Hematology Mock Exam
Course Introduction
Hematology is the study of blood, blood-forming organs, and blood diseases. This course explores the physiology and pathophysiology of blood cells and plasma, including their production, function, and disorders. Students will examine topics such as erythrocyte and leukocyte abnormalities, anemia, coagulation pathways, hematologic malignancies, and transfusion medicine. In addition, the course covers laboratory techniques used in hematological diagnostics and the interpretation of clinical laboratory data to support patient diagnosis and care.
Recommended Textbook
Modern Blood Banking and Transfusion Practices 6th Edition by Denise M. Harmening
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27 Chapters
1413 Verified Questions 1413 Flashcards
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Chapter 1: Red Blood Cells and Platelet Preservation:
Historical Perspectives and Current Trends
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Sample Questions
Q1) A standing order of platelets was shipped to your facility by your supplier. It was inadvertently left in the corner of the department until discovered 36 hours later. What would the appropriate action be for the blood banker?
A) If the temperature in the box was 22 +/- 2°C and the platelet swirl seemed OK, it would be OK to accept the unit into inventory.
B) The platelets have fallen outside the supplier's quality assurance. The unit should be discarded because the pH has probably dropped too low and platelet activation has been compromised.
C) If the temperature was 1°C to 6°C and the platelet swirl seemed OK, it would be OK to accept the unit into inventory.
D) If the platelets appeared OK and passed the platelet swirl test after being placed on the agitator, they could be accepted into the inventory. Answer: B
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3
Chapter 2: Basic Genetics
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Sample Questions
Q1) Which of the following best describes the structure of human chromosomes?
A) Linear strands of DNA wound around histones
B) Linear strands of RNA wrapped around histones
C) Tertiary structure of DNA wound around histones
D) Quaternary structure of DNA wound around histones
Answer: A
Q2) How is RNA different from DNA?
A) RNA usually exists as one strand
B) Ribose is substituted for deoxyribose
C) RNA incorporates uracil
D) All of the above
Answer: D
Q3) Which of the following best describes classical genetics?
A) DNA alteration that is caused by a physical or chemical agent
B) Transmission of characteristics from parents to offspring
C) Possessing a pair of identical alleles
D) The synthesis of RNA from DNA requiring RNA polymerase
Answer: B
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4
Chapter 3: Fundamentals of Immunology
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Sample Questions
Q1) Opsonization is:
A) the coating of pathogens with factors that facilitate phagocytosis.
B) a major role of complement in immunity.
C) the binding of an opsonin, such as an antibody, to a receptor on the pathogen's cell membrane.
D) all of the above.
Answer: D
Q2) What cells are responsible for mounting a secondary response when exposure to the same antigen occurs?
A) Memory T/B cells
B) Neutrophils
C) Plasma cells
D) Myeloblasts
Answer: A
Q3) Which antibodies characteristically demonstrate a decreased avidity for antigen?
A) Rh
B) HTLA
C) Lewis
D) ABO
Answer: B
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Chapter 4: Concepts in Molecular Biology
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Sample Questions
Q1) In this procedure, PCR products are blotted in a nylon filter and hybridized with specific probes that allow the distinction of the different known alleles.
A) Sequence-specific PCR
B) Sequence-specific oligonucleotide probe
C) Sequence-specific RFLP
D) Allele-specific PCR
Q2) Risks for using retroviruses, adenoviruses, and lentiviruses as vectors in gene therapy include all of the following except:
A) the exogenous gene may cause disease if overexpressed or expressed in certain cell types.
B) contaminants may be introduced during vector manufacture.
C) antitumor responses by overexpression of cytokines may occur.
D) there is a potential for recombination of gene therapy vectors with human endogenous sequences.
Q3) Southern blotting techniques are mostly being replaced by ______________ .
A) Northern blotting techniques
B) Eastern blotting techniques
C) polymerase chain reaction-based methods
D) all of the above
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Page 6
Chapter 5: The Antiglobulin Test
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Sample Questions
Q1) If not labeled "gamma heavy chain-specific," monospecific anti-IgG may contain antibodies to:
A) immunoglobulin light chains.
B) alpha heavy chains.
C) mu heavy chains.
D) C3d.
Q2) How is polyclonal antiglobulin serum made?
