Lecture Hematology Final Flashcards Preview

MLT Hematology, Chemistry, Phlebotomy, Micro > Lecture Hematology Final > Flashcards

Flashcards in Lecture Hematology Final Deck (267):
1

Co-efficient of variation means:

The smaller the CV, the less accurate the values

The larger the CV, the less accurate the values

The smaller the CV, the more precision in the values

The larger the CV, the more precision in the values

The smaller the CV, the more precision in the values

2

What is the mean value of the following hemoglobin values? 8.9, 9.0, 8.6, 9.2, 9.4, 8.7, 8.9, 9.2
Question options:

8.8

9.0

9.2

8.0

9.0

3

The reference range for a control sample is 13.0 Gm/dl plus or minus 0.4 Gm/dl. The results that have been tested are as follows: 12.0, 12.1, 12.0, 12.2, 12.1 These results are:
Question options:

Precise, but not accurate

Both accurate and precise

Accurate but not precise

Neither accurate nor precise

precise not accurate

4

Two consecutive control tests have values outside two standard deviations but less than 3 standard deviations. According to Westgard rules, you should:
Question options:

Ignore the result. The testing system is in control

Repeat the control test to see if it comes within 2 standard deviations

Dilute the control, repeat the test, and multiply the result times the dilution

Do not report patient results. The system is out of control

Do not report patient results. The system is out of control

5

The extent that replicate analysis of a sample agree with each other defined as:
Question options:

accuracy

precision

standard deviation

random error

precision

6

Comparing the results of the analysis of a patient sample to the results of the previous sample analysis is called:
Question options:

delta check

standard deviation

Westgard multirule

Levy-Jennings analysis

delta check

7

Manufacturers of chemicals provide laboratories with information on those chemicals to promote safe handling. Which document would contain this information?
Question options:

A chemical hygiene plan

Material Safety Data Sheets (MSDS)

a Fire Safety Plan

Job Safety analysis

MSDS

8

The difference between a standard and a control is:
Question options:

A standard has a fixed and known value.

A control has a fixed and known value.

A control is used to calibrate laboratory testing equipment.

A control never has a range of values.

A standard has a fixed and known value.

9

Quality Assurance is defined as:
Question options:

the coordinated effort to organize all activities of the lab to provide the best possible service to patients and physicians.

the running of internal controls and standards to provide accurate and precise laboratory results.

one component of a Quality Control system.

the running of external proficiency specimens to ensure that the results obtained are consistent with results obtained by other laboratories.

the coordinated effort to organize all activities of the lab to provide the best possible service to patients and physicians.

10

The distribution of data about the mean in a Gaussian curve is expressed as the "standard deviation." Two standard deviations incorporates:
Question options:

99.7% of the data

68.3% of the data

95.5% of the data

100% of the data

95.5 % of data

11

Quality control is defined as:
Question options:

The coordinated effort to organize all activities of the laboratory to provide the best possible service to patients and physicians.

The running of external proficiency specimens to ensure that results obtained are consistent with results obtained by other laboratories.

The process used within the laboratory to assure accuracy but not precision of results.

Using procedures for monitoring and evaluating the characteristics of the testing system within the laboratory.

Using procedures for monitoring and evaluating the characteristics of the testing system within the laboratory.

12

On a run of 20 hemoglobin samples, 95% are 0.4 g/dl more than known values. This type of error is known as:
Question options:

Random error

Preportional systematic error

Constant systematic error

Coefficient of variation

constant systematic error

13

A mean value of 6 x 109/L for a leukocyte control is obtained. One standard deviation is 0.3 x 109
The 95.5% confidence level would be:
Question options:

3.0 - 9.0 times 109

5.4 - 6.6 times 109

5.5 - 6.5 times 109

5.7 - 6.3 times 109

5.4 - 6.6 times 109

14

The closeness of a measurement in comparison with the true or actual value is:
Question options:

accuracy

precision

standard deviation

random error

accuracy

15

Under which of these circumstances would a Material Safety Data Sheet (MSDS) be most helpful?
Question options:

A phlebotomist has experienced a needle puncture with a clean needle.

A fire extinguisher failed during routine testing.

A pregnant laboratory staff member has asked whether she needs to be concerned about working with a given reagent.

During a safety inspection, an aged microscope power supply is found to have a frayed power cord.

A pregnant laboratory staff member has asked whether she needs to be concerned about working with a given reagent.

16

Levy-Jennings charts are used to:
Question options:

track delta checks on patient results.

track trends, shifts, and out of limit control results.

track trends, shifts, and out of limit patient results.

display results of external proficiency test results.

track trends, shifts, and out of limit control results.

17

We say that test results on control specimens are "within the reference interval" if:
Question options:

the result does not exceed one standard deviation from the mean.

the result exceeds three standard deviations from the mean.

the result falls within two standard deviations from the mean.

the result can be replicated over many assays demonstrating precision

the result falls within two standard deviations from the mean.

18

The following can be used to allow comparisons of the precision of different assays by different means.
Question options:

Standard deviation

Delta check

Coefficient of variation

Westgard rules

Coefficient of variation

19

Which of the following uses Quality Control as a means of insuring accuracy and precision?
Question options:

Preanalytical processes

Analytical processes

Postanalytical processes

Both pre and post analytical processes

Analytical processes

20

A term that describes the range of values for an analyte in healthy individuals is:
Question options:

reference interval

levy-jennings trend

standard deviation

delta check

reference interval

21

Which of the following QC rules would occur 1 in 20 times by chance alone?
Question options:

12s

2 2s

1 3s

1 4s

1 2s

22

When referring to Quality Control results, what parameter usually determines the acceptable range?
Question options:

The 95.5% confidence level from the mean.

The range that includes 50% of the data.

The central 68% of results.

The range encompassed by 2.5 standard deviations

The 95.5% confidence level from the mean.

23

The most important safety practice in preventing the spread of disease is:
Question options:

wearing masks during patient contact.

proper handwashing.

wearing disposable laboratory coats.

identifying specimens from known or suspected HIV and hepatitis patients with a red label.

proper handwashing.

24

A mean value of 80 mg/dL is determined for a glucose control. One standard deviation from the mean equals 10 mg/dL. The 95.5% confidence level for glucose testing on this control material is:
Question options:

70 -90 mg/dL

60 - 90 mg/dL

60 -100 mg/dL

70 -100 mg/dL

60 - 100 mg/dL

25

What is the most common disinfectant used in laboratories to kill viruses on table tops, counters, etc.?
Question options:

10% sodium chloride

10% sodium fluoride

10% sodium bicarbonate

10% household bleach

10% household bleach

26

Fire drills should be conducted:
Question options:

weekly

monthly

quarterly

annually

quarterly

27

The control value for hemoglobin testing is 12.0 gm/dL plus or minus 2 gm/dL. On two consecutive control runs the technician obtains a value of 14.5 gm/dL. According to Wesgard rules, these values are:
Question options:

Acceptable because it could be repeated.

A warning limit.

A rejection limit.

Within normal random error.

rejection limit

28

Which of the following represents a preanalytical error?
Question options:

Failure to calibrate the instrument correctly.

Failure to perform quality control testing prior to testing the patient sample.

Failure to refrigerate the test reagents.

Failure to adequately mix the collection blood tubes when drawing the patient.

