Medical Laboratory Technology Test Bank
Course Introduction
Medical Laboratory Technology is a comprehensive course that introduces students to the theoretical foundations and practical applications of laboratory science in medical diagnostics. The curriculum covers essential topics such as hematology, clinical biochemistry, microbiology, immunology, pathology, and the operation of laboratory equipment. Students learn the principles of specimen collection, handling, and analysis, alongside quality assurance and laboratory safety protocols. Emphasis is placed on the critical role of laboratory professionals in disease detection, monitoring, and prevention. Upon completion, students gain the technical skills and scientific knowledge necessary to contribute effectively to healthcare teams and support accurate clinical decision-making.
Recommended Textbook
Clinical Laboratory Hematology 3rd Edition by Shirlyn B. McKenzie
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1441 Verified Questions
1441 Flashcards
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Page 2
Chapter 1: Introduction
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Sample Questions
Q1) The cellular component of blood that is involved in hemostasis is:
A)Leukocyte
B)Erythrocyte
C)Thrombocyte
D)Hemoglobin
Answer: C
Q2) Which of the following could be reflexed as the result of an abnormal RBC count?
A)Prothrombin time
B)Blood urea nitrogen
C)Reticulocyte count
D)WBC count
Answer: C
Q3) Name three blood analytes that show significantly different results in adults,children,and infants.
Answer: Hemoglobin is higher in infants and children than in adults. WBC counts are higher in infants than in children and adults. Differential results are different in children (inverted ratio of lymphs: neutrophils) than in infants and adults.
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Chapter 2: Cellular Homeostasis
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Sample Questions
Q1) Predict the effect of p16 on the cell cycle of dividing cells.
A)Increases cell cycle progression
B)Decreases cell cycle progression
C)Causes no change in the cell cycle progression
D)Initiates apoptosis
Answer: B
Q2) The (R)restriction point occurs during what phase in the cell cycle?
A)S
B)G
C)G
D)M
Answer: C
Q3) Which of the following are apoptosis activators?
A)BCL-2
B)Mcl-1
C)Bcl-XL
D)Bak
Answer: D
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Chapter 3: Structure and Function of Hematopoietic Organs
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Sample Questions
Q1) Peyer's patches are an example of:
A)Primary lymphoid tissue
B)Secondary lymphoid tissue
C)Splenic tissue
D)Medullary tissue
Answer: B
Q2) Primitive erythropoiesis in the yolk sac is important to what process?
A)Transportation of oxygen to developing tissue
B)Development of immunity
C)Liver development
D)Cellular differentiation
Answer: A
Q3) Hypersplenism associated with compensatory hypertrophy of the spleen is associated with:
A)Neoplasms when malignant cells occupy much of the splenic space
B)Congestive heart failure
C)Liver cirrhosis with portal hypertension
D)Infection and inflammatory diseases
Answer: D
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Chapter 4: Hematopoiesis
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Sample Questions
Q1) Which of the following lineages are derived from the bipotential progenitor cell CFU-EMk?
A)Erythrocytes and megakaryocytes
B)Eosinophils and megakaryocytes
C)Erythrocytes and monocytes
D)Eosinophils and monocytes
Q2) Explain how hematopoiesis uses autocrine,paracrine,and juxtacrine signaling.Choose one and provide an example of signaling through that pathway.
Q3) Which of the following molecules (synthetically generated)is administered to patients with renal disease to stimulate red cell production?
A)GM-CSF
B)Interleukin-2
C)EPO
D)G-CSF
Q4) All of the following can be formed from CFU-GEMM except:
A)Neutrophil
B)Erythrocyte
C)Platelet
D)Lymphocyte
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Chapter 5: The Erythrocyte
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Sample Questions
Q1) Choose the correct order of normoblastic maturation from least mature to most mature.
A)Erythrocyte,reticulocyte,polychromatophilic normoblast,orthochromatic normoblast,basophilic normoblast,pronormoblast
B)Pronormoblast,basophilic normoblast,polychromatophilic normoblast,orthochromatic normoblast,reticulocyte,erythrocyte
C)Basophilic normoblast,pronormoblast,polychromatophilic normoblast,orthochromatic normoblast,erythrocyte
D)Pronormoblast,polychromatophilic normoblast,orthochromatic normoblast,reticulocyte,erythrocyte
Q2) Where does normal extravascular hemolysis take place?
A)Blood vessels and bone marrow
B)Lymph nodes and spleen
C)Spleen and liver
D)Bone marrow and liver
Q3) Explain how EPO regulates RBC production.
Q4) Explain how the body catabolizes hemoglobin in both extravascular and intravascular hemolysis.
