Deck 31: Hematology Methods

Question 1

What cells are hemolyzed when ammonium oxalate is used for platelet counts?

A) Leukocytes
B) Reticulocytes
C) Mature red cells
D) Macrophages
E) None of the above

Answer 1

Mature red cells

Question 2

Manual cell counts are frequently performed on patients with extreme cases of:

A) Thrombocytosis
B) Thrombocytopenia
C) Leukocytosis
D) Leukopenia
E) All of the above

Answer 2

All of the above

Question 3

The normal RBC range for a child is ________.

A) 4.2-5.4  10¹²/L
B) 4.7-6.1  10¹²/L
C) 4.4-5.8  10¹²/L
D) 3.8-5.5  10¹²/L
E) None of the above

Answer 3

3.8-5.5  10¹²/L

Question 4

In a manual RBC count, the difference between the highest and lowest number of cells of the 10 squares should be no greater than _______.

A) 20
B) 10
C) 25
D) 15
E) 30

Question 5

The center primary square of the hemacytometer is divided into 25 smaller squares, each with an area of ______.

A) 0.02 mm²
B) 0.04 mm²
C) 1 mm²
D) 4 mm²
E) None of the above

Question 6

The RBC count when using the hemacytometer is the determination of the number of erythrocytes in ________ or microliters of whole blood.

A) 9 mm³
B) 1 mm³
C) 4 mm³
D) 3 mm³
E) None of the above

Question 7

When using a hemocytometer to count cells, all 25 secondary squares of the center primary square are used to count _______.

A) Erythrocytes
B) Leukocytes
C) Platelets
D) Basophils
E) None of the above

Question 8

Each large square is divided into nine smaller squares, each with an area of _____.

A) 4 mm²
B) 1 mm²
C) 10 mm²
D) 9 mm²
E) None of the above

Question 9

The normal RBC range for an adult female is _______.

A) 4.2-5.4  10¹²/L
B) 4.7-6.1  10¹²/L
C) 3.8-5.5  10¹²/L
D) 4.4-5.8  10¹²/L
E) None of the above

Question 10

Which objective lens is used to count erythrocytes in the four corner squares and the center square of the primary center square of a hemacytometer?

A) x10
B) x40
C) x100
D) x4
E) None of the above

Question 11

What is the anticoagulant of choice for manual cell counts?

A) Ethylenediaminetetraacetic acid (EDTA)
B) Sodium citrate
C) Sodium heparin
D) Sodium oxalate
E) None of the above

Question 12

When counting cells on a hemacytometer, the four corner and center secondary square of the center primary square are used to count _______.

A) Erythrocytes
B) Leukocytes
C) Platelets
D) Basophils
E) None of the above

Question 13

A normal RBC range for a newborn is _________.

A) 3.8-5.5  10¹²/L
B) 4.4-5.8  10¹²/L
C) 4.7-6.1  10¹²/L
D) 4.2-5.4  10¹²/L
E) None of the above

Question 14

When counting cells in a hemacytometer, cells inside a square with a double boundary line should be counted as well as:

A) Cells touching the middle inward line
B) Cells touching the innermost line
C) Artifacts
D) All of the above
E) None of the above

Question 15

Which type of microscope is preferred for the differentiation and enumeration of platelets?

A) Light microscope
B) Phase-contrast
C) Electron
D) Polarized
E) None of the above

Question 16

What is the diluent used when counting platelets by the Unopette method?

A) Ammonium oxalate
B) Hayem's solution
C) Gower's solution
D) Acetic acid
E) None of the above

Question 17

Each side of the hemacytometer has a large square with a total area of _____.

A) 3 mm²
B) 12 mm²
C) 9 mm²
D) 16 mm²
E) None of the above

Question 18

The distance between the bottom of the cover slip and the surface of the counting area of the hemacytometer chamber is _______.

A) 1 mm
B) 4 mm
C) 0.1 mm
D) 0.4 mm
E) None of the above

Question 19

An example of a blood dilution vial that is used for manual cell counts of white blood cells (WBCs), platelets, red blood cells (RBCs), eosinophils, and hemoglobin is the _______.

A) Unopette
B) Westergren
C) Hemacue
D) Wintrobe
E) None of the above

Question 20

The normal RBC range for an adult male is ________.

