Hematology Medialab Questions

This covers Hematology, UA, Blood bank, and Lab practices (so there is some chem/micro)

What characteristics are most often associated with alpha thalassemia intermedia?

No clinical abnormalities present

Polycythemia, hepatomegaly

Anemia, splenomegaly

Erythroid hypoplasia

Anemia, splenomegaly

Which of the following cells would be increased if the CSF of a patient suspected of having multiple sclerosis?

Neutrophils
Lymphocytes
Macrophages
Monocytes

Lymphocytes

Which of the following cells would be increased if the CSF of a patient suspected of having a bacterial infection?

Neutrophils
Lymphocytes
Macrophages
Monocytes

Neutrophils

Which of the following cells would be increased if the CSF of a patient suspected of having lymphoma?
Neutrophils
Lymphocytes
Macrophages
Monocytes

Macrophages

Which of the following cells would be increased if the CSF of a patient suspected of having a subarachnoid hemorrhage?
Neutrophils
Lymphocytes
Macrophages
Monocytes

Monocytes

What is the normality (N) of a 700 mL solution that contains 5g of H2SO4 (gmw=98 g/mol, valence =2)?

.146 N

.00014 N

.023 N

.841 N

.146 N

Where does most cerebrospinal fluid originate?

Cerebral arachnoid space
Choroid plexus
Ventricles
Lumbar region

Choroid plexus

Which of the following may be seen in a CSF sample of a patient that has a subarachnoid (intracranial) hemorrhage (SAH)?

Macrophages containing hemosiderin

Uneven distribution of blood in CSF tubes collected

Clot in present in the CSF sample

Supernatant of CSF sample does not have xanthochromia

Macrophages containing hemosiderin

What are the MAIN functions of the distal convoluted tubules?

Balance hydrogen ions and keep the body pH at 6.8
Control aldosterone production and ammonia reabsorption
Excrete various antibiotics and uric acid
Maintain water-electrolyte and acid-base balances

Maintain water-electrolyte and acid-base balances

All of the following are primary functions of the kidney, except?

Acid base balance

Retention of essential nutrients and water

Reabsorption of waste products

Blood filtration

Reabsorption of waste products

Which test is not used as a screen for retroviruses in donated blood?

Antibody to HIV type 1 and type 2

Nucleic acid testing to detect HIV-1 RNA

Antibody to HTLV types I and II

Nucleic acid testing for HCV

Nucleic acid testing for HCV

For blood gas analyzers, all ofthe following technologies are used for measurement of pH except:

Ion selective electrodes

Macroelestrochemical sensors

Optical sensors

Microelectrodes

Optical sensors

Which of the following is the most common technique that is used by clinical lab for therapeutic drug monitoring?

Immunoassay

Electrophoresis

Atomic absorption

Ion selective electrode voltametry

Immunoassay

The course of multiple sclerosis can be monitored by measuring which of the following in cerebrospinal fluid (CSF) analytes?

Glucose

Lactate

Myelin basic protein (MBP)

Glutamine

Myelin basic protein (MBP)

Which of the following conditions will cause a positive reagent strip blood result due to hematuria?

Hemolytic anemia

Severe burns

Glomerulonephritis

Dehydration

Glomerulonephritis

Increased destruction of RBC caused by an intracorpuscular abnormality

Which HFE genotype is most common in patients with hereditary hemochromatosis (HH)?

Homozygous for C282Y

Heterozygous for C282Y

Homozygous for H63D

Heterozygous for H63D

Homozygous for H63D

Which of the following viruses is least commonly associated with solid organ or hematopoietic stem cell trasplants?

EBV
BKV
Bocavirus
CMV

Bocavirus

Which of the following is a drawback of point of care testing (POCT)?

Speed of result generation

Not challenging to use

unable to perform patient testing until QC is performed due to QC lock out

Decreased precision in data

Decreased precision in data

Which of the following is composed of DNA?

Howell Jolly bodies

Heinz bodies

Pappenheimer bodies

Dohle bodies

Howell Jolly bodies

In DNA sequencing, multiple fluorescence labeled nucleotides are commonly separated using what type of test?

Serum protein electrophoresis

Capillary electrophoresis

Two-D electrophoresis

HPLC

Capillary electrophoresis

What would the following Schilling test result indicate:

Tropical sprue

Transcobalamin deficiency

Folic acid deficiency

Pernicious anemia

Pernicious anemia

If spinal fluid is slightly hazy, what is the best dilution?

