Question 1

What principle does the Sysmex SE-9000/9500 use to analyze and separate white cell populations?

Accepted Answer

A)  Electronic impedance 
B)  Optical light scatter 
C)  Volume, conductivity, and scatter 
D)  Low-frequency direct current and high-frequency current 
A)  Electronic impedance 
B)  Optical light scatter 
C)  Volume, conductivity, and scatter 
D)  Low-frequency direct current and high-frequency current D

Question 2

An elevated immature reticulocyte fraction is associated with:

Accepted Answer

A)  Bone marrow suppression 
B)  Chemotherapy 
C)  Bone marrow response to anemia 
D)  Renal disease 
A)  Bone marrow suppression 
B)  Chemotherapy 
C)  Bone marrow response to anemia 
D)  Renal disease C

Question 3

Which of the following uses a peroxidase stain channel?

Accepted Answer

A)  Siemens Healthcare Diagnostics ADVIA 2120 
B)  Coulter LH750 
C)  Sysmex SE-9000 
D)  Abbott CELL-DYN 4000 
A)  Siemens Healthcare Diagnostics ADVIA 2120 
B)  Coulter LH750 
C)  Sysmex SE-9000 
D)  Abbott CELL-DYN 4000 A

Question 4

What is the greatest limitation of automated cell counters?

Accepted Answer

A)  Poor precision 
B)  Speed 
C)  Unavailability of quality control materials 
D)  Inherent specimen problems leading to occasional spurious results 
A)  Poor precision 
B)  Speed 
C)  Unavailability of quality control materials 
D)  Inherent specimen problems leading to occasional spurious results

Question 5

Platelet clumps would most likely interfere with which other automated parameter?

Accepted Answer

A)  WBC count 
B)  RBC 
C)  Hemoglobin 
D)  Red cell indices 
A)  WBC count 
B)  RBC 
C)  Hemoglobin 
D)  Red cell indices

Question 6

How do CELL-DYN instruments differentiate red cells and platelets from one another?

Accepted Answer

A)  Differences in forward scatter using optical light scatter principle 
B)  Use of a unique reagent that selectively lyses red cells while preserving platelets 
C)  Differences in volume (fL) using electrical impedance principle 
D)  Use of a unique reagent that selectively lyses platelets while preserving red cells 
A)  Differences in forward scatter using optical light scatter principle 
B)  Use of a unique reagent that selectively lyses red cells while preserving platelets 
C)  Differences in volume (fL) using electrical impedance principle 
D)  Use of a unique reagent that selectively lyses platelets while preserving red cells

Question 7

What is the mechanism for the three-part differential found in older Coulter machines or those designed for smaller laboratories?

Accepted Answer

A)  Volume, conductivity, scatter 
B)  Multiangle polarized scatter separation 
C)  Peroxidase staining and light scatter 
D)  Impedance after cytoplasm shrinkage 
A)  Volume, conductivity, scatter 
B)  Multiangle polarized scatter separation 
C)  Peroxidase staining and light scatter 
D)  Impedance after cytoplasm shrinkage

Question 8

Which automatic hematology analyzer performs the white count (by both optical scatter and electrical impedance) and then compares the two as an internal quality control check?

Accepted Answer

A)  Sysmex 9000/9500 
B)  Coulter LH750 
C)  CELL-DYN 4000 
D)  Advia 2100 
A)  Sysmex 9000/9500 
B)  Coulter LH750 
C)  CELL-DYN 4000 
D)  Advia 2100

Question 9

Compared with manual methods, automated reticulocyte counting improved which of the following?

Accepted Answer

A)  Distribution error 
B)  Statistical sampling error 
C)  Interobserver error 
D)  All of the above 
A)  Distribution error 
B)  Statistical sampling error 
C)  Interobserver error 
D)  All of the above

Question 10

Select the most appropriate action for the results in Question 18:

Accepted Answer

A)  Report the results. 
B)  Lyse the red cells manually and rerun. 
C)  Warm sample to 37$\degree$ C and rerun. 
D)  Replace plasma with saline and rerun. 
A)  Report the results. 
B)  Lyse the red cells manually and rerun. 
C)  Warm sample to 37$\degree$ C and rerun. 
D)  Replace plasma with saline and rerun.

