Blood Banking and Transfusion Science Study Guide Questions
Course Introduction
Blood Banking and Transfusion Science is a comprehensive course that explores the principles and practices involved in the collection, testing, processing, storage, and transfusion of blood and its components. The course covers essential topics such as blood group systems, compatibility testing, transfusion reactions, donor selection, and screening for infectious diseases. Emphasis is placed on the application of immunohematology in ensuring safe and effective transfusion therapy, as well as on regulatory and quality assurance aspects within blood bank operations. Through both theoretical instruction and practical laboratory experience, students gain the knowledge and skills necessary to play a vital role in transfusion medicine and patient care.
Recommended Textbook
Clinical Laboratory Hematology 3rd Edition by Shirlyn B. McKenzie
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Chapter 1: Introduction
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Q1) Which component of blood passes through blood vessel walls into surrounding tissues to defend the body against invading foreign antigens?
A)Red blood cells
B)Platelets
C)Leukocytes
D)Gamma globulin
Answer: C
Q2) The protein found in erythrocytes that is responsible for oxygen transport is:
A)Albumin
B)Gamma globulin
C)Oxygen protein
D)Hemoglobin
Answer: D
Q3) Which two populations account for the greatest difference in reference intervals?
A)Adults and 12-year-olds
B)Newborns and 12-year-olds
C)Newborns and adults
D)Whites and blacks
Answer: C
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Page 3
Chapter 2: Cellular Homeostasis
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Q1) Describe the apoptotic pathway.
Answer: Death receptor binding of death receptor to cell receptor caspase recruitment activation of initiator caspases activation of effector caspases cleavage of crucial cellular proteins cell death.
Q2) The (R)restriction point occurs during what phase in the cell cycle?
A)S
B)G
C)G
D)M
Answer: C
Q3) Explain the role of epigenetic alterations in cancer development.
Answer: The most common epigenetic change in the development of cancer involves a methylation/demethylation of CpG dinucleotide bases.Cancer can involve demethylation of promoter regions of genes making them transcriptionally ready.Methylation can result in transcriptional silencing of the gene and loss of function of tumor suppressor genes.Deacetylation of key histones can result in gene silencing which may favor growth over differentiation.
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Chapter 3: Structure and Function of Hematopoietic Organs
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Q1) Where in the body does maturation of T lymphocytes take place?
A)Lymph node
B)Bone marrow
C)Spleen
D)Thymus
Answer: D
Q2) The primary sites of lymphoid tissue include:
A)Bone marrow,spleen,and liver
B)Bone marrow,thymus,and liver
C)Thymus,spleen,and lymph nodes.
D)Thymus,bone marrow,and lymph nodes
Answer: C
Q3) Which of the following is considered a MALT tissue?
A)Lymph node
B)Thymus
C)Tonsils
D)Bone marrow
Answer: C
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Chapter 4: Hematopoiesis
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Q1) Which of the following cells gives rise to the lymphoid and myeloid cells?
A)Committed lymphoid progenitor cell
B)Multipotential progenitor cell
C)Committed myeloid progenitor cell
D)CFU-GEMM
Q2) Which component of the BM stroma is responsible for the formation of the ECM?
A)Cytokines
B)Fibroblasts
C)Osteoclasts
D)Osteoblasts
Q3) Which of the following statements describes the role of transcription factors (TF)in hematopoiesis?
A)TF expression does not change during hematopoiesis.
B)TF function either to activate or suppress target gene expression.
C)TF block the differentiation pathway for hematopoietic precursors.
D)TF abnormalities are rarely seen in hematologic malignancies.
Q4) Compare and contrast the HSC and the progenitor cells.How are they similar?
How are they different?
Q5) Explain the JAK-STAT signaling pathway,and describe how it can contribute to disease.
Page 6
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Chapter 5: The Erythrocyte
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Q1) Which of the following molecules is a senescence signal when it is exposed on the outer leaflet of the erythrocyte?
A)Band 3
B)Ankyrin
C)Phosphatidylethanolamine (PE)
D)Phosphatidylserine (PS)
Q2) Red blood cell production begins with what cell?
A)Progenitor
B)Hematopoietic stem cell
C)CFU
D)BFU
Q3) Which of the following "marks" the RBC as senescent?
A)A cluster of band 3 proteins on the RBC membrane
B)An RBC with denatured hemoglobin on the RBC membrane
C)An elongated RBC
D)Hyperphosphorylation of integral proteins
Q4) Explain how EPO regulates RBC production.
Q5) Describe the nuclear and cytoplasmic morphologic changes in erythrocytes during maturation.