1:200
1:10
1:20
1:100

1:10

Classic automated blood cell counters are based on which of the following technologies?

Laser scatter
radiofrequency
unifluidics
impedance principle

impedance principle

The quality of a test to show a positive result in the presence of a disease it was designed to detect:

Specificity
Sensitivity
Precision
Accuracy

Sensitivity

Which of the following about HBV vaccine is incorrect?

vaccine is effective 90% of cases

Employers may require a fee to administer the vaccine

side effects are rare and minimal

the vaccine is administered over a six month period

Employers may require a fee to administer the vaccine

In which of the following would one see Pappenheimer bodies on the peripheral blood smear?

Iron deficiency anemia
Malarial infections
G6PD deficiency
Splenectomies

Splenectomies

What is the most likely disease associated with these results?

Myelofibrosis
Leukemoid reaction
Chronic myelogenous leukemia
Acute myelogenous leukemia

Leukemoid reaction

Von Willebrand Factor multimer analyses of patient’s plasma can be performed by:

Ristocetin induced platelet aggregation tests

Elisa antigen assays

SDS agarose gel electrophoresis

latex agglutination tests

SDS agarose gel electrophoresis

Which antibodies have not been eliminated?

anti-c, D, e, K, Fya, Jka, M, s, Leb

anti-C, D, E, K, Fyb, Jkb, M, s, Leb

anti-c, D, E, K, Fya, Jkä, N, s, Leb

anti-c, D, E, K, Fyb,Jka, M, s, Leb

anti-c, D, E, K, Fyb,Jka, M, s, Leb

All of the following statements describe a method by which platelets aid coagulation EXCEPT:

Lower blood pressure by releasing heparin

Catalyze coagulation by releasing Platelet Factor 3

Cause blood vessels to constrict by releasing serotonin

Form a plug to stop the flow of blood

Lower blood pressure by releasing heparin

Which of the following descriptions is matched correctly to the organism?

Enterobius vermicularis ova - ovoid in shape with one side flattened. The embryo is separated from the shell by a clear space.

Trichomonas vaginalis - is considered an important factor in the etiology of carcinoma of the bladder. The ova are elongated and are 60 X 160 microns. They are a yellowish color, slightly transparent, and possess a delicate terminal spine.

Schistosoma haematobium ova - have a characteristic oval body with a long thin tail and are 50 microns in length.

Sperm - are highly motile, measuring 8 - 15 microns with a characteristic pear shape. They possess multiple anterior flagella and the nucleus is often apparent.

Enterobius vermicularis ova - ovoid in shape with one side flattened. The embryo is separated from the shell by a clear space.

What is a workload reporting system, and why is it an important part of laboratory management?

It tells exactly how much should be charged per test

Keeps personnel busy in their free time

Counts only the tests performed and specimens received in the laboratory without inflating these figures by adding in quality control and standardization efforts

Helps in planning, developing, and maintaining efficient laboratory services with administrative and budget controls

Helps in planning, developing, and maintaining efficient laboratory services with administrative and budget controls

A direct antigen test for detecting the presence of an infection has the statistics in the table. Therefore, you can conclude that:

The higher the prevalence, the greater the chance a positive test result is correct

The lower the prevalence, the greater the chance a positive test result is correct

The higher the prevalence, the greater the chance a negative test result is correct

The lower the prevalence, the less the chance a negative test result is correct

The higher the prevalence, the greater the chance a positive test result is correct

Identify the hemoglobin bands present, from cathode (negative) to anode (positive), in the sample shown in lane 5 of this alkaline hemoglobin electrophoresis.

CSA

ASC

SFA

AFS

CSA

A deficiency of platelet receptor llb/llla can be found in which of the following?

Glanzmann Thrombasthenia

Von Willebrand Disease

Aspirin therapy

Bernard Soulier Syndrome

Glanzmann Thrombasthenia

In a normal distribution of results, the mean value +/- 2 SDS will include what percentage of the population?

