3/30/22, 8:23 AM Preboards: Hematology 3/30/22, 8:23 AM Preboards: Hematology

Which of the following is not associated with hereditary spherocytosis? 1 point

Preboards: Hematology
Extravascular hemolysis
myca.yanes.up@phinmaed.com Switch account
Intravasular hemolysis

An MCHC greater than 36%

Choose the best answer. Good luck! Increased osmotic fragility

Qualitative and quantitative neutrophil changes noted in response to 1 point

infection include all of the following except:

A peripheral smear shows 75% blasts. These stain positive for both Sudan 1 point

Neutrophilia Black B(SBB) and peroxidase. Given these values, which of the following
disorders is most likely?
Pelgeroid hyposegmentation
Acute myelocytic leukemia
Toxic granulation
CML
Vacuolization
Acute undifferetiated leukemia

Acute lymphocytic leukemia

Which of the following factors is not present in BaSO4 adsorbed plasma? 1 point

VIII
In a patient with human immunodeficiency virus (HIV) infection, one should 1 point

II expect to see:

XII Reactive lymphocytes

V Target cells

Pelgeroid cells

Shift to the in WBCs

Which of the following is a characteristic of Auer rods? 1 point

They are nonspecific esterase positive

Seen in chronic myelogenous leukemia

Stain periodic-acid-Schiff (PAS) positive

Composed of azurophilic granules

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What influence does the Philadelphia (Ph1)chromosome have on the 1 point What would be the most likely designation by the WHO for the FAB AML 1 point

prognosis of patients with chronic myelocytic leukemia? M2 by the French-American-British classification?

It is not predictive AML with t(15;17)

The prognosis is worse if Ph1 is present AML with inv(16)

The prognosis is better if Ph1 is present AML with mixed lineage

The disease usually transforms into AML when Ph1 is present AML with t(8;21)

Sodium fluoride may be added to the naphthyl AD acetate (NASDA) 1 point Causes of monocytosis: 1. SBE 2. Tuberculosis 3. Syphilis 4. IM 1 point

esterase reaction. The fluoride is added to inhibit a positive reaction with:

1, 2 and 3
Erythrocytes
1 and 3
Megakaryocytes
4 only
Monocytes
1, 2, 3 and 4
Granulocytes

Glanzmann's thrombasthenia: 1 point

Causes of thrombocytopenia, except: I. Decreased platelet production II. 1 point

Decreased platelet survival time III. Increased platelet sequestration by the Normal aggregation to ADP, epinephrine and collagen, abnormal ristocetin
spleen IV. Multiple blood transfusions
Normal aggregation to ristocetin, abnormal to ADP, epinephrine and collagen

I, II, and III

Normal in all aggregating agents

II, III, IV
None of the aggregating agents

I, III, and IV

I, II, III and IV

None of the above

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A characteristic starry-sky pattern is commonly seen in what precursor B- 1 point In leukemia, which term describes a peripheral blood finding of 1 point
cell neoplasm? leukocytosis with a shift to the left, accompanied by nucleated red cells?

Follicular Lymphoma Megaloblastosis

Burkitt’s Lymphoma Myelophthisis

Diffuse Large B-cell Lymphoma Dysplasia

Small Lymphocytic Lymphoma Leukoerythroblastosis

Neutrophil phagocytosis and particle ingestion are associated with an 1 point Decreased platelet production, except: I. Fanconi's syndrome II. TAR 1 point
increase in oxygen utilization called respiratory burst. What are the two syndrome III. Chronic alcohol consumption IV. Myelofibrosis
most important products of this biochemical reaction?
I, II and III
Cytochrome b and collagenase
II, III, and IV
Lactoferrin and NADPH oxidase
I, III and IV
Hydrogen peroxide and superoxide anion
All of the above
Alkaline phosphatase and ascorbic acid
None of the above

All of the following statements are true about Vascular hemolysis except: 1 point
Which of the following can shift the hemoglobin oxygen dissociation curve 1 point

Macrophage mediated hemolysis occurs most often in the spleen and the liver where to the right?
macrophages possess receptors for those markers
Increases in 2,3-DPG
Protoporphyrin IX is the base substance from which unconjugated bilirubin is derived
Acidosis
in Extravascular hemolysis, Macrophage ingests a portion of the membrane, leaving
RBC to reseal with decreased membrane and therefore a RBC with decreased surface Hypoxia
area.
All of these options
When free in plasma, hemoglobin exists mostly alpha/Beta dimers that rapidly
complex to a liver produced plasma protein called Hemopexin.

