Question 1

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 D

Question 2

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 C

Question 3

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 4

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 5

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 6

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 7

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 8

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 9

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.

Question 10

Forward light scatter,when used in an instrument using the optical scatter principle,correlates with cell

Accepted Answer

A) granules 
B) volume 
C) nuclear chromatin 
D) number 
A) granules 
B) volume 
C) nuclear chromatin 
D) number

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

An automated hematology analyzer is used to evaluate a blood specimen.Which of the following,coming off the instrument,would require performance of a manual white cell differential as opposed to blood film review?

Accepted Answer

A) flagged data 
B) suppression of automated differential data 
C) abnormal red cell indices 
D) a slightly elevated platelet count 
A) flagged data 
B) suppression of automated differential data 
C) abnormal red cell indices 
D) a slightly elevated platelet count

Question 13

What does the pneumatic system of cell counters do?

Accepted Answer

A) operates the valves and moves the sample 
B) controls computer software 
C) digitizes the pulses generated by cell passage 
D) controls the laser light 
A) operates the valves and moves the sample 
B) controls computer software 
C) digitizes the pulses generated by cell passage 
D) controls the laser light

Question 14

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

Question 15

How do Beckman Coulter and Abbott instruments count red cells and platelets?

Accepted Answer

A) florescent staining and enumeration 
B) survival staining and conductivity 
C) optical scatter 
D) electrical impedance 
A) florescent staining and enumeration 
B) survival staining and conductivity 
C) optical scatter 
D) electrical impedance

Question 16

A patient's white blood count comes off an automated cell counter as 380 × 10⁹/L.Which of the following could be reported without any additional testing?

Accepted Answer

A) red blood count 
B) hemoglobin 
C) hematocrit 
D) platelet count 
A) red blood count 
B) hemoglobin 
C) hematocrit 
D) platelet count

Question 17

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 18

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 19

Platelet volume normally

Accepted Answer

A) is 15 to 20 fL. 
B) increases as the sample sits in ethylenediaminetetraacetic acid (EDT
A) . 
C) is 5 to 18 fL. 
D) is not reliable on most electronic instruments. 
A) is 15 to 20 fL. 
B) increases as the sample sits in ethylenediaminetetraacetic acid (EDT
A) . 
C) is 5 to 18 fL. 
D) is not reliable on most electronic instruments.

Question 20

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.

Exam 15: Automated Blood Cell Analysis

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

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

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

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

What is the greatest limitation of automated cell counters?

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

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

An elevated immature reticulocyte fraction is associated with

Forward light scatter,when used in an instrument using the optical scatter principle,correlates with cell

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

An automated hematology analyzer is used to evaluate a blood specimen.Which of the following,coming off the instrument,would require performance of a manual white cell differential as opposed to blood film review?

What does the pneumatic system of cell counters do?

Which of the following uses a peroxidase stain channel?

How do Beckman Coulter and Abbott instruments count red cells and platelets?

A patient's white blood count comes off an automated cell counter as 380 × 10⁹/L.Which of the following could be reported without any additional testing?

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 true regarding automated reticulocyte counts?

Platelet volume normally

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

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

Manual, Semiautomated and Point-of-Care Testing in Hematology

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

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