Failure to adequately mix the collection blood tubes when drawing the patient.

29

Evaluation of Levy-Jennings charts when using multiple levels of controls is done by:
Question options:

comparing Delta checks.

comparing external proficiency sample test results.

using Westgard rules.

obtaining feedback from patients and ;physicians.

comparing external proficiency sample test results

30

The term "precision" might also be called:
Question options:

accuracy.

linearity.

calibration.

reproducibility.

reproducibility.

31

How close should the fire alarm be in relation to the laboratory?
Question options:

within 75 feet

within 100 feet

within 150 feet

within 200 feet

within 200 feet

32

Regular review of blood collection quality is an example of:
Question options:

Preanalytical quality assurance

Analytical quality control

Postanalytical quality assurance

External quality assurance

Preanalytical quality assurance

33

List at least three prohibited practices in the clinical laboratory

No smoking, No eating, no drinking, no mouth pipetting, no recapping needles

34

List four types of Personal Protective Equipment used in the clinical laboratory.

Gloves Lab Coat Shield Googles shoe covers

35

What is the correct per cent concentration of bleach used to disinfect laboratory tabletops and counters?

10%

36

Two different methodologies were used to perform glucose testing on 20 patient samples. The CV of methodology number 1 equals 3%. The CV of methodology number 2 equals 5%. Which methodology is the preferred methodology for performing glucose testing on patient samples based only on the CV results?

Methodology number 1

37

Define "fomite" and list three fomites that would likely be found in a clinical laboratory.

a nonliving object that can transfer diseases.
pens
paper
microscopes

38

List three times when handwashing would be appropriate in the clinical laboratory.

after removing gloves
before leaving the lab
before and after eating and drinking

39

What are the outside dimensions of the Neubauer counting chamber in millimeters? What are the dimensions of one of the largest squares within the Neubauer chamber in millimeters?

3x3 1x1

40

A technician counts WBC's from a patient's CSF on a Neubauer chamber. The spinal fluid is clear so no dilution was made. The technician counts cells on the total area of the chamber and counts a total of 30 WBC's. How many WBC's should be reported to the physician?

33 WBCs

41

A total of 50 WBCs were counted on a Neubauer chamber using a dilution of 1:20 and all four corner squares were counted. What is the WBC count in 109/L?

2.5

42

A reticulocyte count is 3.0. The patient's hematocrit is 30%. What is the reticulocyte count after correcting it for the patient's anemia?

2.0%

43

A patient's hemoglobin is 11.0 gm/dL and his RBCs appear normocytic and normochromic. What is the range of values you would expect for the hematocrit?

30-36

44

A patient's MCV is 76, MCH is 24, and MCHC is 30. What do you expect the RBC morphology to be when you look at the cells under the microscope?

microcytic, hypochromic

45

What is the purpose for performing a reticulocyte count? What would a low reticulocyte count mean?

The purpose is to see if the bone marrow is producing enough RBC at high enough rate to replace the cells being destroyed. If the reticulocyte count is low it would mean the bone marrow is not producing enough cells at a rate of about 0.5% to 1.5%.

46

A newborn has a WBC count of 20 x 1012L. The technician notes 5 nucleated RBCs when performing the differential. What value should be reported to the physician for total WBC count?

WBC count of 19 x 10^12L

47

Why was it necessary to correct the total WBC count in the previous question?

Because the machine that counts the WBC will count the nucleated RBCs because they will not lyse out and will move through the machine.

48

What is the procedure for performing a Reticulocyte count? (stain used, stain to cell ratio, counting procedure, reporting units)

Take the same amount, 1:2 ratio, of plasma and new methylene blue stain and mix in a tub. Let it sit for about 10 mins. Make a smear with this and count 1000 RBCs including the retics. Make note of how many retics are counted. Divide the number of retics into a 1000 and times by 100. That percentage is the percent of Reticuloytes.

49

Calculate the MCV and MCHC using the following data:
RBC count = 4.0, Hemoglobin = 11.0, Hematocrit = 32%
Are the RBCs normocytic, microcytic, or macrocytic?
Are the RBCs normochromic or hypochromic?

MCV = 80
MCHC = 34.38
RBC are normocytic and normochromic

50

Which of the Red Blood Cell Indices can indicate anisocytosis?

MCV

MCH

MCHC

RDW

RDW

51

Which of the Red Blood Cell Indices reflects the average size of the RBCs?

MCV

MCH

MCHC

RDW

MCV

52

Which of the Red Blood Cell Indices reflects the average hemoglobin content of the RBCs and would indicate hypochromia, if less than the reference range?

MCV

MCH

MCHC

RDW

MCHC

53

List four (4) possible errors when performing a manual cell count using the Neubauer counting chamber.

not allowing the RBCs to lyse completely out
not cleaning the cover and the slide
counting a corner twice
figuring the dilution wrong for lysing the RBCs

54

A technician used a microscope with a Miller Disc to perform a Reticulocyte count. The technician counted 112 RBCs in the small square and 25 Reticulocytes in the large square. What value should the technician report to the physician?

2.5 %

55

Calculate the MCV and MCHC using the following values:
RBC = 4.0 x 1012/L
Hgb = 9 gm/dL
Hct = 30%

MCV = 75 MCHC = 30

56

What does a Hematocrit test measure?

The average cells to volume

57

Which of the following can only be determined by examination of a peripheral blood smear?

microcytosis

hypochromia

poikilocytosis

anisocytosis

poikilocytosis

58

Which of the following, if elevated, would indicate reduced RBC life span?

Reticulocyte Count

RDW

Hemoglobin

MCHC

Reticulocyte Count

59

What does the term "Anisocytosis" describe?

Variation in RBC shape

Variation in RBC size

Decreased hemoglobin in RBCs

Increased production of RBCs

Variation in RBC size

60

What does the term "Poikilocytosis" describe?

Variation in RBC shape

Variation in RBC size

Decreased hemoglobin in RBCs

Increased production of RBCs

Variation in RBC shape

61

What is the average life span of an erythrocyte (RBC)?

80 days

30 days

120 days

2 days

120 days

62

What is the approximate per cent of senescent (old) erythrocytes that are lost daily?

0.1%

1%

10%

100%

1%

63

An anemic patient has the following test results:
RBC = 3.0 x 1012/L, Hgb = 7.5 gm/dL, Hct = 23%, Reticulocyte Count = 2.5%
What would this indicate?


Anemia due to increased loss or increased destruction of RBCs

Anemia due to reduced RBC production

Anemia due to overcrowding of normal bone marrow cells by a tumor

Anemia due to a hereditary defect in hemoglobin production

Anemia due to increased loss or increased destruction of RBCs

64

The Erythrocyte Sedimentation Rate (ESR) is commonly referred to as "Sed Rate". How is the Sed Rate reported?

milligrams per deciliter

Liter per Liter

millimeters per hour

centimeters per hour

millimeters per hour

65

A patient has a hemoglobin of 9 gm/dL. What is the expected range for the patient's hematocrit?

23 to 30%

24 to 30%

27 to 30%

24 to 27%

24 to 30%

66

What is the reference range for MCV?

80 to 100

32 to 36

11.5 to 14.5

4.5 to 11.5

80 to 100

67

What is the reference range for MCHC?

