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BOC:HEMATOLOGY
MLT BOC HEMATOLOGY
| Question | Answer |
|---|---|
| The light-colored zone adjacent to the nucleus in a plasmacyte is the: a. ribosome b. chromatin c. mitochondria d. Golgi area | -Golgi Area |
| The majority of the iron in an adult is found as a constituent of: a. hemoglobin b. hemosiderin c. myoglobin d. transferrin | -Hemoglobin |
| The main function of the hexose monophosphate shunt in the erythrocyte is to: a. regulate the level of 2,3-DPG b. provide reduced glutathione to prevent oxidation of hemoglobin c. prevent the reduction of heme iron d. provide energy for membrane maint | -Provide reduced glutathione to prevent oxidation of hemoglobin |
| n order for hemoglobin to combine reversibly with oxygen, the iron must be: a. complexed with haptoglobin b. freely circulating in the cytoplasm c. attached to transferrin d. in the ferrous state | -In the ferrous state |
| n which of the following disease states are teardrop cells and abnormal platelets most characteristically seen? a. hemolytic anemia b. multiple myeloma c. G-6-PD deficiency d. myeloid metaplasia | -myeloid metaplasia |
| In the normal adult, the spleen acts as a site for: a. storage of RBCs b. production of RBCs c. synthesis of erythropoietin d. removal of imperfect and aging cells | -removal of imperfect and aging cells |
| After the removal of RBCs from the circulation hemoglobin is broken down into: a. iron, prophyrin, amino acids b. iron, protoporphyrin, globin c. heme, protoporphyrin, amino acids d. heme, hemosiderin, globin | -iron, protoporphyrin, globin |
| Heinz bodies are: a. readily identified with polychrome stains b. rarely found in glucose-6-phosphate dehydrogenase deficient erythrocytes c. closely associated with spherocytes d. denatured hemoglobin inclusion that are readily removed by the spleen | -denatured hemoglobin inclusion that are readily removed by the spleen |
| Cells for the transport of O2 and CO2 are: a. erythrocytes b. granulocytes c. lymphocytes d. thrombocytes | -erythrocytes |
| Erythropoietin acts as: a. shorten the replication time of the granulocytes b. stimulate RNA synthesis of erythroid cells c. increase colony-stimulating factors produced by the B-lymphs d. decrease the release of marrow reticulocytes | stimulate RNA synthesis of erythroid cells |
| What cell shape is most commonly associated with an increased MCHC? a. teardrop cells b. target cells c. spherocytes d. sickle cells | -Spherocytes |
| Which of the following characteristics are common to hereditary spherocytosis, hereditary elliptocytosis, hereditary stomatocytosis, and paroxysmal nocturnal hemoglobinuria? a. autosomal dominant inheritance b. red cell membrane defect c. positive DAT | - Red cell membrane defect |
| Which of the following is most closely associated with iron deficiency anemia? a. iron overload in tissue b. target cells c. basophilic stippling d. chronic blood loss | -Chronic blood loss |
| Evidence indicates that the genetic defect in thalassemia usually results in: a. the production of abnormal globin chains b. a quantitative deficiency in RNA resulting in decreased globin chain production c. a structural change in the heme portion of t | a quantitative deficiency in RNA resulting in decreased globin chain production |
| An enzyme deficiency associated with a moderate to severe hemolytic anemia after the patient is exposed to certain drugs and characterized by red cell inclusions formed by denatured hemoglobin is: a. LD deficiency b. G-6-PD deficiency c. pyruvate kinas | G-6-PD deficiency |
| Patients with A(-) type G-6-PD deficiency are least likely to have hemolytic episodes in which of the following situations? a. following the administration of oxidizing drugs b. following the ingestion of fava beans c. during infections d. spontaneous | spontaneously |
| A patient has a congenital nonspherocytic hemolytic anemia. After exposure to anti-malarial drugs the patient experiences a severe hemolytic episode. This episode is characterized by red cell inclusions caused by hemoglobin denaturation. Which of the foll | a (G-6-PD deficiency-anti-malarial drugs.) |
| Peripheral blood smears from patients with untreated anemia are characterized by: a. pancytopenia and macrocytosis b. leukocytosis and elliptocytosis c. leukocytosis and ovalocytes d. pancytopenia and microcytosis | pancytopenia and macrocytosis |
