Medical Technology Exam Practice
Tests
Course Introduction
Medical Technology is an interdisciplinary field that focuses on the application of technological innovations and scientific principles to diagnose, treat, and monitor diseases. The course provides an in-depth understanding of laboratory techniques, diagnostic equipment, and information systems used in modern healthcare settings. Students will explore topics such as clinical chemistry, hematology, microbiology, immunology, and molecular diagnostics, while gaining hands-on experience with laboratory instruments and procedures. The course also covers emerging trends in medical technology, including automation and biotechnology, as well as the ethical, regulatory, and safety issues relevant to healthcare professionals working with medical devices and diagnostic tools.
Recommended Textbook
Clinical Laboratory Hematology 2nd Edition by Shirlyn B. McKenzie
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40 Chapters
1419 Verified Questions
1419 Flashcards
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Chapter 1: Introduction
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Sample Questions
Q1) When bilirubin is increased above the reference range, what disease process should be suspected if liver disease is ruled out?
A)Increased osmotic pressure
B)Hormone imbalance
C)Decreased albumin
D)Increased metabolism of hemoglobin
Answer: D
Q2) 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
Q3) Explain how the hemostatic pathway is activated in times of need.
Answer: Traumatic events to body tissue stimulate the activation of repair mechanisms.As a result of both external and internal stimuli, the hemostatic pathway becomes activated in stages called primary, secondary hemostasis and fibrinolysis
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3
Chapter 2: Cellular Homeostasis
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Sample Questions
Q1) Disposal of damaged or misfolded proteins is carried out by which cell component?
A)Lysosome
B)Ubiquitin/proteosome system
C)Caspase/apoptosis system
D)Molecular chaperones
Answer: B
Q2) Predict the effect of the Bax:Bcl-2 complex on the apoptotic pathway.
A)The pathway is activated by Bax: Bcl-2.
B)The pathway is inhibited by Bax: Bcl-2.
C)The pathway is not affected by Bax: Bcl-2.
D)The pathway will be activated and then inhibited by Bax:Bcl-2.
Answer: B
Q3) The sections of a gene which contain the coding sequences for the final protein product are:
A)Exons.
B)Introns.
C)UTRs.
D)Nucleosomes.
Answer: A
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Page 4
Chapter 3: Hematopoiesis
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Sample Questions
Q1) Which of the following best describes the phenotype of the hematopoietic stem cell?
A)CD34+ CD38+Lin-HLA-DR-Rh123<sup>Bright</sup>, SCF-R+,TPO-R+
B)CD34+ CD33+CD38+Lin- Rh123<sup>Dull</sup>
C)CD34+ CD38-Lin-HLA-DR-Rh123<sup>Dull</sup>, SCF-R+,TPO-R+
D)CD3+,CD4+,CD5+,CD8+,CD38-,HLA-DR-
Answer: C
Q2) Several cytokines are used for clinical purposes.Which three cell lines are primarily increased by the injection of EPO, TPO, and CFU-GM?
A)Lymphocytes, monocytes, and platelets
B)Erythrocytes, platelets, and granulocytes
C)Monocytes, platelets, and stem cells
D)Stem cells, precursor cells, and maturing cells
Answer: B
Q3) All of the following are key components of hematopoietic differentiation except:
A)The formation of mature blood components with a finite life span.
B)The differentiation of blood components when exposed to different cytokines.
C)The commitment to produce blood cells only.
D)The activation of programmed cell death.
Answer: D
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Page 5
Chapter 4: Structure and Function of Hematopoietic Organs
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Sample Questions
Q1) Normal proliferation of hematopoietic cells in adulthood takes place at what location?
A)Peripheral blood
B)Bone marrow
C)Stroma
D)Liver
Q2) A hyperplastic marrow can occur with which of the following?
A)Leukemia
B)Post-chemotherapy
C)Anemia
D)Oxygen Therapy
Q3) Splenomegaly as a result of bone marrow failure is indicative of:
A)Liver disease.
B)An accelerated immune response.
C)Extramedullary hematopoiesis.
D)Nuclear asynchrony.
Q4) List and explain the function of the cells in the bone marrow stroma.
Q5) List four causes of a hyperplastic marrow.
Page 6
Q6) What would you expect to see on microscopic examination of a stained blood smear if the patient has had a splenectomy and why?
