bone marrow knowledge check

What is hematopoiesis?

A. Destruction of blood cells
B. Production and differentiation of blood cells
C. Storage of iron
D. Breakdown of bone

B. Production and differentiation of blood cells

What is medullary hematopoiesis?

A. Blood-cell production outside the marrow
B. Blood-cell production in the bone marrow
C. RBC destruction
D. Platelet destruction

B. Blood-cell production in the bone marrow

What is extramedullary hematopoiesis?

A. Blood-cell production inside bone marrow
B. Blood-cell production outside bone marrow
C. RBC destruction in the spleen
D. Platelet production only

B. Blood-cell production outside bone marrow

What is the correct sequence of major prenatal hematopoietic sites?

A. Marrow → spleen → liver → yolk sac
B. Yolk sac → liver → spleen → marrow
C. Liver → marrow → yolk sac → spleen
D. Spleen → yolk sac → marrow → liver

B. Yolk sac → liver → spleen → marrow

Osteoblasts primarily:

A. Destroy bone
B. Make bone
C. Make RBCs
D. Make platelets

B. Make bone

Osteoclasts primarily:

A. Make RBCs
B. Make platelets
C. Break down/remodel bone
D. Make lymphocytes

C. Break down/remodel bone

Erythropoietic islands contain:

A. Megakaryocytes surrounded by platelets
B. Macrophages surrounded by developing erythroblasts
C. Osteoclasts surrounded by bone
D. Lymphocytes surrounded by plasma cells

B. Macrophages surrounded by developing erythroblasts

Which cells belong to the proliferating pool?

A. Metamyelocytes, bands, segs
B. Myeloblasts, promyelocytes, myelocytes
C. Bands and segs only
D. Lymphocytes and plasma cells

B. Myeloblasts, promyelocytes, myelocytes

he proliferating pool contains cells that are growing, reproducing, and maturing:

Which cells belong to the maturation/storage pool?

A. Myeloblasts, promyelocytes, myelocytes
B. Metamyelocytes, bands, segs
C. Stem cells only
D. Erythroblasts only

B. Metamyelocytes, bands, segs

When the body suddenly needs more granulocytes, what can happen?

A. WBCs can be released into circulation within minutes/hours
B. RBCs immediately become WBCs
C. Platelets become neutrophils
D. Bone marrow stops producing cells

A. WBCs can be released into circulation within minutes/hours

Rationale: The marrow can release stored/maturing granulocytes into the blood, increasing the WBC count in minutes/hours.

What are the two major characteristics of stem cells?

A. Destruction and storage
B. Self-renewal and multilineage differentiation
C. Phagocytosis and secretion
D. Bone formation and destruction

B. Self-renewal and multilineage differentiation

What are hematogones?

A. Abnormal RBCs
B. Normal lymphoid progenitor cells
C. Mature neutrophils
D. Platelets

B. Normal lymphoid progenitor cells.

Rationale: Hematogones are normal lymphoid progenitor cells that can develop into lymphocytes.

Hematogones can resemble:

A. Platelets
B. Blasts
C. RBCs
D. Osteoclasts

B. Blasts

Rationale: Hematogones can appear like blasts, which is important when examining marrow.

What happens to the percentage of lymphoid cells in bone marrow as a person ages?

A. It increases
B. It decreases
C. It remains exactly the same
D. It disappears completely

B. It decreases

What is the primary function of central storage macrophages?

A. Make bone
B. Deliver iron to developing erythroblasts
C. Make platelets
D. Make lymphocytes

B. Deliver iron to developing erythroblasts

Rationale: Central storage macrophages store and deliver iron to growing immature erythroblasts.

Which type of marrow is hematopoietically active?

A. Yellow marrow
B. Red marrow
C. Fat marrow
D. Cortical marrow

B. Red marrow

Rationale: Red marrow contains active hematopoietic cells.

Yellow marrow is primarily composed of:

A. Granulocytes
B. Fat/adipose tissue
C. Megakaryocytes
D. Erythroblasts

B. Fat/adipose tissue

Approximately what percentage of adult bone marrow volume is adipose tissue?

A. 10%
B. 25%
C. 50%
D. 90%

C. 50%

What is the most common site for a bone marrow tap?

A. Sternum
B. Posterior superior iliac crest
C. Skull
D. Femur

B. Posterior superior iliac crest

What does a bone marrow tech look for when making a marrow smear?

A. Urine crystals
B. Marrow and fat particles/spicules
C. Sperm
D. Bacteria only

B. Marrow and fat particles/spicules

Rationale: The technician makes smears and checks for marrow and fat particles called spicules.

What is a touch prep?

A. Touching a slide to the marrow core
B. Touching blood to a urine slide
C. Touching a slide to an RBC
D. Touching a slide to bone

A. Touching a slide to the marrow core

Rationale: A touch prep is made by touching the slide to the marrow core.

Which bone marrow cell is considered a scavenger/cleaner?

