biol 4670 exam 1 study guide

The most important element in standard precautions is:

A. Behavior that prevents contact with electrical hazards.

B. Behavior that prevents direct contact with bodily fluids or contaminated surfaces.

C. Behavior that prevents contact with pediatric patients.

D. Behavior that prevents contact with terminally ill patients.

B. Behavior that prevents direct contact with bodily fluids or contaminated surfaces.

Which one of the following is considered PPE?

A. Operating room attire

B. Head nets

C. Laboratory coats

D. White shoes

C. Laboratory coats

What types of samples are used primarily in the clinical laboratory?

A. Blood and bodily fluids

B. Solid organs

C. Bone

D. Skin

A. Blood and bodily fluids

Which part(s) on the microscope is (are) used for focusing?

A. Oculars

B. Stage

C. Diaphragm

D. Coarse and fine adjustments

D. Coarse and fine adjustments

Which one of the following is a postanalytic factor? (two answers)

A. Calling results when a critical value is obtained

B. Checking the tube for clots

C. Identifying the patient

D. Sample mixing

A. Calling results when a critical value is obtained

B. Checking the tube for clots

The proper definition for a standard is

A. Materials used to monitor a method.

B. A normal distribution curve.

C. A target range.

D. Solutions with a known amount of the analyte.

D. Solutions with a known amount of the analyte.

Which of the following is the definition of a reference interval?

A. A solution of a known amount of analyte

B. Materials analyzed concurrently with unknown samples

C. Values established for a particular analyte, given a method, instrument, or patient population

D. Validation techniques on flagged samples

C. Values established for a particular analyte, given a method, instrument, or patient population

Which of the following is not considered a postanalytic variable?

A. Delta checks

B. Proper anticoagulant used

C. Specimen check for clots

D. Critical results called

B. Proper anticoagulant used

Error analysis, standard protocols, and turnaround time all are part of the

A. Quality assurance system.

B. Quality control program.

C. Reference standards.

D. Delta check protocol.

A. Quality assurance system.

The most important element in standard precautions is

A. Face shields.

B. Handwashing.

C. Gloves.

D. Gowns.

B. Handwashing.

What is (are) the organ(s) of hematopoiesis in fetal life?

A. Bone marrow

B. Thymus and thyroid gland

C. Spleen and liver

D. Pancreas and kidneys

C. Spleen and liver

How does the bone marrow respond to anemic stress?

A. Production is expanded, and red blood cells are released to the circulation prematurely.

B. Production is expanded, and platelets are rushed into circulation.

C. Production is diminished, and the M:E ratio is increased.

D. Production is diminished, and the M:E ratio is unaffected.

A. Production is expanded, and red blood cells are released to the circulation prematurely.

Which chemical substances are responsible for differentiation and replication of the pluripotent stem cell?

A. Cytokines

B. Insulin

C. Thyroxine

D. Oxygen

A. Cytokines

A hormone released from the kidney that is unique for erythroid regeneration is

A. Estrogen.

B. Erythropoietin.

C. Progestin.

D. Testosterone.

B. Erythropoietin.

Which organs are involved in extramedullary hematopoiesis?

A. Heart and pancreas

B. Liver and spleen

C. Skin and connective tissue

D. Nervous system and spine

B. Liver and spleen

What is the most stable parameter of the complete blood count (CBC)?

A. WBC

B. MCV

C. RDW

D. Platelet count

B. MCV (Mean Corpuscular Volume)… defines average size and volume of your red blood cells

Which one of the following values is a critical value?

A. WBC of 5,000

B. Hgb of 12

C. Hct of 36

D. Platelet count of 10,000

D. Platelet count of 10,000

Of the following formulas, which formula indicates the correlation check between hemoglobin and hematocrit?

A. (Hgb ÷ Hct) × 100

B. Hgb × 3 = Hct

C. Hct = MCV × RBC

D. (Hgb = RBC) × 100

B. Hgb × 3 = Hct

The M:E ratio describes

A. Intramedullary versus extramedullary hematopoiesis.b

B. The amount of erythropoietin produced by the kidney.

C. The calculation of red blood cell indices.

D. The amount of myeloid elements in relation to erythroid elements in the marrow.

D. The amount of myeloid elements in relation to erythroid elements in the marrow.

Which of the following tests is the most effective means of assessing red blood cell generation in response to anemia?

