Hematology Part 2

Which of the following conditions is a myeloproliferative neoplasm?

Essential Thrombocythemia

In comparison to malignant lymphocytes, reactive lymphocytes:

Are morphologically more variable throughout the smear

Which pari of malignancies represent different clinical manifestations of the same disease?

CLL and SLL

Increased levels of TdT activity are indicative of:

ALL

Which of the following is true of ALL?

Primitive lymphoid-appearing cells accumulate in bone marrow

The most common form of childhood leukemia is:

Acute Lymphocytic

CLL is defined as an:

Accumulation fo monoclonal B cells

Hairy cell leukemia is a:

Chronic Leukemia of Myelocytic Origin

Which of these characteristics is usually associated with hairy cell leukemias?

Mononuclear cells with ruffled edges

Morphologic variants of plasma cells include:

Flame Cells

The disease most closely associated with cytoplasmic granule fusion is:

Chediak-Higashi

Which of these anomalies is an autosomal dominant disorder characterized by irregularly-sized inclusions in polymorphonuclear neutrophils, abnormal giant platelets and often thrombocytopenia?

May-Hegglin

The disease most closely associated with granulocyte hypo segmentation is:

Pelger-Huett

Which of the following is associated with Chediak-Higashi syndrome?

Membrane defect os lysosomes

Which of the following is associated with Alder-Reilly inclusions?

Mucopolysaccharidosis

Which of the following is associated with May-Hegglin?

Dohle bodies and giant platelets

A differential is performed on an asymptomatic patient. The differential included 60% neutrophils, 55 of which had 2 lobes and 5 had 3 lobes. There are no other abnormalities. This is consistent with which of these anomalies?

Pelger-Huett

Which of the following can cause neutropenia?

Medications

Which of the following immunohistochemical patterns is most consistent with CLL/SLL?

CD5+/CD23+

Which of the following morphologic characteristics is consistently associated with hairy cell leukemia?

Uneven cytoplasmic margins

What is the most common immunoglobulin present in plasma cell myeloma?

IgG

Which of the following is suggestive of a myeloproliferative disorder?

Granulocytosis

Which of the following is characteristic of the myelodysplastic syndrome?

Unillineage or multilineage dyspoiesis

Which of the following is a WHO classification of myelodysplastic syndrome?

MDS with low blasts

Which of the following disorders is a category in the WHO classification of myelodysplastic syndromes/myeloproliferative neoplasms?

JMML

Which of the following features define chronic myelogenous leukemia?

T(9;22)

Which of the following are main groups of AML in the WHO classification system?

AML, NOS

What type of morphologically abnormal cells proliferate in acute myelogenous leukemia with inv(16)?

Eosinophils

What defines acute myelogenous leukemia with minimal differentiation?

>20% blasts lacking cytochemical evidence of myeloid differentiation

What is the most common presentation of acute erythroid leukemia?

>80% of nucleated marrow cells are erythroid precursors

Which of the following is associated with acute megakaryoblastic leukemia?

Down Syndrome

A useful chemical test for the diagnosis of hairy cell leukemia is the:

Tartrate-resistant acid phosphatase test

Chronic lymphocytic leukemia cells are most likely to express which of the following cell surface markers?

CD5, 19, 20, 21

Which of the following markers, typically detected in normal myeloid cells, are expressed on the surface of hairy cell leukemia lymphocytes?

CD11c

vWF antigen can be found in which of the following?

Megakaryocytes

The life span of a platelet is:

10 days

In pts who present with bleeding disorders caused by platelets, the most common type of bleeding is:

Mucosal

vWF mediates platelet adhesion by binding to platelet receptor:

GPlb/GPIX/GPV

The most common cause of bleeding in pts is:

Quantitative abnormality of platelets

Large blue inclusion bodies in WBC are found in pts with:

May-Hegglin anomaly

In polycythemia vera, the platelet count is:

Elevated

Which of the following is the formula to calculate an absolute cell count?

% of cells count X total count

The mean value of a reticulocyte count on specimens of cord blood from healthy, full-term newborns is approximately:

5.0%

Supravital staining is important for reticulocytes since the cells must be living in order to stain the:

Remaining RNA in the cell

Which of the following is used for staining reticulocytes?

New methylene blue

Which of the following values is calculated form the red blood cell indices in an automated hematology analyzer?

Hematocrit

A hematology analyzer counts red blood cells by which method?

Impedence

The RDW is elevated on a CBC report. The smear would show:

Anisocytosis

Which of these is the formula to calculate a manual white cell count?

(# cells counted X dilution X 10) / # squares counted

A flag of immature granulocytes is reported from a hematology analyzer. The next step is to perform an:

Manual Differential

In an automated hematology analyzer, the WBC printed result is +++. The next step is to:

Make an appropriate dilution of the sample

A specimen analyzed on an automated hematology instrument has a platelet count of 19×10³. The first procedure to follow is:

Review the stained blood smear

The electrical resistance method of cell counting requires:

A conductive liquid

On an automated hematology analyzer, if the RBC is erroneously increased, how will other parameters be affected?