| Lab tests performed on a patient indicate macrocytosis, anemia, leukopenia and thrombocytopenia. Which of the following disorders is the patient most likely to have? a. anemia of chronic disorder b. vitamin B12 deficiency c. iron deficiency d. acute h | vitamin B12 deficiency |
| The characteristic morphologic feature in folic acid deficiency is: a. macrocytosis b. target cells c. basophilic stippling d. rouleaux formation | -Macrocytosis |
| The most likely cause of the macrocytosis that often accompanies anemia of myelofibrosis is: a. folic acid deficiency b. increased reticulocyte count c. inadequate B12 absorption d. pyridoxine deficiency | a (Myelofibrosis is often accompanied by folate deficiency, which causes macrocytic anemia.) |
| A characteristic morphologic feature in hemoglobin C disease is: a. macrocytosis b. spherocytosis c. rouleaux formation d. target cells | -Target cells |
| Thalassemias are characterized by: a. structural abnormalities in the hemoglobin molecule b. absence of iron in hemoglobin c. decreased rate of heme synthesis d. decreased rate of globin synthesis | decreased rate of globin synthesis |
| Lab findings in hereditary spherocytosis do not include: a. decreased osmotic fragility b. increased autohemolysis corrected by glucose c. reticulocytosis d. shortened erythrocyte survival | -Decreased osmotic fragility |
| Which of the following types of polycythemia is a severely burned patient most likely to have? a. polycythemia vera b. polycythemia, secondary to hypoxia c. relative polycythemia associated with dehydration d. polycythemia associated with renal diseas | relative polycythemia associated with dehydration |
| Which of the following is most likely to be seen in lead poisoning? a. iron overload in tissue b. codocytes c. basophilic stippling d. ringed sideroblasts | -Basophilic stippling |
| The characteristic morphologic feature in lead poisoning is: a. macrocytosis b. target cells c. basophilic stippling d. rouleaux formation | -Basophilic stippling |
| Which of the following technical factors will cause a decreased erythrocyte sedimentation rate? a. gross hemolysis b. small fibrin clots in the sample c. increased room temp d. tilting of the tube | small fibrin clots in the sample |
| Which of the RBC indices is a measure of the amount of hemoglobin in individual RBC's? a. MCHC b. MCV c. Hct d. MCH | -MCH |
| The RDW-CV and RDW-SD performed by automated cells counters are calculations that provide: a. an index of the distribution of RBC volume b. a calculated mean RBC hemoglobin concentration c. a calculated MCH d. the mean RBC volume | an index of the distribution of RBC volume |
| The erythrocyte sedimentation rate can be falsely elevated by: a. tilting the tube b. refrigerated blood c. air bubbles in the column d. specimen being to old | tilting the tube |
| Which of the following is the formula for absolute cell count? a. number of cells counted /total count b. total count/number of cells counted c. 10 x total count d. % of cells counted x total count | % of cells counted x total count |
| The lab tests performed on a patient indicate macrocytosis, anemia, leukopenia and thrombocytopenia. Which of the following disorders is the patient most likely to have? a. iron deficiency b. hereditary spherocytosis c. vitamin B12 deficiency d. acute | vitamin B12 deficiency |
| The mean value of a reticulocyte count on a specimen of cord blood from a healthy, full term newborns is approximately: a. 0.5 % b. 2.0 % c. 5.0 % d. 8.0 % | -5.0% |
| A RBC about 5 um in diameter that stains bright red and shows no central pallor is a: a. spherocyte b. leptocyte c. microcyte d. macrocyte | -Spherocyte |
| Evidence of active red cell regeneration may be indicated on a blood smear by: a. basophilic stippling, NRBC, and polychromasia b. hypochromia, macrocytes and NRBC's c. hypochromia, basophilic stippling and NRBC's d. Howell-Jolly bodies, Cabot rings a | basophilic stippling, NRBC, and polychromasia |
| The presence of excessive rouleaux formation on a blood smear is often accompanied by an increased: a. reticulocyte count b. sedimentation rate c. hematocrit d. erythrocyte count | sedimentation rate |
| The characteristic peripheral blood morphologic feature in multiple myeloma is: a. cytotoxic T cells b. rouleaux formation c. spherocytosis d. macrocytosis | -Rouleuax formation |
| In polycythemia vera, the hemoglobin, hematocrit, RBC count and red cell mass are: a. elevated b. normal c. decreased | -Elevated |
