the patient’s nurse and document the patient’s refusal.

Factor VII deficiency: A. Normal PT, Prolonged APTT, Normal TCT B. Prolonged PT, Normal APTT, Normal TCT C. Prolonged PT and APTT, Normal TCT D. Prolonged PT, APTT and TCT

B. Prolonged PT, Normal APTT, Normal TCT

Hemophilia A: A. Normal PT, Prolonged APTT, Normal TCT B. Prolonged PT, Normal APTT, Normal TCT C. Prolonged PT and APTT, Normal TCT D. Prolonged PT, APTT and TCT

A. Normal PT, Prolonged APTT, Normal TCT

Factor X deficiency: A. Normal PT, Prolonged APTT, Normal TCT B. Prolonged PT, Normal APTT, Normal TCT C. Prolonged PT and APTT, Normal TCT D. Prolonged PT, APTT and TCT

C. Prolonged PT and APTT, Normal TCT

Fibrinogen deficiency: A. Normal PT, Prolonged APTT, Normal TCT B. Prolonged PT, Normal APTT, Normal TCT C. Prolonged PT and APTT, Normal TCT D. Prolonged PT, APTT and TCT

D. Prolonged PT, APTT and TCT

Disseminated intravascular coagulation (DIC) is most often associated with which of the following types of acute leukemia? A. Acute myeloid leukemia without maturation B. Acute promyelocytic leukemia C. Acute myelomonocytic leukemia D. Acute monocytic leukemia

B. Acute promyelocytic leukemia

Cardiovascular complications of phlebotomy: 1.Cardiac arrest 2.Hypotension 3.Syncope 4.Shock A. 1 and 2 B. 1 and 3 C. 1, 2 and 3 D. 1, 2, 3 and 4

D. 1, 2, 3 and 4

Phlebotomy complications including diaphoresis, seizure, pain, and nerve damage: A. Cardiovascular complications B. Vascular complications C. Neurological complications D. Infections

C. Neurological complications

Acute, uncompensated DIC 1. Prolonged PT, PTT and TT 2. Normal fibrinogen 3. Increased FDPs A. 1 only B. 1 and 2 C. 1 and 3 D. 1, 2 and 3

C. 1 and 3

The only abnormal test result in CHRONIC DIC: A. PT B. APTT C. Thrombin time D. D-dimer

D. D-dimer

What coagulation plasma protein should be assayed when platelets fail to aggregate properly? A. Factor VIII B. Fibrinogen C. Thrombin D. Factor X

B. Fibrinogen

What clotting factors (cofactors) are inhibited by protein S? A. V and X B. Va and VIIIa C. VIII and IX D. VIII and X

B. Va and VIIIa

A prolonged thrombin time is indicative of which of the following antithrombotic therapies? A. Prasugrel B. Clopidogrel C. Aspirin D. Heparin

D. Heparin

A patient on therapeutic warfarin will most likely have a(n) A. Normal PT/INR, increased APTT, prolonged bleeding time, low platelet count B. Increased PT/INR, increased APTT, normal bleeding time, normal platelet count C. Normal PT/INR, normal APTT, normal bleeding time, normal platelet count D. Increased PT/INR, normal APTT, prolonged bleeding time, low platelet count

B. Increased PT/INR, increased APTT, normal bleeding time, normal platelet count

If a child ingested rat poison, which of the following tests should be performed to test the effect of the poison on the child’s coagulation mechanism? A. APTT B. PT C. Fibrinogen assay D. Thrombin time

B. PT

What test is used to monitor heparin therapy? A. INR B. APTT C. TT D. PT

B. APTT

POCT/BEDSIDE Which of the following is the preferred method to monitor heparin therapy at the point of care during cardiac surgery? A. APTT B. Activated clotting time test (ACT) C. PT D. TT

B. Activated clotting time test (ACT)

B. Use the other arm

Neutrophil in the maturation-storage phase: A. 7 to 10 hours B. 7 to 10 days C. 8.5 hours D. 12 hours

B. 7 to 10 days

Basophil in the maturation-storage phase: A. 7 to 10 hours B. 7 to 10 days C. 8.5 hours D. 12 hours

D. 12 hours

Eosinophil in the maturation-storage phase: A. 2.5 days B. 3.5 days C. 8.5 hours D. 12 hours

A. 2.5 days

Average life span of neutrophils in circulating blood: A. 7 to 10 hours B. 7 to 10 days C. 8.5 hours D. 12 hours

A. 7 to 10 hours

Average life span of basophils in circulating blood: A. 7 to 10 hours B. 7 to 10 days C. 8.5 hours D. 12 hours

C. 8.5 hours

What is the correct order for removing protective clothing? A. Gloves, gown, mask B. Gown, gloves, mask C. Gown, mask, gloves D. Mask, gown, gloves

A. Gloves, gown, mask

What is the proper order for putting on protective clothing? A. Gloves first, then gown, mask last B. Gown first, then gloves, mask last C. Gown first, then mask, gloves last d. Mask first, then gown, gloves last

C. Gown first, then mask, gloves last

B. Human tissue factor

The recommended type of microscopy for the performance of manual platelet counts is: A. Electron B. Darkfield C. Light D. Phase contrast

D. Phase contrast

The size threshold range used by electrical impedance methods to count particles as platelets is: A. 0 to 10 fL B. 2 to 20 fL C. 15 to 40 fL D. 35 to 90 fL

B. 2 to 20 fL

Most common complication encountered in obtaining a blood specimen: A. Ecchymosis (bruise) B. Hematoma C. Hemoconcentration D. None of these

A. Ecchymosis (bruise)

It is caused by leakage of a SMALL AMOUNT OF BLOOD in the tissue around the puncture site: A. Ecchymosis (bruise) B. Hematoma C. Hemoconcentration D. None of these

A. Ecchymosis (bruise)

Leakage of a LARGE AMOUNT OF BLOOD around the puncture site causes the area to rapidly swell: A. Ecchymosis (bruise) B. Hematoma C. Hemoconcentration D. None of these

B. Hematoma

B. Ask the patient’s nurse to attach an ID band and proceed when it is attached.

Smallest platelets seen: A. Alport syndrome B. Bernard-Soulier syndrome C. May-Hegglin anomaly D. Wiskott-Aldrich syndrome

D. Wiskott-Aldrich syndrome

Largest platelets seen: A. Alport syndrome B. Bernard-Soulier syndrome C. May-Hegglin anomaly D. Wiskott-Aldrich syndrome

B. Bernard-Soulier syndrome

C. Notify the patient’s nurse and document the patient’s refusal.

Cardiovascular complications of phlebotomy: 1. Cardiac arrest 2. Hypotension 3. Syncope 4. Shock A. 1 and 2 B. 1 and 3 C. 1, 2 and 3 D. 1, 2, 3 and 4

D. 1, 2, 3 and 4

Acute, uncompensated DIC 1. Prolonged PT, PTT and TT 2. Normal fibrinogen 3. Increased FDPs A. 1 only B. 1 and 2 C. 1 and 3 D. 1, 2 and 3

C. 1 and 3

Phlebotomy complications including diaphoresis, seizure, pain, and nerve damage: A. Cardiovascular complications B. Vascular complications C. Neurological complications D. Infections

C. Neurological complications

The only abnormal test result in CHRONIC DIC: A. PT B. APTT C. Thrombin time D. D-dimer

D. D-dimer

What coagulation plasma protein should be assayed when platelets fail to aggregate properly? A. Factor VIII B. Fibrinogen C. Thrombin D. Factor X

B. Fibrinogen

What clotting factors (cofactors) are inhibited by protein S? A. V and X B. Va and VIIIa C. VIII and IX D. VIII and X

B. Va and VIIIa

A prolonged thrombin time is indicative of which of the following antithrombotic therapies? A. Prasugrel B. Clopidogrel C. Aspirin D. Heparin

D. Heparin

B. Increased PT/INR, increased APTT, normal bleeding time, normal platelet count

B. PT

What test is used to monitor heparin therapy? A. INR B. APTT C. TT D. PT

B. APTT

POCT/BEDSIDE Which of the following is the preferred method to monitor heparin therapy at the point of care during cardiac surgery? A. APTT B. Activated clotting time test (ACT) C. PT D. TT

B. Activated clotting time test (ACT)

B. Use the other arm

Neutrophil in the maturation-storage phase: A. 7 to 10 hours B. 7 to 10 days C. 8.5 hours D. 12 hours