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Chapter 6: Hemoglobin
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Sample Questions
Q1) An elevated hemoglobin A1C indicates that:
A)The patient has an elevated hemoglobin.
B)The patient is anemic.
C)The patient's RBCs have been exposed to an elevated blood glucose for a prolonged period of time.
D)The patient's RBCs need glucose.
Q2) What are the chain designations for hemoglobin F?
A)
B)
C)
D)
Q3) During extravascular hemolysis,which of the following hemoglobin components are physiologically recycled?
A)Iron and heme
B)Haptoglobin and heme
C)Iron and globin
D)Heme and globin
Q4) Correlate embryonic/fetal hemoglobin production to stages of fetal hematopoiesis.
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Chapter 7: Granulocytes and Monocytes
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Sample Questions
Q1) Differentiate between absolute and relative concentrations of specific types of leukocytes and give an example of a condition that typically produces abnormal absolute or relative concentrations.
Q2) All of the following can cause a leukocytosis except:
A)Malignancy
B)Viral infection
C)Exposure to radiation
D)Immune responses
Q3) Phagocytosis consumes a large amount of energy provided by what process?
A)Diapedesis
B)Erythrophagocytosis
C)Innate immune response
D)Aerobic and/or anaerobic glycolysis
Q4) All of the following are included in the kill mechanism by neutrophils except:
A)Chemoattraction of neutrophils to infectious agent.
B)Diapedesis of neutrophils from blood into tissues.
C)The formation of the phagolysosome by the neutrophil.
D)The presentation of the infectious agent to a monocyte for phagocytosis.
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Page 9
Chapter 8: Lymphocytes
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Sample Questions
Q1) List the subtypes of lymphocytes in normal adult peripheral blood from most numerous to least numerous.
Q2) Which of the following is considered the "pan-B" antigen?
A)CD4
B)CD8
C)CD19
D)CD10
Q3) The commitment of a lymphocyte precursor cell to a T lymphocyte can be defined based on:
A)Rearrangement of the gene loci for the TCR
B)Rearrangement of the immunoglobulin gene
C)Presence of CD 19 and CD 10 by flow cytometry
D)Presence of TdT
Q4) Which cell line matures and differentiates upon exposure to antigen?
A)Neutrophilic
B)Basophilic
C)Monocytic
D)Lymphocytic
Q5) Compare and contrast the five isotypes of immunoglobulins.Include structure,function,and leukocyte interaction in your answer.
Page 10
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Chapter 9: The Platelet
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Sample Questions
Q1) Which of the following cytokines stimulate progenitor megakaryocytes to proliferate?
A)IL-6 and IL-11
B)TPO and GM-CSF
C)EPO and M-CSF
D)IL-4 and IL-10
Q2) The normal reference interval for the mean platelet volume (MPV)is:
A)9-11
B)11-14 g/dL
C)150-450 * 10 /L
D)8-12 fL
Q3) Which of the following criteria describes giant platelets?
A)8-12 fL in volume
B)>5 mcM in size
C)>2N in chromosome number
D)>400 × 10 /L in number
Q4) Identify the major cytokines that regulate platelet production and describe their effects on megakaryocytic cells and circulating platelets.
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11
Chapter 10: The Complete Blood Count and Peripheral
Blood Smear Evaluation
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Sample Questions
Q1) The hemoglobin and hematocrit on a newborn are 18.9 g/dL and 60%.How would you interpret these data?
A)Lower than expected on a newborn
B)Higher than expected on a newborn
C)Expected results on a newborn
D)Erroneous results that should be rejected
Q2) Codocytes are associated with all of the following conditions except:
A)Iron-deficiency anemia
B)Thalassemias
C)Hemoglobinopathies
D)Hemolytic anemia
Q3) An increased red cell distribution width (RDW)usually indicates what abnormality?
A)Increase of average erythrocyte volume
B)Increase of average weight of hemoglobin
C)Decrease in ratio of hemoglobin mass to volume
D)Variation in erythrocyte size
Q4) Why do we see Howell-Jolly bodies in patients who have had a splenectomy?
Explain your answer.
Q5) Describe the purpose of and the way to calculate the "rule of three."
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Chapter 11: Introduction to Anemia
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Sample Questions
Q1) A 34-year-old woman has severe anemia.She complains of a feeling of fullness and splenomegaly.This diagnosis and clinical symptoms indicate:
A)a chronic hemolytic process
B)an acute hemolytic anemia
C)intravascular hemolysis
D)extravascular hemolysis
Q2) All of the following are classic signs of anemia except:
A)Fatigue
B)Pallor
C)Shortness of breath
D)Nosebleeds
Q3) Patient results indicate an RPI of 1.8 and an MCV of 10 fl.Do these results make sense? Why or why not?