95.5%

99.7%

68.2%

100.0%

95.5%

A tool used to show chain of command by defining responsibility and authority is a/an:

Hospital employee directory

Organizational strategic plan

Clinical laboratory lean design

Organizational chart

Organizational chart

When three tubes of cerebrospinal fluid are received in the laboratory they should be distributed to the various laboratory sections as follows:

#1 Hematology, #2 Chemistry, #3 Microbiology

#1 Chemistry, #2 Microbiology, #3 Hematology

#1 Microbiology, #2 Hematology, #3 Chemistry

#1 Chemistry, #2 Hematology, #3 Microbiology

#1 Chemistry, #2 Microbiology, #3 Hematology

What structure is C?

Kidney

Ureter

Bladder

Urethra

Bladder

How long after collection can a patient's sample be used for compatibility testing?

72 hours

24 hours

96 hours

7 days

72 hours

The MOST accurate observation about osmotic pressure is that it is:

Proportional to concentration of solute particles

Equal to number of solvent molecules times a factor

Measurable by how much it raises the freezing point of water

Directly proportional to the inverse log of solvent molecules

Proportional to concentration of solute particles

Which of the following is the deferral period following the collection of double red blood cell units?

1 year

16 weeks

8 weeks

4 weeks

16 weeks

What do you need to make up 450 mL of a 3.8 M solution of NaOH (gmw=39.997 g/mol)?

68.4 g NaOH

72.8 g NaOH

84.6 g NaOH

96.8 g NaOH

68.4 g NaOH (39.9997g/mol × 3.8mol × 450mL)/1000mL

In patients with Sickle cell disease, upon sickling what laboratory test will see an increase?

MCV

RBCs

MCHC

Hematocrit

MCHC

In which disorder may a mild anemia be present even with an increased red blood cell (RBC) count and normal adult hemoglobin electrophoresis?

Alpha thalassemia silent carrier

Alpha thalassemia minor

Alpha thalassemia intermedia

Alpha thalassemia major

Alpha thalassemia minor

Determine the molarity of a solution of HCl that is contained in a Class A I-L volumetric flask filled to the calibration mark. The content label reads 32 g HCl. The gmw of HCl=36.46 g/mol.

0.88 mol/L

0.90 mol/L

0.92 mol/L

0.98 mol/L

0.88 mol/L

What is the best type of fire extinguisher to use with wood or paper fires?

C02

Halon

ABC

Water-soda

ABC

General Hospital is considering the addition of a new chemistry panel containing 12 tests. The laboratory is asked to calculate the total cost of quality control per new chemistry test panel. Quality control must be performed 3 times per day (every 8 hours). The labor cost per quality control test for this panel is $2.63. A month's worth of quality control reagent costs $354.00. What is the total quality control cost per new

$0.01

$0.09

$0.04

$1.70

$0.09

354 × 12=4248

365 days x 3 runs x 2.63=2879.85

2879.85+4248=7127.85

76000/7127.85=.09

In which situation is gamma irradiation of cellular blood components required?

Prevention of post-transfusion purpura

Prevention of Graft-Versus-Host (GVH) disease

Sterile components

Prevention of non-cardiogenic pulmonary edema

Prevention of Graft-Versus-Host (GVH) disease

Leukocyte reduction may be performed at the same time as which step in blood component collection?

During the initial light spin

During the heavy spin

During the preparation of fresh frozen plasma

At the same time the additive solution is added

All of the following should be done when centrifuging specimens, EXCEPT?

Specimens without anticoagulant should sit for 30 minutes before centrifugation.

Specimens with anticoagulant should sit for 20 minutes before centrifugation.

Cap all tubes for centrifugation.

Allow the centrifuge to come to a complete stop by itself before opening it.

Specimens with anticoagulant should sit for 20 minutes before centrifugation.

If septic arthritis is suspected, specimens from which of the following normally sterile sites should be collected to detect the microorganism causing the condition?

Serous fluid

Synovial fluid

Cerebrospinal fluid (CSF)

Blood

Synovial fluid

Which of the following is considered to be a variable cost in the clinical laboratory?

Instrument leases

Overtime pay

Facilities upkeep

Equipment costs

Overtime pay

The renal threshold is best described as:

Concentration at which a substance in the blood spills into the urine

Concentration at which reabsorption first occurs

Concentration at which kidney can no longer filter the blood

Concentration at which kidney failure begins

Concentration at which a substance in the blood spills into the urine

The Lecithin/Sphingomyelin (L/S) ratio determination of amniotic fluid is useful in assessing the probability of:

Cystic fibrosis

Phenylketonuria

Respiratory distress syndrome

Chromosomal abnormalities

Respiratory distress syndrome

A deficiency in which of these vitamins leads to increased clotting time and may result in hemorrhagic disease?

