HEMATOLOGY
I. MULTIPLE CHOICE: Each of the questions or incomplete statements that follow comprises four suggested responses. Select the
best answer or completion statement in each case.
1. After the removal of RBCs from the circulation, hemoglobin is broken down into _________.
A. Iron, porphyrin, and amino acids C. Heme, protoporphyrin, and amino acids
B. Iron, porphyrin, and globin D. Heme, hemosiderin, and globin
2. The term “shift to the left” refers to _____________.
A. Immature cell forms in the peripheral blood C. A calibration adjustment on an instrument
B. A trend on a Levy-Jennings chart D. A microscopic adjustment
C. M1 and M2 CIn the French-American-British (FAB) classification, myelomonocytic
leukemia would be ______________.
D. . M4
E. M3 D. M5
3. To evaluate normal platelet numbers in an appropriate area of a blood smear, approximately how many platelet should be
observed per oil immersion field?
A. 1-4 C. 8-20
B. 4-10 D. 20-50
4. When platelets concentrate at the edges and feathered end of a blood smear, it is usually due to _____________.
A. Abnormal proteins C. Poorly made wedge smear
B. Hemorrhage D. Inadequate mixing of blood and anticoagulant - IRREGULAR CLUMPING
5. What is the depth of the space between the counting platform and the coverslip on a hemocytometer?
A. 0.01 mm C. 1.00 mm
B. 0.10 mm D. 0.1 cm
6. A clinically significant difference between two electronic cell counts is indicated when the SD is greater than _________.
A. ± 1.0 C. ± 2.0
B. ± 1.5 D. ± 3.0
7. Acquired sideroblastic anemia may be present in all of the following EXCEPT ________________.
A. Alcoholism C. Malabsorption
B. Lead poisoning D. Myelodysplastic syndromes
8. All stages of neutrophils are most likely to be seen in the peripheral blood of a patient with ______________.
A. Chronic granulocytic leukemia C. Erythroleukemia
B. Myelofibrosis w/ myeloid metaplasia D. Acute granulocytic leukemia
9. The ideal capillary blood collection site on a newborn is ___________.
A. Tip of the thumb C. Plantar surface of the heel
B. Ear lobe D. The great toe
10. The chamber counting method of platelet enumeration _______________.
A. Has a high degree of reproducibility C. Allows direct visualization of the particles being counted
B. Has a high degree of precision D. Is the method of choice for performing 50-60 counts/day
11. Thrombocytopenia is a characteristic of _____________.
A. Classic von Willebrand’s disease C. Glanzmann’s thrombasthenia
B. Hemophilia A D. May – Hegglin anomaly
Pag
e
12. Coagulation factors affected by coumarin drugs are _______________.
PA
GE
A. VIII, IX, X C. II, VII, IX, X \*
B. I, II, V, VII D. II, V, VII ME
RG
EF
OR
13. Which of the following procedures is most helpful in differentiating severe liver disease and accompanying fibrinolysis from MA
disseminated intravascular coagulation? T9
A. Increased APTT C. Presence of fibrin split products
B. Factor VIII activity D. Fibrinogen level
, 14. An automated leukocyte count is 22.5 x 10 3/ uL. The differential reveals 200 normoblasts/ 100 leukocytes. What is the
actual leukocyte count per microliter?
