Hematology Exam 2 (Chapter 8)

A patient with infectious mononucleosis would most likely produce which of the following?

A. Polyclonal antibodies

B. IgD antibodies

C. IgE antibodies

D. Monoclonal antibodies

A. Polyclonal antibodies

Which of the following describes the components used to construct an immunoglobulin?

A. 2 identical heavy chains with 2 identical light chains

B. 2 light chains

C. 5 heavy chains

D. 5 identical heavy chains with 2 identical light chains

A. 2 identical heavy chains with 2 identical light chains

A blood sample from a 40-year-old white female has a WBC count of 10.2 × 109/L and a lymphocyte percentage of 47%. What can be concluded from this?

A. The relative and absolute counts are normal.

B. The patient has both a relative and an absolute lymphocytosis.

C. The patient has only an absolute lymphocytosis.

D. The patient has only a relative lymphocytosis.

D. The patient has only a relative lymphocytosis.

Which of the following is considered the "pan-B" antigen?

A. CD4

B. CD8

C. CD19

D. CD10

C. CD19

An instrument printout shows a normal WBC count with a lymphocyte count of 30%. What can be concluded from this?

A. The patient is an infant.

B. The patient has leukemia.

C. The patient is suffering from an infection.

D. There is a normal lymphocyte concentration.

D. There is a normal lymphocyte concentration.

What cell has CD8 on its surface?

A. Macrophage

B. T-helper cell

C. Cytotoxic T cell

D. B cell

C. Cytotoxic T cell

Which of the following describes the distribution of lymphocytes within the body?

A. 80% are short-lived, 20% are long lived

B. 50% exist in the circulating pool, 50% in the marginating pool

C. 95% are found in the lymph nodes and spleen, 5% in the peripheral blood

D. 75% exist in peripheral blood, 25% in lymph nodes and spleen

C. 95% are found in the lymph nodes and spleen, 5% in the peripheral blood

The lymphoid progenitor that gives rise to T, B, and NK lymphocytes is recognized as which of the following?

A. CFU-T

B. CFU_GM

C. CLP

D. CMP

C. CLP

Natural killer cells recognize and kill antigens with attached IgG. This mechanism is described as:

A. Innate immune response

B. Phagocytosis

C. Antibody-dependent cellular activity

D. Cyanosis

C. Antibody-dependent cellular activity

Which of the following terms describes an absolute increase in the number of lymphocytes?

A. Eosinophilia

B. Leukocytosis

C. Neutropenia

D. Lymphocytosis

D. Lymphocytosis

The commitment of a lymphocyte precursor cell to a T lymphocyte can be defined based on:

A. Rearrangement of the immunoglobulin gene

B. Presence of CD 19 and CD 10 by flow cytometry

C. Presence of TdT

D. Rearrangement of the gene loci for the TCR

D. Rearrangement of the gene loci for the TCR

The identity of immunoglobulins is determined by:

A. The specificity of the variable region

B. The number of B cells containing the antibody

C. The complexity of the antibody

D. The isotype of the heavy chain

D. The isotype of the heavy chain

A blood sample from a 5-month-old infant indicates a WBC count of 12.5 × 109/L with 65% lymphocytes. What can you conclude from this?

A. The infant has a malignancy in the lymphocyte lineage.

B. The infant has an infection as indicated by the elevated WBC count.

C. There is not enough information to draw accurate conclusions.

D. The infant is normal.

D. The infant is normal.

Which two CD markers are used to differentiate helper T cells and cytotoxic T cells?

A. BCR and TCR

B. CD10 and CD19

C. CD4 and CD8

D. CD1 and CD3

C. CD4 and CD8

Which of the following is a characteristic of NK cells?

A. They function in the innate immune response.

B. They phagocytize bacteria.

C. They are capable of antibody synthesis

D. They are made up the majority of lymphocytes in peripheral blood.

B. They phagocytize bacteria.

Which of the following is a characteristic of T lymphocytes?

A. Few in number within peripheral blood

B. Phagocytosis of bacteria

C. Antibody synthesis

D. Cytokine secretion

D. Cytokine secretion

Which of the following describes the distribution of lymphocytes within the body?

A. 95% are found in the lymph nodes and spleen, 5% in the peripheral blood

B. 80% are short-lived, 20% are long lived

C. 75% exist in peripheral blood, 25% in lymph nodes and spleen

D. 50% exist in the circulating pool, 50% in the marginating pool

A. 95% are found in the lymph nodes and spleen, 5% in the peripheral blood

Reactive lymphocytes differ from normal lymphocytes in that the reactive form:

A. Has a condensed nuclear pattern with light pink cytoplasm

B. Has a condensed nuclear chromatin, eccentric nucleus, and deep blue cytoplasm

C. Has many granules, deep basophilic cytoplasm, and blast-like nucleus

D. Is larger with an increase in basophilic cytoplasm, vacuoles, and scalloped cell shape

D. Is larger with an increase in basophilic cytoplasm, vacuoles, and scalloped cell shape

Which cell line matures and differentiates upon exposure to antigen?

A. Basophilic

B. Lymphocytic

C. Neutrophilic

D. Monocytic

B. Lymphocytic

Which of the following is found on early T-cell precursors?