A) Serum from one human is injected into another human, and an antibody is produced.
B) Human serum is injected into rabbits, and an immune response triggers the production of an antibody.
C) Murine serum is injected into rabbits, and an immune response triggers the production of an antibody.
D) Murine serum is injected into mice, and an immune response triggers the production of an antibody.
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Chapter 6: The Abo Blood Group System
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Sample Questions
Q1) What testing is available that will differentiate between a true B and an acquired B?
A) Anti-B lectin
B) Acidification of anti-B reagent
C) Secretor studies
D) All of the above
Q2) What percentage of the type-A population are A<sub>1</sub>?
A) 80%
B) 50%
C) 20%
D) 10%
Q3) Why is reverse grouping not performed on cord blood specimens?
A) Antigens are not present at birth.
B) Antibodies are generally not present at birth.
C) Antibody titer is too high.
D) Antigens are too weak.
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8
Chapter 7: The RH Blood Group System
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Sample Questions
Q1) Which of the following statements regarding anti-LW is true?
A) Anti-LW reacts poorly with cord cells.
B) Anti-LW reacts stronger with Rh-positive cells than with Rh-negative cells.
C) Rh-null individuals lack the LW gene.
D) The gene coding for LW is located on the same chromosome as the Rh genes.
Q2) What clinical manifestation may be associated with the Rh-null syndrome?
A) Reticulocytosis
B) Stomatocytosis
C) Low hemoglobin
D) All of the above
Q3) Anti-LW will react most strongly with:
A) adult Rh-positive RBCs.
B) Rh-negative RBCs.
C) Rh-null RBCs.
D) Rh-negative cord blood.
Q4) The antigen ceCF is known as:
A) Wrights antigen
B) Crawford antigen
C) D mosaic
D) V antigen
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Chapter 8: Blood Group Terminology and the Other Blood Groups
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Sample Questions
Q1) A patient who has a pathologic autoanti-I must be transfused with:
A) a leukocyte filter.
B) a cold pack.
C) a blood warmer
D) none of the above
Q2) Persons who phenotype as Fy(a-b-) are resistant to infection by which organism?
A) Plasmodium falciparum
B) Plasmodium vivax
C) Plasmodium ovale
D) Plasmodium malariae
Q3) All of the following characteristics regarding the Kell antigen are true except:
A) it is well-developed at birth.
B) it exhibits dosage.
C) it is destroyed by ficin treatment.
D) it is strongly immunogenic.
Q4) What sample requirement is essential for identification of a Kidd antibody?
A) Fresh whole blood
B) Fresh serum or plasma
C) Fasting sample
D) Sample on ice
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Chapter 9: Detection and Identification of Antibodies
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Sample Questions
Q1) Routine pre-transfusion testing consists of all of the following except:
A) ABO typing.
B) Rh typing.
C) an antibody screen.
D) a DAT.
Q2) Of the antibodies listed below, which does NOT fit with the others in terms of the optimal temperature of reactivity?
A) Anti-P1
B) Anti-I
C) Anti-A1
D) Anti-E
Q3) Which of the following statements concerning acid eluates is false?
A) Citric acid is an example of an acid eluate
B) The pH is reduced to 3 or less to disrupt the antigen-antibody complex
C) The pH of the eluate remains at 3 before testing against a panel
D) None of the above
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11
Chapter 10: Pre-Transfusion Testing
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Sample Questions
Q1) What is an "electronic" crossmatch?
A) A database compiled by the American Red Cross for rare phenotype accessibility
B) Comparison of donor and patient ABO groups and serologic data from a computer file
C) A crossmatch performed in microtiter plates and read by a spectrophotometer
D) All of the above
Q2) During an antiglobulin crossmatch, the cells had a jagged edge appearance after the addition of AHG and centrifugation. This indicates a(n)_____ result.
A) positive
B) negative
C) inconclusive
D) none of the above
Q3) What is the most common cause of clerical errors in transfusion therapy?
A) Entering an erroneous ABO type
B) Misidentification of the patient
C) Entering an erroneous crossmatch result
D) Labeling units as antigen-positive instead of antigen-negative when phenotyping
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Chapter 11: Overview of the Routine Blood Bank Laboratory
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Sample Questions
Q1) What test(s) are involved when a physician orders a 4-unit crossmatch on a patient?