B. 7 to 10 days

Basophil in the maturation-storage phase: A. 7 to 10 hours B. 7 to 10 days C. 8.5 hours D. 12 hours

D. 12 hours

Eosinophil in the maturation-storage phase: A. 2.5 days B. 3.5 days C. 8.5 hours D. 12 hours

A. 2.5 days

Average life span of neutrophils in circulating blood: A. 7 to 10 hours B. 7 to 10 days C. 8.5 hours D. 12 hours

A. 7 to 10 hours

Average life span of basophils in circulating blood: A. 7 to 10 hours B. 7 to 10 days C. 8.5 hours D. 12 hours

C. 8.5 hours

Which of the following parameters can be abnormal in classic von Willebrand's disease type I? A. Bleeding time B. PT C. Platelet count D. All of the above

A. Bleeding time

Platelet aggregation studies in cases of classic von Willebrand’s disease should reveal: A. Normal platelet aggregation when factors such as ristocetin are used for testing B. Absence of aggregation when actors such as epinephrine are used for testing C. Decrease aggregation when factors such as ristocetin are used for testing D. Decreased ADP activity when tested

C. Decrease aggregation when factors such as ristocetin are used for testing

The most common form of vWD is: A. Type I B. Type II C. Type III D. All have about the same incidence

A. Type I

Unique characteristic associated with a deficiency of factor XII deficiency is: A. Frequent nosebleeds B. No history of bleeding C. A common factor deficiency D. Decreased risk of foming blood clots

B. No history of bleeding

Warfarin is a vitamin ___ antagonist. A. B B. C C. D D. K

D. K

Wiskott-Aldrich syndrome is characterize by: A. Giant platelets B. Smallest platelets seen C. Large platelets D. Absence of platelets

B. Smallest platelets seen

May-Hegglin anomaly is characyerized by: A. Giant platelets B. Smallest platelets seen C. Large platelets D. Absence of platelets

C. Large platelets

Bernard-Soulier syndrome is characterize by: A. Giant platelets B. Smallest platelets seen C. Large platelets D. Absence of platelets

A. Giant platelets

Aspirin ingestion has the following hemostatic effect in a normal person: A. Prolongs bleeding time B. Prolongs the clotting time C. Inibits factor VIII D. Has no effect

A. Prolongs bleeding time

Neither the APTT nor the PT detects a deficiency of: A. Platelet factor 3 B. Factor VII C. Factor VIII D. Factor IX

A. Platelet factor 3

Symbolic designation for thrombin is: A. III B. XII C. VIII D. IIa

D. IIa

If a pediatric preoperative patient has a family history of bleeding but has never had a bleeding episode herself, what test should be included in a coagulation profile in addition to the PT, APTT and platelet count? A. Lee and White clotting time B. Clot retraction C. Bleeding time D. Fibrin split products

C. Bleeding time

Stem cells are present in the first few hours after an ovum is fertilized; most versatile type of stem cell: A. Multipotential stem cells B. Pluripotential stem cells C. Totipotential stem cells D. Any of these

C. Totipotential stem cells

Stimulation of erythropoietin is caused by: A. Tissue hypoxia B. Hypervolemia C. Inflammation D. Infection

A. Tissue hypoxia

An erythrocyte remains in the reticulocyte stage in the circulating blood for: A. 1 day B. 2.5 days C. 3 days D. 120 days

A. 1 day

Identify the cell with these characteristics: Prominent primary granules that are rich in myeloperoxidase and chloroacetate esterase and have a diameter of 14 to 20 um. A. Myeloblast B. Promyelocyte C. Myelocyte D. Promonocyte

B. Promyelocyte

The earliest granulocytic maturational stage in which secondary or specific granules appear: A. Myeloblast B. Monoblast C. Promyelocyte D. Myelocyte

D. Myelocyte

Hereditary platelet dysfunction can be caused by: A. Aspirin B. von Willebrand’s disease C. Uremia D. Factor V deficiency

B. von Willebrand’s disease

A normal PDW is: A. Less than 5% B. Less than 10% C. Less than 15% D. Less than 20%

D. Less than 20%

Which clinical or specimen condition will produce an increase reticulocyte count test result? A. Splenectomy B. Rouleaux formation C. Polycythemia D. Hemolytic anemia crisis

D. Hemolytic anemia crisis

On a Wright-stained peripheral blood smear, stress or shift reticulocytes are: A. Smaller than normal reticulocytes B. About the same size as normal reticulocytes C. Larger than normal reticulocytes D. Noticeable because of a decreased blue tint

C. Larger than normal reticulocytes

The number of heme groups in a hemoglobin molecule is: A. 1 B. 2 C. 3 D. 4

D. 4

The average diameter of a normal erythrocyte is _____ um. A. 5.2 B. 6.4 C. 7.2 D. 8.4

C. 7.2

Nantucket Island is an endemic area for: A. P. vivax B. P. falciparum C. Babesiosis D. All of the above

C. Babesiosis

The average adult has _____ g of total iron. A. 0.2 to 1.4 B. 1.5 to 3.4 C. 3.5 to 5.0 D. 5.1 to 10.0

C. 3.5 to 5.0

In IDA, the erythrocytic indices are typically: A. MCV increased, MCH decreased, and MCHC decreased B. MCV decreased, MCH decreased, and MCHC decreased C. MCV decreased, MCH increased, and MCHC decreased D. MCV decreased, MCH decreased, and MCHC normal

B. MCV decreased, MCH decreased, and MCHC decreased

The greatest portion of operational body iron is normally contained in what compound? A. Hemoglobin B. Ferritin C. Cytochromes D. Myoglobin

A. Hemoglobin

Acute leukemia: A. Of short duration with many mature leukocyteforms in the peripheral blood B. Of short duration with many immature leukocyteforms in the peripheral blood C. Of short duration with little alteration of the leukocytes of the peripheral blood D. Of long duration with many mature leukocyte forms in the peripheral blood

B. Of short duration with many immature leukocyteforms in the peripheral blood

Gaucher disease: A. Monocyte-macrophage series B. Neutrophilic series C. Lymphocytic series D. Erythrocytic series

A. Monocyte-macrophage series

Niemann-Pick disease: A. Monocyte-macrophage series B. Neutrophilic series C. Lymphocytic series D. Erythrocytic series

A. Monocyte-macrophage series

Chédiak-Higashi syndrome: A. Monocyte-macrophage series B. Neutrophilic series C. Lymphocytic series D. Erythrocytic series

B. Neutrophilic series

Chronic granulomatous disease: A. Monocyte-macrophage series B. Neutrophilic series C. Lymphocytic series D. Erythrocytic series

B. Neutrophilic series

Lazy leukocyte syndrome: A. Monocyte-macrophage series B. Neutrophilic series C. Lymphocytic series D. Erythrocytic series

B. Neutrophilic series

Acanthocytes are found in association with: A. Abetalipoproteinemia B. G6PD deficiency C. Rh deficiency syndrome D. Vitamin B12 deficiency

A. Abetalipoproteinemia

Maintains cellular energy by generating ATP: A. Methemoglobin reductase pathway B. Hexose monophosphate shunt C. Luebering-Rapaport pathway D. Embden-Meyerhof pathway

D. Embden-Meyerhof pathway

Regulates oxygen affinity of hemoglobin: A. Methemoglobin reductase pathway B. Hexose monophosphate shunt C. Luebering-Rapaport pathway D. Embden-Meyerhof pathway

C. Luebering-Rapaport pathway

Prevents oxidation of heme iron: A. Methemoglobin reductase pathway B. Hexose monophosphate shunt C. Luebering-Rapaport pathway D. Embden-Meyerhof pathway

A. Methemoglobin reductase pathway

Prevents denaturation of globin of the hemoglobin molecule: A. Methemoglobin reductase pathway B. Hexose monophosphate shunt C. Luebering-Rapaport pathway D. Embden-Meyerhof pathway

B. Hexose monophosphate shunt

The megakaryocyte progenitor that undergoes endomitosis is: a. MK-1 b. BFU-Meg c. CFU-Meg d. LD-CFU-Meg

d. LD-CFU-Meg

Increased amounts of 2,3-DPG _____ the oxygen affinity of the hemoglobin molecule. A. Increases B. Decreases C. Does not alter D. Any of these

