ASCP Hematology Review | 250 Questions | 100%
Correct Answers
Course
ASCP
Question 1
A 45-year-old male patient presents with fatigue and pallor. A complete blood count (CBC)
shows a hemoglobin level of 10 g/dL, hematocrit of 30%, and a mean corpuscular volume
(MCV) of 70 fL. What type of anemia is most likely?
A) Macrocytic anemia
B) Microcytic anemia
C) Normocytic anemia
D) Sideroblastic anemia
Answer: B) Microcytic anemia
Rationale: The low hemoglobin and hematocrit levels, along with an MCV of 70 fL (below
the normal range), suggest microcytic anemia, which is often due to iron deficiency.
Question 2
A patient presents with recurrent infections and an abnormal white blood cell count. A bone
marrow biopsy reveals an increased number of blast cells. What is the most likely diagnosis?
A) Chronic lymphocytic leukemia (CLL)
B) Acute myeloid leukemia (AML)
C) Multiple myeloma
D) Lymphoma
Answer: B) Acute myeloid leukemia (AML)
Rationale: The presence of increased blast cells in the bone marrow and recurrent infections
indicates acute myeloid leukemia, which is characterized by the accumulation of immature
myeloid cells.
Question 3
Which of the following laboratory findings is most characteristic of hemolytic anemia?
A) Decreased reticulocyte count
B) Increased bilirubin levels
C) Decreased lactate dehydrogenase (LDH) levels
D) Increased haptoglobin levels
,Answer: B) Increased bilirubin levels
Rationale: Hemolytic anemia leads to increased destruction of red blood cells, resulting in
elevated bilirubin levels due to the breakdown of hemoglobin.
Question 4
A 60-year-old woman presents with unexplained bruising and a CBC shows a platelet count
of 30,000/μL. A peripheral blood smear reveals large platelets. What is the most likely
condition?
A) Idiopathic thrombocytopenic purpura (ITP)
B) Thrombotic thrombocytopenic purpura (TTP)
C) Myelodysplastic syndrome
D) Bone marrow infiltration
Answer: A) Idiopathic thrombocytopenic purpura (ITP)
Rationale: ITP is characterized by isolated thrombocytopenia and the presence of large
platelets on the smear, indicating increased platelet turnover.
Question 5
In which condition would you expect to see a "smudge cell" on a peripheral blood smear?
A) Chronic lymphocytic leukemia (CLL)
B) Acute lymphoblastic leukemia (ALL)
C) Chronic myeloid leukemia (CML)
D) Acute myeloid leukemia (AML)
Answer: A) Chronic lymphocytic leukemia (CLL)
Rationale: Smudge cells are indicative of chronic lymphocytic leukemia, resulting from
fragile lymphocytes that break apart during the preparation of the blood smear.
Question 6
A 30-year-old male presents with bone pain and recurrent infections. Laboratory results show
hypercalcemia, anemia, and a high level of monoclonal immunoglobulin in serum. What is
the most likely diagnosis?
A) Waldenström macroglobulinemia
B) Multiple myeloma
C) Lymphoma
D) Chronic lymphocytic leukemia (CLL)
,Answer: B) Multiple myeloma
Rationale: The combination of bone pain, recurrent infections, hypercalcemia, and
monoclonal immunoglobulin in the serum is characteristic of multiple myeloma.
Question 7
What is the primary function of platelets in hemostasis?
A) To transport oxygen
B) To form a fibrin clot
C) To adhere to the site of vascular injury
D) To activate the coagulation cascade
Answer: C) To adhere to the site of vascular injury
Rationale: The primary function of platelets is to adhere to the site of vascular injury and
aggregate to form a temporary plug before the coagulation cascade leads to fibrin clot
formation.
Question 8
A patient with known sickle cell disease presents with severe pain in the chest and back.
Which complication should be suspected?