Decreased MCH

On initial start up of the automated hematology analyzer, one of the controls is slightly below the range for the MCV. Which of the following is indicated?

Repeat the control

Which of the following will cause erroneous results when using a phase optical system for enumerating platelets?

Aggregated platelets

Blood collected in EDTA undergoes which of the following changes if kept at room temperature for 6-24 hours?

Increased hematocrit and MCV

A platelet determination is performed on an automated instrument and a very low value is obtained. The platelets appear adequate when estimated from the stained blood film. The best explanation for this discrepancy is:

Many platelets are abnormally large

In which of the following disease states are teardrop cells and abnormal platelets most characteristically seen in?

Primary Myelofibrosis

Which of the following represent residual nuclear fragments?

Cabot Rings

Which of the following RBC inclusions are seen in sideroblastic anemia and contain high amounts of iron?

Pappenheimer Bodies

A wright-stained peripheral blood smear reveals blue, ring-shaped inclusions with red chromatin dots in several of the RBCs. These inclusions are consistent with:

Malarial parasites

A RBC about 5UM diameter that stains bright red and shows no central pallor is a:

Spherocyte

Evidence of active red cell regeneration may be indicated on a blood smear by:

nRBCs and Polychromasia

The presence of excessive rouleaux formation on a blood smear is often accompanied by an increased:

Sedimentation Rate

The characteristic peripheral blood morphologic feature in multiple myeloma is:

Rouleaux Formation

Many microspherocytes, schistocytes, and spherocytes with budding cytoplasm can be seen on blood smears of pts with:

Extensive Burns

The light-colored zone adjacent to the nucleus in a plasma cell is the:

Golgi Area

The term “shift to the left” refers to:

Immature cell forms in the peripheral blood

A term that means varying degrees of leukocytosis with a shift to the left and occasional nucleated red cells in the blood is:

Leukoerythroblastosis

A pt is diagnosed as having bacterial septicemia. Which of the following would best describe the expected change in his blood?

Granulocytic leukemia reaction

Characteristic morphologic features of reactive lymphocytes include:

Large size, Irregularly shaped nucleus, Abundant blue cytoplasm

If a blood smear is dried too slowly, the RBCs are often:

Crenated

The specimen of choice for preparation of blood films for manual diff leukocyte counts is whole blood collected in:

EDTA

On a smear made directly from a finger stick, no platelets are found in the counting area. The first thing to do is:

Examine the slide for clumping

Evidence of a hemolytic event is present in the blood smear when which of the following is seen?

Increased polychromasia

A common source of interference in measuring hemoglobin concentration is:

Very high WBC count

A pt with beta-thalassemia characteristically has an:

Elevated A2 hemoglobin

The most appropriate screenign test for hemoglobin S is:

Dithionite solubility

A native of Thailand has a normal hemoglobin level. Hemoglobin electrophoresis on cellulose acetate shows 70% HgbA and approximately 30% of a hemoglboin with the mobility of HgbA2. This is most consistent with hemoglobin:

E trait

Automated methods of measuring hemoglobin cannot detect this form:

Sulfhemoglobin

In the hemoglobin solubility (dithionite) test, which the of hemoglobin causes turbidity (positive reaction)?

HgbS

The presence of HgbH may be demonstrated by:

Brilliant Cresyl Blue

Automated hematology analyzers calculate the hematocrit using which of the following parameters?

MCV and RBC

A false elevation in a manual hematocrit determination may result from:

Trapped Plasma

What cell shape is most commonly associated with an increased MCHC?

Spherocytes

Which of the RBC indices is a measure of the amount of hemoglobin in individual RBCs?

MCH

Which of these formulas is used for calculating the mean corpuscular hemoglobin (MCH)?

Hgb X 10/RBC

Which of these formulas is used for calculating the MCHC?

Hgb X 100/Htc

Which of these formulas is used for calculating the MCV?

Htc X 10/RBC

Which of these lab findings is associated with extravascular hemolysis?

Spherocytes

One of the major differences between extravascular and intravascular hemolysis is:

Free Hemoglobin

A screening procedure for detecting Hgb F is the:

KB test

The Prussian blue staining of peripheral blood identifies:

Siderotic Granules

Which of the following stains is used to demonstrate iron, ferritin, and hemosiderin?

Prussian Blue

Which of the following stains can be used to differentiate sideritic granules from basophilic stippling?

Prussian Blue

Which cell type shows the most intense tainting with myeloperoxidase?

Neutrophil

Which substrate is used for the detection of specific esterase?

Chloroacetate

Which of the following stains is closely associated with the lysosomal enzyme in primary granules?

Myeloperoxidase

Heinz bodies are:

Denatured hemoglobin inclusions