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3/30/22, 8:23 AM Preboards: Hematology 3/30/22, 8:23 AM Preboards: Hematology

The following results are obtained from a patient who developed severe 1 point How does a separator gel work as an additive? 1 point

bleeding:
It undergoes a temporary change in viscosity during centrifugation

It Changes the density gradient of the blood

It changes the Specific gravity of the liquid portion during centrifugation

It has a thixotropic property that enables it to pull down the liquid portion of the blood.

Factor VIII concentrate

Fresh frozen plasma

The following laboratory results were obtained on a 25-year-old woman 1 point

Cryoprecipitate with menorrhagia after delivery of her second son. The patient has no
previous bleeding history.
Platelets

All of the following are not true about liver disease, except: I. Multiple 1 point

factor deficiencies II. Abnormal fibrinolysis III. Thrombocytopenia IV.

Qualitative platelet abnormalities

I, II, and III

II, III, and IV Lupus anticoagulant

I, III, and IV Factor VIII deficiency

I, II, III and IV Factor IX deficiency

Factor VIII inhibitor

Which of the following may be seen in the peripheral blood smear of a 1 point

patient with obstructive liver disease?

Microcytes

Macrocytes

Schistocytes

Howell-Jolly bodies

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Theo the intern, was able to collect a sample from an uncooperative 1 point All of the following are associated with intravascular hemolysis except: 1 point

patient. Before reaching the lab, he noticed that the blue top tube has tiny
clots. Because he did not want to go back to the same patient again, he Methemoglobinemia
carefully extracted the tiny clot out of the tube and gave it to his staff med
Hemoglobinuria
tech for testing. Which of the following test is most likely not affected?
Hemoglobinemia
Bleeding time
Decreased haptoglobin
Clotting time

5M Urea solubility test

Reptilase test A 7.0-mL ethylenediaminetetraacetic acid (EDTA)tube is received in the 1 point

laboratory containing only2.0 mL of blood. If the laboratory is using manual
techniques, which of the following tests will most likely be erroneous?

Which of the following Antigen Designation is commonly found in T-cells? 1 point RBC count
1. CD42. CD83. CD10 4. CD11
Hemoglobin

a. 1 and 2 are correct

Hct

b. 1, 2, and 3 are correct

WBC count

c. 1 and 3 are correct

d. 1, 2, 3, and 4 are correct

A patient hematocrit from a morning specimen was 0.35 L/L; later that 1 point
afternoon it was 0.40 L/L. Both specimens were collected in EDTA
evacuated tube. Assuming that there should not have been any significant
A manual RBC count is performed on a pleural fluid. The RBC count in the 1 point change in the hematocrit, what is one possible explanation for the
large center square of the Neubauer hemacytometer is 125, and the discrepancy?
dilution is 1:200. What is the total RBC count?
a. The correct order of draw was not followed
62.5 × 10^9/L
b. The tourniquet was applied too long during the first collection
27.8 x 10^9/L
c. The tourniquet was applied too long during the second collection
125.1 x 10^9/L
d. An improper anticoagulant was used
250.0 x 10^9/L

Other:

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Christmas disease, except: I. Autosomal recessive II. Plasma or whole blood 1 point Cells that exhibit a positive stain with acid phosphatase and are not 1 point

should be fresh when transfused III. Female carriers experience no inhibited with tartaric acid are characteristically seen in:
bleeding tendencies IV. Sex linked recessive trait
Infectious lymphocytosis
I, II and III
Infectious mononucleosis
II, III, and IV
Hairy cell leukemia
I, II, and IV
T-cell acute lymphoblastic leukemia
I, II, III and IV

Embryonic hemoglobins: 1 point

Which anemia is characterized by a lack of intrinsic factor that prevents B12 1 point
absorption? Portland has 2 zeta and 2 epsilon chains

