Deck 11: Principles and Practice of Clinical Hematology

Question 1

When insufficient amounts of oxygen are present in the circulating blood,a patient's skin will appear:

A) bright cherry red.
B) pale pink.
C) blue.
D) white.

Answer 1

blue.

Question 2

The maximum allowable time for determination of a WBC count,microhematocrit,or platelet count using blood that has been collected in EDTA is ____ hours,if it is refrigerated at 4° C.

A) 4
B) 8
C) 24
D) 48

Answer 2

24

Question 3

Blood cells are initially formed in the ____ of the embryo.

A) yolk sac
B) liver
C) spleen
D) bone marrow

Answer 3

yolk sac

Question 4

Oxyhemoglobin contains ____ molecule(s)per hemoglobin molecule.

A) 1
B) 2
C) 4
D) 8

Question 5

When the concentration of a salt solution is equal inside and outside of an RBC,it is:

A) isotonic.
B) hypotonic.
C) hypertonic.
D) equaltonic.

Question 6

The total volume of blood in an average adult is about ____ liters.

A) 2
B) 4
C) 6
D) 8

Question 7

Hemoglobin consists of:

A) heme.
B) iron-containing portion of the molecule.
C) globin (protein-containing portion of the molecule).
D) all of the above.

Question 8

The reference range for hemoglobin in normal adult females is ____ g/dL.

A) 15 to 20
B) 12 to 16
C) 9 to 14
D) 13 to 18

Question 9

In normochromic,normocytic individuals,a quick quality control check on hemoglobin results can be done by:

A) remeasuring the hemoglobin.
B) checking the hematocrit.
C) comparing the hemoglobin and hematocrit results.
D) none of the above.

Question 10

Another term used for the RBC measurement,hematocrit,is:

A) RBC count.
B) packed cell volume.
C) packed cell count.
D) erythrocyte indices.

Question 11

Neutrophils,eosinophils,and monocytes act as:

A) antibody producers.
B) inactivators of foreign antigens.
C) phagocytic scavengers.
D) both a and b.

Question 12

An immature RBC that has just lost its nucleus is referred to as a:

A) prorubricyte.
B) rubricyte.
C) metarubricyte.
D) reticulocyte.

Question 13

Blood samples that are unsuitable for hematology testing include ____ specimens.

A) hemolyzed
B) clotted
C) icteric
D) both a and b

Question 14

Less than ____% of the bone marrow consists of stem cells.

A) 0.5
B) 1
C) 10
D) 50

Question 15

Carboxyhemoglobin:

A) cannot bind to oxygen.
B) cannot carry oxygen to tissues.
C) will result in carbon monoxide poisoning.
D) All of the above are correct..

Question 16

Hemoglobin F makes up ____% of hemoglobin in an adult.

A) 5
B) 10
C) 25
D) 75

Question 17

The most popular anticoagulant used to prevent clotting in order to perform a complete blood count is:

A) EDTA.
B) heparin.
C) sodium fluoride.
D) sodium citrate.

Question 18

The most popular anticoagulant used to prevent clotting in order to perform a coagulation test (e.g.,prothrombin time)is:

A) EDTA.
B) heparin.
C) sodium fluoride.
D) sodium citrate.

Question 19

An example of a clinically important abnormal hemoglobin is hemoglobin:

A) S.
B) C.
C) E.
D) All of the above are correct.

Question 20

The principal adult hemoglobin contains:

A) two alpha and two beta globin chains.
B) three alpha and one beta globin chain.
C) two alpha and two gamma chains.
D) either a or c.

Question 21

An initial evaluation of a blood smear should include):

A) an evaluation of the overall quality of the blood film.
B) an estimate of the red and white (leukocyte) blood cell counts.
C) a scan of the blood film for abnormal cells and clumps of platelets.
D) all of the above.

Question 22

When RBCs are examined morphologically,what characteristics should be observed?

