Medical Technology Test Questions
Course Introduction
Medical Technology explores the principles, methodologies, and applications of modern diagnostic and therapeutic tools used in the medical field. The course covers areas such as clinical laboratory science, biomedical instrumentation, and molecular diagnostics, emphasizing the role of technology in disease detection, monitoring, and treatment. Students will gain foundational knowledge about the operation and interpretation of a variety of medical devices and laboratory tests, the quality assurance measures necessary for accurate results, and the ethical standards governing patient care. Through lectures, case studies, and hands-on laboratory experiences, students will develop competencies vital for careers in healthcare, laboratory management, and research settings.
Recommended Textbook
Clinical Laboratory Hematology 2nd Edition by Shirlyn B. McKenzie
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1419 Verified Questions
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Chapter 1: Introduction
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Sample Questions
Q1) The predominant blood leukocyte found in children is the:
A)Monocyte.
B)Lymphocyte.
C)Neutrophil.
D)Eosinophil.
Answer: B
Q2) List five ways to optimize laboratory test utilization to improve patient outcomes. Answer: Five ways to optimize laboratory test utilization include: Development of critical pathways, managing the test ordering system, instituting sequential testing protocols, eliminating incorrect use of tests, and designing wellness panels.
Q3) Which of the following formed elements could result in hypoxia if decreased?
A)Leukocytes
B)Erythrocytes
C)Platelets
D)None of the above
Answer: B
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Chapter 2: Cellular Homeostasis
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Sample Questions
Q1) All of the following are potential proto-oncogenes except:
A)Proteins that function as growth factor receptors.
B)Proteins that bind DNA.
C)Growth factors.
D)Proteins that neutralize growth factor receptors.
Answer: D
Q2) Malignancies can result from which of the following?
A)Accelerated apoptosis
B)Inhibited apoptosis
C)Normal occurrence of apoptosis
D)None of the above
Answer: B
Q3) If an organism fails to regulate apoptosis, resulting in excessive apoptosis, which of the following processes might result?
A)Neurodegenerative disorder
B)Autoimmune disorder
C)Lymphoma
D)Carcinoma
Answer: A
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Page 4
Chapter 3: Hematopoiesis
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Sample Questions
Q1) Compare and contrast the HSC and the progenitor cells.How are they similar? How are they different?
Answer: The hematopoietic stem cell HSC) has capabilities of self renewal, and helps give rise to progenitor cells that will create the sequence of blood cell maturation.The main difference between the HSC and the progenitors is their outcomes.The HSC has the capability of giving rise to any of the blood cell lineages, whereas the progenitors are more restricted in their ability to produce different types of blood cells.The two types of cell are morphologically indistinguishable.
Q2) All of the following are hematopoietic growth factor receptor subgroups except:
A)Unique ligand-specific alpha chains, with shared beta chains.
B)Unique ligand-specific alpha chains that share GP130.
C)Unique ligand-specific alpha chains, with shared gamma chains.
D)Unique ligand-specific alpha chains, with shared zeta chains.
Answer: D
Q3) Explain the role of selected cytokines in the treatment of disorders affecting the hematopoietic system.
Answer: EPO: stimulation of erythropoiesis in renal disease.
G-CSF/GM-CSF: recovery from treatment-induced myelosuppression.
IL-3/GM-CSF/EPO: therapy of MDS.
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Page 5
Chapter 4: Structure and Function of Hematopoietic Organs
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Sample Questions
Q1) Where in the body does maturation of T lymphocytes take place?
A)Lymph node
B)Bone marrow
C)Spleen
D)Thymus
Q2) A diagnosis of hypersplenism is made when which conditions are met?
A)Presence of anemia, leukopenia, or thrombocytopenia
B)Cytopenia in both the peripheral blood and bone marrow, and correction of cytopenia after splenectomy
C)Anemia and cytopenia in the peripheral blood, existence of a cellular or hyperplastic bone marrow corresponding to the peripheral blood cytopenia, and splenomegaly
D)Cytopenia in both the peripheral blood and bone marrow
Q3) The first sign of erythroid development in an embryo occurs in:
A)Yolk sac.
