Chapter 14: Thalassemia
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Q1) Nucleated red blood cells in the peripheral blood are a common finding in beta thalassemia patients.Explain why.
Q2) When a diagnosis of thalassemia is suspected,which test should always be done?
A)Hemoglobin electrophoresis
B)Bone marrow aspiration
C)Iron studies
D)Vitamin B assay
Q3) Impaired beta chain production translates to what on hemoglobin electrophoresis?
A)An increase in Hb H
B)An increase in Hb A1
C)An increase in Hb F and Hb A
D)A decrease in Hb S
Q4) Choose the thalassemia with the best prognosis from the following choices.
A)Hgb H disease
B)Silent carrier alpha thalassemia
C)Beta thalassemia minor
D)Beta thalassemia intermedia
Q5) Why are thalassemias considered a separate entity from hemoglobinopathies?
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Chapter 15: Megaloblastic and Nonmegaloblastic
Macrocytic Anemias
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Q1) Patients with blind loop syndrome can have vitamin B deficiency complications resulting from:
A)Inadequate diet
B)Increased minimum daily requirements
C)Malabsorption
D)Biologic competition
Q2) What can falsely elevate the serum folate level?
A)Hemolysis of the serum sample
B)Recent low dietary intake
C)Vitamin B deficiency
D)Recent alcohol consumption
Q3) Pernicious anemia is a malabsorption of vitamin B from what component deficiency?
A)Gastric juice
B)Intrinsic factor
C)Histamine
D)Folate
Q4) Explain why peripheral neuropathy is a common finding in vitamin B deficiency.
Page 17
Q5) Explain how high alcohol intake can cause macrocytosis.
Q6) Explain how vitamin B deficiency can cause folate deficiency.
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Chapter 16: Hypoproliferative Anemias
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Q1) Chronic renal disease is a common cause of anemia.Which of the following is one of the possible causes of anemia in chronic renal disease?
A)Increased erythropoietin production
B)Increased erythrocyte survival
C)Blood loss
D)Iron production
Q2) Define constitutional aplastic anemia,and give an example.
Q3) What CBC parameter would help differentiate Fanconi's syndrome from Diamond-Blackfan anemia?
A)MCV
B)WBC and PLT counts
C)RBC counts
D)Differential
Q4) 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
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Chapter 17: Hemolytic Anemia: Membrane Defects
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Q1) A 5-year-old boy is admitted to the pediatric unit with a fractured tibia.Routine blood work is ordered.His PB smear shows moderate spherocytosis.An osmotic fragility is also ordered,and the test result indicates an increased osmotic fragility.Based on these findings,what is the most likely defect?
A)Hereditary elliptocytosis
B)Hereditary spherocytosis
C)Microangiopathic hemolytic anemia from trauma
D)Cold autoimmune hemolytic anemia
Q2) 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
Q3) Explain how a somatic mutation in the PIGA gene leads to PNH.
Q4) Explain why patients with HS typically have an MCHC >36%.
Q5) Explain why patients with HS sometimes suffer from gallstones.
Q6) Differentiate between the three different subtypes of HE based on PB smear morphology.
Page 20
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Chapter 18: Hemolytic Anemia: Enzyme Deficiencies
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Q1) What metabolic pathway catabolizes approximately 10% of the glucose essential for maintaining adequate concentrates of reduced glutathione?
A)Glycolytic pathway
B)Metabolic pathway
C)Hexose-monophosphate shunt
D)Nucleotide pathway
Q2) Bite cells are produced during:
A)Removal of Döhle bodies by macrophages
B)Passage of RBCs through fibrin strands
C)Removal of Holly-Jolly bodies by the spleen
D)Removal of Heinz bodies by macrophages
Q3) Which of the following is the most common RBC enzymopathy?
A)PK
B)HK
C)G6PD
D)GPI
Q4) Why are echinocytes seen in PK deficiency?
Q5) What is the purpose of the HMP shunt,and why is it important?
Q6) How do Heinz bodies differ morphologically from other erythrocyte inclusions?
Q7) Why are Heinz bodies seen in G6PD deficiency?
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Chapter 19: Hemolytic Anemia: Immune Anemias
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Q1) A sample demonstrates a DAT profile that is positive with polyspecific AHG,negative with anti-IgG,and positive with anti-C3.If the Donath-Landsteiner test was also positive,what should the clinical laboratory professional do?