A. 7500/ uL C. 14,400/ uL
B. 11,500/ uL D. 22,300/ uL
15. Which of the following is a TRUE statement about the idiopathic thrombocytopenic purpura (ITP)?
A. Women are more commonly affected C. Peripheral destruction of platelets is decreased
B. It is found primarily in adults D. Spontaneous remission usually occurs within several weeks
16. The most common cause of error when using automated cell counters is _____________.
A. Contamination of the diluent C. Inadequate mixing of the sample prior to testing
B. A calibrating error D. Variation in voltage of the current supply
17. Which of the following lab findings is associated with Factor XIII deficiency?
A. Prolonged thrombin time C. Prolonged APTT
B. Prolonged prothrombin time D. Clot solubility in a 5 molar urea solution
18. Hemoglobin H disease results from _________.
A. Absence of 3 of 4 alpha genes C. Absence of 1 of 4 alpha genes
B. Absence of 2 of 4 alpha genes D. Absence of all alpha genes
19. Which of the following is associated with pseudo – Pelger – Huet anomaly?
A. Aplastic anemia C. Chediak-Higashi syndrome
B. Iron deficiency anemia D. Myelogenous leukemia
20. An increased amount of cytoplasmic basophilia in a blood cell indicates _______________.
A. Increased cytoplasmic maturation C. Reduction in cell size
B. Decreased cytoplasmic maturation D. Decreased nuclear maturation
21. Many microspherocytes and schistocytes and budding off spherocytes can be seen in PBS of patients with _________.
A. Hereditary spherocytosis C. Acquired hemolytic anemia
B. DIC D. Extensive burns
22. Blood collection in EDTA undergoes which of the following changes if kept at RT for 6-24 hours?
A. Increased hematocrit and MCV C. Increased MCHC and MCV
B. Increased ESR and MCV D. Decreased reticulocyte count and hematocrit
23. The absence of Philadelphia chromosome in granulocytic leukemia suggests ________________.
A. Rapid progression of the disease C. Excellent response to therapy
B. Polyclonal origin of the disease D. Conversion to another myeloproliferative disorder
24. A PBS demonstrating an absolute increase in small “hypermature” lymphocytes and “smudge” cells would be suggestive of
____________.
A. Chronic lymphocytic leukemia C. Leukomoid reaction
B. Acute lymphocytic leukemia D. Infectious mononucleosis
25. A patient with normal hemoglobin and WBC count values, a persistently elevated platelet count (over 1,000 x 10 9/L),
increased marrow megakaryocytes, and a history of frequent bleeding and clotting episodes most likely has __________.
A. Polycythemia vera C. Essential thrombocytopenia
B. Chronic myelofibrosis D. Chronic myelogenous leukemia
26. Falsely increased automated platelet counts may result from ____________.
A. Platelet satellitism C. Exceptionally large platelets
B. Platelet agglutinins D. Erythrocyte inclusion bodies
27. If a patient has a reticulocyte count of 7% and a hematocrit of 20%, what is the corrected reticulocyte count?
A. 1.4% C. 3.5%
B. 3.1% D. 14% Pag
e
28. What is the total RBC count if an average of 400 RBCs were counted in 5 of the 25 squares in the large 1-mm square and the PA
specimen dilution factor is 200? GE
A. 2.3 x 1012/L C. 4.0 x 1012/L \*
12
B. 3.5 x 10 /L D. 4.2 x 1012/L ME
RG
29. A native of Thailand has a normal hemoglobin level. Hemoglobin electrophoresis on cellulose acetate shows 45% Hgb A and EF
approximately 40% of a hemoglobin with the mobility of Hgb A2. This is most consistent with ________________. OR
MA
T9
A. Hgb C trait C. Hgb O trait
B. Hgb E trait D. Hgb D trait
I. MULTIPLE CHOICE: Each of the questions or incomplete statements that follow comprises four suggested responses. Select the
best answer or completion statement in each case.
1. After the removal of RBCs from the circulation, hemoglobin is broken down into _________.
A. Iron, porphyrin, and amino acids C. Heme, protoporphyrin, and amino acids
B. Iron, porphyrin, and globin D. Heme, hemosiderin, and globin
2. The term “shift to the left” refers to _____________.
A. Immature cell forms in the peripheral blood C. A calibration adjustment on an instrument
B. A trend on a Levy-Jennings chart D. A microscopic adjustment
C. M1 and M2 CIn the French-American-British (FAB) classification, myelomonocytic
leukemia would be ______________.
D. . M4
E. M3 D. M5
3. To evaluate normal platelet numbers in an appropriate area of a blood smear, approximately how many platelet should be
observed per oil immersion field?
A. 1-4 C. 8-20
B. 4-10 D. 20-50
4. When platelets concentrate at the edges and feathered end of a blood smear, it is usually due to _____________.
A. Abnormal proteins C. Poorly made wedge smear
B. Hemorrhage D. Inadequate mixing of blood and anticoagulant - IRREGULAR CLUMPING
5. What is the depth of the space between the counting platform and the coverslip on a hemocytometer?
A. 0.01 mm C. 1.00 mm
B. 0.10 mm D. 0.1 cm
6. A clinically significant difference between two electronic cell counts is indicated when the SD is greater than _________.