Q4) Which of the following is best to measure RBC survival?
A)Using conjugated bilirubin
B)Using urine hemoglobin
C)Monitoring 51Cr labeled RBCs
D)Using reticulocyte count
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Chapter 12: Anemias of Disordered Iron Metabolism and Heme Synthesis
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Sample Questions
Q1) Explain the difference between the chemical composition of hemosiderin and that of ferritin.
Q2) Which of the following is not characteristic of iron deficiency anemia?
A)Decreased ZPP
B)Decreased serum iron
C)Increased TIBC
D)Decreased serum ferritin
Q3) Note the text states 200 mcg/L in premenopausal females and 300 µg/L in men and postmenopausal women (page 220).Iron overload exists when ferritin levels are higher than:
A)100 ng/mL
B)200 ng/mL
C)50 ng/mL
D)24 ng/mL
Q4) Iron-deficiency anemia can occur from what three mechanisms?
A)Impaired iron absorption,blood loss,inadequate iron intake
B)ALAS deficiency,blood loss,decreased transferrin
C)Mutation of HFE gene,decreased transferrin,increased hepcidin
D)Inadequate iron intake,impaired iron absorption,decreased hepcidin
Q5) Differentiate between primary and secondary hemochromatosis.
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Chapter 13: Hemoglobinopathies: Qualitative Defects
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Sample Questions
Q1) A patient has a positive sickle solubility test.Further investigation reveals hemoglobin of 8.5 g/dL.What can be done to confirm these findings? Explain your answer.
Q2) This patient presented with swollen hands and feet.This patient suffering from what kind of crisis?
A)Vaso-occlusive
B)Oxidative
C)Transfusion reaction
D)Anaphylactic reaction
Q3) What preoperative therapy is effective in a diagnosed sickle cell patient?
A)Stem cell transplant
B)Transfusion of red blood cells
C)Hydroxyurea administration
D)Gene therapy
Q4) In hemoglobin C disease,the cell's life span is decreased to what length?
A)90-120 days
B)7-10 days
C)75-90 days
D)30-55 days
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Chapter 14: Thalassemia
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Sample Questions
Q1) When three of the four alpha genes are deleted,what is the disorder known as?
A) -thalassemia
B) -thalassemia
C)Hydrops fetalis
D)Hemoglobin H disease
Q2) List the predominating hemoglobins in each of the following disorders:
a.Hgb H disease
b. -thalassemia minor
c. -thalassemia major
d. -thalassemia intermedia
Q3) What test could provide the diagnosis differential for -thalassemia minor and iron deficiency?
A)PB smear
B)Iron studies
C)Hemoglobin electrophoresis
D)Bone marrow aspirate
Q4) Why are thalassemias considered a separate entity from hemoglobinopathies?
Q5) Nucleated red blood cells in the peripheral blood are a common finding in beta thalassemia patients.Explain why.
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Chapter 15: Megaloblastic and Nonmegaloblastic
Macrocytic Anemias
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Sample Questions
Q1) Predict the levels of MMA and homocysteine in patients with Vitamin B deficiency.
A)Both will be normal.
B)Both will be decreased.
C)Both will be increased.
D)MMA will be increased and homocysteine will be normal.
Q2) The reason that lack of vitamin B causes megaloblastic changes is that vitamin B :
A)Is needed for the formation of nucleotide bases
B)Is needed for the conversion of methionine to SAM
C)Initiates mitosis
D)Is needed for synthesis of intrinsic factor
Q3) What diagnosis is suggested if part II of the Schilling test is more than 7.5% when part I was 1%?
A)Sprue
B)Pernicious anemia
C)Renal disease
D)Celiac disease
Q4) Explain how high alcohol intake can cause macrocytosis.
Q5) Explain why peripheral neuropathy is a common finding in vitamin B deficiency.
Page 17
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Chapter 16: Hypoproliferative Anemias
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Sample Questions
Q1) Which of the following is among the diagnostic criteria for aplastic anemia?
A)Granulocyte count > 0.5 x 10 /L
B)Platelet count < 20 × 10 /L
C)Anemia
D)Anemia with
Q2) Fanconi's syndrome is an example of:
A)Constitutional aplastic anemia
B)Acquired aplastic anemia
C)Constitutional anemia from external stimuli
D)Acquired aplastic anemia from external exposure
Q3) Laboratory findings include a blood urea nitrogen >30 mg/dL,serum ferritin levels higher than normal,and a normocytic,normochromic morphology.What cause can be attributed to the anemia?