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Chapter 6: Hemoglobin
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Q1) Which of the following is considered a normal hemoglobin concentration in an adult?
A)9.1 g/dL
B)1.8 g/dL
C)21.2 g/dL
D)14.8 g/dL
Q2) Which abnormal hemoglobin contains a molecule of carbon monoxide?
A)Carboxyhemoglobin
B)Methemoglobin
C)Sulfhemoglobin
D)Deoxyhemoglobin
Q3) Which of the following conditions produces a favorable environment for hemoglobin to bind to oxygen? (Normal body temperature is <100°F;normal blood pH: 7.35-7.45. )
A)A body temperature of 102°F
B)A high 2,3-BPG concentration
C)A blood pH of 7.31
D)High PO
Q4) Correlate embryonic/fetal hemoglobin production to stages of fetal hematopoiesis.
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Chapter 7: Granulocytes and Monocytes
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Q1) Absolute cell count calculation adjusts for what variation(s)?
A)Total WBC count
B)Differential count
C)Total WBC and differential counts
D)Total lymphocyte counts
Q2) The life span of the neutrophil is spent in three compartments.Which compartment is the primary site of host defense?
A)Bone marrow
B)Liver
C)Thymus
D)Tissues
Q3) Leukocyte surface markers identify cell lineage and are helpful in differentiating neoplastic hematologic disorders.What is one method used to identify these surface markers?
A)Chamber counts
B)Leukocyte differential
C)Cytogenetic methods
D)Flow cytometry
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9
Chapter 8: Lymphocytes
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Q1) What are three defining characteristics that would help the laboratory professional differentiate between a blast and an activated lymphocyte?
Q2) T,B,and NK lymphocytes can be differentiated by:
A)Morphology
B)Flow cytometry
C)Cytochemistry
D)Cytogenetic karyotype
Q3) Which of the following is a characteristic of T lymphocytes?
A)Phagocytosis of bacteria
B)Antibody synthesis
C)Cytokine secretion
D)Few in number within peripheral blood
Q4) Natural killer cells recognize and kill antigens with attached IgG.This mechanism is described as:
A)Phagocytosis
B)Cyanosis
C)Antibody-dependent cellular activity
D)Innate immune response
Q5) Describe the immunologic features and functions of NK cells.
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Chapter 9: The Platelet
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Q1) On average,how long does a platelet live in the peripheral circulation?
A)6 hours
B)120 days
C)5 days
D)10 days
Q2) Which of the following cells is defined as cytoplasmic extensions that are released in groups and fragmented into individual platelets?
A)Megakaryocyte
B)Megakaryoblast
C)Thrombocyte
D)Proplatelet
Q3) The effect of thrombopoietin (TPO)on megakaryocytic cells can be described by all of the following except:
A)Promote endomitosis
B)Inhibit proliferation
C)Increase the number in the bone marrow
D)Advance the rate of maturation
Q4) Describe megakaryocyte development and the role of endomitosis and thrombopoietin in this process.
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Chapter 10: The Complete Blood Count and Peripheral
Blood Smear Evaluation
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Q1) Which RBC parameter describes the variation in the volume of the RBCs in a blood sample?
A)MCV
B)RDW
C)Reticulocyte count
D)MCHC
Q2) How does the mean cell volume value classify cells?
A)Normochromic,hypochromic,and hyperchromic
B)Normocytic,microcytic,macrocytic
C)Poikilocytosis
D)Polychromasia
Q3) Which RBC inclusion is characterized by diffusely staining RNA precipitate that can be seen when blood is stained with Wright's stain?
A)Heinz bodies
B)Pappenheimer bodies
C)Howell-Jolly bodies
D)Basophilic stippling
Q4) List four pre-examination precautions that must be observed to produce quality results when performing a CBC.
12
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Chapter 11: Introduction to Anemia
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Q1) Which of the following defines an intrinsic erythrocyte defect:
A)Erythrocytes that are damaged by chemical,mechanical,or physical agents
B)The agglutination of erythrocytes by antigen/antibody interactions
C)Inherited abnormalities of an erythrocyte
D)Destruction of red cells within the vasculature
Q2) CBC results on a pregnant patient indicate an MCV of 112 fl.What would be the most appropriate reflex test?
A)Iron studies
B)Bilirubin
C)LDH
D)Folate assay
Q3) Microcytic hypochromic anemias are associated with which functional abnormality?
A)Defective folate utilization
B)Bone marrow hypoplasia
C)Fibrotic bone marrow
D)Defective hemoglobin synthesis
Q4) A patient sample had a retic count of 5% and hematocrit of 25%.Normal hematocrit is 45%.What other bone marrow test(s)could you perform to help determine whether the bone marrow is responding to the pancytopenia?