Transcobalamin deficiency Gower II has 2 alpha and 2 epsilon chains

Tropical sprue Both are correct

Blind loop syndrome Neither is correct

Pernicious anemia

Sample quality flags: 1 point

Bernard-Soulier syndrome: I. Autosomal dominant II. Autosomal recessive 1 point Lipemia

III. Gp IIb-IIIa deficiency IV. Gp Ib deficiency
Icterus

I and II Photooptics error

II and III Specimen track error

I and IV No end point detected

II and IV

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Which of the following reactions are often positive in ALL but are negative 1 point A patient has a history of mild hemorrhagic episodes. Laboratory results 1 point

in AML? include a prolonged prothrombin time and activated partial thromboplastin

time. The abnormal prothrombin time was corrected by normal and
Terminal deoxynucleotidyl transferase and PAS adsorbed plasma, but not aged serum. Which of the following coagulation
factors is deficient?
Chloroacetate esterase and nonspecific esterase

prothrombin
Sudan Black B and peroxidase

Factor V
New methylene blue and acid phosphatase

Factor X

Factor VII
Which of the following statements is usually not true? 1 point

The patient has the right to refuse to give a blood specimen

It suggests that all blood cells are derived from a single progenitor cell 1 point
If two unsuccessful attempts at collection have been made, the CLSI recommends
called a pluripotent stem cell
that the phlebotomist seek the assistance of another phlebotomist

Sensitivity to latex should be determined before any phlebotomy procedure Pluriphyletic Theory

The CLSI requires the physician permsission before the blood is drawn from the other Monophyletic Theory
side as a prior mastectomy.
Polyphyletic Theory

Monoblastic

The APTT results are not elevated in a patient receiving heparin. Which of 1 point
the following factors may be associated with the lack of response to
heparin therapy in this patient?
A patient has 80 nucleated red blood cells per 100 leukocytes. In addition 1 point

Protein C deficiency
to increased polychromasia on the peripheral smear, what other finding
maybe present on the CBC?
Protein S deficiency
Increased Hct
Antithrombin deficiency
Increased MCV
Factor VIII deficiency
Increased platelets

Increased red blood cell count

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The familial condition of Pelger-Huet anomaly is important to recognize 1 point Prekallikrein deficiency: I. Autosomal recessive II. Autosomal dominant III. 1 point

because this disorder must be differentiated from: Bleeding tendencies IV. Normal PT, TT, and bleeding time

Infectious mononucleosis I, II, and III

A shift-to-the-left increase in immature granulocytes II, III, and IV

May-Hegglin anomaly I, III, and IV

G6PD deficiency I, II, III and IV

In addition to morphology, cytochemistry, and immunophenotyping, the 1 point Bethesda assay is used for which determination? 1 point

WHO classification of myelo- and lymphoproliferative disorders is based

upon which characteristics? Factor VIII inhibitor titer

Cytogenetic abnormalities Factor V Leiden titer

Proteonomics Lupus anticoagulant titer

Carbohydrate-associated tumor antigen production Protein S deficiency

Cell signaling and adhesion markers

A 3-year-old male was admitted to a hospital with scattered petechiae and 1 point
epistaxis. The patient had normal growth and had no other medical
Afibrinogenemia: I. An autosomal recessive trait II. An autosomal dominant 1 point problems except for chicken pox 3 weeks earlier. His family history was
trait III. ESR is 0 IV. Excessive bleeding following surgery or trauma, as well unremarkable.
as gingival bleeding

I, II, and III

II, III and IV

I, III and IV
DIC
I, II, III, and IV
TTP

ITP

HUS

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Which AML cytogenetic abnormality is associated with acute 1 point SDS-Page electrophoresis uses what dye to identify the RBC membrane 1 point

myelomonocytic leukemia with marrow eosinophilia under the WHO proteins?

classification of AML with recurrent genetic abnormalities?
A. Amido Black S

AML with t(15;17) B. Coomassie blue dye

AML with inv(16) C. Bromcresol Green

AML with mixed lineage D. Ponceau S

AML with t(8;21)