B. Decreases

The alkaline denaturation test detects the presence of hemoglobin: A. A1C B. F C. C D. S

B. F

If an alkaline (pH 8.6) electrophoresis is performed,hemoglobin E has the same mobility as hemoglobin: A. S B. F C. A D. C

D. C

Basophilic stippling: A. DNA B. Precipitated denatured hemoglobin C. Granules composed of ribosomes and RNA D. Aggregates of iron, mitochondria, and ribosomes

C. Granules composed of ribosomes and RNA

Pappenheimer bodies: A. DNA B. Precipitated denatured hemoglobin C. Granules composed of ribosomes and RNA D. Aggregates of iron, mitochondria, and ribosomes

D. Aggregates of iron, mitochondria, and ribosomes

Heinz bodies: A. DNA B. Precipitated denatured hemoglobin C. Granules composed of ribosomes and RNA D. Aggregates of iron, mitochondria, and ribosomes

B. Precipitated denatured hemoglobin

What is the most common glycolytic enzyme deficiency associated with the aerobic pathway of erythrocyte metabolism? A. Glucose-6-phosphate dehydrogenase (G6PD) B. Pyruvate kinase (PK) C. Methemoglobin reductase deficiency D. Hexokinase deficiency

A. Glucose-6-phosphate dehydrogenase (G6PD)

What is the most common glycolytic enzyme deficiency associated with the anaerobic pathway of erythrocyte metabolism? A. Glucose-6-phosphate dehydrogenase (G6PD) B. Pyruvate kinase (PK) C. Methemoglobin reductase deficiency D. Hexokinase deficiency

B. Pyruvate kinase (PK)

Which of the following is NOT associated with hemolytic anemia? A. Decreased hemoglobin and packed cell volume B. Increased reticulocyte count C. Increased serum haptoglobins D. Decreased erythrocyte survival

C. Increased serum haptoglobins

Major systems in a flow cytometer include all of the following except: A. Fluidics B. Optics C. Computerized electronics D. Gating

D. Gating

A patient being treated for metastatic carcinoma was found to have a white cell count of 5×10^9/L with 5 metarubricytes (nucleated red cells) per 100 white WBCs. What is the corrected white cell count for this patient? A. 2.1 × 10^9/L B. 2.4 × 10^9/L C. 4.8 × 10^9/L D. 5.2 × 10^9/L

C. 4.8 × 10^9/L

A white blood cell (WBC) count and WBC differential are performed. WBC count: 7.0 × 10^9/L; of 100 WBCs classified: 70% neutrophils 20% lymphocytes 7% monocytes 2% eosinophils 1% basophil The absolute neutrophil cell count is: A. 2.10×10^9/L B. 3.55×10^9/L C. 3.99×10^9/L D. 4.9×10^9/L

D. 4.9×10^9/L

Typical dilution for manual RBC count: A. 1:10 B. 1:20 C. 1:100 D. 1:200

C. 1:100

Typical dilution for manual WBC count: A. 1:10 B. 1:20 C. 1:100 D. 1:200

B. 1:20

Typical dilution for manual platelet count: A. 1:10 B. 1:20 C. 1:100 D. 1:200

C. 1:100

For manual WBC count, allow the dilution to sit for ________ to ensure that the red blood cells have lysed. A. 3 minutes B. 5 minutes C. 10 minutes D. 15 minutes

C. 10 minutes

For manual WBC count, after charging the hemacytometer, place it in a moist chamber for _______ before counting the cells to give them time to settle. A. 3 minutes B. 5 minutes C. 10 minutes D. 15 minutes

C. 10 minutes

For manual platelet count, place the charged hemacytometer in a moist chamber for _________ to allow the platelets to settle. A. 3 minutes B. 5 minutes C. 10 minutes D. 15 minutes

D. 15 minutes

Typical dilution for manual platelet count: A. 1:10 B. 1:20 C. 1:100 D. 1:200

C. 1:100

If fewer than 50 platelets are counted on each side, the procedure should be repeated by diluting the blood to: A. 1:10 B. 1:20 C. 1:100 D. 1:200

B. 1:20

If more than 500 platelets are counted on each side, a ___ dilution should be made. A. 1:10 B. 1:20 C. 1:100 D. 1:200

D. 1:200

High WBC count that can cause turbidity and a falsely high hemoglobin result: A. WBCs > 10 x 10 9th/L B. WBCs > 20 x 10 9th/L C. WBCs > 50 x 10 9th/L D. WBCs > 70 x 10 9th/L

B. WBCs > 20 x 10 9th/L

High platelet count that can cause turbidity and a falsely high hemoglobin result: A. Platelets > 150 x 10 9th/L B. Platelets > 200 x 10 9th/L C. Platelets > 500 x 10 9th/L D. Platelets > 700 x 10 9th/L

D. Platelets > 700 x 10 9th/L

Values of the duplicate hematocrits should agree within ____. A. 1% B. 5% C. 10% D. 20%

A. 1%

To improve accuracy of the retic count, have another laboratorian count the other film; counts should agree within _____. A. 1% B. 5% C. 10% D. 20%

D. 20%

The difference between the total cells counted on each side of the counting chamber should be less than ______. A. 1% B. 5% C. 10% D. 20%

C. 10%

The heme portion of the hemoglobin molecule consists of ____ iron (Fe2+) atom and ____ pyrrole rings that are joined to each other. A. 4 iron atoms, 4 pyrrole rings B. 1 iron atom, 2 pyrrole rings C. 1 iron atom, 4 pyrrole rings D. 4 iron atoms, 4 pyrrole rings

C. 1 iron atom, 4 pyrrole rings

Typically the size of a small lymphocyte and has a dark-staining, clumped, nuclear chromatin pattern; the distinctive folded, groove-like chromatin pattern is described as cerebriform. A. Hairy cell B. Sezary cell C. Mott cell D. Reed-Sternberg cell

B. Sezary cell

Its most characteristic feature is that the nucleus begins to assume an indented or kidney bean shape, which will continue to elongate as the cell matures. A. Promyelocyte B. Myelocyte C. Metamyelocyte D. Band

C. Metamyelocyte

A process in which a segment of one chromosome BREAKS AWAY from its normal location: A. Duplication B. Deletion C. Substitution D. Translocation

D. Translocation

Effect of platelet clumping in automated cell counting: A. Decrease platelets and WBCs B. Decrease platelets, increase WBCs C. Increase platelets and WBCs D. Increase platelets, decrease WBCs

B. Decrease platelets, increase WBCs

The majority of the iron in an adult is found as a constituent of: A. Hemoglobin B. Hemosiderin C. Myoglobin D. Transferrin

A. Hemoglobin

Increased numbers of basophils are often seen in: A. Acute infections B. Chronic myelocytic leukemia C. Chronic lymphocytic leukemia D. Erythroblastosis fetalis (hemolytic disease of the newborn)

B. Chronic myelocytic leukemia ## Footnote Basophils may be increased in CML as well as immature neutrophils and eosinophils.

Which of the following is most closely associated with chronic myelogenous leukemia? A. Ringed sideroblasts B. Disseminated intravascular coagulation C. Micromegakaryocytes D. BCR/ABL fusion gene

D. BCR/ABL fusion gene

QUANTITATIVE PLATELET DISORDER The disease state that presents with a quantitative platelet disorder is: A. von Willebrand disease B. Hemophilia A C. Glanzmann thrombasthenia D. May-Hegglin anomaly

D. May-Hegglin anomaly ## Footnote Incorrect Glanzmann's = Qualitative or Functional Platelet Disorder

Evidence of a hemolytic event is present in the peripheral blood smear when which of the following is seen? A. Basophilic stippling B. Increased polychromasia C. Increased target cells D. Stomatocytes

B. Increased polychromasia ## Footnote (due to bone marrow response to blood loss)

A common source of interference in measuring hemoglobin concentration is: A. Hemolysis B. Very high WBC count C. Cold agglutinins D. Clumped platelets

B. Very high WBC count

Automated methods of measuring hemoglobin cannot detect this form: A. Methemoglobin B. Carboxyhemoglobin C. Deoxyhemoglobin D. Sulfhemoglobin

D. Sulfhemoglobin

The hemoglobin variant that is seen frequently in the South East Asian population, demonstrates a microcytic blood smear, and migrates with Hb C at pH 8.6 is: A. Hb Barts B. Hb F C. Hb E D. Hb H