A)Chronic renal disease
B)Iron deficiency
C)Diamond-Blackfan anemia
D)Fanconi's syndrome
Q4) Define constitutional aplastic anemia,and give an example.
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Page 18
Chapter 17: Hemolytic Anemia: Membrane Defects
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Sample Questions
Q1) PNH is currently detected in the lab by which of the following?
A)Immunophenotyping
B)Ham and sucrose lysis tests
C)Donath-Landsteiner test
D)Osmotic fragility
Q2) The characteristic "fish-mouth" central pallor seen in overhydrated hereditary stomatocytosis is caused by an excessive influx of what in the RBCs?
A)Potassium
B)Chloride
C)Sodium and water
D)Sodium
Q3) Which of the following statements best describes the function of DAF in the body?
A)Facilitates the amplification of the complement cascade by activating C3 convertase
B)Prevents the amplification of C3/C5 convertase activity
C)Facilitates complement binding on erythrocytes
D)Prevents apoptosis of erythrocyte precursors
Q4) Explain why patients with HS sometimes suffer from gallstones.
Q5) Explain why patients with HS typically have an MCHC >36%.
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Chapter 18: Hemolytic Anemia: Enzyme Deficiencies
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Sample Questions
Q1) What poikilocyte is typically seen in PK deficiency?
A)Heinz bodies
B)Acanthocytes
C)Spherocytes
D)Echinocytes
Q2) Female heterozygotes for G6PD deficiency have one population of cells that is normal and one that is G6PD deficient because:
A)There is random inactivation of one X chromosome
B)There is random inactivation of one Y chromosome.
C)There is random activation of one X chromosome.
D)There is random activation of one Y chromosome.
Q3) The erythrocyte morphology associated with pyruvate kinase deficiency is:
A)Microcytic,hypochromic
B)Macrocytic,hypochromic
C)Normocytic,normochromic.
D)Normocytic,hypochromic
Q4) How do Heinz bodies differ morphologically from other erythrocyte inclusions?
Q5) Why are Heinz bodies seen in G6PD deficiency?
Q6) What is the purpose of the HMP shunt,and why is it important?
Q7) Why are echinocytes seen in PK deficiency?
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Chapter 19: Hemolytic Anemia: Immune Anemias
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Sample Questions
Q1) During transfusion,a patient developed pain in the area of the needle,shortness of breath,and chest tightness.What is the most likely cause?
A)Heart attack
B)Acute hemolytic transfusion reaction
C)TRALI
D)Anaphylactic transfusion reaction
Q2) Which of the following conditions is not paired with the correct autoantibody?
A)Infectious mononucleosis / autoanti-i
B)WAIHA / autoanti-K
C)CAD / autoanti-I
D)PCH / autoanti-P
Q3) Compare the differences in the activation of complement that can lead to intravascular hemolysis or extravascular hemolysis.
Q4) Paroxysmal cold hemoglobinuria is confirmed by a positive:
A)Antibody class IgM.
B)Thermal amplitude of antibody over 20°C.
C)Donath-Landsteiner test
D)Cold agglutinin test.
Q5) Compare the three mechanisms of drug-induced immune hemolysis.
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Chapter 20: Hemolytic Anemia: Nonimmune Defects
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Q1) A 20-year-old disoriented female is brought to the hospital with a fever of 102°F.Results of the CBC demonstrate a platelet count of 68 × 10 /L,a hemoglobin of 9.0 gm/dl,WBC count of 22 × 10 /L,and the presence of polychromasia and schistocytes on the peripheral blood smear.Her husband indicated she had no recent episodes of diarrhea but had been taking penicillin for an ongoing infection.The most likely diagnosis for the patient is:
A)TTP
B)D-HUS
C)DIC
D)HELLP syndrome
Q2) Explain why infections with Clostridium perfringens lead to hemolysis of the RBCs.
Q3) In what type of hemolytic anemia does damage to the endothelial lining of the small vessels result in deposits of fibrin with the vessels?
A)Exercise-induced hemoglobinuria
B)The type associated with infectious agents
C)The type associated with animal venoms
D)Microangiopathic hemolytic anemia
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Chapter 21: Nonmalignant Disorders of Leukocytes:
Granulocytes and Monocytes
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Q1) An adult patient's blood sample was collected in an EDTA blood collection tube for a CBC.The automated WBC count was 2.1 × 10 /L.Upon microscopic examination of the cells,the laboratory professional noted that the neutrophils adhered to the erythrocytes.What corrective action should be taken in this situation?
A)Draw the blood in heparin anticoagulant.
B)Recollect the blood from a finger stick and make manual dilutions.
C)Draw the blood in citrate anticoagulant.
D)Draw the blood in a plain red top tube.