A) Variations in color
B) Variations in size (anisocytosis)
C) Variations in shape (poikilocytosis)
D) All of the above

Question 23

The criteria for a satisfactory blood smear include:

A) no interruption of the smear with ridges, waves, or holes; progressively going from a thick smear to a thinner smear.
B) covering one quarter to half of the length of the slide; moving smoothly from a thin to a thick smear.
C) making the smear with a smooth action and having a good feathered edge with a defined border on the end.
D) both a and c.

Question 24

The RBC distribution width is:

A) measurement of the degree of anisocytosis present.
B) measurement of the degree of RBC size variability.
C) abbreviated as RDW.
D) all of the above.

Question 25

The reference range for the MCV is:

A) 65 to 85 pg.
B) 65 to 86 fL.
C) 80 to 96 g/dL.
D) 80 to 96 fL.

Question 26

Examination of a blood smear should begin using 10× objective where the RBCs are:

A) spread far apart.
B) just touching each other or barely overlapping.
C) clumped together.
D) it doesn't matter.

Question 27

The identification of leukocytes is guided by:

A) overall size of the cell.
B) shape and size of the cellular nucleus.
C) color of the cytoplasm.
D) all of the above.

Question 28

The most important requirement for the diluting fluid used to determine a WBC count is the ability to:

A) lyse cells.
B) allow cells of interest to fluoresce.
C) maintain cellular integrity.
D) do either a or b.

Question 29

The anticoagulant of choice for cell counts is:

A) lithium.
B) sodium citrate.
C) EDTA.
D) heparin.

Question 30

The reference range of the microhematocrit in adult males is:

A) 32% to 36%.
B) 36% to 45%.
C) 41.5% to 50.4%.
D) 45% to 55.5%.

Question 31

A total platelet count of 250× 10⁹/L is:

A) below normal.
B) within the reference range.
C) above normal.
D) normal for children but not for adults.

Question 32

One of the most frequent conditions in which hypochromic,microcytic RBCs can be observed is ____ anemia.

A) iron deficiency
B) pernicious
C) sickle cell
D) either iron deficiency or sickle cell

Question 33

A hematocrit and PCV are the same measurement.However,the hematocrit is expressed in percentage (%)but the PCV is expressed as:

A) g/dL.
B) L/L.
C) ×1012/L.
D) ×109/L.

Question 34

If a patient has a total leukocyte count of 20.0× 10⁹/L with 70% neutrophils and 30% lymphocytes on the leukocyte differential smear,what is the absolute lymphocyte count?

A) 3.6× 109/L
B) 6.0× 109/L
C) 6.6× 109/L
D) 14.0× 109/L

Question 35

The blood cell that produces immunoglobulins (antibodies)is the:

A) lymphocyte.
B) plasma cell.
C) monocyte.
D) neutrophil.

Question 36

Leukopenia is a(n):

A) increased total white blood count.
B) decreased total while blood count.
C) increased number of segmented neutrophils.
D) decreased number of lymphocytes.

Question 37

The stage of erythrocyte (RBC)development during which remnants of RNA can be seen is:

A) polychromatophilic normoblast (rubricyte).
B) orthochromic normoblast (metarubricyte).
C) reticulocyte (diffusely basophilic erythrocyte).
D) mature erythrocyte.

Question 38

If an excess of anticoagulant,for example,EDTA is present in a specimen for microhematocrit determinations,this error will cause ____ result.

A) a falsely lower
B) no observable change in the
C) a falsely higher
D) no difference in the

Question 39

A properly stained Wright-Giemsa stained blood smear has a ____ appearance when observed with the naked eye.

A) blue
B) red
C) pink
D) yellow

Question 40

A hematocrit determined by automated instrumentation is consistently ____ when done by the spun microhematocrit method.

A) lower
B) higher
C) the same as
D) not comparable

Question 41

Match the RBC indices term with the appropriate equation.
MCV

A)
B)
C)

Question 42

Reticulocytes represent RBCs that:

A) have lost their nuclei but not their cytoplasmic RNA.
B) are immature, nucleated RBCs.
C) are increased in untreated pernicious anemia.
D) have abnormal staining characteristics.