C. Hb E

This AML with recurrent cytogenetic abnormality often presents with disseminated intravascular coagulation: A. Inv(3) B. t(6;9) C. t(8;21) D. t(15;17)

D. t(15;17)

When a patient is placed on warfarin therapy, the first factor that will be decreased is: A. Factor II B. Factor V C. Factor VII D. Factor VI11

C. Factor VII

Protein C and its cofactor protein S proteolytically inactivate factors: A. Ila and Xa B. Va and VIIIa C. VIIIa and IXa D. XIa and Xlla

B. Va and VIIIa

In a patient diagnosed with liver disease, which one of the following factors typically shows an increase? A. Factor VII B. Factor VIII C. Factor IX D. Factor X

B. Factor VIII

Which subtype of von Willebrand disease is the most common A. Type 1 B. Type 2A C. Type 2B D. Type 3

A. Type 1

An initial prenatal evaluation at 10 weeks is conducted on a healthy female. PT, APTT and fibrinogen are normal with the exception of her platelet count, which is 42,000/ul. The peripheral smear shows platelet clumps. What is the next step? A. Conduct a workup for an autoimmune disease B. Evaluate for risk of thromboembolism C. Recollect the sample in EDTA D. Recollect the sample in sodium citrate

D. Recollect the sample in sodium citrate

Platelet aggregation will occur with the end production of: A. Cyclooxygenase B. Arachidonic acid C. Prostacyclin D. Thromboxane A2

D. Thromboxane A2 ## Footnote Thromboxane A2 is necessary for normal platelet aggregation. Its formation initiates a series of events, which results in the secretion and aggregation of platelets.

A new PT reagent is being set up in the coagulation laboratory. The ISI of the new reagent is 1.0; the previous reagent had an ISI of 2.1. The new reagent is said to be: A. More sensitive B. Less sensitive C. Insensitive D. No change

A. More sensitive

One of the coagulation test results that correlates with mortality in patients with the SARS-CoV-2 virus was: A. PT B. APTT C. D-dimer D. Thrombin time

C. D-dimer ## Footnote Patients with COVID-19 present with prolonged coagulation screening tests, but the higher and more persistently high D-dimer levels are associated with poorer outcomes and an increased risk of mortality.

A pregnant woman has routine coagulation testing performed. PT and aPTT are normal. Her fibrinogen level is elevated at 450 (reference range 150-350) due to acute phase reactants during pregnancy. The other factor that may be elevated due to this is: A. FVII B. FVIII C. FXI D. FXIII

B. FVIII ## Footnote vWF and FVIII are acute phase reactants and will be increased in pregnancy, as well as trauma, infection and stress

In order to be a plateletpheresis donor, the platelet count must be at least: A. 150,000/μL B. 200,000/μL C. 250,000/μL D. 300,000/μL

A. 150,000/μL

When RBCs are stored, there is a “shift to the left.” This means: A. Hemoglobin oxygen affinity increases, owing to an increase in 2,3-DPG. B. Hemoglobin oxygen affinity increases, owing to a decrease in 2,3-DPG. C. Hemoglobin oxygen affinity decreases, owing to a decrease in 2,3-DPG. D. Hemoglobin oxygen affinity decreases, owing to an increase in 2,3-DPG.

B. Hemoglobin oxygen affinity increases, owing to a decrease in 2,3-DPG.

Increased risk of thrombosis: 1.Young-old 2.Old-old 3.Very old A. 3 only B. 1 and 3 C. 2 and 3 D. 1, 2 and 3

D. 1, 2 and 3

In manual wedge technique, the PUSHER SLIDE is held securely in the dominant hand at about: A. 15 to 20 degree angle B. 30 to 45 degree angle C. 45 to 50 degree angle D. 50 to 75 degree angle

B. 30 to 45 degree angle

When the hematocrit is higher than normal (60%), as is found in patients with polycythemia or in newborns, the angle should be: A. 15 B. 25 C. 35 D. 50

B. 25

Uneven or dirty edge of spreader slide: A. Ridges or waves in smear B. Holes in smear C. Artifacts or unusual cell appearance D. Smear too thin

B. Holes in smear

Uneven pressure on spreader slide: A. Smear too short B. Smear too long C. Ridges or waves in smear D. Artifacts or unusual cell appearance

C. Ridges or waves in smear

RBC with membrane folded over: A. Aplastic anemia B. Iron deficiency anemia C. Hemoglobin C, hemoglobin SC disease D. Sickle cell anemia, thalassemia

C. Hemoglobin C, hemoglobin SC disease

Inadequate fibrinolysis: a. Bleeding, incomplete wound healing b. Bleeding and thrombosis c. Clot extension and thrombosis d. Clot extension and thrombosis, incomplete wound healing

c. Clot extension and thrombosis ## Footnote FIBRINOLYSIS Final stage of coagulation, begins a few hours after fibrin polymerization and cross-linking There should be a balance between activators and inhibitors EXCESSIVE FIBRINOLYSIS Can cause BLEEDING due to premature clot lysis before wound healing is established INADEQUATE FIBRINOLYSIS Can lead to CLOT EXTENSION AND THROMBOSIS

ADAMTS-13 deficiency is responsible for thrombocytopenia found in: A. TTP B. DIC C. HUS D. ITP

A. TTP

All of the following are sites for bone marrow aspiration. Preferred for adults: A. Anterior iliac crest B. Posterior iliac crest C. Sternum D. Tibia

B. Posterior iliac crest

All of the following are sites for bone marrow aspiration. Infants younger than 18 months: A. Anterior iliac crest B. Posterior iliac crest C. Sternum D. Tibia

D. Tibia

A decreased osmotic fragility test would be associated with which of the following conditions? A. Sickle cell anemia B. Hereditary spherocytosis C. Hemolytic disease of the newborn D. Acquired hemolytic anemia

A. Sickle cell anemia

Which of the following statistical terms reflects the best index of precision when comparing two CBC parameters? A. Mean B. Median C. Coefficient of variation D. Standard deviation

C. Coefficient of variation

Which is the first stage of erythrocytic maturation in which the cytoplasm is pink due to the formation of hemoglobin? A. Reticulocyte B. Pronormoblast C. Basophilic normoblast D. Polychromatic normoblast

D. Polychromatic normoblast

Which is the major Hgb found in the RBCs of patients with sickle cell trait? A. Hgb S B. Hgb F C. Hgb A2 D. Hgb A

D. Hgb A

An autohemolysis test is positive in all the following conditions except: A. Glucose-6-phosphate dehydrogenase (G6PD)deficiency B. Hereditary spherocytosis (HS) C. Pyruvate kinase (PK) deficiency D. Paroxysmal nocturnal hemoglobinuria (PNH)

D. Paroxysmal nocturnal hemoglobinuria (PNH)

Microangiopathic hemolytic anemia is characterized by: A. Target cells and Cabot rings B. Toxic granulation and Döhle bodies C. Pappenheimer bodies and basophilic stippling D. Schistocytes and nucleated RBCs

D. Schistocytes and nucleated RBCs

Iron deficiency anemia may be distinguished from anemia of chronic infection by: A. Serum iron level B. Red cell morphology C. Red cell indices D. Total iron-binding capacity

D. Total iron-binding capacity

Which of the following may be seen in the peripheral blood smear of a patient with obstructive liver disease? A. Schistocytes B. Macrocytes C. Howell–Jolly bodies D. Microcytes

B. Macrocytes

Which of the following is contained in the primary granules of the neutrophil? A. Lactoferrin B. Myeloperoxidase C. Histamine D. Alkaline phosphatase

B. Myeloperoxidase

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

B. Giant lysosomal granules

B. Acute promyelocytic leukemia

The WHO classification requires what percentage for the blast count in the blood or bone marrow for the diagnosis of AML? A. At least 30% B. At least 20% C. At least 10% D. Any percentage

B. At least 20%

In essential thrombocythemia, the platelets are: A. Increased in number and functionally abnormal B. Normal in number and functionally abnormal C. Decreased in number and functional D. Decreased in number and functionally abnormal

A. Increased in number and functionally abnormal

CML is distinguished from leukemoid reaction by which of the following? A. CML: low LAP; leukemoid: high LAP B. CML: high LAP; leukemoid: low LAP C. CML: high WBC; leukemoid: normal WBC D. CML: high WBC; leukemoid: higher WBC

