Hematology Final

A set of laboratory practices that ensure reliable outcomes for patient results is

Quality Assurance

which of the following is the most important element of standard precautions?

Handwashing

Production, development, and maturation of all blood cells is called?

Hematopoiesis

The development order for Red Blood Cells (RBCs) is which of the following?

Pronormoblast, basophilic normoblast, polychromatophilic normoblast, orthochromic normoblast, reticulocyte, erythrocyte

How many parameters does a CBC have?

9

When viewing a slide with a 100x objective and 10x ocular lens, what is the total magnification?

1000

The most stable parameter of a CBC

MCV

Intrinsic factor, secreted by the parietal cells of the stomach, is necessary for

absorption of b12

Pancytopenia means

Low WBC, RBC, PLT

n which of the following conditions should a CBC be placed at 37 degree C for 15-30 minutes before running the test?

Cold Agglutinin Syndrome

A male with sickle cell (SS) and a female sickle cell trait (AS) have what likelihood of having a child with sickle cell anemia?

50%

It is common to see increased RBC inclusions post splenectomy

True

Hypersegmentation means

Neutrophil has more than 5 lobes

An enzyme deficiency associated with a moderate to severe hemolytic anemia after the patient is exposed to certain drugs or infections and characterized by red cell inclusions formed by denatured hemoglobin is:

G6PD deficiency

In which of the following, are smudge cells usually present?

CLL

Which of the following is an abnormal protein that is is an overproduction of IgM?

Waldenstrom's Macroglobulinemia

Reed-Sternberg cells are present in

Hodgkin's Lymphoma

Lymphocytes in CLL are

increased in number and nonfunctional

What is the cytochemical stain used to diagnosis Hairy cell leukemia?

TRAP

Which disease results in an accumulation of plasma cells in the bone marrow?

Multiple Myeloma

What is the red cell condition known for looking like a stack of coins and caused by abnormal proteins?

Roleaux

Bence-Jones protein is found in the urine of patients with

Multiple Myeloma

Preleukemia, Dysmyelopoietic syndrome, Oligoblastic anemia, and Refractory anemias are all other names for what syndromes?

Myelodysplastic syndromes

All of the coagulation factors except a portion of factor VIII are produced in

The liver

A patient with classic Hemophilia A is deficient in

Factor VIII

Which lab test measures the extrinsic pathway?

PT

Which lab test measures the intrinsic pathway?

PTT

The anticoagulant of choice for coagulation testing is (blue-top tube)

Sodium citrate

The blood–to–anticoagulant ratio for coagulation testing is

9:1

Which of the following is a normal platelet count?

212,000

The most common drug related platelet abnormality is due to

aspirin

Any group of disorders in which a particular clotting factor is decreased is referred to as

Hemophilia

The principal substrate of the coagulation and fibrinolytic system isis

fibrinogen

Which of the following short-term anticoagulant drugs, administered by intravenous infusion, is monitored by the PTT value?

Heparin

The international normalized ratio (INR) is useful in:

monitoring coumadin therapy

What is the expected Prothrombin (PT) result in a patient who is on coumadin and is stable?

26 seconds

Obstetrical complications like retained placenta or abruption placenta are a leading cause of:

DIC

A normal cerebrospinal fluid has a clear and colorless appearance.

True

Cerebrospinal fluids (CSF), synovial fluids, and serous fluids (pericardial, pleural and peritoneal) have cellular elements which often change in predictable patterns with disease states.

True

What department is the CSF tube labeled 3 routinely sent to?

Hematology

A total CSF cell count on a clear fluid should be:

counted undiluted

The purpose of adding albumin to body fluids before cytocentrifugation is to:

increase the cell yield and decrease cellular distortion

Before testing, viscous synovial fluid should be treated with :

hyaluronidase

The procedure for collecting synovial fluid is called:

Arthrocentesis

The procedure for collecting pleural fluid is called:

thoracentesis

A milky-appearing pleural fluid indicates:

thoracic duct leakage or chronic inflammation

A significant cell found in pericardial or pleural fluid that should be referred to cytology is a:

mesothelioma cell

The most characteristic change seen in the peripheral smear of a patient with multiple myeloma is the presence of:

Roleaux

The JAK2 chromosomal mutation is associated with

Polycythemia vera

According to current WHO classification criteria, acute leukemia is characterized by which of the following?

Hypercellular bone marrow with greater than 20% blasts

_____ is predominantly a disease of children.

ALL

An autosomal disorder that manifests itself with large lysosomal inclusions, recurring infections, and albinism is

Chediak-Higashi Syndrome

The best corrective action for a patient who exhibits platelet satellitium on peripheral blood smear is to

redraw the sample in sodium citrate

Toxic vacuolization occurs most frequently in

neutrophils

Patients with hemophilia A or B have abnormal results in which coagulation assay?

PTT

Which of the following is the most useful in differentiating hemophilia A from hemophilia B?

Factor Assays

Infectious mononucleosis is caused by the EBV virus, which infects B lymphocytes.