80 to 100

32 to 36

11.5 to 14.5

4.5 to 11.5

32 to 36

68

What is the reference range for RDW?

80 to 100

32 to 36

11.5 to 14.5

4.5 to 11.5

11.5 to 14.5

69

Which terms would best describe the red blood cells (erythrocytes) of a patient who has an MCV = 115 fL, and an RDW = 20%

Microcytic and hypochromic

Microcytic with anisocytosis

Macrocytic and hypochromic

Macrocytic with anisocytosis

Macrocytic with anisocytosis

70

The membranes of the RBC have several purposes. One of these purposes would be to:

1) restrict and facilitate the interchange of substances.


2) stimulate the early release of reticulocytes


3) increase the rate of the pentose-phosphate shunt


4) control the rate of production by shortening the maturity process

restrict and facilitate the interchange of substances.

71

Protein synthesis occurs in

1) the lysosome


2) the mitochondria


3) the Golgi complex


4) the ribosomes

the Golgi complex

72

What are the three components that make up the nucleus of a cell?

1) ribosomes, lysosome, and enzymes


2) chromatin, nuclear envelope, and nucleoli


3) endoplasmic reticulum, ribosomes, and mitochondria


4) lysosome, microfilaments, and microtubule

chromatin, nuclear envelope, and nucleoli

73

The mitochondria are chiefly responsible for

1) metabolic processes or as an energy source


2) protein synthesis and receptors for cellular identity


3) selective permeability


4) endocytosis and locomotion

metabolic processes or as an energy source

74

A stained reticulocyte showing the reticulum indicates

1) residual ATP


2) residual DNA


3) residual RNA


4) residual polypeptides

residual RNA

75

An erythrocyte is a biconcave disc with a measurement of

1) 9-10 um


2) 7-8 um


3) 8-11 um


4) 3-10um

7-8 um

76

A plasma protein carries iron in the ferric form to the erythrocyte precursors to make hemoglobin or to the liver for storage. The protein is:

1) transferrin


2) hemosiderin


3) apoferritin


4) ferritin

transferrin

77

Iron is stored in the form of

1) hemosiderin and ferritin


2) hemosiderin and spectrin


3) hemosiderin and transferrin


4) oxyhemoglobin and methemoglobin

hemosiderin and ferritin

78

The iron in the hemoglobin molecule is in which form?

1) ferritin


2) ferrous


3) ferric


4) apoferritin

ferrous

79

What are the percentages of hemoglobin types in an adult individual?

1) 95%HgbA, 80-90%Hgb A2, 5%-10%HgbA, 1-5%HgbF


3) 2-3.5% Gower 1, >60-75% HgbA2, 20-40% HgbF


4) 90% HbA,

95%HgbA,

80

One of the most important functions of the erythrocyte is to deliver O2 to the tissues. The erythrocyte must survive to do this. The anaerobic process that produces energy for RBC survival is:

1) Hexose monophosphate pathway


2) Embden-Meyerhof pathway


3) Rapoport-Leubering pathway


4) Methemoglobin reductase pathway

Embden-Meyerhof pathway

81

Aerobic or oxidative glycolysis diverts glucose into what pathway?

1) Hexose monophosphate pathway


2) Embden-Meyerhof pathway


3) Rapoport-Leubering pathway


4) Methemoglobin reductase pathway

Hexose monophosphate pathway

82

Erythrocyte production must equal the loss of erythrocytes. What is this condition called and how is it measured?

1) Equilibrium and measured with 2,3 DPG studies


2) Steady state and measured with reticulocyte counts


3) Erythrocyte kinetics and measured with NADPH


4) Erythrocyte catabolism and measured with G6 phosphate dehydrogenase

Steady state and measured with reticulocyte counts

83

Which form of hemoglobin has iron in the ferric state?

1) Sulfhemoglobin


2) Carboxyhemoglobin


3) Methemoglobin


4) Hemoglobin A1C

Methemoglobin

84

Carboxyhemoglobin results from the binding of the heme molecule to what compound?

1) Ferric iron


2) Methemoglobin


3) Carbon monoxide


4) Hydrogen sulfide

Carbon monoxide

85

What is the normal survival time of the mature erythrocyte?

1) 20-35 days


2) 100-120 days


3) 30-40 days


4) 20-60 days

100-120 days

86

Which compound regulates the affinity for and release of oxygen by hemoglobin?

1) ferric iron


2) 2,3-DPG


3) G-6-PD


4) globin

2,3-DPG

87

The oxygen dissociation curve is the description of the relationship between O2 saturation of hemoglobin and the partial pressure of O2. Does the oxygen dissociation curve shift Left or Right as body temperature increases?

1) Right


2) Left

Right

88

What are the three phases of embryonic hematopoesis?

1) Lysosomes, ribosomes, and mitochondria


2) spectrin, ferritin, and transferrin receptor


3) mesoblastic, hepatic, medullary


4) mesoblastic, splenic, and hepatic

mesoblastic, hepatic, medullary

89

What is the substance produced by the kidney that stimulates production of red blood cells?

1) Erythropoetin


2) Spectrin


3) glycoprotein


4) thrombopoeitin

Erythropoetin

90

What is the definition of Apoptosis?

1) anaerobic glycolysis


2) aerobic glycolysis


3) programmed cell death


4) energy production

programmed cell death

91

Which element binds with oxygen in the Red Blood Cell?

1) CO2


2) Iron


3) Protoporphyrin IX


4) Glutathione

Iron

92

What percentage of iron remains in storage for use if needed?

1) 25%


2) 50%


3) 75%


4) 65%

25%

93

The majority of hemoglobin in adults is Hemoglobin A (also called Hemoglobin A1) and is composed of which globin chains?

1) alpha and gamma


2) alpha and delta


3) alpha and beta


4) alpha and zeta

alpha and delta

94

What are the three compounds that have the following functions:
transport of iron
Storage of iron
Receiving iron

1) Spectrin, erythropoetin, and ferritin


2) Heme, globin, and ferritin


3) Transferrin, transferrin receptor, and erythropoetin


4) Transferrin, ferritin, transferrin receptor

Transferrin, ferritin, transferrin receptor

95

Which enzyme deficiency is the most common hereditary enzyme deficiency worldwide?

1) hexokinase


2) G-6-PD


3) pyruvate kinase


4) glucose oxidase

G-6-PD

96

Which cellular constituents synthesize globin chains?

1) lysosomes


2) ribosomes


3) golgi complex


4) endoplasmic reticulum

ribosomes

97

Question 29 1 / 1 point
Hemoglobin is composed of four heme molecules and

1) two globin chains


2) three globin chains


3) four globin chains


4) three methemoglobin chains

four globin chains

98

Which of the following statements is NOT true concerning the breakdown of hemoglobin in extravascular tissue?

1) Iron is recycled to be used for red blood cell production.


2) Protoporphryn IX is degraded to bilirubin


3) Globin is broken down and returned to the amino acid pool.


4) hemoglobin is excreted in the urine.

hemoglobin is excreted in the urine.

99

A small amount of hemoglobin has glucose attached and is used to monitor diabetic therapy. It is:

1) Hemoglobin A


2) Hemoglobin A1c


3) Hemoglobin A2


4) Hemoglobin F

Hemoglobin A1c

100

What of the following is the correct list for the number and type of globin chains in normal adult hemoglobin structure?

