MLS Review Hematology
(Hct / RBC) * 10 – correct answer MCV calculation
(Hgb / Hct) * 100 – correct answer MCHC calculation
reticulocytes(%) * (Hct / 45) – correct answer corrected reticulocyte calculation
acid, eosin, pink – correct answer when the pH is too low (<6.4), the red cells take up more dye, () becoming more _ heinz bodies – correct answer which RBC inclusion does not show up with Wrights stain MCH – correct answer which RBC indice is not affected by Hct? MCHC in excess of 36% – correct answer spherocytosis is most associated with what RBC indice coefficient of variaition – correct answer statistical term which is a good index of precision right – correct answer acidosis is a shift to the __
alkalosis – correct answer a shift to the left is acidosis or alkalosis?
lymphocytes – correct answer aplastic anemia shows elevation of what leukocyte
20-44% – correct answer normal percentage of adult leukocytes
1-8% – correct answer normal monocyte percentage
polychromatic normoblast – correct answer first stage of RBC maturation when
cytoplasm is pink from hemoglobin
beta4 – correct answer hemoglobin configuration characteristic of Hgb H
leukopenia – correct answer hypersplenism is characterized by:
spleen – correct answer organ responsible for pitting process of RBCs
normocytic, normochromic – correct answer classification of anemia in sickle cell
disease
Hgb A (50-70%) (Hgb S =20-40%) – correct answer major Hgb found in people with sickle
cell trait
valine for glutamic acid – correct answer amino acid substitution responsible for sickle
cell anemia
sickle cell disease – correct answer condition where autosplenectomy may occur
Anti-P – correct answer antibody associated with paroxysmal cold hemoglobinuria
G6PD deficiency – correct answer bite cells are usually seen in patients with:
spherocytic red cells – correct answer autoimmune hemolytic anemia characterized by
RBC indices – correct answer morphological classification of anemia is based on
bizzare multinucleated erythroblasts – correct answer congenital dyserythropoetic
anemias (CDAs) are characterized by:
ASCP MLS Hematology
Insufficient centrifugation will result in:
A. A false increase in hematocrit (Hct) value
B. A false decrease in Hct value
C. No effect on Hct value
D. All of these options, depending on the patient – correct answer A. Insufficient
centrifugation does not pack down the
red blood cells; therefore, the Hct, which is the
volume of packed cells, will increase.
Variation in red cell size observed on the peripheral smear is described as:
A. Anisocytosis
B. Hypochromia
C. Poikilocytosis
D. Pleocytosis – correct answer A. A mature erythrocyte is approximately 7-8 μm in
diameter. Variation in normal size is denoted by the
term anisocytosis. Hypochromia is a term that indicates increased central pallor in
erythrocytes, and poikilocytosis denotes variation in red cell shape.
Which of the following is the preferable site for bone marrow aspiration and biopsy in an
adult?
A. Iliac crest
B. Sternum
C. Tibia
D. Spinous processes of a vertebra – correct answer A. The iliac crest is the most
frequently used site for
bone marrow aspiration and biopsy. This site is the
safest and most easily accessible, with the bone just
beneath the skin, and neither blood vessels nor
nerves are in the vicinity.
Mean cell volume (MCV) is calculated using the following formula:
A. (Hgb / RBC) × 10
B. (Hct / RBC) × 10
C. (Hct / Hgb) × 100
D. (Hgb / RBC) × 100 – correct answer B. MCV is the average “volume” of the red cells.
This is
obtained by dividing the Hct or packed cell volume
(PCV) by the red blood cell (RBC) count in millions per
microliter of blood and multiplying by 10. The MCV is
expressed in cubic microns (μm3) or femtoliters (fL).
What term describes the change in shape of erythrocytes seen on a Wright’s-stained
peripheral blood smear?
A. Poikilocytosis
B. Anisocytosis
C. Hypochromia
D. Polychromasia – correct answer A. Variation in shape of the erythrocytes on a
peripheral
blood smear is poikilocytosis. Anisocytosis refers to a
change in size. Hypochromia is an increase in central
pallor in erythrocytes. Polychromasia describes the bluish tinge of the immature
erythrocytes (reticulocytes) circulating in the peripheral blood.
Calculate the mean cell hemoglobin concentration (MCHC) using the following values:
Hgb: 15 g/dL (150 g/L)
Hct: 47 mL/dL (0.47)
RBC: 4.50 × 106/μL (4.50 × 1012/L)
A. 9.5% (.095)
B. 10.4% (.104)
C. 31.9% (.319)
D. 33.3% (.333) – correct answer C. MCHC is the average concentration of Hgb in red
cells expressed as a percentage. It expresses the ratio of the weight of Hgb to the volume
of erythrocytes and is calculated by dividing Hgb by the Hct, and then multiplying by 100.
A decreased MCHC indicates that cells are hypochromic. In this example, (15 ÷ 47) × 100
= 31.9%. The reference range for MCHC is 32%-36%.
A manual white blood cell (WBC) count was performed. A total of 36 cells were counted
in all 9-mm^2 squares of a Neubauer-ruled hemacytometer. A 1:10 dilution was used.
What is the WBC count?
A. 0.4 × 10^9/L
B. 2.5 × 10^9/L
C. 4.0 × 10^9/L
D. 8.0 × 10^9/L – correct answer A. The formula used for calculating manual cell counts
using a hemacytometer is:
Number of cells counted × dilution factor × depth factor (10) divided by the area.
In this example, 36 × 10 × 10 = 3600 ÷ 9 = 400/mm^3 or 0.4 × 10^9/L.
When an erythrocyte containing iron granules is stained with Prussian blue, the cell is
called a:
A. Spherocyte
B. Leptocyte
C. Schistocyte
D. Siderocyte – correct answer D. Siderocytes are red cells containing iron granules
and are visible when stained with Prussian blue.
A 7.0-mL ethylenediaminetetraacetic acid (EDTA) tube is received in the laboratory
containing only 2.0 mL of blood. If the laboratory is using manual techniques, which of
the following tests will most likely be erroneous?
A. RBC count
B. Hemoglobin (Hgb)
C. Hct
D. WBC count – correct answer C. Excessive anticoagulant causes shrinkage of cells;
thus, the Hct will be affected. RBC and WBC counts
remain the same, as does the Hgb content.
A 1:200 dilution of a patient’s sample was made and 336 red cells were counted in an
area of 0.2 mm^2. What is the RBC count?
A. 1.68 × 1012/L
B. 3.36 × 1012/L
C. 4.47 × 1012/L
D. 6.66 × 1012/L – correct answer B. RBC count = number of cells counted × dilution
factor × depth factor (10), divided by the area.
In this example, 336 × 200 × 10 = 672,000 ÷ 0.2 = 3.36 ×
106/mm^3 = 3.36 × 10^12/L.
What phagocytic cells produce lysozymes that are bacteriocidal?