Riboflavin

Pyridoxine

Vitamin C

Vitamin K

Vitamin K

The volume of urine recommended for centrifugation for a microscopic examination is:

1 - 3 mL

10-15 mL

15-20 mL

Volume is not important

10-15 mL

A dilution commonly used for a routine sperm count is:

1:2

1 :20

1 :200

1 :400

1 :20

In automated methods utilizing a bi-chromatic analyzer, the dual wavelengths are employed to:

Minimize the effect of interference

Improve precision

Facilitate dialysis

Monitor temperature changes

Minimize the effect of interference

What percentage of glycerol is most commonly used when freezing red blood cell units?

70%

40%

10%

20%

40%

Give the objective, "The student will perform the biuret assay for total protein with control values within ±2SD of stated values," ±2SD of stated values is an example of a:

Terminal behavior

Condition

Standard

Learning outcome

Standard

All of the following could explain why screening cell #2 has a stronger reaction than screening cell #1 EXCEPT:

The patient has more than one antibody and all corresponding antigens are on screen cell #2 but not on screen cell #1.

The patient has an antibody other than anti-D and screen cell #2 has a double dose of the antigen, whereas cell #1 has only a single dose.

Operator variability - When dislodging the cell buttons during reading, the technologist shook screen cell #1 •s test more vigorously than cell #2's test.

Screening cell #1 has homozygous antigen for the reacting antibody whereas screening cell #2 is heterozygous.

Screening cell #1 has homozygous antigen for the reacting antibody whereas screening cell #2 is heterozygous.

Anti-U antibodies can be produced by which of the following genotypes?

M-N-

S+s+

S+s-

S-s-

S-s-

Which of the following represents the lower reference limit for semen volume?

0.5 mL

1.5 mL

6.0 mL

10.0 mL

1.5 mL

When processing umbilical cord blood samples for hematopoietic progenitor cells (HPC), what tests are performed on both the mother's blood and cord blood?

ABO & Rh

HIV-I & HIV-2

HBV & HCV

HTLV-I & HTLV-II

ABO & Rh

Which of the following statements is correct regarding bone marrow evaluation?

Bone marrow cellularity increases with age.

Bone marrow cellularity is highest in young children compared to adults.

In a healthy person, the expected myeloid : erythroid ratio is less than 1 (one).

As we age, the amount of adipose tissue (fat) decreases.

Bone marrow cellularity is highest in young children compared to adults.

Parasites that may be found in urinary sediment include all of the following EXCEPT:

Enterobius vermicularis

Trichomonas vaginalis

Plasmodium malariae

Schistosoma haematobium

Plasmodium malariae

Which of the following is responsible for inhibiting the tissue plasminogen activator?

Antithrombin

Tissue Factor Pathway Inhibitor

Thrombin

Protein C

Protein C

A 1:10 dilution is made on a CSF sample. Five squares on each side of the hemacytometer are counted for a total of 10 squares and a total of 1 50 cells are recorded. What is the count per microliter?

527

758

833

1500

1500

Which of the following best describes the Westgard multirule 22S?

Two control data points fall within the 95.5% confidence interval.

One control data point falls outside +2 SD and a second data point falls outside - 3 SD.

Two consecutive data points fall outside +2 SD or -2 SD limits.

One data point from two days ago fell outside +2 SD and today one data point for the same assay fell outside +2 SD.

Two consecutive data points fall outside +2 SD or -2 SD limits.

In essential thrombocythemia, the platelets are usually:

Increased in number and functionally abnormal

Normal in number and functionally abnormal

Decreased in number and functionally normal

Decreased in number and functionally abnormal

Increased in number and functionally abnormal

Which of the following evaluation tools for documenting direct observations is the least subjective?

Anecdotal record4

Checklist

Rating scale with detailed descriptions of traits

Rating scale with general descriptions of traits

Rating scale with detailed descriptions of traits

A urine specimen which was collected in a dark container, stored in the dark, has a pH of 7.5, and whose sample aliquot is wrapped in foil, is most likely being sent for:

Aldosterone

Porphyrins

Catecholamines

Metanephrines

Porphyrins

An example of a cause of a "relative erythrocytosis" is:

Dehydration

Increased erythropoietin production

High oxygen affinity hemoglobinopathy

Genetic polycythemia

Dehydration

Which of the following is considered an indication for Rh immune globulin (RhlG) administration in postpartum mothers?