A. CML: low LAP; leukemoid: high LAP

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

B. The prognosis is better if Ph1 is present

Patients with Waldenström’s macroglobulinemia exhibit abnormally large amounts of: A. IgM B. IgG C. IgE D. IgA

A. IgM

What reagents are used in the PT test? A. Thromboplastin and sodium chloride B. Thromboplastin and potassium chloride C. Thromboplastin and calcium D. Actin and calcium chloride

C. Thromboplastin and calcium

A protein that plays a role in both coagulation and platelet aggregation is: A. Factor I B. Factor VIII C. Factor IX D. Factor XI

A. Factor I

Aspirin prevents platelet aggregation by inhibiting the action of which enzyme? A. Phospholipase B. Cyclo-oxygenase C. Thromboxane A2 synthetase D. Prostacyclin synthetase

B. Cyclo-oxygenase

Which of the following prevents platelet aggregation? A. Thromboxane A2 B. Thromboxane B2 C. Prostacyclin D. Antithrombin

C. Prostacyclin

Which test result would be normal in a patient with dysfibrinogenemia? A. Thrombin time B. APTT C. PT D. Immunologic fibrinogen level

D. Immunologic fibrinogen level

Factor XII deficiency is associated with: A. Bleeding episodes B. Epistaxis C. Decreased risk of thrombosis D. Increased risk of thrombosis

D. Increased risk of thrombosis

Fletcher factor (prekallikrein) deficiency may be associated with: A. Bleeding B. Thrombosis C. Thrombocytopenia D. Thrombocytosis

B. Thrombosis

The most common subtype of classic von Willebrand’s disease is: A. Type 1 B. Type 2A C. Type 2B D. Type 3

A. Type 1

A 50-year-old man has been on heparin for the past 7 days. Which combination of the tests is expected to be abnormal A. PT and APTT only B. APTT, TT only C. APTT, TT, fibrinogen assay D. PT, APTT, TT

D. PT, APTT, TT ## Footnote Heparin is a therapeutic anticoagulant with an antithrombin activity. Heparin also inhibits factors XIIa, XIa, Xa, and IXa. In patients receiving heparin therapy, the PT, APTT, and TT are all prolonged. Quantitative fibrinogen assay, however, is not affected by heparin therapy.

What clotting factors (cofactors) are inhibited by protein S? A. V and X B. Va and VIIIa C. VIII and IX D. VIII and X

B. Va and VIIIa

Which of the following tests is most likely to be abnormal in patients taking aspirin? A. Platelet morphology B. Platelet count C. Bleeding time D. Prothrombin time

C. Bleeding time

The Bethesda assay is used for which determination? A. Lupus anticoagulant titer B. Factor VIII inhibitor titer C. Factor V Leiden titer D. Protein S deficiency

B. Factor VIII inhibitor titer

Heparin-induced thrombocytopenia (HIT) results from: A. Antibodies to heparin B. Antibodies to platelets C. Antibodies to PF4 D. Antibodies to heparin-PF4 complex

D. Antibodies to heparin-PF4 complex

A standard blue-top tube filled appropriately (with 4.5 mL blood) was submitted to the laboratory for preoperative PT and APTT testing. The results of both tests were elevated. The patient’s PT and APTT from the previous day were within normal limits, and he is not on heparin therapy. Which is the most appropriate first step to investigate the abnormal results? A. Report the result as obtained B. Perform a mixing study C. Check the sample for a clot D. Report the APTT only

C. Check the sample for a clot

A plasma sample submitted to the lab for PT testing has been stored for 25 hours at 4°C. The PT result is shortened. What is the most probable cause? A. Factor VII deficiency B. Activation of factor VII due to exposure to cold temperature C. Lupus inhibitor D. Factor X inhibitor

B. Activation of factor VII due to exposure to cold temperature

A three-part blood cell differential separates: A. Erythrocytes, leukocytes, and platelets B. Monocytes, granulocytes, and lymphocytes C. Mononuclear cells, granulocytes, and lymphocytes D. Segmented neutrophils, eosinophils, and basophils

C. Mononuclear cells, granulocytes, and lymphocytes

Penicillin given in massive doses has been associated with RBC hemolysis. Which of the classic mechanisms is typically involved in the hemolytic process? A. Immune complex. B. Drug adsorption. C. Membrane modification. D. Autoantibody formation.

B. Drug adsorption.

Which of the following can be given to an apheresis donor to increase the number of circulating granulocytes? A. DDAVP B. Hydroxyethyl starch (HES) C. Immune globulin D. G-CSF

D. G-CSF

The most common anticoagulant used for apheresis procedures is: A. Heparin B. Sodium fluoride C. Warfarin D. Citrate

D. Citrate

Which of the following is considered to be an advantage of the mechanical end-point detection methodology? a. It is not affected by lipemia in the sample b. It has the ability to provide a graph of clot formation c. It can incorporate multiple wavelengths into a single testing sequence d. It can measure proteins that do not have fibrin formation as the end-point

a. It is not affected by lipemia in the sample

What test is commonly used to monitor warfarin therapy? a. INR b. APTT c. TT d. Ecarin time

a. INR ## Footnote INR og 2.0 - 3.0 a higher dose of warfarin (INR 2.5-3.5) is required for patients with mechanical heart valves

A patient on warfarin therapy will be deficient in a functional amount of: a. Fibrinogen and prothrombin b. Stable and labile factors c. Protein C and protein S d. Fletcher and Firtzgerald factors

c. Protein C and protein S ## Footnote Vit K is requried for liver synthesis of regulatory proteins C and S and funcitonal clotting

Ecarin clotting time may be used to monitor: a. Heparin therapy b. Warfarin therapy c. Fibrinolytic therapy d. Hirudin therapy

d. Hirudin therapy

Key component of hemostatis: a. Platelets b. Coagulation c. Fibrinolysis

a. Platelets

Upon stimulation, platelets change in shape from discoid to ____, extend pseudopodsm undergo internal contraction resulting in centralization of their alpha granules and dense granules, and release the granule contents. a. Cylindrical b. Irregular c. Oval d. Spherical

d. Spherical

All but one are related: a. Eicosanoid synthesis pathway b. Prostaglandin pathway c. Cycloosygenase pathway d. Thromboxane pathway e. IP3-DAG

e. IP3-DAG ## Footnote Platelet activation pathways 1.Eicosanoid - alternatively prostaglandin, cyclooxygenase, or thromboxane 2.IP3-DAG

Aspirin prevents platelet aggregation by inhibiting the action of which enzyme? A. Phospholipase B. Cyclo-oxygenase C. Thromboxane A2 synthetase D. Prostacyclin synthetase

B. Cyclo-oxygenase

Which of the following tests is most likely to be abnormal in patients taking aspirin? A. Platelet morphology B. Platelet count C. Bleeding time D. Prothrombin time

C. Bleeding time

At all times, approximately ____ of the total number of platelets are in the systemic circulation: A.One fourth B.One third C.One half D.Two thirds

D.Two thirds

Normal platelet adhesion depends upon: a. Fibrinogen b. Glycoprotein Ib c. Gycoprotein IIb, IIIa complex d. Calcium

b. Glycoprotein Ib

Bernard soulier syndrome is associated with: a. Decreased bleeding time b. Decreased factor VIII assay c. Thrombocytopenia and giant platelets d. Abnormal platelet aggregation to ADP

c. Thrombocytopenia and giant platelets

Primary Platelet aggregation disorders: a. Bernard soulier syndrome b. Glanzmann' s thrombasthenia c. Essential anthrombia d. Both B and C

d. Both B and C

Which defect charcterizes Gray's syndrome? a. Platelet adhesion defect b. Dense granule defect c. Alpha granule defect d. Coagulation defect

c. Alpha granule defect

In END-STAGE LIVER DISEASE, the fibrinogen level may fall to less than mg/dL, which is a mark of liver failure. A.Less than 100 mg/dL B.Less than 150 mg/dL C.Less than 200 mg/dL D.Less than 300 mg/dL

A.Less than 100 mg/dL

Fibrinogen, which has been implicated as a primary risk factor for thrombotic disorders, increases approximately mg/dL per DECADE in the elderly (65 to 79 years), 174 from 280 mg/dL to over 300 mg/dL. A.1 mg/dL per decade B.3 mg/dL per decade C.5 mg/dL per decade D.10 mg/dL per decade

D.10 mg/dL per decade

Primary substrate of thrombin: A.Fibrinogen B.Prothrombin C.Factor V D.Factor X

A.Fibrinogen

True of platelet satellitism (satellitosis): A. ANTIBODY-MEDIATED in vitro adhesion of platelets to segmented neutrophils B. Occurs primarily in specimens anticoagulated with EDTA C. Causes pseudothrombocytopenia D.All of these

D.All of these EDTA-induced platelet clumping or satellitosis causes automated analyzers to report falsely decreased platelet counts (pseudothrombocytopenia) and falsely increased WBC counts (pseudoleukocytosis). USING SODIUM CITRATE AS THE ANTICOAGULANT SHOULD CORRECT THIS PROBLEM. Heparinized specimens have never been validated for use in plasma coagulation testing but may be necessary in cases of platelet satellitosis (satellitism) as a substitute for specimens collected in EDTA or sodium citrate.