| The M:E ratio in polycythemia vera is usually: a. normal b. high c. low d. variable | -Normal |
| Many microspherocytes, schistocytes and budding off of spherocytes can be seen on peripheral blood smears of patients with: a. hereditary spherocytosis b. DIC c. acquired autoimmune hemolytic anemia d. extensive burns | -Extensive burns |
| Which of the following is most closely associated with erythroleukemia? a. ringed sideroblasts, nuclear budding and Howell-Jolly bodies b. DIC c. micromegakaryocytes d. lysozymuria | ringed sideroblasts, nuclear budding and Howell-Jolly bodies |
| The most characteristic peripheral blood smear finding in multiple myeloma is: a. plasmacytic satellitosis in the bone marrow b. many plasma cells in the peripheral blood c. many Mott cells in the peripheral blood d. rouleaux formation of the red cell | rouleaux formation of the red cells |
| A common source of interference in the cyanmethemoglobin method is: a. hemolysis b. very high WBC count c. cold agglutinins d. clumped platelets | b (A very high WBC count causes turbidity in cyanmethemoglobin reagent-patient specimen that will result in falsely elevated hemoglobin values.) |
| The most appropriate screening test for detecting hemoglobin F is: a. osmotic fragility b. dithionite solubility c. Kleihauer-Betke d. heat instability test | Kleihauer-Betke |
| The most appropriate screening test for hemoglobin S is: a. Kleihauer-Betke b. dithionite solubility c. osmotic fragility d. sucrose hemolysis | dithionite solubility |
| Hematology standards include: a. stabilized RBC suspension b. latex particles c. stabilized avian RBC's d. certified cyanmethemoglobin solution | certified cyanmethemoglobin solution |
| When using the turbidity method for detecting the presence of hemoglobin S, an incorrect interpretation may be made when there is a: a. concentration of <7 g/dL hemoglobin b. glucose concentration >150 mg/dL c. blood sugar > 2 hrs. old d. increased he | -Increased Hemoglobin d (The low hemoglobin can result in a false-negative result.) |
| The lab findings on a patient are as follows: MCV = 55 um MCHC = 25% MCH = 17 pg A stained blood film of this patient would most likely reveal a red cell picture that is: a. microcytic, hypochromic b. macrocytic, hypochromic c. normocytic, normochr | microcytic, hypochromic |
| A patient has a high cold agglutinin titer. Automated cell counter results reveal an elevated MCV, MCH and MCHC. Individual erythrocytes appear normal on a stained smear, but agglutinates are noted. The appropriate course of action would be to: | a. perform the RBC, Hgb and Hct determinations using manual methods c. repeat the determination using a microsample of diluted blood d. repeat the determinations using a prewarmed microsample of diluted blood |
| A blood sample from a patient with a high titer cold agglutinin, analyzed at room temp, with an electronic particle counter would cause an error in the: a. Hgb and MCV b. MCHC and WBC c. WBC and RBC d. MCV and MCHC | d. MCV and MCHC |
| When using an electronic cell counter, which of the following results can occur in the presence of a cold Agglutinin: a. increased MCV and decreased RBC b. increased MCV and normal RBC c. decreased MCV and increased MCHC d. decreased MCV and RBC | increased MCV and decreased RBC |
| In polycythemia vera, the leukocyte alkaline phosphatase activity is: a. elevated b. normal c. decreased | -Elevated |
| Which of the following is the formula for MCH? a. Hct / (RBC x 1000) b. Hgb / Hct c. RBC / Hct d. (Hgb x 10) / RBC | (Hgb x 10) / RBC |
| Which of the following is the formula for MCHC? a. (Hgb x 100) / Hct b. Hgb / RBC c. RBC / Hct d. (Hct x 1000) / RBC | (Hgb x 100) / Hct |
| Which of the following is the formula for MCV? a. (Hgb x 10) / RBC b. Hgb / Hct c. (Hct x 10) / RBC d. RBC / Hct | (Hct x 10) / RBC |
| The primary confirmatory test for hereditary spherocytosis is: a. osmotic fragility b. sucrose hemolysis c. heat instability test d. Kleihauer-Betke | -Osmotic fragility |
| A screening test for paroxysmal nocturnal hemoglobinuria is: a. heat instability test b. sucrose hemolysis c. osmotic fragility d. dithionite solubility | sucrose hemolysis |
| The Prussian blue staining of peripheral blood identifies: a. Howell-Jolly bodies b. siderotic granules c. reticulocytes d. basophilic stippling | -Siderotic Granules |
