Question 1

If a bone marrow aspiration results in a dry tap,or when the marrow aspirate lacks spicules,the best source for studying cellular detail and maturation sequence is

Accepted Answer

A)  Touch imprints of the core biopsy
B)  Core biopsy washings
C)  Reaspiration of marrow
D)  Histologic embedded paraffin blocks A

Question 2

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

Question 3

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

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,whereas benign have an aberrant phenotype. A

Question 4

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

Accepted Answer

A)  Normal
B)  Increased
C)  Decreased
D)  None

Question 5

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

Question 6

The role of the hematology technologist in bone marrow evaluation is to:

Accepted Answer

A)  Perform the bone marrow aspirate procedure
B)  Administer anesthetic in preparation of the procedure
C)  Make bone marrow smears after collection
D)  Report the results of the bone marrow examination to the attending physician

Question 7

How many cells typically are counted when performing a bone marrow differential?

Accepted Answer

A)  100
B)  2000
C)  1000
D)  10 of each lineage

Question 8

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

Question 9

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

Accepted Answer

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

Question 10

What are the main reasons for using a core biopsy specimen versus an aspirate specimen?

Accepted Answer

The answer of What are the main reasons for using...

Question 11

All of the following are procedures in which a bone marrow aspirate is indicated except:

Accepted Answer

A)  Diagnosing infections of known origin
B)  Staging malignancies
C)  Evaluating unexplained cytopenia
D)  Making primary diagnosis of hematologic malignancies

Question 12

The following assays are typically performed on bone marrow specimens.Match each assay with the appropriate specimen type,assuming that both are available.
a.Bone marrow differential
b.M:E ratio
c.Cellularity
d.Assessment of iron stores

Accepted Answer

The answer of The following assays are typically performed on...

Question 13

A normal M:E ratio is about 3:1.A patient has three times more myeloid precursors than erythroid precursors in the bone marrow because:

Accepted Answer

A)  The body needs more cells to fight infection than to transport oxygen.
B)  The life cycle of a WBC is much longer than that of an RBC.
C)  WBCs undergo more steps in hematopoiesis than do RBCs.
D)  The life cycle of a WBC is much shorter than that of an RBC.

Question 14

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

Accepted Answer

A)  Well defined
B)  Well defined with mature lymphocytes
C)  Diffuse and patchy
D)  Well defined with plasma cells

Question 15

The calculation to determine the normal expected cellularity range in an adult is to subtract the patient's age from 100% and:

Accepted Answer

A)  Add/subtract 20%
B)  Add/subtract 10%
C)  Add/subtract 30%
D)  Add/subtract 50%

Question 16

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.

Question 17

The primary uses of flow cytometry in the evaluation of hematologic disorders are to:

Accepted Answer

A)  Detect the presence of clonality and diagnose and classify malignant lymphomas and leukemias
B)  Classify anemias associated with defective hemoglobin synthesis
C)  Identify specific genetic rearrangements
D)  Detect chromosomal alterations

Question 18

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

Accepted Answer

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

Question 19

Which of the following is not typically found on a bone marrow report?

Accepted Answer

A)  Patient's insurance information
B)  Patient's biographical data
C)  Patient's clinical diagnosis
D)  Relevant therapeutic information

Question 20

All of the following are required information on a bone marrow report except:

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)  Final diagnosis by the pathologist

Exam 38: Bone Marrow Examination