Hematology in Practice 2nd Edition Test Bank

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Chapter 1: Introduction to Hematology and Basic Laboratory PracticeMultiple ChoiceIdentify the choice that best completes the statement or answers the question.____1.Tube length when referring to the microscope is the:a.Resolution power of the objectiveb.Distance from the eyepiece to the objectivec.Numerical apertured.Magnitude of the image on the stage____2.What is the most useful corrective action for the microscope when fine details cannot be visualizedin immature cells?a.Open up diaphragm for maximum light.b.Wipe off lenses with lens cleaner.c.Get a new slide.d.Move to a lower power.____3.Which of the following behaviors is a violation of standard precautions?a.Handwashing after glove removalb.Use of impermeable laboratory gownsc.Use of goggles and face shieldsd.Placing laboratory notebooks on laboratory work area____4.Standards and calibrators differ from control materials because:a.An exact amount of analyte is present in a standard or calibratorb.A variable amount of analyte is present depending on patient samplesc.Standards only need to be within a target ranged.Standards are run to the best estimate of the known value____5.If the confidence interval for most laboratories is 95.5%, what is the acceptable range forhemoglobin if a hemoglobin control was run with a mean of 12.5 and a standard deviation of1.0?a.9.5 to 12.5b.10.5 to 14.5c.11.5 to 15.5d.10.0 to 13.5____6.Proper mixing of samples and timely delivery of samples to the laboratory are both examplesof:a.Delta checksb.Postanalytic variablesc.Preanalytic variablesd.Reflex testing____7.A delta check is a historical reference on samples run in the laboratories. Once a sample fails a deltacheck, the most obvious corrective action is to:a.Verify the identification of the patient sampleb.Reestablish the parameters of the delta checkc.Perform reflex testing

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d.Perform a manual method____8.Which of the following is the definition of a reference interval?a.A solution of a known amount of analyteb.Materials analyzed concurrently with unknown samplesc.Values established for a particular analyte, given a method, instrument, or patientpopulationd.Validation techniques on flagged samples____9.Which of the following isnotconsidered a postanalytic variable?a.Delta checksb.Proper anticoagulant usedc.Specimen checked for clotsd.Critical results called____10.Error analysis, standard protocols, and turnaround time are all part of the:a.Quality assurance systemb.Quality control programc.Reference standardsd.Delta check protocol____11.The average of a group of data points is defined as the:a.Meanb.Modec.Mediand.Modicum____12.Safety training is part of new employee training in health care and includes:a.Biological hazardsb.Chemical hazardsc.Environmental hazardsd.All of the above____13.Control materials are:a.Analyzed concurrently with the unknown samplesb.Substances with a known amount of analytec.Used to calibrate the methodd.All of the above____14.Delta checks are used in the hematology laboratory to:a.Compare past patient results to the current resultb.Verify control accuracyc.Establish a target ranged.Establish reference ranges for a particular analyte____15.When handwashing after a patient contact, the soap application process should last at least:a.5 secondsb.15 secondsc.20 seconds

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d.30 seconds____16.Which of the following represents an example of a safety violation in the laboratory?a.Application of cosmeticsb.Mouth pipettingc.Consuming bottled waterd.All the aboveTrue/FalseIndicate whether the statement is true or false.____17.Standard deviation is a measurement of precision.____18.Accuracy is a measurement of the true value of an analyte.____19.A normal distribution curve will have 99.7% of the measured values fall within 2 SDs.Short Answer20.Label the parts of the microscope.

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Chapter 1: Introduction to Hematology and Basic Laboratory PracticeAnswer SectionMULTIPLE CHOICE1.ANS:BPTS:12.ANS:APTS:13.ANS:DPTS:14.ANS:APTS:15.ANS:BPTS:16.ANS:CPTS:17.ANS:APTS:18.ANS:CPTS:19.ANS:BPTS:110.ANS:APTS:111.ANS:APTS:112.ANS:DPTS:113.ANS:APTS:114.ANS:APTS:115.ANS:BPTS:116.ANS:DPTS:1TRUE/FALSE17.ANS:TPTS:118.ANS:TPTS:119.ANS:FPTS:1SHORT ANSWER20.ANS:1. Objectives2. Stage3. Eye piece4. Base5. Light source6. Iris diaphragm7. Course adjustment knob8. Fine adjustment knob9. Stage adjustment knobs10. Clips11. Substage condenser

