Question 1

In phase contrast microscopy, what is the function of the phase ring?

Accepted Answer

A)  Directs light through its open circular area 
B)  Retards the wavelength of deflected light 
C)  Projects the beam of light onto the sample 
D)  Diffracts the light from the condenser 
A)  Directs light through its open circular area 
B)  Retards the wavelength of deflected light 
C)  Projects the beam of light onto the sample 
D)  Diffracts the light from the condenser B

Question 2

A patient's osmotic fragility test results show beginning hemolysis at 0.40% NaCl and complete hemolysis at 0.20% NaCl.Increased numbers of which erythrocyte morphology are associated with these findings?

Accepted Answer

A)  Schistocytes 
B)  Tear drop cells 
C)  Spherocytes 
D)  Target cells 
A)  Schistocytes 
B)  Tear drop cells 
C)  Spherocytes 
D)  Target cells D

Question 3

Which of the following is not mandated by OSHA?

Accepted Answer

A) Two patient identifiers must be used when collecting blood samples. 
B) The use of plastic tubes when performing venipuncture 
C) Education regarding regulation of the transmission of bloodborne pathogens 
D) Education regarding regulation of needlesticks 
A) Two patient identifiers must be used when collecting blood samples. 
B) The use of plastic tubes when performing venipuncture 
C) Education regarding regulation of the transmission of bloodborne pathogens 
D) Education regarding regulation of needlesticks A

Question 4

In the chloroacetate esterase procedure, which reagent component undergoes color change due to the enzyme's activity?

Accepted Answer

A)  Hematoxylin 
B)  Diazonium salt 
C)  3,3 diaminobenzidine 
D)  Naphthol AS-D chloroacetate 
A)  Hematoxylin 
B)  Diazonium salt 
C)  3,3 diaminobenzidine 
D)  Naphthol AS-D chloroacetate

Question 5

Which of the following represents a potential pre-examination error?

Accepted Answer

A)  Reading the test result before the timer expires 
B)  Observing a turbid solution and reporting the result as negative 
C)  Performing the test on a sample from a recently transfused patient 
D)  Using the reagent solution immediately after it is removed from the refrigerator 
A)  Reading the test result before the timer expires 
B)  Observing a turbid solution and reporting the result as negative 
C)  Performing the test on a sample from a recently transfused patient 
D)  Using the reagent solution immediately after it is removed from the refrigerator

Question 6

The 18 gauge needles used to collect donor blood for transfusion have a larger bore than do standard blood collection needles.What is the advantage of this needle?

Accepted Answer

A)  The needle minimizes discomfort to the donor. 
B)  The needle allows for tube holder and vacutainer use. 
C)  The phlebotomist has better technique with a larger needle. 
D)  The collection process is faster and less hemolysis occurs. 
A)  The needle minimizes discomfort to the donor. 
B)  The needle allows for tube holder and vacutainer use. 
C)  The phlebotomist has better technique with a larger needle. 
D)  The collection process is faster and less hemolysis occurs.

Question 7

A technologist is reviewing differentials, and notices that the last few smears appear blue.What can be done to correct this?

Accepted Answer

A) Lengthen the staining time. 
B) Change the buffer solution, as it might be too alkaline 
C) Change the buffer solution, as it might be too acidic 
D) Lengthen the staining time 
A) Lengthen the staining time. 
B) Change the buffer solution, as it might be too alkaline 
C) Change the buffer solution, as it might be too acidic 
D) Lengthen the staining time

Question 8

The microscopic examination of a Wright-stained blood smear revealed bright red erythrocytes and pale leukocyte nuclei.What is the best explanation for this appearance?

Accepted Answer

A)  The buffer is too acidic. 
B)  The staining process was prolonged. 
C)  The blood smear was too thick. 
D)  The Wright stain was too alkaline. 
A)  The buffer is too acidic. 
B)  The staining process was prolonged. 
C)  The blood smear was too thick. 
D)  The Wright stain was too alkaline.

Question 9

Proper technique for the capillary puncture includes:

Accepted Answer

A)  Wiping the first drop of blood away from the puncture. 
B)  Squeezing the puncture site prior to use of the lancet. 
C)  Placing an ice pack on the puncture site prior to collection. 
D)  Performing the puncture immediately following alcohol cleansing. 
A)  Wiping the first drop of blood away from the puncture. 
B)  Squeezing the puncture site prior to use of the lancet. 
C)  Placing an ice pack on the puncture site prior to collection. 
D)  Performing the puncture immediately following alcohol cleansing.

Question 10

A clinical laboratory professional observes numerous smudge cells on a Wright-stained blood smear and experiences difficulty performing the 100-cell differential.What should be done to obtain an accurate differential?

