Medical Technology
Exam Questions
Course Introduction
Medical Technology is a dynamic field that combines laboratory science with healthcare, focusing on the detection, diagnosis, and treatment of diseases through the analysis of bodily fluids, tissues, and other specimens. This course explores the fundamental principles and advanced techniques used in clinical laboratories, including microbiology, hematology, clinical chemistry, immunology, and molecular diagnostics. Students will gain hands-on experience with laboratory equipment and procedures, understand quality assurance practices, and learn to interpret laboratory results in a clinical context, preparing them for essential roles in healthcare settings, research institutions, and public health laboratories.
Recommended Textbook
Clinical Laboratory Hematology 3rd Edition by Shirlyn
B. McKenzie
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1441 Flashcards
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Chapter 1: Introduction
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Sample Questions
Q1) Name three blood analytes that show significantly different results in adults,children,and infants.
Answer: Hemoglobin is higher in infants and children than in adults. WBC counts are higher in infants than in children and adults. Differential results are different in children (inverted ratio of lymphs: neutrophils) than in infants and adults.
Q2) Which two populations account for the greatest difference in reference intervals?
A)Adults and 12-year-olds
B)Newborns and 12-year-olds
C)Newborns and adults
D)Whites and blacks
Answer: C
Q3) 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
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3
Chapter 2: Cellular Homeostasis
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Sample Questions
Q1) In which phase of the cell cycle is a cell quiescent?
A)The G phase
B)The G0 phase
C)The R phase
D)The S phase
Answer: B
Q2) Which regulatory protein is present in all stages of the cell cycle but has varying degrees of phosphorylation (activation)from phase to phase?
A)p53
B)Rb protein
C)p21
D)Cyclin D
Answer: B
Q3) In which phase of mitosis do the chromosomes align on opposite poles of the cell?
A)Prophase
B)Metaphase
C)Anaphase and telophase
D)Interphase
Answer: C
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Page 4
Chapter 3: Structure and Function of Hematopoietic Organs
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Sample Questions
Q1) Track the path of maturation of the T lymphocyte.
Answer: Precursor T cells leave the bone marrow (where they develop from the committed lymphoid progenitor cell) and enter the thymus through arterioles in the cortex. The thymus is the maturation compartment for T-lymphocytes. As they travel through the cortex and medulla, the T-lymphocytes interact with epithelial cells and dendritic cells, which provide signals to ensure that T cells recognize foreign antigen, not self-antigen. In addition, the T cells undergo substantial proliferation.
Q2) A characteristic that defines a tissue as primary vs.secondary lymphoid tissue is:
A)That activated cells reside in primary and resting cells reside in secondary lymphoid tissue
B)The quantity of cells in each
C)T cells in primary and B cells in secondary tissue
D)The ability of the lymphoid cells to respond to antigens
Answer: D
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Chapter 4: Hematopoiesis
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Sample Questions
Q1) All of the following are negative regulators of hematopoiesis except:
A)TGF
B)TNF
C)Kit ligand
D)MIP1
Q2) Which of the following types of cell signaling describes how SCF and Flt3 ligand predominately regulate stem cell homeostasis?
A)Autocrine
B)Paracrine
C)Juxtacrine
D)Endocrine
Q3) Which of the following lineages are derived from the bipotential progenitor cell CFU-EMk?
A)Erythrocytes and megakaryocytes
B)Eosinophils and megakaryocytes
C)Erythrocytes and monocytes
D)Eosinophils and monocytes
Q4) Explain the role of selected cytokines in the treatment of disorders affecting the hematopoietic system.
Q5) Explain the role of stromal cells in the hematopoietic microenvironment.
Page 6
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Chapter 5: The Erythrocyte
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Q1) Polychromatophilic red blood cells are commonly called what cell type?
A)Normoblast
B)Prorubricyte
C)Reticulocyte
D)Metarubricyte
Q2) The average RBC is what size?
A)20-25 mcM
B)2-3 ,mcM
C)12-15 mcM
D)7-8 mcM
Q3) Which major integral protein is used in the mechanism to transport the chloride-bicarbonate exchange?
A)Glucose transporter
B)Anion exchange protein
C)Ankyrin
D)Adducing
Q4) Describe the nuclear and cytoplasmic morphologic changes in erythrocytes during maturation.
