Question 1

The M:E ratio is determined by examining the relationship between:

Accepted Answer

A)  Myeloid precursors and erythroid and lymphoid precursors 
B)  Myeloid precursors and lymphoid precursors 
C)  Megakaryocytic precursors and nucleated erythroid precursors 
D)  All granulocytic precursors and nucleated erythroid precursors 
A)  Myeloid precursors and erythroid and lymphoid precursors 
B)  Myeloid precursors and lymphoid precursors 
C)  Megakaryocytic precursors and nucleated erythroid precursors 
D)  All granulocytic precursors and nucleated erythroid precursors D

Question 2

The role of the hematology technologist in bone marrow evaluation is to:

Accepted Answer

A)  Perform the bone marrow aspirate procedure 
B)  Administer anesthetic in preparation of the procedure 
C)  Make bone marrow smears after collection 
D)  Report the results of the bone marrow examination to the attending physician 
A)  Perform the bone marrow aspirate procedure 
B)  Administer anesthetic in preparation of the procedure 
C)  Make bone marrow smears after collection 
D)  Report the results of the bone marrow examination to the attending physician C

Question 3

What cells are examined for morphologic characteristics of iron particles in the diagnosis of myelodysplastic syndrome?

Accepted Answer

A)  Leukocytes 
B)  Erythrocytes 
C)  Histiocytes and red cell precursors 
D)  Lymphocytes 
A)  Leukocytes 
B)  Erythrocytes 
C)  Histiocytes and red cell precursors 
D)  Lymphocytes C

Question 4

The Prussian blue stain is used to stain what element?

Accepted Answer

A)  Organelle-associated enzymes 
B)  Carbohydrates 
C)  Iron 
D)  Proteins 
A)  Organelle-associated enzymes 
B)  Carbohydrates 
C)  Iron 
D)  Proteins

Question 5

All of the following are sites for bone marrow specimen collection except the:

Accepted Answer

A)  Tibia 
B)  Femur 
C)  Sternum 
D)  Iliac crest 
A)  Tibia 
B)  Femur 
C)  Sternum 
D)  Iliac crest

Question 6

The following assays are typically performed on bone marrow specimens. Match each assay with the appropriate specimen type, assuming that both are available.
a. Bone marrow differential
b. M:E ratio
c. Cellularity
d. Assessment of iron stores

Accepted Answer

a. Bone marrow differential: bone marrow

Question 7

Name five distinguishable characteristics that will help differentiate benign lymphoid aggregates and malignant lymphoma.

Accepted Answer

• Benign lymphoid aggregates: nonparatra

Question 8

Which of the following is not typically found on a bone marrow report?

Accepted Answer

A)  Patient's insurance information 
B)  Patient's biographical data 
C)  Patient's clinical diagnosis 
D)  Relevant therapeutic information 
A)  Patient's insurance information 
B)  Patient's biographical data 
C)  Patient's clinical diagnosis 
D)  Relevant therapeutic information

Question 9

All of the following are required information on a bone marrow report except:

Accepted Answer

A)  Site of sampling and type of sample(s) obtained 
B)  Side-by-side comparison of bone marrow differential and peripheral blood differential results 
C)  Results of ancillary studies 
D)  Final diagnosis by the pathologist 
A)  Site of sampling and type of sample(s) obtained 
B)  Side-by-side comparison of bone marrow differential and peripheral blood differential results 
C)  Results of ancillary studies 
D)  Final diagnosis by the pathologist

Question 10

Which of the following indicates a reason for performing cytochemical staining on bone marrow specimens of suspected hematologic dyscrasias?

Accepted Answer

A)  It has higher specificity for hematopoietic lineage differentiation than does standard morphology. 
B)  It has lower incidence of false negatives in detecting malignancies. 
C)  Manual differentials are prone to misinterpretation, whereas cytochemical staining is not. 
D)  It provides a better overview of bone marrow status of hematopoiesis than does the manual differential. 
A)  It has higher specificity for hematopoietic lineage differentiation than does standard morphology. 
B)  It has lower incidence of false negatives in detecting malignancies. 
C)  Manual differentials are prone to misinterpretation, whereas cytochemical staining is not. 
D)  It provides a better overview of bone marrow status of hematopoiesis than does the manual differential.

Question 11

A bone marrow core biopsy is received on a 10-year-old male patient suspected of having aplastic anemia. The pathologist reviews the smear and concludes the overall cellularity to be 22% with an M:E ratio of 2.5:1. Is the patient likely suffering from aplastic anemia? Why or why not?