B)AGM.
C)Liver.
D)Lymph node.
Q4) List and explain the function of the cells in the bone marrow stroma.
Q5) Explain how the bone marrow receives nutrients to survive.
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Chapter 5: The Erythrocyte
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Sample Questions
Q1) Which of the following best correlates with an increased reticulocyte count?
A)An increased bilirubin
B)The presence of schistocytes in the peripheral blood smear
C)Increased polychromasia on the peripheral blood smear
D)Anisocytosis and poikilocytosis
Q2) All of the following proteins interact with spectrin in the RBC membrane except:
A)Glycophorin A.
B)Ankyrin.
C)Protein 4.1.
D)Actin.
Q3) What contributes to the RBC cell membrane integrity?
A)Skeletal proteins
B)Glycolytic pathway
C)2,3 DPG
D)Methemoglobin reductase
Q4) Where does normal extravascular hemolysis take place?
A)Blood vessels and bone marrow
B)Lymph nodes and spleen
C)Spleen and liver
D)Bone marrow and liver
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Chapter 6: Hemoglobin
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Sample Questions
Q1) In the complete hemoglobin structure, where is iron located?
A)Attached to the alpha-globin chains
B)Attached to the non alpha-globin chain
C)In the mitochondria
D)In the protoporphyrin ring
Q2) Measurement of glycosylated hemoglobin is used as an indicator of what disease process?
A)Anemia
B)Oxygen affinity
C)Cyanosis
D)Diabetes
Q3) What two molecules condense to begin heme synthesis?
A)Iron and protoporphyrin IX
B)Ferrochelatase and ALA dehydrase
C)Succinyl CoA and glycine
D)PBG deaminase and ALA dehydrase
Q4) How would a tense configuration of hemoglobin impact transport of oxygen? Explain your answer.
Q5) Correlate embryonic/fetal hemoglobin production to stages of fetal hematopoiesis.
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Chapter 7: The Leukocyte
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Sample Questions
Q1) All of the following are included in the kill mechanism of neutrophils except:
A)Chemoattraction of neutrophils to infectious agent.
B)Diapedesis of neutrophils from blood into tissues.
C)The formation of the phagolysosome by the neutrophil.
D)The presentation of infectious agent to monocyte for phagocytosis.
Q2) The lymphoid progenitor that gives rise to T, B, and NK lymphocytes is recognized as which of the following?
A)CFU_GM
B)CLP
C)CMP
D)CFU-T
Q3) 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
Q4) List and explain the four phases of neutrophil kill function.
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Chapter 8: Introduction to Anemia
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Sample Questions
Q1) Red blood cell survival is best measured by which of the following when hemoglobin levels are stable?
A)Conjugated bilirubin
B)Urine hemoglobin
C)Depending on the disorder, the most sensitive and specific test available
D)Reticulocyte count
Q2) What staining method can be used to differentiate Pappenheimer bodies from reticulocytes?
A)New methylene blue
B)PAS
C)Perl's Prussian blue
D)Phase microscopy on wet prep
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
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10
Chapter 9: Anemias of Disordered Iron Metabolism and Heme Synthesis
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Sample Questions
Q1) 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.
Q2) What reflex laboratory tests would be helpful to identify the cause of this anemia?
A)Serum iron studies
B)vitamin B
C)Bone marrow aspirate
D)Cytogenetic studies
Q3) Iron overload exists when ferritin levels are higher than:
A)100 ng/mL.
B)200 ng/mL.
C)50 ng/mL.
D)24 ng/mL.
Q4) Differentiate primary and secondary hemochromatosis?
Q5) Explain the difference in the chemical composition of hemosiderin and ferritin.
Page 11
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Chapter 10: Hemoglobinopaties: Qualitative Defects
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Sample Questions
Q1) What is the purpose of treating sickle-cell patients with hydroxyurea?
A)To dilute the amount of sickled red blood cells
B)To destroy the sickling red blood cells by initiating an immune response
C)To convert Hgb S into Hgb A
D)To increase the level of hemoglobin F that will reduce intracellular sickling
Q2) Evolution dictates that patients with sickle-cell disease have an inherent resistance to what?
