LEMAR REVIEW HUB +6 3 9 4 795 6 0 660 Page

LEMAR REVIEW HUB

ASSESSMENT EXAMINATION IN HEMATOLOGY Or
Directions Each of the numbered items or incomplete statemets is followed by answers or by completions
Statement. Select the one lettered answer or completion that is best in each case.

1Which of the followirg locations is hoda site of extramedullaryhematopoiesis?

Aa Bone maTow b. Liver C. Spleen d. Thymus
often estimated by examining which following? Elsevier
of the
Bone marrowcellularity is most
c. Core biopsy d. Crush preparations
a) Aspirate b. Buffy coat
anemia. Which tests would best rule in a
.A patient has macrocytic anemia, the physician suspects pernicious
definitive diagnosis of pernicious anemia7 c. Ova and parasite examination for D. latum
a Homocysteine d. Bone marrow exarination
CbIntrinsic factor antibodies anemia? hmo hom anr)

Which of the following is nof implicated as a cause of nonmegaloblastic macrocytic

a. Alcoholism (Hemochromatosis c. Hypothyroidisn g Liver dise ase
Which of the following is decreased in cases of intravascular hemolytic.anemia?
b . Urine hemosiderin Haptoglobin d. Serum hemogio
a. Bilirubin
yDge nruy'e anup
an a
following disordersdoes nof have a hemolytio component? Por Kit
P6.
Nhich of the b. AlHA aunhemgS C. G6PD deficiency
d. Anemia of chronIc disease
7 Sickle with renal failure often exhibit compromised hematopoietic activity
a Patients cell anemia. because of which of the following?

a Concurent depression
of the
thyroid
Decreased production of erythropoietin
C. Decreased production of GM-CSF
d. BM suppression caused by medicaions LEMAR
REVIEW HUB
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is characterized by flow cytometry results that are:
Paroxysmal noctumal hemoglobinuria
aNegative for CD55 and CD59 C. Negative for CD4 and CD8
b. Positive for CD55 and CD59 d. Positive for all nomal CD markers
which of the following?
G6PD deficiency episodes are related to C. Antibodies to RBCs
Exposure to oxidant drugs
Lnfir mahmg d. Abnomal protein structures
b. Defetive globin chains
cell anemia?
b10. Which laboratory test is best used for definitive diagnosis of sickle
C. Peripheral smear review for sickle cells
9

Solubility testing 6v
d. Bone marrow ânalysis
b.Hemoglobin electrophoresis
11. Which of the following best describes the function of the Rapoport-Leubering pathway?
produces 2,3 diphosphoglycerate (2,3 DPG)
EEM a. it produces ATP to help maintain RBC membrane defomabilitycIt
d. It produces cytochrome b reductase
MR 12.bThe
.
denree of reduction glutathione
of
in effective erthropoiesis
It results
is best assessed by: lept ship
d. Ferrokinetic studies
a. Serum iron leveis b. Serial hgb deteminations CReticulocyte count
the erythroblast in manufacturing:
13 Lack vitamin B12 orfoliclacid hinders
of
(c)DNA d. RNA
a. Heme Globin
is composed offour beta globin chains?
14. Which of the following hemoglobins
a. Hemoglobin F b. Hemogiobin C C. Bart's hemoglobin Hemoglobin H
of:ATTS
15. A nypochromic, microcytic anemia is suggestive
3. Metastatic carcinoma
Pasian B i e f r Mnunadlauns
4 Aptastic anemiathrrkuusrm 4. Chronic blood loss
2. Acute blood loss
a 4 2 and 3 b. 1 and 3 C. 2 and 4 Only 4 e. ALL are corect
minor have:
16. Most patients with beta thalassemia 3. Decreased hemoglobin F
1. Normocytic, normochromic anemia
2. Occasional target cells 4. Increased hemoglobin Az
C)2 and 4 d. Only 4 e. ALL are correct
à 4 2 and 3 b4and3
picture of megaloblastic anemia: . t N mer Pmugtouo
17.Peripheral blood 3. Oval macrocytes a l oncn
1. Hypersegmented neutrophil
4. Leukopenia
2. Thrombocytopenia d. Only 4 e. ALL are correct
. 1 and 3 c. 2 and 4
a. 1,2 and 3
18. Laboratory findings in hereditary spherocytosis include: prc"*PEienag ,humouic aneria

corrected 3.
by glucose Reticulocytosis
1. Increased autohemolysis test
Y4. Positive direct antiglobulin test
2. Decreased osmotic fragility
D, 1 and3 G-2and 4 d. Only 4 ALL are comect
a1,2 and 3
19. Reticulocytes: aptr hemoArhama,sp t fD nzua SipmT
3. Usually increased after hemorrhage
1. Immature red cells gtain
of RNA 4. Stained with Romanowsky stains
2 Contain remnants
1,2 and 3 b. 1 and3 C.2 and 4 cellulose d. Only 4 e. ALL are correct
at pH 8.6
diferentiated by using only acetate electrophoresis are:
20. The hemoglobins which can be
1. Dand s 2. O and C 3. C andE A andH
1, 2 and 3 b. 1 and3 C. 2 and 4 COpnly 4 e. ALL are correct
a.
conditions? 4e stai4 A, y t d viee
21. Heinz bodies are formed in which of the following3. Presence
er7
upr
ejost maLopieplest of unstable hemoglobin
1 . G6PD deficiency 4. Microangioathic hemolytic anemia
dentun 2. Hereditary spherocytosis C. 2 and 4 d. Onty 4 e. ALL are correct
tHob a. 1, 2 and 3 b 1 and3
f 2 2 . in which of the following condition is (are) the osmotic fragility test abnormal?
1. Immediately following acute hemorrhage 3. Aplastic anemia
2. Thalassemia OFT t4. Hereditary spherocytosis
a. 1,2 and 3
b and 3 C2 and 4 Only 4 e. ALL are correca

