Question 1

What causes sea-blue histiocytosis,and how is the sea-blue histiocyte identified?

Accepted Answer

Sea-blue histiocytosis is an inherited,usually benign,disorder in which macrophages containing blue- or blue-green-staining granules can be found in the liver,spleen,and bone marrow.

Question 2

In the identification of Pelger-Huët cells,what nuclear characteristic other than the dumbbell shape aids in differentiating these cells from bands?

Accepted Answer

A) Excessive coarse clumping of chromatin 
B) Lack of primary granules 
C) Presence of Döhle bodies 
D) Toxic granules present 
A) Excessive coarse clumping of chromatin 
B) Lack of primary granules 
C) Presence of Döhle bodies 
D) Toxic granules present A

Question 3

Interpret the following results: WBC count,1.4 × 10⁹/L;bone marrow shows myeloid hypoplasia with a decreased M:E ratio of 1:1.There is no history of medications or drug exposure.What can be concluded from this?

Accepted Answer

A) The patient has a pseudoneutropenia. 
B) The patient has a neutropenia resulting from decreased production. 
C) The patient has a neutropenia resulting from increased loss in circulation. 
D) The patient has a neutropenia resulting from toxin exposure. 
A) The patient has a pseudoneutropenia. 
B) The patient has a neutropenia resulting from decreased production. 
C) The patient has a neutropenia resulting from increased loss in circulation. 
D) The patient has a neutropenia resulting from toxin exposure. B

Question 4

A patient presents with larger-than-normal neutrophils with hypersegmentation,oval macrocytes,and pancytopenia.This could be an indicator of:

Accepted Answer

A) Pelger-Huët anomaly 
B) Myeloproliferative disorder 
C) Megaloblastic anemia 
D) Infection 
A) Pelger-Huët anomaly 
B) Myeloproliferative disorder 
C) Megaloblastic anemia 
D) Infection

Question 5

A patient has a fever and a WBC of 25 × 10⁹/L with bands and metamyelocytes present.Which of the following conditions describes these results?

Accepted Answer

A) Reactive leukopenia 
B) Pseudoneutrophilia 
C) Left shift 
D) May-Hegglin anomaly 
A) Reactive leukopenia 
B) Pseudoneutrophilia 
C) Left shift 
D) May-Hegglin anomaly

Question 6

Which of the following is associated with bacterial infections?

Accepted Answer

A) Acute neutrophilia 
B) Toxic granulation 
C) Döhle bodies 
D) All of the above 
A) Acute neutrophilia 
B) Toxic granulation 
C) Döhle bodies 
D) All of the above

Question 7

How does immediate neutrophilia differ from acute neutrophilia?

Accepted Answer

A) Immediate neutrophilia occurs within 4-5 hours of stimulus,whereas acute neutrophilia occurs within 30 minutes. 
B) Immediate neutrophilia lasts 20-30 minutes,whereas acute neutrophilia lasts hours to days. 
C) In immediate neutrophilia,circulating neutrophils show an increase in early neutrophil precursors,whereas acute neutrophilia has mature neutrophils. 
D) In immediate neutrophilia,the leukocytes return to normal as the bone marrow production increases,whereas acute neutrophilia has mature neutrophils. 
A) Immediate neutrophilia occurs within 4-5 hours of stimulus,whereas acute neutrophilia occurs within 30 minutes. 
B) Immediate neutrophilia lasts 20-30 minutes,whereas acute neutrophilia lasts hours to days. 
C) In immediate neutrophilia,circulating neutrophils show an increase in early neutrophil precursors,whereas acute neutrophilia has mature neutrophils. 
D) In immediate neutrophilia,the leukocytes return to normal as the bone marrow production increases,whereas acute neutrophilia has mature neutrophils.

Question 8

A patient has a high fever,leukopenia,thrombocytopenia,and elevated liver enzymes.A blood smear shows WBCs with large basophilic,spherical cellular inclusions.Which of the following is a likely cause for these findings?

Accepted Answer

A) Toxic drugs 
B) Ehrlichia sp.infection 
C) Severe burns 
D) Malaria infection 
A) Toxic drugs 
B) Ehrlichia sp.infection 
C) Severe burns 
D) Malaria infection

Question 9

A laboratician is scanning a blood smear and notices that many of the neutrophils have more than six lobes.Which of the following would be consistent with that finding?

