Question 1

Sudan black is used to distinguish which types of leukemia?

Accepted Answer

A)  Acute myeloid leukemia from acute lymphoblastic leukemia 
B)  Acute myeloid leukemia from chronic myelogenous leukemia 
C)  Acute myeloid leukemia from acute promyelocytic leukemia 
D)  Acute promyelocytic leukemia from acute myelomonocytic leukemia 
A)  Acute myeloid leukemia from acute lymphoblastic leukemia 
B)  Acute myeloid leukemia from chronic myelogenous leukemia 
C)  Acute myeloid leukemia from acute promyelocytic leukemia 
D)  Acute promyelocytic leukemia from acute myelomonocytic leukemia A

Question 2

A patient has a very high white blood count with many blasts in the blood and bone marrow. Esterase stains using both naphthol AS-D chloroacetate and $\alpha$-naphthyl acetate esterase as substrates are both positive. What condition is likely?

Accepted Answer

A)  Chronic myelogenous leukemia 
B)  Acute lymphoblastic leukemia 
C)  Acute myelomonocytic leukemia 
D)  Hairy cell leukemia 
A)  Chronic myelogenous leukemia 
B)  Acute lymphoblastic leukemia 
C)  Acute myelomonocytic leukemia 
D)  Hairy cell leukemia C

Question 3

The bone marrow of a patient with acute leukemia is stained with the periodic acid-Schiff (PAS) stain. When this stain is evaluated, segmented neutrophils show diffuse pink staining. Select the correct interpretation.

Accepted Answer

A)  The patient has acute lymphoblastic leukemia. 
B)  The patient has acute myeloid leukemia. 
C)  The stain did not work. 
D)  No conclusion can be reached; blast cells must be examined. 
A)  The patient has acute lymphoblastic leukemia. 
B)  The patient has acute myeloid leukemia. 
C)  The stain did not work. 
D)  No conclusion can be reached; blast cells must be examined. D

Question 4

Tartrate-resistant acid phosphatase is strongly positive in which of the following cells?

Accepted Answer

A)  Myeloblasts 
B)  Hairy cells 
C)  Granulocytes 
D)  Lymphocytes 
A)  Myeloblasts 
B)  Hairy cells 
C)  Granulocytes 
D)  Lymphocytes

Question 5

A myeloperoxidase stain is performed on peripheral blood cells of a patient with acute leukemia and 85% blasts; the patient has an occasional mature neutrophil. When the stained slide is evaluated, the blasts are all negative but the mature neutrophils are strongly positive. What is the significance of this finding?

Accepted Answer

A)  The stain worked (internal positive control). 
B)  Nothing can be determined until a positive control is also examined. 
C)  Nothing can be determined because mature neutrophils are always positive. 
D)  Nothing can be determined because only examination of the blasts is useful. 
A)  The stain worked (internal positive control). 
B)  Nothing can be determined until a positive control is also examined. 
C)  Nothing can be determined because mature neutrophils are always positive. 
D)  Nothing can be determined because only examination of the blasts is useful.

Question 6

Which of the following would stain most strongly for myeloperoxidase?

Accepted Answer

A)  Lymphoblasts 
B)  Auer rods 
C)  Monocytes 
D)  Normal myeloblasts 
A)  Lymphoblasts 
B)  Auer rods 
C)  Monocytes 
D)  Normal myeloblasts

Question 7

What cells may demonstrate a coarse block pattern of activity with the PAS stain?

Accepted Answer

A)  Normal lymphocytes 
B)  mature neutrophils 
C)  Normal erythroid precursors 
D)  Malignant lymphoblasts 
A)  Normal lymphocytes 
B)  mature neutrophils 
C)  Normal erythroid precursors 
D)  Malignant lymphoblasts

Question 8

Cytochemical procedures stain what cellular elements?

Accepted Answer

A)  Enzymes 
B)  Lipids 
C)  Glycogen 
D)  All of the above 
A)  Enzymes 
B)  Lipids 
C)  Glycogen 
D)  All of the above

Question 9

A patient has a white blood count of 35 *109/L with a left shift. The leukocyte alkaline phosphatase stain is 220. Which of the following is most likely?

Accepted Answer

A)  Severe bacterial infection 
B)  Chronic myelogenous leukemia 
C)  Paroxysmal nocturnal hemoglobinuria 
D)  Values normal 
A)  Severe bacterial infection 
B)  Chronic myelogenous leukemia 
C)  Paroxysmal nocturnal hemoglobinuria 
D)  Values normal

Question 10

A patient has a leukocyte alkaline phosphatase score of 9. The positive control is 5. Select the correct interpretation.

Accepted Answer

A)  Chronic myelogenous leukemia 
B)  Acute lymphocytic leukemia 
C)  Polycythemia vera 
D)  Test must be repeated 
A)  Chronic myelogenous leukemia 
B)  Acute lymphocytic leukemia 
C)  Polycythemia vera 
D)  Test must be repeated

Exam 30: Cytochemistry

Sudan black is used to distinguish which types of leukemia?

A patient has a very high white blood count with many blasts in the blood and bone marrow. Esterase stains using both naphthol AS-D chloroacetate and α\alphaα -naphthyl acetate esterase as substrates are both positive. What condition is likely?

The bone marrow of a patient with acute leukemia is stained with the periodic acid-Schiff (PAS) stain. When this stain is evaluated, segmented neutrophils show diffuse pink staining. Select the correct interpretation.

Tartrate-resistant acid phosphatase is strongly positive in which of the following cells?

Which of the following would stain most strongly for myeloperoxidase?

What cells may demonstrate a coarse block pattern of activity with the PAS stain?

Cytochemical procedures stain what cellular elements?

A patient has a white blood count of 35 *109/L with a left shift. The leukocyte alkaline phosphatase stain is 220. Which of the following is most likely?

A patient has a leukocyte alkaline phosphatase score of 9. The positive control is 5. Select the correct interpretation.

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

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

Automated Cell-Counting Instrumentation

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

Filters

A patient has a very high white blood count with many blasts in the blood and bone marrow. Esterase stains using both naphthol AS-D chloroacetate and $\alpha$ -naphthyl acetate esterase as substrates are both positive. What condition is likely?

A patient has a white blood count of 35 *10⁹/L with a left shift. The leukocyte alkaline phosphatase stain is 220. Which of the following is most likely?