The greatest activity ofserum muramidase (lysozyme) occurs with:

23.
2. M1 b. M3 M5 d. M6
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comprising reticuloendothelial system (mononuclear phagocyte
the
system) are:
1. Reticulum cells
of the spleen 3. Sinusoid cells of the lymph nodes
2. Kupffer cells in sinusoids of the liver 4. Blood
a 1, 2 and 3
monocytes
b. 1 and 3 C. 2 and 4 d. Only 4
25. Tartrate-resistant acid phosphatase (TRAP) activity is diagnostic ALL are correct
1. Acute lymphoblastic leukemia of
3. Chronic lympho tic leukemia
2. Hodgkin's lymphoma 4 Hairy cell leukemia
a. 1,2 and 3 b. 1 and 3 C. 2 and 4
r 26. The nitroblue tetrazolium reduction test is used to assist in the diagnosis of: d Only4 e. ALL are correct

a Leukocyte adhesion disorders (LADs) C. May-Hegglin anomaly

Chronic granulomatous disease (CGD) d. Pelger-Huet anomaly
27.Which of the following cells exhibit igE receptors on their surface membranes?
a. Basophils (b2 Eosinophils C. Band neutrophils d. Monocytes
28. The neutrophil mitotic pool includes
1. Promyelocytes 2. Myeloblasts 3. Myelocytes
1, 2 and 3 b. 1 and 3 C. 2 and 44
4. Metamyelocytes
d. Only 4 ALL are correct
29. Cause(s) of lymphocytosis:
1, Geman measles 2. Whooping cough IM 4. HIV
a. 1,2 and 3 b. 1 and 3 c. 2 and 4 d. Only 4 eALL
infection
v
are correc
wmnho
30. If the hemoglobin is 13.0 g/dL, hematocrit is 0.40 LL, and the RBC is 4.35 x 1012, which is the correct value for
MCV?
a. 33 fL b. 29.9 fL C. 89 fL
31. What is the reticulocyte count (%) if 23 reticulocytes were seen
among 1000 RBCS?
ay92
a. 0.02 b. 0.23 C. 2.3 23
32. What is the total WBC count if blood is drawn to the 0.5 mark and diluted to the 11.0 mark, and 100 cells are
counted in 4 comer squares of the inmproved Neubauer
a. 2.5 x 10° b. 4.4 x 10°L
hemocytometer? d. 8.0x 10L hm dam m u
5.0 x10/L
33. What volume of 10 g/dL NaCl solution be required to prepáre-800 mL of 0.85 g/dl solution? V 6 V
a. 6.7 mL b. 10.6 mL
34. Which ofthe following manual tests is least reliable?
S 8 mL
94.1 mL g/aLA) 558
a. Erythrocyte count b. Leukocyte count C.Platelet count d. Hemoglobin
35. Calculatethe mean cell hemoglobin concentration (MCHc using the following values:
Hgb: 15 g/dL (150 g/L)
a. 9.5%
RBC: 4.50x 10°/uL (4.50 x 1012)
b. 10.4%
Hct 47 mLUdL (0.47)
c. 31 9%d.33.3% REVIEW HUB
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36. A 7.0mLEDTATubeisreceived in the laboratory containing
o n y ~.0mL of blood. f the laboratory is using manuai
techniques, which of the following tests will most likely be erroneous?
' a RBC count b. Hemoglobin C. Hematocrit d. WBC count
37Adecreased osmotic fragility test would be associated which of the following conditions?
aSickle cell anemia b. Hereditary spherocytosis c. HDN d. Acquired hemolytic anemia
38. Which ofthe following erythrocyte inclusions can be visualized with supravitalstainbutcannot be detected on a
Wright's-stained blood smear?
a. Basophilic stippling b. Heinz bodies c. Howell-Jolly bodies d. Siderotic granules
39. A Miller disk is an ocular
device used to facilitate counting of:
a. Platelets b Reticulocytes c. Sickle cells d. Nucleated RBCs
40. Which conditions which shift the oxyhemoglobin dissociation curve to the right?
(a)Acidosis C. Multiple blood transfusions
b. Alkalosis d. Increased quantities of hemoglobin S or C
41. In which stage of erythrocytic maturation does hemoglobin formation begin?
a. Reticulocyte b. Pronomoblast C. Basophilic nomoblast dPolychromatophilic nomoblast
42. What is theMastnucleated stage/in development of erythrocyte? -e miro a imd
a. Prorubricyte b. Rubricyte c Metarubricyte
43. Which is the major hemoglobin found in the RBCs of patients with sickle cell trait?
d. Reticulocyte