1) 4 alpha, 2 delta chains


2) 2 alpha, 2 non-alpha chains


3) 2 alpha, 4 beta, 1 delta, and 1 epsilon chain


4) 4 alpha, 2 beta, 2 delta, and 2 epsilon chains

2 alpha, 2 non-alpha chains

101

Which of the following hematopoietic growth factors is produced in the kidney?

Erythropoeitin

Thrombospondin

GM-CSF

M-CSF

Erythropoeitin

102

The predominant hemoglobin found in a normal newborn baby is:

Gower 1

Hemoglobin A2

Hemoglobin A

Hemoglobin F

Hemoglobin F

103

A hemoglobin molecule is composed of (select the best answer):

One heme molecule and four globin chains

Ferrous iron, protoporphyrin IX, and one globin chain

One Protoporphyrin IX plus four globin chains

Four heme molecules and four globin chains

Four heme molecules and four globin chains

104

Which of the following is true concerning 2,3BPG? (It is also called 2,3 DPG).

It regulates the uptake and release of oxygen from hemoglobin.

It provides a source of glucose for the RBC.

It converts ferric iron to ferrous iron.

It protects the red cell against oxidative compounds.

It regulates the uptake and release of oxygen from hemoglobin.

105

Lysing of RBCs in the blood circulation is called:

Intravascular hemolysis.

Extravascular hemolysis.

Endocytosis.

Diapedesis.

Intravascular hemolysis.

106

List the three main parts of a cell.

Nucleus Cell Membrane Cytoplasm

107

How many mature erythrocytes are produced by a single pronormoblast (rubriblast)?

two

four

six

eight

eight

108

What is the name of the stain that is used to stain Reticulocytes?

Safranin

Eosin

New Methylene Blue

Crystal Violet


New Methylene Blue

109

How many net moles of ATP are generated from one mole of glucose in the Emden-Myerhoff pathway?

two

four

six

eight

two

110

Which protein comprises 50-70% of the skeletal mass of the red blood cell membrane?

Spectrin

Band 3

Actin

Globin

Spectrin

111

Does hemoglobin have iron in the ferric or ferrous state?

Ferrous

112

Which pathway converts hemoglobin that has ferric iron back to ferrous iron?

Emden-Myerhoff

Leubering-Rappaport

Methemoglobin Reductase

Hexose Monophosphate

Methemoglobin Reductase

113

Which cell in the bone marrow produces platelets?

Rubriblast

Myeloblast

Erythroblast

Megakaryocyte

Megakaryocyte

114

Which of the following describes a macrocytic anemia?

1) Hgb 8.0 g/dL Hct .24 L/L MCV 115 fl


2) Hgb 12.0 g/dL Hct .36 L/L MCV 99 fl


3) Hgb 7.0 g/dL Hct .20 L/L MCV 78 fl


4) Hgb 6.0 g.dL Hct .18 L/L MCV 82 fl

Hgb 8.0 g/dL Hct .24 L/L MCV 115 fl

115

What primary test should be performed on patients if the complete blood count indicates an anemia?

1) An M:E ratio


2) A schilling B12 test


3) A Chromium 51 study


4) A reticulocyte count

A reticulocyte count

116

Which of the indices is most useful in classifying an anemia?

1) MCV


2) MCH


3) RBC


4) MCHC & RDW

MCV

117

Variation in RBC size is termed:

1) poikilocytosis


2) Erythrocytosis


3) Anisocytosis


4) Spherocytosis

Anisocytosis

118

Variation in cell shape is termed:

1) Anisocytosis


2) Poikilocytosis


3) Erythrocytosis


4) Pancytopenia

Poikilocytosis

119

Sideroblastic Anemia usually shows which of the following:

1) Decreased serum Iron Levels


2) Decreased serum ferritin levels


3) Positive Prussian Blue test on RBC precursors.


4) Decreased serum transferrin levels

Positive Prussian Blue test on RBC precursors.

120

Aplastic anemia is characterized by a deficiency of hemopoetic cells. This results in

1) An Acellular bone marrow


2) Folate & B12 deficiency


3) Iron deposits in the RBC


4) Increased reticulocyte count

An Acellular bone marrow

121

Which laboratory test is used to monitor red cell production?

1) Serum iron level


2) Schilling test


3) Total iron binding capacity


4) Reticulocyte count

Reticulocyte count

122

Which stain is used to demonstrate iron:

1) Wright's Stain


2) New Methylene Blue


3) Periodic acid-schiff (PAS)


4) Prussian Blue

Prussian Blue

123

A characteristic morphology of red blood cells in folic acid deficiency is:

1) Macrocytosis


2) Target cells


3) Basophilic stippling


4) Rouleaux formation

Macrocytosis

124

An anemia of chronic disease (inflammation) is classified as a

1) Microcytic anemia


2) Macrocytic anemia


3) Normocytic anemia


4) Macrocytic hypochromic anemia

Microcytic anemia

125

Megaloblastic anemia is caused by a deficiency of:

1) Iron


2) Vitamin B-12 or folate


3) Sideroblastic cells


4) Porphyrias

Vitamin B-12 or folate

126

Lead toxicity is usually accompanied by the following RBC morphology:

1) Howell-Jolly bodies


2) Basophilic stippling


3) Heinz bodies


4) spherocytes

Basophilic stippling

127

The red blood cell indices that is related to average red cell size is:

1) MCV


2) MCHC


3) RDW


4) MPV

MCV

128

A disease that is characterized by excessive red blood cell production resulting in iron overload is:

1) hereditary acanthocytosis


2) sideroblastic anemia


3) hereditary hemachromatosis


4) hereditary spherocytosis

hereditary hemachromatosis

129

Ingestion of lead causes impaired heme production and results in

1) iron deficiency anemia


2) sideroblastic anemia


3) megaloblastic anemia


4) anemia of chronic inflammation

sideroblastic anemia

130

Vitamin B12 is bound to haptocorrin in saliva and then released in the intestine by the enzyme:

1) erythropoietin


2) trypsin


3) papain


4) intrinsic factor

trypsin

131

Aplastic anemia results in:

1) macrocytosis


2) eosinophilia


3) pancytopenia


4) leukocytosis

pancytopenia

132

Which molecule carries free hemoglobin in the circulation to the liver for degradation?

1) erythropoietin


2) haptocorrin


3) haptoglobin


4) intrinsic factor

haptoglobin

133

One way to determine if intravascular hemolysis is occurring is to measure:

1) serum iron levels


2) folic acid level


3) haptoglobin level


4) haptocorrin level

haptoglobin level

134

The Schilling Test helps in the diagnosis of:

1) aplastic anemia


2) iron deficiency anemia


3) thalassemia


4) pernicious anemia

pernicious anemia

135

Destruction of red blood cells that is caused by a defect in the red blood cells themselves such as iron deficiency, megaloblastic anemia, hemoglobinopathies and thalassemia is what kind of defect?

1) acquired


2) intravascular


3) intrinsic


4) extrinsic

intrinsic

136

Excessive extravascular hemolysis is characterized by:

1) low serum iron levels.


2) elevated bilirubin levels


3) decreased haptoglobin levels


4) positive Schilling test

elevated bilirubin levels

137

RDW level in iron deficiency anemia is:

1) low


2) high


high

138

Which of the red blood cell indices is typically elevated in Hereditary Spherocytosis?