Which antibiotic(s) is (are) most often implicated in the development of 1 point

aplastic anemia?
A rapid platelet consumption and results in severe thrombocytopenia. In 1 point
addition, levels of factor V, factor VIII, and fibrinogen are decreased as a
Penicillin
result of in vivo thrombin generation. The test for D-dimer (a breakdown
product of stabilized fibrin) almost always yields positive results. Tetracycline

Acute DIC Sulfonamides

Chronic DIC Chloramphenicol

Primary hypercoagulable state

Secondary hypercoagulable state

A laboratory test that s always useful in the differential diagnosis of relative 1 point
and absolute erythrocytosis is:

Hemoglobin electrophoresis
The Coulter principle for counting cells is based upon the fact that: 1 point

Plasma erythropoietin quantification

Cells conduct electricity better than cells do
Hemoglobin quantitation
Conductivity varies proportionally to the number of cells
Red cell mass quantification
Isotonic solutions conduct electricity better than cells do

Isotonic solutions cannot conduct electricity

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Insufficient centrifugation will result in: 1 point Compared to a rubricyte, a metarubricyte looks different because of its: 1 point

A false increase in hematocrit (Hct) value Dark blue cytoplasm

No effect on Hct value Larger size

A false decrease in Hct value Pyknotic nucleus

All of these options, depending on the patient Nucleoli

Erythropoiesis: 1 point Thrombocytopenia related to cardiopulmonary bypass, except: I. DIC II. 1 point
Dilution III. Sequestration IV. Increased fibrinolysis
It takes approximately 3 days for the pronormoblast to develop into orthochromic
normoblast I, II, and III

Reticulocytes are held within the bone marrow for an additional 24 hours before it is
II, III, IV
released into the peripheral blood

I, III, and IV
Both are correct

All of the above

Neither is correct

None of the above

All of the following are true about chronic myelogenous leukemia, EXCEPT? 1 point

A differential was performed on an asymptomatic patient. The differential 1 point

There is a presence of a chimeric BCR-ABL gene derived from portions of the BCR
included 60% neutrophils: 55 of which had 2 lobes and 5 had 3 lobes. There
gene on chromosome 22 and the ABL gene on chromosome 9.
were no other abnormalities. This is consistent with which of the following
BCR-ABL is created by a reciprocal (9; 22) (q34; q11) translocation the so called anomalies?
Philadelphia chromosome.
Pelger-Huet
This disorder is a type of Myeloproliferative Disorders.

May-Hegglin
Presence of scattered macrophages with abundant wrinkled, green-blue cytoplasm a
so-called sea-blue histiocytes.
Alder-Reilly
AOTA
Chediak-Higashi
NOTA

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Leukemic lymphoblasts reacting with anti-CALLA are characteristically 1 point Used to treat inherited fibrinogen deficiencies: I. Purified fibrinogen II. 1 point
seen in: Cryoprecipitate III. Fresh frozen plasma IV. Platelet concentrate

Null-cell ALL I, II and III

T-cell ALL II, III, and IV

Common ALL I, III and IV

B-cell ALL I, II, III, and IV

Spectrin is a protein that occupies a major role in: 1 point Hemolytic anemia is not indicated by a(an): 1 point

Red cell membrane structure Positive urine hemosiderin

Red cell transport and removal of CO2 Positive fecal occult blood

Reducing ferric iron Increased in plasm unconjuagted bilirubin

Iron recovery during hemoglobin degradation Decreased serum haptoglobin

A 15-year-old girl is taking primaquine for a parasitic infection and notices 1 point Instrument malfunction flags: 1 point
her urine is a brownish color. A CBC shows mild anemia. The laboratorian
performing the reticulocyte count notices numerous irregular shaped Abnormal clot formation
granules near the periphery of the RBC. These cellular inclusions are most
Probe not aspirating
likely:
Temperature error
Howell-Jolly bodies
Photo-optics error
basophilic stippling
Icterus

Heinz bodies

Pappenheimer bodies

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In addition to an increase in red blood cells, which of the following is 1 point Disseminated intravascular coagulation (DIC) is most often associated with 1 point
characteristic of polycythemia vera? which of the following types of acute leukemia?