A. ± 1.0 C. ± 2.0
B. ± 1.5 D. ± 3.0
7. Acquired sideroblastic anemia may be present in all of the following EXCEPT ________________.
A. Alcoholism C. Malabsorption
B. Lead poisoning D. Myelodysplastic syndromes
8. All stages of neutrophils are most likely to be seen in the peripheral blood of a patient with ______________.
A. Chronic granulocytic leukemia C. Erythroleukemia
B. Myelofibrosis w/ myeloid metaplasia D. Acute granulocytic leukemia
9. The ideal capillary blood collection site on a newborn is ___________.
A. Tip of the thumb C. Plantar surface of the heel
B. Ear lobe D. The great toe
10. The chamber counting method of platelet enumeration _______________.
A. Has a high degree of reproducibility C. Allows direct visualization of the particles being counted
B. Has a high degree of precision D. Is the method of choice for performing 50-60 counts/day
11. Thrombocytopenia is a characteristic of _____________.
A. Classic von Willebrand’s disease C. Glanzmann’s thrombasthenia
B. Hemophilia A D. May – Hegglin anomaly
Pag
e
12. Coagulation factors affected by coumarin drugs are _______________.
PA
GE
A. VIII, IX, X C. II, VII, IX, X \*
B. I, II, V, VII D. II, V, VII ME
RG
EF
OR
13. Which of the following procedures is most helpful in differentiating severe liver disease and accompanying fibrinolysis from MA
disseminated intravascular coagulation? T9
A. Increased APTT C. Presence of fibrin split products
B. Factor VIII activity D. Fibrinogen level
, 14. An automated leukocyte count is 22.5 x 10 3/ uL. The differential reveals 200 normoblasts/ 100 leukocytes. What is the
actual leukocyte count per microliter?
A. 7500/ uL C. 14,400/ uL
B. 11,500/ uL D. 22,300/ uL
15. Which of the following is a TRUE statement about the idiopathic thrombocytopenic purpura (ITP)?
A. Women are more commonly affected C. Peripheral destruction of platelets is decreased
B. It is found primarily in adults D. Spontaneous remission usually occurs within several weeks
16. The most common cause of error when using automated cell counters is _____________.
A. Contamination of the diluent C. Inadequate mixing of the sample prior to testing
B. A calibrating error D. Variation in voltage of the current supply
17. Which of the following lab findings is associated with Factor XIII deficiency?
A. Prolonged thrombin time C. Prolonged APTT
B. Prolonged prothrombin time D. Clot solubility in a 5 molar urea solution
18. Hemoglobin H disease results from _________.
A. Absence of 3 of 4 alpha genes C. Absence of 1 of 4 alpha genes
B. Absence of 2 of 4 alpha genes D. Absence of all alpha genes
19. Which of the following is associated with pseudo – Pelger – Huet anomaly?
A. Aplastic anemia C. Chediak-Higashi syndrome
B. Iron deficiency anemia D. Myelogenous leukemia
20. An increased amount of cytoplasmic basophilia in a blood cell indicates _______________.
A. Increased cytoplasmic maturation C. Reduction in cell size
B. Decreased cytoplasmic maturation D. Decreased nuclear maturation
21. Many microspherocytes and schistocytes and budding off spherocytes can be seen in PBS of patients with _________.
A. Hereditary spherocytosis C. Acquired hemolytic anemia
B. DIC D. Extensive burns
22. Blood collection in EDTA undergoes which of the following changes if kept at RT for 6-24 hours?
A. Increased hematocrit and MCV C. Increased MCHC and MCV
B. Increased ESR and MCV D. Decreased reticulocyte count and hematocrit
23. The absence of Philadelphia chromosome in granulocytic leukemia suggests ________________.
A. Rapid progression of the disease C. Excellent response to therapy
B. Polyclonal origin of the disease D. Conversion to another myeloproliferative disorder
24. A PBS demonstrating an absolute increase in small “hypermature” lymphocytes and “smudge” cells would be suggestive of
____________.
A. Chronic lymphocytic leukemia C. Leukomoid reaction
B. Acute lymphocytic leukemia D. Infectious mononucleosis
25. A patient with normal hemoglobin and WBC count values, a persistently elevated platelet count (over 1,000 x 10 9/L),
increased marrow megakaryocytes, and a history of frequent bleeding and clotting episodes most likely has __________.
A. Polycythemia vera C. Essential thrombocytopenia
B. Chronic myelofibrosis D. Chronic myelogenous leukemia
26. Falsely increased automated platelet counts may result from ____________.
A. Platelet satellitism C. Exceptionally large platelets
B. Platelet agglutinins D. Erythrocyte inclusion bodies
27. If a patient has a reticulocyte count of 7% and a hematocrit of 20%, what is the corrected reticulocyte count?
A. 1.4% C. 3.5%
B. 3.1% D. 14% Pag
e
28. What is the total RBC count if an average of 400 RBCs were counted in 5 of the 25 squares in the large 1-mm square and the PA
specimen dilution factor is 200? GE
A. 2.3 x 1012/L C. 4.0 x 1012/L \*
12
B. 3.5 x 10 /L D. 4.2 x 1012/L ME
RG
29. A native of Thailand has a normal hemoglobin level. Hemoglobin electrophoresis on cellulose acetate shows 45% Hgb A and EF
approximately 40% of a hemoglobin with the mobility of Hgb A2. This is most consistent with ________________. OR
MA
T9
A. Hgb C trait C. Hgb O trait
B. Hgb E trait D. Hgb D trait