a. Hgb S b. Hgb F CHgb A d. Hgd A

44. Which antibody is associated with paroxysmal cold hemoglobinuria(PCH)?
annti-l b. Anti-i c. Anti-M d. Anti-P
45. All of the following are associated with hemolytic anemia except:
a. Methemoglobinemia b. Hemoglobinuria
46. Bite cells are usually seen in patients with:
c. Hemoglobinemia Increased haptoglobin
a. Rh null trait b. Chronic granulomatous disease G6PD deficiency d. PK deficiency
47. Which antibiotic(s) is (are) most often implicated in the development of aplastic anemia?
a. Sulfonamides b. Penicilin C. Tetracycline d Chloramphenicol
48. Which anemia has red cellmorphology similar to that seen in iron deficiency anemia?
a. Sickle cell anemia bThalassemia syndrome c. Pernicious anemia d. Hereditary spherocytosis
49. The familial condition of Pelger-Huet anomaly is important to recognize because this disorder must be
differentiated from:
a. Infectious mononucleosis c Shift to the left increase in immature granulocytes
b. May-Hegglin anomaly d. G6PD deficiency
50. Auer rods may be seen in all of the following except: >tun ia m Aut praptlaugtie
a Acute myelomonocytic leukemia (M4) c. Acute myeloid leukemia without maturation (M1)
Acute lymphoblastic leukemia d. Acute promyelocytic leukemia (M3)
51. in myeloid cells, the stain that selectively identifies phospholipids in the membranes of both primary and
secondary granules is:
a. PAS Myeloperoxidase c Sudan black B stain d. Tdt
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Sodium fluoride maybe added to naphthyl ASD (NAsDA) esterase reaction. The fluoride is added to inhibit a
positive reaction with:
a. Megakaryocytes 6Monocytes
53. What ís the characteristic finding seen in the
c. Erythrocytes
Granulocytes
peripheral smear of a patient with multipte myeloma?
a. Microcytic hypochromic cells
b. Intracellular inclusion bodies
CRouleaux
d. Hypersegmented neutrophis
54. Of the following, the disease most closely assOciated with granulocyte hyposegmetation is:
May-Hegolin anomaly c. Chediak-Higashi syndrome
relgar-Huet anomely d. Gaucher's disease
55.Which otr the following is associated with Alder-Relly inclusions7
a. membrane defect of lysosomes
D. Dohle bodies and giant platelets
two-lobed neutrophils
d mucopolysaccharidosis
56. Which of the following is not considered a disoreder of plasma cells?
Monoclonal gammopathy of undetemined significance c. Sezary syndrome redls
b Multiple myeloma d. Waldenstrom's macroglobulinemia
57. The following are compounds fomed in the synthesis of heme:
coproporphyrinogen
2. porphobilinogen POR Prd 3 uroporphyrinogen
4. protoporphyrinogen
Which of the following responses lists these compounds in the order in which they are fomed?
a 4,3,1.2 b. 2.3,1,4
2,4,3,1
58. Asynchronous development of hematopoietic cells withiñ d 2,1,3,4
the bone marrow is the result of:
a. Inadequate levels of RNA
c. Defective stem cell1s
b. Decreased erythropoietin (dImpaired DNA synthesis
59. Megaloblastic anemia is characterized by all of the following, EXCEPT:
e Decreased WBC and retics
b. Hypersegmented neutrophils
Oval macrocytes
aIncreased platelets REVIE HUB
LEMAR
60. Many microspherocytes and schistocytes and budding off of spherocytes can be seen on peripheral blood smears
of patients with:
a. hereditary spherocytosis C. acquired autoimmune hemolytic anemia
disseminatedintravascular coagulation (DIC)
61:Which
d. extensive burns
of these hemoglobin derivatives cannot be reduced back to normal
hemoglobin?
a. Methemoglobin b. Oxyhemoglbin
C)Sulfhemoglobin d. Carboxyhemogiobin
62. Which of the following is associated with
Chediak-Higashi syndrome?
embrane defect of lysosomes C. two-lobed neutrophils
6Dohle bodies and giant platelets d. mucopolysaccharidosis
63. Which cells are involved
in immediate hypersensitivity reactions?
Eosinophils bBasophils C. Plasma cells d. Reactive lymphocytes
64. The first hemostatic response to injury of a blood vessel is:
a. Platelet adhesion b. Platelet
65. Bieeding
aggregation
disorders associated with vascular abnomality:
Vasoconstriction d. Extrinsic coagulation
1. Hemorrhagic telangiectasia 3. Scurvy
2.
Ehlers-Danlos syndrome 4. Senile purpura
a. 1,2 and 3 b. 1 and 3 c. 2 and 4 d. Only 4 e. ALL are corect
c66. Which of the following is characteristic of cellular
changes as
megakaryoblasts mature into megakaryocytes within
the bone marrow?
.progressive decrease in overall cell size c. nuclear division without cytoplasmic division
b. increasing basophilia of cytoplasm d. fusion of the nuclear lobes
67. The type of nuclear
a. Polyploid mitosis
reproduction seen in megakaryocytes is:
B.Endomitosis c. Meiosis d Binary fission
68. Platelet dense granules contain:
1. Calcium 2. Storage ADP 3. Serotonin 4. Platelet factor 4
a. 1and 3 b. 2 and 4 o. 1,2 and 3
69. The outermost zone of platelet is called:
1 , 2.3 and 4
aPeripheral zone b. Sol-gel zone C. Alpha zone d. Organelle zone
70. The enzyme inhibited by aspirin is:
a. Thromboxane synthetase c. Lactate dehydrogenase
D Cycooxygenase d. Phospholipase
71. Which of the following cells is the largest cell in the bone marrow:
Megakaryocyte b. Histiocyte