A)Babesia infections
B)Acute leukemia
C)Hemolytic transfusion reactions
D)Plasmodium infections
Q3) What reflex test is most appropriate to investigate these results?
A)Hemoglobin electrophoresis and iron studies
B)Bone marrow aspirate
C)Vitamin B?? and folate assays
D)Cytogenetic analysis
Q4) How is methemoglobin detected in the laboratory?
Q5) A patient has a positive sickle solubility test.Further investigation reveals hemoglobin of 8.5 g/dL.What can be done to confirm these findings? Explain your answer.
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Chapter 11: Thalassemia
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Sample Questions
Q1) 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.
Q2) All of the following morphology are typically seen in beta thalassemia patients except:
A)Codocytes.
B)Polychromasia.
C)Microcytes.
D)Drepanocytes.
Q3) Alpha thalassemia major results from deletion in _____ alleles of the alpha chain gene.
A)1
B)2
C)3
D)4
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?
Page 13
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Chapter 12: Megaloblastic and Nonmegaloblastic
Macrocytic Anemias
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Sample Questions
Q1) Which CDA is characterized by a positive Ham test and a negative sucrose lysis test?
A)CDA I
B)CDA II
C)CDA III
D)CDA IV
Q2) The majority of PA patients have antibodies against what component necessary for vitamin B absorption?
A)Parietal cells
B)Vitamin B
C)Intrinsic factor
D)Blocking antibody
Q3) Acquired chronic pure red cell aplasia is a rare disorder encountered in association with several autoimmune disorders.What does the mechanism appear to be?
A)B cell-mediated immunosuppression of neutrophils
B)T cell-mediated immunosuppression of erythropoiesis
C)Cytokine-mediated immunosuppression of erythropoiesis
D)Increased serum erythropoietin
Q4) Explain how vitamin B deficiency can cause folate deficiency.
Page 14
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Chapter 13: Introduction to Hemolytic Anemia
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Sample Questions
Q1) The presence of schistocytes in the peripheral blood smear indicate:
A)Hemolysis due to extracorpuscular defects.
B)Hemolysis due to intracorpuscular defects.
C)Hemolysis due to both extracorpuscular and intracorpuscular defects.
D)Hemolysis with prominent bone marrow response.
Q2) Which of the following test results may help differentiate between intravascular hemolysis and extravascular hemolysis in the body?
A)Hemoglobin
B)Unconjugated bilirubin
C)Splenomegaly
D)Haptoglobin
Q3) A patient has numerous spherocytes noted on the blood smear.Which of the following will confirm a diagnosis of autoimmune hemolytic anemia.
A)MCV of 70 fl
B)Banding in the A1, A2, and F regions
C)Positive direct antiglobulin test
D)Normal unconjugated bilirubin
Q4) List three laboratory test results from peripheral blood that indicate increased erythropoietic activity in the bone marrow.
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Chapter 14: Hemolytic Anemia: Membrane Defects
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Sample Questions
Q1) List one cause of horizontal interactions of skeletal protein abnormalities?
A)Ankyrin
B)Glycophorin C
C)Band 3
D)Protein 4.2
Q2) Hereditary pyropoikilocytosis differs in red cell morphology from other erythrocyte membrane defects by what characteristic cell shape?
A)Spherocytes
B)Elliptocytes
C)Schistocytes
D)Target cells
Q3) Differentiate between the three different subtypes of HE based on PB smear morphology.
Q4) 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.
Q5) Explain how a somatic mutation in the PIGA gene leads to PNH.
Q6) Explain why patients with HS sometimes suffer from gallstones.
Page 16
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Chapter 15: Hemolytic Anemia: Enzyme Deficiencies
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Sample Questions
Q1) A 53-year-old Italian male was hospitalized with increased fatigue and hemoglobinuria.Patient history revealed his last ingested meal contained fava beans.G6PD levels were performed 3 months later, and the result was 5%.Based on these findings, which class of G6PD variant is most likely affected?
A)Class I
B)Class II
C)Class III
D)Class IV
Q2) PK deficiency causes which of the following to occur in the erythrocyte?