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Page 7
Chapter 5: The Erythrocyte
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Sample Questions
Q1) In a nonanemic adult, what is the normal range for peripheral blood reticulocytes?
A)0.5-1.0%
B)0.1-1.0%
C)2-4%
D)0.5-2.5%
Q2) 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
Q3) A reticulocyte count is 6%.This result is:
A)Normal.
B)Increased.
C)Decreased.
D)Erroneous.
Q4) Explain how EPO regulates RBC production.
Q5) Explain how hemoglobin is catabolized by the body in both extravascular and intravascular hemolysis.
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Chapter 6: Hemoglobin
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Sample Questions
Q1) Which of the following sets of values represents a normal hemoglobin distribution?
A)90% A, 5% A2, 5% F
B)90% A, 8% A2, 2% F
C)97% A, 1% F, 2% A2
D)96% A, 2% A2, 4% F
Q2) Fetal hemoglobin is composed of what two globin chains?
A)Two alpha, two beta
B)Two alpha, two gamma
C)Two alpha, two delta
D)Four gamma
Q3) Choose the hemoglobin that has the highest oxygen affinity.
A)Hb A
B)Hb F
C)Methemoglobin
D)Sulfhemoglobin
Q4) How will oxygen transport be affected in a patient with a defect in beta globin chain production? A patient with a defect in alpha chain production?
Q5) Correlate embryonic/fetal hemoglobin production to stages of fetal hematopoiesis.
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Page 9
Chapter 7: The Leukocyte
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Sample Questions
Q1) Reactive lymphocytes differ from normal lymphocytes in that the reactive form:
A)Is larger with an increase in basophilic cytoplasm, vacuoles and scalloped cell shape.
B)Has a condensed nuclear pattern with light pink cytoplasm.
C)Has many granules, deep basophilic cytoplasm and blast-like nucleus.
D)Has a condensed nuclear chromatin, eccentric nucleus and deep blue cytoplasm.
Q2) 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
Q3) What are three defining characteristics that would help the laboratory professional differentiate between a blast and an activated lymphocyte?
Q4) What is the difference between polyclonal antibodies and monoclonal antibodies? List examples of disorders that generate each type of antibody in your answer.
Q5) List and explain the four phases of neutrophil kill function.
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Page 10
Chapter 8: Introduction to Anemia
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Sample Questions
Q1) How would you differentiate between an acanthocyte and an echinocyte?
A)The variety in length and distribution of the spikes
B)The number of spikes
C)The presence or absence of a fish-mouth central pallor
D)The size of the cell
Q2) A peripheral blood smear has an even distribution of both normocytic normochromic cells and microcytic hypochromic cells.What is this phenomenon called?
A)Extramedullary hematopoiesis
B)Nuclear-cytoplasmic asynchrony
C)Dimorphic cell population
D)Monoclonal cell population
Q3) Acanthocytes or spur cells have membranes with irregular distribution of spikes.What other significant feature does this cell possess?
A)Increased size
B)Presence of Pappenheimer bodies
C)Decreased life span
D)Lack of central pallor
Q4) Patient results indicate an RPI of 1.8 and an MCV of 109 fl.Do these results make sense? Why or why not?
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Chapter 9: Anemias of Disordered Iron Metabolism and Heme Synthesis
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Sample Questions
Q1) All of the following disorders will have normal-to-elevated ferritin levels except:
A)Iron-deficiency anemia.
B)Anemia of chronic disease.
C)Sideroblastic anemia.
D)Lead poisoning.
Q2) Iron-deficiency anemia can occur by what three mechanisms?
A)Impaired iron absorption, blood loss, inadequate iron intake
B)ALAS deficiency, blood loss, decreased transferrin
C)Mutation of HFE gene, decreased transferrin, increased hepcidin
D)Inadequate iron intake, impaired iron absorption, decreased hepcidin
Q3) An unknown sample reveals a low serum iron, high TIBC, low ferritin, low hemoglobin and a microcytic hypochromic picture in the peripheral blood.Which stage of IDA is this?
A)Stage 1 IDA
B)Stage 2 IDA
C)Stage 3 IDA
D)It cannot be determined based on the information given.
Q4) Explain the difference in the chemical composition of hemosiderin and ferritin.
Q5) Differentiate primary and secondary hemochromatosis?
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Chapter 10: Hemoglobinopaties: Qualitative Defects
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Sample Questions
Q1) Other than hemoglobin S, name two abnormal hemoglobins that produce a positive sickle solubility test.Explain how they could be differentiated from HbS.