72. The number of platelets an average
c. Osteoblast d Mast cell
megakaryocyte generates is approximately:
a. 25 50 b. 50 200 C. 200 500
73. The life span of a platelet is about: 2.000 4,000
a. 2-3 hours b. 1-3 days c8 11 days d 60 80 days
74. Approximately. of the total number of platelets circulaté in the systemic
circulation?
a. One-fourth b. One-third c. One-half
75. The nomal range of platelets in the Two-thirds
a. 50 150 x 10°L
systemic
b. 100-200 x 10 /L
circulation is: w nubibilong sA brd tmuar
150 400 x 10L d. Greater than 500 x 10°/L
76. In disseminated intravascular
coagulation (DIC) and immune thrombocytopenic purpura (!TP)
There is decreased production of platelets c. There is a defect of platelet membrane
There is increased destruction of platelets d. There is defect of platelet release reaction
77. mmune thrombocytopenic purpura (ITP):
a. Fomeny known as disseminated intravascular
coagulation (DIC)
Absence of megakaryocytes in the bone marrow
Wi 3spread fomation of platelet thrombi
Due to platelet antibodies
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LEMAR REVIEW HUB 6 3 9 4 795 60560 Page
thrombgcythémia,the plateiets are:
Increase b. Decreased c. Nomal d. Nomal in number, abnomal morphology
19. Thrombocytosis may be associated with:
1. Post-splenectomy DIC 3.Polycythemia verg 4 Megaloblastic anemia
a. 1, 2 and 3 1 and 33 c2 and 4 d. Only 4
80.Which of the following is characteristic of Bernard-Soutlier syndrome?
a giant platelets C. abnomal aggregation with ADDP
b. normal bleeding time d. increesed platelet count
81. The automated platelet count on an EDTA specimen is 68 x 10/L. The platelet estimate on the blood smear appears
nomal, but it was noted that the platelets weresurroundingjthe neutrophils. The next step should be to:
a. Report the automated platelet count since it is more accurate than a platelet estimate
b.Warm the EDTA tube and repeat the automated piatelet count
C. Rerun the original specimen since the platelet count and blood smear estirnate do not match
aRecolled a specimen for a platelet count using a different anticoagulant
82. Blood is diluted 1:200, and a platelet count is perfomed, 180 platelets were counted in the center square milimeter
on one side of the hemacytometer and 186 on the other side. The total platelet count is: TD
a. 146 x 10°L b. 183 x 109/ 366 x 10°L 3 2 x 10°L
83. The recommended type of microscopy r the perfomance of manual platelet coumt is:
a. electron b. darkfield light d. phase contrast
84 Platelet aggregation studies revealed normal aggregatfon curves with gollagen, epinephrine, and ADP, but an
abnorma aggregation curve with ristocetin. Based on these findings, what is the differertial diagnosis?
a o n Willebrand disease and Bermard-Soulier syndrome
b. Glanzmann's thrombasthenia and von Willebrand disease
c. Storage pool disease and Glanzmann's thrombasthenia
d. Bemard-Soulier syndrome and storage pool disease
85. Which set of platelet responses would be most likely be associated with Glanzmann's thrombasthenia?
a Nomal platelet aggregation response to ADP and ristocetin; decreased response to collagen
bNonal platelet aggregation response to collagen; decreasedresponse to ADP and colagen
Normal platelet aggregation response to ristocetin; decreased response to collagen, ADP and epinephrine
dNormal platelet aggregation response to ADP; decreased response to collagen and ristocetin
86. In the lvy method of bleeding time, the blood pressure cyffisinflated to:
a. 20 mm. Hg b. 30 mm. Hg C40 mm. Hg d. 45 mm. Hg
87. To evaluate nomal platelet numbers in an appropriate area of a blood smear, approximately how many plateiets,
should be observed per ojimmersion field?
a. 1-4 b8-20 C. 4-10 d. 20 -50
88. If an average of 10 platelefs are seen per oil immersion field, what is the estimatedplateletcout?
a. 50 x 10 /L b. 100 x 10 /L (c)200x 109/L d. 300 x 10L
89. The preferred blood product for a bleeding patient with von Willebrand's disease is transfusion with:
a. Factor Il, ViI, IX, X concentrates C. Fresh Frozen Plasma and Platelets
b. Platelet Concentrates dCryoprecipitated AHF
90. Which coagulation factor is present in thebighest.concentration in plasma?
a. Factor II b. Factor XH C.Factor d. Factor Vll
91 Which of the following participates ONLYin the extrinsic.pathway?
C. Factor X d. Factor l
aFactor VIl b. Factor IX
92. Plasma thromboplastin or prothrombinase includes:
a Calcium ion only
b. Complex of calcium ions and activated factor XI
C. Complex of activated factor Vll and calcium ions
d: Complex of activated factors X and V, plateletfactor 3 and calcium ions
93. The activated partial thromboplastintime is NOoT affected by deficiency of: pP.
a. Factor VIl b. Factor X
94. Prothrombin time is NOT affected by a deficiency of: PT nat
C. Factor XI Factor VI
Factor VIll T b. FactorV c. Factor I d. Factor X
95. Classic haemophilia is a condition in which there may be a: a
a.Prolonged bleeding time Prolonged prothrombin time
b.Decrease in piatelets aProlonged activated partial thromboplastin time
96. Which of the following is vitamin Kdependent? ,v C. antithrombin lI
x.

