Hematology
1. Anticoagulant of choice
for platelet studies
a. Citrate
b. EDTA
c. Heparin
d. Oxalate
2. Most preferable site for
bone marrow aspiration and biopsy in an adult
a. Iliac crest
b. Sternum
c. Tibia
d. Spinous processes of a vertebra
3. Non-infectious wet wastes
should be disposed in a ___ colored container
a. Red
b. Black
c. Green
d. Yellow with a black band
4. Most predominant cell in
an adult bone marrow:
a. Prolymphocyte
b. Metamyelocyte
c. Promonocyte
d. Metarubricyte
5. Defibrinated blood can be
used on all of the following tests EXCEPT:
a. EOFT
b. Autohemolysis test
c. Ham’s acidified serum test
d. Donath-Landsteiner test
6. Which of the following
forms of hemoglobin cannot be measured by the hemiglobincyanide method?
a. Carboxyhemoglobin
b. Carbaminohemoglobin
c. Sulfhemoglobin
d. Methemoglobin
7. What is the effect of
pancytosis on ESR result?
a. Increased
b. Decreased
c. Variable
d. Not affected
8. Using a Coulter counter
analyzer, an increased RDW should correlate with:
a. Spherocytosis
b. Anisocytosis
c. Poikilocytosis
d. Leukoerythroblastosis
9. A miller disc is an
ocular device used to facilitate counting of:
1.
Polychromatophilic erythrocytes 3.
Nucleated RBCs
2. Reticulocytes 4. Platelets
a. 1 and 2
b. 2 only
c. 1, 2 and 3
d. 4 only
10. A defective centrifuge
was used to determine a hematocrit value. Which of the following parameters
will not be affected?
a. MCH
b. MCHC
c. MCV
d. RDW
11. What effect would using
a buffer at pH 6.0 have on a Wright-stained smear?
a. Red cells would be stained too blue
b. Red cells would be stained too pink
c. White cell cytoplasm would be stained too blue
d. Red cells could lyse on the slide
12. The naphthol AS-D
chloroacetate esterase stain is positive on which type of cell?
a. Megakaryoblast
b. Prolymphocyte
c. Promonocyte
d. Myeloblast
13. What is the principle of
automated impedance cell counters?
a. Angle of laser beam scatter by cells
b. Amplification of an electrical current by cells
c. Interruption of an electrical current by cells
d. Change in optical density of the solution containing cells
14. Side angle scatter in a
laser-based cell counting system is used to measure:
a. Cell size
b. Cytoplasmic granularity
c. Cell number
d. Antigenic identification
15. A WBC count is done on
an automated impedance cell counter from a patient with leukoerythroblastosis.
The WBC count is most likely:
a. Falsely increased due to nRBCs
b. Falsely increased due to RBC fragments
c. Falsely decreased due to nRBCs
d. Accurate; no error with this methodology
16. Automated cell counters
should be calibrated:
a. At least every 6 months
b. After replacement of any major part
c. Using commercially available controls
d. All of the above
17. On automated hematology
analyzers, marked red blood cell fragments will cause an abnormal histogram
and/or scatterplots for:
a. WBCs and RBCs
b. RBCs and platelets
c. WBCs and platelets
d. WBCs, RBCs and platelets
18. G-6-PD deficiency is an abnormality
in:
a. Rapoport-Luebering pathway
b. Embden-Meyerhoff pathway
c. Methemoglobin reductase pathway
d. Hexose monophosphate shunt
19. Nonspecific granules
appear at what stage of the myelocytic series?
a. Myeloblast
b. Myelocyte
c. Promyelocyte
d. Juvenile granulocyte
20. The demarcating membrane
system (DMS) begins to form in what stage of platelet maturation?
a. Megakaryoblast
b. Promegakaryocyte
c. Megakaryocyte
d. Metamegakaryocyte
21. Stem cell marker:
a. CD16
b. CD56
c. CD34
d. CD10
22. A well-defined hof and a
cart-wheel like pattern of chromatin are characteristics of:
a. Macrophages
b. Plasma cells
c. Megakaryocytes
d. Mast cells
23. A single megakaryocyte
can produce how many platelets?
