Advanced Hematology Exam Preparation Guide
Course Introduction
Advanced Hematology delves into the complex physiology and pathophysiology of blood and its disorders, building on foundational hematology principles. The course explores advanced diagnostic techniques and laboratory methods, such as flow cytometry, cytogenetics, and molecular testing. Students will analyze the mechanisms and clinical manifestations of hematological diseases, including anemia, leukemias, lymphomas, coagulopathies, and hemoglobinopathies. Emphasis is placed on interpreting laboratory data, understanding current evidence-based treatment strategies, and discussing recent advances in therapeutic interventions, including transfusion medicine and stem cell transplantation. Case studies and critical reviews of the literature foster clinical reasoning and research skills essential for practice in hematology.
Recommended Textbook
Hematology in Practice 2nd Edition by Betty Ciesla
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19 Chapters
414 Verified Questions
414 Flashcards
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Chapter 1: Introduction to Hematology and Basic Laboratory Practice
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20 Flashcards
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Sample Questions
Q1) Delta checks are used in the hematology laboratory to:
A) Compare past patient results to the current result
B) Verify control accuracy
C) Establish a target range
D) Establish reference ranges for a particular analyte
Answer: A
Q2) Which of the following represents an example of a safety violation in the laboratory?
A) Application of cosmetics
B) Mouth pipetting
C) Consuming bottled water
D) All the above
Answer: D
Q3) When handwashing after a patient contact, the soap application process should last at least:
A) 5 seconds
B) 15 seconds
C) 20 seconds
D) 30 seconds
Answer: B
Page 3
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Chapter 2: From Hematopoiesis to the Complete Blood Count
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Sample Questions
Q1) A patient's hemoglobin is 12.3 g/dL.On the peripheral smear, the red cells appear normochromic, normocytic.The hematocrit value that correlates with these data is:
A) 34%
B) 37%
C) 40%
D) 43%
Answer: B
Q2) Antibody-coated red cells that have their antibodies stripped away in the spleen usually reappear in the circulation as:
A) Spherocytes
B) Microcytes
C) Acanthocytes
D) Burr cells
Answer: A
Q3) Patients with moderate anemias (7 to 10 g/dL) may be asymptomatic.
A)True
B)False
Answer: True
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Chapter 3: Red Blood Cell Production, Function, and
Relevant Red Blood Cell Morphology
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24 Flashcards
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Sample Questions
Q1) Which of the following RBC pathways is responsible for providing 90% of the cellular ATP for red cell metabolism?
A) Embden-Meyerhof pathway
B) Methemoglobin reductase pathway
C) Rapoport-Luebering pathway
D) Hexose monophosphate shunt
Answer: A
Q2) When hemolysis is produced by the intravascular fragmentation of red cells, which red cell morphology will be produced?
A) Spherocytes
B) Macrocytes
C) Acanthocytes
D) Schistocytes
Answer: D
Q3) Red cell inclusions that are remnants of DNA are termed:
A) Cabot rings
B) Howell Jolly bodies
C) Heinz bodies
D) Pappenheimer bodies
Answer: B
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Chapter 4: Hemoglobin Function and Principles of Hemolysis
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Sample Questions
Q1) Hemoglobin begins to be synthesized at the polychromatophilic stage of red cell development.
A)True
B)False
Q2) Which of the following abnormal hemoglobins will result in a cyanotic condition?
A) Sulfhemoglobin
B) Cyanmethemoglobin
C) Hemoglobin F
D) Hemoglobin M
Q3) Abnormal hemoglobins have a lower affinity for oxygen.
A)True
B)False
Q4) Fetal hemoglobin consists of which of the following chains?
A) \(\alpha\)2\(\beta\)2
B) \(\alpha\)2\(\gamma\)2
C) \(\alpha\)2\(\sigma\)2
D) \(\alpha\)2\(\varepsilon\)2
Q5) Oxygen delivery is the primary purpose of hemoglobin.
A)True
B)False
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Chapter 5: The Microcytic Anemias
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Sample Questions
Q1) Given the laboratory results of serum iron = 300 \(\mu\)g/dL, transferrin = 312 mg/dL, transferrin saturation = 122%, and ferritin = 1,000 ng/mL, which of the following should be considered?
A) Hereditary hemochromatosis
B) Anemia of inflammation
C) Iron deficiency anemia
D) Lead poisoning
Q2) In addition to iron ingestion, over 90% of iron in adults that is used for erythropoiesis is obtained through:
A) Transfusion
B) Recycling of iron
C) Storage forms from spleen and the liver
D) Hemosiderin
Q3) In iron deficiency anemia, the reticulocyte count will be:
A) Normal
B) Low
C) High
D) Extremely high
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Chapter 6: The Macrocytic Anemias
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Sample Questions
Q1) A bone marrow aspiration/examination is not necessary for patients with megaloblastic anemia.
A)True
B)False
Q2) Which of the following terms describes the appearance of the erythropoietic precursors in the megaloblastic process?