A) Stroke
B) Acute chest syndrome
C) Pulmonary embolism
D) Aplastic crisis
Answer: B) Acute chest syndrome
Rationale: Chest pain in a patient with sickle cell disease may indicate acute chest syndrome,
a serious complication resulting from sickle-shaped red blood cells obstructing pulmonary
blood flow.
Question 9
Which of the following laboratory findings is indicative of vitamin B12 deficiency?
A) Decreased reticulocyte count
B) Hypersegmented neutrophils
C) Increased platelet count
D) Microcytic red blood cells
, Answer: B) Hypersegmented neutrophils
Rationale: Hypersegmented neutrophils are a classic finding in vitamin B12 deficiency and
reflect impaired DNA synthesis.
Question 10
In which condition is the "hairy cell" appearance typically observed in peripheral blood?
A) Chronic lymphocytic leukemia (CLL)
B) Hairy cell leukemia
C) Acute lymphoblastic leukemia (ALL)
D) Myelodysplastic syndrome
Answer: B) Hairy cell leukemia
Rationale: The "hairy cell" appearance refers to the abnormal lymphocytes seen in hairy cell
leukemia, characterized by fine cytoplasmic projections.
Question 11
A patient with chronic kidney disease presents with anemia. What is the most likely cause of
the anemia in this patient?
A) Iron deficiency
B) Vitamin B12 deficiency
C) Decreased erythropoietin production
D) Bone marrow infiltration
Answer: C) Decreased erythropoietin production
Rationale: In chronic kidney disease, the kidneys produce less erythropoietin, which is
necessary for red blood cell production, leading to anemia.
Question 12
A 28-year-old female presents with menorrhagia and a CBC shows microcytic anemia. What
laboratory test would be most useful in confirming the diagnosis of iron deficiency anemia?
A) Serum ferritin
B) Serum B12 level
C) Peripheral blood smear
D) Bone marrow biopsy
Answer: A) Serum ferritin
Rationale: Serum ferritin is the most sensitive indicator of iron deficiency anemia and
reflects the body’s iron stores.
Correct Answers
Course
ASCP
Question 1
A 45-year-old male patient presents with fatigue and pallor. A complete blood count (CBC)
shows a hemoglobin level of 10 g/dL, hematocrit of 30%, and a mean corpuscular volume
(MCV) of 70 fL. What type of anemia is most likely?
A) Macrocytic anemia
B) Microcytic anemia
C) Normocytic anemia
D) Sideroblastic anemia
Answer: B) Microcytic anemia
Rationale: The low hemoglobin and hematocrit levels, along with an MCV of 70 fL (below
the normal range), suggest microcytic anemia, which is often due to iron deficiency.
Question 2
A patient presents with recurrent infections and an abnormal white blood cell count. A bone
marrow biopsy reveals an increased number of blast cells. What is the most likely diagnosis?
A) Chronic lymphocytic leukemia (CLL)
B) Acute myeloid leukemia (AML)
C) Multiple myeloma
D) Lymphoma
Answer: B) Acute myeloid leukemia (AML)
Rationale: The presence of increased blast cells in the bone marrow and recurrent infections
indicates acute myeloid leukemia, which is characterized by the accumulation of immature
myeloid cells.
Question 3
Which of the following laboratory findings is most characteristic of hemolytic anemia?
A) Decreased reticulocyte count
B) Increased bilirubin levels
C) Decreased lactate dehydrogenase (LDH) levels
D) Increased haptoglobin levels
,Answer: B) Increased bilirubin levels
Rationale: Hemolytic anemia leads to increased destruction of red blood cells, resulting in
elevated bilirubin levels due to the breakdown of hemoglobin.
Question 4
A 60-year-old woman presents with unexplained bruising and a CBC shows a platelet count
of 30,000/μL. A peripheral blood smear reveals large platelets. What is the most likely
condition?
