Clinical Hematology Practice Exam
Course Introduction
Clinical Hematology focuses on the study and clinical application of knowledge related to blood, blood-forming tissues, and blood disorders. This course examines the principles of hematopoiesis, the pathology of anemias, leukemias, lymphomas, bleeding and clotting disorders, and other hematologic conditions. Students will learn diagnostic techniques such as blood smear analysis, bone marrow examination, and interpretation of laboratory findings. The course also explores therapeutic interventions, transfusion medicine, and the monitoring of patients undergoing treatment for hematological diseases, integrating both theoretical knowledge and practical laboratory skills to prepare students for clinical practice.
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 Verified Questions
20 Flashcards
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Sample Questions
Q1) Label the parts of the microscope.
Answer: 1. Objectives2. Stage3. Eye piece4. Base5. Light source6. Iris diaphragm7. Course adjustment knob8. Fine adjustment knob9. Stage adjustment knobs10. Clips11. Substage condenser 11ea8f8c_a35f_cfdc_b491_39c0cc95f0f6_TB3286_00
Q2) Which of the following is not considered a postanalytic variable?
A) Delta checks
B) Proper anticoagulant used
C) Specimen checked for clots
D) Critical results called
Answer: B
Q3) Control materials are:
A) Analyzed concurrently with the unknown samples
B) Substances with a known amount of analyte
C) Used to calibrate the method
D) All of the above
Answer: A
Q4) Standard deviation is a measurement of precision.
A)True
B)False
Answer: True
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Chapter 2: From Hematopoiesis to the Complete Blood Count
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20 Flashcards
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Sample Questions
Q1) 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
Q2) T cells are responsible for humoral immunity.
A)True
B)False
Answer: False
Q3) Opsonizing antibodies produced by the spleen serve to:
A) Strip the capsule from bacterial pathogens
B) Recycle erythrocyte byproducts
C) Aid in extramedullary hematopoiesis
D) Fight viral infection
Answer: A
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Page 4
Chapter 3: Red Blood Cell Production, Function, and
Relevant Red Blood Cell Morphology
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) Most hypochromic cells will have an MCHC that is:
A) Greater than 36%
B) Less than 30%
C) Greater than 27%
D) Less than 27%
Answer: B
Q2) The anucleate mature red blood cell has no ability to produce protein.
A)True
B)False
Answer: True
Q3) Reversible sickled cells are described as having a:
A) Crescent shape with one pointed projection
B) Crescent shape with two pointed projections
C) Half-moon shape with rounded ends
D) Half-moon shape with pointed projection
Answer: C
Q4) The higher the N:C ratio, the more mature the cell.
A)True
B)False
Answer: False
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Chapter 4: Hemoglobin Function and Principles of Hemolysis
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Sample Questions
Q1) ____may be seen in intravascular hemolysis but not in extravascular hemolysis.
A) Hemoglobinuria
B) Splenomegaly
C) Increased LDH
D) Elevated serum bilirubin
Q2) The hemoglobin molecule will either hold onto or release oxygen depending on the:
A) Amount of alpha or beta chains
B) Relationship between the pulmonary and venous circulations
C) Viscosity of the blood
D) M:E ratio
Q3) Physiologic conditions in the body that can decrease hemoglobin's oxygen affinity include:
A) Increased pH
B) Decreased 2,3-DPG
C) Increased body temp
D) The presence of abnormal hemoglobins
Q4) 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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26 Verified Questions
26 Flashcards
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Sample Questions
Q1) In patients with iron overload, Desferal may be administered to chelate the excess iron.The chelated iron is shed in:
A) The feces
B) The urine
C) Gastric secretions
D) None of the above
Q2) Hemoglobin H disease is associated with:
A) Bart's hydrops fetalis
B) Alpha thalassemia disease
C) Thalassemia major
D) Hereditary hemochromatosis
Q3) Which type of inclusion is likely to be seen in the above patient?
A) Howell-Jolly bodies
B) Pappenheimer bodies
C) Hemoglobin H inclusion bodies
D) Cabot rings
Q4) In regards to the thalassemias, the deficit has nothing to do with iron.
A)True
B)False
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Chapter 6: The Macrocytic Anemias
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17 Flashcards
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Sample Questions
Q1) The Schilling test continues to be an historic reference method for the determination of:
A) IDA
B) Pernicious anemia
C) Folic acid deficiency
D) Hereditary hemochromatosis
Q2) A key substance required for the incorporation of vitamin B<sub>12</sub> in red cell nuclear synthesis is the presence of:
A) EPO
B) Transferrin
C) Intrinsic factor
D) Cytokines
Q3) Which of the following morphological features is classic in the megaloblastic anemias?