Q5) Explain how the body catabolizes hemoglobin in both extravascular and intravascular hemolysis.
7
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Chapter 6: Hemoglobin
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Q1) Which of the following abnormal hemoglobins is formed when iron is in the ferric state?
A)Oxyhemoglobin
B)Carboxyhemoglobin
C)Methemoglobin
D)Sulfhemoglobin
Q2) An elevated hemoglobin A1C indicates that:
A)The patient has an elevated hemoglobin.
B)The patient is anemic.
C)The patient's RBCs have been exposed to an elevated blood glucose for a prolonged period of time.
D)The patient's RBCs need glucose.
Q3) To regulate the amount of heme produced,what enzyme must be regulated?
A)ALAS
B)PBG deaminase
C)Uroporphyrinogen III
D)Ferrochelatase
Q4) How is oxygen transport affected in a patient with a defect in beta globin chain production?
A patient with a defect in alpha chain production?
8
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Chapter 7: Granulocytes and Monocytes
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Q1) The life span of the neutrophil is spent in three compartments.Which compartment is the primary site of host defense?
A)Bone marrow
B)Liver
C)Thymus
D)Tissues
Q2) Which of the following is associated with an increased leukocyte concentration?
A)Birth,pregnancy,infection
B)Older adults,birth
C)Older adults,pregnancy
D)Tissue necrosis,whole body irradiation
Q3) Hematological analysis was performed on a 10-day-old baby who appeared to have difficulty breathing and had a temperature of 101.2°F.The WBC was 29.8 × 10 /L.This finding represents a(n):
A)Normal leukocyte count
B)Absolute leukocytosis
C)Relative leukopenia
D)Absolute leukopenia
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Chapter 8: Lymphocytes
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Sample Questions
Q1) Describe the immunologic features and functions of NK cells.
Q2) Which cell line matures and differentiates upon exposure to antigen?
A)Neutrophilic
B)Basophilic
C)Monocytic
D)Lymphocytic
Q3) A patient with infectious mononucleosis would most likely produce which of the following?
A)IgD antibodies
B)Polyclonal antibodies
C)Monoclonal antibodies
D)IgE antibodies
Q4) A blood sample from a 5-month-old infant indicates a WBC count of 12.5 × 10 /L with 65% lymphocytes.What can you conclude from this?
A)The infant is normal.
B)The infant has an infection as indicated by the elevated WBC count.
C)The infant has a malignancy in the lymphocyte lineage.
D)There is not enough information to draw accurate conclusions.
Q5) What is the difference between polyclonal antibodies and monoclonal antibodies?
List examples of disorders that generate each type of antibody in your answer.
Page 10
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Chapter 9: The Platelet
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Q1) Which of the following represents a normal platelet number and morphology?
A)A platelet that is 10 mcM in size with a blood concentration of 200 × 10 /L
B)A platelet that is 80 mcM in size with a blood concentration of 8 × 10 /L
C)A platelet that is 2.5 mcM in size with a blood concentration of 250 × 10 /L
D)A platelet that is 5 mcM in size with a blood concentration of 600 × 10 /L
Q2) Increased DNA content in exact multiples that are contained within a single nuclear envelope defines cells that are:
A)Polyploid
B)Proliferating
C)Apoptotic
D)Differentiated
Q3) Which of the following criteria describes giant platelets?
A)8-12 fL in volume
B)>5 mcM in size
C)>2N in chromosome number
D)>400 × 10 /L in number
Q4) Describe megakaryocyte development and the role of endomitosis and thrombopoietin in this process.
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Page 11
Chapter 10: The Complete Blood Count and Peripheral
Blood Smear Evaluation
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Sample Questions
Q1) A patient sample arrives in the laboratory with the name on the tube and no other information.What is missing?
Q2) An increased red cell distribution width (RDW)usually indicates what abnormality?
A)Increase of average erythrocyte volume
B)Increase of average weight of hemoglobin
C)Decrease in ratio of hemoglobin mass to volume
D)Variation in erythrocyte size
Q3) An instrument printout indicates an MCV of 63 fl and an MCHC of 26 g/dl.How will the red cells appear under the microscope?
A)Normocytic,normochromic
B)Macrocytic,normochromic
C)Microcytic,hypochromic
D)Normocytic,hypochromic
Q4) 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
Q5) Describe the purpose of and the way to calculate the "rule of three."