a. 1,000-3,000
b. 5,000-7,000
c. 4,000-6,000
d. 2,000-4,000
24. Drabkin’s solution
contains:
a. Calcium chloride
b. Cyanide
c. Magnesium sulfate
d. Sulfosalicylic acid
25. The color of
Wright-stained RBCs may be adjusted by:
a. Dipping the slide in methanol before staining
b. Rapid drying of slides
c. Adjusting the buffer pH
d. Decreasing the concentration of glycerol in the stain
26. The addition of 0.5 mL
of blood to 4.5 mL of diluent results in a dilution of:
a. 1:5
b. 1:50
c. 1:20
d. 1:10
27. Which determination is
considered a reliable assessment of effective erythropoiesis in the bone
marrow?
a. Reticulocyte count
b. Hemoglobin
c. RBC count
d. M:E ratio
28. The specific diagnosis
of sickle cell anemia can be made from which of the following laboratory tests?
a. Solubility test
b. Sodium metabisulfite
c. Hemoglobin electrophoresis
d. Presence of sickle cells
29. Which among the
following instruments applies the principle of optical light scattering?
a. Fibrometer
b. Technicon autoanalyzer
c. Coulter counter
d. Sysmex counter
30. A clotted EDTA tube can
be used to perform a(n):
a. Platelet count
b. ESR
c. Hematocrit
d. Solubility test for HbS
31. In the platelet count
procedure using phase microscopy:
a. Platelets
appear dark against a light background
b. The entire
ruled counting surface of the hemocytometer is used
c. Ammonium
oxalate will lyse the WBCs
d. Platelets
should be counted immediately after plating the hemacytometer
32. The blood smear made on
a patient with polycythemia vera is too short. What should be done to correct
this problem?
a. Decrease the angle of the spreader slide
b. Increase the angle of the spreader slide
c. Adjust the angle of the spreader slide to 45 degrees
d. Use a smaller drop of blood
33. If a patient with an RBC
count of 2.90 x 1012/L has a reticulocyte count of 9.0%, what is the
absolute reticulocyte count in SI units?
a. 2.61 x 109/L
b. 26.1 x 109/L
c. 261 x 109/L
d. 261 x 103/μL
34. Which of the following
would not be the cause of a falsely high MCHC of 40.5 g/dL on an automated
instrument?
a. Hereditary spherocytosis
b. Lipemia
c. Presence of cold agglutinins
d. Instrument sampling or mixing error
35. A Wintrobe tube is
graduated between
a. 0-18 mm
b. 0-50 mm
c. 0-100 mm
d. 0-200 mm
36. A platelet count of
100,000-150,000/μL is reported as:
a. Normal
b. Low normal
c. Slightly decreased
d. Moderately decreased
37. A stomatocyte grading of
3+ indicates how many stomatocytes per oil-immersion field?
a. 0-2/oio
b. 2-10/oio
c. 10-20/oio
d. 20-50/oio
38. Which of the following
types of hemoglobin is the fastest to migrate on cellulose acetate hemoglobin
electrophoresis?
a. A1
b. Bart
c. I
d. H
39. Fetal hemoglobin can be
detected by:
a. Sickle preparation
b. Osmotic fragility test
c. Measuring alkali-resistant hemoglobin
d. Looking for basophilic stippling
40. Which of the following
blood stains is used to demonstrate reticulocyte?
a. Wright’s stain
b. Brilliant cresyl blue
c. May-Grunwald
d. Giemsa
41. A blood pressure cuff is
needed to carry out the following test(s):
1. Ivy’s bleeding
test 3. Coomb’s test
2. Duke’s
bleeding test 4. Lee and White
clotting time
a. 1 only
b. 1 and 2
c. 1, 2 and 4
d. 1, 2, 3 and 4
42. Which ratio of
anticoagulant to blood is correct for coagulation procedures?
a. 4:1
b. 1:5
c. 9:1
d. 1:9
43. Which anemia has red
cell morphology similar to that seen in iron deficiency anemia?
a. Sickle cell anemia
b. Thalassemia
c. Pernicious anemia
d. Hereditary spherocytosis
44. Which type of anemia is
usually present in a patient with acute leukemia?
a. Microcytic, hyperchromic
b. Microcytic, hypochromic
c. Normocytic, normochromic
d. Macrocytic, normochromic
45. Iron deficiency anemia
may be distinguished from anemia of chronic infection by:
a. Serum iron level
b. Red cell morphology
c. Red cell indices
d. TIBC
46. In which of the
following conditions does LAP show the least activity?