A. Histiocyte
B. Osteoblast
C. Endothelial cell
D. Megakaryocyte

A. Histiocyte

Rationale: Histiocytes are scavengers and cleaners of hematopoietic tissue.

Which cell is alkaline phosphatase positive according to your notes?

A. Histiocyte
B. Reticulum cell
C. Osteoclast
D. Fat cell

B. Reticulum cell

. Which cell is acid phosphatase positive?

A. Histiocyte
B. Osteoblast
C. Reticulum cell
D. Endothelial cell

A. Histiocyte

What does M:E stand for?

A. Megakaryocyte:Eosinophil
B. Myeloid:Erythroid
C. Monocyte:Erythrocyte
D. Myelocyte:Eosinophil

B. Myeloid:Erythroid ratio

What does the M:E ratio compare?

A. RBCs to platelets
B. Granulocytes/precursors to nucleated RBCs/precursors
C. Lymphocytes to monocytes
D. Platelets to WBCs

B. Granulocytes/precursors to nucleated RBCs/precursors.

M:E compares all granulocytes and precursors with all nucleated RBCs and precursors.

What is the approximate normal M:E ratio?

A. 1:10
B. 1:1
C. 3:1–4:1
D. 10:1–20:1

C. 3:1–4:1

Rationale: Normal M:E is approximately 3:1 to 4:1 according to your notes.

A marrow differential has 80% granulocytes and 20% NRBCs. What is the M:E ratio?

A. 1:4
B. 2:1
C. 4:1
D. 8:1

C. 4:1

Rationale: 80 ÷ 20 = 4, giving an M:E ratio of 4:1.

Approximately how many cells are counted for a bone marrow differential?

A. 50–100
B. 100–200
C. 500–1,000
D. 5,000–10,000

C. 500–1,000

Are megakaryocytes included in the bone marrow differential?

A. Yes
B. No
C. Only in children
D. Only in adults

B.no

An increased M:E ratio may be associated with:

A. Infection
B. Leukemia
C. Leukemoid reaction
D. All of the above

D. All of the above

Rationale: Your notes list infection, leukemia, leukemoid reaction, and erythroid hypoplasia as causes/associations of increased M:E.

A decreased M:E ratio may be associated with:

A. Depression of leukopoiesis
B. Increased erythropoiesis
C. Both A and B
D. Neither

C. Both A and B

Rationale: A decreased ratio can result from decreased WBC production or increased RBC production.

Why does the marrow normally contain more granulocytes than erythroid cells?

A. Granulocytes survive longer than RBCs
B. Granulocytes have a shorter survival time than RBCs
C. RBCs cannot reproduce
D. Granulocytes are larger

B. Granulocytes have a shorter survival time than RBCs

Rationale: Granulocytes have a shorter survival time, so the marrow needs to continually produce more of them.

A hypercellular marrow has:

A. Too many cells
B. Too few cells
C. No cells
D. Only fat

A. Too many cells

A marrow with very few hematopoietic cells is called:

A. Hypercellular
B. Normocellular
C. Aplastic
D. Granulocytic

C. Aplastic

Which condition can be an indication for bone marrow examination?

A. Anemia
B. Leukopenia
C. Thrombocytopenia
D. All of the above

A. Anemia
B. Leukopenia
C. Thrombocytopenia

Bone marrow examination can be used to evaluate anemia, leukopenia, thrombocytopenia, and many other abnormalities.

Which WBC finding can be an indication for bone marrow examination?

A. Unexplained leukocytosis
B. Normal WBC count
C. Normal differential
D. Normal neutrophils

A. Unexplained leukocytosis

Bone marrow examination may be used to investigate:

A. Tumors that metastasize to bone marrow
B. Infections
C. Fever of undetermined origin
D. All of the above

A. Tumors that metastasize to bone marrow
B. Infections
C. Fever of undetermined origin
D. All of the above

Bone marrow differential counts can help diagnose or follow:

A. Leukemias
B. Refractory anemias
C. Myelodysplastic syndromes
D. All of the above

D. All of the above

Rationale: Bone marrow differential evaluation can help diagnose and monitor leukemias, refractory anemias, and myelodysplastic syndromes.

Which statement about bone marrow iron is correct?

A. Evaluation of marrow iron stores is important in diagnosing anemia
B. Bone marrow iron is never evaluated
C. Iron is only found in platelets
D. Iron evaluation replaces the marrow differential

A. Evaluation of marrow iron stores is important in diagnosing anemia

Rationale: Your notes state that evaluation of bone marrow iron stores is essential in diagnosis of anemias.

Which cells are supplied by bone marrow into blood circulation?

A. Erythrocytes
B. Granulocytes
C. Lymphocytes
D. All of the above

D. All of the above

Rationale: Bone marrow supplies mature hematopoietic cells, including RBCs, granulocytes, lymphocytes, and supports platelet production through megakaryocytes

Which statement is TRUE?

A. Red marrow is hematopoietically active
B. Yellow marrow is mainly fat
C. Aplastic marrow has very few hematopoietic cells
D. All of the above

D. All of the above