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Chapter 12: Anemias of Disordered Iron Metabolism and Heme Synthesis
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Q1) What enzyme is responsible for reducing ferric iron to the ferrous state at the enterocyte brush border?
A)Apoferritin
B)DcytB
C)Ferritin
D)Transferrin
Q2) Which of the following is the correct progression of iron-deficiency anemia?
A)Storage depletion,iron-poor hemoglobin production,transport depletion
B)Storage depletion,transport depletion,iron-poor hemoglobin production
C)Iron-poor hemoglobin production,transport depletion,storage depletion
D)Iron-poor hemoglobin production,storage depletion,transport depletion
Q3) What measurements are used in the percent saturation calculation?
A)Transferrin and ferritin
B)Ferritin and bone marrow iron
C)Serum iron and TIBC
D)Serum iron and ferritin
Q4) Differentiate between primary and secondary hemochromatosis.
Q5) Explain the absorption and assimilation of nonheme iron into hemoglobin in the RBC.
Q6) Explain how lead inhibits heme synthesis.
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Chapter 13: Hemoglobinopathies: Qualitative Defects
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Q1) Which of the following has the highest prevalence worldwide?
A)Hgb S
B)Hgb C
C)Hgb D
D)Hgb E
Q2) Patients with sickle cell disease suffer from vaso-occlusive crises because:
A)The altered hemoglobin facilitates the formation of bar-shaped hemoglobin crystals that occlude blood vessels.
B)The altered hemoglobin impairs the hemoglobin's ability to effectively transport oxygen that causes vaso-occlusion.
C)The altered hemoglobin facilitates tactoid crystal formation that alters the shape of the red blood cell,resulting in impeded blood flow in vessels.
D)The altered hemoglobin interferes with globin chain assembly,which impedes blood flow in the vessels.
Q3) How is methemoglobin detected in the laboratory?
Q4) Patients with sickle cell disease and those with sickle cell trait differ greatly in clinical presentation.List at least two features in clinical presentation,and explain why they differ.
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Chapter 14: Thalassemia
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Q1) Molecular analysis on a 4-month-old Chinese patient revealed three alpha genes deleted on chromosome 16.The physician ordered a hemoglobin electrophoresis on this patient.What is the expected finding?
A)80% F;15% A1;5% A
B)95% Hgb H
C)95% Hgb Bart's
D)80% A1;10% F;10% A
Q2) Thalassemia differs from hemoglobinopathies by what characteristic?
A)The production of abnormal globin chains
B)The point of genetic mutations
C)A decreased synthesis of normal hemoglobin
D)A qualitative defect in the globin structure
Q3) All of the following morphology are typically seen in beta thalassemia patients except:
A)Codocytes
B)Polychromasia
C)Microcytes
D)Drepanocytes
Q4) Nucleated red blood cells in the peripheral blood are a common finding in beta thalassemia patients.Explain why.
Page 16
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Chapter 15: Megaloblastic and Nonmegaloblastic
Macrocytic Anemias
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Q1) Megaloblastic anemia is most often caused by deficiencies of what two components?
A)Iron and transferrin
B)Ferritin and hemoglobin
C)Vitamin B and folate
D)Iron and liver disease
Q2) All of the following disorders can lead to macrocytic anemia except:
A)Alcoholism
B)Liver disease
C)Hypothyroidism
D)Iron deficiency
Q3) The defect in DNA synthesis associated with megaloblastic anemia affects which cells?
A)Only erythrocytes
B)Only gastric cells and WBCs
C)Only neurological cells
D)All dividing cells
Q4) Explain why patients undergoing gastric bypass surgery are prone to developing pernicious anemia.
Q5) Explain how vitamin B deficiency can cause folate deficiency.
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Chapter 16: Hypoproliferative Anemias
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Q1) Patients with renal disease are at risk for developing megaloblastic anemia because of:
A)Decreased EPO production and utilization
B)Increased NADPH production
C)Folate deficiency
D)Acute blood loss
Q2) Correlate the prognosis associated with the following treatments for aplastic anemia.
a.Bone marrow transplant
b.Cytokine therapy
c.Stem cell transplant
d.Immunosuppression therapy
Q3) Hypoproliferative anemia is defined as:
A)Decreased hematopoiesis in the bone marrow
B)Decreased hematopoiesis in the liver
C)Decreased erythropoiesis in the bone marrow
D)Ineffective erythropoiesis in the bone marrow
Q4) Define constitutional aplastic anemia,and give an example.
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Chapter 17: Hemolytic Anemia: Membrane Defects
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Q1) Hereditary pyropoikilocytosis differs in red cell morphology from other erythrocyte membrane defects by what characteristic cell shape?