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Chapter 11: Introduction to Anemia
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Sample Questions
Q1) Normal hematocrit is 45%.What is the RPI for this patient with a reticulocyte count of 5% and hematocrit of 25%?
A)2.39
B)2.59
C)1.39
D)4.50
Q2) Which of the following defines hemolysis?
A)The destruction of red cells resulting in the release of hemoglobin
B)The disorder characterized by a decrease in the normal concentration of hemoglobin or erythrocytes
C)The breakdown product of the heme portion of the hemoglobin molecule
D)The loss of a large amount of blood either internally or externally
Q3) A patient presents with a RPI of >2 and macrocytic morphology of the red blood cells.Which survival defect does this most likely represent?
A)B deficiency
B)Folate deficiency
C)Hemorrhage or hemolysis
D)Myelodysplasia
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13
Chapter 12: Anemias of Disordered Iron Metabolism and Heme Synthesis
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Sample Questions
Q1) A bone marrow aspirate is performed on a patient with sideroblastic anemia.The smear is stained with Prussian blue iron.The expected findings in this patient would be that iron stores:
A)Will be decreased as compared with the normal control
B)Will be the same as those in the normal control
C)Will be increased as compared with the normal control
D)Cannot be determined based on the diagnosis alone
Q2) What measurements are used in the percent saturation calculation?
A)Transferrin and ferritin
B)Ferritin and bone marrow iron
C)Serum iron and TIBC
D)Serum iron and ferritin
Q3) Which of the following is the correct progression of iron-deficiency anemia?
A)Storage depletion,iron-poor hemoglobin production,transport depletion
B)Storage depletion,transport depletion,iron-poor hemoglobin production
C)Iron-poor hemoglobin production,transport depletion,storage depletion
D)Iron-poor hemoglobin production,storage depletion,transport depletion
Q4) How is sideroblastic anemia confirmed by laboratory analysis?
Explain your answer.
Q5) Explain how lead inhibits heme synthesis.
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Chapter 13: Hemoglobinopathies: Qualitative Defects
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Q1) The net decrease in negative charge in the hemoglobin S molecule is responsible for which laboratory finding?
A)Increase in solubility
B)Change in the electrophoretic mobility
C)Increase in oxygen infinity
D)Increase in flexibility of the red blood cell
Q2) What reflex test is most appropriate for investigating these results?
A)Hemoglobin electrophoresis and iron studies
B)Bone marrow aspirate
C)Vitamin B and folate assays
D)Cytogenetic analysis
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) Other than hemoglobin S,name two abnormal hemoglobins that produce a positive sickle solubility test.Explain how they could be differentiated from HbS.
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Chapter 14: Thalassemia
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Q1) What is the typical electrophoresis pattern in each of the following disorders?
a. -thalassemia minor
b.Hgb H disease
c. -thalassemia major
d. -thalassemia minor
Q2) What red cell morphology marks most types of thalassemia?
A)Target cells
B)Basophilic stippling
C)Polychromasia
D)Normal findings
Q3) a-thalassemia major results from deletion in _____ alleles of the alpha chain gene.
A)1
B)2
C)3
D)4
Q4) Correlate the mutation type to each of the following disorders:
a. -thalassemia major
b. -thalassemia major
c. - thalassemia silent carrier
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Chapter 15: Megaloblastic and Nonmegaloblastic
Macrocytic Anemias
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Q1) An analyzed blood specimen reveals the following: the MCV is increased,the hemoglobin level is decreased,and the reticulocyte count is normal or low.What test could give more information on the cause of the anemia without drawing another blood specimen?
A)Serum iron
B)Vitamin B assay
C)Blood smear morphological exam
D)Serum alcohol
Q2) What would be the results of vitamin B and/or folate levels in a diagnosis of pernicious anemia?
A)Increased folate
B)Increased vitamin B
C)Decreased vitamin B
D)Decreased folate and vitamin B
Q3) Vitamin B is a cofactor used in the conversion of _______ to _______.
A)Hydroxocobalamin;thymidine
B)5-methyltetrahydrofolate;tetrahydrofolate
C)Folate;methionine
D)Succinyl CoA;methylmalonic acid
Q4) Explain how high alcohol intake can cause macrocytosis.
