Advanced Hematology Final Review

A pool of undifferentiated cells that can proliferate and differentiate is (are) known as:

stem cells

RBC size and shape and serum immunoglobulin levels affect the:

erythrocyte sedimentation rate

What is the earliest granulocytic maturational stage in which secondary or specific granules appear?

myelocyte

What is the depth of the space between the counting platform and the coverslip on a hemacytometer?

.1 mm

Using a Coulter counter analyzer, an increased RDW should correlate with:

anisocytosis

Specific granules of the neutrophilic granulocyte:

appear first at the myelocyte stage

What effect would using a buffer at pH 6.0 have on a Wright's-stained smear?

red cells would be stained too pink

What describes erythropoietin?

Renal hormone that regulates marrow red cell production

Thrombocytosis would be indicated by a platelet count of:

600 x 10^3/ul

Parasitic infections and allergies often cause:

eosinophilia

A patient has a RDW of 18.2%. What should be seen on the peripheral smear?

anisocytosis

The two parameters used to calculate the hematocrit are the:

RBC count and MCV

_________ cells are responsible for obtaining antigen from antigen-presenting cells and passing this information on to B-cells

T-cells

What is the main function of neutrophilic granulocytes?

phagocytosis

What reagents are used in the PT test?

thromboplastin and calcium

Which ratio of anticoagulant-to-blood is correct to for coagulaton procedures?

1:9

The function of the T lymphocyte is to:

participate in cellular immunity

After staining a peripheral blood smear with Wright's stain and a buffer with the correct pH, the RBCs appear pale pink and the WBCs stain very weakly with little-to-no nuclear detail. One possible explanation is:

There was excessive washing of smear

What effect would using a buffer at pH of 6.0 have on a Wright's stained smear?

Red cells would be stained too pink

The reagents necessary to run an APTT are:

activated partial thromboplastin and CaCl2

Which of the following measures platelet function?

bleeding time

Give the common name for Factor XII

hageman factor

The approximate ratio of hemoglobin to hematocrit is:

1:3

Which of the following is correct regarding the international normalized ratio (INR)?

It standardizes PT results

A leukocyte containing large dark blue granules (granules with an affinity for the basic stain)in the cytoplasm is a

basophil

Facts about Coumadin:

1. alters the synthesis of vitamin K-dependent clotting factors

2. can be prescribed on a long-term basis to patients with a history of thrombotic events

3. dosage must be moitored regularly with the PT/INR

Where does most hematopoiesis occur in the adult?

Bone marrow of the sternum, ribs, pelvis, vertebrae, skull and the proximal ends of long bones

About _______ of RBC destruction is extravascular and occurs mostly in the spleen.

90%

Autoagglutination of RBCs at room temperature can result in which of the following?

1. Low RBC count

2. High MCV

3. Low hematocrit

Christmas factor is the name for factor:

IX

A falsely elevated Hct is obtained. Which of the folloiwng calculated values will NOT be affected?

MCH

Which of the following hemoglobins is not normally found in adults?

Hemoglobin Portland

Heinz bodies may be found when there is a defect in the:

Hexose monophosphate shunt

What is most consistent with the cytologic findings of a reactive lymphocyte?

finely to coarsely clumped chromatin, frequently with nucleoli and abundant, blue, vacuolated cytoplasm scalloping around adjacent RBCs

Elevation of the lymphocyte percentage above 47% is termed:

relative lymphocytosis

Hypersegmentation of neutrophils is defined as more than ____________ segments.

5

A senescent RBC is one that has

lived its lifespan

What is the average life span of a normal red blood cell?

120 days

Which of the following factors is required in the extrinsic, intrinsic, and common pathways?

V

A standard 4.5 mL blue-top tube filled with 3.0 mL of blood was submitted to the laboratory for PT and APTT tests. The sample is from a patient undergoing surgery the following morning for a tonsillectomy. Which of the following is the necessary course of action for the technologist?

reject the sample and request a new one

Hemoglobin F is composed of two alpha globin chains and two

gamma-globulin chains

Which is the first stage of RBC maturation in which the cytoplasm is pink due to the formation of hemoglobin?

polychromatophilic normoblast

Lack of spleen function to "pit" results in:

inclusions in RBCs

About ________ of all PB lymphs are T-cells

80

The Na, K pump in RBC is an important mechanism in keeping the RBC intact. Its function is to maintain a high level of

Intracellular potassium

Age, gender, and geographic altitude influence the:

Hgb value

_________ contain digestive enzymes, such as myeloperoxidase and esterase.

Neutrophils

Mean cell volume (MCV) is calculate using the following formula:

(Hct/RBC) x 10

Thrombin enhances coagulation by:

converting fibrinogen to fibrin

A Wright's stained smear of a patient with an elevated reticulocyte count will show:

polychromasia

The Coulter principle for counting of cells is based upon the fact that:

Isotonic solutions conduct electricity better than cells do

Which of the following processes is not an element of primary hemostasis?

formation of fibrin

Which of the following statistical terms reflects the best index of precision when comparing two CBC parameters?

coefficient of variation

The red cell series matures in the following sequence:

pronormoblast, basophilic normoblast, polychromatic normoblast, orthochromic normoblast, reticulocyte, mature RBC

An elevated PT and normal APTT is consistent with a deficiency of factor:

Factor VII

The substances that are vital for the production and proliferation of stem cells are called:

colony stimulating factors

Hemoglobin in the ferric (Fe +++ ) state is called

methemoglobin

The extrinsic pathway is monitored by the:

prothrombin time (PT)

Which clotting factor is NOT measured by PT and APTT tests?

Factor XIII

GEMM stands for

granulocyte, erythrocyte, megakaryocyte, monocyte

The hemoglobin pigment that cannot be quanitated by the cyanmethemoglobin method is:

sulfhemoglobin

In order for hemoglobin to combine reversibly with oxygen, the iron must be:

in the ferrous state

Which of the following initiates in vivo coagulation by activation of factor VII?

Protein C

clotting factors are measured by the APTT test?

XII, XI, IX, VIII, X, V, II, I

The internationally accepted method of hemoglobin measurement requires the conversion of hemoglobin to

cyanmethemoglobin

In granulocytic development, which is the last stage to divide?

Myelocyte

Which coagulation test(s) would be abnormal in a vitamin K-deficient patient?

PT and APTT

Insufficient centrifugation will result in:

A false increase in hematocrit (Hct) value

can shift the hemoglobin-oxygen dissociation curve to the right?

- Hypoxia

- Increases in 2,3 DPG

- Acidosis

Wright's stain is a mixture of

methylene blue and eosin

is considered a normal hemoglobin?

deoxyhemoglobin

The reference range for an adult male Hct would be:

42-52%

The RBC organic phospate 2,3-BPG:

controls hemoglobin affinity for oxygen

During mid-fetal life, what is the primary site of hematopoiesis?

liver

Heparin:

binds with Antithrombin III to inhibit thrombin

The primary hemostatic plug consists of:

aggregated platelets

Ninety percent of the ATP or glucose required by RBCs is provided by the:

glycolytic pathway

Which test would be abnormal in a patient with Stuart-Prower factor deficiency?

PT and APTT

Tissue cells that look like basophils (and thought by some to be basophils in the tissues) are called ______________ cells.

mast

Which of the following statements about microhematocrits is FALSE?

Centrifuging for too long causes falsely low results

Insufficient centrifugation will result in:

A false increase in hematocrit (Hct) value

can shift the hemoglobin-oxygen dissociation curve to the right?

- Hypoxia

- Increases in 2,3 DPG

- Acidosis

Insufficient centrifugation will result in:

A false increase in hematocrit (Hct) value

can shift the hemoglobin-oxygen dissociation curve to the right?

- Hypoxia

- Increases in 2,3 DPG

- Acidosis

Insufficient centrifugation will result in:

A false increase in hematocrit (Hct) value

Insufficient centrifugation will result in:

A false increase in hematocrit (Hct) value

Insufficient centrifugation will result in:

A false increase in hematocrit (Hct) value

Insufficient centrifugation will result in:

A false increase in hematocrit (Hct) value

Insufficient centrifugation will result in:

A false increase in hematocrit (Hct) value

Which coagulation test(s) would be abnormal in a vitamin K-deficient patient?

PT and APTT

clotting factors are measured by the APTT test?

XII, XI, IX, VIII, X, V, II, I

Which of the following conditions would produce oval macrocytes?

pernicious anemia

An aplastic anemia is most often classified morphologically as:

normocytic, normochromic

Which of the following is used to monitor red cell production?

reticulocyte count

An eldery patient with rheumatoid arthritis develops ACI? The laboroatory results leading to the ACI diagosis were:

low serum iron and low TIBC

Serum ferritin is a good indicator of the amount of:

storage iron

Heinz bodies are:

denatured hemoglobin

Spherocytes may be seen in hereditary spherocytosis and patients with:

severe burns

If a patient who has iron deficiency anemia receives blood transfusions from healthy adults, the peripheral blood smear most likely will show:

anisocytosis

A major cause of non-megaloblastic macrocytosis is:

alcoholism