A) Polychromasia
B) Macroovalocytes
C) Basophilic stippling
D) Hypochromia
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8
Chapter 7: Normochromic Anemias: Biochemical,
Membrane, and Miscellaneous Red Blood Cell Disorders
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Sample Questions
Q1) The inability of the red blood cell to generate ATP for membrane function is most closely associated with:
A) Pyruvate kinase deficiency
B) G6PD deficiency
C) Fanconi's anemia
D) Congenital hemolytic anemia
Q2) The cells circled below show an eccentric "puddling" of their hemoglobin contents.This is most closely associated with:
A) Stomatocytosis
B) Xerocytosis
C) G6PD deficiency
D) Pyruvate kinase deficiency
Q3) The cell pictured at the tip of the pointer is known as a (an):
A) Sickle cell
B) Acanthocyte
C) Bite cell
D) Stomatocyte
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Page 9
Chapter 8: The Normochromic Anemias Caused by
Hemoglobinopathies
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Sample Questions
Q1) Painful swelling of hands and feet caused by sickle cells in the microcirculation of sickle cells infants is termed:
A) Dactylitis
B) Necrosis
C) Apoptosis
D) Fibrosis
Q2) is the second most common hemoglobin variant worldwide.
A) Hemoglobin S
B) Hemoglobin E
C) Hemoglobin C
D) Hemoglobin D
Q3) The hemoglobin that cannot be separated from Hgb S through electrophoresis in buffer at pH 8.6 is:
A) Hgb D
B) Hgb C
C) Hgb A
D) Hgb F
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Page 10
Chapter 9: Leukopoiesis and Leukopoietic Function
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Sample Questions
Q1) One of the primary glands responsible for lymphocyte origination in the infant is the:
A) Thymus gland
B) Adrenal gland
C) Thyroid gland
D) Pituitary gland
Q2) An adult has a total white count of 4.0 \(\times\) 10<sup>9</sup>/L.The differential count is as follows:
Segmented neutrophils 25%
Lymphocytes 65%
Bands 5%
Monocytes 5%
If the normal values for absolute lymphocyte count are 1.2 to 3.4 \(\times\) 10<sup>9</sup>/L, which of the following is true?
A) The absolute number of lymphocytes is low.
B) There is an absolute lymphocytosis.
C) There is a relative lymphocytosis.
D) There is an absolute and a relative lymphocytosis.
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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) In which white cell disorder will you see gray-green cytoplasmic granules in the neutrophils?
A) May-Hegglin anomaly
B) Alder's anomaly
C) Pelger-Huët anomaly
D) Chediak-Higashi syndrome
Q2) 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
Q3) The normal ratio of CD4 to CD8 lymphocytes is:
A) 1:2
B) 1:1
C) 2:1
D) 4:1
Q4) Infectious mononucleosis is caused by the EBV virus, which infects B lymphocytes.
A)True
B)False
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Chapter 11: Acute Leukemias
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25 Flashcards
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Sample Questions
Q1) According to current WHO classification criteria, acute leukemia is characterized by which of the following?
A) Hypercellular bone marrow with greater than 20% blasts
B) Hypercellular bone marrow with less than 20% blasts
C) Hypocellular bone marrow with greater than 20% blasts
D) Hypocellular bone marrow with less than 20% blasts
Q2) The monoclonal marker that is often positive in T-ALL is:
A) CD1
B) CD7
C) CD10
D) CD41
Q3) The L3 classification of leukemia is defined by:
A) Small homogeneous blasts
B) Large vacuolated blasts
C) Large heterogeneous blasts
D) Predominance of prolymphocytes
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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) 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
Q3) The red cell morphology associated with IMF is:
A) Burr cells
B) Acanthocytes
C) Teardrop cells
D) Target cells
Q4) Pancytosis is a prominent feature of which of the following disorders?