Q2) 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.
Q3) Which of the following patients would have the highest percentage of hemoglobin S?
A)A neonate with sickle-cell disease
B)An adult with sickle-cell disease
C)An adult with sickle-cell trait
D)An adult with SC disease
Q4) The net decrease in negative charge in the hemoglobin S molecule is responsible for what laboratory finding?
A)Solubility is increased.
B)Change in the electrophoretic mobility
C)Increase in oxygen infinity
D)Increase in flexibility of the red blood cell
Q5) How is methemoglobin detected in the laboratory?
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Chapter 11: Thalassemia
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Sample Questions
Q1) Impaired alpha chain production in alpha thalassemias causes:
A)Overproduction of hemoglobin F and A2.
B)Production of Hb Bart's and Hb H.
C)Normal hemoglobin distribution.
D)Fusion of alpha and gamma chains.
Q2) What is the treatment of choice for thalassemias?
A)Supportive transfusions
B)Bone marrow transplant
C)Chemotherapy
D)Radiation
Q3) All of the following can lead to the development of thalassemias except:
A)Deletion mutation.
B)Substitution mutation.
C)Exposure to a mutagenic agent.
D)Frameshift mutation.
Q4) Nucleated red blood cells in the peripheral blood are a common finding in beta thalassemia patients.Explain why.
Q5) Why are thalassemias considered a separate entity from hemoglobinopathies?
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Chapter 12: Megaloblastic and Nonmegaloblastic
Macrocytic Anemias
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Sample Questions
Q1) Pernicious anemia is a disorder characterized by:
A)Anti-vitamin B antibodies.
B)Lack of IF.
C)Improper dietary intake of vitamin B .
D)Increased absorption of vitamin B .
Q2) Which of the following are key features found in nonmegaloblastic macrocytosis?
A)Oval red blood cells
B)Hypersegmented neutrophils
C)Jaundice, glossitis, and neuropathy
D)Round macrocytes
Q3) Aplastic anemia is most often caused by:
A)Drugs.
B)Radiation.
C)Unknown causes.
D)Infectious agents.
Q4) Explain why peripheral neuropathy is a common finding in vitamin B deficiency.
Q5) Name three causes of folate deficiency.How would they differ in results in regards to serum and RBC folate levels?
Q6) Explain how high alcohol intake can cause macrocytosis.
Q7) Define constitutional aplastic anemia, and give an example. Page 15
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Page 16
Chapter 13: Introduction to Hemolytic Anemia
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Sample Questions
Q1) Which results will help to differentiate between intravascular and extravascular hemolysis.
A)Low hemoglobin in extravascular; normal hemoglobin in intravascular
B)Low unconjugated bilirubin in extravascular; high unconjugated bilirubin in intravascular
C)Presence of splenomegaly in intravascular; absence of splenomegaly in extravascular
D)Normal haptoglobin in extravascular; low haptoglobin in intravascular
Q2) Infections with Plasmodium cause __________ hemolysis.
A)Intravascular
B)Extravascular
C)Both intravascular and extravascular
D)It cannot be determined.
Q3) Prosthetic heart valves can lead to an ________ form of hemolysis in which the predominating cell seen is a __________.
A)Inherited; schistocyte
B)Acquired; schistocyte
C)Inherited; spherocyte
D)Acquired; polychromasia
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Chapter 14: Hemolytic Anemia: Membrane Defects
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Sample Questions
Q1) The SAO variant of HE is associated with:
A)Defective pectrin tetramer formation.
B)Defective protein 4.1.
C)Defective band 3 protein and abnormally tight binding to ankyrin.
D)All of the above.
Q2) A patient is suspected of having HS.However there appear to be less than 1% spherocytes on the peripheral blood smear and the osmotic fragility test is normal.What test could be performed to increase the sensitivity of testing for HS?
A)Incubated osmotic fragility test
B)Immunophenotyping for CD55 and CD59
C)Sucrose hemolysis test
D)Ham test
Q3) Which of the following disorders is characterized by increased erythrocyte membrane sphingomyelin and decreased lecithin?
A)HS
B)HE
C)Acanthocytosis
D)HPP
Q4) Explain why patients with HS typically have an MCHC greater than 36%.
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Chapter 15: Hemolytic Anemia: Enzyme Deficiencies
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Sample Questions
Q1) What are the two main metabolic pathways that erythrocytes use to break down glucose?