A. Eosinophils
B. Lymphocytes
C. Platelets
MLS Hematology Hematology
Hematopoiesis – correct answer Production and development of blood cells normally
occurring in the bone marrow
Yolk sac – correct answer -the beginning of hematopoiesis
-begins as early as the eighteenth day after fertilization
Aorta-gonad-mesonephros (AGM) – correct answer -the beginning of intraembryonic
hematopoiesis
-beings at about four weeks of gestation
Where is the location of hematopoiesis during the fetal development at the third month? –
correct answer liver
Bone Marrow – correct answer -the blood-forming tissue located between the trabeculae
of spongy bone
-location for formation and maturation of blood cells
Two major departments of the bone marrow – correct answer -vascular compartment
-endosteal compartment
Vascular Compartment – correct answer composed of the bone marrow arteries and
veins, stromal cells, and hematopoietic cells
Endosteal Compartment – correct answer the primary site of bone remodeling but also
contains hematopoietic stem cells (HSCs)
Bone Marrow Hyperplasia – correct answer -an excessive proliferation of normal cells
-occurs with all conditions of increased of ineffective hematopoiesis
Extramedullary hematopoiesis – correct answer the formation and development of blood
cells at a site other than the bone marrow
Bone marrow is the site of cell development for __. – correct answer -myeloid
cells
-erythroid cells
-megakaryocytic cells (mother cells)
-lymphoid cells
What are other sites of cell development for lymphoid cells besides the bone marrow? –
correct answer -thymus
-spleen
-lymph nodes
Bone Marrow Hypoplasia – correct answer -hematopoietic tissue becomes inactive
-fat cells increase to offer a cushion for the marrow
What are some causes for bone marrow hypoplasia? – correct answer Environmental
factors
-chemicals
-toxins
Genetically determined
Blood Cell Passage – correct answer blood cells migrate from bone marrow to the
vascular space
What causes extramedullary hematopoiesis? – correct answer hyperplasia of the marrow
does not meet the physiologic needs of the tissues
Where does extramedullary hematopoiesis usually occur? – correct answer -liver
-spleen
Thymus – correct answer lymphopoietic organ
-bilobular organ with an outer cortex and central medulla
-supplies immunocompetent T lymphocytes to T-dependent areas
What is inside the cortex of the thymus? – correct answer -small lymphocytes
(thymocytes)
-cortical epithelial cells
-few macrophages
What is inside the medulla of the thymus? – correct answer -mature thymocytes
-medullary epithelial cells
-dendritic cells
-macrophages
Hypersplenism – correct answer spleen may become enlarged
-happens through the exaggeration of its normal activities of filtering and phagocytosis
What does hypersplenism cause? – correct answer -anemia
-leukopenia (decreased WBC)
-thrombocytopenia (decreased platelets)
-combinations of cytopenias (decreased cells)
Splenectomy – correct answer removal of the spleen
Splenectomy’s effect of the lifespan of RBCs – correct answer stays the same
Kupffer cells – correct answer -special macrophages that line the sinusoids
-performs similar filtering functions as the phagocytes in the splenic cords and marginal
zones
MLS Hematology Hematology
Hematopoiesis – correct answer Production and development of blood cells normally
occurring in the bone marrow
Yolk sac – correct answer -the beginning of hematopoiesis
-begins as early as the eighteenth day after fertilization
Aorta-gonad-mesonephros (AGM) – correct answer -the beginning of intraembryonic
hematopoiesis
-beings at about four weeks of gestation
Where is the location of hematopoiesis during the fetal development at the third month? –
correct answer liver
Bone Marrow – correct answer -the blood-forming tissue located between the trabeculae
of spongy bone
-location for formation and maturation of blood cells
Two major departments of the bone marrow – correct answer -vascular compartment
-endosteal compartment
Vascular Compartment – correct answer composed of the bone marrow arteries and
veins, stromal cells, and hematopoietic cells
Endosteal Compartment – correct answer the primary site of bone remodeling but also
contains hematopoietic stem cells (HSCs)
Bone Marrow Hyperplasia – correct answer -an excessive proliferation of normal cells
-occurs with all conditions of increased of ineffective hematopoiesis
Extramedullary hematopoiesis – correct answer the formation and development of blood
cells at a site other than the bone marrow
Bone marrow is the site of cell development for __. – correct answer -myeloid
cells
-erythroid cells
-megakaryocytic cells (mother cells)
-lymphoid cells
What are other sites of cell development for lymphoid cells besides the bone marrow? –
correct answer -thymus
-spleen
-lymph nodes
Bone Marrow Hypoplasia – correct answer -hematopoietic tissue becomes inactive
-fat cells increase to offer a cushion for the marrow
What are some causes for bone marrow hypoplasia? – correct answer Environmental
factors
-chemicals
-toxins
Genetically determined
Blood Cell Passage – correct answer blood cells migrate from bone marrow to the
vascular space
What causes extramedullary hematopoiesis? – correct answer hyperplasia of the marrow
does not meet the physiologic needs of the tissues
Where does extramedullary hematopoiesis usually occur? – correct answer -liver
-spleen
Thymus – correct answer lymphopoietic organ
-bilobular organ with an outer cortex and central medulla
-supplies immunocompetent T lymphocytes to T-dependent areas
What is inside the cortex of the thymus? – correct answer -small lymphocytes
(thymocytes)
-cortical epithelial cells
-few macrophages
What is inside the medulla of the thymus? – correct answer -mature thymocytes
-medullary epithelial cells
-dendritic cells
-macrophages
Hypersplenism – correct answer spleen may become enlarged
-happens through the exaggeration of its normal activities of filtering and phagocytosis
What does hypersplenism cause? – correct answer -anemia
-leukopenia (decreased WBC)
-thrombocytopenia (decreased platelets)
-combinations of cytopenias (decreased cells)
Splenectomy – correct answer removal of the spleen
Splenectomy’s effect of the lifespan of RBCs – correct answer stays the same
Kupffer cells – correct answer -special macrophages that line the sinusoids
-performs similar filtering functions as the phagocytes in the splenic cords and marginal
zones
MLS Hematology Final
Which is true regarding the red blood cell? – correctanswer The body increases the
amount of RBC progenitors at all times to increase the response time when anemia
occurs.
Active hematopoiesis in an adult would most likely take place in the: – correctanswer Hip
What are the two reasons that the erythrocyte loses its nucleus?(multiple) –
correctanswer To gain membrane deformability; To allow for better oxygen transport into
the tissues
What is the major function of the erythrocyte? – correctanswer Oxygen transport
Which descibe intravascular hemolysis?(multiple) – correctanswer It can result from
membrane damage caused by the turbulence in the chambers of the heart; It can be
triggered by membrane-bound complement proteins
Why do newborns have a higher normal red cell count than adults? – correctanswer The
newborns cells have a higher concentration of Hgb F which has a higher affinity for
oxygen
As the erythrocyte matures, why does it decrease in size? – correctanswer It undergoes
multiple cell divisions
Which term describes hematopoiesis that takes place outside the bone marrow? –
correctanswer Extramedullary
Match the organ: Liver – correctanswer Can be site of hematopoiesis during bone marrow
failure
Match the organ: Kidney – correctanswer involved in the detection of hypoxia in
erythrocytes
Match the organ: Thymus – correctanswer the site for T cell maturation
Match the organ: Spleen – correctanswer Involved in the removal of damaged or
senescent red blood cells
Match the organ: Lymph nodes – correctanswer Site of antigenic encounter for specific B
cells and T cells
Match the organ: Bone Marrow – correctanswer The major site for hematopoiesis in an
adult
A cardiac patient would be expected to have a lower number of red cells in circulation
due to his physiological condition. – correctanswer False
As the erythrocyte matures, why does the cytoplasm change from blue to pink?
(multiple) – correctanswer Blue-staining RNA synthesis decreases; Pink-staining
hemoglobin synthesis increases
The number of RBCs in circulation is controlled by a variety of factors. Which would NOT
be considered a normal control mechanism? – correctanswer Necrosis
Which defines the last mitotic stage of erythropoiesis? – correctanswer Polychromatic
normoblast
A stem cell committed to becoming a B cell will have which CD marker? – correctanswer
CD19
Which best defines a stem cell? (multiple) – correctanswer Is subject to apoptosis if the
numbers are too high; can give rise to an identical daughter cell without differentiation;
has the ability to differentiate into all functional cell types
Match the cell type: Endothelial cells – correctanswer Help regulate the passage of
particles entering and leaving the hematopoietic spaces
Match the cell type: Macrophages: – correctanswer Store recycled iron
Match the cell type: Stromal cells – correctanswer Originate from the mesenchymal cells
Match the cell type: Mesenchymal cells – correctanswer A type of embryonic tissue that
migrates into the marrow to support blood cell development
Match the cell type: Adipocytes – correctanswer Help regulate the volume of the bone
marrow
Match the cell type: Reticular adventitial cells – correctanswer Extend fibers into the bone
marrow cavity on which mature blood cells will adhere
Erythropoietin has a positive influence on erythropoiesis. Which would be considered a
mechanism of action by the hormone? (multiple) – correctanswer It inhibits the
production of adhesion molecule receptors on the maturing red blood cell; It stimulates
RNA synthesis of the red blood cells; It inhibits normal apoptosis; It causes an increase
in the release of reticulocytes form the bone marrow
What ultimately happens to the nucleus of the mature erythrocyte? – correctanswer It is
extruded from the cell in a membrane-bound vesicle and is phagocytized by
macrophages
During hematopoiesis, which cell type, located toward the middle of the extravascular
cord in the bone marrow, undergoes receptor-mediated migration toward the periphery of
the cord as they mature? – correctanswer Granulocytes
Match the events: This phase begins around the fourth month gestation – correctanswer
Medullary
Match the events: The 3:1 ratio of myeloid to erythroid cells is achieved in this phase –
correctanswer Medullary
Match the events: Cell development occurs inside the developing blood vessels –
correctanswer Mesoblastic
Hematology Exam 1 MLS
Protoporphyrin ring is the backbone of what? – correct answer Heme Molecule
Protoporphyrin combines with what to make Heme? – correct answer Fe++ or Ferrous
Iron
Hemoglobin and Ferric Iron = – correct answer Methemoglobin
Hemoglobin + CO2 = – correct answer Carbaminohemoglobin
1 g Hbg contains how much O2 – correct answer 1.34 mL O2
1g Hgb contains how much iron? – correct answer 3.47 mg Fe
Drabkin’s reagent is used in what method of hemoglobin measurement? – correct answer
Cyanmethemoglobin
This reagent contains
-NaHCO3
-KCN
-K3FeCN
-Water – correct answer Drabkin’s reagent
What wavelength is cyanmethemoglobin measured? – correct answer 540 nm
Potassium ferricyanide oxidizes Hb to methemoglobin, then potassium cyanide converts
MetHgB to Cyanmethemoglobin.