Decreased platelets, decreased granulocytes, decreased erythropoietin level Acute myelomonocytic leukemia

Decreased platelets, decreased granulocytes, increased erythropoietin level Acute myeloid leukemia without maturation

Increased platelets, increased granulocytes, increased erythropoietin level Acute promyelocytic leukemia

Increased platelets, increased granulocytes, decreased erythropoietin level Acute monocytic leukemia

Patients with beta-thalassemia: 1. Normocytic normochromic anemia 3. 1 point I. Superficial bleeding (e.g., petechiae, epistaxis, or gingival bleeding), 1 point
Decreased hemoglobin F 2. Occassional target cells 4. Increased usually associated with a plasma clotting factors deficiencies/disorders II.
hemoglobin A2 Deep tissue bleeding (e.g., hematomas or hemarthrosis), usually
associated with platelet function disorders.
1 and 3
Only statement 1 is true
2 and 4
Only statement 2 is true
1, 2 and 3
Both are true
1, 2, 3 and 4
Both are false

Autoagglutination of red cells at room temperature can cause which of the 1 point
following abnormal test results? Laboratory findings in acute hemolytic anemia: 1. Hemoglobinemia 2. Inc. 1 point
plasma haptoglobin 3. Hemoglobinuria 4. Hematuria
High MCV
1 and 3
Low RBC count
2 and 4
Low hematocrit
1, 2 and 3
All of these options
, 2, 3 and 4

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Culling and pitting of erythrocytes in the circulation takes place in the: 1 point A medtech intern saw a mixture of Megalocytes, microcytes and immature 1 point
RBCs on the Blood smear of a patient. Which of the following values will
germinal centers of lymph nodes likely reflect the status of the patient?

cords of red and white pulp and marginal zone of the spleen RDW value of 15.5 %

cortex of the thymus MCHC value of 37

sinuses of the bone marrow RDW value of 14.3%

B and C

With respect to globin chain genes, which of the following statements is 1 point
correct?
A patient on therapeutic warfarin will most likely have a(an): 1 point
The genes for the alpha globin chains are located on chromosome 16 and the genes
for the gamma, delta and beta chains are located on chromosome 11 Normal PT/INR, increased APTT, prolonged bleeding time, low platelet count

The genes for the gamma, delta and beta globin chains are located on chromosome
Increased PT/INR, increased APTT, normal bleeding time, normal platelet count
16 and the genes for the alpha chains are located on chromosome 11

The genes for the alpha globin chains are located on chromosome 10 and the genes Normal PT/INR, normal APTT, normal bleeding time, normal platelet count
for the gamma, delta and beta chains are located on chromosome 15
Increased PT/INR, normal APTT, prolonged bleeding time, low platelet count
The genes for the alpha and delta globin chains are located on chromosome 11 and
the genes for the gamma and beta chains are located on chromosome 16

CML is distinguished from leukemoid reaction by which of the following: 1 point

Which of the following is characteristic of cellular changes as 1 point

CML: high WBC; Leukemoid: normal WBC
megakaryoblasts mature into megakaryocytes within the bone marrow?
CML: high WBC; leukemoid: higher WBC
progressive decrease in overall cell size
CML: low LAP; leukemoid: high LAP
nuclear division without cytoplasmic division
CML high LAP: leukemoid: low LAP
increasing basophilia of cytoplasm

fusion of the nuclear lobes

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A prolonged thrombin time and a normal reptilase-R time are characteristic 1 point A correction is necessary for WBC counts when nucleated RBCs are seen 1 point
of: on the peripheral smear because:

Dysfibrinogenemia The RBC count is too low

Increased D-dimer The WBC count would be falsely lower

Therapeutic heparinization Nucleated RBCs are counted as leukocytes

Fibrin monomer split product complexes Nucleated RBCs are confused with giant platelets

What is the normal WBC differential lymphocyte percentage (range) in the 1 point The following are compounds formed in the synthesis of heme: 1. 1 point
adult population? coproporphyrinogen 3. uroporphyrinogen 2. porphobilinogen 4.
protoporphyrinogen Which of the following responses lists these
5% - 10% compounds in the order in which they are formed?