Accepted Answer

A)  Recollect the sample using sodium citrate and prepare a blood smear. 
B)  Warm the blood to 37ᵒC for 15 minutes and prepare a blood smear. 
C)  Add one drop of isotonic saline to five drops of blood, mix, and prepare blood smear. 
D)  Add one drop of 22% bovine albumin to five drops of blood, mix, and prepare a blood smear. 
A)  Recollect the sample using sodium citrate and prepare a blood smear. 
B)  Warm the blood to 37ᵒC for 15 minutes and prepare a blood smear. 
C)  Add one drop of isotonic saline to five drops of blood, mix, and prepare blood smear. 
D)  Add one drop of 22% bovine albumin to five drops of blood, mix, and prepare a blood smear.

Question 11

Why is acid used in the quantification of hemoglobin F laboratory test?

Accepted Answer

A) Because fetal cells are resistant to acid, which facilitates quantification of hemoglobin F. 
B) Because adult cells are resistant to acid, which facilitates quantification of hemoglobin F.. 
C) Because acid inhibits other interfering hemoglobins. 
D) Because acid will lyse RBCs to release hemoglobin F. 
A) Because fetal cells are resistant to acid, which facilitates quantification of hemoglobin F. 
B) Because adult cells are resistant to acid, which facilitates quantification of hemoglobin F.. 
C) Because acid inhibits other interfering hemoglobins. 
D) Because acid will lyse RBCs to release hemoglobin F.

Question 12

A patient is about to begin a regimen of chemotherapy, and his attending has ordered a battery of lab tests.These include: comprehensive chemistry metabolic panel, complete blood count, coagulation studies, amylase and lipase, hemoglobin A1C, lipid panel, thyroid panel, PSA, rubella IgG, HIV, and syphilis.Five tiger-top tubes, 2 light blue-top tubes, and 2 lavender-top tubes are needed.Correlate each test to the appropriate tube, and indicate the correct order of draw for the tubes.

Accepted Answer

SST tube: comprehensive chemistry metabo

Question 13

Which laboratory test would be useful in the differential diagnosis of polycythemia?

Accepted Answer

A)  EPO 
B)  sTfR 
C)  Hct 
D)  MCV 
A)  EPO 
B)  sTfR 
C)  Hct 
D)  MCV

Question 14

An elevated potassium in a hemolyzed specimen is classified as:

Accepted Answer

A) Preanalytical error. 
B) Analytical error. 
C) Postanalytical error. 
D) All of the above. 
A) Preanalytical error. 
B) Analytical error. 
C) Postanalytical error. 
D) All of the above.

Question 15

Below are preliminary screening test results.Name the suspected disorder associated with each finding, and explain how you would confirm these findings.
A)Positive sugar-water test
B)Positive hemolysis after both incubation periods
C)Normal sTFR levels
D)Many spherocytes noted on PB smear
E)Blasts noted on PB smear

Accepted Answer

a.Suspected disorder: PNH; Confirmation:

Question 16

Which substance when added to the acid phosphatase stain is useful in the identification of hairy cells?

Accepted Answer

A)  Sodium fluoride 
B)  Sodium tartrate 
C)  Potassium chloride 
D)  Disodium phosphate 
A)  Sodium fluoride 
B)  Sodium tartrate 
C)  Potassium chloride 
D)  Disodium phosphate

Question 17

How does the anticoagulant EDTA prevent coagulation from occurring?

Accepted Answer

A)  Binds calcium in a soluble complex 
B)  Enhances antithrombin activity 
C)  Chelates calcium ions 
D)  Inhibits factor XII activity 
A)  Binds calcium in a soluble complex 
B)  Enhances antithrombin activity 
C)  Chelates calcium ions 
D)  Inhibits factor XII activity

Question 18

Why is brilliant green used as the stain of choice for Heinz body preparation?

Accepted Answer

A) Because of its sensitivity for detecting small amounts of Heinz bodies present 
B) Because of its specificity for differentiating Heinz bodies from other inclusions 
C) Because of its ease of use and minimal teratogenic effects on the personnel utilizing it 
D) Because it keeps the cells alive to accurately visualize it. 
A) Because of its sensitivity for detecting small amounts of Heinz bodies present 
B) Because of its specificity for differentiating Heinz bodies from other inclusions 
C) Because of its ease of use and minimal teratogenic effects on the personnel utilizing it 
D) Because it keeps the cells alive to accurately visualize it.

