Question 1

Which of the following is required information on a bone marrow report?

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) All of the above 
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) All of the above D

Question 2

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 D

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

It has been determined that the M:E ratio of a 55 year old patient is 12:1.What can be concluded about the cellularity of the bone marrow?

Accepted Answer

A) The bone marrow has myeloid hyperplasia. 
B) The bone marrow has erythroid hyperplasia. 
C) The bone marrow is normal. 
D) The overall cellularity of the marrow is hypercellular. 
A) The bone marrow has myeloid hyperplasia. 
B) The bone marrow has erythroid hyperplasia. 
C) The bone marrow is normal. 
D) The overall cellularity of the marrow is hypercellular.

Question 5

What is the difference between a malignant lymphoid aggregate and a benign lymphoid aggregate?

Accepted Answer

A) Benign aggregates are well defined, whereas malignant aggregates are ill-defined. 
B) Malignant aggregates are composed of single polymorphic cells, whereas benign aggregates are composed of multiple monomorphic cells. 
C) Benign aggregates are clonal, whereas malignant aggregates are polyclonal. 
D) Malignant aggregates have a normal phenotype and benign have an aberrant phenotype. 
A) Benign aggregates are well defined, whereas malignant aggregates are ill-defined. 
B) Malignant aggregates are composed of single polymorphic cells, whereas benign aggregates are composed of multiple monomorphic cells. 
C) Benign aggregates are clonal, whereas malignant aggregates are polyclonal. 
D) Malignant aggregates have a normal phenotype and benign have an aberrant phenotype.

Question 6

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 7

The primary location for bone marrow collection is dependent on which two factors?

Accepted Answer

A) Age and patient condition 
B) Change in sites of hematopoiesis and cellularity 
C) The M:E ratio and medical history 
D) Age and medical history 
A) Age and patient condition 
B) Change in sites of hematopoiesis and cellularity 
C) The M:E ratio and medical history 
D) Age and medical history

Question 8

What are the primary uses of flow cytometry in the evaluation of hematologic disorders?

Accepted Answer

A) To detect the presence of clonality, and diagnose and classify malignant lymphomas and leukemias 
B) Classifying anemias associated with defective hemoglobin synthesis 
C) Identifying specific genetic rearrangements 
D) To detect chromosomal alterations 
A) To detect the presence of clonality, and diagnose and classify malignant lymphomas and leukemias 
B) Classifying anemias associated with defective hemoglobin synthesis 
C) Identifying specific genetic rearrangements 
D) To detect chromosomal alterations

Question 9

The assays below are typically performed on bone marrow specimens.Match each assay with the appropriate specimen type, assuming both are available.
A)Bone marrow differential
B)M:E ratio
C)Cellularity
D)Assessment of iron stores

Accepted Answer

Bone marrow differential: bone marrow as

Question 10

A 2-year-old boy is suspected of having leukemia, and a bone marrow examination is requested.From which body site should the bone marrow be collected?

Accepted Answer

A) Superior iliac crest 
B) Vertebrae 
C) Tibia 
D) Sternum 
A) Superior iliac crest 
B) Vertebrae 
C) Tibia 
D) Sternum

Question 11

Which of the following would be an expected finding in the bone marrow in a patient with the following results: serum iron = 124 ug/dL (reference range: 35-170 ug/dL); TIBC = 284 ug/dL (reference range: 225-425 ug/dL)?

Accepted Answer

A) Decreased or absent Prussian blue specks 
B) Adequate iron stores with Prussian blue stain 
C) Sea blue histiocytes 
D) Increased iron stores 
A) Decreased or absent Prussian blue specks 
B) Adequate iron stores with Prussian blue stain 
C) Sea blue histiocytes 
D) Increased iron stores

Question 12

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 the diagnosis of aplastic anemia. 
C) No, the patient is not suffering from aplastic anemia, because the overall cellularity is increased. 
D) Yes, the patient may be suffering from aplastic anemia, due to 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 the diagnosis of aplastic anemia. 
C) No, the patient is not suffering from aplastic anemia, because the overall cellularity is increased. 
D) Yes, the patient may be suffering from aplastic anemia, due to the low overall cellularity and the normal M:E ratio.

Question 13

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

Accepted Answer

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

Question 14

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 15

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 16

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.

Question 17

The cellularity of the marrow is best examined in ________, and it is determined by the red bone marrow's relationship to _________.

Accepted Answer

A) BM aspirate; the patient's age 
B) BM aspirate; hematogones 
C) BM biopsy; yellow marrow 
D) BM biopsy; stromal cells 
A) BM aspirate; the patient's age 
B) BM aspirate; hematogones 
C) BM biopsy; yellow marrow 
D) BM biopsy; stromal cells

Question 18

What would be the expected effect of chronic myelogenous leukemia on the M:E ratio?

Accepted Answer

A) Normal M:E ratio 
B) Increased M:E ratio 
C) Decreased M:E ratio 
D) No effect on the M:E ratio 
A) Normal M:E ratio 
B) Increased M:E ratio 
C) Decreased M:E ratio 
D) No effect on the M:E ratio

Question 19

The cellularity of the bone marrow is determined by examining the ratio of:

Accepted Answer

A) Stromal cells to hematopoietic cells. 
B) Hematogones to hematopoietic cells. 
C) Adipose tissue to hematopoietic cells. 
D) Hematopoietic cells to non-hematopoietic cells. 
A) Stromal cells to hematopoietic cells. 
B) Hematogones to hematopoietic cells. 
C) Adipose tissue to hematopoietic cells. 
D) Hematopoietic cells to non-hematopoietic cells.

Question 20

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

Accepted Answer

A) Well defined. 
B) Ill defined, and small to large. 
C) Diffuse and patchy. 
D) Well defined with plasma cells. 
A) Well defined. 
B) Ill defined, and small to large. 
C) Diffuse and patchy. 
D) Well defined with plasma cells.

Exam 34: Bone Marrow Examination

Which of the following is required information on a bone marrow report?

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

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

It has been determined that the M:E ratio of a 55 year old patient is 12:1.What can be concluded about the cellularity of the bone marrow?

What is the difference between a malignant lymphoid aggregate and a benign lymphoid aggregate?

The primary location for bone marrow collection is dependent on which two factors?

What are the primary uses of flow cytometry in the evaluation of hematologic disorders?

The assays below are typically performed on bone marrow specimens.Match each assay with the appropriate specimen type, assuming both are available. A)Bone marrow differential B)M:E ratio C)Cellularity D)Assessment of iron stores

A 2-year-old boy is suspected of having leukemia, and a bone marrow examination is requested.From which body site should the bone marrow be collected?

Which of the following would be an expected finding in the bone marrow in a patient with the following results: serum iron = 124 ug/dL (reference range: 35-170 ug/dL); TIBC = 284 ug/dL (reference range: 225-425 ug/dL)?

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?

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

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

The Prussian blue stain is used to stain what element?

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

The cellularity of the marrow is best examined in ________, and it is determined by the red bone marrow's relationship to _________.

What would be the expected effect of chronic myelogenous leukemia on the M:E ratio?

The cellularity of the bone marrow is determined by examining the ratio of:

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

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

Hematology Procedures and Hemostasis

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

Filters

The cellularity of the marrow is best examined in , and it is determined by the red bone marrow's relationship to _.