A) Chronic myelocytic leukemia
B) Idiopathic myelofibrosis
C) Polycythemia vera
D) Essential thrombocythemia
Page 14
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Chapter 13: Lymphoproliferative Disorders and Related
Plasma Cell Disorders
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Sample Questions
Q1) The protein electrophoresis pattern pictured above is most frequently associated with:
A) Hodgkin's lymphoma
B) Multiple myeloma
C) Thalassemia major
D) Essential thrombocytopenia
Q2) Russell bodies are associated with:
A) Multiple myeloma
B) Hodgkin's lymphoma
C) Non-Hodgkin's lymphoma
D) Waldenström's macroglobulinemia
Q3) Reed Sternberg cells are associated with:
A) Sézary syndrome
B) CLL
C) Hodgkin's lymphoma
D) Multiple myeloma
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Chapter 14: The Myelodysplastic Syndromes
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Sample Questions
Q1) The cell at the tip of the pointer is a:
A) Hairy cell
B) Basket cell
C) Degenerating lymphocyte
D) Giant platelet
Q2) The most common hematological malignancy in the adult population is:
A) Acute leukemia
B) Multiple myeloma
C) Myelodysplastic syndrome
D) Chronic leukemias
Q3) The bone marrow and peripheral smear of a patient with an MDS will show dysplastic changes in _over time.
A) white cells
B) red cells
C) platelets
D) All of the above
Q4) The FAB classification of the MDSs include CML.
A)True
B)False
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Chapter 15: Overview of Hemostasis and Platelet Physiology
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30 Flashcards
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Sample Questions
Q1) The anticoagulant known as heparin:
A) Inhibits PF3 activity
B) Inhibits thrombin activity
C) Degrades antithrombin activity
D) Chelates calcium
Q2) The vasoconstrictor substance released from the platelets at the site of injury is:
A) Thrombin
B) Thromboxane A<sub>2</sub>
C) Adenosine diphosphate
D) Prostacyclin
Q3) In the prothrombin test, the patient's citrated plasma is combined with:
A) Phospholipids
B) Thromboplastin only
C) Ca<sup>2+</sup> and actin
D) Ca<sup>2+</sup> and thromboplastin
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Chapter 16: Quantitative and Qualitative Platelet Disorders
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Sample Questions
Q1) A platelet release defect in which there is a severe lack of alpha granules in platelets is known as:
A) Bernard-Soulier syndrome
B) Chediak-Higashi syndrome
C) Glanzmann's thrombasthenia
D) Gray platelet syndrome
Q2) A decreased platelet count is most often anticipated when a patient demonstrates:
A) Rectal bleeding
B) Epistaxis
C) Genitourinary bleeding
D) Severe hemorrhage
Q3) The single best predictive assay for von Willebrand factor is:
A) Ristocetin co-factor activity
B) Bleeding time
C) aPTT
D) Platelet count
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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) Hemophilia B is best treated with:
A) A mixture of factors II, VII, IX, and X
B) Factor X concentrate
C) Factor VIII concentrate
D) Vitamin K
Q3) The following laboratory results have been obtained for a 40-year-old woman: PT = 20 seconds (reference range is 11 to 15 seconds), aPTT = 50 seconds (reference range is 22 to 40 seconds), and thrombin time = 18 seconds (reference range is 11 to 15 seconds).What factor deficiency is most likely?
A) Factor VII deficiency
B) Factor VIII deficiency
C) Factor X deficiency
D) Factor XIII deficiency
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19
Chapter 18: Fibrinogen, Thrombin, and the Fibrinolytic System
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Sample Questions
Q1) An excess of which of the following is indicative of the breakdown of fibrin products within the circulating blood?
A) D-dimers
B) Alpha-2-antiplasmin
C) Protein C
D) Plasmin
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 D-dimer test measures:
A) Fibrinogen deposition
B) Fibrinogen degradation
C) Fibrin degradation
D) Fibrin deposition
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Page 20
Chapter 19: Introduction to Thrombosis and Anticoagulant Therapy
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Sample Questions
Q1) The primary role of plasmin is:
A) Platelet aggregation
B) Fibrin breakdown
C) Prevention of thrombotic events
D) Coagulation inhibition
Q2) Primary hemostasis refers to the process by which:
A) The platelet plug is formed
B) A cross-linked fibrin clot is formed
C) Fibrin degradation products are generated
D) None of the above
Q3) Protein C is activated by which of the following?
A) Heparin cofactor II
B) Factor VIII a
C) Antithrombin
D) Protein S
Q4) Heparin-induced thrombocytopenia (HIT) usually:
A) Occurs as a result of protein C deficiency
B) Will show an increase in platelets
C) Occurs 5 to 14 days after heparin therapy
D) Occurs only in males
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