A) IS crossmatch
B) AHG crossmatch
C) ABO, Rh, antibody screen, IS crossmatch
D) ABO, Rh, DAT, IS crossmatch
Q2) In which section of the blood bank laboratory would blood be issued for transfusion?
A) Component preparation and storage
B) Donor processing
C) Main laboratory
D) Reference laboratory
Q3) A STAT type and screen comes from surgery. Your institution uses a blood bank band ID bracelet system. The nurse who obtained specimens did not label them with the blood bank number before she handed them to transport to take to the laboratory. What would be the most appropriate action to take?
A) Call surgery and have the nurse come down and properly label the specimens.
B) Accept the specimen as is.
C) Reject the specimen and have it re-collected.
D) Label the specimen yourself and continue with testing.
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13
Chapter 12: Other Technologies and Automation
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Sample Questions
Q1) Upon centrifugation of an antibody screen procedure done by the gel system, the red blood cell agglutinates are dispersed throughout the gel column with a few agglutinates at the bottom of the microtubes. This reaction should be graded as a:
A) 4+ reaction.
B) 3+ reaction.
C) 2+ reaction.
D) 1+ reaction.
Q2) Using the affinity column technique, a serologic reaction that forms a fine red blood cell band at the top of the gel column and a red blood cell button at the bottom of the gel column is interpreted as:
A) mixed-field
B) weak positive
C) strong positive
D) negative
Q3) The FDA has approved the _____ for application of gel technology.
A) ABO, Rh, DAT, antibody screen and identification, as well as crossmatching
B) ABO, antibody screen, and DAT
C) Antibody screen, antibody identification, and crossmatching
D) ABO, Rh, DAT, and antibody screen
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Page 14
Chapter 13: Donor Screening and Component Preparation
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Sample Questions
Q1) Which of the following statements explains why bacterial contamination of blood is rarely a problem?
A) Regulated procedures for arm preparation prevent most bacteria contamination from occurring during collection.
B) Citrate in the anticoagulant is not conducive to bacterial growth.
C) The cold storage of blood is not conducive to bacterial growth.
D) All of the above
Q2) What is the expiration time for platelet concentrates that have been pooled?
A) 24 hours
B) 6 hours
C) 4 hours
D) 48 hours
Q3) What dose of RhIG would be appropriate for a D-negative woman who has had a miscarriage at 11 weeks gestation?
A) 300 µg
B) 120 µg
C) 50 µg
D) All of the above
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15
Chapter 14: Apheresis
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Sample Questions
Q1) Which apheresis method carries the additional risk of returning red blood cells to the wrong individual and yielding the smallest volume of selected blood component?
A) IFC
B) Manual apheresis
C) CFC
D) Membrane filtration
Q2) What variables are necessary to calculate the donor's total blood volume?
A) Height
B) Weight
C) Sex
D) All of the above
Q3) _____ testing is performed on platelet apheresis products to make sure that HIV, WNV, and hepatitis C are not present.
A) Serological
B) Nucleic acid
C) Electrophoretic
D) Rapid
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Page 16
Chapter 15: Transfusion Therapy
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Sample Questions
Q1) Granulocytes for transfusion should:
A) be administered through a microaggregate filter.
B) be ABO- and Rh-compatible with the recipient's serum.
C) be infused within 72 hours of collection.
D) never be transfused to patients with a history of febrile transfusion reaction.
Q2) Why is the increase in hemoglobin and hematocrit evident more quickly in red blood cell transfusions than in whole blood transfusions?
A) Blood volume adjustment is less when red blood cells are transfused.
B) Blood volume adjustment is greater when red blood cells are transfused.
C) Whole blood takes longer to mix.
D) Whole blood is usually transfused through a porous filter.
Q3) Antithrombin III concentrates are used in the treatment of:
A) dysfibrinogenemia.
B) acquired antithrombin III deficiency caused by DIC.
C) hereditary antithrombin III deficiency caused by venous thrombosis.
D) All of the above
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Chapter 17: Cellular Therapy
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Sample Questions
Q1) Which of the following is not characteristic of an anaphylactic reaction?
A) Hypotension
B) Abdominal cramps
C) Electrophoretic levels of IgA
D) Loss of consciousness
Q2) Alloimmunization may result from which of the following?