A)Denatured hemoglobin to precipitate
B)Splenic sequestration of normal erythrocytes
C)Premature apoptosis due to lack of ATP formed
D)Membrane instability with excessive sodium and calcium influx
Q3) Which of the following is used to screen for G6PD deficiency?
A)Supravital stain
B)Fluorescent spot test
C)PB smear
D)Cytochemical staining
Q4) Why are Heinz bodies seen in G6PD deficiency?
Q5) Why are echinocytes seen in PK deficiency?
Page 17
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Chapter 16: Hemolytic Anemia: Immune Anemias
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Q1) Which of the following is consistent with a diagnosis of CAD?
A)MCHC 44 g/dL
B)DAT positive with polyspecific AHG and anti-IgG
C)Spherocytes on the peripheral blood smear
D)MCV 104 fL
Q2) A Group O, Rh negative woman with no evidence of antibodies delivers her first child who shows a slightly decreased hemoglobin and the presence of spherocytes on the peripheral blood film.The DAT is positive with polyspecific AHG and anti-IgG.The baby is Group A, Rh negative and is slightly jaundiced with a bilirubin of 2.1 mg/dl.What is the most likely cause of the baby's jaundice?
A)Normal physiologic jaundice
B)Rh HDFN
C)ABO HDFN
D)Other type HDFN
Q3) Mixed-type AIHA is typically characterized by autoantibodies of which classes?
A)IgA and IgG
B)IgG and IgM
C)IgM and IgA
D)IgA and IgE
Q4) Compare the three mechanisms of drug-induced immune hemolysis.
Page 18
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Chapter 17: Hemolytic Anemia: Nonimmune Defects
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Q1) Plasmodium falciparum infection is accompanied by a severe form of anemia due to what factor?
A)Toxins produced by P.falciparum
B)High levels of parasitemia
C)Lack of spleen removal of the infected cells
D)Production of exotoxins that affect host cell membranes
Q2) Which of the following mechanisms is thought to cause exercise-induced hemoglobinuria?
A)Erythrocyte membrane protein changes
B)Oxidative stress and erythrocyte age
C)Excessive thermal buildup and damage to membranes
D)Foot strike damage
Q3) The type of anemia commonly associated with HUS is:
A)Microcytic, hypochromic.
B)Macrocytic, normochromic.
C)Normocytic, normochromic.
D)Microcytic, normochromic.
Q4) Explain why infections with Clostridium perfringens will lead to hemolysis of the RBCs.
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Page 19
Chapter 18: Nonmalignant Granulocyte and Monocyte Disorders
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Sample Questions
Q1) 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
Q2) Interpret the following results: WBC count 1.4 x 10<sup>9</sup>/L; bone marrow shows myeloid hypoplasia with a decreased M:E ratio of 1:1.There is no history of medications or drug
Exposure.What can be concluded from this?
A)The patient has a pseudoneutropenia.
B)The patient has a neutropenia due to decreased production.
C)The patient has a neutropenia due to increased loss in circulation.
D)The patient has a neutropenia due to toxin exposure.
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.
Q5) What causes sea-blue histiocytosis, and how is the sea-blue histiocyte identified?
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Chapter 19: Nonmalignant Lymphocyte Disorders
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Q1) Which of the following is expected to decrease as the HIV infection progresses into AIDS?
A)WBC count
B)CD4:CD8 ratio
C)Lymphocyte count
D)All of the above
Q2) Which of the following cell types is commonly infected by the HIV-1 virus?
A)Cytotoxic T cells
B)CD8 cells
C)CD4 cells
D)Neutrophils
Q3) Correlate each disorder with the following:
1.population (s) most affected by it;
2.whether it produces a lymphocytosis or lymphocytopenia;
3.morphology associated with each.
4.pathophysiology of the infection.
A)Infectious mononucleosis
B)Whooping cough
C)Toxoplasmosis
D)CMV infection
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Chapter 20: Introduction to Hematopoietic Neoplasms
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Q1) Name the two main classification systems that identify the following leukemias.Indicate how they are different.
