Question 1

A patient had the following results: 
$\begin{array}{llll}
\mathrm{RBC} & 2.45 \times 10^{12} / \mathrm{L} & \mathrm{MCV} & 90 \mathrm{fL} \
\mathrm{Hb} & 7.5 \mathrm{~g} / \mathrm{dL} & \mathrm{MCH} & 31 \mathrm{pg} \
\mathrm{Hct} & 22.0 \% & \mathrm{MCHC} & 34 \mathrm{~g} / \mathrm{dL}\
\text {DAT }&\text { negative }\
\text { Haptoglobin }& 10 \mathrm{mg} / \mathrm{dL}\
\end{array}$
Which is the most appropriate reflex test?

Accepted Answer

A)  Reticulocyte count 
B)  Hemoglobin electrophoresis 
C)  Osmotic fragility test 
D)  Erythropoietin assay 
A)  Reticulocyte count 
B)  Hemoglobin electrophoresis 
C)  Osmotic fragility test 
D)  Erythropoietin assay

Question 2

All of the following are needed on a phlebotomist's supply tray to perform a venipuncture except:

Accepted Answer

A) Needles. 
B) Tourniquets. 
C) Gauze. 
D) Lancets. 
A) Needles. 
B) Tourniquets. 
C) Gauze. 
D) Lancets.

Question 3

Increased levels of Heinz bodies are seen in which of the following?

Accepted Answer

A) Thalassemia 
B) G6PD deficiency 
C) AML 
D) Increased hemolysis 
A) Thalassemia 
B) G6PD deficiency 
C) AML 
D) Increased hemolysis

Question 4

Which cytochemical stain is useful in the differentiation of myeloblasts from lymphoblasts?

Accepted Answer

A)  PAS 
B)  LAP 
C)  MPO 
D)  TRAP 
A)  PAS 
B)  LAP 
C)  MPO 
D)  TRAP

Question 5

Which of the following is the most appropriate test to differentiate hemoglobin S trait from hemoglobin S disease?

Accepted Answer

A)  Quantitation of hemoglobin A₂ 
B)  Hemoglobin electrophoresis 
C)  Acid elution for hemoglobin F 
D)  Solubility for hemoglobin S 
A)  Quantitation of hemoglobin A₂ 
B)  Hemoglobin electrophoresis 
C)  Acid elution for hemoglobin F 
D)  Solubility for hemoglobin S

Question 6

The resolution of a microscope is a function of:

Accepted Answer

A) Numerical aperture. 
B) Wavelength of reflected light. 
C) Refractive index. 
D) The presence of chromatic aberrations. 
A) Numerical aperture. 
B) Wavelength of reflected light. 
C) Refractive index. 
D) The presence of chromatic aberrations.

Question 7

The following erythrocyte data were obtained from an EDTA-anticoagulated sample: erythrocyte count = 3.92 x 1012/L, hemoglobin = 11.4 g/dL, hematocrit = 34 % (.34 L/L), calculate the MCHC.

Accepted Answer

A)  29.1 g/dL 
B)  33.5 g/dL 
C)  67.2 g/dL 
D)  86.7 g/dL 
A)  29.1 g/dL 
B)  33.5 g/dL 
C)  67.2 g/dL 
D)  86.7 g/dL

Question 8

The acid elution test for hemoglobin F was performed on a patient sample and examination of the slide revealed an uneven distribution of hemoglobin F within the erythrocytes.Control slides were acceptable.Which of the following is associated with this observation?

Accepted Answer

A)  Iron deficiency anemia 
B)  Sickle cell anemia 
C)  Pernicious anemia 
D)  Hereditary persistence of fetal hemoglobin 
A)  Iron deficiency anemia 
B)  Sickle cell anemia 
C)  Pernicious anemia 
D)  Hereditary persistence of fetal hemoglobin

Question 9

The patient has difficult veins, and a winged infusion set is used to collect the blood from a small vein in the patient's hand.After successfully filling all the SST tubes, the phlebotomist proceeds to fill the light blue-top tube, but is unsuccessful.She changes tubes, thinking that it might be a tube with a lost vacuum, but there is still no blood flow.She inspects the entry site and notices some bruising around it that wasn't present before.Discuss possibilities of the unsuccessful draw, and explain how to correct them.