Accepted Answer

A)  There is not enough information to determine whether the patient has aplastic anemia. 
B)  Yes, the patient is presumably suffering from aplastic anemia, but the M:E ratio does not correlate well with that diagnosis. 
C)  No, the patient is not suffering from aplastic anemia because the overall cellularity is increased. 
D)  Yes, the patient is presumably suffering from aplastic anemia because of the low overall cellularity and the normal M:E ratio. 
A)  There is not enough information to determine whether the patient has aplastic anemia. 
B)  Yes, the patient is presumably suffering from aplastic anemia, but the M:E ratio does not correlate well with that diagnosis. 
C)  No, the patient is not suffering from aplastic anemia because the overall cellularity is increased. 
D)  Yes, the patient is presumably suffering from aplastic anemia because of the low overall cellularity and the normal M:E ratio.

Question 12

The presence of which of the following in the bone marrow is diagnostic for sideroblastic anemia?

Accepted Answer

A)  Iron-laden macrophages 
B)  Sea blue histiocytes 
C)  Moderate siderocytes 
D)  Ringed sideroblasts 
A)  Iron-laden macrophages 
B)  Sea blue histiocytes 
C)  Moderate siderocytes 
D)  Ringed sideroblasts

Question 13

The calculation to determine the normal expected cellularity range in an adult is to subtract the patient's age from 100% and:

Accepted Answer

A)  Add/subtract 20% 
B)  Add/subtract 10% 
C)  Add/subtract 30% 
D)  Add/subtract 50% 
A)  Add/subtract 20% 
B)  Add/subtract 10% 
C)  Add/subtract 30% 
D)  Add/subtract 50%

Question 14

A differential is performed on a bone marrow specimen obtained from a patient suspected of having CML in blast crisis. The results are as follows: 45% blasts, 13% metamyelocytes, 18% myelocytes, 10% promyelocytes, 8% bands, 2% segmented neutrophils, 1% pronormoblasts, 1% basophilic normoblasts, 1% polychromatophilic normoblasts, and 1% orthochromatophilic normoblasts. What is the M:E ratio?

Accepted Answer

A)  2:1 
B)  24:1 
C)  12:1 
D)  15:1 
A)  2:1 
B)  24:1 
C)  12:1 
D)  15:1

Question 15

A physician performing a bone marrow biopsy on a patient suspected of having acute leukemia was unable to obtain any aspirate but was able to obtain two core biopsies. What is the best way for the laboratorian to use the material obtained?

Accepted Answer

A)  Place both core biopsies in formalin and process one immediately; save the other for ancillary tests. 
B)  Place one core biopsy in formalin and freeze the second one at -70°C. 
C)  Place one core biopsy in formalin after making touch imprints; put the second in saline. 
D)  Place both core biopsies in saline; freeze one at 0°C, and process the other immediately. 
A)  Place both core biopsies in formalin and process one immediately; save the other for ancillary tests. 
B)  Place one core biopsy in formalin and freeze the second one at -70°C. 
C)  Place one core biopsy in formalin after making touch imprints; put the second in saline. 
D)  Place both core biopsies in saline; freeze one at 0°C, and process the other immediately.

Question 16

If a bone marrow aspiration results in a dry tap, or when the marrow aspirate lacks spicules, the best source for studying cellular detail and maturation sequence is:

Accepted Answer

A)  Touch imprints of the core biopsy 
B)  Core biopsy washings 
C)  Re-aspiration of marrow 
D)  Histologic embedded paraffin blocks 
A)  Touch imprints of the core biopsy 
B)  Core biopsy washings 
C)  Re-aspiration of marrow 
D)  Histologic embedded paraffin blocks

Question 17

A low M:E ratio in a patient represents what possible process?

Accepted Answer

A)  Erythroid hypoplasia 
B)  Erythroid hyperplasia 
C)  Myeloid hyperplasia 
D)  CML 
A)  Erythroid hypoplasia 
B)  Erythroid hyperplasia 
C)  Myeloid hyperplasia 
D)  CML

Question 18

The primary uses of flow cytometry in the evaluation of hematologic disorders are to:

Accepted Answer

A)  Detect the presence of clonality and diagnose and classify malignant lymphomas and leukemias 
B)  Classify anemias associated with defective hemoglobin synthesis 
C)  Identify specific genetic rearrangements 
D)  Detect chromosomal alterations 
A)  Detect the presence of clonality and diagnose and classify malignant lymphomas and leukemias 
B)  Classify anemias associated with defective hemoglobin synthesis 
C)  Identify specific genetic rearrangements 
D)  Detect chromosomal alterations

Question 19

One morphological difference between benign lymphoid aggregates and malignant lymphoma is that malignant aggregates are:

Accepted Answer

A)  Well defined 
B)  Well defined with mature lymphocytes 
C)  Diffuse and patchy 
D)  Well defined with plasma cells 
A)  Well defined 
B)  Well defined with mature lymphocytes 
C)  Diffuse and patchy 
D)  Well defined with plasma cells

Question 20

What is the overall cellularity range of a bone marrow in a 35-year-old female patient?