A)MDS
B)Acute leukemias
Q2) How are the HSC and the cancer stem cell similar?
A)Morphology
B)CD markers
C)Cytochemical staining
D)Replicating potential
Q3) Which of the following disorders is characterized by signs of dyshematopoiesis?
A)Acute leukemias
B)Chronic leukemias
C)Myelodysplastic syndromes
D)Myeloproliferative disorders
Q4) Leukemias can be classified by which of the following?
A)Morphology
B)Lineage
C)Cytogenetic abnormality
D)All of the above
Q5) What is the difference between the HSC and the cancer stem cell?
Page 22
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Chapter 21: Myeloproliferative Disorders
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Q1) 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
Q2) Which of the following would be the best way to differentiate a myeloproliferative disorder from a myelodysplastic disorder?
A)Bone marrow differential
B)Morphology of cells present
C)Number of cells present
D)Amount of fat present
Q3) Which of the following myeloproliferative disorders is characterized by an elevated white count and a markedly elevated platelet count?
A)CML
B)ET
C)PV
D)CIMF
Q4) Explain the significance of the Philadelphia chromosome in ALL.
Q5) Discuss the role of EDTA in the LAP score evaluation.
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Chapter 22: Myelodysplastic Syndromes
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Q1) Explain the pathophysiology of MDS.
Q2) A bone marrow specimen is received in the cytogenetics lab.FISH analysis has been ordered.The technologist performs the assay and notices that 96% of the patient cells contain both 5q- and 12q- deletions.These cytogenetic findings are characteristic of: A)CML
B)AML
C)MDS
D)ALL
Q3) Which WHO classification for MDS is best supported when the peripheral blood shows a general cytopenia, 5-19% blasts with Auer rods, and less than 1 x10<sup>9</sup> /L monocytes?
A)Refractory anemia (RA)
B)Refractory anemia with excess blasts 2
C)5Q-syndrome
D)Refractory cytopenia with multilineage dysplasia
Q4) Explain how the FAB and WHO classifications of the MDS differ.
Q5) Give at least five morphologic indicators of dyserythropoiesis.
Q6) Explain the IPSS score system for prognosis and treatment of MDS.
Q7) Explain the relationship between myelodysplastic syndromes and acute leukemia.
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Chapter 23: Acute Myeloid Leukemias
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Q1) The M:E ratio of a patient with AML typically displays which of the following?
A)Myeloid hyperplasia
B)Erythroid hyperplasia
C)Both myeloid and erythroid hyperplasia
D)Normal
Q2) The FAB classification nomenclature for acute leukemia also appears under which WHO classification group?
A)AML with recurrent genetic abnormalities
B)AML with multilineage dysplasia
C)AML and MDS-therapy-related
D)AML not otherwise categorized
Q3) Traditional therapy in APL includes pharmacological concentration of RA (ATRA) and chemotherapy.What is the function of the chemotherapy component in this treatment protocol?
A)Induces maturation of the promyelocytes to mature granulocytes
B)Binds with the target PML/RAR gene, and represses gene transcription
C)Eradicates the leukemic stem cells
D)Induces cytolysis of the malignant promyelocytes
Q4) Compare and contrast WHO and FAB classification systems of AML.
Q5) Explain how bone marrow analysis helps establish an AML diagnosis.
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Chapter 24: Acute Lymphoblastic Leukemias
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Q1) Explain the molecular and cytogenetic profile of a patient with Burkitt's ALL.
Q2) Which of the following patient populations is most commonly afflicted with ALL?
A)Newborns
B)Adults
C)Pregnant females
D)Children
Q3) Name at least five classifications of ALL, and explain how they are different.
Q4) B-lymphoblasts in ALL exhibit which of the following markers on their surface that is also helpful in their identification?
A)CD4
B)CD2
C)CD10
D)HLA-DR
Q5) 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
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Chapter 25: Lymphoid Malignancies: Chronic Lymphoid
Leukemias, Lymphomas, and Plasma Cell Neoplasms
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Q1) 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
Q2) 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
Q3) Explain how environmental factors contribute to the pathogenesis of lymphoid neoplasms.