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Chapter 16: Hypoproliferative Anemias
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Q1) Aplastic anemia is most often caused by:
A)Drugs
B)Radiation
C)Unknown causes
D)Infectious agents
Q2) How can infection with the Epstein-Barr virus (EBV)lead to aplastic anemia?
A)EBV causes defects in precursor cells.
B)EBV infects stem cells,and an immune response to destroy the stem cells is initiated.
C)EBV creates immune complexes on the surface of the stem cell that damages it.
D)Infection with the virus shuts down cytokine production by macrophages.
Q3) Explain how exposure to the following can lead to aplastic anemia.
a.Chloramphenicol
b.Benzene
c.Gamma radiation
d.Starvation
Q4) Define constitutional aplastic anemia,and give an example.
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18
Chapter 17: Hemolytic Anemia: Membrane Defects
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Q1) Differentiate between the three different subtypes of HE based on PB smear morphology.
Q2) Explain how a somatic mutation in the PIGA gene leads to PNH.
Q3) What is the principal confirmation test in the diagnosis of HS?
A)Erythrocyte indices
B)Erythrocyte survival test
C)Osmotic fragility test
D)Hemoglobin electrophoresis
Q4) Which of the following disorders has an abnormal erythrocyte membrane that is abnormally permeable,resulting in the loss of K+ and water and decreased deformability?
A)Overhydrated hereditary stomatocytosis
B)Dehydrated hereditary stomatocytosis
C)Hereditary elliptocytosis
D)Hereditary spherocytosis
Q5) The function of the MIRL is to:
A)Induce red cell agglutination
B)Prevent activation of C3b converting enzyme
C)Interfere with C8/C9 activation
D)All of the above
Page 19
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Chapter 18: Hemolytic Anemia: Enzyme Deficiencies
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Sample Questions
Q1) How do Heinz bodies differ morphologically from other erythrocyte inclusions?
Q2) 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
Q3) Intrinsic erythrocyte enzyme deficiencies lead to:
A)Increased erythrocyte oxidative susceptibility
B)Exacerbated immune response against erythrocytes
C)Increased opsonization of erythrocytes
D)Increased extravascular hemolysis
Q4) Which of the following is a quantitative test for G6PD?
A)Fluorescent spot test
B)Quantitative NADP rate reduction test
C)NADP dye reduction test
D)Ascorbate cyanide test
Q5) What is the purpose of the HMP shunt,and why is it important?
Q6) Why are Heinz bodies seen in G6PD deficiency?
Q7) Why are echinocytes seen in PK deficiency?
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Chapter 19: Hemolytic Anemia: Immune Anemias
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Q1) Paroxysmal cold hemoglobinuria is associated with viral and bacterial infections in children.With what other disease(s)is it associated?
A)Lymphoproliferative diseases in adults
B)Mixed-type AIHA
C)CAD
D)Warm autoimmune hemolytic anemia
Q2) Cold hemolytic anemia is usually caused by the presence of an:
A)IgD antibody.
B)IgG antibody.
C)IgM antibody.
D)IgG1 antibody.
Q3) Which of the following is an example of an anemia that occurs as a result of antibody development to an antigen that the individual lacks?
A)Autoimmune hemolytic anemia
B)Mixed-type autoimmune hemolytic anemia
C)Drug-induced hemolysis
D)Hemolytic disease of the newborn
Q4) Compare the differences in the activation of complement that can lead to intravascular hemolysis or extravascular hemolysis.
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Chapter 20: Hemolytic Anemia: Nonimmune Defects
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Q1) A 7-year-old girl is brought to a physician because she has a swollen hand with an ischemic lesion.The physician suspects a brown recluse spider bite.What is the suspected mechanism of erythrocyte damage caused by venom of this spider?
A)Changes in glycophorin on the erythrocyte membrane
B)DIC
C)Lysis caused by passage through the fibrin clot
D)Changes in the permeability of the cell membrane
Q2) Describe the mechanism that causes the production of schistocytes in microangiopathic hemolytic anemia.
Q3) The destruction of erythrocytes in MAHA is primarily the result of what mechanism?
A)Extravascular hemolysis
B)Loss of membrane proteins
C)Complement-mediated hemolysis
D)DIC
Q4) Explain why infections with Clostridium perfringens lead to hemolysis of the RBCs.
Q5) Explain how the action of E.coli O157:H7 toxin is related to the development of HUS.