A) 4.2-5.4  10¹²/L
B) 4.4-5.8  10¹²/L
C) 4.7-6.1  10¹²/L
D) 3.8-5.5  10¹²/L
E) None of the above

Question 21

Normal erythrocytes have a mean corpuscular volume (MCV) of _______.

A) 100-110 fL
B) 80-100 fL
C) 32-35 fL
D) 60-80 fL
E) None of the above

Question 22

In states of ________, the reticulocyte percentage is not a true reflection of reticulocyte production.

A) Anemia
B) Polycythemia
C) Infection
D) All of the above
E) None of the above

Question 23

The range of normal values for reticulocytes in an adult is:

A) 2.5-6.0%
B) 1.0-3.0%
C) 0.5-2.0%
D) 3.0-5.0%
E) None of the above

Question 24

Reticulocytes are immature RBCs that contain remnant cytoplasmic ________.

A) Denatured hemoglobin
B) DNA
C) RNA
D) All of the above
E) None of the above

Question 25

Which anticoagulant is recommended for correcting manual platelet counts that exhibit "platelet satellitosis"?

A) Sodium citrate
B) Sodium oxalate
C) Sodium fluoride
D) Lithium heparin
E) None of the above

Question 26

Stress reticulocytes can be differentiated from mature reticulocytes by:

A) Filamentous reticulum
B) Presence of polychromatophilic macrocytes on the peripheral smear
C) Presence of microcytes on the peripheral smear
D) All of the above
E) None of the above

Question 27

Reticulocytes are counted under _________ magnification.

A) Low-power
B) High-power
C) Oil-immersion
D) Two of the above
E) None of the above

Question 28

The range of normal values for reticulocytes in a newborn is:

A) 0.5-2.0%
B) 2.5-6.0%
C) 1.0-3.0%
D) 3.0-5.0%
E) None of the above

Question 29

_______ reticulocytes result when the reticulocytes of the bone marrow pool are shifted to the circulating pool to compensate for anemia.

A) Juvenile
B) Shift
C) Stress
D) A and B
E) B and C

Question 30

Platelet satellitosis is a phenomenon that occurs when EDTA is used as the anticoagulant where ________ are ringed with adhering platelets.

A) Erythrocytes
B) Neutrophils
C) Eosinophils
D) Basophils
E) None of the above

Question 31

Calculate the RPI based on the following: reticulocyte count = 3.5%, patient hematocrit = 28%, normal hematocrit = 45%.

A) 1.1
B) 2.3
C) 3.5
D) 1.5
E) None of the above

Question 32

When performing a reticulocyte count, _________ total red cells are counted in consecutive oil-immersion fields.

A) 5000
B) 500
C) 1000
D) 2000
E) None of the above

Question 33

Fifty reticulocytes per 1000 red cells are counted under oil immersion. What is the reticulocyte count?

A) 3.0%
B) 1.5%
C) 5.0%
D) 1.0%
E) None of the above

Question 34

A _______ ratio of whole blood to supravital stain is required for reticulocyte staining.

A) 1:5
B) 1:1
C) 1:10
D) 2:1
E) None of the above

Question 35

The normal platelet count range is ________.

A) 50-100  10⁹/L
B) 200-450  10⁹/L
C) 300-500  10⁹/L
D) 130-400  10⁹/L
E) None of the above

Question 36

A calculation that corrects for both the RBC count and presence of shift reticulocytes is called the ___________.

A) Stress reticulocyte count
B) Corrected reticulocyte count
C) Reticulocyte production index (RPI)
D) Shift reticulocyte count
E) None of the above

Question 37

Red blood cells with an MCV of greater than 100 fL are said to be _______.

A) Microcytic
B) Macrocytic
C) Normocytic
D) Hypochromic
E) None of the above

Question 38

Given the following, what is the corrected reticulocyte count: reticulocytes = 2%, patient hematocrit = 33%, normal hematocrit = 45%.

A) 2.5%
B) 2.0%
C) 1.5%
D) 1.0%
E) 0.5%

Question 39

Which stain is used to visualize reticulocytes?

A) Prussian blue
B) New methylene blue
C) Wright's stain
D) Giemsa stain
E) None of the above

Question 40

Platelet counts performed using the Unopette system will appear as round, oval, or rod-like and sometimes showing dendritic processes. In contrast, red cells will appear as:

A) Eccentric cells
B) Bipolar cells
C) Mall disc-like cells
D) Ghost cells
E) None of the above

Question 41

The normal hematocrit value for an adult male is _______.