A) Ordered arrangement of chromatin
B) Asynchrony
C) Eccentric nucleus
D) Pale cytoplasm
Q3) One of the most common pathophysiologies that contribute to folic acid deficiency is:
A) Tropical sprue
B) Intrinsic factor deficiency
C) IDA
D) Infection with Diphyllobothrium latum
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Chapter 7: Normochromic Anemias: Biochemical,
Membrane, and Miscellaneous Red Blood Cell Disorders
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Sample Questions
Q1) The deficit of which of these is most closely associated with Southeast Asian ovalocytosis?
A) Spectrin
B) Ankyrin
C) Molecular band 3
D) G6PD
Q2) Cholelithiasis is a frequent complication of patients with hereditary spherocytosis because:
A) Spherocytes are an abnormal red cell morphology
B) The gallbladder does not function well in this condition
C) Continued hemolysis in this condition causes gallstones to form
D) The filtration function of the spleen is overworked
Q3) The RBC inclusions that are composed of denatured hemoglobin are called:
A) Pappenheimer bodies
B) Howell-Jolly bodies
C) Heinz bodies
D) Siderotic granules
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Page 9
Chapter 8: The Normochromic Anemias Caused by Hemoglobinopathies
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Sample Questions
Q1) Sickle cell disease is best differentiated from sickle cell trait by:
A) Wright smear examination
B) Determination of fetal hemoglobin
C) Genetic testing
D) Hemoglobin electrophoresis
Q2) The Benin haplotype of sickle cell disease is prevalent in which country or countries?
A) Saudi Arabia and Asia
B) Senegal
C) West Africa
D) Central and South Africa
Q3) Alkaline electrophoresis will not separate hemoglobin C from:
A) Hemoglobin A<sub>2</sub>
B) Hemoglobin F
C) Hemoglobin S
D) Hemoglobin A
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Chapter 9: Leukopoiesis and Leukopoietic Function
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Sample Questions
Q1) Lymphocyte concentrations in peripheral blood are greatest during what age interval?
A) Immediately after birth
B) Older adult (40 to 70 years)
C) Young adult (16 to 40 years)
D) Young child (1 to 4 years)
Q2) The plasma cell is responsible for:
A) Humoral immunity
B) Cell mediated immunity
C) Tumor suppression
D) Delayed hypersensitivity
Q3) The spleen harbors approximately ___ of the white blood cell population
A) one-fourth
B) one-half
C) one-third
D) three-fourths
Q4) The absolute WBC count refers to the percentage of a particular cell counted from the 100 WBC differential.
A)True
B)False
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Chapter 10: Abnormalities of White Blood Cells:
Quantitative, Qualitative, and the Lipid Storage Diseases
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Sample Questions
Q1) All of the following are lipid storage syndromes/diseases except:
A) Gaucher's disease
B) Tay-Sachs disease
C) Chediak-Higashi syndrome
D) Niemann-Pick disease
Q2) Toxic vacuolization occurs most frequently in:
A) Neutrophils
B) Monocytes
C) Lymphocytes
D) Erythrocytes
Q3) A patient who presents with a low white cell count, thrombocytopenia, elevated liver enzymes, and mulberry-like inclusions in the granulocytes is most likely suffering from:
A) May-Hegglin anomaly
B) Chediak-Higashi anomaly
C) Human ehrlichiosis
D) Alder's anomaly
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12
Chapter 11: Acute Leukemias
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Sample Questions
Q1) ______may arise as a blastic transformation in patients with CML.
A) Acute basophilic leukemia
B) Acute myelofibrosis
C) Acute lymphocytic leukemia
D) Erythroleukemia
Q2) The structure at the end of the pointer is a(n):
A) Auer rod
B) Dohle body
C) Engulfed bacteria
D) None of the above
Q3) The t(15:17)(q22;q12) is associated with which of the following leukemias?
A) Acute promyelocytic leukemia
B) Acute myelomonocytic leukemia
C) Acute lymphocytic leukemia
D) Acute myelocytic leukemia
Q4) The cells pictured above are most consistent for:
A) Acute myeloid leukemia
B) Acute myelomonocytic leukemia
C) Acute lymphoblastic leukemia
D) Acute erythroid leukemia
Page 13
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Chapter 12: Chronic Myeloproliferative Disorders
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Sample Questions
Q1) The translocation of genetic material, t9:22, is associated with:
A) The Philadelphia chromosome
B) ALL
C) A leukemoid reaction
D) Polycythemia vera
Q2) All of the following are causes of secondary erythrocytosis except:
A) Hypertension
B) Alcohol
C) Sleep apnea
D) Smoking
Q3) A high-risk factor for the diagnosis of essential thrombocythemia is:
A) A platelet count of greater than 600,000
B) Extramedullary hematopoiesis
C) The presence of BCR/ABL
D) Fibrotic bone marrow
Q4) ____has the worst prognosis of all the myeloproliferative disorders.