Why would this be a useful chemical reaction for measuring hemoglobin concentrations?
- correct answer CMH is stable and measured at 540 nm.
Reference range for neonatal hemoglobin – correct answer 15-24.6 g/dL
Female HbG reference range – correct answer 12-15 g/dL
Male hbG reference range – correct answer 14-18 g/dL
What is the relationship between the hemoglobin level and the hematocrit level for a
given patient? – correct answer HgB X 3 = HCT
Name the HgB formed in septicemia caused by Clostridium welchii – correct answer
Sulfhemoglobin
What color is the blood of patients with sulfhemoglobin? – correct answer Bright Green
When measuring hemoglobin with a spectrophotometer, these conditions will have what
effect on the hgb result?
-High WBC
-High platelet count
-Lipemia
-Abnormal hemoglobins like hgb S or hbg C – correct answer Falsely elevated
HemoCue uses what method for hemoglobin analysis? – correct answer Photometric
Azide Methemoglobin
The HemoCue testing microcuvette functions as what during analysis? – correct answer
Pipette, Test Tube, Measuring Vessel
Hematocrit is – correct answer Volume of blood comprised of rbc
Buffy coat is – correct answer The layer of wbc and platelets between rbc and plasma
interface in centrifuge whole blood specimens
MLS Hematology – Quizzes
The thymus is primarily responsible for the development of: – correct answer T
Lymphocytes
Which of the following is the correct order of maturation for hematopoiesis from earlier
to later stages? – correct answer Pluripotential, Progenitor, Precursor
Which of these acts on the pluripotent hematopoietic stem cells to initiate proliferation
and differentiation into progenitor cells? – correct answer KIT Ligand
During the Mesoblastic period, the primary organ of hematopoiesis is: – correct answer
Yolk Sac
A patient who has too many leukocytes has: – correct answer Leukocytosis
CD34 is expressed on which kind of cells? – correct answer Stem
Which of the following cytokines is essential for the formation of an erythrocyte? –
correct answer Erythropoietin
The primary site of hematopoiesis in a fetus of 4 month gestational age? – correct answer
the liver
Which of these is a function of stromal cells in the bone marrow? – correct answer
Formation of an extracellular matrix
The index that is calculated using the hematocrit and the RBC count and provides
information about the size of an RBC is: – correct answer Mean Corpuscular Volume
How is an infant’s thymus different from the thymus in an adult? – correct answer It is
larger than that of an adult
Hematopoiesis is defined as the formation of: – correct answer All blood cells
A stem cell labeled as CFU-GEMM is NOT capable of becoming… – correct answer A
lymphocyte
Given an RBC count of 1.25 x 10^6/ul, a hemoglobin of 6.0 g/dl and a hematocrit of 18%,
calculate the MCV for this patient. – correct answer 144 fL
Which of the following sets of data follow the rule of three?
Choice RBC Hgb Hct
A 4.50 x 10^6/ul 18.0 g/dl 43%
B 4.50 x 10^6/ul 13.5 g/dl 40.5%
C 3.00 x 10^6/ul 14.0 g/dl 36%
D 2.75 x 10^6/ul 12.5 g/dl 32.5% – correct answer B. 4.5 x 10^6 = RBC
13.5 g/dl = Hgb
40.5% = Hct
Which RBC precursor is the last stage to have a nucleus? – correct answer
Orthochromatophilic normoblast
Which of the following is true about mature erythrocytes? – correct answer They cannot
make hemoglobin
If the cytoplasm of a cell is very basophilic or blue when stained with Wright’s stain it
contains: – correct answer large number of ribosomes
What feature of normal RBCs is most responsible for limiting the life span of the RBC? –
correct answer Loss of nucleus
What are the components of the erythrocyte membrane? – correct answer -carbohydrates
-lipids
MLS BOC – Hematology
this is an expression of inactive X chromosome seen in Neutrophils of females only –
correct answer Barr body
Also known as Azurophilic granules or Non-specific granules, disappear with maturation
and reappears in toxic granulation – correct answer Primary granules
which Neutrophilic granules has in its contents cytotoxic compounds, Myeloperoxidase
(MPO) – correct answer primary azurophilic non-specific granules
Also known as Specific granules and gives the neutrophilic cytoplasm a characteristic
pink/neutral color – correct answer Secondary granules
Which neutrophilic granules has pro-inflammatory and chemotactic factors – correct
answer Secondary granules
during bacterial killing by the neutrophils through the process of phagocytosis the
production of ROS cytotoxic reactive oxygen species is catalyzed by – correct answer
MPO which is a content of primary granules
in basophils what are the content of the purple granules – correct answer Histamine,
Tryptase (inflammatory enzyme), Heparin
When in the tissues is known as MAST CELLS and it is IgE mediated allergies – correct
answer Basophils
Monocytes when in the tissues is known as – correct answer Macrophage or Histiocytes
what is the function of Macrophages in the innate immunity – correct answer Phagocytic
scavengers
what is the function of Macrophages in acquired immunity – correct answer P-PAC =
Professional Antigen Presenting Cell ( MHC class II)
what are the functions of the cytokines produced by the MAcrophages – correct answer
Stimulate hematopoiesis and chemotactic factors
what is called the procedure to aspirate fluid from peritoneal cavity – correct answer
paracentesis
what kind of cells make up the thin membrane that lines the internal organs such as
lungs, heart, peritoneal etc.? – correct answer mesothelial cells
what is called the accumulation of fluid in the peritoneal cavity, causing abdominal
swelling – correct answer Ascites
what is called an abnormal collection of fluid in the pleural, pericardial or peritoneal
space – correct answer Effusion
the effusion due to a systemic disease, low protein count and WBC <1000/uL is called – correct answer transudate effusion the effusion due to a localized disease, high protein content and WBC >1000/uL – correct
answer Exudate effusion
what is called the yellowish tinge in the CSF fluid due to breakdown of heme, indicative
of subarachnoid hemorrage – correct answer Xanthochromia
during the CSF collection, this is a product of Hgb metabolism – correct answer
Hematoidin crystals
Monosodium urate crystals is known to form – correct answer Gout
Calcium pyrophosphate crystals is known to form – correct answer Pseudogout
Cholesterol crystals is known to form – correct answer different types of chronic arthritis
which blood tube anticoagulant prevents coagulation by interacting with antithrombin to
inhibit thrombin. Normally used for osmotic fragility test – correct answer Lithium heparin
when IgM antibodies directed against RBC antigens form a complex what is it called –
correct answer Cold agglutinin
when the automated cell counter show elevated MCH and decreased RBC with normal
Hgb what may this indicate – correct answer Cold agglutinin
corrected WBC count in the presence of nRBC – correct answer (WBC count x
100)/(nRBC + 100)
Hemocytometer manual calculation for WBC – correct answer [(# cells counted)(DF)]/[(#
of squares)(0.1)]. if you count both chambers add them up divide by 2
Hemocytometer manual calculation for RBC – correct answer [(# cells counted)(DF)]/[(# of
squares)(0.004)].
MCV formula – correct answer Hct/RBC x 10
MCH formula – correct answer Hgb/RBC x 10
MCHC formula – correct answer Hgb/Hct x 100
How to calculate reticulocyte using Miller disk – correct answer Rectic%= (# rectic in
square A x 100)/(# RBC in square B x 9)
the solubility test for hemoglobin is a standard screen test for the presence of – correct
answer Hgb S
turbid color for positive
MLS Hematology Exam 1
What is the pH of methyl blue – correct answer 6.7 to 6.8 “acidic”
Why are blood cells a salmon pink color? {factors} – correct answer The hemoglobin is
positively charged and reacts with the dye.