1) MCV


2) MCH


3) MCHC


4) MPV

MCHC

139

Hemoglobinemia and hemoglobinuria are signs of:

1) Intravascular destruction of erythrocytes


2) Extravascular destruction of erythrocytes

Intravascular destruction of erythrocytes

140

Neutrophils with multi-lobed nucleus (hypersegmentation) is characteristic of:

1) Megaloblastic anemia


2) Iron deficiency anemia


3) Sideroblastic anemia


4) Anemia of chronic inflammation

Megaloblastic anemia

141

Which of the following anemias has low MCV, low MCHC, and high RDW?

1) Aplastic anemia


2) Hereditary Spherocytosis


3) Iron deficiency


4) Megaloblastic anemia

Iron deficiency

142

Erythrocyte precursors in the bone marrow that have iron deposits surrounding the nucleus when stained with Prussian Blue stain are called:

Spherocytes

Acanthocytes

Ringed Sideroblasts

Ringed Schistocytes

Ringed Sideroblasts

143

The compound that transports iron to the liver for storage or to the bone marrow to be re-used to make heme is:

hepcidin

ferritin

transferrin

transferrin receptor

transferrin

144

Iron is stored in the liver as:

hepcidin

ferritin

transferrin

transferrin receptor

ferritin

145

Which hormone is released during inflammation as an acute phase reactant that causes decreased iron absorption and blocks release of iron from macrophages and hepatocytes? (causes Anemia of Chronic Inflammation)

hepcidin

ferritin

transferrin

haptocorrin

hepcidin

146

Name a condition when macrocytosis of red blood cells would be a normal finding.

newborns

147

Are ferritin levels normal, increased, or decreased in sideroblastic anemia?

normal

increased

decreased

not applicable to sideroblastic anemia


increased

148

Is the RDW normal, increased, or decreased in megaloblastic anemia?

normal

increased

decreased

not applicable to megaloblastic anemia

increased

149

Which RBC inclusions are present after patients have had their spleens removed (splenectomy)?

Basophilic stippling

RNA

Dohle bodies

Howell-Jolly bodies

Howell-Jolly bodies

150

Which cluster of differentiation (CD) markers are absent from the red blood cells of patients with Paroxysmal Nocturnal Hemoglobinuria?

CD55 and CD59

151

Which laboratory test is used to help diagnose Hereditary Spherocytosis?

osmotic fragility test

Ham's test

Sugar water test

G-6-PD test

osmotic fragility test

152

Which cause of macrocytic anemia does not result in a megaloblastic bone marrow?

liver disease, Alcoholism

153

Is the Reticulocyte count normal, increased, or decreased in megaloblastic anemia?

Low

154

Other than macrocytes, what characteristic RBC shape is a frequent finding in megaloblastic anemia?

Ovalocytes

Spherocytes

Acanthocytes

Stomatocytes

Ovalocytes

155

What is the name of the salivary protein that binds vitamin B12?

Hepcidin

Trypsin

Haptocorrin

Intrinsic factor

Haptocorrin

156

The most common clinical disorder resulting from an amino acid substitution in the globin chain is:

1) Sickle cell disease


2) Hemoglobin C disease


3) Thalassemia

4) Hemoglobin E Disease

Thalassemia

157

Which of the folowing descriptions correctly describes the Donath Landsteiner antibody?

1) Bi-phasic antibody associated with Paroxysmal Cold Hemoglobinuria


2) A single phase IgM antibody associated with a Drug Induced Anemia


3) A warm reactive alloimmune antibody


4) A cold-reactive idiopathic antibody associated with Mycoplasma pneumoniae

Bi-phasic antibody associated with Paroxysmal Cold Hemoglobinuria

158

The hemoglobinopathies are normocytic, normochromic anemias except for the following one which is microcytic:

1) Hemoglobin SS


2) Hemoglobin CC


3) Hemoglobin EE


4) Hemoglobin MM

Hemoglobin EE

159

Anemias characterized by structural defects in globin chains are:

1) Drug Induced Hemolytic Anemias


2) Warm Autoimmune Hemolytic Anemias


3) Hemoglobinopathies


4) Microangiopathic Anemias

Hemoglobinopathies

160

The most striking differences in symptoms between Thrombotic Thrombocytopenic Purpura and Hemolytic-Uremic Syndrome are:

1) severity of thrombocytopenia and degree of anemia.


2) severity of neurologic symptoms and renal involvement.


3) severity of rbc destruction and liver involvement.


4) severity of thrombocytopenia and liver involvement.

severity of neurologic symptoms and renal involvement.

161

Microangiopathic Anemias, burns, cardiac anemia and march anemia all are characterized by fragmented cells, helmet cells, and triangular cells. Collectively, these cells are called:

1) stomatocytes


2) elliptocytes


3) acanthocytes


4) schistocytes

schistocytes

162

If you saw bar shaped inclusions in the Red Blood Cells of a patient, which hemoglobinopathy would you suspect is causing this condition?

1) Hemoglobin S


2) Hemoglobin C


3) Hemoglobin E

Hemoglobin C

163

The most severe hemoglobinopathy is:

1) homozygous hemoglobin C


2) homozygous hemoglobin S


3) hemoglobin S inherited with hemoglobin E
4) homozygous hemoglobin E

homozygous hemoglobin S

164

The definitive test to identify all hemoglobinopathies is:

1) red blood cell count plus red blood cell indices.


2) hemoglobin electrophoresis


3) protein electrophoresis


4) immunoelectrophoresis

hemoglobin electrophoresis

165

This anemia is characterized by reduced number of platelets, vaso-occlusion, and acute neurologic symptoms.

1) Hemolytic-Uremic Symdrome


2) Thalassemia Major


3) Thalassemia Minor


4) Thrombotic Thrombocytopenic Purpura

Thrombotic Thrombocytopenic Purpura

166

This disease is characterized by reduced number of platelets, vaso-occlusion without neurologic symptoms but severe renal involvement.

1) Hemolytic-Uremic Syndrome


2) Beta thalassemia


3) Alpha thalassemia


4) Thrombotic Thrombocytopenic Purpura

Hemolytic-Uremic Syndrome

167

The species of malaria that causes the most severe disease is:

1) Plasmodium malariae


2) Plasmodium falciparum


3) Plasmodium vivax


4) Plasmodium ovale

Plasmodium falciparum

168

The species of malaria that most frequently is harbored in the liver for many years is:

1) Plasmodium malariae


2) Plasmodium falciparum


3) Plasmodium vivax


4) Plasmodium ovale

Plasmodium vivax

169

The ring forms in red blood cells infected with Babesia can be distinguished from the ring forms of Plasmodium falciparum by:

1) double dots on a single ring in a red blood cell.
2) more than one ring in one red blood cell.

3) four dots (tetrads) on a single ring.

4) thickness and shape of the ring form.

four dots (tetrads) on a single ring.

170

Select the amino acid substitution that is responsible for sickle cell disease.

