Question 1

The calculated indices on Mary Jones from the previous question 
$\begin{array}{lccc}
&\underline { \text {  MCV (fL) }} & \underline { \text {  MCH }(\mathrm{pg}) }& \underline { \text { MCHC }(\mathrm{g} / \mathrm{dL})}\
\text { a. }& 93 & 50 & 53 \
\text { b. } & 105 & 29 & 37 \
\text { c. }& 93 & 22 & 28 \
\text { d. } &105 & 34 & 35
\end{array}$

Accepted Answer

A
When the red cell indices are calculated,they are as follows:
Mean cell volume (MCV)= (30.0/3.22)* 10 = 93 fL.
Mean cell hemoglobin (MCH)= (16.0/3.22)* 10 = 50 pg.
MCHC = (16.0/30.0)* 100 = 53 g/dL.

Question 2

Manual cell counting methods in automated hematology laboratories are used for all of the following except

Accepted Answer

A) routine testing. 
B) very low counts. 
C) malfunctioning automated instruments. 
D) counting spinal fluids. 
A) routine testing. 
B) very low counts. 
C) malfunctioning automated instruments. 
D) counting spinal fluids. A

Question 3

Any of the following could be an explanation for the invalid hemoglobin (MCH = 50)for Mary Jones in Question 9 except

Accepted Answer

A) the blood sample is hemolyzed. 
B) lipemia is present in the plasma. 
C) the patient has hemoglobin S (Hb S). 
D) the patient's white count is 150.0 x 109/L. 
A) the blood sample is hemolyzed. 
B) lipemia is present in the plasma. 
C) the patient has hemoglobin S (Hb S). 
D) the patient's white count is 150.0 x 109/L. A

Question 4

In the center square on one side of a hemocytometer,100 platelets were found;200 were found in the center square on the other side.Select the best course of action.

Accepted Answer

A) Report the count as 150 x 109/L. 
B) Verify the count by estimating the platelet number on the blood film. 
C) Recount the hemocytometer on a phase microscope. 
D) Repeat the procedure-the two counts are not close enough. 
A) Report the count as 150 x 109/L. 
B) Verify the count by estimating the platelet number on the blood film. 
C) Recount the hemocytometer on a phase microscope. 
D) Repeat the procedure-the two counts are not close enough.

Question 5

What is the total volume of one side of a hemocytometer if the ruled area is 3 * 3 mm and the depth is 0.1 mm?

Accepted Answer

A) 0.3 mm3 
B) 0.9 mm3 
C) 1.0 mm3 
D) 9 mm3 
A) 0.3 mm3 
B) 0.9 mm3 
C) 1.0 mm3 
D) 9 mm3

Question 6

Which of the following is a good use of the erythrocyte sedimentation rate (ESR)?

Accepted Answer

A) Monitor patients with rheumatoid arthritis. 
B) Diagnose acute appendicitis. 
C) Diagnose multiple myeloma. 
D) Monitor patients with osteoarthritis. 
A) Monitor patients with rheumatoid arthritis. 
B) Diagnose acute appendicitis. 
C) Diagnose multiple myeloma. 
D) Monitor patients with osteoarthritis.

Question 7

Which of the following red cell indices supports macrocytic normochromic red cell morphology?
$\begin{array}{ccc}
\underline { \text {  MCV (fL) }} & \underline { \text {  MCH }(\mathrm{pg}) }& \underline { \text { MCHC }(\mathrm{g} / \mathrm{dL})}\
120 & 36 & 35 \
68 & 22 & 28 \
90 & 30 & 34 \
75 & 30 & 34
\end{array}$

Accepted Answer

A
The red cells are large but

Question 8

In the four large corner squares of a hemocytometer,95,102,105,and 98 white cells were counted from a 1:20 dilution.Select the correct interpretation for the white blood count calculated from these values.

Accepted Answer

A) normal for infant and elevated for an adult 
B) normal for any patient 
C) elevated for any patient 
D) normal for an infant and decreased for an adult 
A) normal for infant and elevated for an adult 
B) normal for any patient 
C) elevated for any patient 
D) normal for an infant and decreased for an adult

Question 9

Which of the following can cause a falsely increased ESR?

Accepted Answer

A) concentration of anticoagulant increased 
B) tube not totally vertical 
C) tuberculosis 
D) increased plasma viscosity 
A) concentration of anticoagulant increased 
B) tube not totally vertical 
C) tuberculosis 
D) increased plasma viscosity

Question 10

The MCV on a patient is calculated to be 115 fL and the MCHC is 35 g/dL.What,in general terms,must be true of the MCH if it is consistent with the previous two indices?