10%-20%
4,3,1,2

20%-44%
2,3,1,4

50%-70%
2,4,3,1

2,1,3,4

A condition in which platelets are always in an “activated” state and 1 point

express phosphatidylserine on the outer leaflet of the membrane without

prior activation. A prolonged thrombin time is indicative of which of the following 1 point
antithrombotic therapies?
Scott syndrome
Heparin
Stormorken syndrome
Clopidogrel
Hermansky-Pudlak Syndrome
Aspirin
Chédiak-Higashi Syndrome
Prasugrel

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The abnormally increased hemoglobin electrophoresis value(s) that would 1 point Which of the following is associated with antithrombin deficiency? 1 point
usually exclude the possibility of alpha thalassemia is (are):1. HbA2 2. HbH
3. HbF 4. Hb Barts Bleeding

1 and 3 Thrombocytopenia

2 and 4 Thrombosis

1, 2 and 3 Thrombocytosis

4 only

A 62-year-old female presents withy jaundice and the following laboratory 1 point

data:
The JAK2(V617F) mutation may be positive in all of the following chronic 1 point
myeloproliferative disorders except:

Essential thrombocythemia

Idiopathic myelofibrosis

PV

CML

Inherited factor VII deficiency

Cirrhosis of the liver

This abnormality consists of marked dilation and tortuosity of the surface- 1 point

connecting tubular system (the so-called Swiss cheese platelet). DIC

von Willebrand disease

Hermansky-pudlak syndrome

Wiskott-aldrich syndrome

Chédiak-Higashi Syndrome

Gray platelet syndrome

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A rare autosomal recessive disorder characterized by partial 1 point Parahemophilia, except: I. Autosomal recessive disorder II. Congenital 1 point
oculocutaneous albinism, frequent pyogenic bacterial infections, giant deficiency of Factor IX III. Congenital deficiency of Factor V IV.
lysosomal granules in cells of hematologic and non hematologic origin, Heterozygous individuals are usually asymptomatic
platelet dense granule deficiency, and hemorrhage.
I and III
Hermansky-pudlak syndrome
II and IV
Wiskott-aldrich syndrome
I, II and III
Chédiak-Higashi Syndrome
I, II, III, and IV
Gray platelet syndrome

What is the name of the eicosanoid metabolite produced from endothelial 1 point
The Na+ - K+ cation pump is an important mechanism in keeping the red 1 point cells that suppresses platelet activity?
blood cell intact. Its function is to maintain a high level of:
TXA2
Intracellular Na+
Arachidonic acid
Intracellular K+
Cyclooxygenase
Plasma Na+
Prostacyclin
Plasma K+

Features of secondary polycythemia include all of the following except: 1 point

The Mechanism of action of this evacuated tube is to inhibit thrombin 1 point
formation Increased red cell mass

Light blue Increased erythropoeitin

Yellow Decreased oxygen saturation

Green Splenomegaly

Red W/ Gray/Gold

Tan (plastic)

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All of the following are synthesized in the Mitochondria, EXcept: 1 point DIC: I. Defibrination syndrome II. Consumption coagulopathy III. Presence 1 point

of schistocytes and microspherocytes IV. Positive D-dimer test

Heme
I, II and III
Protoporphyrin
II, III, and IV
Succinyl CoA + D-ALA
I, III, and IV
Uroporphyrinogen III
I, II, III and IV

In essential thrombocythemia, the platelets are: 1 point

Conditions associated with reactive thrombocytosis, except: I. Blood lost II. 1 point

Increased in number and functionally abnormal Splenectomy III. Inflammation and disease IV. Exercise

Normal in number and functionally abnormal I and II

Decreased in number and functional II and III

Decreased in number and functionally abnormal III and IV

IV and I

All of the above

Relative polycythemia is characterized by:1. Increase total red cell mass 3. 1 point

Normal plasma volume2. Normal total red cell mass 4. Decreased plasma None of the above
volume

1, 2 and 3

A 56-year-old woman was admitted to the hospital with a history of a 1 point

1 and 3
moderate to severe bleeding tendency of a several years’ duration.
2 and 4 Epistaxis and menorrhagia were reported. Prolonged APTT was corrected
with fresh normal plasma, adsorbed plasma, and aged serum. Deficiency of
Only 4 which of the following is most likely?

Factor XII

Factor VIII

Factor XI

Factor IX

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