Accepted Answer

A) A decreased vitamin B₁₂ level 
B) An increased serum iron level 
C) A positive DAT result 
D) Decreased serum iron 
A) A decreased vitamin B₁₂ level 
B) An increased serum iron level 
C) A positive DAT result 
D) Decreased serum iron

Question 10

A patient presents with neutrophilia of 40 × 10⁹/L with many circulating immature cells.The blood contains many bands,metamyelocytes,myelocytes,promyelocytes,and a rare blast.No nucleated erythrocytes are present.What disease state is most likely with these results?

Accepted Answer

A) Leukoerythroblastosis 
B) Hypersensitivity reaction 
C) Tissue damage from burns 
D) Neutrophilic leukemoid reaction 
A) Leukoerythroblastosis 
B) Hypersensitivity reaction 
C) Tissue damage from burns 
D) Neutrophilic leukemoid reaction

Question 11

The processing of a sample in a lavender top tube received in the lab at 10a.m.is delayed because of a sudden fire drill.The sample is processed and analyzed at 2 p.m.Significant findings on this patient include an absolute neutrophil count of 1.5 × 10⁹/L.What can be concluded from this?

Accepted Answer

A) The patient is suffering from a neutropenia that needs to be investigated. 
B) The delay in testing resulted in a false neutropenia. 
C) The patient has pseudoneutropenia because of time of day the sample was drawn. 
D) There is not enough information to draw an accurate conclusion. 
A) The patient is suffering from a neutropenia that needs to be investigated. 
B) The delay in testing resulted in a false neutropenia. 
C) The patient has pseudoneutropenia because of time of day the sample was drawn. 
D) There is not enough information to draw an accurate conclusion.

Question 12

Acute infection,inflammatory reaction,and administration of glucocorticosteroids can result in:

Accepted Answer

A) Basophilia 
B) Eosinopenia 
C) Mastocytosis 
D) Histiocytosis 
A) Basophilia 
B) Eosinopenia 
C) Mastocytosis 
D) Histiocytosis

Question 13

Which of the following diseases is characterized by a defect in sphingomyelinase,which results in macrophages with a foamy appearance?

Accepted Answer

A) Gaucher's 
B) Fabry's 
C) Tay-Sachs 
D) Niemann-Pick 
A) Gaucher's 
B) Fabry's 
C) Tay-Sachs 
D) Niemann-Pick

Question 14

A peripheral blood smear examination shows many WBCs with many blue-staining round inclusions.Thrombocytopenia with giant platelets is present.What autosomal dominant disease is associated with these findings?

Accepted Answer

A) May-Hegglin anomaly 
B) Alder-Reilly anomaly 
C) Chédiak-Higashi anomaly 
D) Megaloblastic anemia 
A) May-Hegglin anomaly 
B) Alder-Reilly anomaly 
C) Chédiak-Higashi anomaly 
D) Megaloblastic anemia

Question 15

A healthy individual has his blood drawn as a part of a routine physical.The laboratician performing the differential notes a neutrophil with a nucleus that appears dumbbell shaped.After scanning the entire slide,it appears that the vast majority of neutrophils have the same nuclei.All other leukocytes appear normal.The conclusion from this is that the patient has:

Accepted Answer

A) May-Hegglin anomaly 
B) Hypersegmented neutrophils 
C) Pelger-Huët anomaly 
D) Alder-Reilly anomaly 
A) May-Hegglin anomaly 
B) Hypersegmented neutrophils 
C) Pelger-Huët anomaly 
D) Alder-Reilly anomaly

Question 16

Which of the following can result in basophilia?

Accepted Answer

A) Chronic myeloproliferative neoplasm 
B) Parasitic infections 
C) Connective tissue disorders 
D) All of the above 
A) Chronic myeloproliferative neoplasm 
B) Parasitic infections 
C) Connective tissue disorders 
D) All of the above

Question 17

Define leukoerythroblastosis,and name a condition in which this is seen.

Accepted Answer

Leukoerythroblastosis is characterized b

Question 18

Which of the following is most likely able to distinguish a leukemoid reaction from CML?

Accepted Answer

A) LAP score 
B) Platelet count 
C) Shift to the left 
D) RBC count 
A) LAP score 
B) Platelet count 
C) Shift to the left 
D) RBC count

Question 19

A patient's smear shows clumping of neutrophils.The absolute neutrophil count shows a neutropenia.What can be done to obtain a reliable neutrophil count?

Accepted Answer

A) Shake the tube vigorously. 
B) Assay the blood sample on another instrument. 
C) Assay the sample after using a warm diluent. 
D) Perform a finger stick and make manual dilutions and blood smears. 
A) Shake the tube vigorously. 
B) Assay the blood sample on another instrument. 
C) Assay the sample after using a warm diluent. 
D) Perform a finger stick and make manual dilutions and blood smears.

