MISC 1 & 2

Question 1

The erythrocyte sedimentation rate is increased in:

Answer 1

Pregnancy, severe anemia and multiple myeloma

Question 2

The anticoagulant used in performing the Westergren ESR (erythrocyte sedimentation rate) is:

Answer 2

Sodium citrate

Question 3

What causes a Wrights stained peripheral blood smear to appear “too pink”?

Answer 3

under buffering

Question 4

When using a Romanowsky stain, what stains the leukocytes nuclear material?

Answer 4

basic dye

Question 5

Which stain is used for staining thick smears for malaria parasites?

Answer 5

Giemsa stain

Question 6

Hemolysis is greatest in which species of malaria?

Answer 6

P. falciparum

Question 7

What stains make up a Romanowsky stains?

Answer 7

eosin and methylene blue

Question 8

How are the results affected when the erythrocyte sedimentation tube is not placed exactly in the vertical position?

Answer 8

Increased

Question 9

Which of the following would be classed as a non-technical factor that affects the ESR?

Answer 9

Size of red cells

Question 10

How is Malaria transmitted?

Answer 10

Bite of the Anopheles mosquito

Question 11

Which species of malaria prefers to infect only young RBC’s?

Answer 11

P. vivax and P. ovale

Question 12

Which specie(s) of malaria prefers to infect only old RBC’s?

Answer 12

P. malariae

Question 13

What is the major hemoglobin found in the RBC’s of a patient with Homozygous Sickle Cell anemia?

Answer 13

HGB S

Question 14

What is measured by the ESR?

Answer 14

the settling of RBC’s in a specific period of time

Question 15

How does the species P. vivax differ from P. falciparum?

Answer 15

Presence of a large ring for, enlargement of red cell, presence of schuffner’s dots

Question 16

Which factors affect the result of the ESR?

Answer 16

The diameter of the tube, change in temperature more than 25C, anemia

Question 17

How will cells appear in a blood smear, stained with Wright’s stain, when the pH of the buffer is 8.0?

Answer 17

Nuclei stained deep blue, red cells blue or greenish, eosinophil granules gray

Question 18

What is the purpose of the phosphate buffer in the Wright’s stain?

Answer 18

dissociates the dyes to stain the various cellular elements

Question 19

In P. falciparum, which stage is rarely found on the peripheral blood smear?

Answer 19

Schizont

Question 20

What is the most common reason for blood smears having red cells that are gray and white cells that are barely visible?

Answer 20

Over-rinsing

Question 21

What tests are used as a screening tool for sickle cell anemia?

Answer 21

hemoglobin/hematocrit, blood smear examination and HGB S solubility

Question 22

Which stain is used to demonstrate siderocytes?

Answer 22

Perl’s Prussian Blue

Question 23

What is the name of malarial life cycle that takes place in the mosquito?

Answer 23

Sexual cycle

Question 24

What is the earliest age, sickle cells can be seen on the peripheral blood smear in a patient with homozygous sickle cell anemia?

Answer 24

6 months

Question 25

To differentiate between homozygous and heterozygous sickle cell anemia, which one of these tests should be performed?

Answer 25

HGB electrophoresis

Question 26

Which species of malaria is the most pathogenic and can cause death in 36 to 48 hours?

Answer 26

P. falciparum

Question 27

Increased ESR is most affected by:

Answer 27

increased plasma proteins

Question 28

In sickle cell anemia, what causes the abnormality in the beta chain of the hemoglobin molecule?

Answer 28

Replacement of glutamic acid by valine

Question 29

What conditions may be associated with Sickle Cell disease?

Answer 29

Decreased red cell survival, positive hemoglobin solubility test, abnormal hgb electrophoresis

Question 30

All the following would be expected 1 year after a splenectomy on a patient with severe hereditary spherocytosis EXCEPT

Answer 30

Reticulocyte count of 10%

Question 31

What lab findings is exhibited with a patient with G6PD deficiency?

Answer 31

Precipitous HGB drop. normochromic, normocytic anemia, bite cells

Question 32

What are Pappenheimer bodies composed of?

Answer 32

Ferric iron

Question 33

What is the name of the enzyme needed to catalyze the first step in the pentose phosphate shunt/ Hexose Monophosphate Pathway?

Answer 33

Glucose-6-phosphate dehydrogenase

Question 34

What are Heinz bodies composed of?

Answer 34

Denatured hemoglobin

Question 35

What best describes a siderocyte?

Answer 35

Erythrocyte with Pappenheimer bodies

Question 36

What inclusion body is composed of remnants of the mitotic spindle?

Answer 36

Cabot ring

Question 37

What does the presence of spherocytes and polychromasia in the peripheral blood indicate?

Answer 37

Extravascular hemolysis

Question 38

What does the presence of schistocytes in the peripheral blood indicate?

Answer 38

intravascular hemolysis

Question 39

What diagnostic test would help diagnosis of a G6PD-deficient person in a hemolytic crisis?

Answer 39

Heinz body prep

Question 40

What disorders are associated with Howell Jolly Bodies?

Answer 40

Hemoglobin S/S disease, hyposplenism, anemia of chronic disease

Question 41

What defect is associated with Hereditary Spherocytosis (HS)?

Answer 41

Red cell membrane skeletal proteins

Question 42

What is the purpose of performing a reticulocyte count?

Answer 42

Assessing the erythropoietic activity of the bone marrow

Question 43

What are the primary molecular defects in Hereditary Spherocytosis?

Answer 43

Ankyrin, band 3, protein 4.2 and spectrin deficiency

Question 44

What best describes Schistocytes?

Answer 44

RBC sheared from fibrin deposits

Question 45

What stain is used to perform a manual reticulocyte count?

Answer 45

Supravital stain

Question 46

What causes microcytes?

Answer 46

Impaired Hb synthesis in BM

Question 47

What causes sickle cells?

Answer 47

Deoxygenation causes polymerization of Hb distorting RBC

Question 48

What are Sideroblastic granules composed of?

Answer 48

Iron granules

Question 49

What are coverslip smears used primarily for

Answer 49

bone marrow aspirates

Question 50

What is suggested by the presence of polychromatophilic red blood cells (RBCs) on a blood film?

Answer 50

reticulocyte count will be increase and there is enhanced bone marrow erythropoiesis

Question 51

What patient condition causes macroscopic holes in a blood smear?

Answer 51

increased lipids in the plasma can cause the appearance of holes all over the smear