1. Leukemoid
reaction 3. Chronic Myelogenous
Leukemia
2. Idiopathic myelofibrosis 4. Polycythemia vera
a. 1, 2 and 4
b. 2, 3 and 4
c. 3 only
d. 1 only
47. Cells exhibiting a
positive stain with tartrate-resistant acid phosphatase are characteristically
seen in:
a. Infectious mononucleosis
b. Hairy cell leukemia
c. Sezary syndrome
d. Gaucher’s disease
48. Auer rods may be seen in
which of the following:
1. Acute
myeloblastic leukemia 3. Acute
promyelocytic leukemia
2. Acute
lymphoblastic leukemia 4. Acute myelomonocytic leukemia
a. 1, 2 and 3
b. 2, 3 and 4
c. 1, 3 and 4
d. 1, 2, 3 and 4
49. In myelofibrosis, the
characteristic poikilocyte is:
a. Codocyte
b. Schistocyte
c. Drepanocyte
d. Dacryocyte
50. According to FAB, to
establish the diagnosis for leukemia, the percentage of blasts found in the
bone marrow should be:
a. ≥20%
b. ≥30%
c. ≥15%
d. ≥40%
51. Stage in the myelocytic
series wherein a given granulocyte can be identified:
a. Promyelocyte
b. Myeloblast
c. Metamyelocyte
d. Myelocyte
52. A term that describes a
plasma cell with red to pink cytoplasm is known as:
a. Grape cell
b. Morula cell
c. Flame cell
d. Plasmacytoid lymphocyte
53. Faggot cells are
predominantly seen in which type of leukemia?
a. M1
b. M2
c. M3
d. M4
54. Which of these tests
will determine the inability of phagocyte to kill ingested microorganisms?
a. LAP score
b. NBT dye test
c. Boyden chamber assay
d. All of these
55. Oval macrocytes,
Howell-Jolly bodies and hypersegmented neutrophils are associated with what
condition?
a. Broadfish tapeworm infection
b. Cyanocobalamin deficiency
c. Pteroylglutamic acid deficiency
d. All of these
56. Which of the following
stains are most often positive in ALL but are negative in AML?
1. Terminal
deoxyribonucleotidase 3. Esterases
2. Periodic acid
Schiff 4. Sudan black B
a. 1 and 3
b. 1, 2 and 4
c. 1 and 2
d. 1, 2, 3 and 4
57. Which organ removes
erythrocyte inclusions without destroying the cell?
a. Liver
b. Spleen
c. Kidney
d. Lymph nodes
58. Hemoglobin configuration
characteristic of Hemoglobin H:
a. Gamma4
b. Alpha2-Gamma2
c. Beta4
d. Alpha2-Delta2
59. Which of the following
match(es) is(are) incorrect?
1. Stomatocyte –
Mouth cell 4. Elliptocyte –
Pear-shaped cell
2. Spherocyte –
Bronze cell 5. Acanthocyte – Burr
cell
3. Schistocyte –
Fragmented cell 6. Ovalocyte – Mexican
hat cell
a. 1, 2 and 3
b. 4, 5 and 6
c. 2, 4 and 5
d. 3, 5 and 6
60. Which of the following
pathways generates 2,3-Biphosphoglycerate that regulates hemoglobin affinity
for oxygen?
a. Rapoport-Luebering
b. Glycolytic
c. Pentose phosphate
d. Methemoglobin reductase
61. Mauve lavender color of
blood is associated with increased concentration of what hemoglobin?
a. Carboxyhemoglobin
b. Methemoglobin
c. Oxyhemoglobin
d. Sulfhemoglobin
62. Which of the following
is incorrect regarding aplastic anemia?