Accepted Answer

A lost vacuum is the most common reason

Question 10

The following erythrocyte indices were determined as part of a CBC: MCV 84 fL, MCH 24 pg, MCHC 30 g/dL.What would you expect to observe on the Wright-stained peripheral blood smear?

Accepted Answer

A)  Normochromic, normocytic erythrocytes 
B)  Hypochromic, microcytic erythrocytes 
C)  Hypochromic, normocytic erythrocytes 
D)  Normochromic, macrocytic erythrocytes 
A)  Normochromic, normocytic erythrocytes 
B)  Hypochromic, microcytic erythrocytes 
C)  Hypochromic, normocytic erythrocytes 
D)  Normochromic, macrocytic erythrocytes

Question 11

A CBC is performed on a polycythemic patient.What must be done to ensure that the technologist makes an optimal blood smear on this specimen?

Accepted Answer

A) The technologist should increase the angle of the spreader slide. 
B) The technologist should decrease the angle of the spreader slide. 
C) The technologist should not change the angle of the spreader slide. 
D) The technologist should stain with albumin. 
A) The technologist should increase the angle of the spreader slide. 
B) The technologist should decrease the angle of the spreader slide. 
C) The technologist should not change the angle of the spreader slide. 
D) The technologist should stain with albumin.

Question 12

Name the cytochemical stains that are typically used in the workup of the following:
A)AML-myelomonocytic
B)APL
C)ALL
D)AML-Monoblastic
E)AML-Erythroid

Accepted Answer

MPO is used to differentiate AML from AL

Question 13

A panel of cytochemical stains is performed to determine a patient's subtype of AML.Myeloperoxidase and Sudan Black B are positive.Specific esterase is positive and nonspecific esterase o is negative.Based on this information, what lineage is implicated as the chosen subtype of AML?

Accepted Answer

A) Lymphoid 
B) Myeloid 
C) Monocytic 
D) Erythroid 
A) Lymphoid 
B) Myeloid 
C) Monocytic 
D) Erythroid

Question 14

An instrument printout reports a WBC count of 12 x 109/L.The technologist reviews the peripheral blood smear and counts 45 nucleated RBCs.What is the best course of action regarding these findings?

Accepted Answer

A) Repeat the instrument count after making a 1:10 dilution. 
B) Make a new smear with albumin. 
C) Adjust the WBC count for the presence of nRBCs. 
D) Warm the specimen. 
A) Repeat the instrument count after making a 1:10 dilution. 
B) Make a new smear with albumin. 
C) Adjust the WBC count for the presence of nRBCs. 
D) Warm the specimen.

Question 15

The reference interval for hemoglobin varies with age.Which of the following age groups is associated with the highest hemoglobin level?

Accepted Answer

A)  Adults, over 75 years old 
B)  Adults, between 25-35 years old 
C)  Children, 2-8 years old 
D)  Newborns 
A)  Adults, over 75 years old 
B)  Adults, between 25-35 years old 
C)  Children, 2-8 years old 
D)  Newborns

Question 16

Which of the following receptacles is most appropriate when disposing of used needles?

Accepted Answer

A) A regular garbage can 
B) A biohazard bag 
C) A biohazard sharps container 
D) Any of the above can be used. 
A) A regular garbage can 
B) A biohazard bag 
C) A biohazard sharps container 
D) Any of the above can be used.

Question 17

Why are two incubation sessions needed in the Donath-Landsteiner test?

Accepted Answer

A) To detect the biphasic thermal reactivity of the offensive antibody 
B) To detect complement binding in vivo 
C) To detect the antibody's specificity to the P antigen in vitro 
D) To detect the antibody's specificity to group O cells 
A) To detect the biphasic thermal reactivity of the offensive antibody 
B) To detect complement binding in vivo 
C) To detect the antibody's specificity to the P antigen in vitro 
D) To detect the antibody's specificity to group O cells

Question 18

What is the anticoagulant in the most commonly utilized tube in hematology, and how does it prevent coagulation from taking place?