Question 19

The ESR determination on the MINI-VESᵀᴹ instrument is based on:

Accepted Answer

A)  Decrease in height of the erythrocyte column at a given time. 
B)  Decrease in absorbance as erythrocytes aggregate in column at a given time. 
C)  Distance that the erythrocytes settle within a column in 1 hour's time. 
D)  Deflection of light by the erythrocyte aggregrates in the column at 1 hour's time. 
A)  Decrease in height of the erythrocyte column at a given time. 
B)  Decrease in absorbance as erythrocytes aggregate in column at a given time. 
C)  Distance that the erythrocytes settle within a column in 1 hour's time. 
D)  Deflection of light by the erythrocyte aggregrates in the column at 1 hour's time.

Question 20

A sickle solubility test is requested on a 45-year-old patient.They have ordered it "STAT" because the patient is due to have surgery very soon.The technologist receives the sample and immediately takes out the reagent from the refrigerator and performs the test.It comes back positive.The surgery is postponed until hemoglobin electrophoresis is performed, and it shows a normal distribution of adult hemoglobins.What is the most likely reason for the discrepant result?

Accepted Answer

A) There was a false positive on the sickle solubility test due to the cold reagent. 
B) The hemoglobin electrophoresis findings need to be confirmed on acid gel. 
C) There was a false negative on the sickle solubility test due to inadequate mixing. 
D) The wrong patient was drawn. 
A) There was a false positive on the sickle solubility test due to the cold reagent. 
B) The hemoglobin electrophoresis findings need to be confirmed on acid gel. 
C) There was a false negative on the sickle solubility test due to inadequate mixing. 
D) The wrong patient was drawn.

Exam 33: Hematology Procedures and Hemostasis

In phase contrast microscopy, what is the function of the phase ring?

A patient's osmotic fragility test results show beginning hemolysis at 0.40% NaCl and complete hemolysis at 0.20% NaCl.Increased numbers of which erythrocyte morphology are associated with these findings?

Which of the following is not mandated by OSHA?

In the chloroacetate esterase procedure, which reagent component undergoes color change due to the enzyme's activity?

Which of the following represents a potential pre-examination error?

The 18 gauge needles used to collect donor blood for transfusion have a larger bore than do standard blood collection needles.What is the advantage of this needle?

A technologist is reviewing differentials, and notices that the last few smears appear blue.What can be done to correct this?

The microscopic examination of a Wright-stained blood smear revealed bright red erythrocytes and pale leukocyte nuclei.What is the best explanation for this appearance?

Proper technique for the capillary puncture includes:

A clinical laboratory professional observes numerous smudge cells on a Wright-stained blood smear and experiences difficulty performing the 100-cell differential.What should be done to obtain an accurate differential?

Why is acid used in the quantification of hemoglobin F laboratory test?

Which laboratory test would be useful in the differential diagnosis of polycythemia?

An elevated potassium in a hemolyzed specimen is classified as:

Which substance when added to the acid phosphatase stain is useful in the identification of hairy cells?

How does the anticoagulant EDTA prevent coagulation from occurring?

Why is brilliant green used as the stain of choice for Heinz body preparation?

The ESR determination on the MINI-VESᵀᴹ instrument is based on:

Introduction

Cellular Homeostasis

Hematopoiesis

Structure and Function of Hematopoietic Organs

The Erythrocyte

Hemoglobin

The Leukocyte

Introduction to Anemia

Anemias of Disordered Iron Metabolism and Heme Synthesis

Hemoglobinopaties: Qualitative Defects

Thalassemia

Megaloblastic and Nonmegaloblastic Macrocytic Anemias

Introduction to Hemolytic Anemia

Hemolytic Anemia: Membrane Defects

Hemolytic Anemia: Enzyme Deficiencies

Hemolytic Anemia: Immune Anemias

Hemolytic Anemia: Nonimmune Defects

Nonmalignant Granulocyte and Monocyte Disorders

Nonmalignant Lymphocyte Disorders

Introduction to Hematopoietic Neoplasms

Myeloproliferative Disorders

Myelodysplastic Syndromes

Acute Myeloid Leukemias

Acute Lymphoblastic Leukemias

Lymphoid Malignancies: Chronic Lymphoid Leukemias, Lymphomas, and Plasma Cell Neoplasms

Hematopoietic Stem Cell Transplantation

Morphologic Analysis of Body Fluids in the Hematology Laboratory

Primary Hemostasis

Secondary Hemostasis and Fibrinolysis

Disorders of Primary Hemostasis

Disorders of Secondary Hemostasis

Thrombophilia

Bone Marrow Examination

Automation in Hematology and Hemostasis

Flow Cytometry

Chromosome Analysis of Hematopoietic and Lymphoid Disorders

Molecular Analysis of Hematologic Diseases

Laboratory Testing in Coagulation

Quality Assessment in the Hematology Laboratory

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