A)Spherocyte
B)Elliptocyte
C)Schistocyte
D)Target cell
Q2) Which of these disorders has a defective vertical protein interaction between RBC skeleton and the membrane?
A)Hereditary elliptocytosis
B)Hereditary pyropoikilocytosis
C)Hereditary spherocytosis
D)Acanthocytosis
Q3) Which of the following disorders has an abnormal erythrocyte membrane that is abnormally permeable,resulting in the loss of K+ and water and decreased deformability?
A)Overhydrated hereditary stomatocytosis
B)Dehydrated hereditary stomatocytosis
C)Hereditary elliptocytosis
D)Hereditary spherocytosis
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Page 19
Chapter 18: Hemolytic Anemia: Enzyme Deficiencies
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Q1) The mode of inheritance for G6PD deficiency is:
A)Autosomal recessive
B)Autosomal dominant
C)No pattern established
D)Sex linked
Q2) The presence of which poikilocyte in the peripheral blood could indicate G6PD deficiency?
A)Schistocyte
B)Spherocyte
C)Blister cell
D)Elliptocyte
Q3) Increased bilirubin in the blood of infants can lead to ________,and is seen in
A)Hemoglobinuria;acute,acquired hemolytic anemia
B)Hemosiderinuria;congenital,nonspherocytic hemolytic anemia
C)Kernicterus;neonatal hyperbilirubinemia
D)Kernicterus;congenital,nonspherocytic hemolytic anemia
Q4) How do Heinz bodies differ morphologically from other erythrocyte inclusions?
Q5) Why are Heinz bodies seen in G6PD deficiency?
Q6) Why are echinocytes seen in PK deficiency?
Page 20
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Chapter 19: Hemolytic Anemia: Immune Anemias
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Q1) Which of the following is consistent with a diagnosis of CAD?
A)MCHC 44 g/dL
B)DAT positive with polyspecific AHG and anti-IgG
C)Spherocytes on the peripheral blood smear
D)MCV 104 fL
Q2) Which of the following antibody specificities is associated with PCH?
A)Anti-I
B)Anti-Lea
C)Anti-P
D)Anti-D
Q3) A patient is admitted with chest pain and extreme shortness of breath.Patient history is unremarkable except for ingestion of oral cefoxitin for the past 4 days.A DAT profile is positive with polyspecific AHG,negative with anti-IgG,and positive with anti-C3.The hemoglobin is 8.0 gm/dl.Based on these results,what mechanism of drug-induced hemolysis is present?
A)Immune complex
B)Autoantibody
C)Drug adsorption
D)Membrane modification
Q4) Compare the three mechanisms of drug-induced immune hemolysis.
Page 21
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Chapter 20: Hemolytic Anemia: Nonimmune Defects
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Q1) A patient presented with fever,mild anemia,and thrombocytopenia.The peripheral blood smear showed the presence of intracellular organisms that were present as singles,doubles,and tetrads.What is the most likely identification of the organism?
A)Plasmodium falciparum
B)Babesia microti
C)Bartonella bacilliformis
D)Trypanosoma cruzi
Q2) Which of the following results are typically found in HUS? PT aPTT
A)ProlongedProlonged
B)NormalProlonged
C)ProlongedNormal
D)NormalNormal
Q3) What are typical findings on the blood smear in DIC?
A)Spherocytes and leukopenia
B)Target cells and leukocytosis
C)Schistocytes and thrombocytopenia
D)Helmet cells and thrombocytosis
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Chapter 21: Nonmalignant Disorders of Leukocytes:
Granulocytes and Monocytes
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Q1) A patient presents with neutrophilia of 40 × 10 /L with many circulating immature cells.The blood contains many bands,metamyelocytes,myelocytes,promyelocytes,and a rare blast.No nucleated erythrocytes are present.What disease state is most likely with these results?
A)Leukoerythroblastosis
B)Hypersensitivity reaction
C)Tissue damage from burns
D)Neutrophilic leukemoid reaction
Q2) A 45-year-old female who returned from a trip abroad had nausea and diarrhea,and then later,muscle aches,fever,and chills.She was admitted to a local hospital and was diagnosed with the parasitic disease,trichinosis.Which of the following is most consistent with this disease?
A)Eosinophilia
B)Basophilia
C)Basopenia
D)Monocytosis
Q3) Define leukoerythroblastosis,and name a condition in which this is seen.
Q4) What causes sea-blue histiocytosis,and how is the sea-blue histiocyte identified?
Page 23
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Chapter 22: Nonmalignant Lymphocyte Disorders
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Q1) Name five hematologic findings associated with HIV infections other than lymphocytopenia.
