Hematology Test Questions
Course Introduction
Hematology is the study of blood, blood-forming organs, and blood diseases. This course covers the fundamental principles of hematology, including the physiology and pathology of blood cells, hemostasis, and the mechanisms underlying various hematological disorders. Students will explore the diagnosis, clinical features, and management of anemias, leukemias, lymphomas, and clotting disorders. Laboratory techniques such as blood smear evaluation, cell counting, and interpretation of hematological tests are also emphasized, preparing students for clinical and research settings in diagnosing and treating blood-related diseases.
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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44 Verified Questions
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Sample Questions
Q1) Which of the following red blood cell morphologies may be present on the peripheral blood smear as a result of loss of RBC membrane?
A) Spherocytes
B) Target cells
C) Burr cells
D) Schistocytes
Answer: A
Q2) What role do platelets play in hemostasis?
A) Maintenance of vascular integrity
B) Initial arrest of bleeding by platelet plug formation
C) Stabilization of the hemostatic plug
D) All of the above
Answer: D
Q3) Regarding loss of RBC membrane deformability, all of the following are true except:
A) increase in ATP level.
B) decrease in ATP level.
C) increase in calcium level.
D) decrease in spectrin phosphorylation level.
Answer: A
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Chapter 2: Basic Genetics
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Sample Questions
Q1) In which of the following circumstances will Hardy-Weinberg's principle fail?
A) Mutation
B) Genetic drift
C) Non-random mating
D) All the above
Answer: D
Q2) A triple set of nucleotides is a: A) helix.
B) base.
C) codon.
D) template.
Answer: C
Q3) When an individual is said to have blood group A, it refers to the individual's: A) alleles on the chromosome.
B) genotype.
C) phenotype.
D) haplotype.
Answer: C
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Chapter 3: Fundamentals of Immunology
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Sample Questions
Q1) The four unique serum proteins of the alternate pathway of complement include all but which of the following?
A) Factor B
B) X factor
C) Factor D
D) Initiating factor
E) Factor P
Answer: B
Q2) Which of the following statements is true concerning immunoglobulin variations?
A) Allotypic variations occur primarily in the variable region.
B) Isotypic refers to all members of a species.
C) Idiotypic variation occurs in the constant region.
D) Isotypic variation is associated with organ transplantation and paternity testing.
Answer: B
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Chapter 4: Concepts in Molecular Biology
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Sample Questions
Q1) All of the following are sources of DNA for performing Southern blot analysis except:
A) bone marrow.
B) leukocytes.
C) cell cultures.
D) pericardial fluid.
Q2) What blood grouping information can be ascertained from RFLP analysis?
A) Rh factor
B) HLA phenotype
C) Sda
D) Polyagglutination
Q3) Biotechnology is important in blood banking because of:
A) its production of growth factors.
B) its production of erythropoietin.
C) its production of clotting factors.
D) all of the above.
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Chapter 5: The Antiglobulin Test
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Sample Questions
Q1) Why was anticomplement introduced into AHG sera?
A) Certain clinically significant antibodies demonstrate complement activity.
B) Complement components enhance Kell antibodies.
C) It provides additional information for transfusion reaction workups.
D) All of the above
Q2) What effect does a low pH have on a saline AHG test?
A) Enhances antibody elution
B) Enhances the antigen-antibody complex
C) Increases hydrogen bonding
D) Increases bacterial contamination
Q3) All of the following statements regarding the AHG test are true except:
A) when washing cells, all saline should be removed completely.
B) centrifugation should provide a firm pellet.
C) incubation time with LISS should be a minimum of 30 minutes.
D) Coombs' control cells should be added to all negative tubes.
Q4) Polyspecific AHG contains:
A) anti-IgG.
B) anti-C3b-C3d.
C) anti-IgG and anti- C3d.
D) anti-IgG and anti-IgM.
Page 7
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Chapter 6: The Abo Blood Group System
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Sample Questions
Q1) What percentage of A<sub>2</sub> individuals produce anti-A<sub>1</sub>?
A) 5%
B) 20%
C) 50%
D) 80%
Q2) Where will the ABO discrepancy occur in cis-AB individuals?
A) Forward grouping with anti-A
B) Reverse grouping with B cells
C) Forward grouping with anti-AB
D) Reverse grouping with A<sub>1</sub> cells
Q3) What percentage of the type-A population are A<sub>1</sub>?
A) 80%
B) 50%
C) 20%
D) 10%
Q4) 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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Chapter 7: The RH Blood Group System
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Sample Questions
Q1) A male patient was seen in the emergency room with an acute bleed. The recommendation from the blood supplier is to give O-positive RBCs as uncrossmatched blood. This patient has already been exposed to Rh-positive blood after a previous accident. What is a possible outcome?