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PTS:1

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Chapter 2: From Hematopoiesis to the Complete Blood CountMultiple ChoiceIdentify the choice that best completes the statement or answers the question.____1.What is the average M:E ratio for normal adult bone marrow?a.1:3b.4:1c.1:4d.6:1____2.The key organs involved in extramedullary hematopoiesis include the:a.Kidney and thymusb.Lymph nodes and heartc.Liver and spleend.Kidney and liver____3.Which of these assays is the best test to assess the bone marrow’s response to anemic stress?a.Hemoglobin valueb.MCV valuec.Reticulocyte countd.Hematocrit____4.Antibody-coated red cells that have their antibodies stripped away in the spleen usually reappear inthe circulation as:a.Spherocytesb.Microcytesc.Acanthocytesd.Burr cells____5.A peripheral blood smear indicator ofineffectivebone marrow response is:a.The presence of basophilic stipplingb.A lack of polychromasiac.Higher numbers of nucleated red cellsd.An increased number of red cells____6.A patient with the following values—RBC = 4.011012/L, Hgb = 12.5 g/dL, and Hct =37.2%—will most likely have which of the following RBC indices?a.MCV = 92.8 fL, MCH = 31.2 pg, MCHC = 33.6%b.MCV = 92.8 fL, MCH = 33.6 pg, MCHC = 31.2%c.MCV = 107.8 fL, MCH = 32.1 pg, MCHC = 33.6%d.MCV = 132.2 fL, MCH = 32.1 pg, MCHC = 33.5%____7.The hormone responsible for red blood cell development in the bone marrow is:a.Thyroxinb.Insulinc.Leukopoietind.Erythropoietin

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____8.Which of the following sites is the most preferable site for bone marrow aspiration and biopsy inadults?a.Sternumb.Iliac crestc.Fibulad.Vertebra____9.A patient’s hemoglobin is 12.3 g/dL. On the peripheral smear, the red cells appear normochromic,normocytic. The hematocrit value that correlates with these data is:a.34%b.37%c.40%d.43%____10.A Wright-stained smear of a patient with an elevated reticulocyte count should show:a.Polychromasiab.Agglutinationc.Rouleauxd.Microcytosis____11.Erythropoietin is produced by the:a.Kidneysb.Liverc.Spleend.Thymus gland____12.Bone marrow aspiration is usually required in conditions of:a.Anemiab.Hypoxiac.Leukemiad.Hepatosplenomegaly____13.Opsonizing antibodies produced by the spleen serve to:a.Strip the capsule from bacterial pathogensb.Recycle erythrocyte byproductsc.Aid in extramedullary hematopoiesisd.Fight viral infection____14.The spleen harbors _____ of the circulatory platelet mass.a.one-quarterb.one-thirdc.one-halfd.three-quarters____15.Mature red blood cells leave the bone marrow and enter the circulation via the:a.Reticuloendothelial systemb.Osteoclastsc.Spleen

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d.Bone marrow sinuses____16.Correlation checks between the red blood cell count, the hemoglobin, and the hematocrit aresignificant parts of QA (quality assurance) in the hematology lab. These correlations are known as:a.Delta checksb.The rules of threec.Quality controld.Analytical variables____17.The ______ is one of the most stable parameters in a CBC.a.MCVb.Hctc.MCHCd.MCH____18.The CBC parameter that gives insight as to the amount of anisocytosis present in a specimen is:a.RDWb.MCHCc.MCVd.HgbTrue/FalseIndicate whether the statement is true or false.____19.T cells are responsible for humoral immunity.____20.Patients with moderate anemias (7 to 10 g/dL) may be asymptomatic.

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Chapter 2: From Hematopoiesis to the Complete Blood CountAnswer SectionMULTIPLE CHOICE1.ANS:BPTS:12.ANS:CPTS:13.ANS:CPTS:14.ANS:APTS:15.ANS:BPTS:16.ANS:APTS:17.ANS:DPTS:18.ANS:BPTS:19.ANS:BPTS:110.ANS:APTS:111.ANS:APTS:112.ANS:CPTS:113.ANS:APTS:114.ANS:BPTS:115.ANS:DPTS:116.ANS:BPTS:117.ANS:APTS:118.ANS:APTS:1TRUE/FALSE19.ANS:FPTS:120.ANS:TPTS:1