A)Glycolytic and hexose monophosphate shunt
B)Glycolytic and Luebering-Rapaport pathway
C)Krebs cycle and electron transport system
D)Hexokinase and Krebs cycle
Q2) Which G6PD variant has normal activity and no hemolysis present?
A)G6PD-Mediterranean
B)Minnesota
C)Iowa
D)G6PD-B
Q3) The mode of inheritance for G6PD deficiency is:
A)Autosomal recessive.
B)Autosomal dominant.
C)No established inheritance pattern.
D)Sex-linked.
Q4) Why are echinocytes seen in PK deficiency?
Q5) Why are Heinz bodies seen in G6PD deficiency?
Q6) What is the purpose of the HMP shunt, and why is it important?
Q7) How do Heinz bodies differ morphologically from other erythrocyte inclusions?
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Chapter 16: Hemolytic Anemia: Immune Anemias
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Sample Questions
Q1) 2-14 days after a transfusion, a patient is cross-matched for another transfusion.Slight hemolysis and a positive DAT are found.What testing should follow?
A)Urine hemoglobin
B)An elution procedure
C)Plasma-free hemoglobin test
D)Bilirubin measurement
Q2) Compare the three mechanisms of drug-induced immune hemolysis.
Q3) Which of the following antibody specificities is associated with PCH?
A)Anti-I
B)Anti-Le<sup>a</sup>
C)Anti-P
D)Anti-D
Q4) Which of the following will have the greatest effect on the rate of hemolysis in immune hemolytic anemia?
A)Presence of IgG2 on the erythrocyte
B)A limited number of antigens
C)Antibody that reacts at 37° C
D)Presence of IgM antibody
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Page 20
Chapter 17: Hemolytic Anemia: Nonimmune Defects
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Sample Questions
Q1) What features are identified on the peripheral blood smear in TTP?
A)Increase in presence of reticulocytes, nucleated erythrocytes, abundance of schistocytes
B)Leukocytosis with left shift, schistocytes present reticulocytopenia
C)Abundance of schistocytes, thrombocytosis and leukopenia
D)Nucleated erythrocytes, Howell-Jolly bodies and absence of schistocytes
Q2) Which of the following results would typically be found in HUS?
\(\begin{array}{ll}
{\text { PT }} & \text { PTT } \\
\hline\text { a. Prolonged } & \text { prolonged } \\
\text { b. Normal } & \text { prolonged } \\
\text { c. Prolonged } & \text { prolonged } \\
\text { d. Normal } & \text { normal } \end{array}\)
Q3) Which of the following laboratory findings are similar in both HUS and TTP?
A)Increased reticulocytes; thrombocytopenia; decrease in haptoglobin
B)Decreased reticulocytes; decrease in haptoglobin and thrombocytopenia
C)Increased total and unconjugated serum bilirubin, and increase in haptoglobin
D)Decreased total and unconjugated serum bilirubin, and decreased haptoglobin
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Chapter 18: Nonmalignant Granulocyte and Monocyte Disorders
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Sample Questions
Q1) A patient presents with splenomegaly and bone pain.Laboratory findings reveal large macrophages with small eccentric nuclei, and cytoplasm with a wrinkled appearance.
Further testing shows leukopenia, thrombocytopenia, and anemia.What is the probable Cause?
A)Niemann-Pick disease
B)Gaucher's disease
C)Tay-Sachs disease
D)Sandhoff's disease
Q2) Which of the following disorders is characterized by a defect in sphingomyelinase, which results in macrophages with a foamy appearance?
A)Gaucher's disease
B)Fabry's disease
C)Tay-Sachs disease
D)Niemann-Pick disease
Q3) Define leukoerythroblastosis, and name a condition in which this is seen.
Q4) List three laboratory results that can distinguish a leukemoid reaction from CML.
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Chapter 19: Nonmalignant Lymphocyte Disorders
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Sample Questions
Q1) Correlate antibody titers with the stage of infection.What antibody titer excludes current infection?
Q2) What characteristics are associated with reactive lymphocytes?
A)Can contain vacuoles, and chromatin pattern is very fine.
B)Can contain vacuoles, deep blue abundant cytoplasm..
C)Nucleus has a fine Chromatin pattern and the N:C ratio is increased.
D)High N:C ratio with small amount of deep blue cytoplasm
Q3) Compare and contrast X-linked SCID and autosomal SCID.