Question 20

A 45-year-old male visited his physician for a routine checkup.His absolute neutrophil count was 8.5 × 10⁹/L.Which of the following terms describes these results?

Accepted Answer

A) Absolute neutrophilia 
B) Intermediate neutrophilia 
C) Acute neutrophilia 
D) Relative neutrophilia 
A) Absolute neutrophilia 
B) Intermediate neutrophilia 
C) Acute neutrophilia 
D) Relative neutrophilia

Exam 21: Nonmalignant Disorders of Leukocytes: Granulocytes and Monocytes

What causes sea-blue histiocytosis,and how is the sea-blue histiocyte identified?

In the identification of Pelger-Huët cells,what nuclear characteristic other than the dumbbell shape aids in differentiating these cells from bands?

Interpret the following results: WBC count,1.4 × 10⁹/L;bone marrow shows myeloid hypoplasia with a decreased M:E ratio of 1:1.There is no history of medications or drug exposure.What can be concluded from this?

A patient presents with larger-than-normal neutrophils with hypersegmentation,oval macrocytes,and pancytopenia.This could be an indicator of:

A patient has a fever and a WBC of 25 × 10⁹/L with bands and metamyelocytes present.Which of the following conditions describes these results?

Which of the following is associated with bacterial infections?

How does immediate neutrophilia differ from acute neutrophilia?

A patient has a high fever,leukopenia,thrombocytopenia,and elevated liver enzymes.A blood smear shows WBCs with large basophilic,spherical cellular inclusions.Which of the following is a likely cause for these findings?

A laboratician is scanning a blood smear and notices that many of the neutrophils have more than six lobes.Which of the following would be consistent with that finding?

A patient presents with neutrophilia of 40 × 10⁹/L with many circulating immature cells.The blood contains many bands,metamyelocytes,myelocytes,promyelocytes,and a rare blast.No nucleated erythrocytes are present.What disease state is most likely with these results?

The processing of a sample in a lavender top tube received in the lab at 10a.m.is delayed because of a sudden fire drill.The sample is processed and analyzed at 2 p.m.Significant findings on this patient include an absolute neutrophil count of 1.5 × 10⁹/L.What can be concluded from this?

Acute infection,inflammatory reaction,and administration of glucocorticosteroids can result in:

Which of the following diseases is characterized by a defect in sphingomyelinase,which results in macrophages with a foamy appearance?

A peripheral blood smear examination shows many WBCs with many blue-staining round inclusions.Thrombocytopenia with giant platelets is present.What autosomal dominant disease is associated with these findings?

Which of the following can result in basophilia?

Define leukoerythroblastosis,and name a condition in which this is seen.

Which of the following is most likely able to distinguish a leukemoid reaction from CML?

A patient's smear shows clumping of neutrophils.The absolute neutrophil count shows a neutropenia.What can be done to obtain a reliable neutrophil count?

A 45-year-old male visited his physician for a routine checkup.His absolute neutrophil count was 8.5 × 10⁹/L.Which of the following terms describes these results?

Introduction

Cellular Homeostasis

Structure and Function of Hematopoietic Organs

Hematopoiesis

The Erythrocyte

Hemoglobin

Granulocytes and Monocytes

Lymphocytes

The Platelet

The Complete Blood Count and Peripheral Blood Smear Evaluation

Introduction to Anemia

Anemias of Disordered Iron Metabolism and Heme Synthesis

Hemoglobinopathies: Qualitative Defects

Thalassemia

Megaloblastic and Nonmegaloblastic Macrocytic Anemias

Hypoproliferative Anemias

Hemolytic Anemia: Membrane Defects

Hemolytic Anemia: Enzyme Deficiencies

Hemolytic Anemia: Immune Anemias

Hemolytic Anemia: Nonimmune Defects

Nonmalignant Lymphocyte Disorders

Introduction to Hematopoietic Neoplasms

Myeloproliferative Neoplasms

Myelodysplastic Syndromes

Acute Myeloid Leukemias

Precursor Lymphoid Neoplasms

Mature Lymphoid Neoplasms

Hematopoietic Stem Cell Transplantation

Morphologic Analysis of Body Fluids in the Hematology Laboratory

Primary Hemostasis

Secondary Hemostasis and Fibrinolysis

Disorders of Primary Hemostasis

Disorders of Secondary Hemostasis

Thrombophilia

Hemostasis: Laboratory Testing and Instrumentation

Hematology Procedures

Bone Marrow Examination

Automation in Hematology

Flow Cytometry

Chromosome Analysis of Hematopoietic and Lymphoid Disorders

Molecular Analysis of Hematologic Diseases

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