a. Factor XII b. fibrinogen dFactor VIl

97. Last factor to be depressedn vitamin K deficiency:
a. Factorl (b.Factor Mll Factor X d. Factor IX
s VA, tN, X
98. Which of the following factors is not present in BaSO, adsorbed plasma? t ,
C. XII
VIl
99.Which
Factor
one of the
following factors typically
VIIof the followingb. factor
Factor VIl
shows an
c. Factor 1X
d. V
increase in liver disease?
Factor X
LEMAR.
REVIEW HUB
100. Which deficiencies is associated with either/ no bieeding pr only a minor bleeding
tendency, even after trauma orsurgery?
a. Factor X Factor XI c. Factor XII d. Factor V
101. Which of the following is the anticoagulant of choice for most coagulation studies?
a. Sodium oxalate DSodium citrate C. Heparin d. EDTA
102. Which ratio of anticoagulant to blood is correct for coagulation procedures?
a. 1:4 b. 1:5 1:9 d. 1:10
103. Which results would be expected for the PT and APTT in a patient with polycythemia?
b. Both shortened c. Nomal PT, prolonged APTT d. Both nomal
a. Both prolonged
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Classic hemophilia is condition in which there may be a: YIl
a. Prolonged BT b. Decreased platelets
In which of the following diseases would you most likely find an abnormal 1 Prolonged time:
APTT PT
c. Prolonged PT
05. prothrombin
a. Hemophilia A b. Hemophilia B WD
106. Increased APTT with a normal PT would indicate a deficiency of: A° 1, x DIc
ix orl
a. Factorl b. Factor VII CFactor IX d. Factor X
107. Nomal APTT with an ipcreased PT would indicate a deficiency of:
a. Factorl
P
.Factor VIll c. Factor I d. Factor X
108. Increased APTT and PT would indicate a deficiency of: (ea n m
aFactor V b. Factor XI a. Factor XI d. Factor VII
109 PTT measures all factors except for:
a. I and V b. Vill and IX
110. A patient on therapeutic warfarin will most
. V and VIl a VIl andXi eT
likely have
Vvt, 1
a(an):
a. Nomal PTANR, increased APTT, prolonged bleeding time, low platelet count
(Increased PT/INR, increased APTT, nomal bleeding time, nomal platelet count
c. Nomal PTANR, nomal APTT, nomal bleeding time, nomal platelet count
d. Increased PTANR, nomal APTT, prolonged bleeding time, low platelet count
111. Reversal of hep arin overdose can be achieved by administration of:
3, VitanminK b. Antithrombin
(Protamine sulfate d.Warfarin
112 Antidote foroverdose-of.coumadin:
Sodium warfadn b. Heparin c. Adsorbed plasma Vitamin K
Thefollowing resuts are obtained:
PT Normal
APTT
Absorbed plasma
Prolonged
Corrects APTT,v,V
TPP
V, VIN,x)i)
LEMAR
REVIEW HUB
he feetor deficiency is:
IX C.X d.
113 Which-of-the fottowing laboratory findings is associated with Factor Xlll deficiency?
aprolonged activated partialthromboplastin time C. prolonged thrombin time
clot solubility ina 5 molar urea solution D e d. prolonged prothrombin time
114. In factor deficiency, a prolonged PT or APTT is corrected by the addition of:
1 Aged plasma 2Agedserum Vl,13,x Fresh serum 4. Adsorbedplasma
, 2 and 3 b. 1 and 3 C. 2 and 4 d. 1,2,3 and 4
115. The following results were obtained on a patient: prolonged bleeding time, nomal platelet count, normal PT,
and prolonged APTT. Which of the following disorders is most consistent with these results?
a. Hemophilia A b. Hemophilia B ( WD/ vil d. Glanzmann's thrombasthenia
116. Refer to the following results:
PTprolonged APTT prolonged Platelet count decreased Bleeding time increased
a. Facor Vill deficiency
117.
b. vWD GDIC d. Factor IX deficiency
A 56-year-old woman was admitted to the hospital with a history of a moderate to severe bleeding tendency of a
several years' duration. Epistaxis and menorrhagia were reported.
Prolonged APTT was corrected with fresh
normalplasma, adsorbed plasma, and aged serum. Deficiency of which ofthe followingis mostlikely? ,
a. Factor XII
118.
ViL, M b. Factor villv I Cactor Xl d. Factor IX xu)
A patient has a history of mild hemorrhagic episodes. Laboratory results include a prolonged prothrombin time
and activated partial thromboplastin time. The abnomal prothrombin time was corrected by normal and adsorbed
asma, butnot aged serum Which of the following coagulationfactors is defigient?
a. prothrombin DFactor V
119.
c. Factor X
The abnormal APTT seen in pathological circulating anticoagulant is: Factor Vi
a. Corrected with aged serum c. Corrected with nomal plasma
b. Corrected with adsorbed plasma N o t corected with any of the above
120The activity of the lupus anticoagulant and anticardiolipin antibodies appearsto bedirected against:
a. FactorV b. Factor Vill c. Factor IX Phospholipid
121. A prolonged Stypvend(Russell viper venom) time is associated with deficiency of the following factors EXCEPT
a. Factori Gb. Factor II C. Factor X Factor Vill
122. Normal PT and APTT results in a patient with a poor wound healing may be associated with:
a. Factor VIl deficiency b. Factor VIll deficiency c. Factor Xil deficiency
123. The laboratory test formonitoring heparin therapy is:
)Factor XIll deficiency
PT bPTT C. Activated clotting time
124. All of the following tests are affected by heparin therapy except TT
a. Thrombin time b. Whole blood clotting time C. APTT dReptilase time
125. An abnormai thrombin time is associated with:
a. Factor X deficiency b. Excess plasminogen oFibrinogen deficiency d. Protein C deficiency
126. The observation of a nomal reptilase time and a prolongedthrombin time is indicative of
a. Presence of fibrin degradation products
Dysfibrinogenemia
b. Hypoplasminogenemia Presence of heparin
127. Which of the following coagulation test results is nomal in patient with classic vWD?
a. Bleeding time APTT CPlatelet count d. Factor ViI:C and vWF
128. Which of the following is the primary inhibitor of theibrinolytic system?
a. Protein C b. Protein S Alpha2 antiplasmin d. Alpha:macroglobulin
129. The D-dimer test is a specific test for:
a. Plasminogen activation Plasmin degradation of fibrin
G.
Plasmin degradation offibrnogen d. Factor XI!
130 Acute disseminated intravascular coagulation is characterized by:
ahypofibrinogenemia b. thrombocytosis C. negative D-dimer d. shortened thrombin time
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A positive protamine sulfate is suggestive of:
WD 6Primary fibrinolysis c. DIC d Glanzmann's thrombasthenia
The test reagent in APTT contains which of the foilowing substance(s)?
32. 1. citrated plasma 2. calcium ions 3. tissue thromboplastin 4. phospholipids
a. 1, 2 and 3 are comect C. 2 and 4 are correct eAll are corea
b. 1 and 3 are comect d. Only 4 is correcd
133. The test reagent in PT conteins which of the following substance(s)?
1. calciunm ions 2. kaolin 3. tissue thromboplastin 4. celite
a. 1, 2 and 3 are comrect C. 2 and 4 are correct e All are correct
b. 1 and 3 are comect d. Only 4 is correct
134. Abnomal Stypven timne:
Lfactor X deficiency 2. factor l deficiency3. factor I deficiency 4. factor VII deficiency
(a. ). 2 and 3 are comet C. 2 and 4 are correct e. All are corred
B.1 and 3 are comect d. Only 4 is correct
135. Abnomal thrombin time:
. fibrinogen deficiency 2. presence of FDP 3. presence of streptokinase 4 heparin therapy
a. 1, 2 and 3 are comect C. 2 and 4 are correct All are correa