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Chapter 21: Nonmalignant Disorders of Leukocytes:
Granulocytes and Monocytes
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Q1) 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
Q2) A peripheral blood smear examination shows many WBCs with many blue-staining round inclusions.Thrombocytopenia with giant platelets is present.What autosomal dominant disease is associated with these findings?
A)May-Hegglin anomaly
B)Alder-Reilly anomaly
C)Chédiak-Higashi anomaly
D)Megaloblastic anemia
Q3) Which of the following is associated with bacterial infections?
A)Acute neutrophilia
B)Toxic granulation
C)Döhle bodies
D)All of the above
Q4) Define leukoerythroblastosis,and name a condition in which this is seen.
Page 23
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Chapter 22: Nonmalignant Lymphocyte Disorders
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Q1) CMV infections complicate transplants by which of the following mechanisms?
A)Form antibodies to CMV-infected cells that cross-react with stem cells
B)Suppress normal immune function and elicit the formation of autoantibodies that are lymphocytotoxic
C)Impair mitotic division of normal hematopoietic cells and stimulate neoplastic cells to proliferate
D)Stimulate antibodies against RBCs resulting in an autoimmune hemolytic anemia
Q2) Bordetella pertussis is characterized by rapid peripheral lymphocytosis and decreased cellularity of the lymph nodes.What can explain this phenomenon?
A)Loss of homing of B cells to lymphoid tissues
B)Loss of homing of T cells to lymphoid tissue
C)Abnormal homing of lymphocytes to the bone marrow
D)Increase of L-selectin expression by T cells
Q3) The Epstein-Barr virus targets B cells that express _______.Once infected,they cause expression of the_______ marker.
A)CD21;CD23
B)CD23;CD21
C)CD22;CD23
D)CD34;CD19
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Page 24
Chapter 23: Introduction to Hematopoietic Neoplasms
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Q1) Which of the following is a complication of leukemia treatment?
A)Increased uric acid levels
B)Graft-versus-host disease
C)DIC
D)All of the above
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 of the following have the potential to progress into acute leukemia:
A)Myeloproliferative neoplasms
B)Acute neutrophilia
C)Megaloblastic anemias
D)Reactive leukocytosis
Q4) What is the difference between the HSC and the cancer stem cell?
Q5) Explain how proto-oncogenes contribute to tumor formation.
Q6) Name the two main classification systems that identify MDS and acute leukemia.Indicate how they are different.
Page 25
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Chapter 24: Myeloproliferative Neoplasms
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Q1) Which is a characteristic of ET that would help distinguish it from reactive thrombocytosis?
A)Transitory elevated platelet count
B)Splenomegaly
C)Normal platelet function
D)No abnormalities in erythrocytes or leukocytes
Q2) What substance(s)is(are)primarily responsible for stimulating the growth and proliferation of fibroblasts in PMF?
A)PDGF
B)EGF
C)TGF-
D)Fibronectin
Q3) The characteristic poikilocyte often seen in the peripheral blood of patients with PMF that indicates extramedullary hematopoiesis is:
A)Drepanocyte
B)Schistocyte
C)Spherocyte
D)Dacryocyte
Q4) Explain how a variant of CML is identified utilizing laboratory values.
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Chapter 25: Myelodysplastic Syndromes
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Q1) Myelodysplastic syndromes are sometimes called preleukemias because:
A)They have a progressive induction into acute leukemia.
B)They frequently progress to aplastic anemia.
C)Treatment for this disorder leads to leukemia.
D)They always precede leukemia.
Q2) A bone marrow specimen is received in the cytogenetics lab.FISH analysis has been ordered.The laboratician performs the assay and notices that 96% of the patient's cells contain both 5q- and 12q- deletions.These cytogenetic findings are characteristic of: A)CML
B)AML
C)MDS
D)ALL
Q3) 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
Q4) Give at least five morphologic indicators of dyserythropoiesis.
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Page 27
Chapter 26: Acute Myeloid Leukemias
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Q1) Which of the following confirms that a blast of unknown lineage is myeloid?
A)Toxic granulation
B)Leukocytosis
C)Auer rod
D)Basophilia
Q2) A patient presents with bleeding and is found to be in DIC.The peripheral smear contains hypergranular promyelocytes.The white count is slightly elevated.The bone marrow contains cells with multiple Auer rods with a clear blue cytoplasm.What is the probable type of AML?