Q2) Which of the following is used as a screening test for infectious mononucleosis?
A)Heterophile antibody test
B)EBV IgG and IgM tests
C)HBsAg
D)ANA IFA
Q3) A 42-year-old HIV-positive patient recently was diagnosed with disseminated histoplasmosis.Which of the following should be ordered to monitor this patient's progression?
A)HIV antibody screen
B)HBsAg
C)CBC
D)CD4:CD8 ratio
Q4) The Epstein-Barr virus targets B cells that express _______.Once infected,they cause expression of the_______ marker.
A)CD21;CD23
B)CD23;CD21
C)CD22;CD23
D)CD34;CD19
24
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Chapter 23: Introduction to Hematopoietic Neoplasms
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Q1) Name the two main classification systems that identify MDS and acute leukemia.Indicate how they are different.
Q2) Which of the following does the World Health Organization use to classify hematopoietic neoplasms?
A)Lineage morphology
B)Clinical presentation
C)HIV status
D)DNA profiling
Q3) The HSC and the cancer stem cell are similar in:
A)Morphology
B)CD markers
C)Cytochemical staining
D)Replicating potential
Q4) A gene involved in regulating the growth of myeloid cells is hypermethylated,resulting in a block in transcription.This is an example of malignancy as a result of:
A)Post-translational modification
B)DNA mutation
C)Epigenetic change
D)Genomic instability
25
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Chapter 24: Myeloproliferative Neoplasms
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Q1) The myeloproliferative disorder best described by increased leukocytes,immature granulocytes,and decreased LAP with the Philadelphia chromosome present is which of the following?
A)CIMF
B)CML
C)PV
D)ET
Q2) Which of the following test results is most consistent with a diagnosis of PMF?
A)>30% blasts in the peripheral blood
B)High WBC count
C)Dacryocytes in the peripheral blood
D)High PLT count
Q3) Which of the following tests would help differentiate ET from other causes of thrombocytosis?
A)Coagulation screening
B)Platelet function
C)Liver enzymes
D)D-dimer
Q4) Contrast MDS and MPN utilizing laboratory test result information.
Q5) Explain how a variant of CML is identified utilizing laboratory values.
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Chapter 25: Myelodysplastic Syndromes
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Q1) An unknown cell possesses the following characteristics: blastlike with open chromatin pattern,prominent nucleoli,absence of granules,and a high N:C ratio.Based on this information,what is the cell's most probable identity?
A)Agranular blast
B)Granular blast
C)Dysplastic promyelocyte
D)Promyelocyte
Q2) Which of the following characteristics are associated with a poor prognosis for MDS?
A)25% bone marrow blasts
B)Normal karyotypes
C)No cytopenias
D)<5% marrow blasts
Q3) MDS associated with isolated del(5q)frequently shows dysplasia in which cell lineage?
A)Erythroid
B)Myeloid
C)Megakaryocytic
D)Monocytes
Q4) Explain the relationship between myelodysplastic syndromes and acute leukemia.
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Chapter 26: Acute Myeloid Leukemias
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Q1) A laboratory professsional reviewed the CBC of a patient who had a WBC count of 5 × 103/ L with 32% blasts present.Follow up testing with cytogenetics revealed t(15;17) ( q22;q12).Which of the following is a likely diagnosis for the patient?
A)APL
B)MDS
C)MPN
D)CLL
Q2) Which of the following differentiates an AL and an MPN?
A)The cells in an MPN are dysplastic,but morphology is normal in an AL.
B)Patients present with leukocytosis and mostly mature cells in AL,whereas blasts predominate in MPNs.
C)MPNs are defined by a bone marrow blast count of at least 20%.
D)A defining characteristic of ALs is that the cell of origin acquires the ability to proliferate continuously and demonstrates arrested development.
Q3) Explain how bone marrow analysis helps establish an AML diagnosis.
Q4) Why are Auer rods seen only in myeloblasts?
Q5) What is the definition of acute leukemia,according to the World Health Organization?
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Chapter 27: Precursor Lymphoid Neoplasms
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Q1) A 5-year-old patient has been diagnosed with Pre-B-cell ALL.Routine cytogenetic analysis confirms the presence of the Philadelphia chromosome.What does this mean for the patient?
A)The patient is in remission.
B)The patient has relapsed.
C)The patient has a poor prognosis.
D)More aggressive treatment is needed.
Q2) Cytogenetic analysis confirms the presence of t(1;14).This verifies which of the following types of ALL?
A)Precursor B-cell ALL
B)Precursor T-cell ALL
C)PV
D)AML
Q3) Which leukemia reveals the laboratory findings of TdT+,CD7+,and CD3+?