b. 1 and 3 are comect d. Only 4 is correct
136 Abnomal reptilase time:
1. fibrinogen deficiency 2. presence of FDP 3. presence of streptokinase 4. heparin therapy
a1, 2 and 3 are correct C. 2 and 4 are correct e. All are correct
1 and 3 are comect d. Only 4 is correct
TT is found in:
137 An abnormal PT, APTT2.and
1. DIC dysfibrinogenemia 3, heparin overdose 4. deficiency of factor
a. 1, 2 and 3 are corect . 2 and 4 are correct e.)All are comect
b. 1 and 3 are comeect d. Only 4 is corect
138. An abnomal PT, abnomal APTT and normal TT is found in:
1. deficiency of factor I 2. adm of Coumadin 3. deficiency of factor VM 4. afibrinogenemia
e All are correct
Ca1, 2 and 3 are correct C. 2 and4 are correct
b. 1 and 3 are come d. Only 4 is corret
139. An abnomal PI,nomal APTT and nomal Tisfound in:
early oral anticoagulant therapy (3. deficiency of factor VIl LEMAR
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2. deficiency of factor X 4administrationof heparin
a. 1,2 and-3-are correct 2 and 4arecorect
d. Only 4 is correct
e. All are corect
b. 1 and 3 are corect
140 The fibrinogen group of coagulation factors is:
1. present in seru 3. adsorbed by barium sulfate
2. not vitamin K dependent 4. calciunm dependent
a. 1, 2 and 3 are cored C. 2 and 4 are corect e. All are correct
b. 1 and 3 are corect d. Only 4 is correct
141. The contact group of coagulation factors is:
1. not consumed during coagulation 3. not reduced by oral anticoagulants
2. not vitamin K dependent 4. absorbed by barium sulfate & aluminum hydroxide
a42and3are corTect G2and4 are corect e AHare coFrect
b. 1 and 3 are correct a)Only 4 is correct
142. The prothrombin group of coagulation factors ís: PPS
1notpresent in serum 3. not synthesized in the liver
2. not adsorbed by barium sulfate vitamin K dependent
a-4-2 and3 are correct C. 2 and 4 are correct e-Alt are correct
b.1 and 3 are corect d. Only 4 is correct
143. Coagulation factor(s) affected by coumarin drugs: tVI, IY,X
1. W 2. VII 3. IX .X
a. 1,2 and 3 are corret C. 2 and 4 are correct All are corect
b. 1 and 3 are corect d. Only 4 is correct
144. Factors common to the intrinsic and extrinsic systems of coagulation include:
2. VII 3. 4.
a.1,2 and 3 are corred c. 2 and 4 are correct e. All are corect
D1 and 3 are comect d. Only 4 is correct
'.145. Which coagulation factorls) is (are) removed by barium sulfate or aluminium hydroxide?
1. factor 2. factor Vil 3. factor IX 4. factor
a. 1,2 and 3 are cored C. 2 and 4 are comect e. All are correct
b. 1 and 3 are comect d. Only 4 is correct
146. Which coagulation factor(s) is (are) present in serum: ,
1. factor VIl, 2. factor X 3. factorX 4. factor
1 , 2 and 3 are correct C. 2 and 4 are correct e. All are correct
D. 1 ard 3 are corect d. Only4 is correct
147. Vitamin K dependent factors:
1. factorl 2. factor 2 factor V 4. factor X
a. 1, 2 and 3 are correct 2 and 4 are correct e. All are corect
b. 1 and 3 are comect d. Only 4 is correct
148. In a factor XI deficiency, a APTT is corrected by the addition of:
1. aged plasma 2. aged serum 3. fresh serum 4. adsorbed plasmna
a. 1, 2 and 3 are correct C. 2 and 4 are correct All are correct
nr dOnlhr A i c corront
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contact group of factors: +639 4 7 95 6 0 660 Page 17
factor XI 2. factor XI 3. HMWK
1, 2 and 3 are correct 4. factor VIlI
c. 2 and 4 are correct e. All are correct
1 and 3 are corect d. Only 4 is correct
150 Abnomal PT:
1 factor Vll deficiency 2. factor Vil def.
1. 2 and 3 are correct
DIC 4. vWD
C. 2 and4 are
correct e. All are correct
(D 1 and 3 are corect d. Only 4 is corect
151. In which of the following lists the steps of hemostatic response in the correct order?
Fibrinolysis injury secondary hemostasis primary hemostasis
Injyry Pprimary hemostasis secondary hemostasis fibrnolysis
Injury secondary hemostasis primary hemostasis fibrinolysis
d. Injuryfibrinolysis pimary hemostasis secondary hemostasis
152. Which of the following tests is helpful in differentiating fibrinogenolysis from DIC?
PT b. APTT c. Fibrinogen EDD-dimer
153. Which antibiotic is mogt oten implicated In the development of aplastic anemia?
a. Sulfonamides 6 Chloramphenicol C. Teracycline d. Penicillin
164. In myelofibrosis, the characteristic abnomal red cell morphology is:
a Target cells b. Schistocytes CTeardrop cells d. Ovalocytes
155. A'boratory test that s always useful in the differential diagnosis of relative and absolute erythrocytosis is:
a. Hemoglobin electrophoresis c. Plasma erythropoietin quantification
b. Hemoglobin quantitation d. Red cel mass quantification
156. PV is characterized by:
a. Increased plasma volume . Decreased oxygen saturation
b.Pancytopenia gAbsolute increase in total red cell mass
157. In addition to an increase in red blood cells, which of the following is characteristic of polycythemia vera?
a. Decreased platelets, decreased granulocytes, decreased erythropoietin level
Decreased platelets, decreased granulocytes, increased erythropoietin level
Increased platelets, increased granulocytes, increased erythropoietin level
Increased platelets, increased granulocytes, decreased erythropoietin level
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158. Relative polycythemia is characterized by:
1. Increase total red cell mass 3Nomaplasma-vekume
2 Normal total red cell-mass 4. Decreased plasma volume
12 and 3 b. 1 and 3 2 and 4 Only 4
159. Which of the following types of polycythemia is most often associated with emphysema?
a. Polycythemia vera c. Relative polycythemia associated with dehydration
b. Polycythemia, secondary to hypoxia d. Polycythemia associated with renal disease
160. A patient has a tumor that concentrates erythropoietin. He is most likely to have which of the following types of
polycythemia?
a. Polycythemia vera c. Benign familial polycythemia
b. Polycythemia, secondary to hypoxia d. Polycythemia associated with renal disease
161. In the French-American-Bristish (FAB) classification, myelomonocytic leukemia would be:
M1 and M12 b. M3 . M4 MS
162. A cytogenic abnomality is found in almost 50% of the patients with which ofthe following classifications of
acute nonlymphocytic leukemia?
M2 b. M3 C. M5 d. M6
163. DIc is most often associated with which of the following FAB designation of acute leukemia?
M1 M3 M4 d. M5
164. FAB type M6 is characterized by increased:
Promyelocytes and lysozyme activity Marrow erythroblasts and multinucleated red cells
D. Marrow megakaryocytes and thrombocytosis d. Marrow monoblasts and immature monocytes
165. Which of the followingstains is helpful in the diagnosis of suspected erythroleukemia?
a. peroxidase Dperiodic acid-Schiff C. nonspecific esterase d. acid phosphatase
166. Which type of anemiais usually present in a patient with acute leukemia?
a. Microcytic, hyperchromic C. Nomocytic, nomochromic
b. Microcytic, hypochromic d. Macrocytic, nomochromic
167. In the French-American-British (FAB) classification, acute lymphocytic leukemia is divided into groups
according to:
a. prognosis b. immunology c. cytochemistry d morphology
168 The FAB classification of ALL seen most commonly in children is:

al1A 50-year-old woman who has been receivingC.busulfan

b L2 L3 d. Burkit's type
169 for 3 years for chronic myelogenous leukemia becomes
anemic. Laboratory tests reveal:
Thrombocytopenia Perv
Many peroxldase-negative blast cells in the peripheral blood Au
Bone marrow hypercellular in blast transformatlon
Aw
Markedly increased bone marrow TdT
Which of the following complications is this patient mostlikely to have?
(acute lymphocytic leukemia C. acute myelomonocytic leukemia
b. acute myelocytic leukemia d. busulfan toxicity
170. Which substrate is used for the detection of specific esterase?
c. Pararosanilin acetate d Phenylene diacetate
a. Acetate b Chloroacetate
 LEMAR REVIEW HUB Page
639479560660
cytochemical stains were performed on bone marow smears from an acute leukemia patient. All blasts were
oeriodic acid-Schiff (PAS) negative. The majority of the blasts showed varying amounts of Sudan Black B positivity.
Some of the biastS stained positive for naphthol A8-D acetate esterase, some were positive for naphthol A S
chloroacetate esterase, and some blasts stained positive for both esterases. What type of leukemia is indicated?
a. Lymphocytic b. Myelogenous
CMyelomonocytic
The cell series most readily identified by a positive Sudan Black B is:
d. Erythroleukemia
172.
a. Erythrocytic .Myelocytic c. Plasmacytic d. Lymphocytic
173. A peripheral smear shows 75% blasts. These stalin positive for 8BB and peroxidase. Given these values, which
of the following disorders is most likely?
a. AML CML c. Undiff.leukemia d. ALL
174. Which FAB designation is called the true monocytic leukemia and follows an acute or subacute ourse
characterized by monoblasts, promonocytes and monocytes?
a. FAB M1 b. FAB M3 c. FAB M4 FAB MS
In the French-American-British (FAB) classifiçation, myelomonocytic leukemia would be:
175.
a. M1 and M2 . M3 CM4 . M5
176. A peripheral blood smear demonstrating an absolute increase in small "hypermature" lymphocytes and
"smudge" cells would be suggestive of:
a) Chronic lymphocytic leukemia c. Leukomoid reaction
b. Acute lymphocytic leukemia d. Infectious mononucleosis
177. A patient with nomal hemoglobin and WBC count values, a persistenty elevated platelet cout (over 1,00x
10L, increased marrow megakaryocytes, and a history of frequent bleeding and ciotting episodes most ikely has:
a. Polycythemia vera QEssential thrombocythemia
d. Chronic myelogenous leukemia
b. Chronic myelofibrosis
this infomation, what
178.myeloproliferative
Chromosome analysis revealed the presence of the Philadelphia chromosome. Based
disorder is present?
on