A. CD8

B. CD4

C. CD34

D. CD2

C. CD34

The function of the lymphocyte is:

A. phagocytosis

B. antigen recognition

C. hypersensitivity

D. allergic response

B. antigen recognition

Which description best fits the plasma cell?

A. high N:C ratio, nuclear chromatin lacy and fine, nucleoli present, agranular cytoplasm

B. nucleus eccentric, chromatin in a cartwheel arrangement, deeply basophilic cytoplasm

C. decreased N:C ratio, nucleus irregular, abundant cytoplasm indented by erythrocytes

D. round nucleus, abundant cytoplasm, cytoplasm contains large pink granules.

B. nucleus eccentric, chromatin in a cartwheel arrangement, deeply basophilic cytoplasm

Lymphocytes can be differentiated from monocytes because lymphocytes have:

A. cytoplasm with fine granules and a lobulated nucleus

B. lacey chromatin pattern with a low N:C ratio

C. low N:C ratio with intense cytoplamic basophilia

D. round dense chromatin nuclear pattern and sky blue cytoplasm

D. round dense chromatin nuclear pattern and sky blue cytoplasm

A cell on a Wright's stain peripheral blood smear was observed with a stretched or irregular nucleus; occasional nucleoli were present. The cytoplasm was abundant and scalloped around the erythrocytes. This description best fits the:

A. plasma cell

B. lymphoblast

C. reactive lymph

D. monocyte

C. reactive lymph

The first immunoglobulin heavy chain produced in the maturing B lymphocyte is:

A. α

B. β

C. μ

D. γ

C. μ

The adult reference interval for peripheral blood lymphocytes is:

A. 0.2-0.8 x 109/L

B. 1.0-4.8 x 109/L

C. 2.0-7.0 x 109/L

D. 3.9-10.6 x 109/L

B. 1.0-4.8 x 109/L

An 80% lymphocyte count with a total WBC count of 4.4 x 109/L on an adult indicates a:

A. relative and absolute decrease in lymphocytes

B. relative decrease in lymphocytes but an absolute number within the reference interval

C. relative increase in lymphocytes but an absolute number within the reference interval

D. relative and absolute increase in lymphocytes

C. relative increase in lymphocytes but an absolute number within the reference interval

Lymphocyte concentrations in peripheral blood are highest at what age interval?

A. 6 months

B. 5 years

C. 25 years

D. 75 years

A. 6 months

Which of the following is a characteristic of B lymphocytes?

A. regulate immune response

B. synthesize antibody

C. secrete cytokines

D. are majority of peripheral blood lymphocytes

B. synthesize antibody

Which of the following are cells of the innate immune system?

A. plasma cells

B. natural killer cells

C. B lymphocytes

D. T lymphocytes

B. natural killer cells

Pre-B cells are characterized by the presence of:

A. CD4 antigen

B. CD8 antigen

C. CD19

D. CD3

C. CD19

A major function of CD4+ lymphocytes is:

A. to produce immunoglobulin

B. cellular immunity

C. to phagocytize microbes

D. nonspecific cytotoxic function

B. cellular immunity

Natural killer cells are:

A. T lymphocytes

B. B lymphocytes

C. plasma cells

D. non-T, non-B lymphocytes

D. non-T, non-B lymphocytes

The most likely explanation for a patient who has a WBC count of 16 x 109/L with many reactive lymphocytes and a few immunoblasts present is:

A. a heightened immune response

B. early leukemia or lymphoma

C. the presence of immunodeficiency

D. qualitatively abnormal lymphocytes

A. a heightened immune response

A patient has lymphocytic leukemia with 60% lymphoblasts in the peripheral blood. The best way for the clinical laboratory professional to determine whether these are T or B lymphoblasts is to:

A. do a TdT stain on the blood

B. determine the CD surface markers on the blasts by flow cytometry

C. do a molecular analysis to find oncogenes

D. send the peripheral blood specimen to cytogenics

B. determine the CD surface markers on the blasts by flow cytometry

A patient diagnosed with infectious mononucleosis would most likely produce:

A. monoclonal antibody

B. paraprotein

C. polyclonal antibody

D. M protein

C. polyclonal antibody

A patient who is immunosuppressed would most likely have:

A. an increase in CD4+ lymphocytes

B. lymphocytosis and eosinophilia

C. a decrease in CD4+ lymphs

D. an increase in the T-cell to B-cell ratio

C. a decrease in CD4+ lymphs

Interleukin 4 plays a role in:

A. inducing proliferation and activation of lymphocytes

B. enhancing T lymphocytes cell survival

C. stimulating proliferation of B lymphocytes

D. activating macrophages and granulocytes

C. stimulating proliferation of B lymphocytes

KIR molecules are found on which type of lymphocyte?

A. B lymphocytes

B. T lymphocytes

C. Treg cells

D. NK cells

D. NK cells

CD surface markers including CD2, CD3, CD5, and CD7 are associated with which subclass of lymphocytes?

A. B lymphocytes

B. T lymphocytes

C. Treg cells

D. NK cells

B. T lymphocytes