Hematology Rotation Practice Final Exam

100 Questions Multiple Choice

If you collect blood from an infant via a heel stick, what is the maximum length of the lancet?

2.0 mm

When making a wedge-type smear, at what angle should the spreader slide be held?

25 to 40 degrees

Which of the clotting factors is NOT a part of the intrinsic clotting cascasde?

Factor VII

The anticoagulant of choice for most coagulation procedures is:

Sodium citrate

The lab collected a blood specimen from a 36 y/o male.  If a hemoglobin electrophoresis is ordered, which of the following hemoglobin bands will be observed if the patient's results are normal?

A₂

A trend in the Q.C. data may be defined as:

A progressive change that moves in one direction for at least six consecutive days.

Which of the following clotting factors will be depressed by Coumadin?

Factor X

Examine the following lab values:  Hematocrit (Hct) = 42%, Hemoglobin (Hgb) = 14.5 g/dL, and RBC count = 4.33 x 10⁶/uL.  Calculate the MCV in fL.

97.0

Which of the following cells is most likely to "fit" this description?  A cell that measures about 24 um, has a large nucleus that has a somewhat immature appearance, light blue cytoplasm with no cytoplasmic granules present, but a few small vacuoles are seen.  The cytoplasm has distinctive peripheral basophilia and conforms to the contour of the red blood cells it touches.

Reactive lymphocyte

The following lab data was posted to the patient's chart:  Hemoglobin (Hgb) = 10.4 g/dL, Hematocrit (Hct) = 32%, RBC count = 3.41 x 10⁶/uL.  Calculate the MCH in pg.

30.5

The creatinine clearance test was performed on a 50 y/o male.  His height is 6 feet and he weights in at 190 pounds.  Calculate the rate of urine formation from a four hour specimen with a volume of 420 mL.  The other lab values were:  urine creatinine = 140 mg/dL and plasma creatinine = 1.4 mg/dL.  What is the corrected creatinine clearance for this patient in mL per minute?  A nomogram is available to be printed from a separate file.

157

The lab reported a shift-to-the-left.  This means:

An increase in bands and juvenile forms.

Given the following data, calculate the WBC count when using a Neubauer hemocytometer and the blood is diluted 1:20:  Square #1 = 31 cells counted, Square #2 = 36 cells counted, Square #3 = 29 cells counted, and Square #4 = 34 cells counted.

6,500/uL

The clinical laboratory scientist assisted the pathologist at the bedside of the patient scheduled for a bone marrow aspiration.  Which of the following sites would be the preferred choice for the aspiration technique?

Iliac crest

The lab performed a platelet aggregation test on a patient previously diagnosed with Von Willebrand's disease.  The test was abnormal.  Which agonist was used?

Ristocetin

Sternheimer-Malbin (SM) stain for urine sediment utilizes what two dyes?

Safranin O and crystal violet

The following lab results were reported to the physician:  RBC = 3.57 x 10⁶/uL, hematocrit (Hct) = 36%, and hemoglobin (Hgb) = 11.2 g/dL.  Calculate the MCHC in g/dL.

31.1

The CSF specimen was contaminated with RBCs from a traumatic tap.  review the following data and calculate the corrected WBC count for this specimen:  WBC count (blood) = 9.6 x 10³/uL, RBC count (blood) = 4.60 x 10⁶/uL, WBC count (CSF) = 81/uL, and RBC count (CSF) = 1.80 x 10⁴/uL

43/uL

A patient has been taking an aspirin a day for the past two years as a precaution against heart problems.  The physician is going to order a coagulation test.  If the test is performed while the patient continues the aspirin therapy, which coagulation test is affected?

Prolonged bleeding time

If the CSF albumin is 41 mg/dL and the serum albumin is 4.1 g/dL, what is the CSF/serum albumin index?

10

The ability of a procedure to reproduce essentially the same results again and again on the same sample is best described by which of the following terms?

Precision

A patient, when tested for a deficiency in factor XIII, will usually present with which of the following test results?

Normal bleeding time, PT, and aPTT

The laboratory reported the following data for an 18 y/o male.  The hemoglobin, hematocrit, RBC, WBC, and platelet counts were all within normal range.  WBC differential results were 9% Neutrophils, 2% Eosinophils, 89% Lymphocytes, with most of the lymphocytes being the large type with basophilia present as patches and especially in the cytoplasm periphery.  The Heterophile antibody test was positive, but the CMV antibody test was negative.  Clinical chemistry test results were AST = 19 U/L, ALT = 24 U/L, Bilirubin = 0.3 mg/dL, and GGT = 31 U/L.  Which of the following is the most likely diagnosis?        