Q4) What component is responsible for the accumulation of lymphocytes in the blood during a whooping cough infection?
A)Pertussis toxin
B)Leukemoid reaction
C)T lymphocytes
D)VCA-IgG
Q5) The prominent lymphocytosis in whooping cough is due to:
A)An exacerbated immune response.
B)Cell-mediated immunity accompanying a neutrophilia.
C)Redistribution of lymphocytes from the lymphatics into peripheral circulation.
D)Increased cytokine stimulation of lymphopoiesis in the bone marrow.
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Chapter 20: Introduction to Hematopoietic Neoplasms
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Sample Questions
Q1) An abundance of blasts and some mature forms with an apparent decrease in the intermediate maturational stages is referred to as:
A)Acute lymphoid leukemia.
B)Chronic myelogenous leukemia.
C)Chronic lymphocytic leukemia.
D)Leukemic hiatus.
Q2) Which disease state has Auer bodies present on examination of the blood smear?
A)MDS
B)MPD
C)MDS/MPD
D)AML
Q3) Which laboratory test confirms the lineage of hematologic neoplasms?
A)Cytogenetic analysis
B)Immunophenotyping
C)Nuclear staining
D)Bone marrow differential
Q4) What is the difference between the HSC and the cancer stem cell?
Q5) Explain how proto-oncogenes contribute to tumor formation.
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Chapter 21: Myeloproliferative Disorders
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Q1) Which is found in >90% of cases of PV and promotes EPO receptor activation?
A)JAK2(V617F)
B)Bcl-x1
C)BCR/ABL1
D)RAS
Q2) Discuss the role of EDTA in the LAP score evaluation.
Q3) 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
Q4) What laboratory finding distinguishes leukemoid reaction from CML?
A)Normal platelets in CML, abnormal in leukemoid reaction
B)LAP low in CML and increased in leukemoid reaction
C)Blasts only in leukemoid reaction
D)Occasional micromegakaryocytes in leukemoid reaction
Q5) Explain the significance of the Philadelphia chromosome in ALL.
Q6) Explain how a variant of CML is identified utilizing laboratory values.
Page 25
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Chapter 22: Myelodysplastic Syndromes
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Q1) Which of the six WHO MDS subgroups contains two or more cytopenias, rare or no blasts, less than 1 x 10<sup>9</sup> /L monocytes in the peripheral blood and less than 5% blasts and less than 15% ringed sideroblasts in the bone marrow?
A)Refractory anemia (RA)
B)Refractory anemia with ringed sideroblasts (RARS)
C)Refractory cytopenia with multilineage dysplasia (RCMD)
D)Refractory anemia with excess blasts 2 (RAEB 2)
Q2) Which of the following IPSS scores has the highest survival rate in MDS?
A)Grade 0
B)Grade 0.5
C)Grade 1
D)Grade 1.5
Q3) Many of the myelodysplastic syndromes share a common cytogenetic abnormality.What is it?
A)Philadelphia chromosome
B)5q- deletion
C)t(8, 14)
D)t(15;17)
Q4) Explain the relationship between myelodysplastic syndromes and acute leukemia.
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Chapter 23: Acute Myeloid Leukemias
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Sample Questions
Q1) A bone marrow sample is sent to the lab for cytochemical staining.MPO, SBB, and NSE have been ordered.Staining results come back as follows:
MPO: positive \( \quad\)\( \quad\) SBB: positive \( \quad\)\( \quad\) NSE: positive Based on these findings, what lineage(s) is/are most likely affected?
A)Myeloid and monocytic
B)Lymphoid
C)Erythroid
D)Monocytic
Q2) What is the most likely diagnosis?
A)AML without maturation
B)AML minimally differentiated
C)APL
D)AMML
Q3) All of the following AML subtypes have positive reactivity with myeloperoxidase stain except:
A)Acute monocytic leukemia.
B)AML with maturation.
C)Acute erythroid leukemia.
D)AML minimally differentiated.
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Page 27
Chapter 24: Acute Lymphoblastic Leukemias
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Q1) Which of the following is a positive predictive factor in children with precursor B-ALL?
A)High leukocyte count; less than 1 year of age
B)Low leukocyte count; 4-10 years of age
C)High leukocyte count; PBX/E2A translocation
D)Hyperdiploid chromosomes, high leukocyte count, less than 1 year of age
Q2) Which phase of leukemia treatment is considered to induce complete remission of the disease, eradicating the leukemic blast population?