Q2) Acute infection,inflammatory reaction,and administration of glucocorticosteroids can result in:
A)Basophilia
B)Eosinopenia
C)Mastocytosis
D)Histiocytosis
Q3) Define leukoerythroblastosis,and name a condition in which this is seen.
Q4) List three laboratory results that can distinguish a leukemoid reaction from CML.
Q5) What causes sea-blue histiocytosis,and how is the sea-blue histiocyte identified?
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Chapter 22: Nonmalignant Lymphocyte Disorders
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Q1) Bordetella pertussis is characterized by rapid peripheral lymphocytosis and decreased cellularity of the lymph nodes.What can explain this phenomenon?
A)Loss of homing of B cells to lymphoid tissues
B)Loss of homing of T cells to lymphoid tissue
C)Abnormal homing of lymphocytes to the bone marrow
D)Increase of L-selectin expression by T cells
Q2) What is the agent responsible for infectious mononucleosis?
A)Toxoplasmosis
B)CMV
C)EBV
D)Bordetella pertussis
Q3) Name five hematologic findings associated with HIV infections other than lymphocytopenia.
Q4) A 5-year-old girl has a WBC count of 11 × 10 /L with 55% lymphocytes.Which of the following best describes this phenomenon?
A)Absolute lymphocytosis
B)Relative lymphocytosis
C)Normal leukocyte count
D)Absolute lymphocytopenia
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Chapter 23: Introduction to Hematopoietic Neoplasms
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Q1) Which of the following disorders is characterized by signs of dyshematopoiesis?
A)Acute leukemias
B)Chronic leukemias
C)Myelodysplastic syndromes
D)Myeloproliferative disorders
Q2) Explain how proto-oncogenes contribute to tumor formation.
Q3) Which of the following has the best prognosis?
A)ALL in children
B)ALL in adults
C)AML in adults
D)AML in children
Q4) Which of the following does the World Health Organization use to classify hematopoietic neoplasms?
A)Lineage morphology
B)Clinical presentation
C)HIV status
D)DNA profiling
Q5) Name the two main classification systems that identify MDS and acute leukemia.Indicate how they are different.
Q6) What is the difference between the HSC and the cancer stem cell?
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Chapter 24: Myeloproliferative Neoplasms
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Q1) What cell appears to be the primary site for the defect in MPN?
A)HSC
B)GMP
C)Myeloblast
D)CFU-MK
Q2) The characteristic poikilocyte often seen in the peripheral blood of patients with PMF that indicates extramedullary hematopoiesis is:
A)Drepanocyte
B)Schistocyte
C)Spherocyte
D)Dacryocyte
Q3) A 45-year-old male patient presents to his physician with a palpable spleen.A CBC reveals an absolute eosinophil count of 2.5 × 10 /L.After six weeks,the patient's CBC indicates an absolute eosinophil count of 2.9 × 10 /L.Which of the following is a likely diagnosis for this patient?
A)Severe infection
B)Leukemoid reaction
C)MPN,U
D)Clonal hypereosinophilia
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Page 26
Chapter 25: Myelodysplastic Syndromes
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Q1) Myelodysplastic syndromes are sometimes called preleukemias because:
A)They have a progressive induction into acute leukemia.
B)They frequently progress to aplastic anemia.
C)Treatment for this disorder leads to leukemia.
D)They always precede leukemia.
Q2) A technologist is reviewing a blood smear and finds a rare blast.Bone marrow analysis shows dysplasia in 30% of the erythroblasts and the myeloid precursors and 4% blasts.What is a possible diagnosis based on these findings?
A)RA
B)RAEB-1
C)RARS
D)RCMD
Q3) Which of the following laboratory tests would not be helpful in identifying MDS/MPN,U?
A)Immunophenotyping
B)Bone marrow analysis
C)Cytogenetic analysis
D)Molecular-based testing
Q4) Give at least five morphologic indicators of dyserythropoiesis.
Q5) Explain the pathophysiology of MDS.
Page 27
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Chapter 26: Acute Myeloid Leukemias
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Q1) A bone marrow review on a 15-year-old girl with acute leukemia revealed many blasts with the following characteristics: high N:C ratio,prominent nucleoli,open chromatin pattern,and basophilic cytoplasm.Cytochemical staining revealed negative reactivity with MPO and SBB.Nonspecific esterase was positive.No cytogenetic abnormalities were detected.What is the most likely lineage of the blast cells in question?
A)Myeloid
B)Lymphoid
C)Monocytic
D)Erythroid
Q2) A patient presents with acute leukemia with blasts identified by a positive CD34,CD13,and CD33.Less than 3% of the blasts stain positive for MPO and SBB.Which category of AML is the most likely diagnosis for this patient?