A) 37-42%
B) 42-52%
C) 53-65%
D) 30-43%
E) None of the above

Question 42

By definition, the _______ is the distance in millimeters that RBCs fall per unit of time, usually in 1 hour.

A) Sickle-dex
B) Autohemolysis test
C) Erythrocyte sedimentation rate
D) Donath-Landsteiner test
E) None of the above

Question 43

The normal mean corpuscular hemoglobin (MCH) range in adults is _______.

A) 27-31 pg
B) 32-36 pg
C) 25-45 pg
D) 20-30 pg
E) None of the above

Question 44

________ is defined as the volume occupied by erythrocytes in a given volume of blood and is usually expressed as a percentage of the volume of the whole blood sample.

A) Hemoglobin
B) Hematocrit
C) ESR
D) RDW
E) None of the above

Question 45

The normal WBC values for a 1-week-old baby are _______.

A) 9-30  10⁹/L
B) 5-21  10⁹/L
C) 6-17.5  10⁹/L
D) 6.2-12  10⁹/L
E) 4.8-10.8  10⁹/L

Question 46

The normal mean corpuscular hemoglobin concentration (MCHC) range for an adult is ______.

A) 35-40%
B) 27-31%
C) 32-36%
D) 20-30%
E) None of the above

Question 47

The normal WBC values for a newborn are ________.

A) 9-30  10⁹/L
B) 5-21  10⁹/L
C) 5-15  10⁹/L
D) 4.8-10.8  10⁹/L
E) 6.2-17  10⁹/L

Question 48

The normal hematocrit range for a newborn is _______.

A) 37-42%
B) 42-52%
C) 53-65%
D) 30-43%
E) None of the above

Question 49

The normal WBC values in an adult are ________.

A) 9-30  10⁹/L
B) 5-21  10⁹/L
C) 4.8-10.8  10⁹/L
D) 6.2-17  10⁹/L
E) 5-19.5  10⁹/L

Question 50

Calculate the MCV based on the following: hematocrit = 45%, RBC = 4.7  10⁶/L, hemoglobin = 15 g/dL.

A) 75 fL
B) 96 fL
C) 87 fL
D) 100 fL
E) 120 fL

Question 51

A patient's hematocrit was determined by the microcentrifuge method. In duplicate, the results were 33% and 45%. These results are deemed invalid for which reason(s)?

A) Results cannot be cross-checked with hemoglobin value.
B) Results do not duplicate within 1%.
C) The buffy coat was not included in the reading.
D) All of the above
E) None of the above

Question 52

The normal erythrocyte sedimentation rate (ESR) value for adult males is ______.

A) 0-9 mm/hr
B) 0-15 mm/hr
C) 0-20 mm/hr
D) 0-30 mm/hr
E) None of the above

Question 53

The normal value for RDW is _____.

A) 5.0-12.5%
B) 6.0-8.0%
C) 11.5-14.5%
D) 12.0-16.0%
E) None of the above

Question 54

The hematocrit is usually determined via the _________ method.

A) Cytoprep
B) Cytospin
C) Microcentrifuge
D) Radioimmunoassay
E) None of the above

Question 55

When measuring the hematocrit, the RBCs are separated from plasma during centrifugation, rendering a white band consisting of WBCs and platelets. This band is termed the __________ .

A) Lecithin
B) Buffy coat
C) Red cell interface
D) Plasma interface
E) None of the above

Question 56

The normal ESR range for adult females is _________.

A) 0-9 mm/hr
B) 0-15 mm/hr
C) 0-20 mm/hr
D) 0-30 mm/hr
E) None of the above

Question 57

Calculate the MCH given the following: hematocrit = 33%, RBC = 3.3  10⁶/L, hemoglobin = 11.3 g/dL.

A) 27 pg
B) 34 pg
C) 31 pg
D) 40 pg
E) None of the above

Question 58

The normal hematocrit value for an adult female is ______.

A) 37-47%
B) 42-52%
C) 53-65%
D) 30-43%
E) None of the above

Question 59

The normal WBC values for a 2-year old are ________.

A) 4.8-10.8  10⁹/L
B) 5-21  10⁹/L
C) 6.2-17  10⁹/L
D) 6-17.5  10⁹/L
E) 5-19.5  10⁹/L

Question 60

________ is an automated parameter provided by hematology instruments that indicates the degree of anisocytosis.

A) MCV
B) Red cell distribution width (RDW)
C) Packed cell volume (PCV)
D) MCH
E) MCHC

Question 61

The osmotic fragility test is a measure of erythrocyte _________ .