Q4) Describe the WHO and Ann Arbor classification systems of lymphoid neoplasms.
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Q5) Explain the major differences between Hodgkin and non-Hodgkin lymphomas.
Chapter 26: Hematopoietic Stem Cell Transplantation
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Q1) This antigen can be used to identify stem cells by immunophenotyping:
A)CD34.
B)CD4.
C)CD8.
D)CD33.
Q2) 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)Purging of CD8 lymphocytes.
D)Apheresis.
Q3) How are HSCs different from committed progenitor cells?
A)Their ability to self-renew
B)Their success in autologous transplantation
C)Their potency in the immune response
D)Their location of maturation
Q4) Explain the significance of HLA and ABO antigen compatibility in stem cell transplantation.
Q5) 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) The following results are obtained from a 38-year-old woman with congestive heart failure:
-Specimen: pleural fluid
-Fluid protein = 4.5 g/dl
-Serum protein = 9.5 g/dl
-Serum LD = 110 U/L
-Fluid LD = 60 U/L
These results are most consistent with which of the following?
A)Chylous effusion
B)Exudate
C)Transudate
D)Normal pleural fluid
Q2) A specimen labeled "ascites" is sent to the laboratory.What type of procedure was used to obtain this fluid?
A)Thoracentesis
B)Lumbar puncture
C)Arthrocentesis
D)Paracentesis
Q3) List common morphologic changes associated with cytocentrifugation.
Q4) What is the significance of micro-organisms present in the cytospin?
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Chapter 28: Primary Hemostasis
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Q1) During what stage of megakaryocyte development are the 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.
Q2) The strength of a selected agonist is defined by which of the following?
A)Location from where they are derived
B)Their ability to induce the full range of platelet functions
C)Their ability to interact with thromboxane A2
D)The speed by which the platelets become activated
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) 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) Which of the following are formed on a phospholipid surface?
A)Extrinsic Xase
B)Intrinsic Xase
C)Prothrombinase
D)All of the above
Q2) Which domain of the blood coagulation protein is responsible for its unique identity?
A)Signal peptide domain
B)Catalytic domain
C)Epidermal growth factor domain
D)Noncatalytic domain
Q3) Activation of circulating zymogens is achieved through:
A)Sympathetic nervous system stimulation.
B)Endomitosis.
C)Splenic sequestration.
D)Proteolytic cleavage.
Q4) What are the roles of thrombin in coagulation?
Q5) Compare and contrast systemic and physiologic fibrinolysis.
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Chapter 30: Disorders of Primary Hemostasis
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Q1) A patient is known to be a chronic alcoholic.His blood is drawn, and his platelet count is 72 x 10<sup>9</sup>/L.What is the most likely reason for this occurrence?
A)Immune-mediated thrombocytopenia
B)Acquired hypoplasia due to alcohol consumption
C)Dilutional thrombocytopenia due to liver dysfunction
D)Increased destruction of platelets
Q2) What is the most common cause of thrombocytopenia?
A)Dilutional thrombocytopenia
B)Increased destruction
C)Decreased production
D)Increased splenic sequestration
Q3) What is a common etiology of ITP in children?
A)Tooth extraction
B)Easy bruising syndrome
C)Vasculitis
D)Chickenpox
Q4) What laboratory tests are used to assess disorders of primary hemostasis? Secondary hemostasis?
Q5) How do hematologic disorders contribute to the pathogenesis of thrombocytopenia?
Page 32
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Chapter 31: Disorders of Secondary Hemostasis
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Q1) Explain the inheritance pattern of the following disorders, and explain how this contributes to the clinical manifestations of the disorders:
a.Hemophilia A
b. Hemophilia B
c. von Willebrands disease
d. Bernard-Soulier syndrome
Q2) Screening tests for the evaluation of VWD include the platelet count, APTT, PT, the bleeding time, and/or the PFA-100.Which of the following results would be evident in most cases of VWD?
A)Platelet count low
B)Ristocetin platelet aggregation test decreased
C)rRstocetin platelet aggregation test normal
D)VWF: Ag assay normal
Q3) What should be his next course of action in investigating these results?