Accepted Answer

A) Sodium citrate; chelates calcium 
B) EDTA; chelates calcium 
C) Heparin; neutralizes thrombin 
D) Sodium citrate; decreases thrombin activity 
A) Sodium citrate; chelates calcium 
B) EDTA; chelates calcium 
C) Heparin; neutralizes thrombin 
D) Sodium citrate; decreases thrombin activity

Question 19

An instrument printout reports a platelet count of 85x 109/L.The technologist reviewing the peripheral blood smears notices aggregates of platelets around many of the neutrophils.What is the best course of action to correct this problem?

Accepted Answer

A) Warm the specimen for 10 min at 45°C and rerun the sample. 
B) Centrifuge and rerun the sample. 
C) Remake the smear and use alkaline buffer to stain the slide. 
D) Redraw the sample in sodium citrate and repeat the platelet count. 
A) Warm the specimen for 10 min at 45°C and rerun the sample. 
B) Centrifuge and rerun the sample. 
C) Remake the smear and use alkaline buffer to stain the slide. 
D) Redraw the sample in sodium citrate and repeat the platelet count.

Question 20

List corrective measurements for each of the following:
A)Ensure a good monolayer on a blood smear in a patient with a low hematocrit.
B)Ensure a good monolayer on a blood smear in a patient with a high hematocrit.
C)Platelet satellitism
D)Many smudge cells on PB smear

Accepted Answer

a.Raise the angle of your spreader slide

Exam 33: Hematology Procedures and Hemostasis

A patient had the following results: 2.45\times1/ 90 7.5/ 31 22.0\% 34/ DAT negative Haptoglobin 10/ Which is the most appropriate reflex test?

All of the following are needed on a phlebotomist's supply tray to perform a venipuncture except:

Increased levels of Heinz bodies are seen in which of the following?

Which cytochemical stain is useful in the differentiation of myeloblasts from lymphoblasts?

Which of the following is the most appropriate test to differentiate hemoglobin S trait from hemoglobin S disease?

The resolution of a microscope is a function of:

The following erythrocyte data were obtained from an EDTA-anticoagulated sample: erythrocyte count = 3.92 x 1012/L, hemoglobin = 11.4 g/dL, hematocrit = 34 % (.34 L/L), calculate the MCHC.

The acid elution test for hemoglobin F was performed on a patient sample and examination of the slide revealed an uneven distribution of hemoglobin F within the erythrocytes.Control slides were acceptable.Which of the following is associated with this observation?

The following erythrocyte indices were determined as part of a CBC: MCV 84 fL, MCH 24 pg, MCHC 30 g/dL.What would you expect to observe on the Wright-stained peripheral blood smear?

A CBC is performed on a polycythemic patient.What must be done to ensure that the technologist makes an optimal blood smear on this specimen?

Name the cytochemical stains that are typically used in the workup of the following: A)AML-myelomonocytic B)APL C)ALL D)AML-Monoblastic E)AML-Erythroid

A panel of cytochemical stains is performed to determine a patient's subtype of AML.Myeloperoxidase and Sudan Black B are positive.Specific esterase is positive and nonspecific esterase o is negative.Based on this information, what lineage is implicated as the chosen subtype of AML?

An instrument printout reports a WBC count of 12 x 109/L.The technologist reviews the peripheral blood smear and counts 45 nucleated RBCs.What is the best course of action regarding these findings?

The reference interval for hemoglobin varies with age.Which of the following age groups is associated with the highest hemoglobin level?

Which of the following receptacles is most appropriate when disposing of used needles?

Why are two incubation sessions needed in the Donath-Landsteiner test?

What is the anticoagulant in the most commonly utilized tube in hematology, and how does it prevent coagulation from taking place?

An instrument printout reports a platelet count of 85x 109/L.The technologist reviewing the peripheral blood smears notices aggregates of platelets around many of the neutrophils.What is the best course of action to correct this problem?

List corrective measurements for each of the following: A)Ensure a good monolayer on a blood smear in a patient with a low hematocrit. B)Ensure a good monolayer on a blood smear in a patient with a high hematocrit. C)Platelet satellitism D)Many smudge cells on PB smear

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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