A)Induction therapy phase
B)CNS prophylactic phase
C)CNS prophylactic phase and maintenance chemotherapy phase
D)Maintenance chemotherapy phase
Q3) As part of their disease progression, ALL patients are at risk for developing which of the following?
A)Recurrent infections
B)Bleeding episodes
C)Fatigue
D)All of the above
Q4) Name at least five classifications of ALL, and explain how they are different.
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Page 28
Chapter 25: Lymphoid Malignancies: Chronic Lymphoid
Leukemias, Lymphomas, and Plasma Cell Neoplasms
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Q1) A technologist is reviewing a lymph node biopsy slide, and notices a prominent lymphocytosis as well as the presence of a few tumor cells with the following characteristics: large, multi-lobated nucleus with delicate nuclear membranes; finely granular chromatin; and small, indistinct nucleoli.Based on this information, from what stage and disease is the patient most likely suffering?
A)Anaplastic large cell lymphoma
B)Lymphocyte predominant Hodgkin's lymphoma
C)Monoclonal gammopathy of undetermined significance
D)Lymphocyte depleted Hodgkin's lymphoma
Q2) Which of the following lymphoproliferative disorders is most closely associated with Richter's transformation?
A)CLL
B)PLL
C)Sézary syndrome
D)Hairy cell leukemia
Q3) Describe the WHO and Ann Arbor classification systems of lymphoid neoplasms.
Q4) Explain the major differences between Hodgkin and non-Hodgkin lymphomas.
Q5) Explain how environmental factors contribute to the pathogenesis of lymphoid neoplasms.
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Chapter 26: Hematopoietic Stem Cell Transplantation
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Q1) Which HSC quantitation method would be optimal for verification of late-stage engraftment?
A)Manual count of MNCs
B)CD34 enumeration by flow cytometry
C)Cell culture for CFUs
D)All of the above
Q2) 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
Q3) Which laboratory department is responsible for performing testing to verify short-term engraftment?
A)Hematology
B)Molecular/HLA
C)Microbiology
D)Immunology
Q4) Explain the role of the clinical laboratory professional in stem cell transplantation.
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Chapter 27: Morphologic Analysis of Body Fluids in the
Hematology
Laboratory
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Q1) How would the technologist differentiate between a traumatic specimen collection and a cerebral hemorrhage? Provide at least three macroscopic and three microscopic findings.
Q2) A patient with rheumatoid arthritis has fluid collected from his knee.The fluid has crystals that have a notched-plate shape.They are also birefringent.These crystals are most likely:
A)Calcium pyrophosphate.
B)Monosodium urate.
C)Steroid.
D)Cholesterol.
Q3) What is the significance of micro-organisms present in the cytospin?
Q4) The ability to bend light rays against both fixed and rotating filters is:
A)Xanthochromia.
B)Birefringence.
C)Thermal reactivity.
D)Nephelometry.
Q5) Explain how the following are formed:
a.Transudate
b.Exudate
c.Chylous fluid
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Chapter 28: 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)Processing of blood-borne antigens
B)Production of tissue factor
C)Production of nitric oxide
D)Selective blood/tissue barrier
Q2) Which platelet ultrastructural zone has the functions of secretion, storage, and lipid metabolism?
A)Peripheral zone
B)Structural zone
C)Organelle zone
D)Membrane systems
Q3) Which of the following is a role of the platelets in secondary hemostasis?
A)To provide factors needed for serine protease activation
B)To initiate cross-linking of the fibrin monomers
C)To activate thrombin
D)To initiate contact activation
Q4) Correlate blood vessel histology to vessel type and function in hemostasis.
Q5) Describe megakaryocyte development, and the role of endomitosis and thrombopoietin in this process.
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Chapter 29: Secondary Hemostasis and Fibrinolysis
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Q1) Interpret the results below: -Patient: 12-year-old boy with unexplained bruising, swollen knee joints, and prolonged bleeding from injuries
-Screening tests:
-PT = 12.2 sec (control: 11.5-13.3 sec)/INR: 1.09
-APTT = 57 sec (control: 23-32 sec)
-Bleeding time = 5 min (control: 2-10 min)
Pending results from confirmation tests, this patient could be suffering from:
A)An intrinsic pathway problem.
B)An extrinsic pathway problem.