Question 43

The term shift to the left refers to a(n):

A) increase in mature neutrophils.
B) increase in immature neutrophils.
C) increase in immature lymphocytes.
D) decrease in mature neutrophils.

Question 44

Match the errors in staining with the appropriate description.
large amounts of precipitated stain

A)if the pH of the staining system is too alkaline, the parts of the cells taking up basic dye will be overstained, giving an overall blue effect, with very dark blue to black nuclear chromatin and bluish RBCs
B)parts of the cell taking up acidic dye will be overstained and will appear too red, while the parts of the cells taking up basic dye will appear pale
C)an excessively blue appearance on gross examination
D)improper washing (not washing enough to remove the metallic scum)

Question 45

Platelets maintain the structure or integrity of the endothelium by plugging any gaps in the lining.

Question 46

Match the errors in staining with the appropriate description.
pH of the staining system is too alkaline

A)if the pH of the staining system is too alkaline, the parts of the cells taking up basic dye will be overstained, giving an overall blue effect, with very dark blue to black nuclear chromatin and bluish RBCs
B)parts of the cell taking up acidic dye will be overstained and will appear too red, while the parts of the cells taking up basic dye will appear pale
C)an excessively blue appearance on gross examination
D)improper washing (not washing enough to remove the metallic scum)

Question 47

The reference range for adult (male)reticulocytes is ____% (uncorrected).

A) 0 to 0.2
B) 0.3 to 0.5
C) 0.5 to 1.5
D) 0.5 to 2.5

Question 48

Heme iron is normally recycled for reuse.

Question 49

Observation of many smudge cells on a blood smear can be associated with a diagnosis of:

A) chronic myelogenous leukemia.
B) chronic lymphocytic leukemia.
C) acute bacterial infection.
D) acute viral infection.

Question 50

Match the errors in staining with the appropriate description.
pH of the staining system is too acidic

A)if the pH of the staining system is too alkaline, the parts of the cells taking up basic dye will be overstained, giving an overall blue effect, with very dark blue to black nuclear chromatin and bluish RBCs
B)parts of the cell taking up acidic dye will be overstained and will appear too red, while the parts of the cells taking up basic dye will appear pale
C)an excessively blue appearance on gross examination
D)improper washing (not washing enough to remove the metallic scum)

Question 51

Mature RBCs that are larger than normal are called:

A) macrocytic.
B) microcytic.
C) ovalocytic.
D) normocytic.

Question 52

Match the errors in staining with the appropriate description.
overstaining,inadequate washing,or using too thick a film

A)if the pH of the staining system is too alkaline, the parts of the cells taking up basic dye will be overstained, giving an overall blue effect, with very dark blue to black nuclear chromatin and bluish RBCs
B)parts of the cell taking up acidic dye will be overstained and will appear too red, while the parts of the cells taking up basic dye will appear pale
C)an excessively blue appearance on gross examination
D)improper washing (not washing enough to remove the metallic scum)

Question 53

Match the RBC indices term with the appropriate equation.
mean corpuscular hemoglobin concentration

A)
B)
C)

Question 54

Platelets act as plugs around the opening of a wound.

Question 55

Howell-Jolly bodies represent:

A) residual DNA.
B) residual RNA.
C) toxic granules.
D) either a or b.

Question 56

Platelets release certain factors that are required for the formation of a blood clot.

Question 57

Match the RBC indices term with the appropriate equation.
mean corpuscular hemoglobin

A)
B)
C)

Question 58

Mature platelets are brightly colored oval bodies on a peripheral blood smear.

Question 59

RBCs that have a central area of hemoglobin are called:

A) spherocytes.
B) target cells.
C) microcytes.
D) discocytes.

Question 60

The erythrocyte sedimentation rate (ESR)is used:

A) to track tissue healing after a myocardial infarction (heart attack).
B) as a nonspecific index of inflammatory activity.
C) to diagnose anemias.
D) Both a and b are correct.