A) Idiopathic thrombocytopenic purpura (ITP)
B) Thrombotic thrombocytopenic purpura (TTP)
C) Myelodysplastic syndrome
D) Bone marrow infiltration
Answer: A) Idiopathic thrombocytopenic purpura (ITP)
Rationale: ITP is characterized by isolated thrombocytopenia and the presence of large
platelets on the smear, indicating increased platelet turnover.
Question 5
In which condition would you expect to see a "smudge cell" on a peripheral blood smear?
A) Chronic lymphocytic leukemia (CLL)
B) Acute lymphoblastic leukemia (ALL)
C) Chronic myeloid leukemia (CML)
D) Acute myeloid leukemia (AML)
Answer: A) Chronic lymphocytic leukemia (CLL)
Rationale: Smudge cells are indicative of chronic lymphocytic leukemia, resulting from
fragile lymphocytes that break apart during the preparation of the blood smear.
Question 6
A 30-year-old male presents with bone pain and recurrent infections. Laboratory results show
hypercalcemia, anemia, and a high level of monoclonal immunoglobulin in serum. What is
the most likely diagnosis?
A) Waldenström macroglobulinemia
B) Multiple myeloma
C) Lymphoma
D) Chronic lymphocytic leukemia (CLL)
,Answer: B) Multiple myeloma
Rationale: The combination of bone pain, recurrent infections, hypercalcemia, and
monoclonal immunoglobulin in the serum is characteristic of multiple myeloma.
Question 7
What is the primary function of platelets in hemostasis?
A) To transport oxygen
B) To form a fibrin clot
C) To adhere to the site of vascular injury
D) To activate the coagulation cascade
Answer: C) To adhere to the site of vascular injury
Rationale: The primary function of platelets is to adhere to the site of vascular injury and
aggregate to form a temporary plug before the coagulation cascade leads to fibrin clot
formation.
Question 8
A patient with known sickle cell disease presents with severe pain in the chest and back.
Which complication should be suspected?
A) Stroke
B) Acute chest syndrome
C) Pulmonary embolism
D) Aplastic crisis
Answer: B) Acute chest syndrome
Rationale: Chest pain in a patient with sickle cell disease may indicate acute chest syndrome,
a serious complication resulting from sickle-shaped red blood cells obstructing pulmonary
blood flow.
Question 9
Which of the following laboratory findings is indicative of vitamin B12 deficiency?
A) Decreased reticulocyte count
B) Hypersegmented neutrophils
C) Increased platelet count
D) Microcytic red blood cells
, Answer: B) Hypersegmented neutrophils
Rationale: Hypersegmented neutrophils are a classic finding in vitamin B12 deficiency and
reflect impaired DNA synthesis.
Question 10
In which condition is the "hairy cell" appearance typically observed in peripheral blood?
A) Chronic lymphocytic leukemia (CLL)
B) Hairy cell leukemia
C) Acute lymphoblastic leukemia (ALL)
D) Myelodysplastic syndrome
Answer: B) Hairy cell leukemia
Rationale: The "hairy cell" appearance refers to the abnormal lymphocytes seen in hairy cell
leukemia, characterized by fine cytoplasmic projections.
Question 11
A patient with chronic kidney disease presents with anemia. What is the most likely cause of
the anemia in this patient?
A) Iron deficiency
B) Vitamin B12 deficiency
C) Decreased erythropoietin production
D) Bone marrow infiltration
Answer: C) Decreased erythropoietin production
Rationale: In chronic kidney disease, the kidneys produce less erythropoietin, which is
necessary for red blood cell production, leading to anemia.
Question 12
A 28-year-old female presents with menorrhagia and a CBC shows microcytic anemia. What
laboratory test would be most useful in confirming the diagnosis of iron deficiency anemia?
A) Serum ferritin
B) Serum B12 level
C) Peripheral blood smear
D) Bone marrow biopsy
Answer: A) Serum ferritin
Rationale: Serum ferritin is the most sensitive indicator of iron deficiency anemia and
reflects the body’s iron stores.