C)A primary hemostasis problem.
D)A common pathway problem.
Q2) Which of the following is a role of thrombin?
A)Anticoagulant (protein C activation)
B)Increases fibrinolysis
C)Inhibits endothelial cell release of tissue plasminogen activator
D)Inhibits the formation of fibrin monomers
Q3) How do the following systems contribute to coagulation?
A)Complement
B)Fibrinolysis
C)Kinin
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Chapter 30: Disorders of Primary Hemostasis
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Q1) When petechiae and ecchymoses are found in a higher-than-normal number with less-than-usual trauma, the condition is called which of the following?
A)Hematoma
B)Purpura
C)Easy bruisability
D)Excess bleeding
Q2) Describe the following, and indicate where they are typically seen (disorders of primary hemostasis or secondary hemostasis).
A)Petechiae
B)Purpura
C)Ecchymoses
D)Hematomas
Q3) Which of the following is a mechanism of inducing thrombocytopenia in a patient?
A)Antibody-mediated platelet destruction
B)Inherited platelet membrane defect
C)Increased splenic sequestration
D)All of the above
Q4) What laboratory tests are used to assess disorders of primary hemostasis?
Secondary hemostasis?
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Chapter 31: Disorders of Secondary Hemostasis
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Q1) Which congenital deficiency(s) is 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
Q2) What is the inheritance pattern of hemophilia A?
A)Autosomal dominant
B)Autosomal recessive
C)Sex-linked
D)None of the above
Q3) What plasma factor levels can be expected in a female carrier of F-VIII or F-IX deficiency?
A)25% of the normal plasma levels of the deficient factor
B)12.5% of the normal plasma levels of the deficient factor
C)50% of the normal plasma levels of the deficient factor
D)5% of the normal plasma levels of the deficient factor
Q4) Explain how disseminated intravascular coagulation is not a primary disease state.Correlate etiology, pathophysiology, and laboratory analysis in your response.
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Chapter 32: Thrombophilia
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Q1) Which of the following mechanisms can lead to an increased risk of thrombosis?
A)Increased concentration of plasminogen activator
B)Deficiency of plasminogen
C)Deficiency of plasminogen activator inhibitor
D)Increased concentration of plasminogen
Q2) A tendency to favor thrombus formation that is produced from an imbalance in the major constituents of the hemostatic system is defined as:
A)Hypercoagulability.
B)Thrombophilia.
C)Thrombosis.
D)Thromboembolism.
Q3) How do unfractionated heparin and low-molecular weight heparin differ?
A)In their pharmacokinetics
B)In their composition
C)In the tests used to monitor their biologic activity
D)All of the above
Q4) Why are clotting and molecular assays both needed for a diagnosis of APCR?
Q5) Explain why many patients with an inherited thrombophilia are misdiagnosed.
Q6) How does the INR standardize the prothrombin time?
Q7) What are the physiological processes involved in hypercoagulability?
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Chapter 33: Hematology Procedures and Hemostasis
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Q1) Why are two incubation sessions needed in the Donath-Landsteiner test?
A)To detect the biphasic thermal reactivity of the offensive antibody
B)To detect complement binding in vivo
C)To detect the antibody's specificity to the P antigen in vitro
D)To detect the antibody's specificity to group O cells
Q2) What is the anticoagulant in the most commonly utilized tube in hematology, and how does it prevent coagulation from taking place?
A)Sodium citrate; chelates calcium
B)EDTA; chelates calcium
C)Heparin; neutralizes thrombin
D)Sodium citrate; decreases thrombin activity
Q3) The reference interval for hemoglobin varies with age.Which of the following age groups is associated with the highest hemoglobin level?
A) Adults, over 75 years old
B) Adults, between 25-35 years old
C) Children, 2-8 years old
D) Newborns
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Chapter 34: Bone Marrow Examination
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Q1) Which of the following indicates a reason for performing cytochemical staining on bone marrow specimens of suspected hematologic dyscrasias?
A)Cytochemical staining has higher specificity for hematopoietic lineage differentiation than does standard morphology.
B)Cytochemical staining has lower incidence of false negatives in detecting malignancies..
C)Manual differentials are prone to misinterpretation, whereas cytochemical staining does not have these errors.
D)Cytochemical staining provides a better overview of bone marrow status of hematopoiesis than does the manual differential.