A)Precursor T-cell leukemia
B)Precursor B-cell leukemia
C)Acute lymphoblastic leukemia-Burkitt-type
D)Acute undifferentiated leukemia
Q4) Contrast the clinical and laboratory findings of ALL to LBL.
Q5) Define the phases and purposes of chemotherapy for ALL.
Page 29
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Chapter 28: Mature Lymphoid Neoplasms
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Q1) Explain how environmental factors contribute to the pathogenesis of lymphoid neoplasms.
Q2) A bone marrow aspirate is performed for staging purposes on a patient with Hodgkin lymphoma.The results come back positive for infiltration by Reed Sternberg cells.This means that the patient is:
A)In the early stages of the disease.
B)In the late stages of the disease.
C)Converting to non-Hodgkin lymphoma.
D)Entering remission.
Q3) Which of the following agents promotes the development of non-Hodgkin lymphoma through mucosa-associated lymphoid tissue (MALT)infiltration?
A)BCL-2 translocation
B)Helicobacter pylori
C)Epstein-Barr virus
D)Ataxia telangiectasia
Q4) List and describe the five stages of Hodgkin lymphoma,focusing on laboratory features.
Q5) Explain the major differences between Hodgkin and non-Hodgkin lymphomas.
Q6) Describe the WHO and Ann Arbor classification systems of lymphoid neoplasms.
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Chapter 29: Hematopoietic Stem Cell Transplantation
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Q1) The laboratory professional is not involved in which of following steps associated with SCT?
A)Compatibility testing
B)Pretransfusion testing
C)Apheresis
D)Transfusion of SCT product in patient
Q2) Which laboratory department is responsible for performing testing to verify short-term engraftment?
A)Hematology
B)Molecular/HLA
C)Microbiology
D)Immunology
Q3) An early complication of a stem cell transplant includes:
A)Hypogonadism
B)Development of secondary leukemia
C)Graft-versus-host disease
D)Neuropathies
Q4) Explain the graft-versus-leukemia process in stem cell transplantation.
Q5) Explain the significance of HLA and ABO antigen compatibility in stem cell transplantation.
31
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Chapter 30: Morphologic Analysis of Body Fluids in the
Hematology
Laboratory
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Q1) A laboratician is scanning a cytospin and notices a few solid-staining wrinkled bodies on the cytospin prep.What is the most likely identification of this?
A)Histoplasma infiltration
B)Cryptococcus infiltration
C)Candidiasis
D)Bacterial contamination
Q2) A 3-year-old boy is admitted with febrile seizures.A lumbar puncture is performed to rule out meningitis.The cytospin differential shows many large lymphoblasts with irregular nuclear membranes.This means that the patient:
A)Might be suffering from leukemia that is in the spinal column
B)Has febrile seizures because of a prevalent septicemia that has traveled to the spinal column
C)Has brain cancer that has metastasized from the lymphatic system.
D)Is normal.
Q3) How would the technologist differentiate between a traumatic specimen collection tap and a cerebral hemorrhage?
Provide at least three macroscopic and three microscopic findings.
Q4) What is the significance of micro-organisms present in the cytospin?
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Chapter 31: Primary Hemostasis
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Q1) Which function of the endothelial cell keeps cells and macromolecules in vessels and allows nutrient and gas exchange?
A)Blood-borne antigens processing
B)Tissue factor production
C)Nitric oxide production
D)Blood/tissue barrier
Q2) Formation of a blood clot on the interior surface of an intact (unsevered)vessel is referred to as:
A)Blood coagulation
B)Hemostasis
C)Thrombosis
D)Fibrinolysis
Q3) Beginning with the trauma,what is the sequence of events that leads to the formation of a clot (thrombus)? .
Q4) Correlate blood vessel histology to vessel type and function in hemostasis.
Q5) How does the vascular system contribute to hemostasis?
Q6) Describe megakaryocyte development and the role of endomitosis and thrombopoietin in this process.
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Chapter 32: Secondary Hemostasis and Fibrinolysis
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Q1) Which domain of the blood coagulation protein is responsible for its distinctive identity?
A)Signal peptide domain
B)Catalytic domain
C)Epidermal growth factor domain
D)Noncatalytic domain
Q2) Which of the following is not involved in "contact activation"?
A)Factor XII
B)Factor XI
C)PK
D)Factor X
Q3) Which of the following is responsible for urokinase-catalyzed plasminogen (PLG)activation?
A)ADAMTS-13
B)LRP
C)UPAR
D)EPCR
Q4) What are the roles of thrombin in coagulation?