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Chapter 3: Red Blood Cell Production, Function, and Relevant Red Blood Cell MorphologyMultiple ChoiceIdentify the choice that best completes the statement or answers the question.____1.The erythrocyte stage that marks the beginning of hemoglobinization is called:a.Basophilic normoblastb.Polychromatophilic normoblastc.Orthochromic normoblastd.Pronormoblast____2.One of the key morphological features of the nucleated red cell stages is:a.Basophilic cytoplasm through every stage of maturationb.Granules in the cytoplasmc.A round nucleusd.An increase in size as the cell matures____3.The red cell protein that is responsible for deformability and flexibility of the red cell is:a.Spectrinb.Glycophorinc.Glycined.EPO____4.Increased plasma cholesterol may lead to the development of which of these abnormal red cellmorphologies?a.Spherocytesb.Target cellsc.Microcytesd.Helmet cells____5.Which of the following RBC pathways is responsible for providing 90% of the cellular ATP for redcell metabolism?a.Embden-Meyerhof pathwayb.Methemoglobin reductase pathwayc.Rapoport-Luebering pathwayd.Hexose monophosphate shunt____6.The hemoglobin molecule consists of:a.One heme molecule, one globin chainb.One heme molecule, four globin chainsc.Two heme molecules, two globin chainsd.Four heme molecules, four globin chains____7.The basic pathophysiology of the thalassemic conditions is a/an:a.Decreased or absent globin chain synthesisb.Absence of iron absorptionc.Failure to incorporate iron into the pronormoblastd.Side effect of iron overload

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____8.Asynchrony in the bone marrow is defined as the:a.Presence of nucleoli throughout each maturation phaseb.Presence of extremely basophilic cytoplasm in all precursorsc.Lack of nuclear development in precursor cellsd.Nuclear development and hemoglobin development that is unbalanced____9.Polychromatophilic macrocytes in the peripheral smear are most likely:a.Siderocytesb.Reticulocytesc.Spherocytesd.Pappenheimer bodies____10.The red cell inclusion derived from denatured hemoglobin are:a.Howell-Jolly bodiesb.Pappenheimer bodiesc.Heinz bodiesd.Siderotic granules____11.The degree of effective erythropoietic activity in any hematological disorder is most readily assessedby a/an:a.Red cell countb.Reticulocyte countc.M:E ratiod.Hemoglobin determination____12.When hemolysis is produced by the intravascular fragmentation of red cells, which red cellmorphology will be produced?a.Spherocytesb.Macrocytesc.Acanthocytesd.Schistocytes____13.Most hypochromic cells will have an MCHC that is:a.Greater than 36%b.Less than 30%c.Greater than 27%d.Less than 27%____14.Reversible sickled cells are described as having a:a.Crescent shape with one pointed projectionb.Crescent shape with two pointed projectionsc.Half-moon shape with rounded endsd.Half-moon shape with pointed projection____15.The last nucleated stageof erythrocytic maturation is the:a.Pronormoblastb.Orthochromic normoblastc.Polychromatophilic normoblast

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d.Basophilic normoblast____16.Red cell inclusions that are remnants of DNA are termed:a.Cabot ringsb.Howell Jolly bodiesc.Heinz bodiesd.Pappenheimer bodies____17.From each pronormoblast precursor cell, _____ mature red blood cells are produced.a.4b.8c.12d.16____18.Pappenheimer bodies are composed of:a.Ironb.Denatured hemoglobinc.DNAd.RNA____19.Describe the hemoglobin content of the cell at the end of the pointer.a.Normochromicb.Hypochromicc.Polychromatophilicd.Hyperchromic

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____20.Identify the cell at the end of the pointer.a.Spherocyteb.Schistocytec.Acanthocyted.Normocyte____21.Identify the cell at the end of the pointers.a.Reticulocyteb.Spherocytec.Sickle celld.Target cell

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____22.The term used to describe the inclusions seen in the cell at the end of the pointer is (Wright’s stain):a.Pappenheimer bodiesb.Basophilic stipplingc.Howell Jolly bodiesd.Siderotic granulesTrue/FalseIndicate whether the statement is true or false.____23.The higher the N:C ratio, the more mature the cell.____24.The anucleate mature red blood cell has no ability to produce protein.

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Chapter 3: Red Blood Cell Production, Function, and Relevant Red Blood Cell MorphologyAnswer SectionMULTIPLE CHOICE1.ANS:BPTS:12.ANS:CPTS:13.ANS:APTS:14.ANS:BPTS:15.ANS:APTS:16.ANS:DPTS:17.ANS:APTS:18.ANS:DPTS:19.ANS:BPTS:110.ANS:CPTS:111.ANS:BPTS:112.ANS:DPTS:113.ANS:BPTS:114.ANS:CPTS:115.ANS:BPTS:116.ANS:BPTS:117.ANS:DPTS:118.ANS:APTS:119.ANS:CPTS:120.ANS:APTS:121.ANS:DPTS:122.ANS:BPTS:1TRUE/FALSE23.ANS:FPTS:124.ANS:TPTS:1

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