What is the Wright – Giemsa used on? – correct answer bone marrow
What is the normal size of a red blood cell? – correct answer 6-8 microns
What is the normal ratio that the central pallor occupies? { central pallor is the clear
region in a blood cell} – correct answer 1/3
What are normal blood cells classified as? – correct answer normocytic
What are microcytic and macrocytic cells? {what length classifies them as such} –
correct answer abnormally small – less than 6 & abnormally large – bigger than 8
What does the term anisocytosis mean? – correct answer there is a variation of red blood
cells sizes in a specimen
How does an analyzer calculate if a red blood cells is the correct length? – correct answer
the fluid volume inside the cell known as the mean corpuscular volume
Fun Reminder: microcytosis are associated with what disease? – correct answer iron
deficiency
Fun Reminder: macrocytosis are associated with what disease? – correct answer liver
disease
Poikilocytosis – correct answer nonspecific variation in shape of blood specimen
MLS Review Harr: Hematology
A. A false increase in hematocrit (Hct) value
A Insufficient centrifugation does not pack down the red blood cells; therefore, the Hct,
which is the volume of packed cells, will increase. – correct answer Insufficient
centrifugation will result in:
A. A false increase in hematocrit (Hct) value
B. A false decrease in Hct value
C. No effect on Hct value
D. All of these options, depending on the patient
A. Anisocytosis
A A mature erythrocyte is approximately 7-8 μm in diameter. Variation in normal size is
denoted by the term anisocytosis. Hypochromia is a term that indicates increased central
pallor in erythrocytes, and poikilocytosis denotes variation in red cell shape. – correct
answer Variation in red cell size observed on the peripheral smear is described as:
A. Anisocytosis
B. Hypochromia
C. Poikilocytosis
D. Pleocytosis
A. Iliac crest
A The iliac crest is the most frequently used site for bone marrow aspiration and biopsy.
This site is the safest and most easily accessible, with the bone just beneath the skin,
and neither blood vessels nor nerves are in the vicinity. – correct answer Which of the
following is the preferable site for bone marrow aspiration and biopsy in an adult?
A. Iliac crest
B. Sternum
C. Tibia
D. Spinous processes of a vertebra
B. (Hct ÷ RBC) × 10
B MCV is the average “volume” of the red cells. This is obtained by dividing the Hct or
packed cell volume (PCV) by the red blood cell (RBC) count in millions per microliter of
blood and multiplying by 10. The MCV is expressed in cubic microns (μm3) or femtoliters
(fL). – correct answer Mean cell volume (MCV) is calculated using the following formula:
A. (Hgb ÷ RBC) × 10
B. (Hct ÷ RBC) × 10
C. (Hct ÷ Hgb) × 100
D. (Hgb ÷ RBC) × 100
A. Poikilocytosis
A Variation in shape of the erythrocytes on a peripheral blood smear is poikilocytosis.
Anisocytosis refers to a change in size. Hypochromia is an increase in central pallor in
erythrocytes. Polychromasia describes the bluish tinge of the immature erythrocytes
(reticulocytes) circulating in the peripheral blood. – correct answer What term describes
the change in shape of erythrocytes seen on a Wright’s-stained peripheral blood smear?
A. Poikilocytosis
B. Anisocytosis
C. Hypochromia
D. Polychromasia
C. 31.9% (.319)
C MCHC is the average concentration of Hgb in red cells expressed as a percentage. It
expresses the ratio of the weight of Hgb to the volume of erythrocytes and is calculated
by dividing Hgb by the Hct, and then multiplying by 100. A decreased MCHC indicates
that cells are hypochromic. In this example, (15 ÷ 47) × 100 = 31.9%. The reference range
for MCHC is 32%-36%. – correct answer Calculate the mean cell hemoglobin
concentration
(MCHC) using the following values:
Hgb: 15 g/dL (150 g/L) Hct: 47 mL/dL (0.47)
RBC: 4.50 × 106/μL (4.50 × 1012/L)
A. 9.5% (.095)
B. 10.4% (.104)
C. 31.9% (.319)
D. 33.3% (.333)
A. 0.4 × 109/L
A The formula used for calculating manual cell counts using a hemacytometer is:
Number of cells counted × dilution factor × depth factor (10) divided by the area. In this
example, 36 × 10 × 10 = 3600 ÷ 9 = 400/mm3 or 0.4 × 109/L. – correct answer A manual
white blood cell (WBC) count was performed. A total of 36 cells were counted in all 9-
mm2 squares of a Neubauer-ruled hemacytometer. A 1:10 dilution was used. What is the
WBC count?
A. 0.4 × 109/L
B. 2.5 × 109/L
C. 4.0 × 109/L
D. 8.0 × 109/L
D. Siderocyte
D Siderocytes are red cells containing iron granules and are visible when stained with
Prussian blue. – correct answer When an erythrocyte containing iron granules is stained
with Prussian blue, the cell is called a:
A. Spherocyte
B. Leptocyte
C. Schistocyte
D. Siderocyte
C. Hct
C Excessive anticoagulant causes shrinkage of cells; thus, the Hct will be affected. RBC
and WBC counts remain the same, as does the Hgb content. – correct answer A 7.0-mL
ethylenediaminetetraacetic acid (EDTA) tube is received in the laboratory containing only
2.0 mL of blood. If the laboratory is using manual techniques, which of the following tests
will most likely be erroneous?
A. RBC count
B. Hemoglobin (Hgb)
C. Hct
D. WBC count
B. 3.36 × 1012/L
B RBC count = number of cells counted × dilution factor × depth factor (10), divided by
the area. In this example, 336 × 200 × 10 = 672,000 ÷ 0.2 = 3.36 × 106/mm3 = 3.36 × 1012/L
- correct answer A 1:200 dilution of a patient’s sample was made and 336 red cells were
counted in an area of 0.2 mm2. What is the RBC count?
A. 1.68 × 1012/L
B. 3.36 × 1012/L
C. 4.47 × 1012/L
D. 6.66 × 1012/L
D. Neutrophils
MLS Hematology Exam
What is the first type of cell produced by the developing embryo? – correct answer
Erythrocyte
What percentage of tissue located in the bone marrow cavities of adults is fat? – correct
answer 50%
Which of the following is not characteristic of pluripotent hematopoietic stem cells? –
correct answer Express the stem marker CD13
In an adult, what are the two best areas for obtaining active bone marrow by aspiration? –
correct answer Posterior iliac crest, sternum
What is the normal ratio of myeloid to erythroid precursors in bone marrow (M:E ratio)? –
correct answer 4:1
Which of the following does not accurately describe hematopoietic growth factors? –
correct answer Action of majority is lineage restricted
In the third month of gestation, what is the primary site of hematopoiesis? – correct
answer Liver
The mechanism that relays information about tissue oxygen levels to erythropoietinproducing sites is located in the: – correct answer Kidney
Antigen-independent lymphopoiesis occurs in primary lymphoid tissue located in the: –
correct answer Thymus and bone marrow
Programmed cell death is called: – correct answer Apoptosis
In what area of the bone marrow does hematopoiesis take place? – correct answer Cords
Bone marrow cellularity refers to the ration of: – correct answer Hematopoietic tissue to
adipose tissue
Interleukins and colony stimulating factors are cytokines produced by: – correct answer
Monocytes and T lymphocytes
What is the approximate total blood volume in an adult? – correct answer 6 L
The myeloid progenitor cell can produce cells committed to: – correct answer
Granulocytic, erythrocytic, monocytic, or megakaryocytic lineages
The largest hematopoietic cells in normal bone marrow are: – correct answer
Megakaryocytes
When evaluating a bone marrow aspirate smear, which finding is considered abnormal? –
correct answer The presence of 10% myeloblasts on the cell differential count
As most blood cell lines mature, which of the following is characteristic? – correct
answer Nucleus to cytoplasm ratio (N:C) decreases
Which of the following describes thrombopoietin (TPO)? – correct answer Hormone
produced by the liver that stimulates megakaryopoiesis
When the hepatic phase of fetal life is reactivated in an adult, hematopoiesis can be
termed: – correct answer Myeloid metaplasia or extramedullary
What is the average life span of a normal red blood cell? – correct answer 120 days
The Na+-K+ cation pump is an important mechanism in keeping the red blood cell intact.