| Supravital staining is important for reticulocytes since the cells must be living in order to stain the: a. remaining RNA in the cell b. iron before it precipitates c. cell membrane before it dries out d. denatured hemoglobin in the cell | remaining RNA in the cell |
| Which of the following is used for staining reticulocytes? a. Giemsa stain b. Wright stain c. new methylene blue d. Prussian blue | new methylene blue |
| Which of the following stains is used to demonstrate iron, ferritin and hemosiderin? a. peroxidase b. Sudan black B c. periodic acid-Schiff d. Prussian Blue | -Prussian blue |
| Which of the following stains is used to demonstrate iron, ferritin and hemosiderin? a. peroxidase b. Sudan black B c. periodic acid-Schiff d. Prussian Blue | d. Prussian Blue |
| Which of the following stains can be used to differentiate siderotic granules from basophilic stippling? a. Wright b. Prussian Blue c. crystal violet d. periodic acid-Schiff | b. Prussian Blue |
| A patient has pancytopenia, decreased total serum iron, decreased serum iron binding capacity, and show a homogeneous fluorescence pattern with a high titer on a fluorescent anti-nuclear antibody test. This is suggestive of : | a. polycythemia vera b. SLE c. iron deficiency anemia d. hemoglobin SC disease b (Systemic lupus erythematosus [SLE] is an autoimmune disease. The ANA procedure is a screening tool for SLE.) |
| An increased amount of cytoplasmic basophilia in a blood cell indicates: a. increased cytoplasmic maturation b. decreased cytoplasmic maturation c. reduction in size of the cell d. decreased nuclear maturation | b. decreased cytoplasmic maturation |
| The term "shift to the left" refers to: a. a microscope adjustment b. immature cell forms in the peripheral blood c. a trend on a levy-jennings chart d. a calibration adjustment on an instrument | b. immature cell forms in the peripheral blood |
| A term that means varying degrees of leukocytosis with a shift to the left and occasional nucleated red cells in the peripheral blood is: a. polycythemia vera b. erythroleukemia c. leukoerythroblastosis d. megaloblastoid | c. leukoerythroblastosis |
| Cells that produce antibodies and lymphokines are: a. erythrocytes b. granulocytes c. lymphocytes d. thrombocytes | c. lymphocytes |
| Specific granules of the neutrophilic granulocyte: a. appear first at the myelocyte stage b. contain lysosomal enzymes c. are formed on the mitochondria d. are derived from azurophilic granules | a. appear first at the myelocyte stage |
| In normal adult bone marrow, the most common granulocyte is the: a. basophil b. myeloblast c. eosinophil d. metamyelocyte | d. metamyelocyte |
| Elevation of the total granulocyte count above 7.7 x 10^3 is termed: a. relative lymphocytosis b. leukocytosis c. relative neutrophilic leukocytosis d. absolute neutrophilic leukocytosis | d. absolute neutrophilic leukocytosis |
| Elevation of the granulocyte percentage above 75% is termed: a. absolute lymphocytosis b. leukocytosis c. relative neutrophilic leukocytosis d. absolute neutrophilic leukocytosis | c. relative neutrophilic leukocytosis |
| Elevation of the lymphocyte percentage above 47% is termed: a. relative lymphocytosis b. absolute lymphocytosis c. leukocytosis d. absolute neutrophilic leukocytosis | a. relative lymphocytosis |
| Elevation of the total white cell count above 12 x 10^3 is termed: a. relative lymphocytosis b. absolute lymphocytosis c. leukocytosis d. relative neutrophilic leukocytosis | c. leukocytosis |
| Terminal deoxynucleotidyl tranferase is a marker found on: a. hairy cell b. myeloblasts c. monopolists d. lymphoblasts | d. lymphoblasts |
| Multipotent stem cells are capable of producing: a. daughter cells of only one cell line b. only T-lymphs and B-lymphs c. erythopoeitin, thrombopoietin and leukopoietin d. lymphoid and myeloid stem cells | d. lymphoid and myeloid stem cells |
| The Philadelphia chromosome is formed by a translocation between the: a. long arm of chromosome 22 and long arm of chromosome 9 b. long arm of chromosome 21 and long arm of chromosome 9 c. long arm of chromosome 21 and short arm of chromosome 6 d. lon | a. long arm of chromosome 22 and long arm of chromosome 9 |
| Phagocytosis is a function of: a. erythrocytes b. granulocytes c. lymphocytes d. thrombocytes | b. granulocytes |
| The white cell feature most characteristic of pernicious anemia is: a. eosinophilia b. toxic granulation c. hypersegmentation d. atypical lymphocytes | c. hypersegmentation |