Q5) Compare and contrast systemic and physiologic fibrinolysis.
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Chapter 33: Disorders of Primary Hemostasis
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Q1) A patient has a splitting headache shortly before getting her blood tested.She takes a couple of aspirin and is scheduled for platelet aggregation studies.What effect will this have on the platelet aggregation studies?
A)Platelets will show diminished activity with selected agonists.
B)Platelets will show normal activity with all agonists.
C)Platelets will show increased activity with selected agonists.
D)Platelets will show variable activity with all agonists.
Q2) A patient's peripheral blood smear reveals many giant platelets.All platelet function tests show normal aggregation with the exception of ristocetin.From what is the patient most likely suffering?
A)Glanzmann's thrombasthenia
B)Bernard-Soulier syndrome
C)Storage pool disease
D)Wiskott-Aldrich syndrome
Q3) Which of the following physical symptoms are associated with scurvy?
A)Hemangiomas
B)Ecchymoses
C)Bleeding into joints and muscles
D)Purpura fulminans
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Chapter 34: Disorders of Secondary Hemostasis
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Q1) Screening tests for the evaluation of VWD include the platelet count,APTT,PT,bleeding time,and/or PFA-100.Which of the following results would be evident in most cases of VWD?
A)Low platelet count
B)Decreased ristocetin platelet aggregation
C)Normal ristocetin platelet aggregation
D)Normal Ag assay
Q2) Which congenital deficiency(ies)is(are)suspected with a normal platelet count,an abnormal PT and APTT,and normal PFA-100 and thrombin time?
A)Factor VII
B)Factors X,V,II (prothrombin)
C)Factor VIII
D)Fibrinogen
Q3) A patient might be suffering from a coagulopathy.Which of the following physical manifestations would suggest a primary hemostatic pathway problem?
A)Hematomas
B)Petechiae
C)Joint and muscle bleeding
D)Ecchymoses
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Chapter 35: Thrombophilia
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Q1) A patient has been diagnosed with a coagulopathy and has been given Coumadin as a mode of treatment.What screening test(s)should be performed to monitor this treatment,and what effect will this therapy have on the coagulation pathway?
A)APTT;initial decrease in the vitamin K-dependent factors of the intrinsic pathway
B)PT-INR;initial decrease in the vitamin K-dependent factors of the extrinsic pathway
C)PT-INR and APTT;initial decrease in the vitamin K-dependent factors of all pathways
D)PT-INR;initial decrease in all vitamin K-dependent serine proteases
Q2) Antithrombin and heparin cofactor II primarily inhibit which of the following factors?
A)FV,FVIII,and thrombin
B)FIXa,FXa,and thrombin
C)FXII and thrombin
D)Fibrinogen and thrombin
Q3) Explain why many patients with an inherited thrombophilia are misdiagnosed.
Q4) What are the physiological processes involved in hypercoagulability?
Q5) Why are clotting and molecular assays both needed for a diagnosis of APCR?
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Chapter 36: Hemostasis: Laboratory Testing and Instrumentation
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Q1) What preanalytical quality control procedures are necessary when performing platelet aggregation studies?
A)Assess patient medications before obtaining specimen
B)Obtain specimen after a 12-hour fast
C)Perform a bleeding time before testing
D)Collect the specimen in a glass tube
Q2) A citrated blood sample is tested with the following results: -PT = 60.0 seconds
-APTT = 100.0 seconds
Pending further testing,the most probable reason for these results is not:
A)Factor VIII deficiency
B)Factor V deficiency
C)Factor II deficiency
D)Fibrinogen deficiency
Q3) Which of the following is needed to perform an activated partial thromboplastin time?
A)Potassium chloride and partial thromboplastin reagent
B)Partial thromboplastin reagent and calcium chloride
C)Thromboplastin and potassium chloride
D)Thromboplastin and calcium chloride
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Chapter 37: Hematology Procedures
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Q1) A CBC is performed on a polycythemic patient.What must the laboratician do to ensure that this specimen has an optimal blood smear?
A)Increase the angle of the spreader slide
B)Decrease the angle of the spreader slide
C)Not change the angle of the spreader slide
D)Stain with albumin
Q2) A technologist is performing differentials and notices that all the slides he has reviewed appear pink.What is the best way to correct this problem?
A)Change the buffer so that it is more acidic
B)Change the buffer so that it is more alkaline
C)Clean the slides and make a new smear
D)Filter the stain used
Q3) The 18-gauge needles used to collect donor blood for transfusion have a larger bore than do standard blood collection needles.What is the advantage of this needle?
A)The needle minimizes discomfort to the donor.
B)The needle allows for tube holder and vacutainer use.