A)AML minimally differentiated
B)AML without maturation
C)Acute myelomonocytic leukemia
D)Acute erythroid leukemia
Q3) What is the definition of acute leukemia,according to the World Health Organization?
Q4) Explain how bone marrow analysis helps establish an AML diagnosis.
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Chapter 27: Precursor Lymphoid Neoplasms
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Q1) A technologist is reviewing a patient's blood smear.She notices that 85% blasts are present but is having a difficult time identifying the lineage.Cytochemical staining is subsequently performed,and the results for MPO,SBB,NSE,and PAS are negative.Based on this information,what is the most likely lineage of the unknown blasts?
A)T lymphoid
B)B lymphoid
C)Erythroid
D)Myeloid
Q2) Which phase of leukemia treatment is considered to induce complete remission of the disease,eradicating the leukemic blast population?
A)Induction therapy phase
B)CNS prophylactic phase
C)CNS prophylactic phase and maintenance chemotherapy phase
D)Maintenance chemotherapy phase
Q3) The most common form of ALL relapse in children is:
A)CNS leukemia.
B)BM relapse.
C)Relapse in extramedullary hematopoietic organs.
D)Relapse in the lymphatic system.
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Chapter 28: Mature Lymphoid Neoplasms
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Q1) A 25-year-old male presents with an enlarged lymph node in his axillary region.Further testing confirms malignancy in the enlarged lymph node but nowhere else.In which stage of lymphoma,according to the Ann Arbor classification system,is the patient?
A)Stage I
B)Stage II
C)Stage III
D)Stage IV
Q2) Which of the following detects clonality in an unknown cell population?
A)Absolute lymphocytosis using morphology
B)CD4-positive T cells
C)Kappa light chain only present on B cells
D)Both kappa and lambda light chains present on B cells
Q3) The presence of which of the following cell types confirms the diagnosis of Hodgkin lymphoma?
A)Lymphocyte
B)Plasma
C)Reed-Sternberg
D)Cleaved Sézary
Q4) Explain the major differences between Hodgkin and non-Hodgkin lymphomas.
Page 30
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Chapter 29: Hematopoietic Stem Cell Transplantation
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Q1) One disadvantage of using autologous stem cells for treatment in a leukemia patient is:
A)The graft-versus-leukemia effect is not possible.
B)There is increased risk for graft-versus-host disease.
C)There is not a need for immunosuppression.
D)The yield of stem cells is low.
Q2) A procedure used to decrease the potential for GVHD in an allogeneic transplant is:
A)Freeze thaw to kill lymphocytes
B)Activation of CD4 cells and suppression of CD8 cells.
C)Purge of CD8 lymphocytes
D)Apheresis
Q3) The laboratory professional is not involved in which of following steps associated with SCT?
A)Compatibility testing
B)Pretransfusion testing
C)Apheresis
D)Transfusion of SCT product in patient
Q4) Explain the role of the laboratory professional in stem cell transplantation.
Q5) Explain the graft-versus-leukemia process in stem cell transplantation.
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Chapter 30: Morphologic Analysis of Body Fluids in the
Hematology
Laboratory
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Q1) Explain how the following are formed:
a.Transudate
b.Exudate
c.Chylous fluid
Q2) Examination of joint fluid on a 60-year-old patient with right knee pain reveals many intracellular needlelike crystals that polarize yellow to blue.What is the most likely identification of the crystal?
A)Calcium pyrophosphate
B)Cholesterol crystal
C)Monosodium urate
D)Talc particle
Q3) A patient with rheumatoid arthritis has fluid collected from his knee.The fluid has crystals that have a notched-plate shape.They are also birefringent.These crystals are most likely:
A)Calcium pyrophosphate
B)Monosodium urate
C)Steroid
D)Cholesterol
Q4) List common morphologic changes associated with cytocentrifugation.
Q5) What is the significance of micro-organisms present in the cytospin?
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Chapter 31: Primary Hemostasis
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Q1) On average,how long does a platelet live in the peripheral circulation?
A)6 hours
B)120 days
C)5 days
D)10 days
Q2) Which of the following defines the circulatory system's ability to maintain the blood as a fluid within the blood vessels and to prevent excessive blood loss upon injury?
A)Clot retraction
B)Hemostasis
C)Coagulation
D)Thrombosis
Q3) Which of the following acts as a transport portal for granules to move from the organelle zone to the membrane zone?
A)Open canalicular system
B)Dense tubular system
C)Membrane glycoproteins
D)Endoplasmic reticulum
Q4) How does the vascular system contribute to hemostasis?
Q5) Correlate blood vessel histology to vessel type and function in hemostasis.