A)He should repeat the aggregation studies.
B)He should start the patient on Coumadin.
C)He should order factor assays of the intrinsic pathway.
D)He should order factor assays of the intrinsic, extrinsic, and common pathways.
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Chapter 32: Thrombophilia
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Sample Questions
Q1) Which of the following conditions is NOT associated with an increased tendency for thrombosis?
A)Antiphospholipid antibody syndrome
B)Pregnancy
C)Malignancy
D)Factor VIII deficiency
Q2) Which of the following is thought to be a traditional risk factor associated with the formation of arterial thrombi?
A)von Willebrand's disease
B)Hemophilia
C)Dysfibrinogenemia
D)Diabetes
Q3) Name the genetic mutation that induces increased concentration of prothrombin in the circulation that leads to increased risk of venous thrombosis.
A)G A substitution on nucleotide 20210 of the prothrombin gene
B)Lysine to glutamic acid substitution on the sixth position on the beta globin chain
C)Arginine to glutamine substitution at the 506 position of prothrombin
D)Translocation of chromosome 22 onto the long arm of chromosome 9
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Chapter 33: Hematology Procedures and Hemostasis
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Q1) An instrument printout reports a platelet count of 85x 109/L.The technologist reviewing the peripheral blood smears notices aggregates of platelets around many of the neutrophils.What is the best course of action to correct this problem?
A)Warm the specimen for 10 min at 45°C and rerun the sample.
B)Centrifuge and rerun the sample.
C)Remake the smear and use alkaline buffer to stain the slide.
D)Redraw the sample in sodium citrate and repeat the platelet count.
Q2) A CBC is performed on a polycythemic patient.What must be done to ensure that the technologist makes an optimal blood smear on this specimen?
A)The technologist should increase the angle of the spreader slide.
B)The technologist should decrease the angle of the spreader slide.
C)The technologist should not change the angle of the spreader slide.
D)The technologist should stain with albumin.
Q3) Increased levels of Heinz bodies are seen in which of the following?
A)Thalassemia
B)G6PD deficiency
C)AML
D)Increased hemolysis
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Chapter 34: Bone Marrow Examination
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Sample Questions
Q1) A normal M:E ratio is about 3:1.Why are there three times more myeloid precursors than erythroid precursors in the bone marrow?
A)Because the body needs more cells to fight infection than to transport oxygen
B)Because the life cycle of a WBC is much longer than that of an RBC
C)Because WBCs undergo more steps in hematopoiesis than do RBCs
D)Because the life cycle of a WBC is much shorter than that of an RBC
Q2) A differential is performed on a bone marrow specimen obtained from a patient suspected of having CML in blast crisis.The results are as follows: 45% blasts, 13% metamyelocytes, 18% myelocytes, 10% promyelocytes, 8% bands, 2% segmented neutrophils, 1% pronormoblasts, 1% basophilic normoblasts, 1% polychromatophilic normoblasts, and 1% orthochromatophilic normoblasts.What is the M:E ratio?
A)2:1
B)24:1
C)12:1
D)15:1
Q3) Name five distinguishable characteristics that will help differentiate between benign lymphoid aggregates and malignant lymphoma.
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Chapter 35: Automation in Hematology and Hemostasis
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Q1) Which instrument does NOT use fluorescence intensity in its determination of reticulocytes?
A) LH 750
B) XE-2100
C) ADVIA 120
D) CELL-DYN Sapphire
Q2) In the reticulocyte determination, using the Sysmex XE-2100, the fluorescent dye containing oxazine and polymethine penetrates the cell membranes and stains the blood cells.What does the oxazine bind to within the cells?
A) Residual DNA
B) Hemoglobin
C) Residual RNA
D) Mitochondria
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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Sample Questions
Q1) Explain the advantages of using flow cytometry to count reticulocytes.
Q2) Name at least two pitfalls in immunophenotyping mature lymphoid malignancies, and explain how you would correct this.
Q3) Which analyte is the best indicator of the overall picture of the immune system in an HIV-positive patient?