Question 11

What technology minimizes the problems of a rigid aperture including protein buildup, coincidence, and a single cell being counted twice?

Accepted Answer

A)  Forward scatter 
B)  Radiofrequency 
C)  Hydrodynamic focusing 
D)  Fluorescence 
A)  Forward scatter 
B)  Radiofrequency 
C)  Hydrodynamic focusing 
D)  Fluorescence

Question 12

Which of the following is always calculated on cell counters?

Accepted Answer

A)  Hematocrit 
B)  MCV 
C)  Mean cell hemoglobin concentration (MCH
C)  
D)  Red count 
A)  Hematocrit 
B)  MCV 
C)  Mean cell hemoglobin concentration (MCH
C)  
D)  Red count

Question 13

All of the following will be invalid when lipemia is present in a blood sample except:

Accepted Answer

A)  MCHC 
B)  MCV 
C)  MCH 
D)  Hemoglobin 
A)  MCHC 
B)  MCV 
C)  MCH 
D)  Hemoglobin

Question 14

When the electronic impedance principle is used to count blood cells, what is done to increase platelet-counting sensitivity?

Accepted Answer

A)  Decrease the size of the RBC/platelet aperture. 
B)  Increase the size of the RBC/platelet aperture. 
C)  Use a strong lysing agent to selectively lyse the RBCs. 
D)  Lower the upper threshold for counting platelets so that even microcytic red cells are excluded. 
A)  Decrease the size of the RBC/platelet aperture. 
B)  Increase the size of the RBC/platelet aperture. 
C)  Use a strong lysing agent to selectively lyse the RBCs. 
D)  Lower the upper threshold for counting platelets so that even microcytic red cells are excluded.

Question 15

A patient sample comes off an automated cell counter with a failure of the red cell "rule of three." The red count is lower than expected given the hemoglobin. The MCV, MCH, and MCHC are elevated. Which of the following is the most likely reason for this failure?

Accepted Answer

A)  Megaloblastic anemia 
B)  Lyse-resistant red cells 
C)  Cold agglutinin 
D)  Lipemia 
A)  Megaloblastic anemia 
B)  Lyse-resistant red cells 
C)  Cold agglutinin 
D)  Lipemia

Question 16

What is the recommended method for establishing accuracy of automated hematology analyzers?

Accepted Answer

A)  Use at least three levels of controls for calibration. 
B)  Use whole blood calibration methodology. 
C)  Use commercially prepared whole blood calibrators. 
D)  Perform manual methods for comparison. 
A)  Use at least three levels of controls for calibration. 
B)  Use whole blood calibration methodology. 
C)  Use commercially prepared whole blood calibrators. 
D)  Perform manual methods for comparison.

Question 17

Which of the following is true regarding automated reticulocyte counts?

Accepted Answer

A)  This was one of the earlier cell-counting methods to be automated. 
B)  Ribonucleic acid (RN
A)  is stained with various dyes that allow for detection of reticulocytes by optical scatter or fluorescence. 
C)  They are more accurate but less precise than the manual method. 
D)  They require significantly more time to count reticulocytes than manual methods. 
A)  This was one of the earlier cell-counting methods to be automated. 
B)  Ribonucleic acid (RN
A)  is stained with various dyes that allow for detection of reticulocytes by optical scatter or fluorescence. 
C)  They are more accurate but less precise than the manual method. 
D)  They require significantly more time to count reticulocytes than manual methods.

Question 18

Counting the number and size of electrical interferences created by blood cells as they pass through a small aperture is a description of which of the following principles?

Accepted Answer

A)  Electronic impedance 
B)  Optical scatter 
C)  Conductivity 
D)  Laminar flow 
A)  Electronic impedance 
B)  Optical scatter 
C)  Conductivity 
D)  Laminar flow

Question 19

Which of the following is determined by light transmission between 525 and 555 nm?

Accepted Answer

A)  Reticulocytes 
B)  Hemoglobin 
C)  Mean cell volume (MCV) 
D)  Mean cell hemoglobin (MCH) 
A)  Reticulocytes 
B)  Hemoglobin 
C)  Mean cell volume (MCV) 
D)  Mean cell hemoglobin (MCH)

Question 20

Which of the following occurs if testing is not performed with 24 hours from specimen collection?