Clot retraction is a function of: A.Factor XIII B.Thromboplastin C.Thrombosthenin D.Thromboxane A2

C.Thrombosthenin

Which of the following initiates in vivo coagulation by activation of factor VII? A. Protein C B. Tissue factor C. Plasmin activator D. Thrombomodulin

B. Tissue factor

Most common congenital bleeding disorder: A.von Willebrand's disease B.Hemophilia A C.Hemophilia B D.Platelet function disorders

A.von Willebrand's disease

Initial work-up for wWD: А.СВС B. CBC, PT and APTT C.CBC, PT, APTT and BT D.BT and automated functional platelet assays

B .CBC, PT and APTT

Definitive diagnosis of wWD: A.CBC, PT and APTT B.CBC, PT, APTT and BT C.BT and automated functional platelet assays D.Personal and family history of mucocutaneous bleeding and the laboratory demonstration of decreased VWF activity

D.Personal and family history of mucocutaneous bleeding and the laboratory demonstration of decreased VWF activity

The most common subtype of classic von Willebrand's disease is: A. Type 1 В. Туре 2A С. Туре 2B D. Type 3

A. Type 1

The most common subtype of classic von Willebrand's disease is: A. Type 1 В. Туре 2A С. Туре 2B D. Type 3

A. Type 1 The most common subtype is subtype 1, and 70%-80% of these cases are associated with mild bleeding Subtype 3 involves the total absence of the von Willebrand's molecule and is associated with severe bleeding. Subtypes 2A and 2B result in deficiency of intermediate and/or high molecular weight portions of the von Willebrand molecule and are associated with 10%-12% and 3%-6% of cases of von Willebrand's disease, respectively. Patients with type III, the most severe form of von Willebrand's disease, are likely to have a major episode of bleeding early in life because significantly decreased amounts of VWF and VIII:C are produced. DDAVP, a synthetic vasopressin analog, can stimulate release of the WWF from the vascular endothelium in type I patients.

Blood to anticoagulant ratio in citrate tube for coagulation studies: A.9:1 B.1:9 C.1:4 D.1:10

A.9:1

Specimen used for coagulation tests: A.Platelet-rich plasma (PRP) B.Platelet-poor plasma (PPP) C.Serum D.Whole blood

B.Platelet-poor plasma (PPP)

Which results would be expected for the prothrombin time (PT) and activated partial thromboplastin time (APTT) in a patient with polycythemia? A. Both prolonged B. Both shortened C. Normal PT, prolonged APTT D. Both normal

A. Both prolonged

Normal cells in BM, except: A. Macrophages B. Myeloblast C. Reticulocyte D. Plasmablast

D. Plasmablast The plasmablast and proplasmacyte stages are not found in the normal BM; however the proplasmacyte will usually be present in multiple myeloma.

D. Polychromatic normoblast In normal erythrocytic maturation, Hgb formation in the late polychromatic normoblast stage gives the cytoplasm a prominent pink coloration. The red cell continues to produce Hgb throughout the reticulocyte stage of development.

Tertiary granules: 1. Promyelocyte 2.Myelocyte 3.Metamyelocyte 4. Band A.1 and 2 are correct B.2 and 3 are correct C.1, 2 and 3 are correct D.3 and 4 are correct

D.3 and 4 are correct

Carry proteins from secondary granules to be released into the extracellular medium: A.Primary granules B.Small lysosomal granules C.Lipid bodies D.Storage vesicles

D.Storage vesicles

Eosinophil lipid bodies: 1.Catalase 2.Cyclooxygenase 3. Elastase 4. Esterase A.1 and 2 B.1 and 3 C.2 and 4 D.3 and 4

C.2 and 4

Least diff. PIt Precursor: A LD CFU-Meg B. MK -1 С. МК- II D. МК - ІІІ

B. MK -1

In ______, the tetraploid DNA is checked for proper replication and damage, takes approximately 4 hours. A. G1 B. S C. G2 D. M

C. G2

The portion of DNA that is inactive during transcription to messenger RNA and stains deeply with Wright stain: A. Heterochromatin B. Euchromatin

A. Heterochromatin

What is the first type of cell produced by the developing embryo? A. Erythrocyte В. Granulocyte C. Lymphocyte D. Thrombocyte

A. Erythrocyte

Which of the following is the preferable site for bone marrow aspiration and biopsy in an adult? A. Iliac crest B. Sternum C. Tibia D. Spinous processes of a vertebra

A. Iliac crest

As most blood cell lines mature, which of the following is characteristic? A. Cell diameter increases B. Nucleus to cytoplasm ratio (N:C) decreases C. Nuclear chromatin becomes less condensed D. Basophilia of the cytoplasm increases

B. Nucleus to cytoplasm ratio (N:C) decreases

D. Polychromatic normoblast

Which of the following red blood cell precursors is the last stage to undergo mitosis? A. Pronormoblast B. Basophilic normoblast C. Polychromatophilic normoblast D. Orthochromic normoblast

C. Polychromatophilic normoblast

Where do the early and late stages of heme synthesis occur? A.On ribosomes B.In mitochondria C.In cytoplasm D.In nucleoli

B.In mitochondria

Reticulocytosis usually indicates: A. Response to inflammation B. Neoplastic process C.Aplastic anemia D.Red cell regeneration

D.Red cell regeneration

Production of primary granules ceases and production of secondary granules commences with what cell stage? A. Myeloblast B. Promyelocyte C. Myelocyte D. Metamyelocyte

C. Myelocyte

The most mature granulocyte precursor that can undergo mitosis is the A. Myeloblast B. Promyelocyte C. Myelocyte D.Metamyelocyte

C. Myelocyte

Which of the following is contained in the primary granules of the neutrophil? A. Lactoferrin B. Myeloperoxidase C. Histamine D. Alkaline phosphatase

B. Myeloperoxidase Myeloperoxidase, lysozyme, and acid phosphatase are enzymes that are contained in the primary granules of neutrophils. The contents of secondary and tertiary granules include lactoferrin, collagenase, NADPH oxidase, and alkaline phosphatase.

The most mature granulocyte precursor that can undergo mitosis is the A. Myeloblast B. Promyelocyte C. Myelocyte D.Metamyelocyte

C. Myelocyte

What does the granulocyte mitotic pool in the bone marrow contain? A. Myeloblasts and promyelocytes B. Band and segmented forms C. The majority of marrow granulocytes D. Myelocytes and metamyelocytes

A. Myeloblasts and promyelocytes

What is the approximate amount of time a granulocyte spends in the circulation before migrating into the tissues? A.Less than 1 day B.About 3 days C. Up to 5 days D.More than 10 days

A.Less than 1 day

What is the second stage of phagocytosis? A. Ingestion B. Killing and Digestion C. Formation of Neutrophil Extracellular Traps D. Recognition and Attachment

A. Ingestion

Which of the following is not a characteristic of T lymphocytes? A. Secrete cytokines B. Synthesize antibody C. Comprise majority of cells in the blood lymphocyte pool D. Regulate the immune response

B. Synthesize antibody

The largest hematopoietic cells in normal bone marrow are: A. Osteoblasts B. Osteoclasts C. Megakaryocytes D. Plasma cells

C. Megakaryocytes

Which of the following is not a normal maturation stage for platelets? A. Megakaryoblast B. Promegakaryocyte C. Micromegakaryocyte D. Megakaryocyte