1) Lysine is substituted for glutamic acid at the sixth position of the alpha chain


2) Valine is substituted for glutamic acid at the sixth position of the beta chain


3) Valine is substituted for glutamic acid at the sixth position of the alpha chain


4) Glutamine is substituted for glutamic acid ath the sixth position of the beta chain

Valine is substituted for glutamic acid at the sixth position of the beta chain

171

The anemia seen in sickle cell disease is usually:

1) Microcytic, normochromic


2) Microcytic, hypochromic


3) Normocytic, normochromic


4) Normocytic, hypochromic

Normocytic, normochromic

172

What red cell inclusion may be seen in the peripheral blood smear of a patient post-splenectomy?

1) Toxic granulation


2) Howell-Jolly bodies


3) Basophilic stippling


4) Siderotic granules

Howell-Jolly bodies

173

Malarial parasites are observed in the red blood cells of a patient. The parasites are mostly ring forms. The cells are normal size and some red cells have more than one parasite in them and some cells have a single ring form with two dots. Which species of malaria is present?

1) Plasmodium vivax


2) Plasmodium ovale


3) Plasmodium malariae


4) Plasmodium falciparum

Plasmodium falciparum

174

The Donath-Lansteiner antibody that causes Paroxysmal Cold Hemoglobinuria is:

1) Anti-Rh


2) Anti-I


3) Anti-P


4) Anti-complement

Anti-P

175

The antibody that causes Cold Agglutinin Disease is:

1) Anti-Rh


2) Anti-I


3) Anti-P


4) Anti-complement

Anti-I

176

An anemia that is characterized by rbc destruction after exposure to cold and subsequent warming of the patient back to normal body temperature is:

1) Paroxysmal Cold Hemoglobinuria


2) Sickle Cell trait


3) Hemolytic-Uremic Syndrome


4) thrombotic thrombocytopenic purpura

Paroxysmal Cold Hemoglobinuria

177

The screening test to detect sickle cell trait is:

1) sugar water test


2) solubility test


3) Ham's test


4) osmotic fragility test

solubility test

178

Patients who experience hemolytic episodes when exposed to cold temperatures have:

Warm autoimmune hemolytic anemia

Drug Induced hemolytic anemia caused by absorption of antibody-antigen complexes onto their RBCs.

Cold Agglutinin Disease

Hereditary Pyropoikilocytosis

Cold Agglutinin Disease

179

Warm autoimmune hemolytic anemia is caused by:
IgG antibodies

IgM antibodies

IgE antibodies

IgA antibodies

IgG antibodies

180

List two causes of Alloimmune hemolysis.

Hemolytic Transfusion Reaction, Hemolytic Disease of the Newborn

181

Patients with sickle cell disease do not usually show any symptoms during the first six months of life because they derive most of their oxygen transport from:

Hemoglobin A

Hemoglobin A2

Hemoglobin F

Hemoglobin Bart

Hemoglobin F

182

Patients with hemoglobin M disease exhibit a cyanotic (grayish) appearance because much of their hemoglobin is in the form of:

Methemoglobin

Sulfhemoglobin

Deoxyhemoglobin

Carboxyhemoglobin

Methemoglobin

183

Depositing of RBCs into tissues and organs (vaso-occlusion) which can lead to autosplenectomy is most often observed in:

Hemoglobin SS disease

Hemglobin EE disease

Hemoglobin C disease

Hemoglobin M disease

Hemoglobin SS disease

184

A disease where a patient hemolyzes their RBCs because their cells lack proteins on their cell surface that protect them against complement activation is:

Paroxysmal Cold Hemoglobinuria

Paroxysmal Nocturnal Hemoglobinuria

Pyruvate Kinase Deficiency

Hereditary Elliptocytosis

Paroxysmal Nocturnal Hemoglobinuria

185

Which of the following abnormal RBC morphologies is typically observed in the autoimmune hemolytic anemias?

Spherocytes

Schistocytes

Rouleaux

Stomatocytes

Spherocytes

186

Which CBC value is often increased in thalassemia and assists in distinguishing it from other microcytic, hypochromic anemias

RBC count

187

Which laboratory test detects warm autoimmune hemolytic anemias?

Direct Antiglobulin Test

Donath-Landsteiner Test

Solubility Test

Sugar Water Test

Direct Antiglobulin Test

188

Which of the four types of drug-induced autoimmune hemolytic anemias results in an antibody that reacts with all red blood cells (panagglutinin)?

Ternary type (immune complex)

Hapten or Drug Absorption

Nonimmunologic Protein Absorption

Autoantibody Induced Hemolysis

Autoantibody Induced Hemolysis

189

Which characteristic type of erythrocyte is present on the peripheral blood smear in both hemoglobinopathies and thalassemias?

Target cells

190

Which of the thalassemias requires life-long transfusions?

Alpha thalassemia minor

Beta thalassemia minor

Hemoglobin H disease

Beta thalassemia major

Beta thalassemia major

191

Which type of hemoglobin is usually increased in Beta thalassemia major?

Hemoglobin A

Hemoglobin A2

Hemoglobin F

Hemoglobin H

Hemoglobin F

192

Is the anemia in thalassemia microcytic, normocytic, or macrocytic?

microcytic

193

What is the preferred test for detecting an autoimmune hemolytic anemia?

Direct Antiglobulin Test (DAT)

Solubility Test

Osmotic Fragility Test

Direct Bilirubin Assay

Direct Antiglobulin Test (DAT)

194

The insect vector for malaria is:

Bartonella bacilliformus

Anopheles mosquito

Sand Fly

Ixodes dammini tick

Anopheles mosquito

195

An outstanding abnormality of hereditary spherocytosis noted in the CBC is:

Increased MCV

Increased MCHC

Decreased MCH

Decreased platelet and WBC count

Increased MCHC

196

The thalassemias are caused by:

Structurally abnormal globin chains

Absent or reduced synthesis of globin chains

Excessibe absorption of iron

Abnormal synthesis of porphyrin

Absent or reduced synthesis of globin chains

197

When a patient receives only two alpha genes from one parent (--/aa or -a/-a) then the patient develops:

alpha thalassemia minor

Hemoglobin H disease

Beta thalassemia minor

Beta thalassemia major

alpha thalassemia minor

198

When a patient receives only one alpha gene (--/-a) or one alpha gene and one "constant spring" variant (--/aaCS) the patient has:

alpha thalassemia minor

Hemoglobin H disease

Hydrops fetalis

Beta thalassemia minor

Hemoglobin H disease

199

The characteristic erythrocyte seen in a peripheral blood smear in warm autoimmune hemolytic anemia is:

macrocyte

spherocyte

dacrocyte

elliptocyte

spherocyte

200

A characteristic finding on the peripheral blood smear of a patient with a microangiopathic hemolytic anemia is the presence of:

target cells

drepanocytes

schistocytes

echinocytes

schistocytes

201

A variant or "reactive" lymphocyte is a lymphocyte that

1) is engaged in phagocytosis


2) is small, ranging in size from 7-10um


3) both a and b


4) has been stimulated by an antigen

has been stimulated by an antigen

202

What inherited condition is associated with Dohle inclusion bodies in all cells, thrombocytopenia, and giant platelets??

1) Pelger-Huet anomaly


2) May-Hegglin disease


3) Acute lymphoblastic leukemia


4) Gaucher disease

May-Hegglin disease

203

May-Hegglin is an inherited disorder which affects what type of leukocyte?