a. May be due to
drugs such as chloramphenicol, or chemicals such as benzene
b. Congenital
type is known as Diamond-Blackfan anemia
c. Pancytopenia
d. RBCs are
normocytic and normochromic
63. If the area of RBC palor
is three-fourths (3/4) of the cell diameter, the degree of hypochromia is
graded as:
a. 1+
b. 2+
c. 3+
d. 4+
64. Factors that cause shift
to the right in the Oxyhemoglobin Dissociation Curve:
1. Increased pH 3. Increased temperature
2. Decreased
2,3-BPG 4. Increased pCO2
a. 1 and 2
b. 3 and 4
c. 1, 3 and 4
d. 2, 3 and 4
65. In the Pelger-Huet
anomaly, neutrophils show:
a. A shift to the left
b. Dohle bodies
c. 2 lobes and hyperclumped chromatin
d. Toxic granulation
66. Ehler-Danlos, von
Willebrand and Bernard Soulier are all qualitative platelet disorders that have
abnormalities of:
a. Adhesion
b. Aggregation
c. Granule release
d. None of the above
67. A bleeding tendency is
likely to be present when the platelet count is below:
a. 50,000/μL
b. 150,000/μL
c. 200,000/μL
d. 400,000/μL
68. The phase contrast
microscope is employed in which platelet count method?
a. Rees-Ecker
b. Brecker-Cronkite
c. Indirect
d. Coulter
69. A disorder characterized
by a very high platelet count yet functionally abnormal platelets:
a. Glanzmann’s thrombasthenia
b. Essential thrombocythemia
c. Acute megakaryocytic leukemia
d. Thrombotic thrombocytopenic purpura
70. Aspirin prevents
platelet aggregation by inhibiting the action of which enzyme?
a. Phospholipase
b. Thromboxane A2 synthetase
c. Prostacyclin synthetase
d. Cyclooxygenase
71. Contents of platelet
dense granules:
1. Serotonin 3. ADP 5. ATP
2. Fibrinogen 4. Platelet factor 6. Calcium
a. 1, 2, 3 and 5
b. 1, 4, 5 and 6
c. 1, 3, 5 and 6
d. 1, 3, 4 and 6
72. Which part of the
platelet structure serves as the site of arachidonic acid metabolism?
a. Microfilaments
b. Dense tubular system
c. Microtubules
d. Glycocalyx
73. This factor is essential
for normal platelet aggregation:
a. Calcium
b. Glycoprotein Ib
c. von Willebrand factor
d. Glycoprotein IIb-IIIa complex
74. On a well stained blood
smear of a normal patient, there should be how many platelets in each oil
immersion field?
a. 8-20
b. 6-8
c. 4-5
d. 5-10
75. Part of the platelet
structure major responsible for clot retraction:
a. β-Thromboglobulin
b. Thrombospondin
c. Thrombosthenin
d. Canalicular system
76. Which of the following
does not contribute to hemostasis?
a. Liver
b. Endothelial cells
c. Thrombocytes
d. None of these
77. The activity of the
lupus anticoagulant and anticardiolipin antibodies appears to be directed
against:
a. Factor V
b. Factor VIII
c. Factor IX
d. Phospholipid
78. 5M urea or 1% monochloroacetic
acid are reagents used in tests for which plasma factor deficiency?
a. VIII
b. IX
c. XII
d. XIII
79. Laboratory results from
a patient with DIC are:
1. Decreased
platelets 3. Positive
D-dimer
2. Increased
factors I, V and VIII 4. Prolonged APTT
a. 1, 2 and 3
b. 1, 3 and 4
c. 2, 3 and 4
d. 1, 2, 3 and 4
80. Prolonged PT and APTT
are corrected with aged serum, but not with adsorbed plasma. What factor is
deficient?
a. I
b. II
c. V
d. X
81. Which of the following
coagulation test results is normal in a patient with classic von Willebrand’s
disease?
a. Bleeding time
b. APTT
c. Platelet count
d. Factor VIII:C and vWF levels
82. How is the endpoint in
platelet aggregation test using aggregometer detected?
a. Change in optical density
b. Turbidity
c. Clot formation via clotting time
d. Clot formation via specific gravity
83. Which among these
factors is present in adsorbed plasma but not in aged serum?