A. RDW

B. Reticulocyte count

C. Platelet count

D. CBC

B. Reticulocyte count

The primary function of erythropoietin is to

A. Regulate the size of the nucleus.

B. Determine the hemoglobin content.

C. Remove inclusions from the red blood cells.

D. Stimulate red blood cell production and maturation.

D. Stimulate red blood cell production and maturation.

Which of the following conditions produces microcytic red blood cells?

A. Hemolysis

B. Iron deficiency

C. Vitamin B12 deficiency

D. Thyroid conditions

B. Iron deficiency

All of the following are characteristic of the red blood cell in stages of development except

A. Nuclei are baseball round.

B. Immature cells are larger.

C. N:C ratio decreases as the cell matures.

D. Distinct granulation is in the cytoplasm.

D. Distinct granulation is in the cytoplasm.

Which red blood cell inclusions originate because of denatured hemoglobin?

A. Howell-Jolly bodies

B. Heinz bodies

C. Pappenheimer bodies

D. Malarial parasites

B. Heinz bodies

In which condition can you see elliptocytes?

A. Iron loading processes

B. Aplastic anemia

C. Iron deficiency anemia

D. Hereditary spherocytosis

C. Iron deficiency anemia

Which red blood cell morphology may form because of excess cholesterol taken on the red blood cell membrane?

A. Macrocytes

B. Target cells

C. Schistocytes

D. Ovalocytes

B. Target cells

Hypochromia is used to define

A. Color change in the red blood cell.

B. Variation in the shape of the red blood cell.

C. Variation in the size of the red blood cell.

D. Decrease in the hemoglobin content of the red blood cell.

D. Decrease in the hemoglobin content of the red blood cell.

Normal red blood cell life span depends on all of the following except

A. Baseball round nucleus.

B. Deformable red blood cell membrane.

C. Appropriate hemoglobin structure.

D. Osmotic balance.

A. Baseball round nucleus.

A key morphologic feature of the nucleated red blood cell stages is

A. Basophilic cytoplasm through every stage of maturation.

B. Granules in the cytoplasm.

C. Baseball round nucleus.

D. Increase in size as the cell matures.

C. Baseball round nucleus.

The red blood cell protein that is responsible for deformability and flexibility of the red blood cell is

A. Spectrin.

B. Glycophorin.

C. Glycine.

D. EPO.

A. Spectrin.

Hematology is best defined as the study of:

A. Blood in health and disease.

B. Bone marrow disorders only.

C. Blood chemistry and hormones.

D. The immune system and lymphatic organs.

A. Blood in health and disease.

Which skill is essential for the practice of hematology?

A. Centrifugation

B. Microscopy

C. Blood banking

D. Phlebotomy

B. Microscopy

A compound microscope uses:

A. One lens system.

B. A two-lens system.

C. Three ocular lenses.

D. A single objective lens.

B. A two-lens system.

Which objective is commonly used for oil immersion microscopy?

A. 4×

B. 10×

C. 40×

D. 100×

D. 100×

Which objective may be added to a clinical-grade microscope in addition to the 10×, 40×, and 100× objectives?

A. 20×

B. 50×

C. 60×

D. 80×

B. 50×

Proper care of the microscope is important because it:

A. Eliminates the need for quality control.

B. Maintains microscopic quality.

C. Prevents all laboratory infections.

D. Increases the size of blood cells.

B. Maintains microscopic quality.

Standard precautions are designed primarily to:

A. Prevent the spread of infection and disease.

B. Increase laboratory turnaround time.

C. Prevent damage to laboratory equipment.

D. Improve patient identification.

A. Prevent the spread of infection and disease.

Which of the following is considered personal protective equipment?

A. Laboratory coat

B. Microscope

C. Centrifuge

D. Glass slide

A. Laboratory coat

Which of the following is NOT considered personal protective equipment?