A) Size
B) Surface-to-volume ratio
C) Fragility of red cell organelles
D) All of the above
E) None of the above

Question 62

The normal hematocrit range for a child is _______.

A) 37-42%
B) 42-52%
C) 53-65%
D) 30-43%
E) None of the above

Question 63

What is the percentage of hemoglobin F (HbF) at birth?

A) <1%
B) 3-5%
C) 1-2%
D) 60-90%
E) None of the above

Question 64

The presence or absence of _________ is an effective measure of erythrocyte susceptibility to hypotonic damage.

A) Jaundice
B) Hemolysis
C) Lipemia
D) Inclusion bodies
E) None of the above

Question 65

What is the correct sequence of migration from cathode to anode in hemoglobin electrophoresis using citrate agar at acid pH?

A) C, S, A₁, A₂, D, E, F
B) A₁, S, C, D, A₂, E, F
C) F, S, C, A₂, A₁, D, D
D) D, S, C, A₂, A₁, F, E
E) None of the above

Question 66

What is the basic principle of cyanmethemoglobin determination of hemoglobin?

A) Cyanmethemoglobin oxidizes hemoglobin to methemoglobin, which is converted to potassium cyanide.
B) Potassium cyanide oxidizes hemoglobin to methemoglobin, which is converted to cyanmethemoglobin.
C) Potassium ferricyanide oxidizes hemoglobin to methemoglobin, which is converted to cyanmethemoglobin by potassium cyanide.
D) All of the above
E) None of the above

Question 67

In the acid elution procedure for HbF, cells containing HbF will stain a ________.

A) Light pink
B) Dark pink-red
C) Orange-red
D) Orange-yellow
E) None of the above

Question 68

If when performing an osmotic fragility test the plasma is moderately jaundiced, the plasma should be replaced with __________.

A) Distilled water
B) Dextran
C) Isotonic saline
D) All of the above
E) None of the above

Question 69

The normal support medium for hemoglobin electrophoresis is _______ at a pH of 8.5.

A) Eosin methyl blue
B) Citrate agar
C) Cellulose acetate
D) All of the above
E) None of the above

Question 70

Which type of red cells has a decreased surface-to-volume ratio and subsequent increased osmotic fragility?

A) Sickle cells
B) Hypochromic cells
C) Teardrop cells
D) Spherocytes
E) None of the above

Question 71

Heinz bodies consist of _______.

A) DNA
B) RNA
C) Denatured hemoglobin
D) Hemoglobin h bodies
E) None of the above

Question 72

Which procedure can be used to separate HbA₂ from HbE?

A) Cellulose acetate hemoglobin electrophoresis
B) HbA₂ by anion-exchange chromatography
C) Citrate agar hemoglobin electrophoresis
D) All of the above
E) None of the above

Question 73

The anticoagulant used for blood collection in performing the osmotic fragility test is _________.

A) Oxalate
B) Heparin
C) EDTA
D) Citrate
E) None of the above

Question 74

HbF is ________ to acid elution.

A) Sensitive
B) Resistant
C) Hypotonic
D) All of the above
E) None of the above

Question 75

Heinz bodies are visible via _______ stain.

A) Wright's stain
B) Giemsa stain
C) Crystal violet
D) Eosin stain
E) None of the above

Question 76

Heinz bodies are visualized in which area of a stained red cell?

A) Periphery of the cell
B) Center of cell
C) Bipolar ends
D) All of the above
E) None of the above

Question 77

The normal hemoglobin value for an adult male is ______.

A) 14-18 g/dL
B) 12-16 g/dL
C) 17-23 g/dL
D) 10-12 g/dL
E) None of the above

Question 78

The normal hemoglobin value for an adult female is _______.

A) 14-18 g/dL
B) 12-16 g/dL
C) 17-23 g/dL
D) 10-12 g/dL
E) None of the above

Question 79

The normal hemoglobin value for a newborn is _________ .

A) 14-18 g/dL
B) 12-16 g/dL
C) 17-23 g/dL
D) 10-12 g/dL
E) None of the above

Question 80

Which forms of circulating hemoglobin are readily converted to cyanmethemoglobin?

A) Oxyhemoglobin
B) Hemoglobin
C) Carboxyhemoglobin
D) All of the above
E) None of the above