Accepted Answer

A) It is impossible to know. 
B) It should be in the reference range. 
C) It should be below reference range. 
D) It should be above reference range. 
A) It is impossible to know. 
B) It should be in the reference range. 
C) It should be below reference range. 
D) It should be above reference range.

Question 11

On a standard reticulocyte preparation with new methylene blue,100 of 1000 cells that are counted contain blue-stained granulofilamentous material.The red blood count is 3.22 × 10¹²/L,and the hematocrit is 30%.Calculate the reticulocyte production index (RPI).

Accepted Answer

A) 1.5 
B) 2.7 
C) 3.4 
D) 13.4 
A) 1.5 
B) 2.7 
C) 3.4 
D) 13.4

Question 12

Twenty cells are counted in one of the nine large squares of a hemocytometer.The sample is diluted 1:10.How many cells are present per $\mu$L?

Accepted Answer

A) 200 
B) 1000 
C) 2000 
D) 20,000 
A) 200 
B) 1000 
C) 2000 
D) 20,000

Question 13

On a standard reticulocyte preparation with new methylene blue,100 of 1000 cells that are counted contain blue-stained granulofilamentous material.The red blood count is 3.22 x 10¹²/L,and the hematocrit is 30%.Calculate the absolute reticulocyte count.

Accepted Answer

A) 0.32 x 1012/L 
B) 3.2 x 1012/L 
C) 32.2 x 1012/L 
D) 0.99 x 1012/L 
A) 0.32 x 1012/L 
B) 3.2 x 1012/L 
C) 32.2 x 1012/L 
D) 0.99 x 1012/L

Question 14

Diagnostic testing at or near the site of patient care is known as

Accepted Answer

A) preanalytic testing. 
B) point-of-care testing (POCT). 
C) waived testing. 
D) Clinical Laboratory Improvement Amendments (CLI
A)  testing. 
A) preanalytic testing. 
B) point-of-care testing (POCT). 
C) waived testing. 
D) Clinical Laboratory Improvement Amendments (CLI
A)  testing.

Question 15

A 1:20 dilution of blood is made for a white count,and the following number of cells counted in the four large corner mm² of the hemocytometer: 12,28,18,and 15.What should be done next?

Accepted Answer

A) Report the white count as 3.7 × 109/L. 
B) Clean the hemocytometer and recharge with a well-mixed dilution. 
C) Increase the number of mm2 counted. 
D) Compare this cell count to the one on the other side. 
A) Report the white count as 3.7 × 109/L. 
B) Clean the hemocytometer and recharge with a well-mixed dilution. 
C) Increase the number of mm2 counted. 
D) Compare this cell count to the one on the other side.

Question 16

Which of the following red cell indices supports microcytic hypochromic red cell morphology?
$\begin{array}{ccc}
\underline { \text {  MCV (fL) }} & \underline { \text {  MCH }(\mathrm{pg}) }& \underline { \text { MCHC }(\mathrm{g} / \mathrm{dL})}\
120 & 36 & 35 \
68 & 22 & 28 \
90 & 30 & 34 \
75 & 30 & 34
\end{array}$

Accepted Answer

B
Because the red cells are microcytic,t

Question 17

How do sickle cells or spherocytes interfere with the ESR?

Accepted Answer

A) prevent rouleaux formation, so falsely decrease 
B) encourage rouleaux formation, so falsely increase 
C) agglutinate and increase red cell mass, so falsely increase 
D) decrease plasma viscosity, so falsely decrease 
A) prevent rouleaux formation, so falsely decrease 
B) encourage rouleaux formation, so falsely increase 
C) agglutinate and increase red cell mass, so falsely increase 
D) decrease plasma viscosity, so falsely decrease

Question 18

The platelet count from the automated cell counter is 80 x 10⁹/L.Platelet satellites around neutrophils are observed on the blood film estimate.A sodium citrate tube is drawn,and the count reads 300 x 10⁹/L from the cell counter.What platelet count  x10⁹/L should be reported?

Accepted Answer

A) 80 
B) 300 
C) 330 
D) The estimated count from the blood film 
A) 80 
B) 300 
C) 330 
D) The estimated count from the blood film

Question 19

Why is it important to have a scrupulously clean hemocytometer when manually counting platelets?

Accepted Answer

A) So few platelets exist that they can be missed if dirt is present. 
B) They are so refractile they can be confused with dirt. 
C) Their small size makes them easily confused with dirt. 
D) They are easily confused with the red cells that are present. 
A) So few platelets exist that they can be missed if dirt is present. 
B) They are so refractile they can be confused with dirt. 
C) Their small size makes them easily confused with dirt. 
D) They are easily confused with the red cells that are present.

Question 20

Which regulatory standards mandate the concept of "test site neutrality" for all laboratory procedures?