A. Gloves

B. Eyewear

C. Face shield

D. Microscope

D. Microscope

The most important element of standard precautions is:

A. Gloves

B. Handwashing

C. Laboratory coats

D. Face shields

B. Handwashing

Quality assurance is best described as:

A. A set of laboratory practices that ensures reliable patient results.

B. A procedure used only to calibrate instruments.

C. A method of identifying critical values.

D. A system used only for specimen collection.

A. A set of laboratory practices that ensures reliable patient results.

Quality control is:

A. Separate from the quality assurance plan.

B. Part of the quality assurance plan.

C. Used only during specimen collection.

D. Performed only when an instrument fails.

B. Part of the quality assurance plan.

Which of the following is associated with quality control?

A. Standards and controls

B. Patient diagnosis

C. Blood type only

D. Specimen collection only

A. Standards and controls

Accuracy refers to:

A. How close a result is to the true or accepted value.

B. How frequently a specimen is collected.

C. How quickly a result is reported.

D. How many samples are analyzed.

A. How close a result is to the true or accepted value.

Precision refers to:

A. The closeness of repeated measurements to one another.

B. The patient's reference interval.

C. The number of laboratory tests ordered.

D. The amount of blood collected.

A. The closeness of repeated measurements to one another.

The essential first step in ensuring the quality of laboratory results is:

A. Patient identification

B. Centrifugation

C. Microscopic examination

D. Reporting the results

A. Patient identification

Preanalytic variables refer to events that occur:

A. Before analysis of the sample.

B. During analysis of the sample.

C. After results are reported.

D. During patient treatment.

A. Before analysis of the sample.

Which of the following is an example of a preanalytic variable?

A. Patient identification

B. Result reporting

C. Critical value notification

D. Result interpretation

A. Patient identification

Postanalytic variables refer to laboratory practices that occur:

A. Before specimen collection.

B. Before analysis.

C. After the sample has been analyzed.

D. Before patient identification.

C. After the sample has been analyzed.

Which of the following is an example of a postanalytic activity?

A. Reporting a critical result

B. Selecting the correct anticoagulant

C. Identifying the patient

D. Collecting the specimen

A. Reporting a critical result

A critical result is one that:

A. Falls within the reference interval.

B. Exceeds or is markedly decreased from the reference interval.

C. Is always caused by laboratory error.

D. Does not require immediate attention.

B. Exceeds or is markedly decreased from the reference interval.

Which of the following would be considered a critical result?

A. A value slightly outside the reference interval.

B. A markedly abnormal value requiring immediate attention.

C. A value within the reference interval.

D. A value obtained from a normal control.

B. A markedly abnormal value requiring immediate attention.

Hematopoiesis is defined as:

A. The destruction of mature blood cells.

B. The production, development, and maturation of all blood cells.

C. The removal of blood cells from circulation.

D. The production of plasma proteins.

B. The production, development, and maturation of all blood cells.

During fetal development, erythropoiesis occurs primarily in the:

A. Kidneys and bone marrow.

B. Yolk sac, spleen, and liver.

C. Thymus and lymph nodes.

D. Pancreas and kidneys.

B. Yolk sac, spleen, and liver.

In adults, erythropoiesis occurs primarily in the:

A. Liver

B. Spleen

C. Bone marrow

D. Yolk sac

C. Bone marrow

Hematopoiesis occurring within the bone marrow is called:

A. Extramedullary hematopoiesis

B. Intramedullary hematopoiesis

C. Peripheral hematopoiesis

D. Fetal hematopoiesis

B. Intramedullary hematopoiesis

Hematopoiesis occurring outside the bone marrow is called:

A. Intramedullary hematopoiesis

B. Extramedullary hematopoiesis

C. Marrow hematopoiesis

D. Erythroid hematopoiesis

B. Extramedullary hematopoiesis

Which of the following is one of the largest nonsolid organs in the body?