A) Bacterial contaminated red blood cells
B) Prior exposure to donor blood components
C) Transfusing an O-positive recipient with A-negative packed cells
D) Circulatory overload
Q3) What would be the result of group B blood given to a group O patient?
A) Nonimmune transfusion reaction
B) Immediate hemolytic transfusion reaction
C) Delayed hemolytic transfusion reaction
D) No reaction
Q4) What is the primary mediator of an allergic response?
A) Melatonin
B) Lysozyme
C) Histamine
D) Pyrimidine
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Chapter 18: Transfusion-Transmitted Diseases
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Sample Questions
Q1) This disease can be transmitted through blood transfusion and is characterized by sponge-like lesions of the brain.
A) Cytomegalovirus
B) Epstein-Barr virus
C) Creutzfeldt-Jakob disease
D) Chagas disease
Q2) What marker usually is not detected when the hepatitis B-infected patient enters the convalescent phase?
A) Anti-HBc
B) HBsAg
C) HBeAg
D) Anti-HBe
Q3) Which cell is invaded by the HIV viruses?
A) Monocyte
B) Neutrophil
C) Lymphocyte
D) Basophil
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19
Chapter 19: Hemolytic Disease of the Fetus and Newborn
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Sample Questions
Q1) All Rh-negative recipients who are transfused with as little as 1 mL of Rh-positive cells will develop anti-D.
A)True
B)False
Q2) In the event of a clinically significant antibody found in the mother's serum, which of the following must be performed to determine its concentration?
A) Fetal screen
B) Antibody screen
C) Antibody titer
D) Elution
Q3) Why is suppression of erythropoiesis an advantage of exchange transfusions?
A) Reduces the production of compatible RBCs
B) Reduces the production of incompatible RBCs
C) Decreases the risk of iron overload
D) Clears nucleated RBCs from circulation
Q4) Rh-immune globulin is of no benefit after a person has been actively immunized and formed anti-D.
A)True
B)False
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Chapter 20: Autoimmune Hemolytic Anemias
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Sample Questions
Q1) Which of the following procedures can be used to resolve interference due to anti-I?
A) Cold autoadsorption
B) Prewarm technique
C) Warm adsorption
D) Cold autoadsorption and prewarm technique
Q2) What reagent cell type is used in the immune complex formation test to detect drug-antidrug interaction?
A) Group A
B) Group B
C) Group AB
D) Group O
Q3) In the case of an AB-positive individual, what test must be performed to ensure that a warm-reacting autoantibody is not causing false-positive reactions?
A) Rh control
B) DAT
C) IAT
D) Rosette test
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21
Chapter 21: The Hla System
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Sample Questions
Q1) A double-lung transplant is indicated in which of the following disorders?
A) Pneumonia
B) Pulmonary fibrosis
C) Primary hypertension
D) Cystic fibrosis
Q2) Which MHC region encodes for complement proteins?
A) Class I
B) Class II
C) Class III
D) None of the above
Q3) HLA-DR typing requires a___________ suspension.
A) T-lymphocyte
B) B-lymphocyte
C) granulocyte
D) platelet
Q4) Which of the following is acceptable for cytotoxicity techniques?
A) EDTA
B) ACD
C) Serum
D) CPDA-1
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Chapter 22: Relationship Testing
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Sample Questions
Q1) Apparent opposite homozygosity is also known as:
A) direct exclusion.
B) apparent exclusion.
C) indirect exclusion.
D) direct homozygous transition.
Q2) CODIS stands for:
A) Convicted Offender Digital Identifying System
B) Combined Offender DNA Index System
C) Combined Operation Digital Index System
D) None of the above
Q3) A child was found to express the M+N+ phenotype. The mother's phenotype was M+N-, as was the father's. What type of exclusion is evident in this case?
A) Direct
B) Indirect
C) No exclusion
D) None of the above
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Chapter 23: Quality Management
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Sample Questions
Q1) A physician complains that she has not received a test report from the blood bank. The remedial action is to:
A) complete the occurrence report form.
B) prepare a copy of the report for the physician.
C) locate the original report.
D) determine why the report was not delivered.
Q2) What is the main purpose of linking Current Good Manufacturing Practices (CGMPs) to process control?