Accepted Answer

A)  35-45% 
B)  55-75% 
C)  50-60% 
D)  70-80% 
A)  35-45% 
B)  55-75% 
C)  50-60% 
D)  70-80%

Exam 38: Bone Marrow Examination

The M:E ratio is determined by examining the relationship between:

The role of the hematology technologist in bone marrow evaluation is to:

What cells are examined for morphologic characteristics of iron particles in the diagnosis of myelodysplastic syndrome?

The Prussian blue stain is used to stain what element?

All of the following are sites for bone marrow specimen collection except the:

The following assays are typically performed on bone marrow specimens. Match each assay with the appropriate specimen type, assuming that both are available. a. Bone marrow differential b. M:E ratio c. Cellularity d. Assessment of iron stores

Name five distinguishable characteristics that will help differentiate benign lymphoid aggregates and malignant lymphoma.

Which of the following is not typically found on a bone marrow report?

All of the following are required information on a bone marrow report except:

Which of the following indicates a reason for performing cytochemical staining on bone marrow specimens of suspected hematologic dyscrasias?

A bone marrow core biopsy is received on a 10-year-old male patient suspected of having aplastic anemia. The pathologist reviews the smear and concludes the overall cellularity to be 22% with an M:E ratio of 2.5:1. Is the patient likely suffering from aplastic anemia? Why or why not?

The presence of which of the following in the bone marrow is diagnostic for sideroblastic anemia?

The calculation to determine the normal expected cellularity range in an adult is to subtract the patient's age from 100% and:

A physician performing a bone marrow biopsy on a patient suspected of having acute leukemia was unable to obtain any aspirate but was able to obtain two core biopsies. What is the best way for the laboratorian to use the material obtained?

If a bone marrow aspiration results in a dry tap, or when the marrow aspirate lacks spicules, the best source for studying cellular detail and maturation sequence is:

A low M:E ratio in a patient represents what possible process?

The primary uses of flow cytometry in the evaluation of hematologic disorders are to:

One morphological difference between benign lymphoid aggregates and malignant lymphoma is that malignant aggregates are:

What is the overall cellularity range of a bone marrow in a 35-year-old female patient?

Introduction

Cellular Homeostasis

Structure and Function of Hematopoietic Organs

Hematopoiesis

The Erythrocyte

Hemoglobin

Granulocytes and Monocytes

Lymphocytes

The Platelet

The Complete Blood Count and Peripheral Blood Smear Evaluation

Introduction to Anemia

Anemias of Disordered Iron Metabolism and Heme Synthesis

Hemoglobinopathies: Qualitative Defects

Thalassemia

Megaloblastic and Nonmegaloblastic Macrocytic Anemias

Hypoproliferative Anemias

Hemolytic Anemia: Membrane Defects

Hemolytic Anemia: Enzyme Deficiencies

Hemolytic Anemia: Immune Anemias

Hemolytic Anemia: Nonimmune Defects

Nonmalignant Disorders of Leukocytes: Granulocytes and Monocytes

Nonmalignant Lymphocyte Disorders

Introduction to Hematopoietic Neoplasms

Myeloproliferative Neoplasms

Myelodysplastic Syndromes

Acute Myeloid Leukemias

Precursor Lymphoid Neoplasms

Mature Lymphoid Neoplasms

Hematopoietic Stem Cell Transplantation

Morphologic Analysis of Body Fluids in the Hematology

Primary Hemostasis

Secondary Hemostasis and Fibrinolysis

Disorders of Primary Hemostasis

Disorders of Secondary Hemostasis

Thrombophilia

Hemostasis: Laboratory Testing and Instrumentation

Hematology Procedures

Automation in Hematology

Flow Cytometry

Chromosome Analysis of Hematopoietic and Lymphoid Disorders

Molecular Analysis of Hematologic Diseases

Quality Assessment in the Hematology Laboratory

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