True

In the Hematology lab, it is necessary to wear PPE in the following circumstance

When handling any specimen

The variability of events that can occur to an unknown sample before analysis

preanalytical

Delta Check

QC method for comparing a patient's own current results with previously verified results

reference intervals

values that have been established for a particular analyte, method, or instrument in a particular patient population.

which is a normal hemoglobin value

15 g/dL

used to monitor performance of a method after callibration

Control Materials

Primary purpose of hemoglobin

deliver oxygen

Morphological classification of anemia is determined by

Red cell indices

values outside of the reference range that need immediate action are

critical results

Which of the following tests monitors RBC production

reticulocyte count

in an adult, the usual location for obtaining a bone marrow aspirate is the

illiac crest

The proper definition of a standard is

solutions with a known amount of (fixed) analyte

the majority of iron found in an adult is found in

hemoglobin

Heinz bodies are

unable to be seen with typical, commonly used staining methods

average lifespan of an RBC

120 days

Howell-jolly bodies are remnants of:

DNA

An early indicator of an anemic process may be

RDW

hypochromia is used to define

decrease in hemoglobin content of RBCs

An unusual finding in intravascular hemolysis is

hemoglobinuria may be present

normal adult hemoglobin consists of how many heme molecules?

four

Hormone responsible for RBC production

erythropoietin/EPO

Where is EPO produced?

the kidneys

another name for orthochromic normoblast

nRBC

Which settings on the microscope are used for focusing?

coarse and fine adjustments

The most important preanalytical step

Patient identification

Function of the spleen in adults

removing imperfect and old RBCs

Sickles that are able to be reoxygenated are labelled

reversible

macrocytes and hypersegmented neutrophils indicate which type of anemia?

megaloblastic anemia

Alpha thalassemia major results from

not enough functional hemoglobin A produced

Beta thalassemia major results from

no Hemoglobin A being synthesized

aplastic anemia is characterized by

pancytopenia and reticulocytopenia

What test is used to confirm a positive sickle cell screening test

Hemoglobin electrophoresis

What red cell inclusion may be present post-splenectomy

Howell-Jolly bodies

Hereditary pyropoikilocytosis is a red cell membrane defect characterized by

misshapen budding fragmented cells

Iron deficiency anemia is characterized by

decreased serum iron, decreased serum ferritin, increased TIBC

Macrocytes typically seen in megaloblastic anemias are

oval shaped

which organ is responsible for pitting RBCS

spleen

which antibody is associated with paroxysmal cold hemoglobinuria

anti-p

Which red cell index values are associated with megaloblastic anemias

MCV 125, MCH 30, MCHC 34%

Sickle cell trait is achieved through

heterozygous inheritance of hemoglobin S

pernicious anemia is a subset of which of these anemias?

megaloblastic anemia

Individuals with a vitamin b12 defieciency will require

life long therapy

Which hemoglobin will show crystals appearing like bars of gold?

hemoglobin C disease

Which alpha thalassemia is incompatible with life?

bart's hydrops fetalis

test of choice for hereditary spherocytosis

osmotic fragility test

Characteristic morphologic feature in folic acid deficiency is

macrocytes

typical cell seen in megalosblastic anemia

macrocyte

two parents with sickle cell trait have what % chance of having a child with sickle cell anemia

25%

spherocytes can result from a defective membrane protein

true

repeated blood transfusions can cause iron overload

true

alpha thalassemia causes facial skeletal abnormalities

false

This condition has nothing to do with iron

alpha thalassemia

megaloblastic anemias have a decreased M:E ratio and shortened RBC ratio

true

what is true about patients with sickle cell trait

they have protection from malaria and lead normal lives

these cells cause obstructions in blood vessels, increase viscosity, and slow circulation

sickle cells

most common treatment for IDA

oral iron

rare disorder with congenital malformations

fanconi's anemia

anemia with crystals shaped like washington monument

Hemoglobin SC

two alpha gene deletion

alpha thalassemia disease

primary purpose of WBCs

defend against bacteria, fungi, viruses, and foreign substances

absolute differential count is

total WBC x 1,000 x % of cell type

Which cell is increased and has atypical forms in infectious mono

lymphocytes

which organs are the primary site for lymphocytes

BM and thymus

The primary functions of lymphocytes are recognizing what is foreign, forming antibodies, and securing immunity

true

The primary function of t lymphocytes is making antibodies

false

Define left shift

increase in bands and metamyelocytes

exaggerated response to infection and inflammation

leukamoid reaction

in which of these circumstance do you usually see toxic granulation?

severe infection

reed-sternberg cells are present in

hodgkin's lymphoma

rare genetic disorder characterized by coarse, dark granules in all WBC types

alder-reilly anomaly

inherited disorder showing hyposegmented neutrophils

pelger-huet anomaly

four stages of WBC phagocytosis

chemotaxis, opsonization, ingestion, killing

which is a tick-borne illness

human erlichiosis

the suffic penia means

decrease

the suffix osis or philia means

increase

in infectious mono, lymphocytes tend to be reactive and enlarged with abundant royal blue cytoplasm

True

When blood reacts with EDTA, causing platelets to form rings around neutrophils

platelet satellitism

Which feature distinguishes a monocyte from a lymphocyte

abundant, gray-blue cytoplasm

what statement best describes acute leukemias

a quick onset occurring at any age

acute myeloid leukemias are seen in

myeloid and monocytic cells

patients with AML have

more than 20% blasts in the bone marrow

auer rods are present in which of the following

AML

what type of anemia is present in a patient with acute leukemia?

normocytic, normochromic

all stages of neutrophils are seen in the blood of a patient with:

Chronic granulocytic anemia

a patient with a normal WBC value, elevated platelets, increased marrow megakaryocytes, and a history of frequent bleeding and clotting episodes most likely has

polycythemia vera

what can be used to separate the initial diagnosis between acute and chronic leukemia?

cell maturity

first choice of treatment for polycythemia vera

therapeutic phlebotomy

pink staining rods seen in myeloblasts in leukemias

Auer rods

organ that holds 1/3 of total platelet volume in circulation

spleen

a low platelet count is most often anticipated when a patient demonstrates:

petechiae

What are petechiae