A)Absolute CD4 count
B)Relative lymphocyte count
C)WBC count
D)All of the above
Q4) CD34 enumeration is useful in bone marrow and peripheral blood stem cell transplantation.The EWGCCA recommendations for this enumeration include proper technique and interpretation of the flow cytometry analysis.Which of the following standards were recommended for proper acquisition of events?
A)Include platelets and unlysed red blood cells and debris
B)Include only CD34 dim staining populations
C)Use bright fluorochrome conjugates of class II or III monoclonal antibodies that detect all glycoforms of CD34
D)Acquire only 10 CD34 positive cells
Q5) What is the purpose of CD34 count?
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Chapter 37: Chromosome Analysis of Hematopoietic and Lymphoid Disorders
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Sample Questions
Q1) A 42-year-old female patient has a solid tumor in her left lung.The physician has ordered cytogenetic analysis.What type of specimen is needed?
A)Bone marrow aspirate
B)Pleural effusion
C)Peripheral blood
D)Lymph node biopsy
Q2) Discuss the impact of FISH technology in hematolymphoid disorders and bone marrow transplant recipients.
Q3) A 60-year-old patient is admitted to the local hospital presenting with petechiae on his upper torso.Physical examination revealed a thin, pale man.Admission labs come back and the results reveal 50% blasts and 25% hypergranular promyelocytes present.A bone marrow aspirate is ordered that confirms the peripheral blood picture.Cytogenetic analysis revealed the following: t (11; 17) (q23; q21).How will this impact the patient's care?
A)The patient has a poorer prognosis because of the chromosomal aberration.
B)The patient has a favorable prognosis because of the chromosomal aberration.
C)The patient will be responsive to all trans-retinoic acid.
D)The patient will be resistant to all trans-retinoic acid, so another treatment will be needed.
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Chapter 38: Molecular Analysis of Hematologic Diseases
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Sample Questions
Q1) Explain why molecular testing is essential not only in identifying disorders, such as cancer, but also during the course of a disease.
Q2) Which of the following methods would be most useful for identifying point mutations anywhere in the DNA segment?
A)Southern Blot analysis
B)PCR
C)DNA sequencing
D)FISH
Q3) Explain the central dogma of molecular biology using proper nomenclature.Define each phase.
Q4) 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)Since 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.
Q5) Give the advanatgaes of PCR over Southern Blot and advantages of Southern Blot over PCR.
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Chapter 39: Laboratory Testing in Coagulation
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Sample Questions
Q1) List the tests that are commonly utilized in the workup of the following:
A)von Willebrand's disease
B)Hemophilia A
C)Factor VIII inhibitor
D)Bernard-Soulier syndrome
E)TTP
Q2) Laboratory testing for von Willebrand factor contains variables that can result in difficulty in diagnosing the disease.Which of the factors below is identified as a variable that can contribute to this difficulty?
A)Abnormal screening results
B)Difficulty in obtaining the specimen
C)Age of patient
D)Standardization of the reference plasma
Q3) A patient has prolonged PT and APTT.Which of the following tests would not be warranted to follow up these findings?
A)Factor XIII assay
B)D-dimer
C)Liver function tests
D)Fibrinogen
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Chapter 40: Quality Assessment in the Hematology
Laboratory
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Sample Questions
Q1) When using moving averages to monitor an automated hematology instrument, the clinical laboratory professional notes that a moving average falls out of range, but the recently performed quality control was acceptable, what would this indicate?
A) The instrument should be recalibrated.
B) The range is incorrect for the moving average.
C) The patient samples for last 20 results were from a single location.
D) The clinical laboratory professional should open and run new control materials.
Q2) Identify the critical information that must be on a material safety data sheet.
Q3) Which of the following represents the BEST method to assess a clinical laboratory professional's competency in performing leukocyte differentials?
A) Give the individual a 25-question written examination
B) Observe the individual during performance of a leukocyte differential
C) Assign the individual to complete the next CAP survey for hematology
D) Monitor the number of differentials that require pathology review for this individual
Q4) What is the importance of documentation in a quality assessment program?
Q5) What are the components of a method evaluation? Explain the purpose of each.
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