C. Micromegakaryocyte

An increase in which one of the following suggests a shortened life span of RBCs and hemolytic anemia? A. Hemoglobin B. Hematocrit C. Reticulocyte count D. Red cell distribution width

C. Reticulocyte count

Which antibiotic(s) is (are) most often implicated in the development of aplastic anemia? A. Sulfonamides B. Penicillin C. Tetracycline D. Chloramphenicol

D. Chloramphenicol

The macrocytes typically seen in megaloblastic processes are: A. Crescent-shaped B. Teardrop-shaped C. Ovalocytic D. Pencil-shaped

C. Ovalocytic

Which of the following is detectable only by examination of a peripheral blood film? A. Microcytosis B. Anisocytosis C. Hypochromia D. Poikilocytosis

D. Poikilocytosis

Which of the following disorders has an increase in osmotic fragility? A. Iron deficiency anemia B. Hereditary elliptocytosis C. Hereditary stomatocytosis D. Hereditary spherocytosis

D. Hereditary spherocytosis

Microangiopathic hemolytic anemia is characterized by: A. Target cells and Cabot rings B. Toxic granulation and Döhle bodies C. Pappenheimer bodies and basophilic stippling D. Schistocytes and nucleated RBCs

D. Schistocytes and nucleated RBCs

The red cells found in lead poisoning characteristically exhibit coarse granules composed of that are reported as: A. Precipitated hemoglobin; Pappenheimer bodies B. Aggregated ribosomes; basophilic stippling C. Nuclear fragments; Pappenheimer bodies D. Excess iron deposits; basophilic stippling

B. Aggregated ribosomes; basophilic stippling

Which of the following erythrocyte inclusions can be visualized with supravital stain but cannot be detected on a Wright's-stained blood smear? A. Basophilic stippling B. Heinz bodies c. Howell-Jolly bodies D. Siderotic granules

B. Heinz bodies

Which of the following organs is responsible for the "pitting process" for RBCs? A. Liver B. Spleen C. Kidney D. Lymph nodes

B. Spleen

"Bite cells" are usually seen in patients with: A. Rh null trait B. Chronic granulomatous disease C. G6PD deficiency D. PK deficiency

C. G6PD deficiency

Which of the following inherited leukocyte disorders is caused by a mutation in the lamin B receptor? A. Pelger-Huët anomaly B. Chédiak-Higashi disease C. Alder-Reilly anomaly D. May-Hegglin anomaly

A. Pelger-Huët anomaly The disorder is a result of a mutation in the lamin ß-receptor gene. The lamin B plays a major role in leukocyte nuclear shape changes that occur during normal maturation.

In which anomaly is a failure of granulocytes to divide beyond the band or two-lobed stage observed? A. Pelger-Huet B. May-Hegglin C. Alder-Reilly D. Chediak-Higashi

A. Pelger-Huet

Which of the following inherited leukocyte disorders might be seen in Hurler syndrome? A. Pelger-Huët anomaly B. Chédiak-Higashi disease C. Alder-Reilly anomaly D. May-Hegglin anomaly

C. Alder-Reilly anomaly

Which of the following inherited leukocyte disorders is one of a group of disorders with mutations in nonmuscle myosin heavy-chain IIA? A. Pelger-Huët anomaly B. Chédiak-Higashi disease C. Alder-Reilly anomaly D. May-Hegglin anomaly

D. May-Hegglin anomaly Inclusions in May-Hegglin anomaly are composed of precipitated myosin heavy chains.

What leukocyte cytoplasmic inclusion is composed of ribosomal RNA? A. Primary granules B. Toxic granules C. Döhle bodies D. Howell-Jolly bodies

C. Döhle bodies

Which of the following represents the principal defect in chronic granulomatous disease (CGD)? A. Chemotactic migration B. Phagocytosis C. Lysosomal formation and function D. Oxidative respiratory burst

D. Oxidative respiratory burst

The atypical lymphocyte seen in the peripheral smear of patients with infectious mononucleosis is probably DERIVED from which of the following? A. T lymphocytes B. B lymphocytes C. Monocytes D. Mast cells

A. T lymphocytes

The atypical lymphocyte seen in the peripheral smear of patients with infectious mononucleosis is REACTING to which of the following? A. lymphocytes B. B lymphocytes C. Monocytes D. Mast cells

B. B lymphocytes

B. Gaucher disease

The WHO classification requires what percentage for the blast count in the blood or bone marrow for the diagnosis of AML? A. At least 30% B. At least 20% C. At least 10% D. Any percentage

B. At least 20% FAB: min. 30% blasts WHO: min. 20% blasts

B. Acute promyelocytic leukemia

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

A. Acute myelocytic leukemia (AML)

Which of the following reactions are often positive in ALL but are negative in AML? A. Terminal deoxynucleotidyl transferase and PAS B. Chloroacetate esterase and nonspecific esterase C. Sudan Black B and peroxidase D. New methylene blue and acid phosphatase

A. Terminal deoxynucleotidyl transferase and PAS

What would be the most likely designation by the WHO for the FAB AML M3 by the French-American-British classification? A. AML with t(15;17) B. AML with mixed lineage C. AML with t(8;21) D. AML with inv(16)

A. AML with t(15;17)

What would be the most likely designation by the WHO for the FAB AML M2 by the French-American-British classification? A. AML with t(15;17) B. AML with mixed lineage C. AML with t(8;21) D. AML with inv(16)

C. AML with t(8;21)

A patient with normal chromosomes has a WBC count of 3.0 x10 9th/L and dysplasia in all cell lines. There are 60% blasts of varying sizes. The blasts stain positive for CD61. The most likely type of leukemia is: A. Acute lymphoblastic B. Acute megakaryoblastic C. Acute monoblastic D. AML with t(15;17)

B. Acute megakaryoblastic

The JANUS KINASE or JAK2 mutation may be positive in all of the following chronic myeloproliferative disorders except: A. Essential thrombocythemia B. Idiopathic myelofibrosis C. PV D. CML

D. CML

+ MPO + SBB (-) Tdt

AML 1. Peroxidase/Myeloperoxidase (MPO) Marker for primary granules (+) AML (-) ALL SBB 2. Sudan Black B (SBB) (+) AML (-) ALL 3. Terminal deoxyribonucleotidyltransferase (Tdt) Marker for immature lymphocytes (+) ALL (-) AML

(-) MPO (-) SBB (+) Tdt

ALL 1. Peroxidase/Myeloperoxidase (MPO) Marker for primary granules (+) AML (-) ALL SBB 2. Sudan Black B (SBB) (+) AML (-) ALL 3. Terminal deoxyribonucleotidyltransferase (Tdt) Marker for immature lymphocytes (+) ALL (-) AML

(+) CAE (-) NSE

Myeloblastic leukemia (M1, M2)

(-) САЕ (+) NSE

Monocytic leukemia (M5)

(+) САЕ (+) NSE

Myelomonocytic leukemia (M4)

Which of the following cells is characteristic of Hodgkin's disease? A. Niemann-Pick cells B. Reactive lymphocytes C. Flame cells D. Reed-Sternberg cells

D. Reed-Sternberg cells

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

C. Hairy cell leukemia

A. CML: low LAP; leukemoid: high LAP

In which of the following conditions does LAP show the least activity? A. Leukemoid reactions B. Idiopathic myelofibrosis C. PV D. CML

D. CML

B. The prognosis is better if Ph1 is present

In myelofibrosis, the characteristic abnormal red blood cell morphology is that of: A. Target cells B. Schistocytes C. Teardrop cells D. Ovalocytes

C. Teardrop cells

In ESSENTIAL THROMBOCYTHEMIA, the platelets are: A. Increased in number and functionally abnormal B. Normal in number and functionally abnormal C. Decreased in number and functional D. Decreased in number and functionally abnormal

A. Increased in number and functionally abnormal

In PV, what is characteristically seen in the peripheral blood? A. Panmyelosis B. Pancytosis C. Pancytopenia D. Panhyperplasia

B. Pancytosis

Detects lymphocytic cells and certain abnormal erythrocytic cells by staining of cytoplasmic glycogen: A. Periodic acid Schiff (PAS) B. Esterase C. Peroxidase D. Sudan black B (SBB)

A. Periodic acid Schiff (PAS)

If the stain cannot be performed immediately, the unfixed smears may be stored in the dark at room temperature for up to 2 weeks without significant loss of activity. A. Periodic acid Schiff (PAS) B. Esterase C. Peroxidase D. Sudan black B (SBB)