a. XI
b. II
c. VII
d. VIII
84. Epsilon aminocaproic
acid is an inhibitor of:
a. Platelet activation
b. Fibrinolysis
c. Fibrin clot stabilization
d. Collagent attachment
85. A positive protamine
sulfate test is suggestive of:
a. DIC
b. vWD
c. Glanzmann’s thrombasthenia
d. Primary fibrinolysis
86. Incorrect statement
regarding oral anticoagulants:
a. PT is used to monitor the dosage
b. Not recommended for pregnant and lactating women
c. Vitamin K antagonist
d. Needs antithrombin III as a cofactor
87. Liver disease is
characterized by all of the following EXCEPT:
a. Prolonged PT
b. Acanthocytosis
c. Decreased factor VIII
d. Decreased fibrinogen
88. Hemorrhagic disease of
newborns is often due to hypoprothrombinemia. This condition may be prevented
by giving expectant mothers adequate doses of:
a. Vitamin A
b. Vitamin C
c. Vitamin D
d. Vitamin K
89. Activators used in the
activated partial thromboplastin time:
1. Ellagic acid 3. Micronized silica
2. Celite 4. Kaolin
a. 1 and 2
b. 1, 2 and 3
c. 2, 3 and 4
d. 1, 2, 3 and 4
90. Variables to consider in
the visual detection of fibrin clot formation (tilt tube method):
a. Temperature
b. Pipetor calibration
c. Accuracy of timing devices
d. All of the above
91. What solution is used to
decontaminate the probes in an electromechanical instrument such as the
fibrometer?
a. 0.85% NaCl
b. 2% Acetic acid
c. Tap water
d. 0.1N HCl
92. Which of the following
aggregating agents is very difficult to store because of its susceptibility to
oxidation?
a. ADP
b. Epinephrine
c. Arachidonic acid
d. Collagen
93. In the Coulter Counter
electrical impedance instrument, the R1 flag in flagging indicates:
a. Increased granulocyte count
b. Overlap of cell populations at the lymphocyte-mononuclear
boundary
c. Presence of nucleated RBCs, giant platelets or sickle cells
d. Overlap of cells at the mononuclear-granulocyte boundary
94. In the Sysmex cell
counting instruments, an ‘asterisk with a number’ flag indicates:
a. A value exceeds the linearity of the system
b. Values are outside the numerical limits preset by the user
c. Analysis error
d. Distribution error
95. The size threshold range
used by electrical impedance methods to count particles as platelets is:
a. 0-10 fL
b. 2-20 fL
c. 15-40 fL
d. 35-90 fL
96. If a physician suspects
a qualitative platelet defect, the most useful test to order is:
a. Platelet count
b. Prothrombin time
c. Duckert’s test
d. Bleeding time
97. The expected screening
test results for a patient with a fibrin stabilizing factor deficiency are:
a. Prolonged PT
b. Prolonged APTT
c. Prolonged PT and APTT
d. Normal PT and APTT
98. 0.01 mL of blood is
diluted in 1.99 mL of diluent. This dilution is plated on both sides of a Neubauer
counting chamber. A total of 453 cells is seen when both large center squares
are counted. The platelet count expressed in SI units is:
a. 453 x 109/L
b. 453 x 103/μL
c. 227 x 109/L
d. 906 x 109/L
99. The platelet parameter
PDW refers to the:
a. Average platelet volume
b. Cell weight versus density
c. Variation in platelet cell size
d. Capacity to adhere to foreign substances
100. Causes of positive
errors in particle-counting instruments, EXCEPT:
a. Aperture plugs
b. Bubbles in the sample
c. Extraneous electrical pulses
d. Excessive lysing of RBCs
ANSWER KEY: Hematology
1.
A
2.
A
3.
C
4.
B
5.
D
6.
C
7.
B
8.
B
9.
A
10.
A
11.
B
12.
D
13.
C
14.
B
15.
A
16.
D
17.
B
18.
D
19.
C
20.
B
21.
C
22.
B
23.
D
24.
B
25.
C
26.
D
27.
A
28.
C
29.
B
30.
D
31.
A
32.
A
33.
C
34.
A
35.
C
36.
C
37.
D
38.
D
39.
C
40.
B
41.
A
42.
D
43.
B
44.
C
45.
D
46.
C
47.
B
48.
C
49.
D
50.
B
51.
D
52.
C
53.
C
54.
B
55.
D
56.
C
57.
B
58.
C
59.
B
60.
A
61.
D
62.
B
63.
C
64.
B
65.
C
66.
A
67.
A
68.
B
69.
B
70.
D
71.
C
72.
B
73.
D
74.
A
75.
C
76.
D
77.
D
78.
D
79.
B
80.
D
81.
C
82.
A
83.
D
84.
B
85.
A
86.
D
87.
C
88.
D
89.
D
90.
D
91.
B
92.
C
93.
C
94.
A
95.
B
96.
D
97.
D
98.
A
99.
C
100. D