A)AML with 11q23 abnormalities
B)AML with t(15;17)q22;q12)
C)Microgranular APL variant
D)AML with multilineage dysplasia
Q3) Patients with acute myelomonocytic leukemia are at higher risk of infection compared with individuals with acute myelocytic leukemia with differentiation.Explain why there is a higher risk of infection in patients diagnosed with acute myelomonocytic leukemia.
Q4) What is the definition of acute leukemia,according to the World Health Organization?
Q5) Why are Auer rods seen only in myeloblasts?
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Chapter 27: Precursor Lymphoid Neoplasms
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Q1) B-cell ALL/LBL with recurrent genetic abnormalities includes all of the following translocations except:
A)t(12;21)
B)t(9;22)
C)t(5;14)
D)t(1;19)
Q2) B-lymphoblasts in ALL exhibit which one of the following markers that is helpful in their identification?
A)CD4
B)CD2
C)CD10
D)HLA-DR
Q3) Which of the following cytochemical stains would be most helpful in differentiating AML from ALL?
A)LAP
B)MPO
C)PAS
D)Wright's stain
Q4) Define the phases and purposes of chemotherapy for ALL.
Q5) Contrast the clinical and laboratory findings of ALL to LBL.
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Chapter 28: Mature Lymphoid Neoplasms
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Q1) A male of 65 years of age is seen at a local hospital with symptoms of enlarged lymph nodes and possible gastrointestinal tract problems.The peripheral blood smear revealed cells resembling diffuse large B-cell lymphoma.The FISH studies demonstrated the translocation of BCL-1.What is the probable disease?
A)MALT
B)MCL
C)Burkitt leukemia
D)Follicular lymphoma
Q2) The presence of which of the following cell types confirms the diagnosis of Hodgkin lymphoma?
A)Lymphocyte
B)Plasma
C)Reed-Sternberg
D)Cleaved Sézary
Q3) Explain the molecular and cytogenetic profile of a patient with Burkitt lymphoma.
Q4) List and describe the five stages of Hodgkin lymphoma,focusing on laboratory features.
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) A procedure used to decrease the potential for GVHD in an allogeneic transplant is:
A)Freeze thaw to kill lymphocytes
B)Activation of CD4 cells and suppression of CD8 cells.
C)Purge of CD8 lymphocytes
D)Apheresis
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 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
Q4) Explain the significance of HLA and ABO antigen compatibility in stem cell transplantation.
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Chapter 30: Morphologic Analysis of Body Fluids in the
Hematology
Laboratory
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Q1) An unknown cell in a body fluid possesses the following morphologic characteristics: 35 mcM in size,partially clumped chromatin,prominent nucleoli,jagged nuclear membrane,and clumped cell with nuclear molding.What is the most likely identification of the unknown cell?
A)Mesothelial cell
B)Small-cell carcinoma cell
C)Adenocarcinoma cell
D)Leukemic blast cell
Q2) 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
Q3) List common morphologic changes associated with cytocentrifugation.
Q4) How would the technologist differentiate between a traumatic specimen collection tap and a cerebral hemorrhage?
Provide at least three macroscopic and three microscopic findings.
Q5) What is the significance of micro-organisms present in the cytospin?
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Chapter 31: Primary Hemostasis
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Q1) Which of the following defines the strength of a selected agonist?
A)Location in which they are derived
B)Ability to induce the full range of platelet functions
C)Ability to interact with thromboxane A
D)Speed by which the platelets become activated
Q2) During what stage of megakaryocyte development are platelets released into the circulation?
A)Between stages III and IV
B)At the end of stage II
C)During the cycling phase
D)At the point of proplatelet formation
Q3) Which of the following substances endogenous to the dense bodies is responsible for continuous platelet activation of surrounding platelets?
A)Platelet factor 4
B)Collagen
C)ADP
D)Epinephrine
Q4) How does the vascular system contribute to hemostasis?
Q5) Explain the biochemistry involved in platelet function.
Q6) Correlate blood vessel histology to vessel type and function in hemostasis.
Page 33
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Chapter 32: Secondary Hemostasis and Fibrinolysis
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Q1) Which of the following is not involved in "contact activation"?