Accepted Answer

A)  White blood count rises 
B)  WBCs deteriorate and RBCs swell 
C)  Hemoglobin rises 
D)  MCV decreases 
A)  White blood count rises 
B)  WBCs deteriorate and RBCs swell 
C)  Hemoglobin rises 
D)  MCV decreases

Exam 39: Automated Cell-Counting Instrumentation

What principle does the Sysmex SE-9000/9500 use to analyze and separate white cell populations?

An elevated immature reticulocyte fraction is associated with:

Which of the following uses a peroxidase stain channel?

What is the greatest limitation of automated cell counters?

Platelet clumps would most likely interfere with which other automated parameter?

How do CELL-DYN instruments differentiate red cells and platelets from one another?

What is the mechanism for the three-part differential found in older Coulter machines or those designed for smaller laboratories?

Which automatic hematology analyzer performs the white count (by both optical scatter and electrical impedance) and then compares the two as an internal quality control check?

Compared with manual methods, automated reticulocyte counting improved which of the following?

Select the most appropriate action for the results in Question 18:

What technology minimizes the problems of a rigid aperture including protein buildup, coincidence, and a single cell being counted twice?

Which of the following is always calculated on cell counters?

All of the following will be invalid when lipemia is present in a blood sample except:

When the electronic impedance principle is used to count blood cells, what is done to increase platelet-counting sensitivity?

A patient sample comes off an automated cell counter with a failure of the red cell "rule of three." The red count is lower than expected given the hemoglobin. The MCV, MCH, and MCHC are elevated. Which of the following is the most likely reason for this failure?

What is the recommended method for establishing accuracy of automated hematology analyzers?

Which of the following is true regarding automated reticulocyte counts?

Counting the number and size of electrical interferences created by blood cells as they pass through a small aperture is a description of which of the following principles?

Which of the following is determined by light transmission between 525 and 555 nm?

Which of the following occurs if testing is not performed with 24 hours from specimen collection?

An Overview of Clinical Laboratory Hematology

Safety in the Hematology Laboratory

Specimen Collection

Care and Use of the Microscope

Quality Assurance in Hematology and Hemostasis Testing

Cellular Structure and Function

Hematopoiesis

Erythrocyte Production and Destruction

Energy Metabolism and Membrane Physiology of the Erythrocyte

Hemoglobin Metabolism

Iron Metabolism

Leukocyte Development, Kinetics, and Functions

Platelet Production, Structure, and Function

Routine and Point-Of-Care Testing in Hematology: Manual and Semiautomated Methods

Examination of the Peripheral Blood Film and Correlation With the Complete Blood Count

Bone Marrow Examination

Body Fluids in the Hematology Laboratory

Anemias: Red Blood Cell Morphology and Approach to Diagnosis

Disorders of Iron and Heme Metabolism

Anemias Caused by Defects of Dna Metabolism

Bone Marrow Failure

Introduction to Increased Destruction of Erythrocytes

Intrinsic Defects Leading to Increased Erythrocyte Destruction

Extrinsic Defects Leading to Increased Erythrocytedestructionnonimmune Causes

Extrinsic Defects Leading to Increased Erythrocytedestructionimmune Causes

Hemoglobinopathies Structural Defects in Hemoglobin

Thalassemias

Nonmalignant Leukocyte Disorders

Introduction to Leukocyte Neoplasms

Cytochemistry

Cytogenetics

Molecular Diagnostics in the Clinical Laboratory

Flow Cytometric Analysis in Hematologic Disorders

Myeloproliferative Neoplasms

Myelodysplastic Syndromes

Acute Leukemias

Mature Lymphoid Neoplasms

Pediatric and Geriatric Hematology

Normal Hemostasis and Coagulation

Hemorrhagic Coagulation Disorders

Thrombosis Risk Testing

Thrombocytopenia and Thrombocytosis

Qualitative Disorders of Platelets and Vasculature

Laboratory Evaluation of Hemostasis

Monitoring Antithrombotic Therapies

Coagulation Instrumentation

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