B. Esterase

Hemoglobin is measured spectrophotometrically at which of the following wavelength: A. 340 nm B. 440 nm C. 450 nm D. 540 nm

D. 540 nm

Using manual techniques, the most reproducible test of the following is: A. Leukocyte count B. Hemoglobin determination C. Hematocrit determination D. Platelet count

C. Hematocrit determination

The relative centrifugal force require in the microhematocrit is: A. 2, 500 G В. 3, 000 G C. 5, 000 G D. 10,000 G

D. 10,000 G

Which of the following manual tests is least reliable? A. Erythrocyte count B. Leukocyte count C. Hemoglobin D. Hematocrit

A. Erythrocyte count

When nucleated RBCs are present in the smear, the leukocyte count must be corrected because: A. Nucleated RBCs are counted as leukocytes B. Leukocyte count should be higher C. Leukocyte count should correlate with the low RBC count D. Nucleated RBCs are confused with platelets

A. Nucleated RBCs are counted as leukocytes

The total leukocyte count should be corrected if more than __ nucleated RBC/100 WBCs are seen in the differential count. A. 1 B. 3 C. 5 D. 12

C. 5

In the Coulter series, which parameter is calculated rather than directly measured: A. Hematocrit B. RBC count C. WBC count D. Hemoglobin

A. Hematocrit

Difference between the manual hematocrit to the automated hematocrit due to trapped plasma: A. 1 to 3% B. 1 to 5% С. 10% D. 15%

A. 1 to 3% Increased in macrocytic anemias, spherocytosis, thalassemia, hypochromic anemia and sickle cell anemia. Spun hematocrit result may vary from 1 to 3% higher because of this trapped plasma

The X-axis on a blood cell histogram represents: A. Cell size B. Relative number of cells C. Forward light scatter D. Right angle light scatter

A. Cell size

Side angle scatter in a laser-based cell counting system is used to measure: A. Cell size В. Cytoplasmic granularity C. Cell number D. Immunologic (antigenic) identification

В. Cytoplasmic granularity

Autoagglutination of red cells at room temperature can cause which of the following abnormal test results? A. Low RBC count B. High MCV C. Low hematocrit D. All of these options

D. All of these options Autoagglutination at room temperature may cause a low RBC count and high MCV from an electronic counter. The Hct will be low because it is calculated from the RBC count. Low RBC count and low Hct cause falsely high calculations of MCH and MCHC, respectively.

Effects of cold agglutinins 1. Increased MCHC 2. Increased MCV 3. Decreased MCH 4. Decreased RBC count A. 1 and 3 B. 1, 2 and 3 C. 1, 2 and 4 D. 1, 2, 3 and 4

C. 1, 2 and 4

All of the following are causes of spurious increase in WBCs, except: A. Cryoglobulin B. Cryofibrinogen C. Monoclonal proteins D. Smudge cells

D. Smudge cells

All of the following are causes of spurious increase in RBCs, except: A. Autoagglutination B. Cryoglobulin, cryofibrinogen C. Giant platelets D. High WBCS

A. Autoagglutination

Platelet clumps: A. Decreased platelets and WBCs B. Increased platelets and WBCs C. Decreased platelets, increased WBCs D. Increased platelets, decreased WBCs

C. Decreased platelets, increased WBCs

Leukemia, especially with chemotherapy: A. Decreased platelets and WBCs B. Increased platelets and WBCs C. Decreased platelets, increased WBCs D. Increased platelets, decreased WBCs

D. Increased platelets, decreased WBCs

What are the initial laboratory tests that are performed for the diagnosis of anemia? A. CBC, iron studies, and reticulocyte count B. CBC, reticulocyte count, and peripheral blood film examination C. Reticulocyte count and serum iron, vitamin B12, and folate assays D. Bone marrow study, iron studies, and peripheral blood film examination

B. CBC, reticulocyte count, and peripheral blood film examination

The morphological classification of anemias is based on which of the following? A. M:E (myeloid:erythroid) ratio B. Prussian blue stain C. RBC indices D. Reticulocyte count

C. RBC indices

Which of the following is a pure red cell aplasia? A. Bernard-Soulier syndrome B. Diamond-Blackfan anemia C. DiGuglielmo's disease D. Fanconi's anemia

B. Diamond-Blackfan anemia

A leukoerythroblastic reaction is characterized by the presence of _ in the peripheral blood: A. Immature leukocytes and nucleated erythrocytes B. Leukocytosis and erythrocytosis C. Lymphocytosis and neutropenia D. Pseudo-Pelger Huet cells

A. Immature leukocytes and nucleated erythrocytes

The anemia seen in sickle cell disease is usually: A. Microcytic, normochromic B. Microcytic, hypochromic C. Normocytic, normochromic D. Normocytic, hypochromic

C. Normocytic, normochromic

Which is the major Hgb found in the RBCs of patients with sickle cell trait? A. Hgbs B. Hgb F C. Hgb A2 D. Hgb A

D. Hgb A

Iron deficiency anemia may be distinguished from anemia of chronic infection by: A. Serum iron level B. Red cell morphology C. Red cell indices D. Total iron-binding capacity

D. Total iron-binding capacity

Which morphological classification is characteristic of megaloblastic anemia? A. Normocytic, normochromic B. Microcytic, normochromic C. Macrocytic, hypochromic D. Macrocytic, normochromic

D. Macrocytic, normochromic

Which of the following is (are) characteristic(s) of erythropoietin? A. Glycoprotein B. Secreted by the liver C. Secreted by the kidneys D. All of the above

D. All of the above

In the blast stage of development of leukocytes, the cytoplasm of the cell is: A. Dark blue and lacks vacuoles B. Light blue and lacks vacuoles C. Light blue and has specific granules D. Gray with many dark-blue granules

B. Light blue and lacks vacuoles

Painful crises in patients with SCD occur as a result of: A. Splenic sequestration B. Aplasia C. Vasoocclusion D. Anemia

C. Vasoocclusion

For platelet aggregation and energy production: a. Peripheral zone b. Sol-gel zone c. Organelle zone d. Membraneous system

c. Organelle zone

Biochemical abnormalities characteristic of PCV include: a. Increased serum B12 binding capacity b. Hypohistaminemia c. Hypouricemia d. Decreased leukocyte alkaline phosphatase activity

a. Increased serum B12 binding capacity

The MPV is often decreased a. In sickle cell anemia b. In megaloblastic anemia c. In idiopathic thrombocytopenic purpura d. After splenectomy

b. In megaloblastic anemia

Reticulocytes can be detecte by using ____ stain a. new methylene blue b. thiazole orange c. propidium iodide d. both a and b

d. both a and b

Heparin - induced thrombocytopenia (HIT) results from: a. antibodies to heparin b. antibodies to platelets c. antibodies to PF4 d. antibodies to heparin-PF4 complex

d. antibodies to heparin-PF4 complex

In flow cytometry, the term "gating" refers to: a. selection of a subpopulation of cells to count b. determining the fluorescent emission spectrum of cells of interest c. interference caused by binding of more than a single antibody d. selecting the appropriate counting aperture

a. selection of a subpopulation of cells to count

What effect does selecting the wrong gate have on the results when cells are counted by flow cytometry? a. no effect b. failure to count the desired cell population c. falsely elevated results d. impossible to determine

b. failure to count the desired cell population

AccuVein is a newly marketed hand-held medical device that helps medical staff visualize veins before phlebotomy. The device emits infrared light and is held about ____ inches over the potential phlebotomy site. Hb in the blood absorbs infrared light and projects an image map of the veins onto the patient’s overlying skin. A. 3 inches over the potential phlebotomy site B. 5 inches over the potential phlebotomy site C. 7 inches over the potential phlebotomy site D. 10 inches over the potential phlebotomy site

C. 7 inches over the potential phlebotomy site

Effect of high temperature to blood draw volume: A. Increased B. Decreased C. Variable D. Cannot be determined

B. Decreased

In situations where blood is drawn at high altitudes (>5,000 feet), the draw volume may be: A. Increased B. Decreased C. Variable D. Cannot be determined

B. Decreased

Shelf life of an evacuated tube is defined by: A. Stability of the additive B. Vacuum retention C. Both of these D. None of these

C. Both of these

L1 HEMA Flashcards

(456 cards)