C)The phlebotomist has better technique with a larger needle.
D)The collection process is faster,and less hemolysis occurs.
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Chapter 38: Bone Marrow Examination
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Sample Questions
Q1) What is the difference between a malignant lymphoid aggregate and a benign one?
A)Benign aggregates are well defined,whereas malignant aggregates are ill-defined.
B)Malignant aggregates are composed of single polymorphic cells,whereas benign aggregates are composed of multiple monomorphic cells.
C)Benign aggregates are clonal,whereas malignant aggregates are polyclonal.
D)Malignant aggregates have a normal phenotype,whereas benign have an aberrant phenotype.
Q2) A normal M:E ratio is about 3:1.A patient has three times more myeloid precursors than erythroid precursors in the bone marrow because:
A)The body needs more cells to fight infection than to transport oxygen.
B)The life cycle of a WBC is much longer than that of an RBC.
C)WBCs undergo more steps in hematopoiesis than do RBCs.
D)The life cycle of a WBC is much shorter than that of an RBC.
Q3) What are the main reasons for using a core biopsy specimen versus an aspirate specimen?
Q4) Name five distinguishable characteristics that will help differentiate benign lymphoid aggregates and malignant lymphoma.
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Chapter 39: Automation in Hematology
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Q1) Which analyzer measures platelets in the same channel as reticulocytes?
A)Coulter Gen-S
B)Sysmex XE-2100
C)Advia 2120
D)Trinity Biotech AMAX Destiny Plus
Q2) The immunologic technique available on the AMAX Destiny Plus utilizes specific reagents with:
A)Soluble monoclonal antibody
B)Fluorescent-labeled microparticles
C)Enzyme-labeled monoclonal antibody
D)Monoclonal antibody-coated microparticles
Q3) When using the CELL-DYN Sapphire to perform CBCs,a laboratory professional can choose to run the ImmunoPlt assay if:
A)Leukocyte count is decreased.
B)Erythrocyte fragments are detected.
C)Nucleated erythrocytes are observed.
D)Erythrocyte count is increased.
Q4) What is the principle of impedance?
Name at least two instruments that employ this method for blood cell counting.
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Chapter 40: Flow Cytometry
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Q1) The DNA content of a patient's tumor cells is reported as 2.0,and the DNA content of diploid cells is 1.0.What is the DNA index?
A)2.0
B)3.0
C)1.0
D)0.5
Q2) Explain why flow cytometry is of limited use in identifying AML.
Q3) The following are accurate statements regarding fluorochromes except.
A)They excite at one wavelength and emit light at a different wavelength.
B)They can bind to DNA or RNA.
C)They can be used to label detection antibodies.
D)They contribute to the scattered light caused by a cell when it travels through the flowcell
Q4) In diagnosing PNH,which of the following assays is most sensitive to its detection?
A)GPI anchor phenotype
B)Ham test
C)Sucrose lysis test
D)Osmotic fragility test
Q5) For what reason is flow cytometry used in cell quantitation?
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Chapter 41: Chromosome Analysis of Hematopoietic and Lymphoid Disorders
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Q1) What is the composition of the nucleotides in the chromosome structure?
A)Phosphate and DNA
B)Ribose,deoxyribose,phosphate,and a base
C)Adenine,thymine,guanine,cytosine,and pyrimidine
D)Uracil and thymine
Q2) A 3-year-old girl is confirmed to have ALL by immunophenotyping.She is positive for the CALLA antigen.Cytogenetic analysis results indicate the presence of the Philadelphia chromosome.Which of the following applies to her?
A)A poor prognosis
B)A good prognosis
C)An atypical presentation
D)A tyrosine kinase inhibitor response.
Q3) Which of the following terms is used to describe a chromosomal aberration present in a human cell that is a multiple of n?
A)Trisomy
B)Aneuploid
C)Polyploidy
D)Diploid
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Chapter 42: Molecular Analysis of Hematologic Diseases
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Q1) A multiplex reaction that targets conserved regions within the variable (V),diversity (D),and joining (J)regions of the immunoglobulin heavy chain can be used to determine clonality in which neoplasm?
A)CML
B)AML
C)B-cell leukemia/lymphoma
D)Human T-lymphocytic virus type 1
Q2) Which of the following molecular techniques is useful in detecting the point mutations in a suspected hemoglobinopathy:
A)DNA amplification and sequencing
B)qPCR
C)High-resolution melt curve analysis
D)RT-PCR
Q3) Which molecular technique is useful in monitoring the amount of pathogen-specific nucleic acids in patients with an infectious disease?
A)ASO
B)FISH
C)DNA amplification and sequencing
D)qPCR
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