A)Perform an elution and antibody panel
B)Confer with the supervisor regarding the possibility of PCH
C)Request a serum sample for antibody screen
D)Perform a cold agglutinin test
Q2) The absence of spherocytes on the peripheral blood smear in a case of suspected HDFN usually indicates that which of the following is the most likely cause of the condition?
A)ABO HDFN
B)Splenic hypertrophy
C)Rh HDFN
D)HDFN from other blood group antibodies
Q3) Which of the following conditions is not paired with the correct autoantibody?
A)Infectious mononucleosis / autoanti-i
B)WAIHA / autoanti-K
C)CAD / autoanti-I
D)PCH / autoanti-P
Q4) Compare the three mechanisms of drug-induced immune hemolysis.
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Chapter 20: Hemolytic Anemia: Nonimmune Defects
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Q1) Which of the following is found to be a factor in TTP?
A)Escherichia coli O157:H7
B)Shigella species
C)S.pneumoniae
D)Shigella dysenteriae serotype I
Q2) A runner is in training for the Chicago Marathon.After his most recent 26 mile run,he notices that his urine was reddish-brown.The next morning,his urine is clear and yellow,but he decided to see his primary care physician.All of the hematology and chemistry results are within the reference range.What is the most likely reason for this scenario?
A)Initial dark color was caused by dehydration.
B)This is exercise-induced hemoglobinuria.
C)Uric acid crystals were precipitated in the initial urine.
D)There is insufficient information to determine the reason.
Q3) Which of the following analytes would be increased in MAHA?
A)BUN
B)Haptoglobin
C)Creatinine
D)Bilirubin
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Chapter 21: Nonmalignant Disorders of Leukocytes:
Granulocytes and Monocytes
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Q1) A laboratician is scanning a blood smear and notices that many of the neutrophils have more than six lobes.Which of the following would be consistent with that finding?
A)A decreased vitamin B level
B)An increased serum iron level
C)A positive DAT result
D)Decreased serum iron
Q2) Which of the following anomalies is morphologically similar to toxic granulation and is often seen in patients who have poor mucopolysaccharide degradation?
A)May-Hegglin
B)Pelger-Huët
C)Chédiak-Higashi
D)Alder-Reilly
Q3) Which of the following characteristics is associated with the neutrophilia that accompanies bacterial infection?
A)Left shift
B)Toxic granulation
C)Döhle body
D)All of the above
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Chapter 22: Nonmalignant Lymphocyte Disorders
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Q1) Which of the following infectious agents that can be transmitted from mother to a growing fetus can result in physically and mentally impaired development?
A)Bordetella pertussis
B)Toxoplasma gondii
C)Coxsackievirus A
D)Clostridium botulinum
Q2) Bordetella pertussis and chronic lymphocytic leukemia have increased small lymphocytes with condensed nuclear chromatin on the blood smear.What laboratory test could distinguish whooping cough from CLL?
A)Heterophile testing
B)Biopsy of lymph nodes
C)Molecular testing
D)Culture and serological antibody testing
Q3) All of the following are expected findings of AIDS except:
A)Lymphocytopenia.
B)Leukocytopenia.
C)Anemia.
D)Thrombocytosis.
Q4) Compare and contrast X-linked SCID and autosomal SCID.
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Chapter 23: Introduction to Hematopoietic Neoplasms
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Q1) The HSC and the cancer stem cell are similar in:
A)Morphology
B)CD markers
C)Cytochemical staining
D)Replicating potential
Q2) What is the difference between the HSC and the cancer stem cell?
Q3) 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
Q4) Which of the following laboratory analyses can be used to diagnose hematopoietic neoplasms?
A)Cell morphology
B)Immunophenotyping
C)Cytogenetics
D)All of the above
Q5) Explain how proto-oncogenes contribute to tumor formation.
26
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Chapter 24: Myeloproliferative Neoplasms
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Q1) 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
Q2) Which of the following myeloproliferative disorders is characterized by an elevated white count and a markedly elevated platelet count?
A)CML
B)ET
C)PV
D)CIMF
Q3) What cell appears to be the primary site for the defect in MPN?
A)HSC
B)GMP
C)Myeloblast
D)CFU-MK
Q4) Explain the significance of the Philadelphia chromosome in ALL.
Q5) Contrast primary polycythemia and secondary polycythemia based on pathophysiology.
27
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Chapter 25: Myelodysplastic Syndromes
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Q1) Which of the following represents the granule pattern of a dysplastic cell in MDS?
A)Agranular
B)Hypogranular
C)Clumped granular
D)All of the above
Q2) Explain the International Prognostic Scoring System (IPSS)score system for prognosis and treatment of MDS.