A) The patient may have a hemolytic transfusion reaction from an allo immunized anti-D.
B) Anti-D is not immunogenic, and the patient probably would not have formed an anti-D.
C) Anti-D is not hemolytic, and even with the circulating antibody there would be no danger to the patient.
D) The anti-D would activate complement, and a strong intravascular transfusion reaction would occur.
Q2) When one or more D epitopes within the entire D protein is missing it is termed_______________.
A) weak D
B) C in trans to Rh(D)
C) D<sub>el</sub>
D) partial D
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Chapter 8: Blood Group Terminology and the Other Blood Groups
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Sample Questions
Q1) Why does anti-Lu<sup>a</sup> go undetected in routine testing?
A) Anti-Lu<sup>a</sup> demonstrates low avidity
B) Most reagent cells are Lu(a+)
C) Most reagent cells are Lu(a-)
D) None of the above
Q2) What amino acid is specific for S antigen?
A) Glycine
B) Threonine
C) Methionine
D) Aspartic acid
Q3) Most blood group alleles are:
A) X-linked dominant.
B) X-linked recessive.
C) codominant.
D) none of the above.
Q4) What class of immunoglobulin makes up anti-Lu<sup>a</sup>?
A) IgA
B) IgM
C) IgG
D) All of the above
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Chapter 9: Detection and Identification of Antibodies
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Sample Questions
Q1) Why is it important for screening cells to be from individuals who have a homozygous expression of antigens?
A) Homozygous expression is directly related to clinically significant antibodies.
B) Stronger reactions are seen with heterozygous cells than with homozygous cells.
C) Weakly reacting antibodies may not agglutinate heterozygous cells.
D) All of the above
Q2) What effect does ZZAP reagent have on sensitized red blood cells?
A) Removes antibody from red blood cells
B) Enzyme treats red blood cells
C) Increases adsorption capability of red blood cells
D) All of the above
Q3) Name a disease in which your positive D control might be positive.
A) PCH
B) Multiple myeloma
C) Huntington's disease
D) Epstein-Barr virus
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Chapter 10: Pre-Transfusion Testing
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Sample Questions
Q1) How can the sensitivity of antibody detection be increased?
A) Increase the ratio of patient serum to screening cells.
B) Extend the incubation time.
C) Add potentiators such as albumin.
D) All of the above
Q2) Which of the following regarding blood issued on an emergency basis without patient testing is true?
A) The patient sample is tested for only ABO and Rh at a later time.
B) Units are tagged for emergency release and no further testing is done.
C) Units are tagged for emergency release and segments are pulled for later testing.
D) The medical technician must authorize the emergency transfusion.
Q3) Passive acquisition of anti-A, B, AB may occur through:
A) RhIG injection.
B) bacterial injection.
C) bone marrow transplantation.
D) hepatitis vaccination.
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12
Chapter 11: Overview of the Routine Blood Bank Laboratory
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Sample Questions
Q1) Why are monoclonal anti-D reagents preferred over the slide test reagents?
A) They contain a low protein concentration and are not prone to false-positive reactions.
B) They contain a high protein concentration and are not prone to false-negative reactions.
C) They contain albumin, which acts as a potentiator.
D) None of the above
Q2) In which department of the blood bank laboratory would an ABO discrepancy be resolved?
A) Component preparation and storage
B) Donor processing
C) Main laboratory
D) Reference laboratory
Q3) 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
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Page 13
Chapter 12: Other Technologies and Automation
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Sample Questions
Q1) Which of the following substances may interfere with gel technology but not SPRCA technology?
A) Hemolysis
B) Lipemia
C) Icteric samples
D) All of the above
Q2) When performing an antibody screen by gel technology, the following steps are eliminated:
A) the AHG reagent and control checked cells.
B) the saline wash and control check cells.
C) the cells I and II and saline wash.
D) the centrifugation and saline wash.
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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14
Chapter 13: Donor Screening and Component Preparation
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Sample Questions
Q1) What is the minimal pH required for platelets?
A) 6.0
B) 6.2
C) 7.0
D) 7.2
Q2) What is the minimum hemoglobin level for a potential autologous donor?
A) 11 g/dL
B) 12 g/dL
C) 12.5 g/dL
D) 14 g/dL
Q3) The new international bar code system that most blood banks are converting to is:
A) Codabar.
B) ISBT.
C) Codabar 128.
D) Eian 12.