A)Factor XII
B)Factor XI
C)PK
D)Factor X
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) Which of the following is the smallest degradation product of fibrin?
A)Fragment X
B)Fragment Y
C)D-dimer
D)E fragment
Q4) Compare and contrast systemic and physiologic fibrinolysis.
Q5) What are the roles of thrombin in coagulation?
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Chapter 33: Disorders of Primary Hemostasis
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Sample Questions
Q1) What laboratory tests are used to assess disorders of primary hemostasis and secondary hemostasis?
Q2) A patient is known to be a chronic alcoholic.His blood is drawn,and his platelet count is 72 x 10 /L.What is the most likely reason for this occurrence?
A)Immune-mediated thrombocytopenia
B)Acquired hypoplasia resulting from alcohol consumption
C)Dilutional thrombocytopenia from liver dysfunction
D)Increased destruction of platelets
Q3) A patient has a splitting headache shortly before getting her blood tested.She takes a couple of aspirin and is scheduled for platelet aggregation studies.What effect will this have on the platelet aggregation studies?
A)Platelets will show diminished activity with selected agonists.
B)Platelets will show normal activity with all agonists.
C)Platelets will show increased activity with selected agonists.
D)Platelets will show variable activity with all agonists.
Q4) Give at least five markers of differentiation between acute and chronic ITP.
Q5) How do hematologic disorders contribute to the pathogenesis of thrombocytopenia?
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Chapter 34: Disorders of Secondary Hemostasis
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Q1) 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
Q2) Which of the following is used in the identification of a secondary hemostatic pathway anomaly?
A)Bleeding time
B)ACE activity
C)Platelet aggregation studies
D)Factor assays
Q3) From what disorder is the patient suffering?
A)von Willebrand's disease
B)DIC
C)Hemophilia possibly
D)Lupus anticoagulant
Q4) What laboratory tests typically are utilized to detect lupus anticoagulants?
Q5) Explain how liver disease can be differentiated from DIC through laboratory test analysis.
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Chapter 35: Thrombophilia
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Q1) A patient has been diagnosed with a coagulopathy and has been given Coumadin as a mode of treatment.What screening test(s)should be performed to monitor this treatment,and what effect will this therapy have on the coagulation pathway?
A)APTT;initial decrease in the vitamin K-dependent factors of the intrinsic pathway
B)PT-INR;initial decrease in the vitamin K-dependent factors of the extrinsic pathway
C)PT-INR and APTT;initial decrease in the vitamin K-dependent factors of all pathways
D)PT-INR;initial decrease in all vitamin K-dependent serine proteases
Q2) During coumadin-induced anticoagulation,which factor's activity disappears most rapidly?
A)FIX
B)FVII
C)FVIII
D)FV
Q3) How does the INR standardize the prothrombin time?
Q4) Explain why many patients with an inherited thrombophilia are misdiagnosed.
Q5) What are the physiological processes involved in hypercoagulability?
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Chapter 36: Hemostasis: Laboratory Testing and Instrumentation
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Q1) The international normalized ratio (INR)is used to standardize the wide variations in the reagent of prothrombin testing.What is the goal of creating the ISI value?
A)Reduce the lot-to-lot variability
B)Correlate one manufacturer with another
C)Obtain a reagent that has an ISI of 1.0 or close to it
D)Reduce the use of anticoagulant therapy
Q2) In testing for thrombotic disorders,the ideal test would be:
A)Antigenic measurement of PC,PS,ATIII
B)Functional measurement of PC,PS,ATIII
C)Platelet function test
D)Lupus anticoagulant
Q3) The aPTT is the most common procedure used to monitor the unfractionated heparin therapy.Which of the reagents used in the test provides the activation of the formation of the fibrin clot?
A)Thromboplastin/calcium mixture
B)Activated partial thromboplastin and calcium
C)Thrombin and fibrinogen
D)Normal pooled plasma and thrombin
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Chapter 37: Hematology Procedures
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Sample Questions
Q1) Name the cytochemical stains that are typically used in the workup of the following and how they are used to differentiate these conditions:
a.AML-myelomonocytic
b.APL
c.ALL
d.AML-Monoblastic
e.AML-Erythroid
Q2) A technologist is performing differentials and notices that all the slides he has reviewed appear pink.What is the best way to correct this problem?