Q3) Explain the relationship between myelodysplastic syndromes and acute leukemia.
Q4) A patient blood smear shows oval macrocytes,a dimorphic population,and basophilic stippling.The peripheral blood also has 6% blasts .What is the presumptive classification based on these findings?
A)Refractory anemia
B)Refractory anemia with ringed sideroblasts
C)Refractory anemia with excess blasts -1
D)Refractory anemia with excess blasts -2
Q5) Give at least five morphologic indicators of dyserythropoiesis.
Q6) Explain the pathophysiology of MDS.
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Chapter 26: Acute Myeloid Leukemias
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Q1) A PAS stain is ordered on a leukemic patient.The test is performed,and the technologist confirms that the PAS stain is positive with coarse granularity.Based on these findings,from what is the patient most likely suffering?
A)Acute myelomonocytic leukemia
B)Acute erythroleukemia
C)Acute megakaryoblastic leukemia
D)AML with minimal differentiation
Q2) A bone marrow review on a 15-year-old girl with acute leukemia revealed many blasts with the following characteristics: high N:C ratio,prominent nucleoli,open chromatin pattern,and basophilic cytoplasm.Cytochemical staining revealed negative reactivity with MPO and SBB.Nonspecific esterase was positive.No cytogenetic abnormalities were detected.What is the most likely lineage of the blast cells in question?
A)Myeloid
B)Lymphoid
C)Monocytic
D)Erythroid
Q3) Why are Auer rods seen only in myeloblasts?
Q4) 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) Which of the following is a classic morphologic finding in the peripheral blood in ALL?
A)Increased WBC and platelets with increased lymphoblasts
B)Lymphoblasts,decreased platelets,and decreased neutrophils
C)Lymphoblasts,increased platelets,and increased neutrophils
D)Increased WBC,platelets,and neutrophils
Q2) Define the phases and purposes of chemotherapy for ALL.
Q3) Which of the following sets of markers would be useful for follow-up testing to differentiate B-cell ALL from T-cell ALL?
A)CD2,CD3,CD4,CD19,and CD22
B)HLA-DR,TdT,and CD10
C)CD34,Ig gene rearrangement,and CD22
D)cIg,HLA-DR,and TdT
Q4) Summarize and explain why patients develop the clinical signs and symptoms oberserved in patients with ALL.
Q5) Contrast the clinical and laboratory findings of ALL to LBL.
Q6) Define acute undifferentiated leukemia and explain why it is difficult to identify.
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Chapter 28: Mature Lymphoid Neoplasms
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Q1) 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
Q2) Identify the lab features of the following disorders:
a.Plasmacytoma
b.Multiple myeloma
c.MGUS
d.Waldenström's macroglobulinemia
Q3) Hairy cell leukemia and chronic lymphocytic leukemia appear morphologically similar to the untrained eye.Which of the following tests would help differentiate the two?
A)Immunophenotyping
B)Cytogenetic analysis
C)TRAP stain
D)PAS staining
Q4) Describe the WHO and Ann Arbor classification systems of lymphoid neoplasms.
Q5) Explain how ALL and Burkitt-type ALL are different morphologically.
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Chapter 29: Hematopoietic Stem Cell Transplantation
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Q1) Which of the following is correct regarding allogeneic stem cell transplant and ABO antigens?
A)ABO antigens do not need to be matched.
B)ABO antigens are strongly expressed on stem cells.
C)The O group patient should not receive stem cells from A or B blood group donors.
D)ABO antigens should always be matched between donor and recipient.
Q2) Which of the following determines the number of stem cells needed for a transplant procedure?
A)Patient diagnosis
B)Patient age
C)Patient sex
D)Patient weight
Q3) What is the single most important factor considered in donor selection for an allogeneic transplant?
A)HLA compatibility with the patient
B)ABO compatibility with the patient
C)CMV status of the donor
D)HLA and ABO compatibility with the recipient
Q4) Explain the graft-versus-leukemia process in stem cell transplantation.
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Chapter 30: Morphologic Analysis of Body Fluids in the
Hematology
Laboratory
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Q1) Which of the following is responsible for producing cerebrospinal fluid?
A)Arachnoid cells
B)Choroid plexus cells
C)Pia mater
D)Ventricles
Q2) Explain how the following are formed:
a.Transudate
b.Exudate
c.Chylous fluid
Q3) Necrotic PMNs in a cytospin can be easily mistaken for which of the following?