Its function is to maintain a high level of: – correct answer Intracellular K+
Which of the following depicts the structure of the hemoglobin molecule? – correct
answer Four heme groups, four globin chains
Which of the following describes the process known as culling? – correct answer
Removal of abnormal red cells by spleen
Hemoglobin forms that are incapable of oxygen transport include: – correct answer
Carboxyhemoglobin and methemoglobin
The majority of iron found in an adult is a constituent of: – correct answer Hemoglobin
A senescent red blood cell is one that has: – correct answer Lived its life span
What red cell morphologic abnormality is described by the term “poikilocytosis”? –
correct answer Deviations from normal shape
Howell-Jolly bodies are composed of: – correct answer DNA
When spherocytes are reported, what is observed on the peripheral blood smear? –
correct answer Red cells without a central pallor
The red cells found in lead poisoning characteristically exhibit coarse granules
composed of _ that are reported as . – correct answer Aggregated
ribosomes; basophilic stippling
Rouleaux of red blood cells when seen in the monolayer of a blood smear is
characteristic of: – correct answer Multiple myeloma
Which of the following is most frequently associated with the inclusion bodies seen in
Color Plate 1? – correct answer Post-splenectomy
Which of the following statements about iron absorption is true? – correct answer
Absorption increases when erythropoietic activity increases
What term describes a mature red blood cell that contains iron granules or deposits? –
correct answer Siderocyte
MLT-MLS Hematology 2019-2020 UAMS
exam 1 review
Intramedullary Hemolysis – correct answer cell destruction inside the bone marrow
Leukocytosis – correct answer increase in the number of white blood cells
Intravascular – correct answer Within the blood vessel
Extravascular – correct answer outside the blood vascular system
RES system organs – correct answer Spleen, liver, Thymus, Bone Marrow, Lymph nodes
Where does hematopoiesis occur? – correct answer Inside the bone marrow
Where do megakaryocytes reside? – correct answer along the lining in the bone marrow
What come from magakaryocytes? – correct answer platelets
Where does erythropoietin come from? – correct answer kidneys
What is the function of the RES system? – correct answer formation and destruction of
cells
What is the fast to cell ratio in an adult? – correct answer 50:50
What is the location of the bone marrow in children? – correct answer in all long bones
Which cells are in bone marrow? – correct answer Plasma cells, megakaryocytes,
immature red cells, macrophages, immature WBCs
Which cells are in peripheral blood? – correct answer Banded neutrophils, segmented
neutrophils, eosinophils, basophils, monocytes, lyphocytes and platelets
Which bone marrow cell is hemopoeitically active? – correct answer red marrow
Which organ is involved in red cell circulation? – correct answer spleen
How long do RBCs live? – correct answer 120 days
What is the sequence of WBC maturation? – correct answer myeloblast-> promyelocyte-
myelocyte->metamyelocyte, banded neutrophil-> segmented neutrophils
What cell is the most present at the dawn of neutrophilia? – correct answer Myelocyte
What cell has the ability to become any cell? – correct answer pluripotent stem cell
What can you use to tell the difference between T cells and B cells? – correct answer
Flow cytometry
What cells move to the tissues and what do they become? – correct answer Basophilmast cells
B cells- plasma cells
Monocytes- Macrophages
What is a left shift? – correct answer Increased numbers of immature neutrophils in the
blood
What could be a possible reason to see many blasts in a peripheral blood smear? –
correct answer a possible leukemia
MLS Review – Hematology
Insufficient centrifugation will result in:
a. a false increase in hematocrit (Hct) value
b. a false decrease in Hct value
c. No effect on Hct value
d. all of these options, dependent on the patient – correct answer a. insufficient
centrifugation does not pack down the red blood cells; therefore, the Hct, which is the
volume of packed cells, will increase
variation in red cell size observed on the peripheral smear is described as:
a. anisocytosis
b. hypochromia
c. poikilocytosis
d. pleocytosis – correct answer a. a mature erythrocyte is approximately 7-8 um in
diameter. Variation in normal size is denoted by the term anisocytosis. Hypochromia is a
term that indicates increased central pallor in erythrocytes, and poikilocytosis denotes
variation in red cell shape
Which of the following is the preferable site for bone marrow aspiration and biopsy in an
adult?
a. Iliac crest
b. Sternum
c. Tibia
D. Spinous processes of a vertebra – correct answer a. the iliac crest is the most
frequently used site for bone marrow aspiration and biopsy. This site is the safest and
most easily accessible, with the bone just beneath the skin, and neither blood vessels
nor nerves are in the vicinity
Mean cell volume (MCV) is calculated using the following formula:
a. (Hb / RBC) x 10
b. (Hct / RBC) x 10
c. (Hct / Hb) x 100
d. (Hb / RBC) x 100 – correct answer b. MCV is the average “volume” of the red cells. This
is obtained by dividing the Hct or packed cell volume (PCV) by the red blood cell (RBC)
count in millions per microliter of blood and multiplying by 10. The MCV is expressed in
cubic microns or femtoliters (fL).
What term describes the change in shape of erythrocytes seen on a Wright’s-stained
peripheral blood smear?
a. Poikilocytosis
b. anisocytosis
c. hypochromia
d. polychromasia – correct answer a. Variation in shape of the erythrocytes on a
peripheral blood smear is poikilocytosis. Anisocytosis refers to a change in size.
Hypochromia is an increase in central pallor in erythrocytes. Polychromasia describes
the bluish tinge of the immature erythrocytes (reticulocytes) circulating in the peripheral
blood
Calculate the MCHC using the following values:
Hb: 15 g/dL
RBC: 4.5×10^6/ul
Hct: 47 mL/dL
a. 9.5%
b. 10.4%
c. 31.9%
d. 33.3% – correct answer c. MCHC is the average concentration of Hb in red cells
expressed as a percentage. It expresses the ratio of the weight of Hb to the volume of
erythrocytes and is calculated by dividing Hb by the Hct, and then multiplying by 100. A
decreased MCHC indicates that cells are hypochromic. In this example,
(15/47)x100=31.9%. The reference range for MCHC is 32-36%
A manual white blood cell (WBC) count was performed. A total of 36 cells were counted
in all 9 mm2 squares of a Neubauer-ruled hemacytometer. A 1:10 dilution was used. What
is the WBC count?
a. 0.4×10^9/ul
b. 2.5×10^9/ul
c. 4.0×10^9/ul
d. 8.0×10^9/ul – correct answer a. the formula used for calculating manual cell counts
using a hemacytometer is: number of cells counted x dilution factor x depth factor (10)
divided by the area. In this example, 36 x 10 x 10 = 3600 / 9 = 400/mm3 or 0.4×10^9/L
When an erythrocyte containing iron granules is stained with Prussian blue, the cell is
called a:
a. spherocyte
b. leptocyte
c. schistocyte
d. siderocyte – correct answer d. siderocytes are red cells containing iron granules and
are visible when stained with Prussian blue
A 7 mL ethylenediaminetetraacetic acid (EDTA) tube is received in the lab containing only
2 mL of blood. If the laboratory is using manual techniques, which of the following tests
will most likely be erroneous?
a. RBC count
b. Hb
c. Hct
d. WBC count – correct answer c. excessive anticoagulant causes shrinkage of cells;
thus, the Hct will be affected. RBC and WBC counts remain the same, as does the Hb
content
A 1:200 dilution of a patient’s sample was made and 336 red cells were counted in an
area of 0.2mm2. What is the RBC count?
a. 1.68×10^12/L
b. 3.36×10^12/L
c. 4.47×10^12/L
d. 6.66×10^12/L – correct answer b. RBC count = number of cells counted x dilution factor
x depth factor (10), divided by the area. In this example, 336 x 200 x 10 = 672,000 / 0.2 =
3.36 x 10^6/mm3 = 3.36×10^12/L
What phagocytic cells produce lysozymes that are bacteriocidal?
a. eosinophils
b. lymphocytes
c. platelets
d. neutrophils – correct answer d. neutrophils are highly phagocytic and release
lysozymes, peroxidase, and pyrogenic proteins. Eosinophils migrate to sites where there
is an allergic reaction or parasitic infestation, releasing peroxidase, pyrogens, and other
enzymes, including an oxidase that neutralizes histamine. They are poorly phagocytic
and do not release lysozyme
If a patient has a reticulocyte count of 7% and an Hct of 20%, what is the corrected
reticulocyte count?
a. 1.4%
b. 3.1%
c. 3.5%
d. 14% – correct answer b. in anemic states, the reticulocyte percentage is not a true
measure of reticulocyte production. The following formula must be applied to calculate
the corrected (for anemia) reticulocyte count. Corrected reticulocyte count =
reticulocytes (%) x Hct / 45, the average normal Hct. In this case, 7 x (20/45)=3.1
A decreased osmotic fragility test would be associated with which of the following
conditions?
a. sickle cell anemia
b. hereditary spherocytosis
c. hemolytic disease of the newborn
d. acquired hemolytic anemia – correct answer a. osmotic fragility is decreased when
numerous sickle cells and target cells are present and is increased in the presence of
spherocytes. Spherocytes are a prominent feature of hereditary spherocytosis (HS),
hemolytic disease of the newborn, and acquired hemolytic anemia. The osmotic fragility
test is increased in the presence of spherocytes, whereas this test is decreased when
sickle cells, target cells, and other poikilocyes are present
What effect would using a buffer at pH 6.0 have on a Wright’s stained smear?