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15
Chapter 14: Apheresis
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Sample Questions
Q1) All of the following statements are consistent with CFC except:
A) blood is drawn from one phlebotomy site and returned through another.
B) reinfusion to the patient completes one cycle.
C) the process of phlebotomy, separation, and reinfusion is uninterrupted.
D) separation of components is achieved through centrifugation.
Q2) What effect do steroids have on leukapheresis?
A) Decrease the vascular pool of granulocytes
B) Increase the vascular pool of granulocytes
C) Help to separate red blood cells from white blood cells, using specific gravity properties
D) Neutralize the effect of toxic granulation in neutrophils
Q3) Which cell type is densest in the white blood cell layer when anticoagulated blood is centrifuged?
A) Granulocyte
B) Monocyte
C) Lymphocyte
D) Platelets
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Chapter 15: Transfusion Therapy
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Sample Questions
Q1) 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
Q2) Platelets prepared from_____ are referred to as random donor platelets.
A) recovered plasma
B) pheresis products
C) whole blood units
D) red blood cells
Q3) What is the corrected platelet increment for a patient with a body surface area of 2.7 m<sup>2</sup>, an initial count of 15,000 per µL, and a 1-hour post-transfusion platelet count of 80,000 per µL given one apheresed platelet component?
A) 53,182 per µL
B) 58,500 per µL
C) 31,900 per µL
D) 5,000 per µL
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Chapter 17: Cellular Therapy
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Sample Questions
Q1) Alloimmunization is categorized as what type of transfusion reaction?
A) Immediate nonhemolytic
B) Immediate hemolytic
C) Delayed nonhemolytic
D) Delayed hemolytic
Q2) Persons diagnosed with chronic renal failure and hemosiderosis should be treated with:
A) prednisone.
B) desferrioxamine.
C) neocyte transfusion.
D) washed red blood cells.
Q3) What type of hemolysis is implicated in a DHTR caused by primary alloimmunization?
A) Extravascular
B) Intravascular
C) Nonimmune
D) None of the above
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18
Chapter 18: Transfusion-Transmitted Diseases
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Sample Questions
Q1) 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
Q2) All of the following viruses have been associated with TAH except:
A) hepatitis A.
B) hepatitis B.
C) hepatitis D.
D) hepatitis E.
Q3) 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
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Chapter 19: Hemolytic Disease of the Fetus and Newborn
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Sample Questions
Q1) Rh-immune globulin should be given within how many hours after delivery?
A) 24
B) 48
C) 36
D) 72
Q2) Blood transfusions to the fetus and premature infants should be___________ to prevent graft-versus-host disease.
A) gamma irradiated
B) negative for hemoglobin S
C) less than 7 days old
D) beta irradiated
Q3) What physiological phenomenon associates erythroblastosis fetalis with HDFN?
A) Release of nucleated red blood cells (RBC) into circulation of mother inflicted with HDFN
B) Release of mature RBCs into circulation of neonate inflicted with HDFN
C) Release of nucleated RBCs into circulation of neonate inflicted with HDFN
D) None of the above
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Chapter 20: Autoimmune Hemolytic Anemias
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Sample Questions
Q1) Which of the following characterizes an alloimmune response in immune hemolytic anemia?
A) The patient produces an antibody reactive with her own red blood cells.
B) The patient produces an antibody to a prescribed antibiotic.
C) The patient produces anti-K to transfused red blood cells.
D) None of the above
Q2) Cold panel results obtained are: A1 cells: 4+
A2 cells: 4+
O cells: 4+
O cord cells: 0
These results suggest which antibody?
A) H
B) IH
C) I
D) i
Q3) Which of the following signifies intravascular hemolysis in AIHA?
A) Increased haptoglobin
B) Bilirubinemia
C) Hemoglobinuria
D) Spherocytosis
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Chapter 21: The Hla System
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Sample Questions
Q1) In testing for the HLA-D antigens (DR, DP, DQ, etc.)___________ typing cells of each phenotype are set up in an MLR as against the test cells.
A) heterozygous/responders
B) homozygous/stimulators
C) heterozygous/stimulators
D) homozygous/responders
Q2) The surface marker, or antigen, detected in histocompatibility testing of a single individual is referred to as HLA:
A) phenotype.
B) genotype.
C) haplotype.
D) karyotype.
Q3) MHC class II molecules are expressed on all of the following except: A) monocytes.
B) endothelial cells.
C) B lymphocytes.
D) platelets.
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22
Chapter 22: Relationship Testing
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Sample Questions
Q1) What test systems are used in the ascertainment of paternity?