A. Liver

B. Bone marrow

C. Spleen

D. Kidney

B. Bone marrow

The normal M:E ratio in bone marrow is approximately:

A. 1:1-2:1

B. 2:1-3:1

C. 3:1-4:1

D. 5:1-6:1

C. 3:1-4:1

The M:E ratio represents:

A. The amount of erythroid elements compared with lymphoid elements.

B. The amount of myeloid elements compared with erythroid elements.

C. The amount of mature RBCs compared with reticulocytes.

D. The ratio of WBCs to platelets in peripheral blood.

B. The amount of myeloid elements compared with erythroid elements.

Multipotential stem cells can differentiate into:

A. Only erythroid cells.

B. Only lymphoid cells.

C. Nonlymphoid or lymphoid precursor committed cells.

D. Only myeloid cells.

C. Nonlymphoid or lymphoid precursor committed cells.

Which hormone regulates erythroid production?

A. Insulin

B. Erythropoietin

C. Thyroxine

D. Estrogen

B. Erythropoietin

Erythropoietin is primarily produced by the:

A. Liver

B. Spleen

C. Kidneys

D. Bone marrow

C. Kidneys

Bone marrow aspiration and biopsy are usually performed in adults at the:

A. Sternum only

B. Iliac crest

C. Femur

D. Radius

B. Iliac crest

Which of the following is NOT one of the nine CBC parameters?

A. RBC count

B. Hemoglobin

C. MCV

D. ESR

D. ESR

Which of the following is a parameter included in the CBC?

A. RDW

B. ESR

C. PT

D. PTT

A. RDW

Which CBC parameter is considered one of the most stable over time?

A. WBC

B. MCV

C. RDW

D. Platelet count

B. MCV

An increase in MCV may occur because of:

A. Transfusion

B. Reticulocytosis

C. Hyperglycemia

D. All of the above

D. All of the above

Which medication may be associated with an increased MCV?

A. Methotrexate

B. Insulin

C. Heparin

D. Acetaminophen

A. Methotrexate

The RDW may be an early indicator of:

A. Anemia

B. Leukemia

C. Infection

D. Thrombocytosis

A. Anemia

A critical value is best described as a value that:

A. Is always within the reference interval.

B. Is outside the reference range and requires immediate reporting and action.

C. Is slightly different from the previous result.

D. Requires no further investigation.

B. Is outside the reference range and requires immediate reporting and action.

Which test is the most effective means of assessing red blood cell regeneration in response to anemia?

A. MCV

B. RDW

C. Reticulocyte count

D. Platelet count

C. Reticulocyte count

Effective red blood cell production occurs when the bone marrow:

A. Produces fewer reticulocytes.

B. Responds to anemic stress by increasing reticulocyte and nucleated RBC production.

C. Stops producing erythroid cells.

D. Produces only mature RBCs.

B. Responds to anemic stress by increasing reticulocyte and nucleated RBC production.

Ineffective red blood cell production occurs when:

A. Mature RBCs are destroyed in the spleen.

B. RBC precursors die in the bone marrow before entering peripheral circulation.

C. Reticulocytes increase in circulation.

D. RBCs become larger than normal.

B. RBC precursors die in the bone marrow before entering peripheral circulation.

Morphologic classification of anemia is determined primarily by:

A. White blood cell count.

B. Red blood cell indices.

C. Platelet count.

D. Differential count.

B. Red blood cell indices.

Microcytic, hypochromic anemia is characterized by:

A. MCV <80 fL and MCHC <32%.

B. MCV >100 fL and MCHC >36%.

C. MCV 80-100 fL and MCHC 32-36%.

D. MCV >100 fL and MCHC <32%.

A. MCV <80 fL and MCHC <32%

Macrocytic, normochromic anemia is characterized by:

A. MCV less than 80 fL.

B. MCV between 80 and 100 fL.

C. MCV greater than 100 fL.

D. MCHC less than 20%.

C. MCV greater than 100 fL.

Normocytic, normochromic anemia is characterized by:

A. MCV of 80-100 fL and MCHC of 32-36%.

B. MCV less than 80 fL and MCHC less than 32%.

C. MCV greater than 100 fL.

D. MCV greater than 120 fL and MCHC less than 30%.

A. MCV of 80-100 fL and MCHC of 32-36%.

A normal red blood cell is approximately:

A. 2-4 μm

B. 4-5 μm

C. 6-8 μm

D. 10-12 μm

C. 6-8 μm

The normal red blood cell is best described as:

A. Spherical and rigid.

B. Disk-shaped and flexible.

C. Oval and rigid.

D. Irregular and inflexible.

B. Disk-shaped and flexible.

Red blood cell production is primarily controlled by:

A. Insulin

B. Erythropoietin

C. Thyroxine

D. Cortisol

B. Erythropoietin

Erythropoietin is released primarily from the:

A. Liver

B. Spleen

C. Kidney

D. Bone marrow

C. Kidney

The primary site of adult erythropoiesis includes the bone marrow of the:

A. Sternum and iliac crest.

B. Radius and ulna.

C. Tibia and fibula.

D. Skull and mandible only.

A. Sternum and iliac crest.

Each pronormoblast normally produces approximately how many mature red blood cells?

A. 4

B. 8

C. 16

D. 32

C. 16

As red blood cells mature, they:

A. Increase in size.

B. Become increasingly basophilic.

C. Develop more hemoglobin and lose their nucleus.

D. Develop additional nuclei.

C. Develop more hemoglobin and lose their nucleus.

As erythroid cells mature, the cytoplasm generally:

A. Becomes more basophilic.

B. Develops an orange tinge because of increasing hemoglobin.

C. Becomes completely colorless.

D. Becomes increasingly green.

B. Develops an orange tinge because of increasing hemoglobin.

The most common nucleated red blood cell seen in a peripheral blood smear is the:

A. Pronormoblast

B. Basophilic normoblast

C. Polychromatophilic normoblast

D. Orthochromic normoblast

D. Orthochromic normoblast

The red blood cell membrane contains:

A. Glycolipids, glycoproteins, cholesterol, and proteins.

B. DNA and RNA only.

C. Calcium and bone tissue.

D. Platelet granules only.

A. Glycolipids, glycoproteins, cholesterol, and proteins.

Which proteins help anchor the red blood cell membrane and provide deformability?

A. Spectrin and ankyrin

B. Hemoglobin and albumin

C. Insulin and EPO

D. Actin and myosin only

A. Spectrin and ankyrin

Integral proteins:

A. Are confined to the red blood cell cytoskeleton.

B. Extend through the entire red blood cell membrane.

C. Exist only in the nucleus.

D. Are found only outside the cell.

B. Extend through the entire red blood cell membrane.

Peripheral proteins are:

A. Confined to the red blood cell cytoskeleton.

B. Located throughout the plasma.

C. Found inside the nucleus.

D. Responsible for hemoglobin synthesis.

A. Confined to the red blood cell cytoskeleton.

Sodium and potassium movement across the red blood cell membrane is controlled by:

A. Cationic pumps

B. Hemoglobin

C. Spectrin

D. Erythropoietin

A. Cationic pumps

Which properties are essential for red blood cell survival and circulation?

A. Deformability and elasticity

B. Rigidity and density

C. Increased size and thickness

D. Nuclear flexibility

A. Deformability and elasticity

The red blood cell membrane must be able to extend its surface area by approximately:

A. 25%

B. 50%

C. 75%

D. 117%

D. 117%

The primary pathway providing ATP for anaerobic red blood cell metabolism is:

A. Glycolysis

B. Krebs cycle

C. Oxidative phosphorylation

D. Beta oxidation

A. Glycolysis

Approximately what percentage of cellular ATP necessary for anaerobic RBC metabolism is provided by glycolysis?

A. 25%

B. 50%

C. 75%

D. 90%

D. 90%

Microcytes are red blood cells that are:

A. Larger than normal.

B. Smaller than normal.

C. Normal in size but darker.

D. Normal in size but contain nuclei.

B. Smaller than normal.

Microcytes may be seen in:

A. Iron deficiency anemia.

B. Thalassemia.

C. Anemia of inflammation.

D. All of the above.

D. All of the above.

Macrocytes are associated with:

A. Megaloblastic processes.

B. Liver disease.

C. High reticulocyte counts.

D. All of the above.

D. All of the above.

Polychromasia on a peripheral blood smear indicates:

A. Decreased erythropoiesis.

B. Accelerated erythropoiesis.

C. Decreased hemoglobin synthesis only.

D. Platelet destruction.

B. Accelerated erythropoiesis.