a. red cells would be stained too pink
b. white cell cytoplasm would be stained too blue
c. red cells would be stained too blue
d. red cells would lyse on the slide – correct answer a. the pH of the buffer is critical in
Romanowsky stains. When the pH is too low (<6.4), the red cells take up more acid dye
MLS: Hematology
Blood Composition – correct answer – Plasma: liquid part of blood including clotting
proteins
- Cells:
- Erythrocytes: RBCs
- Leukocytes: WBCs
- Thrombocytes:
Platelets
RBCs – correct answer – red, biconcave disks
- transports O2, CO2, buffer H+
- Average lifespan: 120 days
WBCs – correct answer – fights infections
Granulocytes: - Neutrophil
- Eosinophil
- Basophil
Agranulocytes: - Monocyte
- Lymphocyte
Thrombocytes (platelets) – correct answer – small, bluish-purple, disk-shaped cell
fragment without a nucleus - stops bleeding by forming a platelet plug (clot) and releasing coagulation factors
Hematopoiesis – correct answer – Blood Cell Formation - Occurs in bone marrow
- Stimulated by erythropoietin
Pluripotent Stem Cells – correct answer – Precursors of all blood cells
- Differentiates into specialized cells
Myeloid Stem Cell – correct answer – Erythrocytes and most white cells
Lymphoid Stem Cell – correct answer – Lymphocytes
Blast Cells – correct answer – First identifiable immature cells - Present in circulation in disease states
- Continue to develop and mature before mature cells are released into circulation
Bands – correct answer – Precursors of neutrophils
Anemia – correct answer abnormal decrease in # of RBC or hemoglobin concentration
Polycythemia – correct answer abnormal increase in # of RBCs or hemoglobin
concentration
Lab tests useful for diagnosing RBC disorders – correct answer – RBC count - Hgb: hemoglobin concentration
- MCV: mean red blood cell volume
- Hct: hematocrit= % of blood volume consisting of RBCs
- Manual Blood Smear: morphology of RBCs
Causes of Anemia – correct answer – impaired production - increased destruction
- blood loss
How is anemia classified? – correct answer – based on RBC size (indicated by MCV)
MLS ASCP Hematology
Order of heme synthesis – correct answer Porphobilinogen, Uroporphyrinogen,
Coproporphyrinogen, Protoporphyrinogen
Macrocytic – correct answer The characteristic erythrocyte found in pernicious anemia
Idiopathic Hemochromatosis – correct answer Results in iron overload in tissues
Phlebotomy treatment – correct answer Causes iron deficiency due to blood loss
Anemia of chronic infection – correct answer Characterized by decreased serum iron
levels
Aplastic crisis – correct answer sickle cell anemia labs results hgb is 8 g/dL develops
fever, weakness and malaise. Retic count 0.1%
Thalassemia minor – correct answer Hypochromic anemia associated with normal free
erythrocyte protoporphyrin level
Thalassemia major – correct answer Fatal form appearing in young, severe anemia,
enlarge heart
Delta-beta thalassemia minor – correct answer Quantitative hemoglobin A2 level is
normal but hemoglobin F is 5%(normal <2%)
Normocytic, normochromic – correct answer Anemia related to uremia has normal sized
cells
Hemolytic anemia – correct answer Decreased erythrocyte survival; increased catabolism
of heme
G-6-PD deficiency – correct answer An enzyme deficiency associated with a moderate to
severe hemolytic anemia after the patient is exposed to certain drugs
Positive DAT – correct answer Seen in acquired hemolytic anemias of the autoimmune
variety
Macrocytosis – correct answer Characteristic morphologic feature in folic acid deficiency
Megaloblastic anemias – correct answer is caused by impaired DNA synthesis; lab results
include low platelet and neutrophil counts
Erythroleukemia – correct answer Characteristic morphologic feature giant, vacuolated,
multinucleated erythroid precursors
DiGuglielmo syndrome – correct answer Feature megaloblastoid erythropoiesis
M:E ratio – correct answer Low M:E ratio is seen in erythroleukemia; normal in
polycythemia vera
Polycythemia vera – correct answer Decreased or absent bone marrow iron stores;
elevated Hgb, Hct, and RBCs
Plasmodium vivax – correct answer Smear reveals Schuffner dots, parasites with
irregular “spread-out” trophozoites, golden-brown pigment
beta-thalassemia – correct answer Characteristic elevated A2 hemoglobin
alpha-thalassemia – correct answer Characteristic decreased A2 hemoglobin
Hemoglobin H disease – correct answer Occurs when 3 of 4 alpha genes are deleted
E trait – correct answer Shows 70% Hgb A and 30% of a hemoglobin with the mobility Hgb
A2
MLS Hematology Midterm 1
Which step in the CLSI procedure for venipuncture is part
of standard precautions? – correct answer Wearing gloves
Select the needle most commonly used in standard venipuncture
in an adult: – correct answer One inch, 21 gauge
. For a complete blood count (hematology) and measurement
of prothrombin time (coagulation), the phlebotomist
collected blood into lavender stopper and green stopper
tubes. Are these specimens acceptable? – correct answer . No, although EDTA is used for
hematologic testing,
citrate, not heparin, is used for coagulation testing.
The most important step in phlebotomy is: – correct answer patient identification
The venipuncture needle should be inserted into the arm
with the bevel facing – correct answer . Up and an angle of insertion less than 30 degrees
Failure to obtain blood by venipuncture may occur because
of all of the following except – correct answer Tying the tourniquet too tightly
What is the recommended order of draw when the evacuated
tube system is used? – correct answer Blood culture, coagulation, nonadditive, and gel
separator
or other additives
. Which one of the following is an acceptable site for skin
puncture on infants – correct answer Lateral or medial plantar surface of the heel
One legal area of concern for the phlebotomist is – correct answer Breach of patient
confidentiality
What procedure is employed to validate a new assay? – correct answer a. Comparison of
assay results to a reference method
b. Test for assay precision
c. Test for assay linearity
ALL
You validate a new assay using linear regression to compare
assay calibrator results with the distributor’s published calibrator
results. The slope is 0.99 and the y intercept is 110%.
What type of error is present? – correct answer Constant systematic error
. Which is a statistical test comparing means? – correct answer . Student’s t-test
The acceptable hemoglobin control value range is 13 6 0.4
g/dL. The control is assayed five times and produces the
following five results:
12.0 g/dL 12.3 g/dL 12.0 g/dL 12.2 g/dL 12.1 g/dL
These results are: – correct answer Precise but not accurate
. A WBC count control has a mean value of 6000/mL and
a standard deviation of 300/mL. What is the 95.5% confidence
interval? – correct answer . 5400 to 6600/mL
The ability of an assay to distinguish the targeted analyte
from interfering substances within the specimen matrix is
called: – correct answer Analytical specificity
Hematology Exam 1 MLS (Harmening,
CH. 1-14)
Hematopoiesis in marrow – correct answer What is meant by medullary hematopoiesis?
Hematopoiesis in the spleen
Hematopoiesis in marrow
Hematopoiesis in liver
Hematopoiesis in thymus
None of the above
Thymus, liver, spleen, bone marrow – correct answer What does the hematopoietic
system consists of?
Rubriblast, prorubricyte, rubricyte, metarubricyte, reticulocyte, erythrocyte – correct
answer What is the sequence of maturity for the erythrocyte?
All of the above – correct answer By increasing hematopoiesis, the hematopoietic system
can respond to stimuli such as:
Infection
Bleeding
Hypoxia
All of the above
None of the above
7-8 um – correct answer What is the average diameter of a normal erythrocyte?
All of the above – correct answer The maturation of the granulocytic series is
characterized by:
Decrease in nuclear volume
Appearance and disappearance of primary granules
Nuclear chromatin clumping
Cytoplasmic color change from blue to pink appearance of secondary granules
All of the above
Myeloblast, promyelocyte, myelocyte, metamyelocyte, band neutrophil, segmented
neutrophil – correct answer What is the sequence of maturity for a neutrophil?
Metamyelocyte – correct answer The stage in granulocyte maturation where the nucleus
appears kidney shaped is evident in what cell?
Promyelocyte
Band neutrophil
Metamyelocyte
Myelocyte
2-6% – correct answer What percent of bands are in the peripheral blood?
Myelocyte – correct answer The first sign of neutrophilic differentiation and appearance
of secondary granules is evident in what cell type?