b. PV C.ET d. MMM
(aCML
179 The absence of the Philadelphia chromosome in granulocytic leukemia suggests:
C. Excellent response to therapy
Rapid progression of the disease
6. Polyclonal onigin to the disease d. Conversion to another myeloproloferative disorder
180 The Philadelphia chromosome is formed by a translocation between the:
Long am of chromosome 22 and long am of chromosome 9
Long am of chromosome 21 and long am of chromosome 9
Long am of chromosome 21 and short am of chromosome 9 LEMAR C
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Long am of chromosome 22 and short am of chromosome 6
181. which of the following tests can be useful in differentiating leukemoid reactions from chronic granuocytic
leukemias?
a. peroxidase stain b. surface membrane markers c. Sudan black B stain LAP
182. The following results were obtained on a leukocyte alkaline phosphatase stain:
Score
No. of cells counted
These reactions are most consistent with:
a, leukemoid reaction chronic granulocytic leukemia
B. nephrotic syndrome d. progressive muscular dystrophy
183. The esterase cytochemical stains are useful to differentiate:
Granulocytic from monocytic leukemias
b. Lymphocytic leukemias from myelocytic leukemias
c. Monocytic leukemias from megakaryocytic leukemias
d. Lymphocytic leukemias from monocytic leukemias
184. The FAB classification ofaleukemia with large blasts that are myeloperoxidase and specific esterase negative
but have strong Positivity for nonspecific esterase inhibited by sodium fluoride is:
a. M1 . M4 CM5 . M7
185 Which of the following cells are most likely identified in lesions of mycosis fungoides?
T lymphocytes b. B lymphocytes C. monocytes d mast celts
186 The atypical lymphocyte seen in the peripheral smear of patients with intectious mononucleosis is reacting to
which of the following?
T lymphocytes DB lymphocytes
c. monocytes d. mast cells
187. Which ofthe following cells are the atypicallymphocytes seen on the peripheral blood smear of patients with
iafectious mononucleosis?
a lymphocytes b. B lymphocytes C. monocytes d. mast cells
188.In addition to the number of blasts, what other criterion is essential for the diagnosis of RARS
More than 15% ringed sideroblast c. More than 5% ringed sideroblast
b. Dyshematopoiesis in all three cell lineages d. Pancytopenia
189 What is the key diagnostic test for Hodgkin lymphoma?
A Bone marrow biopsy 6 Lymph node biospy c. Spinal tap d. Skin biopsy
199When Reed-Sternbergélls are found in a lymph node biopsy, they are indicative of:
Hodgkin disease c. Sezary syndrom
b. Intemediate-grade non-Hodgkin lymphoma d. High-grade non-Hodgkin lymphoma
191. The LAP activity will usually berincreased in:
1. Chronic granulocytic leukemia Paroxysmal nocturnal hemoglobinurra
2. Third trimester of pregnancy 4. Polycythemia vera
a. 1,2 and 3 are correct c)2 and 4 are correct e. All are correct
b. 1 and 3 are corect d. Only 4 is correct
 I,EMAR RVIEW MU
In differentiating a
is/are) helpful:
neutrophilic leukemoid reaction from
chronic myelogenous leukemia, whieh d the foAnPWWJ
1. LAP Score
2. Bone marrow cellularity 3. Chromosome studies
1,2 and 3 are corect 4.8uden black stain
b. 1 and 3 are comect C. 2 and 4 are correcd All are (rE
193. All of the d. Only 4 is corred
following are considered signs of
a. Mulinucdeate RBCs
194. FAB classification of b. Basophillc stippling dyserythropoiesis,
. Dohle bodies
excapt:
1. Refractory anemia myelodysplastic syndrome (MD8) include d,val macsMAe
2.
Refractory anemia with ringed sideroblasts 3. Refractory anemia with excese blsste
a. 1, 2 and 3 are correct 4. Chronic myelomonocytic leukemia
b. 1 and3 C 2 and 4 are correct All are rred
195.
are corect d. Only 4 is corred
The following results were obtained on a 36-year-old woman complaining of fatigue and
weigM kvss
WBC 1.8 x 10n
RBC 4.6 x 102L Differentials: Segmenters 30% Matamyakonytes
Plt
Bands: 17% Myelocyts 2Ph
903 x 10n Lymphooytes 13% Promyekftas
Uric acid: 380 4moll 3%
LAP: 0
Monocyte8 Blests 1%
Eosinophlls: 4%
Philadelphia chromosome: positive Basophils: 6%
These results are consistent with:
a. Neutrophilic leukemoid reaction c. Chronic myelogenous leukemia
ldiopathic thrombocythemia d. Leukoerythroblastosis in myelofibrosis
196. A 3-year-old girl was taken to the pediatrician after several days of fever and vomiting. She had petechiae on
her face and trunk and she was very pale. What isthe mostlikely diagnosis?
RESULT REFERENCE RANGE UNTS
WBC 13.8 7.8 :3 X 10L
RBC 3,64 M 5.4007
F4808
HGB 11.2 M 16t2
F 14 t2
HCT 33.8 M 4725
F 42 5
MCV 92.7 M 87 7
F 90 9
MCH 30.8 29 2
MCHC 33.1 34 2
RDW 15.3 11.5 145
PLT 365 140-440 X 10 L
SEGS 40-75
BANDS -6
LYMPHS 40
MONOSS
ECS_
BASOS
BLAST 90
RBCMORPHOLOGY Normal
STAINS Peroxidase negative, TdT positive, PAS strongty
positive
a. CML b. AML ALL Aplastic anema
197 In an automated instrument, which parameterNs calculated rather than directly measured:
a) Hematocrit mw b. RBC count c. WBC count d. Hemoglobin
198 The Coulter principle for counting of cells is based upon the fact that:
Isotonic solutions conduct electricity better than cells do
b.Conductivity vanes proportionally to the number of cells
C. Cells conduct electricity better than saline does
d. Isotonic solutions cannot conduct electricity
199. Side angle scater in a laser-based cell counting system is used to measure:
a. Cell size cytoplasmic granularity c. Cell number d. Imnunologc (antigenic) identification
200. Falsely elevated automated platelet counts may result from:
a. Platelet satellitism CExceptionally large platelets
b. Platelets agglutinins
d Erythrocyte
incdusion bodies
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