Infectious mononucleosis without liver involvement.

Crystals:

Will usually precipitate from solution as the urine cools.

Which test is best for monitoring heparin therapy?

aPTT

Which of the following factors does NOT favor the formation of casts?

High pH

The laboratory performed a prothrombin time (PT) on a 73 y/o patient.  The lab reported out a test value of 17 seconds.  Which of the following is NOT a cause for this test result?

A mild factor VIII deficiency

Distinctly yellowish, whetstone, and rhomboid crystals were observed in acid urine.  The crystals are most likely:

Uric acid

Leukocytes:

All of these statements are correct.

The clinical laboratory scientist examining a Wright stained blood smear believes that he is looking at a Cabot ring.  In which of the following is this inclusion?

The erythrocyte

Calculate the absolute reticulocyte count where 21 reticulocytes were enumerated per 1000 RBCs and the RBC count was 3.57 x 10¹²/L.

75 x 10⁹/L

Which of the following would you NOT expect to find while performing a microscopic examination on a urine from a patient diagnosed with cystitis?

RBC casts

The most commonly occurring characteristic(s) associated with kidney stones is/are:

All of these are correctly stated

The purpose of quality control is to:

Actually all of these are correctly stated purposes.

The following results were obtained on a patient:  WBC = 9,560/uL, RBC = 4.50 x 10⁶/uL, Hct = 42%, Hgb = 14.5 g/dL, nRBC=6/100 WBC.  Calculate the corrected WBC count in cells/uL.

9,019

The specific esterase stain, Naphthol AS-D chloroacetate esterase, is useful in determining which of the following cells?

Promyelocytes, neutrophils, monocytes, myelocytes, bands

Which urine abnormalities are typically characteristic of nephrotic syndrome?

4+ protein, fat droplets, oval fat bodies, fatty casts, hematuria

In lead poisoning, punctate basophilia should be observed in which of the following cells?

Erythrocytes

If a urine specimen is delivered to the laboratory at 10 a.m. and the specific gravity is found to be 1.047, which of the following is the most probably cause?

Radiographic dye is in the urine.

The refractometer principle for measuring urine specific gravity is based upon which of the following?

Measures the velocity of light in a solution with that of air.

Which of the following urinalysis findings is most likely to indicate pyelonephritis?

Clumps of WBCs

The following urine test results were reported for a 16 y/o patient:  Specific gravity = 1.017, pH = 9.0, Glucose = negative, Protein = 1+, Ketone = negative, Bilirubin = negative, Urobilinogen = 1.0 EU, Blood = negative, Nitrate = positive, Bacteria = present in the sediment.  With which of the following are these test results most congruent?

Specimen sat on the bench too long

If a bleeding time is prolonged, you know that the patient most likely has a:

Platelet anomaly

A patient's CBC report listed the following results:  WBC = 26.0 x 10³/uL, RBC = 4.30 x 10⁶/uL, Platelet count = 156 x 10³/uL.  Differential results were as follows:  Segmented neutrophils = 63%, Band neutrophils = 11%, Lymphocytes = 15%, Monocytes = 7%, and Eosinophils = 4%.  What is the absolute lymphocyte count? 

3,900 x 10³/uL  

Which of the following will cause a pink brick dust appearance of urine amorphous urates?

Uroerythrin

The technologist bumped a tube of blood and caused it to fall over on the bench and the blood spilled onto the bench top. How did the lab clean up the spill?

Blotted the blood with paper towels, disposed of the towels in the biohazard bag and cleaned the area with dilute bleach.

Which of the following conditions is most likely to be observed in a patient with a persistently elevated urine specific gravity reading over 1.020?

Diarrhea

A 30 y/o female, in the second trimester of her second pregnancy, is seen by her physician.  He is so concerned about her history and condition that he recommends doing an aminocentesis.  Which of the following findings is the most likely cause for his concern?

There is a possibility of HDN.

Which of the following test procedures would be the preferred method to help identify an unknown fluid as being a urine sample?

Creatinine

Which of the following specimens is preferred for pregnancy testing?

First morning