Long term protection

Antibody blocking

Passive protection

Active immunity

Passive protection

Persons with hemophilia A or hemophilia B that demonstrate inhibitors should be given which of the following products?

Factor VIII concentrates

Factor IX concentrates

Factor VIIa

Factor X

Factor VIIa

Which of the following is considered a macrocytic anemia?

Cooley's anemia

Iron deficiency anemia

Pernicious anemia

Polycythemia vera

Pernicious anemia

Which white blood cell population would have the MOST side scatter when analyzed using flow cytometry?

Monocytes

Lymphocytes

Granulocytes

Erythrocytes

Granulocytes

A small child has albino characteristics, photophobia, frequent pyogenic infections, and her blood smear shows giant dark granules in her monocytes and granulocytes. What is the probable diagnosis?

Pelger-Huet anomaly

Alder-Reilly

Toxic granulation

Chediak-Hegashi syndrome

Chediak-Hegashi syndrome

Which is the best method for examination of synovial crystals?

Phase contrast

Darkfield microscopy

Brightfield microscopy

Polarized light

Polarized light

At minimum, how often should 10% bleach be made in order to remain effective in contamination elimination?

Every day

Once a week

Once a month

Once a year

Once a week

The goal of an ergonomics program is to prevent which of the following disorders or conditions?

Autoimmune disorders

Allergic contact dermatitis

Musculoskeletal disorders

Infection

Musculoskeletal disorders

Which of the following is a sign of dyserythropoiesis that occurs in Myelodysplastic Syndromes?

Oval macrocytes

Schistocytes

Basophilic stippling

Sickle cells

Oval macrocytes

A 3-year old girl was brought to the ER with a temperature of 103 F, lethargy, and cervical rigidity. Three tubes of cloudy

CSF were delivered to the Lab, and preliminary test results showed:

WBC: 4,500/uL Differential: 88% neutrophils

Glucose: 15 mg/dL 12% lymphocytes

Protein: 140 mg/dL

Gram stain: No organisms observed

From these results, what preliminary diagnosis SHOULD the physician consider?

Brain tumor

Bacterial meningitis

Viral meningitis

Subdural hematoma

Bacterial meningitis

If Jka is showing dosage, how might reactions on an antibody panel appear?

Weaker if homozygous for J?

Stronger if heterozygous for Jkä and Jkb

Weaker if heterozygous for -Ika and Jkb

Both heterozygous and homozygous reactions would always be of equal strength

Weaker if heterozygous for -Ika and Jkb

In which of the following situations would a bone marrow aspirate and biopsy be MOST LIKELY recommended to aid in diagnosis?

Primary evaluation of a hypochromic/microcytic anemia

Routine screening for hematologic complications

Part of bone density screening

Evaluation of unexplained cytopenias

Evaluation of unexplained cytopenias

Which of the following statements is correct regarding the bone marrow compartments?

The two main compartments of the bone marrow are the vascular sinuses and hematopoietic cords.

The two main compartments of the bone marrow are the vascular sinuses and blood vessels.

Erythropoiesis in the bone marrow occurs in all areas of the marrow.

A unique bone marrow microenvironment is not necessary for hematopoiesis.

The two main compartments of the bone marrow are the vascular sinuses and hematopoietic cords.

In the ABO blood group system, the A antigen is inherited in what relation to the B antigen?

Codominant

Dominant

Recessive

Amorphic

Codominant

Reabsorption in the kidneys primarily occurs in:

Glomerulus

Bowman's capsule

Proximal convoluted tubule

Loop of Henle

Proximal convoluted tubule

Which of the following instruments measures changes in vapor pressure?

Osmometer

Coulometer

Nephelometer

Spectrophotometer

Osmometer

A patient is admitted to the emergency room with severe lethargy, glossitis, and muscle dysfunction. After the physician orders a complete blood count with differential, the hematology technologist observes cells matching the image to the right. Which condition is most consistent with the clinical and laboratory findings?

Sickle cell anemia

Megaloblastic anemia

Iron deficiency anemia

Aplastic anemia

Iron deficiency anemia