Q2) Compare Prussian blue iron stain results in the following disorders and explain your answers:
A)Iron-deficiency anemia
B)Anemia of chronic disease.
C)Thalassemia
D)Sideroblastic anemia
Q3) What are the main differences in uses between a core biopsy specimen and aspirate specimen?
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Chapter 35: Automation in Hematology and Hemostasis
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Q1) Which analyzer has the ability to quantify nucleated RBCs and calculate a corrected WBC count?
A)Coulter Gen-S
B)Sysmex XE-2100
C)Abbott Cell Dyn Sapphire
D)Coulter LH 780
Q2) 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
Q3) The principle that relies on detecting resistance as cells pass through a photo-detector and is that used by most of the major hematology analyzers is:
A)Spectrophotometry.
B)Impedance.
C)Radio frequency.
D)MAPSS technology.
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Chapter 36: Flow Cytometry
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Q1) Neoplasms are made up of a population of identical cells, or a clone of cells.A clone, when identified, can lead to discovery of a lymphoid malignancy or other lymphoproliferative disorder.In what ways can clonality be detected?
A)Uniform expression of one immunoglobulin light chain
B)Mixture of cells with either kappa or lambda light chains
C)Surface immunoglobulin detection
D)Bright intensity of all monoclonal markers
Q2) It is recommended by the EWGCCA to perform which of the following alongside CD34 enumeration?
A)Dual staining with CD45
B)DNA index
C)IRF
D)All of the above
Q3) In diagnosing PNH, which of the following assays is most sensitive to the detection of the disorder?
A)GPI anchor phenotype
B)Ham test
C)Sucrose lysis test
D)Osmotic fragility test
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Chapter 37: Chromosome Analysis of Hematopoietic and Lymphoid Disorders
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Q1) 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.
Q2) List at least five indications for performing FISH analysis in patients suspected of having a hematolymphoid disorder.
Q3) The cell cycle contains four phases: G1, S, G2, and mitosis.Which phase must be active to study human chromosomes?
A)S
B)G2
C)G1
D)Mitosis
Q4) 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
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Chapter 38: Molecular Analysis of Hematologic Diseases
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Q1) Inherited diseases are characterized by:
A)Sex-linked mutations that are expressed only in females.
B)Acquired mutations that are detected only in affected organs.
C)Lack of correlation between genotype and disease status among family members.
D)A genetic defect that is generally present in all tissues of the patient's body.
Q2) Mutations responsible for the onset of lymphoid leukemias and lymphomas are typically associated with:
A)Antigen receptor genes.
B)Receptors for oncogenes.
C)Specific chromosomal translocations.
D)CD marker alterations.
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/RAR fusion gene
Q4) Explain the central dogma of molecular biology using proper nomenclature.Define each phase.
Q5) Explain the impact of a positive test for HTLV-1 in a lymphoma patient.
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Chapter 39: Laboratory Testing in Coagulation
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Q1) A hemophilic patient (Hemophilia A) has a severe bleed and is being treated with Factor VIII concentrate.When testing his post-infusion, the factor VIII level does not increase.The problem could be:
A)Lupus anticoagulant.
B)Improper drawing of the specimen.
C)Factor VIII Inhibitor.
D)Factor IX inhibitor.
Q2) Interpret the results below.
a.PT = 32 sec
b.APTT = 92 sec
c.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) Give the results (prolonged or normal) for the bleeding time, prothrombin time, activated partial thromboplastin time, and thrombin time for a patient on prolonged anticoagulant therapy.
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Chapter 40: Quality Assessment in the Hematology
Laboratory
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Q1) The following 20 hemoglobin results were collected for Level I control to determine its initial control limit (Results are in g/dL): \(\begin{array}{lllll}
6.2 & 6.5 & 5.4 & 6.0 & 6.4 \\
5.8 & 6.0 & 5.9 & 5.7 & 6.1 \\
6.1 & 6.1 & 6.6 & 6.2 & 6.4 \\
5.7 & 6.2 & 6.3 & 5.9 & 5.8 \end{array}\)
What are the 2s limits?
A) 5.8-6.4 g/dL
B) 5.8-6.5 g/dL
C) 5.5-6.7 g/dL
D) 5.4-6.7 g/dL
Q2) Which of the following Westgard rule violations allows for patient samples to be run?
A)1-3s
B)1-2s
C)R-41s
D)4-1s
Q3) Identify the critical information that must be on a material safety data sheet.
Page 44
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