A) Endocrine, RBC, serum protein, enzymes
B) RBC, HLA, enzymes, serum proteins
C) RBC, enzymes, HLA, hormones
D) Viral antigens, RBC, HLA, serum proteins
Q2) Which of the following AABB standards must be met in paternity testing?
A) DNA testing using double-locus probes
B) Independent reading of electrophoretograms by two technologists
C) HLA and red blood cell antigen testing performed by two independent laboratories
D) All of the above
Q3) The inclusionary calculations are deemed invalid if which of the following possible subjects is to be ruled out as the alleged father of the child?
A) Brother
B) Uncle
C) Father
D) All of the above
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23
Chapter 23: Quality Management
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Sample Questions
Q1) 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.
Q2) Which of the following is an example of an external customer?
A) A night-shift medical technologist
B) A blood donor
C) An intravenous nurse
D) Housekeeping employee
Q3) What is a function of the quality committee or quality council?
A) To provide solutions to recurring clerical errors
B) To provide counseling for departmental downsizing
C) To set priorities for quality improvements
D) To focus on computer upgrades and software implementation
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Chapter 24: Transfusion Safety and Federal Regulatory Requirements
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Sample Questions
Q1) What is contained in Form FDA-483?
A) Objectionable conditions noted by an FDA inspector
B) An FDA checklist used by inspectors
C) A list of blood banks that perform in-house viral testing
D) A list of certified FDA inspectors
Q2) 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
Q3) What is the primary focus of quality assurance?
A) To place blame on employees who make recurring errors
B) To amend the system, procedure, or standard operating procedures, if deemed faulty
C) To analyze post-market stability
D) To rewrite employee job descriptions as needed
Q4) Blood grouping reagents are considered medical devices according to the CBER.
A)True
B)False
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Chapter 24: Utilization Management
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Sample Questions
Q1) Blood utilization management programs are designed to do all but which of the following?
A) Increase safety
B) Decrease component availability
C) Reduce expenditure
D) Manage limited blood resources
Q2) 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.
Q3) Which of the following is not part of a blood utilization review?
A) Retrospective review
B) Concurrent review
C) Interpreted review
D) Prospective review
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26
Chapter 25: Laboratory Information Systems
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Sample Questions
Q1) Many accreditation agencies have checklist items that emphasize the responsibilities of operating an information system. Which of the following is not a volunteer accreditation agency?
A) CAP
B) AABB
C) FDA
D) Joint Commission
Q2) Software ________is the establishment of documented evidence that provides a high degree of assurance that the information system will consistently function as expected.
A) regulation
B) application
C) validation
D) maintenance
Q3) How can information systems in a blood center assist the managerial staff?
A) By isolating the HIV-positive donor population
B) By tabulating deficiencies in cap surveys
C) By monitoring the number of donors deferred
D) None of the above
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Page 27
Chapter 26: Medicolegal and Ethical Aspects of Providing
Blood Collection and Transfusion Services
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Sample Questions
Q1) Plaintiffs have prevailed in TTAIDS multimillion-dollar medical malpractice suits against physicians for which of the following arguments?
A) There is a lack of standard protocol for implementing new HIV test kits.
B) The patient did not need a transfusion based on clinical data.
C) The patient did not give informed consent.
D) The patient was health illiterate and therefore could not comprehend the need for transfusion.
Q2) The ________ is an example of a voluntary standard, as related to transfusion medicine.
A) Clinical Laboratory Improvement Amendments of 1988
B) Journal of the American Medical Association
C) AABB Standards
D) Code of Federal Regulations
Q3) Liability for negligence includes all of the following except:
A) there was a duty owed to the injured party.
B) the duty was not met; the injured party was harmed.
C) failure to meet the duty was indirectly responsible for harm suffered by injured party.
D) some measurable (compensable) harm occurred (called damage).
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Chapter 27: Tissue Banking: A New Role for the Transfusion Service
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Sample Questions
Q1) Which of the following is generally excluded from the tissue bank?
A) Corneas
B) Liver
C) Heart valves
D) Skin
Q2) A bone flap is harvested by a physician for a patient at hospital X. The patient has an issue with hospital X and requests to go to hospital Y. The patient is transferred, but the physician wants to continue with the treatment. Which of the following scenarios is possible?
A) Hospital X would need to be registered with the FDA as a tissue vendor in order to transfer the bone flap to hospital Y.
B) The patient is allowed to take the bone flap with him to hospital Y, because it is autologous.
C) The physician is licensed to practice at both hospitals, so he is allowed to transfer the bone flap.
D) There is no tissue with transfer from one hospital to the next, because the material being transferred is bone.
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