Question 61

Match the following categories of microscopic observations of RBCs with the appropriate example.
variation in RBC color

A)Howell-Jolly body
B)schistocyte
C)hypochromia
D)macrocytes

Question 62

Match the cellular characteristic with the appropriate cell type.
monocyte

A)usually the most numerous of the mature leukocytes (WBCs)
B)dark-purple or black granules in the cytoplasm
C)orange granules in the cytoplasm
D)cytoplasm usually stains a light blue
E)the largest mature WBC

Question 63

Match the adult mean reference value (%) with each of the leukocyte types.
monocytes

A)0.5
B)59
C)3
D)4-6
E)34

Question 64

Match the following granulocyte alterations with an appropriate description.
Auer rods

A)composed of lysosomal materials and fused primary granules
B)associated with acute bacterial infections
C)pale blue inclusions associated with burns

Question 65

Match the cellular characteristic with the appropriate cell type.
basophil

A)usually the most numerous of the mature leukocytes (WBCs)
B)dark-purple or black granules in the cytoplasm
C)orange granules in the cytoplasm
D)cytoplasm usually stains a light blue
E)the largest mature WBC

Question 66

Match the adult mean reference value (%) with each of the leukocyte types.
basophils

A)0.5
B)59
C)3
D)4-6
E)34

Question 67

Match the following granulocyte alterations with an appropriate description.
Döhle bodies

A)composed of lysosomal materials and fused primary granules
B)associated with acute bacterial infections
C)pale blue inclusions associated with burns

Question 68

Match the following categories of microscopic observations of RBCs with the appropriate example.
alteration in RBC size

A)Howell-Jolly body
B)schistocyte
C)hypochromia
D)macrocytes

Question 69

Match the cellular characteristic with the appropriate cell type.
lymphocyte

A)usually the most numerous of the mature leukocytes (WBCs)
B)dark-purple or black granules in the cytoplasm
C)orange granules in the cytoplasm
D)cytoplasm usually stains a light blue
E)the largest mature WBC

Question 70

Match the following terms with an appropriate definition.
anisocytosis

A)variation in cell size
B)increased central pallor in RBCs
C)faint blue-colored RBCs

Question 71

Match the adult mean reference value (%) with each of the leukocyte types.
eosinophils

A)0.5
B)59
C)3
D)4-6
E)34

Question 72

Match the following granulocyte alterations with an appropriate description.
toxic granulation

A)composed of lysosomal materials and fused primary granules
B)associated with acute bacterial infections
C)pale blue inclusions associated with burns

Question 73

Match the following terms with an appropriate definition.
hypochromia

A)variation in cell size
B)increased central pallor in RBCs
C)faint blue-colored RBCs

Question 74

Match the adult mean reference value (%) with each of the leukocyte types.
neutrophils

A)0.5
B)59
C)3
D)4-6
E)34

Question 75

Match the cellular characteristic with the appropriate cell type.
eosinophil

A)usually the most numerous of the mature leukocytes (WBCs)
B)dark-purple or black granules in the cytoplasm
C)orange granules in the cytoplasm
D)cytoplasm usually stains a light blue
E)the largest mature WBC

Question 76

Match the adult mean reference value (%) with each of the leukocyte types.
lymphocytes

A)0.5
B)59
C)3
D)4-6
E)34

Question 77

Match the following categories of microscopic observations of RBCs with the appropriate example.
alteration in RBC shape

A)Howell-Jolly body
B)schistocyte
C)hypochromia
D)macrocytes

Question 78

Match the following categories of microscopic observations of RBCs with the appropriate example.
an RBC inclusion

A)Howell-Jolly body
B)schistocyte
C)hypochromia
D)macrocytes

Question 79

Match the cellular characteristic with the appropriate cell type.
neutrophil

A)usually the most numerous of the mature leukocytes (WBCs)
B)dark-purple or black granules in the cytoplasm
C)orange granules in the cytoplasm
D)cytoplasm usually stains a light blue
E)the largest mature WBC

Question 80

Match the following terms with an appropriate definition.
polychromasia

A)variation in cell size
B)increased central pallor in RBCs
C)faint blue-colored RBCs