Accepted Answer

A) OSHA 
B) CLIA 
C) Joint Commissions 
D) CAP 
A) OSHA 
B) CLIA 
C) Joint Commissions 
D) CAP

Exam 14: Manual, Semiautomated and Point-of-Care Testing in Hematology

The calculated indices on Mary Jones from the previous question a. 93 50 53 b. 105 29 37 c. 93 22 28 d. 105 34 35

Manual cell counting methods in automated hematology laboratories are used for all of the following except

Any of the following could be an explanation for the invalid hemoglobin (MCH = 50)for Mary Jones in Question 9 except

In the center square on one side of a hemocytometer,100 platelets were found;200 were found in the center square on the other side.Select the best course of action.

What is the total volume of one side of a hemocytometer if the ruled area is 3 * 3 mm and the depth is 0.1 mm?

Which of the following is a good use of the erythrocyte sedimentation rate (ESR)?

Which of the following red cell indices supports macrocytic normochromic red cell morphology? 120 36 35 68 22 28 90 30 34 75 30 34

In the four large corner squares of a hemocytometer,95,102,105,and 98 white cells were counted from a 1:20 dilution.Select the correct interpretation for the white blood count calculated from these values.

Which of the following can cause a falsely increased ESR?

The MCV on a patient is calculated to be 115 fL and the MCHC is 35 g/dL.What,in general terms,must be true of the MCH if it is consistent with the previous two indices?

On a standard reticulocyte preparation with new methylene blue,100 of 1000 cells that are counted contain blue-stained granulofilamentous material.The red blood count is 3.22 × 10¹²/L,and the hematocrit is 30%.Calculate the reticulocyte production index (RPI).

Twenty cells are counted in one of the nine large squares of a hemocytometer.The sample is diluted 1:10.How many cells are present per μ\muμ L?

On a standard reticulocyte preparation with new methylene blue,100 of 1000 cells that are counted contain blue-stained granulofilamentous material.The red blood count is 3.22 x 10¹²/L,and the hematocrit is 30%.Calculate the absolute reticulocyte count.

Diagnostic testing at or near the site of patient care is known as

A 1:20 dilution of blood is made for a white count,and the following number of cells counted in the four large corner mm² of the hemocytometer: 12,28,18,and 15.What should be done next?

Which of the following red cell indices supports microcytic hypochromic red cell morphology? 120 36 35 68 22 28 90 30 34 75 30 34

How do sickle cells or spherocytes interfere with the ESR?

The platelet count from the automated cell counter is 80 x 10⁹/L.Platelet satellites around neutrophils are observed on the blood film estimate.A sodium citrate tube is drawn,and the count reads 300 x 10⁹/L from the cell counter.What platelet count x10⁹/L should be reported?

Why is it important to have a scrupulously clean hemocytometer when manually counting platelets?

Which regulatory standards mandate the concept of "test site neutrality" for all laboratory procedures?

An Overview of Clinical Laboratory Hematology

Safety in the Hematology Laboratory

Blood Specimen Collection

Care and Use of the Microscope

Quality Assurance in Hematology and Hemostasis Testing

Cellular Structure and Function

Hematopoiesis

Erythrocyte Production and Destruction

Erythrocyte Metabolism and Membrane Structure and Function

Hemoglobin Metabolism

Iron Kinetics and Laboratory Assessment

Leukocyte Development, Kinetics, and Functions

Platelet Production, Structure, and Function

Automated Blood Cell Analysis

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

Bone Marrow Examination

Body Fluid Analysis in the Hematology Laboratory

Anemias: Red Blood Cell Morphology and Approach to Diagnosis

Disorders of Iron Kinetics 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 Erythrocyte Destruction Nonimmune Causes

Extrinsic Defects Leading to Increased Erythrocyte Destruction Immune Causes

Hemoglobinopathies (Structural Defects in Hemoglobin)

Thalassemias

Nonmalignant Leukocyte Disorders

Cytogenetics

Molecular Diagnostics in Hematopathology

Flow Cytometric Analysis in Hematologic Disorders

Myeloproliferative Neoplasms

Myelodysplastic Syndromes

Acute Leukemias

Mature Lymphoid Neoplasms

Normal Hemostasis and Coagulation

Hemorrhagic Disorders and Laboratory Assessment

Thrombotic Disorders and Laboratory Assessment

Thrombocytopenia and Thrombocytosis

Qualitative Disorders of Platelets and Vasculature

Laboratory Evaluation of Hemostasis

Antithrombotic Therapies and their Laboratory Assessment

Hemostasis and Coagulation Instrumentation

Pediatric and Geriatric Hematology and Hemostasis

Filters

Twenty cells are counted in one of the nine large squares of a hemocytometer.The sample is diluted 1:10.How many cells are present per $\mu$ L?