1) lymphocyte


2) monocyte


3) all cells


4) granulocyte

all cells

204

Toxic granulation is a condition associated with the presence of:

1) Infectious Mononucleosis


2) infection or inflammation


3) Pelger-Huet anomaly


4) Chediac-Higashi

infection or inflammation

205

Hairy cells produce an abundance of which isoenzyme of acid phosphatase?

one

three

four

five

five

206

An LAP score of ten (10) would be consistent with a diagnosis of:

Normal

Chronic Myelogenous Leukemia

Hairy Cell Leukemia

Leukemoid Reaction

Chronic Myelogenous Leukemia

207

Cytochemical staining was performed on the cells from a spleen imprint on a patient with suspected leukemia. The stains were performed and it was not surprising that the infiltrating cells stained positive for leukocyte acid phosphatase. The acid phosphatase stain was repeated on a second imprint, but the slide was pretreated with tartrate. The slide was still positive for acid phosphatase. This result points to which of the following conditions?

Erthrocyte leukemia

Acute lymphoblastic leukemia

Hairy cell leukemia

Acute megakaryocytic leukemia

Hairy cell leukemia

208

All of the following stains can be used to distinguish myeloblasts from lymphoblasts except:

Myeloperxidase

Sudan Black B

Periodic Acid Schiff

Acid Phosphatase

Acid Phosphatase

209

Which cytochemical reaction is most helpful in identifying the blasts in acute monoblastic leukemia?

esterase stains

myeloperoxidase

sudan black B

acid phosphatase (tartrate resistant)

esterase stains

210

What is this inherited disease characterized by large peroxidase positive inclusions in leukocytes. Patients have increased susceptibility to infection.

Chediak-Higashi

211

Which of the inherited lipid storage diseases has a large characteristic cell in the bone marrow that has a "chicken scratch" or "tissue paper" appearance?

Alder-Reilly Anomaly

May-Hegglin Anomaly

Niemann-Pick Disease

Gaucher disease

Gaucher disease

212

Which of the following diseases has a large characteristic cell in the bone marrow that has a frothy cytoplasm filled with lipid droplets and could be described as looking like "bubble wrap"?

Alder-Reilly Anomaly

May-Hegglin Anomaly

Niemann-Pick disease

Gaucher disease

Niemann-Pick disease

213

Which of he following stains would be helpful in diagnosing erythroleukemia?

Myeloperoxidase

Sudan Black B

Periodic Acid Schiff

Leukocyte Alkaline Phosphatase

Periodic Acid Schiff

214

The cytochemical stain alpha-naphthyl butyrate is a non-specific esterase that stains cells of which lineage?

Erythroid

Monocytic

Myeloid

Lymphoid

Monocytic

215

Which of the folowing stains is assessed on mature neutrophils and bands?

Leukocyte acid phosphatase

Leukocyte alkaline phosphatase

Periodic Acid Schiff

Sudan Black B

Leukocyte alkaline phosphatase

216

What is this large cell in the bone marrow that indicates a lipid storage disease due to a deficiency of glucocerebrosidase?

Gaucher

217

What is this bone marrow cell with the foamy, bubble-wrap appearance found in patients who have an abundance of sphingomyelin?

nieman-pick cell

218

What is the "drumstick" looking appendage on the nucleus of this segmented neutrophil called?

Barr bodies

219

A markedly increased number of lymphocytes (lymphocytosis) in an adult patient would suggest:

bacterial infection

viral infection

fungal infection

parasite infection

viral infection

220

A "shift to the left" means that the WBC differential has:

an increase in immature neutrophils.

an increase in lymphocytes.

an increase in eosinophils.

a relative lymphocytosis.

an increase in immature neutrophils

221

List a type of patient who would have a lymphocytosis as a normal condition?

children

222

What is the hematology term for increased numbers of segmented neutrophils and band cells?

Neutrophilia

Neutropenia

Pancytopenia

Neutrocytosis

Neutrophilia

223

What is the hematology term for a decrease in all blood cell lines?

pancytopenia

224

What is the hematology term for increased numbers of immature cells in the circulation?

shift to the left

225

Lymphocytes that have been stimulated by an antigen take on a much different appearance that non-stimulated cells. These cells have been called "atypical", "Turk cells", "Downey cells" "stimulated" and "reactive" cells. What is the term currently used to describe them?

variant lymphocyte

226

List two differences between acute and chronic leukemias?

Acute is blast cells, sudden onset
Chronic is all mature cells, slow onset

227

What is the hematology term to describe an increased number of eosinophils in the circulation?

eosinophilia

228

What is the hematology term used to describe more lymphocytes than segmented neutrophils on the differential count?

reversed differential

229

What are these cells that are resistant to treatment with tartaric acid?

hairy cells

230

What is the safest and least expensive treatment for patients with polycythemia vera:

1) moving to a high altitude


2) decrease of iron levels


3) therapeutic phlebotomy


4) decrease in erythropoietin levels

therapeutic phlebotomy

231

Which of the following findings is typical in cases of chronic myelogenous leukemia?

1) High score for leukocyte alkaline phosphatase stain


2) many teardrop-shaped cells on peripheral smear


3) presence of all stages of maturation of myelocytic cell series in peripheral blood


4) increased number of peripheral blood basophils

presence of all stages of maturation of myelocytic cell series in peripheral blood

232

Lymphocytes that produce immunoglobulins (antibodies) in response to antigenic stimulation are:

1) plasma cells


2) T Lymphocytes


3) thymocytes


4) lymphoblasts

plasma cells

233

What of the following anemias is often manifested as a clinical precursor to acute leukemia?

1) refractory anemia with excess blasts


2) vitamin deficiency or nutritional deficiency anemia


3) immunologic hemolytic anemia


4) non-immunologic hemolytic anemia

refractory anemia with excess blasts

234

Hodgkin`s disease encompasses a large group of disorders but usually includes a diagnostic variant cell on lymph node biopsy. Some people describe it as looking like "owl eyes". This variant cell is called a:

1) small cleaved large-cell lymphoma


2) plasma cell


3) reed-sternberg cell


4) blast cell

reed-sternberg cell

235

FAB classification uses the term "refractory anemia", this refers to what type of condition:

1) iron deficiency anemia


2) macrocytic anemia


3) folic acid deficiency


4) anemia resistant to treatment

anemia resistant to treatment

236

Waldenstrom`s macroglobulinemia is an unusual immunoproliferative disorder that comprises all the following EXCEPT:

1) normocytic normochromic anemia


2) IgM monoclonal antibody


3) hyperviscosity


4) lytic bone lesions/hypercalcemia

lytic bone lesions/hypercalcemia

237

Multiple myeloma is characterized by large amounts of _________ in urine.