Promyelocyte
Myelocyte
Segmented neutrophil
Metamyelocyte
Myelocyte, metamyelocyte, band cell, segmented cell – correct answer What stages do
both basophils and eosinophils pass through in their sequence of maturity?
Histamine release in allergic reactions – correct answer What is the function of mast cells
and basophils?
grey-blue cytoplasm, vacuoles, clumpy chromatin, “ground glass” – correct answer What
is the appearance of a monocyte?
20-44% – correct answer What percent is lymphocytes in peripheral blood?
Hematology Exam 2 Module MLT-MLS
UAMS
Normal Hemoglobin range for an adult male – correct answer 13.5-18 g/dL
Normal Hemoglobin range for an adult female – correct answer 12-15 g/dL
Normal hemoglobin range for newborn – correct answer 16.5-21.5 g/dL
Normal hemoglobin range for young children – correct answer 10-15 g/dL
Normal hematocrit range for adult males – correct answer 40%-54%
Normal hematocrit range for adult female – correct answer 35%-49%
Normal hematocrit range for newborn – correct answer 48 – 68 %
Normal ESR for adult males – correct answer 0-15 mm/hr
Normal ESR for adult females – correct answer 0-20 mm/hr
Normal ESR for children – correct answer 0-20 mm/hr
What % of hemoglobin A is in an adult – correct answer 95-100%
What % of hemoglobin A2 is in an adult? – correct answer 0-3.5%
What % of hemoglobin F is in an Adult? – correct answer 0-2.0%
What % of hemoglobin A is in a newborn? – correct answer 10-40%
What % of hemoglobin A2 is in a newborn? – correct answer 0%
What % of hemoglobin F is in a newborn? – correct answer 60-90%
Globin chain α2γ2 – correct answer Hemoglobin F globin
Globin chain α 2δ2 – correct answer Hemoglobin A2 globin
Globin chain α 2 β2 – correct answer Hemoglobin A globin
What is Emden Meyerhof Pathway? – correct answer Major glycolytic pathway
Generator of ATP
What is Hexose Monophosphate Pathway? – correct answer Main line of injury against
oxidative injury
What is Methemoglobin Reductase Pathway? – correct answer Regeneration of reduced
form of hemoglobin
What is Rapoport-Luebering Pathway? – correct answer Increase 2,3 BPG
What is basophilic stippling composed of? – correct answer RNA
What are Howell-jolly bodies composed of? – correct answer DNA
What are reticulocytes composed of? – correct answer RNA
What are Heinz bodies composed of? – correct answer denatured hemoglobin
What are Pappenheimer bodies composed of? – correct answer iron
What are Cabot rings composed of? – correct answer Remnants of mitotic spindle
What enzyme corresponds with Emden Meyerhof Pathway? – correct answer Pyruvate
Kinase
What enzyme corresponds with Hexose Monophosphate Pathway? – correct answer
Glucose-6 Phosphate Dehydrogenase
What enzyme corresponds with Methemoglobin Reductase Pathway? – correct answer
Methemoglobin Reductase
What enzyme corresponds with Rapoport-Leubering Pathway? – correct answer
Biphosphpglycerate mutase &
Biphosphoglycerate kinase
Emden Meyerhof Pathway defect – correct answer Causes formation of echinocytes
Hexose Monophosphate Pathway defect – correct answer causes formation of heinz
bodies
Methemoglobin Reductase Pathway defect – correct answer causes an increased amount
of methemoglobin
Rapoport-Leubering Pathway defect – correct answer causes inadequate oxygen delivery
Codocyte – correct answer
Acanthocyte – correct answer
Echinocyte – correct answer
sickle cell – correct answer
shistocyte – correct answer
Dacryocyte – correct answer
Spherocyte – correct answer
Elliptocyte – correct answer
Microcyte – correct answer
Macrocyte – correct answer
If ANY of the following are seen, must be reported: – correct answer Sickle cells
RBC fragments
MLS Hematology Leukemias
treatment of leukemias – correct answer radiation
stem cell treatment
chemo
life expectancy of acute leukemia w/o treatment – correct answer less than 6 months
characteristics of acute leukemia – correct answer less life expectancy
blast cells
bone marrow failure
WBC count varies
weakness
flu-like symptoms
characteristics of chronic leukemia – correct answer longer life expectancy
very high WBC count
malaise
loss of appetite -> weight loss
diagnosis of a leukemia – correct answer history/physical
CBC/peripheral smear
bone marrow aspirate
differentiating leukemias – correct answer cell morphology
cytochemistry
immunological markers
genetics
CD – correct answer clusters of differentiation, proteins on cell membrane, detect with
use of monoclonal antibodies
most common type of ALL – correct answer preB-ALL
ALL is more common in what age group – correct answer children (75%)
best prognosis of ALL – correct answer age 2-9
WBC < 50,000 /uL
symptoms of ALL – correct answer fatigue, abnormal bleeding, hepatosplenomegaly,
anemia, bone pain, thrombocytopenia
L1 – correct answer ALL, small uniform lymphoblasts, high ratio nucleus to cytoplasm
(little cytoplasm), more children
L2 – correct answer ALL, large pleomorphic lympblasts, lower ratio nucleus to cytoplasm
(more cytoplasm), seen in adults
L3 – correct answer ALL, Burkitt’s type, vacuolated & deep basophilic cytoplasm
most common mutation for preB-L1 – correct answer t(12;21) TEL-AML 1
t(12;21) TEL-AML 1 CD markers – correct answer strong: CD 10, CD 19
not positive: CD 20
staining for L1& L2: ALL – correct answer TdT +
block staining in PAS
peroxidase/SBB –
staining for Burkitt’s Leukemia – correct answer TdT –
MLS-Hematology test
The following are compounds formed in the synthesis of heme:
- Coproporphyrinogen
2.Porphobilinogen - Uroporphyrinogen
- Protoporphyrinogen
Which of the following responses lists these compounds in the order in which they are
formed? – correct answer 2,3,1,4
Hemolysis in Paroxysmal Nocturnal Hemoglobinuria (PNH) is:
a- temperature dependent
b- complement independent
c- antibody mediated
d- caused by a RBC membrane defect – correct answer caused by a RBC membrane
defect
Which of the following is MOST closely associated with Idiopathic Hemochromatosis?
a- iron overload in tissues
b- target cells
c- basophilic stippling
d- ringed sideroblasts – correct answer iron overload in tissues
A 20 year old woman with sickle cell anemia whose usual hemoglobin concentration is 8
g/dL develops fever, increased weakness and malaise. The hemoglobin concentration is
4 g/dL and the reticulocyte count is 0.1%. The MOST likely explanation for her clinical
picture is:
a- increased hemolysis due to hypersplenism
b- aplastic crisis
c- thrombotic crisis
d- occult blood loss – correct answer aplastic crysis
All of the findings listed below may be seen in acquired hemolytic anemia of the
autoimmune variety. The one considered to be the MOST characteristic is:
a- increased osmotic fragility
b- leukopenia and thrombocytopenia
c- peripheral spheroctosis
d- positive DAT – correct answer positive DAT
Megaloblastic asynchronous development in the bone marrow indicates which one of the
following?
a- proliferation of erythrocyte precursors
b- impaird synthesis of DNA
c- inadequate productio of erythropoietin
d- deficiency of G6PD – correct answer impaired synthesis of DNA
Giant, vacuolated, multinucleated erythroid precursors are present in which of the
following?
a- Chronic Myelocytic Leukemia
b- Meylofibrosis with Myeloid Metaplasisa
c- Erythroleukemia
d- Acute Myelocytic Leukemia – correct answer Erythroleukemia
Which of the following is characteristic of Polycythemia vera?
a- elevated urine erthropoietin levels
b- incrased oxygen affinity of hemoglobin
c- tear drop poikilocytosis
decreased or absent bone marow iron stores – correct answer decreased or absent bone
marrow iron stores
A patient with Beta Thalassemia characteristically has a/an:
MLS (ASCP): Hematology
Variation in red cell size observed on the peripheral smear is described as:
A. Anisocytosis
B. Hypochromia
C. Poikilocytosis
D. Pleocytosis – correct answer A. Anisocytosis
A mature erythrocyte is approximately 7-8um in diameter. Variation in normal size is
denoted by the term anisocytosis. Hypochromia is a term that indicates increased central
pallor in erythrocytes, and poikilocytosis denotes variation in red cell shape.
Which of the following is the preferable site for bone marrow aspiration and biopsy in an
adult?
A. Iliac crest
B. Sternum
C. Tibia
D. Spinous processes of a vertebra – correct answer A. Iliac crest
The iliac crest is the most frequently used site for bone marrow aspiration and biopsy.