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Chapter 32: Secondary Hemostasis and Fibrinolysis
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Q1) Triggering the contact activation factors of the intrinsic pathway does not require which of the following components?
A)Vitamin K
B)Calcium
C)Serine protease
D)Kinins
Q2) Which of the following is the smallest degradation product of fibrin?
A)Fragment X
B)Fragment Y
C)D-dimer
D)E fragment
Q3) Which of the following is responsible for urokinase-catalyzed plasminogen (PLG)activation?
A)ADAMTS-13
B)LRP
C)UPAR
D)EPCR
Q4) What are the roles of thrombin in coagulation?
Q5) Compare and contrast systemic and physiologic fibrinolysis.
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Chapter 33: Disorders of Primary Hemostasis
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Q1) Which of the following is not a mechanism of inducing thrombocytopenia in a patient?
A)Antibody-mediated platelet destruction
B)Inherited platelet membrane defect
C)Increased splenic sequestration
D)Inherited defect in release of ADP and ATP
Q2) Which of the following physical symptoms are associated with scurvy?
A)Hemangiomas
B)Ecchymoses
C)Bleeding into joints and muscles
D)Purpura fulminans
Q3) Thrombocytosis is associated with which of the following?
A)Acute leukemia
B)ITP
C)HUS
D)Myeloproliferative disorder
Q4) What laboratory tests are used to assess disorders of primary hemostasis and secondary hemostasis?
Q5) How do hematologic disorders contribute to the pathogenesis of thrombocytopenia?
Q6) Give at least five markers of differentiation between acute and chronic ITP.
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Chapter 34: Disorders of Secondary Hemostasis
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Q1) A patient has a prolonged PT.Which deficiency can you infer from this result?
A)Coagulation factors of the extrinsic pathway
B)Coagulation factors of the intrinsic pathway
C)Platelets
D)Coagulation factors of the common pathway
Q2) A 5-year-old boy has his blood drawn for platelet aggregation studies.Ristocetin aggregation (RIPA)comes back abnormal with all other agonists displaying normal aggregation.VWF antigen is within normal limits.What is the most likely reason for this discrepancy?
A)The VWF antigen test was performed incorrectly and should be repeated.
B)The patient might be suffering from a qualitative platelet defect disorder.
C)The RIPA exam was performed incorrectly and should be repeated.
D)Multimer analysis should be performed to confirm these findings.
Q3) An advantage of prenatal diagnosis by genotypic analysis for hemophilia over phenotypic analysis is:
A)ABO blood type does not affect the analysis.
B)A chorionic villus biopsy can be tested at 4 weeks gestation.
C)Direct DNA diagnosis is available for all families.
D)It can be done as a point-of-care test.
Q4) What laboratory tests typically are utilized to detect lupus anticoagulants?
Page 36
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Chapter 35: Thrombophilia
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Q1) Which of the following test results would help differentiate between type I and II protein C deficiencies?
A)PT and APTT
B)Protein C antigen assay
C)Protein C functional activity assay
D)Protein S assay
Q2) Patients with protein C and/or S deficiencies are at risk for which type of complication?
A)Hemorrhage
B)Delayed bleeding after injury
C)Thrombosis
D)Fibrinolysis
Q3) A patient being treated with heparin therapy has a 65% decrease in platelet count from the baseline count after 6 days of being on the anticoagulant.What is the probable cause of the decrease?
A)DIC
B)TTP
C)HIT
D)APLS
Q4) How does the INR standardize the prothrombin time?
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Chapter 36: Hemostasis: Laboratory Testing and Instrumentation
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Q1) The platelet function analyzer standardized the bleeding time method by eliminating the variables of the method.Which of the following represents the variables of bleeding time?
A)Dependence on the presence of calcium
B)Ingestion of aspirin
C)Room temperature,depth,location and direction of the incision;movement of the arm,and laboratician experience
D)Abnormal platelet count
Q2) Interpret the following results. -PT = 32 sec
-APTT = 92 sec
-TT = 20 sec.
What is the most likely reason for these aberrant results?
A)The patient is in DIC.
B)There is heparin contamination of the sample.
C)The patient is taking Coumadin.
D)The patient has liver disease.
Q3) Justify the need for a molecular marker test in the workup of a hemostatic problem.
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Chapter 37: Hematology Procedures
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Q1) A laboratory professional is reviewing differentials and notices that the last few smears appear blue.What can be done to correct this?
A)Lengthen the staining time
B)Change the buffer solution,which might be too alkaline
C)Change the buffer solution,which might be too acidic
Q2) Which cytochemical stain is useful in differentiating myeloblasts and lymphoblasts?