A) To comply with the regulations
B) To build quality into the manufacturing process from the beginning to the end
C) To review and approve training programs and employee position descriptions
D) To approve raw test materials and in-house reagents
Q3) As part of postemployment departmental training, a medical technologist was given 10 known blood samples to analyze for ABO specificity. This is referred to as:
A) recertification.
B) a competence assessment.
C) education.
D) a proficiency test.
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Chapter 24: Transfusion Safety and Federal Regulatory Requirements
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Q1) What is the function of the CBER?
A) To monitor continuing education at designated facilities
B) To issue federal licenses to establishments that are manufacturing biological products
C) To issue certification to medical technologists
D) None of the above
Q2) Why is the Center for Biologics Evaluation and Research (CBER) notified in the case of a transfusion-related fatality?
A) To recall all banked units
B) To disclose the name of the deceased
C) To determine if appropriate corrective action has been taken to prevent recurrence
D) To report all reagent lot numbers used in typing deceased patient
Q3) Establishments that hold U.S. licenses for a biological product can:
A) ship products interstate and internationally for sale or exchange.
B) only ship and sell products interstate.
C) market multiple trademark for their product.
D) All of the above
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Chapter 24: Utilization Management
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Sample Questions
Q1) A physician has ordered a 2-unit transfusion on an outpatient. When the outpatient arrives, the patient's hemoglobin is 12. What is the most appropriate action?
A) Cancel the transfusion and send the patient home.
B) Call the physician's office and inform them of their mistake.
C) Inform the pathologist or medical director and allow him to contact the physician.
D) Transfuse. A physicians order should not be questioned.
Q2) The focus of most blood utilization programs is:
A) the underutilization of blood products of a facility.
B) the overutilization of blood products by a facility.
C) to reduce cost.
D) to evaluate the need for ordering more product.
Q3) Which statement is false?
A) There is zero inherent risk of transfusing blood if all protocols are followed.
B) Following quality assurance guidelines for transfusion increases the safety to the patient.
C) You must follow a physician's order no matter what.
D) All of the above statements are true.
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26
Chapter 25: Laboratory Information Systems
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Q1) Which of the following best describes software?
A) Physical pieces of equipment that can be seen and touched
B) The "core" of the information system
C) Programmed instructions that tell computer how to operate and manipulate the data
D) A mechanism for connecting one computer system to another through a telephone line
Q2) What information is accessed from a component barcode sticker?
A) Blood type
B) Unit number
C) Expiration date
D) All of the above
Q3) For ready access by its processor, where does the computer hold information such as the operating system, application programs, and data?
A) In its archive
B) In ROM
C) In RAM
D) On the hard disk
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27
Chapter 26: Medicolegal and Ethical Aspects of Providing
Blood Collection and Transfusion Services
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Q1) How does the doctrine of informed consent protect the donor?
A) By providing a pamphlet of donor risks to the donor on his or her way out the door
B) By not requiring his or her signature
C) By requiring that information be provided to the donor in a manner that he or she can understand and ask questions about, if so desired
D) None of the above
Q2) All of the following are emerging concerns of transfusion medicine except:
A) red blood cell substitute.
B) standards of preoperative blood collection and reinfusion.
C) crossover of autologous (unused) units.
D) antibody testing procedures.
Q3) Which of the following best describes strict liability?
A) Manufacturers are liable when it can be proven the consumer did not misuse the product.
B) Manufacturers are legally liable for all harm that occurs through use of a product.
C) Manufacturers are legally liable for the duration of the warranty period.
D) None of the above
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Page 28
Chapter 27: Tissue Banking: A New Role for the Transfusion Service
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Q1) Which Joint Commission standard has to do with storage of tissues?
A) PC.17.10
B) PC.17.20
C) PC.17.30
D) all of the above
Q2) If your facility is a member of and accredited by the Eye Bank Associates of America, there is no need to be monitored by the FDA.
Multiple Choice
Identify the choice that best completes the statement or answers the question.
A)True
B)False
Q3) The 21 in 21 CFR 1271 refers to:
A) the region from which the tissue was collected, thus falling under the general provisions of that area.
B) the title established for food and drugs in the Code of Federal Regulations.
C) the category of FDA laws that govern all blood bank regulation.
D) none of the above.
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Page 29