A)Nucleated RBCs
B)Hairy cells
C)Leukemic blasts
D)Hypersegmented PMNs
Q4) 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
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Chapter 31: Primary Hemostasis
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Q1) Transient cessation of blood loss is achieved through which of the following?
A)Formation of secondary hemostatic plug
B)Fibrinolysis of established thrombus
C)Formation of primary platelet plug
D)Inhibition of thrombus formation
Q2) Secondary hemostasis involves which of the following events to further hemostasis?
A)Generation of fibrin
B)Blood remains a liquid
C)Fibrinolysis occurs
D)Inhibition of platelet release reaction
Q3) What is the first step in coagulation that occurs after vascular trauma?
A)Vasoconstriction at the site of injury
B)Platelet adhesion to collagen
C)Platelet activation and shape change
D)Platelet aggregation to more platelets
Q4) Beginning with the trauma,what is the sequence of events that leads to the formation of a clot (thrombus)?
.
Q5) Explain the biochemistry involved in platelet function.
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Chapter 32: Secondary Hemostasis and Fibrinolysis
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Q1) Which of the following is responsible for cleaving ultra-large VWF multimers into functional units?
A)LRP
B)ADAMTS-13
C)EPCR
D)UPAR
Q2) Which of the following coagulation factors is(are)found in the extrinsic pathway?
A)HK and FXII
B)FXI and FIX
C)FVII and TF
D)FX
Q3) What reflex test should be done on a patient with an abnormal APTT who is suspected of having hemophilia?
A)Platelet function assay
B)Factor assay
C)Quantitative fibrinogen assay
D)Assay for D-dimer
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) Which of the following characteristics of chronic ITP differentiates it from acute ITP?
A)Platelet count of < 20 × 10 /L
B)Gender predilection in females of 3:1
C)Duration of 2-6 weeks
D)Lymphocytosis
Q2) What is a common etiology of ITP in children?
A)Tooth extraction
B)Easy bruising syndrome
C)Vasculitis
D)Chickenpox
Q3) Thrombocytosis is associated with which of the following?
A)Acute leukemia
B)ITP
C)HUS
D)Myeloproliferative disorder
Q4) How do hematologic disorders contribute to the pathogenesis of thrombocytopenia?
Q5) What laboratory tests are used to assess disorders of primary hemostasis and secondary hemostasis?
Q6) Give at least five markers of differentiation between acute and chronic ITP.
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Chapter 34: Disorders of Secondary Hemostasis
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Q1) Which of the following clinical symptoms correlates with a severe form of hemophilia A or B?
A)Bleeding at circumcision with a factor level of 1-5 U/dL
B)Excessive bleeding after surgery or trauma with a factor level of 6-30 U/dL
C)Frequent spontaneous hemarthroses
D)Infrequent spontaneous joint and tissue bleeds
Q2) How does von Willebrand's disease (VWD)differ from Bernard-Soulier syndrome?
Correlate the pathophysiology of both disorders in your response.Name at least two laboratory tests that differentiate each.
Q3) A patient with a protein C deficiency is at risk for developing which of the following?
A)Thrombosis
B)Hemorrhage
C)Lupus anticoagulant inhibitor
D)Factor deficiency
Q4) What type of VWD is the only type to have a decreased platelet count?
A)Type 1
B)Type 3
C)Type 2B
D)Type 2N
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Chapter 35: Thrombophilia
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Q1) How does the INR standardize the prothrombin time?
Q2) How do red thrombi differ from white thrombi?
A)Their location
B)Their composition
C)Their location and composition
D)Their degree of severity
Q3) 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
Q4) Why does a patient who had a thrombotic incident receive both heparin and Coumadin for 4-5 days before heparin is discontinued?
A)Heparin is not effective as an anticoagulant without Coumadin.
B)Coumadin requires heparin for its full anticoagulant effect.
C)Coumadin and heparin have a synergistic effect
D)Coumadin 's full effect is not achieved for 4- days after initiation because of the half-life of the vitamin K coagulation factors.
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Chapter 36: Hemostasis: Laboratory Testing and Instrumentation
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Q1) 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
Q2) Interpret the following results. -PT = 32 sec
-APTT = 92 sec
-TT = 20 sec.
What is the most likely reason for these aberrant results?
A)The patient is in DIC.
B)There is heparin contamination of the sample.
C)The patient is taking Coumadin.
D)The patient has liver disease.
Q3) A patient has severe liver disease.What test results would you expect?