1) IgM antibodies


2) IgG heavy chains


3) Tamm-Horsfall protein


4) IgG light chains

IgG light chains

238

Non-Hodgkin`s lymphoma is classified in 4 stages with the Ann Arbor staging classification. These stages are based upon:

1) site of organ involvement


2) number of reed-sternberg cells


3) increase and maturity of lymphocytes


4) B & T cell involvement

site of organ involvement

239

Essential (primary) thrombocythemia represents a clonal myeloproliferitive disorder which involves:

1) megakaryopoiesis


2) granulopoiesis


3) erythropoiesis


4) lymphopoiesis

megakaryopoiesis

240

The most common and most curable form of childhood leukemia is:

1) acute lymphoblastic leukemia


2) acute granulocytic leukemia


3) acute monocytic leukemia


4) chronic granulocytic leukemia

acute lymphoblastic leukemia

241

The malignant cell in Chronic Lymphocytic Leukemia is usually a (n):

1) small normal appearing lymphocyte


2) large reticuloendotherial cell


3) large myelomonocytic cells


4) undifferentiated blast cells

small normal appearing lymphocyte

242

Myeloproliferative Disorders (MPD) are clonal hemopoietic stem cell disorders that result in over accumulation of cells. All of the following are MPD`s except:

1) polycythemia vera


2) chronic myelogeneous leukemia


3) essential Thrombocythemia


4) Non-Hodgkin`s lymphoma

Non-Hodgkin`s lymphoma

243

What condition is defined by a platelet count >600 x 10, megakaryocyte hyperplasia, absence of ph chromosome and hemoglobin

essential thrombocythemia

244

The predominant cells in acute leukemia are:

1) mature cells


2) Blast cells


3) left shift in neutrophils


4) many small lymphocytes

Blast cells

245

Among patients with Hodgkin`s disease, the survival and cure rate is 10% or less

1) True


2) False

False

246

The classic Reed-Sternberg cell is observed in essential thrombocythemia.

1) True


2) False

false

247

Acute lymphoblastic leukemia (ALL) occurs most commonly in adults over 50.

1) True


2) False

False

248

Observing cells in the peripheral blood containing auer rods would indicate that the patient has the following leukemia:

1) acute lymphocytic (lymphoblastic) leukemia


2) acute myelogenous leukemia


3) chronic lymphocytic leukemia


4) hairy cell leukemia

acute myelogenous leukemia

249

There are two types of chronic lymphocytic leukemias, CLL and:

1) sezary syndrome


2) hodgkin's lymphoma


3) hairy cell leukemia


4) polycythemia vera

hairy cell leukemia

250

A peripheral blood smear with a proliferation of normal appearing lymphocytes and numerous smudge cells would indicate:

1) acute lymphocytic (lymphoblastic) leukemia


2) acute myelogenous leukemia


3) chronic lymphocytic leukemia


4) chronic myelogenous leukemia

chronic lymphocytic leukemia

251

Match the myeloproliferative disorder with the type of cell most associated with each disease.
___ polycythemia vera
____ essential thrombocythemia
____primary myelofibrosis
____chronic myelogenous leukemia
1.erythrocytes
2.leukocytes
3.megakaryocytes and platelets
4.fibroblasts

__1__ polycythemia vera
__3__ essential thrombocythemia
__4__ primary myelofibrosis
__2__ chronic myelogenous leukemia

252

Two indications that a cell might be a blast cell are:

1) nucleoli or auer rods


2) nucleoli or pseudopods


3) pseudopods or hypergranulation


4) toxic granulation or pince-nez nucleus

nucleoli or auer rods

253

The philadelphia chromosome is generally associated with which leukemia?

1) hairy cell leukemia


2) acute myelogenous leukemia


3) chronic lymphocytic leukemia


4) chronic myelogenous leukemia

chronic myelogenous leukemia

254

Which leukemia can cause Disseminated Intravascular Coagulation (DIC) when granules are released into the blood circulation?

1) Chronic myelogenous leukemia


2) Chronic lymphocytic leukemia


3) Acute Promyelocytic leukemia


4) Hairy cell leukemia

Acute Promyelocytic leukemia

255

Which of the lymphomas occurs primarily in children and young adults and has been associated with the Epstein Barr virus?

1) Hodgkin's lymphoma


2) Burkitt's lymphoma


3) Mantle cell lymphoma


4) T-cell lymphoblastic lymphoma

Burkitt's lymphoma

256

Auer rods are only found in myeloid cells; never in lymphoid cells. (True/False)

1) True


2) False

True

257

One of the rarest leukemias is more prevalent in patients with Down's syndrome. It is:

1) Acute Promyelocytic leukemia


2) Acute Monoblastic leukemia


3) Acute Megakaryocytic leukemia


4) Acute Erythroleukemia

Acute Megakaryocytic leukemia

258

Agnogenic Myeloid Metaplasia (AMM) is also called Chronic Idiopathic Myelofibrosis or Primary Myelofibrosis and is characterized by proliferation of fibroblasts in the bone marrow and:

1) Platelet counts that exceed 600,000


2) Hematocrit levels in male patients that exceed 18.5 mg/dL


3) Extramedullary hematopoiesis


4) WBC counts that exceed 300,000

Extramedullary hematopoiesis

259

The Philadelphia chromosome involves translocation of a part of one chromosome to another. The chromosomes involved are:

9 and 22

9 and 12

8 and 22

8 and 12

9 and 22

260

Agnogenic Myeloid Metaplasia and Chronic Idiopathic Myelofibrosis are other names for:

Chronic Myelogenous Leukemia

Polycythemia Vera

Essential Thrombocythemia

Primary Myelofibrosis or Myelofibrosis with myeloid metaplasia

Primary Myelofibrosis or Myelofibrosis with myeloid metaplasia

261

A 34-year old woman presented with a 2-month history of weakness, cough, fever and chills with night sweats. WBC count was 248 x 103/uL, Hgb = 9.5 gm/dL, Hct = 26.3%, Platelet count = 449 x103/uL. The differential showed 44% segmented neutrophils, 4% bands, 10% lymphocytes, 3% eosinophils, 7% basophils, 30% myelocytes, 1% promyelocytes, 1% myeloblasts and 2 nucleated RBCs per 100 WBCs. Her uric acid and LDH levels were both elevated. Which leukemia do you suspect?

Acute Myelogenous Leukemia

Acute Lymphoblastic Leukemia

Chronic Myelogenous Leukemia

Chronic Lymphocytic Leukemia

Chronic Myelogenous Leukemia

262

The most common lymphoma in young adults is:

follicular lymphoma

DLBCL

Hodgkin lymphoma

Mycosis fungoides

Hodgkin lymphoma

263

A patient presents with anemia, oval macroytes, and hypersegmented neutrophils. Which of the following laboratory tests would be most efficient in differentiating this disorder?

serum iron and ferritin

erythropoietin level

Vitamin B12 and folate

Chromosome analysis

Vitamin B12 and folate

264

Which of the following diseases has IgG light chains (Bence-Jones proteins) excreted into the urine?

multiple myeloma

acute lymphoblastic leukemia

refractory anemia

refractory anemia with excess blasts

multiple myeloma

265

A lymphoma characterized by heavy vacuolation in circulating lymphocytes and occurs primarily in children or young adults is:

Hodgkins Lymphoma

Chronic Lymphocytic Leukemia

Burkitt's Lymphoma

Mantle Cell Lymphoma

Burkitt's Lymphoma

266

The leukemia that has cells resistant to treatment with tartaric acid (tartrate) is:

Acute Promyelocytic Leukemia

Acute Lymphoblastic Leukemia

Chronic Lymphocytic Leukemia

Hairy Cell Leukemia

Hairy Cell Leukemia

267

Which Myelodysplastic Syndrome has the best prognosis?

Refractory Anemia

Refractory Anemia with Excess Blasts

Refractory Anemia with Excess Blasts in Transformation

Chronic Myelogenous Leukemia

Refractory Anemia