| Which of the following conditions is not associated with a high incidence of leukemia? a. paroxysmal nocturnal hemoglobinuria b. Fanconi anemia c. aplastic anemia d. megaloblastic anemia | d. megaloblastic anemia |
| The M:E ratio in chronic myelocytic leukemia is usually: a. normal b. high c. low d. variable | b. high |
| Abnormalities found in erythroleukemia include: a. rapid DNA synthesis b. marrow fibrosis c. megaloblastoid development d. increased erythrocyte survival | c. megaloblastoid development |
| Neutropenia is not usually associated with: a. viral infections b. Hodgkin disease c. select antibodies d. chemotherapy | b. Hodgkin disease |
| Auer rods are most likely present in which of the following? a. chronic myelocytic leukemia b. myelofibrosis with myeloid metaplasia c. erythroleukemia d. acute myelocytic leukemia | d. acute myelocytic leukemia |
| In an uncomplicated case of infectious mononucleus, which of the following cells are affected? a. erythrocytes b. lymphocytes c. monocytes d. thrombocytes | b. lymphocytes |
| The atypical lymphocyte seen in the peripheral smear of patients with infectious mono is probably derived from which of the following: a. T lymphs b. B lymphs c. monocytes d. mast cells | b. B lymphs |
| The disease most frequently present in patients with atypical lymphocytosis and persistently negative tests is: a. toxoplasmosis b. cytomegalovirus infection c. herpes virus infection d. viral hepatitis | b. cytomegalovirus infection |
| Which of the following is associated with pseudo-Pelger-Huet anomaly? a. aplastic anemia b. iron deficiency anemia c. myelogenous leukemia d. Chediak-Higashi syndrome | c. myelogenous leukemia |
| In chronic myelocytic leukemia, blood histamine concentrations tend to reflect the : a. number of platelets present b. serum uric acid concentrations c. number of basophils present d. the total number of granulocytes | c. number of basophils present |
| Biochemical abnormalities characteristic of polycythemia vera include: a. increased serum B12 binding capacity b. hypouricemia c. hypohistaminemia d. decreased leukocyte alkaline phosphatase activity | a. increased serum B12 binding capacity |
| 50% - 90% myeloblasts in a peripheral blood smear is typical of which of the following? a. chronic myelocytic leukemia b. myelofibrosis with myeloid metaplasia c. erythroleukemia d. acute myelocytic leukemia | d. acute myelocytic leukemia |
| The M:E ratio in acute myelocytic leukemia is usually: a. normal b. high c. low d. variable | b. high |
| Which of the following is most closely associated with chronic myelononocytic leukemia? a. Philadelphia chromosome b. DIC c. micromegakaryocytes d. lysozymuria | d. lysozymuria |
| The absence of intermediate maturing cells between the blast and mature neutrophil commonly seen in acute myelocytic leukemia and myelodysplastic syndrome is called: a. subleukemia b. aleukemic leukemia c. leukemic hiatus d. leukemoid reaction | c. leukemic hiatus |
| Which of the following is most closely associated with chronic myelogenous leukemia? a. ringed sideroblasts b. DIC c. micromegakaryocytes d. Philadelphia chromosome | d. Philadelphia chromosome |
| A block in the differentiation or maturation of, and an accretion of immature hematopoietic progenitors is a hallmark of: a. chronic lymphocytic leukemia b. myeloproliferative diseases c. polycythemia vera d. acute myelogenous leukemia | d. acute myelogenous leukemia |
| All stages of neutrophils are most likely to be seen in the peripheral blood of patient with: a. chronic myelocytic leukemia b. myelofibrosis with myeloid metaplasia c. erythroleukemia d. acute myelocytic leukemia | a. chronic myelocytic leukemia |
| All of the following conditions are myeloproliferative disorders except: a. myelocytic leukemia b. lymphocytic leukemia c. polycythemia vera d. idiopathic thrombocythemia | b. lymphocytic leukemia |
| A patient has a tumor that concentrates erythropoietin. He is most likely to have which of the following types of polycythemia? a. polycythemia vera b. polycythemia, secondary to hypoxia c. benign familial polycythemia d. polycythemia associated with | d. polycythemia associated with renal disease |
| Which of the following types of polycythemia is most often associated with emphysema? a. polycythemia vera b. polycythemia, secondary to hypoxia c. relative polycythemia associated with dehydration d. polycythemia associated with renal disease | b. polycythemia, secondary to hypoxia |
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