A)Prolonged PT,TT,increased FDP
B)Prolonged APTT and normal TT
C)Decreased fibrinogen and Normal TT
D)Prolonged bleeding time and Normal APTT
Page 39
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Chapter 37: Hematology Procedures
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Q1) The acid elution test for hemoglobin F was performed on a patient sample,and examination of the slide revealed an uneven distribution of hemoglobin F within the erythrocytes.Control slides were acceptable.Which of the following is associated with this observation?
A)Iron deficiency anemia
B)Sickle cell anemia
C)Pernicious anemia
D)Hereditary persistence of fetal hemoglobin
Q2) Two incubation sessions are needed in the Donath-Landsteiner test to detect:
A)The biphasic thermal reactivity of the offensive antibody
B)Complement binding in vivo
C)The antibody's specificity to the P antigen in vitro
D)The antibody's specificity to group O cells
Q3) All of the following are needed on a phlebotomist's supply tray to perform a venipuncture except:
A)Needles
B)Tourniquets
C)Gauze
D)Lancets
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Chapter 38: Bone Marrow Examination
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Q1) Which of the following is not typically found on a bone marrow report?
A)Patient's insurance information
B)Patient's biographical data
C)Patient's clinical diagnosis
D)Relevant therapeutic information
Q2) The primary location for bone marrow collection depends on which two factors?
A)Age and patient condition
B)Change in sites of hematopoiesis and cellularity
C)The M:E ratio and medical history
D)Age and medical history
Q3) The cellularity of the bone marrow is determined by examining the ratio of:
A)Stromal cells to hematopoietic cells
B)Hematogones to hematopoietic cells
C)Adipose tissue to hematopoietic cells
D)Hematopoietic cells to non-hematopoietic cells
Q4) The role of the hematology technologist in bone marrow evaluation is to:
A)Perform the bone marrow aspirate procedure
B)Administer anesthetic in preparation of the procedure
C)Make bone marrow smears after collection
D)Report the results of the bone marrow examination to the attending physician
Page 41
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Chapter 39: Automation in Hematology
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Q1) Which instrument does not use fluorescence intensity in its determination of reticulocytes?
A)LH 750
B)XE-2100
C)ADVIA 120
D)CELL-DYN Sapphire
Q2) Which technologies are used to generate the LH 750's WBC scatterplot?
A)Impedance,light scatter,and conductivity
B)Fluorescence intensity and radio frequency
C)Absorbance and conductivity
D)Light scatter,absorbance,and radio frequency
Q3) Which of the following represents the degree of light scatter that reflects cell complexity on the CELL-DYN Sapphire?
A)0 degrees
B)7 degrees
C)90 degrees
D)90 degrees depolarized
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 41: Chromosome Analysis of Hematopoietic and Lymphoid Disorders
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Q1) Which of the following structural aberrations results in loss of an entire chromosomal arm?
A)Inversion
B)Deletion
C)Isochromosome
D)Translocation
Q2) FISH is a molecular technique that can provide important clinical information that conventional cytogenetic analysis might not be able to provide.In CML,what can FISH identify that conventional cytogenetics cannot?
A)Cryptic translocations
B)Nondisjunction
C)Constitutional aberration
D)Acquired aberration
Q3) The presence of a chimerism after a bone marrow transplant indicates:
A)A rejected transplant
B)A partial engraftment
C)A complete engraftment
D)A successful transplant
Q4) A cytogenetic analysis is performed,and the result is inv (7) ( q21q32).Name the structural aberration,and explain how it was formed.
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Chapter 42: Molecular Analysis of Hematologic Diseases
Available Study Resources on Quizplus for this Chatper
18 Verified Questions
18 Flashcards
Source URL: https://quizplus.com/quiz/36508
Sample Questions
Q1) Which of the following assays would be most appropriate for monitoring minimal residual disease?
A)Karyotyping
B)Southern blot analysis
C)qPCR Correct
Q2) Explain why molecular testing is essential not only in identifying disorders,such as cancer,but also during the course of a disease.
Q3) Which of the following is associated with chronic myelogenous leukemia?
A)BCR/ABL1 fusion gene
B)t(15;17)
C)t(8,14)
D)PML/RARA fusion gene
Q4) Minimal residual disease testing is a molecular application for which hematopathology?
A)Leukemia/lymphoma
B)Sickle cell disease
C)Cancer
D)Gene mutations
Q5) Explain the impact of a positive test for HTLV-1 in a lymphoma patient.
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