A)Change the buffer so that it is more acidic
B)Change the buffer so that it is more alkaline
C)Clean the slides and make a new smear
D)Filter the stain used
Q3) Which laboratory test is useful in the differential diagnosis of polycythemia?
A)EPO
B)sTfR
C)Hct
D)MCV
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Chapter 38: Bone Marrow Examination
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Sample Questions
Q1) What is the overall cellularity range of a bone marrow in a 35-year-old female patient?
A)35-45%
B)55-75%
C)50-60%
D)70-80%
Q2) Identify 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) It has been determined that the M:E ratio of a 55-year-old patient is 12:1.What can be concluded about the cellularity of the bone marrow?
A)The bone marrow has myeloid hyperplasia.
B)The bone marrow has erythroid hyperplasia.
C)The bone marrow is normal.
D)The overall cellularity of the marrow is hypercellular.
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Chapter 39: Automation in Hematology
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Q1) Explain the purpose of the following used in the standard hematologic cell-counting detection methods:
a.VCS flow cell
b.Photodetector
c.Sheath fluid
d.Direct current detection block
Q2) Which of the following instruments uses both electromechanical and optical density as a means of clot detection?
A)STArt 4 Coagulation system
B)BBL Fibrosystem
C)Trinity Biotech Coag-A-Mate XM
D)AMAX Destiny Plus
Q3) Regarding the CELL-DYN Sapphire,which parameter is determined by the impedance principle?
A)Hemoglobin
B)Nucleated erythrocyte count
C)Platelet count
D)Total leukocyte count
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 40: Flow Cytometry
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Sample Questions
Q1) Name at least two pitfalls in immunophenotyping mature lymphoid malignancies,and explain how you would correct this.
Q2) In diagnosing PNH,which of the following assays is most sensitive to its detection?
A)GPI anchor phenotype
B)Ham test
C)Sucrose lysis test
D)Osmotic fragility test
Q3) Which of the following is not the component(s)of a flow cytometer?
A)Photomultiplier tubes
B)Sheath fluid
C)Flow chamber
D)Hemoglobin chamber
Q4) An increased IRF is not seen in which of the following?
A)Erythropoietin therapy
B)Iron therapy in iron deficient patients
C)Bone marrow recovery post-transplant
D)Aplastic anemia
Q5) Explain why flow cytometry is of limited use in identifying AML.
Q6) What is the purpose of CD34 count?
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Chapter 41: Chromosome Analysis of Hematopoietic and Lymphoid Disorders
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Q1) Which of the following can result in trisomy?
A)Anaphase lag
B)Nondisjunction
C)Chromosome banding
D)Endomitosis
Q2) During the harvesting phase of sample preparation,the cells are arrested in metaphase by:
A)Incubation with colchicine
B)Fixing with Carnoy's fixative
C)Incubation with KCl
D)Addition of phytohemagglutinin
Q3) Why would a bone marrow aspirate be needed as a specimen for cytogenetic analysis in a patient with a lymphoma?
A)Bone marrow aspirate is an optimal source of rapidly dividing cells.
B)Bone marrow cells have good reactivity to colchicine.
C)It would indicate possible metastasis of the lymphoma to that of other hematopoietic organs.
D)Lymphoma cells are always present in the bone marrow if the patient has minimal residual disease.
Page 43
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Chapter 42: Molecular Analysis of Hematologic Diseases
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Q1) Inherited diseases are characterized by:
A)Sex-linked mutations expressed only in females
B)Acquired mutations detected only in affected organs
C)Lack of correlation between genotype and disease status among family members
D)Genetic defect generally present in all tissues of the patient's body
Q2) Explain why molecular testing is essential not only in identifying disorders,such as cancer,but also during the course of a disease.
Q3) A Hodgkin lymphoma patient is admitted for treatment.What would be the benefit in performing an EBV-DNA test on him?
A)It would identify the cause of the Hodgkin lymphoma.
B)Because the patient is immunocompromised,it would identify an opportunistic pathogen.
C)It would help monitor the efficacy of his treatment.
D)It would help rule out other types of lymphomas.
Q4) Give the advantages of PCR over Southern blot and advantages of Southern blot over PCR.
Q5) Name and compare two molecular methods used to detect mutations associated with sickle cell disease.
Q6) Explain the impact of a positive test for HTLV-1 in a lymphoma patient.
Page 44
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