A)PAS
B)LAP
C)MPO
D)TRAP
Q3) Which of the following is the most appropriate test to differentiate hemoglobin S trait from hemoglobin S disease?
A)Quantitation of hemoglobin A
B)Hemoglobin electrophoresis
C)Acid elution for hemoglobin F
D)Solubility for hemoglobin S
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Chapter 38: Bone Marrow Examination
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Q1) 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
A)Touch imprints of the core biopsy
B)Core biopsy washings
C)Reaspiration of marrow
D)Histologic embedded paraffin blocks
Q2) 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)?
A)Decreased or absent Prussian blue specks
B)Adequate iron stores with Prussian blue stain
C)Sea blue histiocytes
D)Increased iron stores
Q3) All of the following are required information on a bone marrow report except:
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
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Chapter 39: Automation in Hematology
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Q1) The purpose of the photodetector on the Diagnostica Stago STA Compact is to:
A)Measure an increase in absorbance caused by the interaction of VWF with its monoclonal antibody
B)Measure an increase in transmittance caused by the interaction of D-dimer fragments in the patient's plasma with its monoclonal antibody
C)Promote the ball's oscillation movement through the electromagnetic sensors
D)Measure the amount of cleavage of p-nitroaniline
Q2) Which analyzer does not use cyanide-free detection of hemoglobin?
A)Advia 120
B)Advia 2120
C)Abbott Cell-Dyn Sapphire
D)Sysmex XE-2100
Q3) Which of the following parameters are calculated on the Coulter Gen-S?
A)Hemoglobin,MCH,MCHC
B)Hematocrit,MCH,MCHC
C)Absolute neutrophil count,RBC count,platelet count
D)RBC count,hematocrit,MCH
Q4) Name two analytes that can be measured immunologically,and list two instruments that currently use this method.
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Chapter 40: Flow Cytometry
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Q1) Name at least two pitfalls in immunophenotyping mature lymphoid malignancies,and explain how you would correct this.
Q2) Explain the advantages of using flow cytometry to count reticulocytes.
Q3) A single group of cells possessing identical aberrant phenotypes is defined as:
A)Monoclonal
B)Clonal
C)Tumorigenic
D)Contour gated
Q4) An increased IRF is not seen in which of the following?
A)Erythropoietin therapy
B)Iron therapy in iron deficient patients
C)Bone marrow recovery post-transplant
D)Aplastic anemia
Q5) Immunophenotyping is essential for diagnosing ALL,separating T- and B- lineage ALL,and identifying subtypes of B lineage ALL.What markers can blasts express in precursor B cell ALL?
A)CD10 and TdT
B)CD1 and CD2
C)CD4 and CD8
D)CD41 and CD61
Page 42
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Chapter 41: Chromosome Analysis of Hematopoietic and Lymphoid Disorders
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Q1) Incubation with ________ stops rapid cell division in metaphase and occurs _______ incubation in hypotonic solution.
A)KCl;after
B)Carnoy's fixative;before C)Giemsa stain;after
D)Colchicine;before
Q2) Describe the steps involved in cytogenetic harvesting and banding,and explain the purpose of each.
Q3) What is the composition of the nucleotides in the chromosome structure?
A)Phosphate and DNA
B)Ribose,deoxyribose,phosphate,and a base
C)Adenine,thymine,guanine,cytosine,and pyrimidine
D)Uracil and thymine
Q4) Following a successful bone marrow transplant as treatment for a hematopoietic disorder,what is the term used if the recipient's cells have a normal karyotype?
A)Partial engraftment
B)Chimerism
C)Mosaic
D)Aneuploid
Page 43
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Chapter 42: Molecular Analysis of Hematologic Diseases
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Q1) Name and compare two molecular methods used to detect mutations associated with sickle cell disease.
Q2) A multiplex reaction that targets conserved regions within the variable (V),diversity (D),and joining (J)regions of the immunoglobulin heavy chain can be used to determine clonality in which neoplasm?
A)CML
B)AML
C)B-cell leukemia/lymphoma
D)Human T-lymphocytic virus type 1
Q3) In reference to detecting minimal residual disease,which of the following is true?
A)PCR,karyotyping,and Southern blot analysis are equally sensitive and specific.
B)qPCR is most sensitive for detecting low levels of tumor burden.
C)Karyotyping is capable of detecting a 0.1% tumor burden.
D)Southern blot analysis has 100% sensitivity and specificity for detecting aberrant proteins formed as a result of the genetic mutation.
Q4) Explain the central dogma of molecular biology using proper nomenclature.Define each phase.
Q5) Explain the impact of a positive test for HTLV-1 in a lymphoma patient.
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