A) Polycythemic vera
B) Essential thrombocythemia
C) Idiopathic myelofibrosis
D) Chronic myelogenous leukemia
Page 14
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Chapter 13: Lymphoproliferative Disorders and Related
Plasma Cell Disorders
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Sample Questions
Q1) Russell bodies are associated with:
A) Multiple myeloma
B) Hodgkin's lymphoma
C) Non-Hodgkin's lymphoma
D) Waldenström's macroglobulinemia
Q2) An abnormal proliferation of dysfunctional B lymphocytes is commonly associated with:
A) Acute lymphocytic leukemia
B) Chronic lymphocytic leukemia
C) Infectious mononucleosis
D) Hodgkin's disease
Q3) The TRAP stain is useful in the diagnosis of:
A) CLL
B) PLL
C) Hairy cell leukemia
D) Hodgkin's lymphoma
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Chapter 14: The Myelodysplastic Syndromes
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Sample Questions
Q1) Which of the following chromosome disorders in MDS has a poor predictive influence?
A) Chromosome 7 disorder
B) Trisomy 12
C) Trisomy 13
D) 17q deletion
Q2) The morphological classification of anemia in the myelodysplastic syndromes is:
A) Normocytic, normochromic
B) Microcytic, hypochromic
C) Macrocytic, normochromic
D) Microcytic, normochromic
Q3) The blast count in most individuals with MDS is:
A) Less than 10%
B) Less than 40%
C) Less than 5%
D) Less than 20%
Q4) Deleted 5q MDS is primarily seen in male patients.
A)True
B)False
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Chapter 15: Overview of Hemostasis and Platelet Physiology
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Sample Questions
Q1) Factor V
A)Stabile factor
B)Labile factor
C)Thromboplastin
D)Calcium
E)Anti-hemophiliac factor
F)Fibrinogen
G)Prothrombin
Q2) Factor II
A)Stabile factor
B)Labile factor
C)Thromboplastin
D)Calcium
E)Anti-hemophiliac factor
F)Fibrinogen
G)Prothrombin
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Chapter 16: Quantitative and Qualitative Platelet Disorders
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Sample Questions
Q1) The presence of thrombocytopenia and giant platelets on the peripheral smear of a patient is characteristic of:
A) Classic von Willebrand's disease
B) Hemophilia A
C) Glanzmann's thrombasthenia
D) Bernard-Soulier syndrome
Q2) Platelets from patients with these two disorders will not aggregate with ristocetin.
A) Glanzmann's syndrome and von Willebrand's
B) Glanzmann's syndrome and Chediak-Higashi
C) HUS and Bernard-Soulier syndrome
D) von Willebrand's disease and Bernard-Soulier
Q3) The anticoagulant of choice for routine coagulation procedure is:
A) Sodium oxalate
B) Sodium citrate
C) Heparin
D) Sodium fluoride
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18
Chapter 17: Defects of Plasma Clotting Factors
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Sample Questions
Q1) Keloid scar formation is most commonly associated with:
A) Factor VIII deficiency
B) Factor IX deficiency
C) Factor XII deficiency
D) Factor XIII deficiency
Q2) Factor V Leiden is a genetic mutation of:
A) Factor IV
B) Factor V
C) The prothrombin molecule
D) Hemophilia A
Q3) Which platelet response(s) is usually associated with hemophilia A?
A) Defective ADP release; normal response to ADP
B) Decreased amount of ADP in platelets
C) Absent aggregation to epinephrine, ADP, and collagen
D) Normal platelet aggregation
Q4) Christmas disease is another name for:
A) Hemophilia A
B) Hemophilia B
C) von Willebrand's disease
D) Factor VII deficiency
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Chapter 18: Fibrinogen, Thrombin, and the Fibrinolytic System
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Sample Questions
Q1) The reference range for fibrinogen is:
A) 100 to 200 mg/dL
B) 200 to 400 mg/dL
C) 400 to 600 mg/dL
D) 600 to 750 mg/dL
Q2) Patients with the heterozygous form of afibrinogenemia will have plasma levels of fibrinogen in the range of:
A) 0 to 20 mg/dL
B) 20 to 100 mg/dL
C) 50 to 150 mg/dL
D) 100 to 200 mg/dL
Q3) The process of fibrin degradation is called ______and is controlled by the enzyme
A) fibrination, plasmin
B) fibrinolysis, plasmin
C) fibrination, protease
D) fibrinolysis, protease
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Page 20
Chapter 19: Introduction to Thrombosis and Anticoagulant Therapy
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Sample Questions
Q1) Protein C is activated by which of the following?
A) Heparin cofactor II
B) Factor VIII a
C) Antithrombin
D) Protein S
Q2) All of the following statements are true regarding Coumadin except:
A) It is a vitamin K antagonist.
B) It needs antithrombin as a cofactor.
C) PT is used to monitor its dosage.
D) It is not recommended for pregnant and lactating women.
Q3) Which of the following PT results would most likely be seen in a patient who is on Coumadin and is stable?
A) Approximately 26 seconds
B) Approximately 13 seconds
C) Approximately 40 seconds
D) Approximately 60 seconds
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