This site is the safest and most easily accessible, with the bone just beneath the skin,
and neither blood vessels nor nerves are in the vicinity.
Mean cell volume (MCV) is calculated using the following formula:
A. (Hgb/RBC) x 10
B. (Hct/RBC) x 10
C. (Hct/Hgb) x 100
D. (Hgb/RBC) x 100 – correct answer B. (Hct/RBC) x 10
MCV is the average “volume” of the red cells. This is obtained by dividing the Hct or
packed cell volume (PCV) by the red blood cell (RBC) count in millions per microliter of
blood and multiplying by 10. The MCV is expressed in cubic microns (um^3) or
femtoliters (fL).
What term describes the change in shape of erythrocytes seen on a Wright’s -stained
peripheral blood smear?
A. Poikilocytosis
B. Anisocytosis
C. Hypochromia
D. Polychromasia – correct answer A. Poikilocytosis
Variation in shape of the erythrocytes on a peripheral blood smear is poikilocytosis.
Anisocytosis refers to a change in size. Hypochromia is an increase in central pallor in
erythrocytes. Polychromasia describes the bluish tinge of the immature erythrocytes
(reticulocytes) circulating in the peripheral blood.
Calculate the mean cell hemoglobin concentration (MCHC) using the following values:
Hgb: 15 g/dL (150 g/L)
RBC: 4.50 x 10^6/uL (4.50 x 10^12/L)
Hct: 47 mL/dL (0.47)
A. 9.5% (.095)
B. 10.4% (.104)
C. 31.9% (.319)
D. 33.3% (.333) – correct answer C. 31.9% (.319)
MCHC is the average concentration of Hgb in red cells expressed as a percentage. It
expresses the ratio of the weight of Hgb to the volume of erythrocytes and is calculated
by dividing Hgb by the Hct, and then multiplying by 100. A decreased MCHC indicates
that cells are hypochromic. In this example, (15/47) x 100 = 31.9%. The reference range
for MCHC is 32%=36%.
A manual white blood cell (WBC) count was performed. A total of 36 cells were counted
in all 9-mm^2 squares of a Neubauer-ruled hemacytometer. A 1:10 dilution was used.
What is the WBC count?
A. 0.4 x 10^9/L
MLT to MLS Hematology Exam 1 Study
What is hematology? – correct answer The study of blood cell production, destruction,
number and disease
What is the RBC lifespan? – correct answer 120 days
What is the WBC lifespan? – correct answer 10-15 days
What is the most common anticoagulant used in Hematology? – correct answer EDTA
Is plasma with or without an anticoagulant? – correct answer With an anticoagulate, no
clot is formed
Is serum with or without an anticoagulant? – correct answer Without an anticoagulant, a
clot forms
Terminology for a RBC – correct answer erythrocyte
Terminology for a WBC – correct answer leukocyte
Terminology for a platelet – correct answer Thrombocyte
What is the function of an RBC? – correct answer To carry oxygen
What is the function of a WBC? – correct answer To protect the host from infection
What is the function of a platelet? – correct answer To stop bleeding/help the body clot
What does -cyte/-oid mean? – correct answer cell
What does intramedullary hemolysis mean? – correct answer The break down of cells
within the bone marrow
What does -plasia mean? – correct answer formation
What does -penia mean? – correct answer Lacking/decrease
What does -philia mean? – correct answer Loving/increase
What does MCV stand for and what is it? – correct answer mean cell volume, indicates
RBC size
What does MCH mean and what is it? – correct answer mean cell hemoglobin, the weight
of hemoglobin contained in an RBC
What does MCHC mean and what is it? – correct answer mean cell hemoglobin content,
the average concentration of hemoglobin in the RBC
What does the RES system do? – correct answer It’s involved in the formation and
destruction of blood cells, metabolism of iron, inflammation and immunity
What are the 5 organs in the RES system? – correct answer Spleen, liver, thymus, lymph
nodes and bone marrow
What is bone marrow? – correct answer Tissue located within the cavities of the cortical
bones
What are the two types of bone marrow and what do they include? – correct answer Red
marrow- hematopoietically active marrow which produces cells
Yellow marrow- hematopoietically inactive marrow composed of adipocytes/fat cells
What is the cell to fat ratio in marrow for an adult? – correct answer 50%/50% or 1:1 ratio
Where is the blood supply from in the bone marrow? – correct answer The periosteal
arteries
Where does cell production occur in the bone marrow? – correct answer In the
hemopoietic spaces
Where do macrophages come from and what do they carry? – correct answer They come
from monocytes and carry recycled iron
When will yellow marrow convert to red marrow? – correct answer Due to an increased
demand such as hemolysis or excessive blood loss
What is the function of the lymph nodes? – correct answer To filter, produce specific
immunoglobulins such as plasma cells and form lymphocytes
What is the largest lymphoid organ in the body? – correct answer The spleen
What is the function of the spleen? – correct answer to filter/remove old or damaged red
cells, develop hematopoiesis
Where does cell production start/what is the most immature cell in bone marrow? –
correct answer The pluripotential stem cell
What stimulates erythropoietin and what does it do? – correct answer The kidneys, it
promotes the production of erythrocytes
In a normal person, what is seen in the peripheral blood? – correct answer Erythrocytes,
apx 1% of polychromatic erythrocytes, platelets, granulocytes, monocytes, lymphs
What do monocytes make? – correct answer marophages
What is seen in bone marrow? – correct answer All immature cells
MLS Hematology Exam 3
hemorrage – correct answer large loss of blood
thrombosis – correct answer formation of a blood clot
serum – correct answer Liquid portion express from unanticoagulated blood
Plasma – correct answer Liquid part of blood
Describe the basic process of primary hemostasis – correct answer
Describe the basic process of secondary hemostasis – correct answer make the fibrin
clot
Describe the basic process of fibrinolysis – correct answer Break down of fibrin clot
List the three layers of the vascular wall – correct answer Tunica intima, Tunica media,
and Tunica externa
Describe the composition of the subendothelial connective tissue. – correct answer
delicate connective tissue with branched cells lying in the interspaces of the tissue
Name the principle component within the subendothelial connective tissue which binds
and activates platelets. – correct answer collagen
Describe the function of blood vessels in vasoconstriction, vasodialation, and increased
vascular permeability, naming the regulators of the vascoconstriction and vasodialation
processes – correct answer vasoconstriction- blood vessels narrow to increase blood
pressure, nSerotonin, Thromboxane A2, Endothelin 1
vasodilation- redness at wound site, Prostacyclin (prostaglandin)
Describe the hemostatic function of vessel endothelial cells – correct answer
Nonthrombogenic (Negatively charged cell surface, Tissue plasminogen activator (tPA)
Thrombogenic (Production/secretion of von Willebrand factor, Thromboplastin (tissue
factor))
List the cells in the maturation series of the platelet – correct answer Progenitor Cell
Megakaryoblast
Promegakaryocyte
Megakaryocyte
Mature platelet
Describe the size, nucleus, and cytoplasm of a megakaryocyte – correct answer 20-60
mm
Nucleus- Matures almost completely before cytoplasmic maturation begins
Cytoplasm- Matures after nuclear maturation is complete, Volume increased with
maturation, Filled with azurophilic granules
Describe the appearance of a mature platelet on a Wright stain. – correct answer larger
that early stage
State the role of thrombopoeitin – correct answer humoral regulator
Describe the development of the megakaryocte within the bone marrow and process
whereby platelets are formed/released – correct answer in bone marrow
Cite the lifespan of the platelet in the peripheral blood – correct answer 9.5 days
List and describe the four zones of the platelet ultrastructure – correct answer Peripheral
zone- adhesion/aggregation
Structural zone- structure/support(actin myosin)
Organelle zone- secretion/storage, granules
Membrane systems- secretion/storage, open canalicular system
Hematology
Hematology – correct answer study of blood
The # of Red Blood Cells indicate: – correct answer – bone marrow disorders
- anemia (low circulating RBC)
- health of blood
- ability to carry oxygen to the tissues via hemoglobin
The # of White Blood Cells indicate: – correct answer – bone marrow disorders - infection
- cancer in the blood
- immunity levels
- allergic reactions
Centrifuge – correct answer used to separate substances of different densities that are in
solution
Safe Operation of a Centrifuge – correct answer – balance all tubes - open ends of tubes towards the center
- never operate with open lids
- only use brake when need to stop quickly
- must be at a specific speed and time for sample
- clean immediately if a tube breaks
Start Spin Centrifuge – correct answer angled head is designed for small volume samples
Rocker Centrifuge – correct answer for continuous mixing of samples